ALL routine operations are being suspended for at least three months as NHS Scotland is placed on an emergency footing amid warnings that the country is “on the cusp of a rapid escalation” in coronavirus cases.
Non-urgent planned surgeries will stop from this week as part of efforts to free up beds for those worst hit by the outbreak. This will include procedures such as hip and knee replacements.
The Scottish Government also outlined plans to create an extra 3000 acute hospital beds, in addition to doubling intensive care capacity from 190 to 380 beds and buying in 700 new ventilators.
READ MORE: Non-urgent cancer surgeries and complex ops likely to be delayed to free up ICU beds
Private hospitals in Scotland will also be expected to take NHS patients in order to “maximise available bed capacity”, and health and social care partnerships are under pressure to deliver a “rapid reduction” in the number of bed days lost to delayed discharge.
The Scottish Government has set a target for a reduction of at least 400 by the end of the month.
It comes as a second elderly patient with underlying health issues died in Scotland after testing positive for Covid-19, the disease caused by the virus.
A total of 195 people in Scotland have been diagnosed to date, but Health Secretary Jeane Freeman said the “the true figure of infections will be substantially higher”
In a statement to the Scottish Parliament, Ms Freeman said the fight against coronavirus will require “the most rapid reconfiguration of our health service in its 71 year history”.
She said: “I am formally placing our NHS on an emergency footing for at least the next 3 months.
“I am giving my instructions to NHS Scotland and the individual health boards to do all that is necessary to be ready to face a substantial and sustained increase in cases of Covid-19.
“Should I be required to lay new regulations to enable our boards to achieve this, I will bring them before this Parliament swiftly.
“Our first goal is to double the ICU capacity in Scotland. Boards are working towards this by providing the necessary training for staff and by repurposing facilities.
“Our contingency planning for the supply of oxygen both in hospital and in the community is in place, and we have ordered a further 450 new standard concentrators for use in the community, as well as further contingency which can be called on if necessary.
“Our current bed capacity in NHS Scotland is approximately 13,000. Our boards are taking all necessary steps to increase this by at least a further 3,000.
“To achieve this, our normal programme of non-urgent elective operations will be suspended.
“I want to be very clear though - vital cancer treatments, emergency, maternity, and urgent care will continue.”
READ MORE: Coronavirus - second Scottish death confirmed
Patients whose operations are cancelled will “remain on the waiting lists until it is clinically appropriate to have their procedure undertaken”, said Ms Freeman.
The Health Secretary added that a national cancer treatment response group has been established to “provide ongoing advice and support around cancer treatments”.
It comes after the Herald revealed that some cancer patients in Scotland are being advised to delay starting chemotherapy due to the risk from coronavirus.
Immuno-suppressed patients, including those on cancer treatment or taking drugs for conditions such as Crohn’s disease, are among those most in danger from the virus.
Ms Freeman said anyone in this category will be contacted directly by the NHS next week advising them on the “stringent measures” they should take to protect themselves.
NHS Western Isles also confirmed that routine dental check ups are cancelled with immediate effect to help reduce the spread of the virus, although emergency dental treatment will continue.
Outpatient activity is “under urgent review”, but the majority of routine appointments with allied health professionals such as physiotherapists are cancelled unless they “will help prevent hospital admission”, said the health board.
NHS Greater Glasgow and Clyde said it was awaiting Scottish Government guidance on dental appointments, but non-urgent outpatient appointments would be re-scheduled for later in the year.
It came as major cinema chains Odeon, Vue and Cineworld announced that they were closing all outlets until further notice following Government advice that people should avoid crowded places.
The Scottish Courts and Tribunals Service has banned any new criminal jury trials from beginning “until further notice”. Jury trials which have already commenced “will run to conclusion of the trial, if practical to do so”, said the SCTS.
The UK and devolved governments have issued strict guidance that anyone with a new persistent cough or fever should stay at home for seven days. Anyone else in a household where someone has symptoms should self-isolate for 14 days as a precaution.
People over 70, those with underlying health conditions for which they get the flu vaccine, and women who are pregnant are “are strongly advised to stay at home as much as possible, and to significantly reduce unnecessary social contact”.
The population as a whole, regardless of health, has also been told to avoid crowded places such as bars, restaurants and cinemas, to minimise public transport use and work from home if possible.
First Minister Nicola Sturgeon said the closure of schools was “under daily review” but is not currently recommended.
She said: “At present, our judgement is that the negative consequences of this – for the overall wellbeing of children and, in terms of the impact on the health service workforce for example – outweigh the benefits.”
Ms Sturgeon also addressed the issue of coronavirus testing after the World Health Organisation chief urged countries to “test every suspected case”.
The Scottish Government is scaling up Covid-19 surveillance testing through 200 GP practices with a total of 1.2 million patients, selected to provide a “representative sample” of the population.
Monitoring will also be targeted to hospital admissions, intensive care patients and specific community cases such as a nursing home outbreak.
Ms Sturgeon defended the decision not to test everyone in the community with a cough or fever for coronavirus, saying that resources are better directed to caring for sick. She added that even if they did test positive “the advice would be the same” - to self-isolate at home for seven days.
It came amid reports that an infection control experiment trialled in the Italian town of Vo’, near Venice, had succeeded in halting its outbreak.
According to the Financial Times, when the town’s 3,300 inhabitants were tested in late February, 3% were infected - half without symptoms. After isolating everyone who had tested positive the infection rate dropped to 0.3% ten days later.
Andrea Crisanti, an infections expert at Imperial College London who is taking part in the Vo’ project, urged the UK and US to learn lessons and ramp up its testing.
Professor Crisanti said: “In the UK, there are a whole lot of infections that are completely ignored.
"We were able to contain the outbreak here because we identified and eliminated the ‘submerged’ infections and isolated them. That is what makes the difference.”
It emerged on Monday that the UK had escalated measures against coronavirus after new evidence from scientific advisers that its “mitigation” strategy could cost 250,000 lives and overload the NHS with eight times more patients than it could cope with.
The report by experts at Imperial College London warned ministers that the public health threat is the “most serious” from a respiratory virus since the 1918 Spanish Flu, and called on the UK to adopt a strategy of “epidemic suppression” for up to 18 months.
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