Covid-19 Testing (Care Homes)

– in the Scottish Parliament at on 3 June 2020.

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Photo of Jackson Carlaw Jackson Carlaw Conservative

1. Last week, I asked how many elderly people in hospital were sent to care homes before mandatory testing for Covid was introduced. Yesterday, we finally got an answer: that happened to more than 1,350 people. As we know, tragically, just over 1,800 care home residents have since died, having caught the disease.

What is the Government doing to prevent a repeat of that tragedy? How many of Scotland’s 50,000 care home workers have been regularly tested for Covid, as the Cabinet Secretary for Health and Sport promised two weeks ago?

Photo of Nicola Sturgeon Nicola Sturgeon Scottish National Party

The programme of regular and routine testing of care home staff is under way. When we have robust and reliable figures to report from that, we will report those regularly. That is the approach that we have taken to all the data that we have published. It is important to note that the testing of care home staff requires to be done not on a one-off basis but on a regular basis.

We will also consider what further groups of the population we will want to test on a routine basis, and that consideration will, of course, include national health service staff. In addition, we will do surveillance testing; some population antibody surveillance testing is already being done. The main strand of our testing is still the demand-led testing of people with symptoms. We all have a duty to encourage everybody with symptoms to come forward for that testing, although we will want that strand of testing to decline, because that will mean that prevalence of the virus is declining.

To respond to Jackson Carlaw’s detailed question, we will publish up-to-date data as soon as we are able to do that in a robust and reliable manner.

Photo of Jackson Carlaw Jackson Carlaw Conservative

The First Minister says that widespread testing of care home staff is now under way, but I am afraid that that is difficult to believe. There are 50,000 care home workers in Scotland. If they were being routinely tested every week, a minimum of 7,000 tests a day would be being carried out, yet yesterday, in total, fewer than 5,000 tests were done for the whole of Scotland, and fewer than 3,000 were done the day before that. It does not add up.

Why are care homes being failed again? Surely, by now, mobile testing teams or general practitioners should have visited every care home in Scotland. Is the First Minister’s Government not letting care homes down all over again?

The First Minister:

No is my immediate answer to that.

I should say as a preface to this comment that I do not consider any death in a care home or anywhere else, or any level of deaths, to be acceptable. Each and every death is a matter of deep regret. However, the number of care home deaths—while it is, of course, still too high—is now declining quite rapidly. In addition, from the peak through to the middle of May, the number of deaths in care homes has been declining slightly faster than the number of deaths in hospitals. That suggests that the package of measures that we are taking in care homes to protect care home residents is having an effect.

Testing is important. That is why we have extended the numbers and the groups of people that we are testing. The programme of care home worker testing is under way and will continue; it will then be routine and regular. If it is helpful to the chamber, the health secretary will set out more details of that programme and, as I said, we will set out the data from that when it is available.

It is understandable that we look at the overall number of tests, but it is important to remind people that the dynamics underneath that headline number are also important. We have different strands of testing. We expect routine testing and surveillance testing to increase with time, but we will want the level of on-demand testing for people with symptoms to reduce; indeed, it might already be reducing because the prevalence of the virus in the community is reducing. We will continue to try to publish data that gets to the granularity of that, as well as headline figures.

We will continue to take forward those various programmes of work to make sure that, as we suppress the virus and come slowly and carefully out of lockdown, testing is doing the job in the variety of ways that we require it to do it.

Photo of Jackson Carlaw Jackson Carlaw Conservative

The First Minister has said repeatedly at her daily briefings that we need to do all that we can to avoid a second spike. That requires delivery on testing. The First Minister says that it is improving. Let me, then, share some figures.

We spoke yesterday to a leading care home provider, Renaissance Care. It has 1,150 staff—women and men who have performed heroic and selfless tasks these past three months—but only 649 of them have been tested, which is just 56 per cent. Even then, they have not been tested on a repeated basis as the health secretary promised on 18 May. What is deeply worrying is that the provider says that 7 per cent of those care home staff who were tested had no symptoms of the disease but their results came back positive for Covid. That is the disappointing reality on the ground.

Is it not the case that yet more mistakes are unfolding right now in our care homes and that those mistakes may yet lead to more deaths? It will not be possible to blame those failings on hindsight, will it?

The First Minister:

I do not blame anything on anything. I take responsibility for the Government’s handling of and response to the coronavirus. I do that daily, and I do it—rightly and properly—in the chamber.

I have never sought, and I will never seek, to blame anybody. What I try to do, to ensure that the public has the understanding that it needs in order to know why it needs to comply with the measures, is explain the developing knowledge that we have of the virus as we go. It would be a bit strange—and, actually, negligent—of me not to do that and not to explain how our approach develops and adapts as our knowledge develops and adapts.

The programme of care home worker testing is on-going. As I said, we will publish the figures and then people will be able to track them. The testing will require to be regular and routine, which I think was—I do not know whether it still is, but I will be corrected if I am wrong—different in Scotland from how it was anticipated to be elsewhere in the UK.

Everything that we do right now is about making sure that we are suppressing the virus and avoiding, as far as possible, the risk of a resurgence. That is why this Government is taking the very careful, considered, slow, steady and cautious approach that we are taking and making sure that we do not come out of lockdown before we have the certainty and assurance that our programmes for testing—whether the routine testing or testing through test and protect—are able to keep the virus suppressed. That is in addition, of course, to all the actions that we all have to take.

We will continue to take those actions, which are based on the best possible evidence, and I will continue to stand up here, in the chamber, and elsewhere on a daily basis and answer questions and explain this Government’s response. That is my duty and responsibility, and it is one that I never have shied away from and never will.

Photo of Jackson Carlaw Jackson Carlaw Conservative

I say to the First Minister that the World Health Organization could not have been clearer at the start of the crisis. It told her that the priority was to test, test, test. Yet for care homes, with this SNP Government, it has been a case of dither, delay and distract.

The tragedy is this: Scotland has the capacity to test. Indeed, if this Government had used that capacity effectively since the end of April, it could have tested all the residents and staff of care homes twice. Instead, capacity is being squandered and care home workers and residents, who have already endured the horror of the crisis, are being let down all over again. Why, two weeks on from a promise to test all care home staff, is this Government still not getting it right?

The First Minister:

I am sorry, but the WHO, on care homes, did not say what Jackson Carlaw has just alleged and asserted. In fact—given that he has based his questions on it today, I am sure that he has read the WHO guidance that I am about to refer to—it issued technical guidance on infection prevention and control in long-term care facilities on 21 March, and all the guidance that the Scottish Government has issued from 13 March, which we updated on 26 March and again, I think, in May, has been consistent with the technical guidance that the WHO has set out. We will continue to adapt our approaches as any evidence and advice from such authorities changes in the future.

We will continue to take the careful and considered steps that we are taking. We will not shy away from the challenges that we face in the unprecedented situation that we are dealing with. The Scottish Government will continue to take that careful, cautious approach, making sure that we—as we have done—build up our testing capacity but also, crucially, use testing in a way that is clinically driven. That is a responsibility that I take seriously, and I will continue to do so.