IF WE COMPARE the Omicron wave with previous waves, examine hospitalisation with Covid data and explore infection spread it is increasingly clear the Scottish Government (ScotGov) jumped the gun when rushing to impose new restrictions, tantamount to a New Year lockdown for hospitality.
A critical ingredient for any successful pandemic policy is public confidence. Voters need to be able to trust that their leaders are fully equipped with the necessary facts and understand how to interpret data. And that public trust is a fragile creature with an amorphous nature – if taken for granted it can turn on the great and the good swiftly.
So, when First Minister Nicola Sturgeon announced a fresh wave of restrictions on the 14th of December, she was asking for public confidence in her judgement. Explaining that Scotland was facing off against a likely “tsunami” of new infection due to the Omicron variant. She told us that this would mean a “very significant” impact on Scotland’s national health service.
She drew attention to the fact that the Omicron variant was more infectious than the previous Delta strain, arguing that this would inevitably mean a critical uptick in hospitalisations; serious enough to place the NHS in crisis:
“That means if just one person in a gathering is infectious, that person is likely to infect many more people in the group than was the case with the Delta variant”, explained Nicola Sturgeon.
And her solution was a fresh round of curbs. New Years Eve was cancelled for Scotland’s capital. From December 26th there would be a 100-person limit for indoor standing events and a 200 limit for indoor seated. A 500 limitation was imposed for any outdoor events and social distancing of one metre would be non-negotiable. Many businesses in hospitality swiftly reported mass cancellations in advance, leading to restaurants, bars and clubs closing rather than being open as hopes of profits evaporated.
“This will of course make sports matches, including football, effectively spectator-free over this three-week period,” Ms Sturgeon told the Scottish parliament, once-more centre-stage.
But interestingly, the UK Government (UKGov)– listening to its own experts – opted for a quite different approach. UKGov declined to impose similar restrictions that would have rendered the vital New Year period null for the hospitality industry. We are now able to judge if ScotGov or UKGov were correct in their judgements.
Who got it wrong? What does the science say?
1 Comparing Covid waves: hospitalisation and mortality
For starters, Nicola Sturgeon announced her lockdown restrictions before a series of studies were published all indicating Omicron was between 40-70 per cent less likely to hospitalise as compared to Delta. But nonetheless, let us begin by being fair. Even with the scientific evidence that Omicron is less likely to hospitalise; if enough people catch the new variant there would still be a hospitalisation uptick. Theoretically speaking it is reasonable to say 3 per cent of 100,000 is inevitably larger than 5 per cent of 50. So perhaps despite the new variant being less likely to hospitalise, this would not necessarily mean no unsustainable NHS pressures.
But if we look at figure 1 (below), we can see that although there is a significant uptick in hospitalisations, the rates are much lower compared to previous Covid waves.
Figure 1: number of people in hospital with COVID-19 in the UK 01/12/20 – 01/12/21
As UKGov expert Sir Chris Whitty explained, “As several people have commented and one of the good things we’ve learned is that, data, both from South Africa but all around the world now including the UK, is there are lower rates of hospitalisation. But lower rates does not mean no hospitalisations, there are significant numbers”
We knew from before Ms Sturgeon announced her lockdowns from the South African experience that Omicron was less likely to hospitalise than previous strains. And only days after ScotGov announced their lockdown plans, new studies confirmed the South African experience projecting a 40-70 per cent less likely to hospitalise range. And now with figure 1, it is abundantly clear that whilst the new strain did increase hospitalisations, it is in no way comparable to the first peak of April 12th 2020.
According to the latest reports, Scotland had only had a single patient with Omicron confirmed as requiring intensive care so far. Additionally, the Daily Record reports that official data “indicates that fewer than 100 people with the new variant have needed hospital treatment”.
Now we can begin to suspect ScotGov of being guilty of massive overreaction, unlike UKGov.
Scotland’s licensed trade industry suffered a £20m loss on Hogmanay due to Nicola Sturgeon’s restrictions. And the Night Times Industry reports an 80 per cent drop in trade. All on what ought to have been a bumper profits period helping businesses survive the slower months of January-March. All because of 1 Omicron patient requiring intensive care and fewer than 100 Omicron patients requiring treatment.
But wait, surely the SNP’s restrictions have helped ensure Scotland enjoys a lower infection rate than England? That would potentially explain low hospitalisations too. This has certainly been John Swinney’s talking point to the news media. He told BBC Good Morning Scotland’s Laura Maxwell the following,
“I think there’s a very important distinction in the data in Scotland and the data in England and that’s demonstrated by the ONS infection study that came out last week, which demonstrated that whilst 1 in 40 individuals in Scotland are likely Covid positive just now, 1 in 25 are likely to have it in England”
There are two things immediately wrong with what John Swinney said. Firstly, he is heavily insinuating – if not explicitly suggesting – that his government’s lockdown restrictions are the cause of Scotland’s lower infection rate. But this is quite simply false.
You see, where John Swinney said, “demonstrated by the ONS infection study”, one thing to note is that while it was published 31st December, it actually only covers the week to December 23rd. Remember, SNP restrictions entered into force on 26th of December; so putting it simply, the ONS data covers period beforethe SNP lockdown restrictions.
The evidence chosen by John Swinney does not in any way back up SNP claims its lockdown measures helped lower Scotland’s infection rate. He’s either not read the ONS study he is referencing (I have) or is deliberately seeking to misrepresent it. Neither is a good look for a Minister.
The second aspect that is wrong with Mr Swinney’s statement to the BBC is his claim Scotland has a better picture than England regarding individuals testing Covid-positive. What Mr Swinney is doing is using figures for England which are heavily distorted by London. If we look at figure 2 (below) we see the statistics for people testing positive in England – excluding London – and the picture is consistent with Scotland’s 1 in 40.
Figure 2: percentage of population testing positive for COVID-19 by English regions
Scotland has 1 in 40 testing positive for Covid-19, an entirely consistent picture with the English regions. Mr Swinney is categorically wrong to claim that the ONS data reveals some sort of Scottish exceptionalism. It does not. Nor does any of this support the Scottish Government’s claim that its restrictions have helped ensure lower Scottish infection rates.
Moving forward, another piece of the puzzle is mortality rates. Nicola Sturgeon has spoken of a need to take a ‘caution first’ approach to protect our elderly, vulnerable and high-risk neighbours and family. But again, looking at the scientific evidence, there is no proof that the Omicron Covid wave poses a comparable risk to previous waves. If you look at figure 3 (below) you can see that we are not witnessing any surge in mortality comparable to the first peak of 10th April 2020.
Figure 3: mortality numbers for people who had a positive Covid test result, UK
As Sir Chris Whitty said, the mortality picture is “extremely good news” as it proves “we are not seeing the surge in mortality that we saw in previous waves”.
So far there have been no Covid mortality spikes remotely compatible to previous Covid waves. This piece of science only further indicates that Nicola Sturgeon jumped the gun back on December 14th. It’s beginning to look as if she was acting on a hunch, assuming greater Omicron infectiousness would inevitably mean major spikes in hospitalisations and mortality.
Having assumed all of this (is there any other explanation if the science is absent?), she could also have assumed Boris Johnson would be compelled to impose restrictions and have wanted to ‘get in first’ ahead of him. But as figures 1 and 3 prove, this has not proven to be the case at all.
She acted on a hunch, not the science. And she most likely wanted to underscore some sort of Scottish distinctiveness in approach, which is a petty political consideration.
2 ‘Hospitalisation with Covid’
A further key aspect to consider is the issue of ‘hospitalisations with Covid’. You see, the SNP-led government has not been entirely candid regarding this data either. We have known for more than a week now that in England, upwards of around one third of ‘hospitalisations with Covid’ are patients who entered hospital for non-Covid reasons, but later diagnosed as having it (so-called ‘incidental hospitalisations’ with Covid). This tells us upward of one-third of patients in England included in the ‘hospitalisation with Covid’ data do not represent pressure on the NHS because of Covid at all. This is why the Chief Executive of NHS Providers in England, Chris Hopson, is warning us all not to over-interpret data showing rise in Omicron hospital admissions. He is fully cognizant of the impact these so-called ‘incidental Covid patients’ are having on the headline ‘hospitalised with Covid’ statistics. He does not wish for anyone to be mislead but misinterpreting the data.
This distinction between patients hospitalised due to having Covid, as compared to incidental Covid patients who entered for non-Covid reasons but later are diagnosed as having it, is a significant one. Not least because the English data does not make clear whether a third of English patients are potentially catching Covid in hospital. It is showing nearly one-third are hospitalised for non-Covid reasons but later discover they have it. This suggests a sizeable portion of Covid pressure on the NHS England was not due to folk dancing at new year. The issue of infection control measures in hospitals is raised; not a lack of restrictions and lockdowns imposed on the general public. The UKGov seems to have understood this important detail when declining to copy ScotGov’s rush to impose harsher restrictions at new year.
So, when SNP politicians such as Health Secretary Humza Yousaf delayed publishing a breakdown of Scottish Covid hospital patients vs positive patients being treated for other conditions, eyebrows were raised. Mr Yousaf informed BBC’s Martin Geissler on ‘The Nine’ on 29th December that he wouldn’t be publishing this data as he needed to check if it was “good”.
Scary stuff; Humza Yousaf actively implied that the data was not reliable or robust enough to be made public on the 29th of December, despite English equivalent data being available and reported on by December 31st. If this data is “good” enough to inform ScotGov policy, it must surely have been robust enough (or “good” enough) for publication – or something was deeply wrong.
We had a right to know this information in a timely and expedient manner. Why can the UKGov publish this data relating to England by end of 2021, but ScotGov could not – Especially if the public is to have any confidence in ScotGov pandemic policy?
And Mr Yousaf’s excuse that relevant statistics aren’t ready for publication only raised questions as to why they are not ready for publication, eroding confidence and trust.
Yousaf’s excuse for refusing to disclose vital information had hair-raising implications for quality of SNP policy decision making.
But that was December 29th, eventually he committed to publishing the breakdown of Covid hospital patients vs positive patients being treated for other conditions. A date was set. It was to be the 5th of January 2022.
Guess what, ScotGov refused to honour its commitment to publish the data, much to the bemusement of award-winning Scottish journalist Chris Musson. Wednesday the 5th of January passed by with no data released regarding the nuanced picture concerning ‘hospitalisation with Covid’.
Why was the SNP reluctant to release this data? Could it be that it would show a consistent picture with England, that a third to half of patients ‘hospitalised with Covid’ are actually ‘incidental patients’? If the data did show this, it would only undercut further any claims that restrictions are unavoidably necessary to relieving NHS pressures.
When the Scottish data concerning hospitalisations was finally released by ScotGov on the 7th of January – two dates later on a Friday – it was indeed consistent with the English picture. Albeit the data released by ScotGov was still narrowly based, only covering 2 of 14 Scottish Health Boards.
It revealed 40 per cent of Scottish patients ‘hospitalised with Covid’ were actually admissions of people who are being treated for other things but happen to have Covid (see figure 4 below). Put it another way, 4 in 10 patients inside the statistic ‘hospitalised with Covid’ are not being treated primarily for Covid at all. In England the statistic quoted by the Daily Mail was only 29 per cent.
So now we know that only 60 per cent of those ‘hospitalised with Covid’ in Scotland throughout December (when Omicron replaced Delta as the dominant variant) was primarily because they had caught Covid. Previous data, also from the ONS, showed that when Delta was the dominant variant earlier last year, 68 per cent were being hospitalised primarily because of Covid. Thus, this new hospitalisation data proves that Omicron is indeed less likely to cause people to be hospitalised primarily because of catching it, as compared to Delta.
Figure 4: number and proportion of community-acquired hospital admissions within 14 days of a positive Covid-19 test ‘because of Covid’ or ‘with Covid’. NHS Boards Greater Glasgow & Clyde 1-2 Jan 2022, Grampian 30th Dec- 4th Jan 2022
Also worth mentioning, regarding the hospitalisation data that ScotGov finally released, is that only 1 in 100 Scots catching Covid require hospital care following the UK’s vaccination programme and spread of Omicron.
Little wonder the SNP-led government was disinclined to release this data as Hogmanay came around. It seriously questions the necessity of its restrictions, given that 4 in 10 Scots ‘hospitalised with Covid’ are not in hospital primarily because of Covid.
3 Infection spread – comparing Scotland with England
Another principal defence put forward by Nicola Sturgeon in favour of her predilection for harsher restrictions and lockdown measures has been to ‘flatten the curve’ of infection spread. But again, there is precious little evidence that ScotGov’s lockdown measures over New Year were effective in lowering the Scottish Omicron-variant infection spread as compared to England, which took a more liberal approach.
Recall that figure 2 (above) ONS data showed that as of Dec 20th 2021 Scotland’s infection rate of 1 in 40 was entirely consistent with all of the regions of England excluding London (which was the Omicron epicentre).
Also remember that ScotGov imposed its restrictions on the 26th December 2021 in order to reduce, or limit the spread of Omicron-variant Covid.
But if we look at the 7-day statistics for cases (figure 5, below) we discover that Scotland as of January 1st 2022 actually had a higher recorded infection rate than England. Figure 5 shows the Scottish rate per 100,000 of population testing positive in at least one Covid-19 test as 2,079.5. Whereas the English rate is lower at only 1,786.8 per 100,000.
Figure 5: cases by area (last 7 days). Total test cases (people who have tested positive in at least one test result). Most recent 7-day data to January 1st 2022.
More interesting still, if we explore a breakdown of the English regions for infection spread using the 7-day data we discover that even Omicron-epicentre London had a lower infection rate than Scotland. Just look at figure 6 (below), only the North-West of England has a higher rate per 100,000 (2,332.4) than the Scottish 2,079.5. None of this suggests that the SNP’s preference for harsher restrictions and lockdown measures are effective at lessening Covid infection spread.
Figure 6: cases by area (last 7-day). English regional breakdown covering last 7 days up to January 1st 2022
The scientific evidence is clear, Nicola Sturgeon’s lockdown was and is unjustified.
When we consider comparisons of the Omicron wave with previous waves regarding mortality spikes and hospitalisation spikes, we are clearly not seeing remotely similar surges. Omicron is, so far, less severe than previous waves regarding mortality and hospitalisations. This undercuts the justification for the Scottish Government’s predilection for harsher restrictions.
Furthermore, regarding those hospitalised with Covid, we discover that 4 in 10 are not even hospitalised primarily because they have the virus. Indeed, of those hospitalised primarily because of Omicron dominant wave Covid infections (60 per cent), this is less than previous Delta dominant wave Covid infections (68 per cent).
Again, the evidence suggests that the Scottish Government overreacted in mid-December, when compared to the UK Government.
This overreaction has not yet been corrected.
There are even serious reason to doubt the usefulness of the Scottish Government’s restrictions on the grounds it ‘flattened the curve’ of Omicron variant Covid spread when compared to England. Consider the timeline and data: Scotland on December 23rd had a Covid testing positive rate of 1 in 40 (ONS infection study published 31st). This was consistent with England (excluding Omicron epicentre London). On December 14th the SNP announced the imposition of harsher restrictions starting on 26th of December. But the 7 day stats for the week until January 1st reveal that Scotland had higher infections per 100,000 than England (including London). So, the question must inevitably be raised, how were SNP restrictions effective? I struggle to conclude they were.
Look at any of the measures, mortality, hospitalisation statistics, ONS infection studies or percentages of people testing Covid positive in Scotland compared to England. Take any of the data presented, all of it, some of it – fact is Ms Sturgeon acted on a hunch not the science.
And when she acted she overreacted – it cost Scottish hospitality upwards of an 80 per cent write-off.
Public trust and confidence are amorphous and a blessing politicians enjoy. But they are always on loan, are never permanent and should never be taken for granted like they were on 14 December 2021.
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Dean M Thomson graduated with a MSc in Development Studies from the University of Glasgow, going on to lecture ‘Anglo-American Society and Culture’ at Shangdong Agricultural University, Peoples Republic of China. Being fully TESOL qualified Dean has taught English for Academic Purposes and modules in critical thinking in Wuhan and Xian Ning, Hubei.