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'We mess with this virus at our peril': Sturgeon urges caution as Covid-19 deaths fall

In Scotland the days when Nicola Sturgeon had to report scores of Covid-19 deaths at the height of the pandemic are a distant memory. Over the past weekend there was a four-day period without a single death recorded in the country’s hospitals.

Buoyed by those figures, and a continuing, steady, decline in coronavirus infections, the first minister hopes Scotland could soon eliminate the virus so is resisting heavy pressure from businesses to quickly ease the strict lockdown.

Airports, wedding companies, hoteliers and bar owners have been clamouring for distancing rules to be relaxed, for air quarantine rules to be waived to the same extent as at English airports, and for the hospitality trade to resume.

At her daily coronavirus press briefing in Edinburgh on Tuesday, Sturgeon likened the process of steering Scotland through the coronavirus pandemic to an airline’s intense focus on safety checks.

“The airline industry, to its great credit, is rigorous when it comes to safety,” she said. “We mustn’t forget [that] the decision-making process that we’re going through right now [on the lockdown] is seeking to be a careful and considered one.”

Covid-19 deaths: seven-day rolling average per million population

For four days over last weekend, there were no confirmed Covid-19 deaths recorded in Scottish hospitals. On Tuesday, Sturgeon reported a single hospital death.

In late June there were five days in succession without a confirmed Covid-19 death in hospital. Meanwhile hospital admissions have continued their steady downward trajectory. There were just seven intensive care unit cases overnight; at the peak of the pandemic, 221 people were in Scottish ICU wards with Covid-19.

“We must continue to be careful,” Sturgeon said. “We simply can’t do everything at the same time, or this virus will spiral out of control in the blink of an eye. We see that in many states in America right now, a spiralling out of control. We mess with this virus at our peril.”

The broader downward trajectories are mirrored in England and Wales, where the rate of recovery has been at times faster, but in Scotland and Northern Ireland the declines have been sharper and consistent.

In Northern Ireland there are currently no Covid-19 patients in intensive care, and only 14 Covid-19 inpatients, and there have been numerous days with no Covid-19 deaths at all in hospital, with none in hospital since Friday.

Per head of population Northern Ireland has fared better. It has had 432 deaths per million; in Scotland the figure is 758 per million; in England it is 841 and in Wales 768.

While the UK government strategy for England appears to be based on containing the virus, Sturgeon’s is essentially to eliminate it, reducing its prevalence to the lowest possible level.

The daily hospital figures do not include Covid-19 deaths in the community, which are continuing.

Hospital admissions for Covid-19

In the last full week of June, the period covering four of the five consecutive days of no deaths in hospital, 35 deaths were registered in all settings by National Records of Scotland, the statistics agency. Those figures underline the case for caution.

Prof Linda Bauld, the Bruce and John Usher chair of public health at the University of Edinburgh, said she believed part of Scotland’s success rested on the clarity of Sturgeon’s leadership, but that the success was also driven by geography, demographics and timing – components which had helped suppress the prevalence of the virus.

As a communicator, Sturgeon had been “phenomenal”, said Bauld. “She is trusted. And if the communicator is trusted and is seen to also communicate uncertainty where there is uncertainty, she does that extremely well. That increases public confidence that there’s a reason why they’re being asked to do x, y and z.”

But there have been stumbles and mistakes, Sturgeon’s political opponents and trade unions argue. Those include failing to test care-home staff for weeks into the outbreak and elderly patients being discharged hurriedly from hospitals into care homes. At the pandemic’s peak, care-home deaths outstripped those in hospitals.

Sturgeon was at the centre of allegations of a cover-up of Scotland’s first outbreak, involving delegates to a conference in an Edinburgh hotel organised by Nike, the sportswear brand, and criticised for a slow start with track and trace testing.

Bauld said Scotland’s lower rate of infection was down substantially to the fact that the infection curve was a week or two later than in England when the UK-wide lockdown was imposed on 23 March. “We were at an early stage, that’s probably a fundamentally important reason,” she said. That meant the pandemic was contained sooner.

Scotland’s more dispersed and more rural population – with far fewer conurbations of the large mass and density existing in England – had also given the virus less chance to spread. The Scottish government protected the islands by banning non-essential ferry travel. Shetland has had no new cases since 21 April. The Western Isles has not had a single fatality. Evidence from many countries was “crystal clear – cities are breeding grounds for the virus”.

Bauld said Scotland’s test and protect programmes had been less chaotic than in England, while Sturgeon’s more gradual easing of the lockdown had had a role to play. Scots were not necessarily more obedient than the English, she said, but unlike Boris Johnson, Sturgeon was “really on top of her brief”.

By contrast, England was easing the lockdown while the virus was still at large. Bauld said the UK government was “propelling ahead” when there were still a lot of cases. “That’s probably not great news. It means England’s decline is going to continue to be slow.”