QUESTIONS have been raised about how well the spread of coronavirus is being tracked in the community in Scotland after it emerged that some Covid assessment centres are not testing at all and a GP surveillance scheme has been ditched.

Monitoring of the infection was originally supposed to be carried out by a network of 200 GP practices encompassing a representative patient population of 1.2 million.

This was expanded from the existing group of 41 “sentinel” surgeries which take part in annual winter flu monitoring for Health Protection Scotland.

GPs based in these 200 practices were expected to perform tests on patients presenting with potential Covid symptoms, such as coughs or fever, in order to provide a snapshot of the virus' prevalence within the community.

This data would then be used to create a model of its likely spread across the general population, without having to burden the majority of GP practices with testing.

At the time that the scheme was announced on March 16, Scotland's then-Chief Medical Officer Dr Catherine Calderwood said the new approach would "enable us to understand the pattern and spread of coronavirus in the community, to develop a clear assessment of the situation and to predict the peak number of cases, without having to test everyone with possible symptoms".

First Minister Nicola Sturgeon said the information would "allow us to assess and report on the spread and profile of coronavirus", adding: “That will be a far more robust indicator than the figures that we’ve been publishing so far.”

However, one week later the surveillance system was derailed by the launch of Covid-19 community hubs and assessment centres designed to "ease pressure on GPs".

As of March 23, members of the public were told they should no longer contact their GP if they were worried about possible coronavirus symptoms, but should instead call the 111 helpline.

Callers were to be assessed over the phone and, if necessary, given an appointment to attend a local community hub which would be staffed by senior clinicians, including GPs.

Sturgeon said this would "help to free up GP practices to treat and care for all non-coronavirus related conditions".

Asked what had happened to virus monitoring, the Scottish Government said it has "made progress with our plans around enhanced surveillance" and is working towards testing 1,000 people a week in the community.

However, a number of GPs from across Scotland told The Herald on Sunday that testing is either not being carried out routinely in the hubs where they work or is not taking place at all.

They also described assessment centres being "incredibly quiet" and of "barely seeing anyone".

A spokesman for NHS Greater Glasgow and Clyde said the community assessment centres "were never set up to test people". He said anyone referred to an NHSGGC Covid hub will have their condition evaluated to determine whether they need to go to hospital, but they will not be tested.

A drive-through testing facility is operational at Gartnavel Hospital in Glasgow, but this is limited to NHS staff or people who share their household.

A spokeswoman for NHS Lothian said it runs one test facility for its NHS employees or health and social care staff from associated HSCPs and private providers.

She confirmed that there are no test sites for the public.

A drive-through test centre at Edinburgh Airport is managed by the UK Government Department of Health and also restricts tests to key workers.

One Lothian GP who has taken part in winter flu surveillance, and would have been part of the sentinel network, said the Scottish Government had "dropped the ball" on community surveillance.

The doctor, who asked not to be named, said: "I don't think anyone would criticise the decision to create the community hubs per se, but in the process we lost a very accurate tool to track and gauge the prevalence of Covid in the general population.

"Now testing is very restricted to certain groups, whereas what we would have had from the sentinel network was a much wider picture. That's important because if you're weighing up how to exit lockdown, you really want as reliable a picture as possible of where the virus is, its incidence and how it's spreading.

"We don't have that."

Earlier this week, the First Minister said that Scotland is "on track" to meet the target of being able to process 3,500 tests a day by the end of April.

Massive testing regimes in Germany and South Korea have been credited with helping both nations to keep their outbreaks under control.

Germany has been processing 50,000 tests a day, including on patients with mild symptoms, while South Korea pioneered drive-through and walk-through testing centres as it ramped up to 20,000 tests a day. Large-scale testing was able to detect people, especially young people, who had no idea they were carrying the virus.

Scottish Labour health spokeswoman Monica Lennon said: “It’s now over a month since the Scottish Government announced there would be widespread community surveillance testing through GP practices – if this pledge has been abandoned, Nicola Sturgeon and Jeane Freeman need to be upfront about it.

“Worryingly, experts have been warning that our current testing capacity is nowhere near the level it should be.

“Every day that passes without widespread testing increases the risk that more lives will be needlessly lost.”

Miles Briggs MSP said the situation "raises serious questions" about the Scottish Government's handling of the crisis.

He said: "We need to see a focus on building testing capacity and understanding how widely coronavirus has spread in the Scottish population.”

The Scottish Government said the Covid hubs were not set up to be testing centres, but that selected patients with moderate symptoms would be invited for testing as part of Health Protection Scotland surveillance.

A spokesman said: “The Health Protection Scotland programme specifically draws a controlled randomised sample of people with moderate Covid symptoms. Its aim is to provide us with statistically robust information on the whole population allowing us to develop a clear understanding of the characteristics of people experiencing moderate symptoms.

“Members of the public are not being invited to come forward for testing as part of the surveillance testing programme. Instead individuals are being identified through their attendance at the community Covid assessment centres and the telephone triage service and invited to participate.”

He added: "At full rollout the community testing approach will see 1,000 people tested a week and the results applied to the full population. The first reliable results will be available soon and we will give an update at that point."