FOR NHS staff and patients, lockdown came even earlier than it did for the rest of the country.
On March 17, Health Secretary Jeane Freeman announced that NHS Scotland was being placed on an “emergency footing” for the next three months.
All non-urgent planned operations would be postponed, routine cancer screening paused, and outpatient appointments put on hold while hospital capacity was freed up “to face a substantial and sustained increase in coronavirus cases”.
By that point, 195 people had tested positive and the first death in a Covid positive patient had been reported a few days earlier, on March 13.
An initial plan to double intensive care capacity was later ramped up to create 700 ICU beds – compared to around 190 normally – by redeploying staff from other departments and converting wards into critical care units with ventilators and oxygen.
READ MORE: Fife patients face up to 20 week wait for routine MRIs
The Scottish Exhibition Centre in Glasgow was also transformed in the space of two weeks into a £43 million Covid field hospital capable of accommodating up to 1,036 patients if the NHS was indeed overwhelmed.
From the outset, First Minister Nicola Sturgeon said she hoped the NHS Louisa Jordan, which became operational on April 20, would not be needed – and so far, it has remained empty.
Even the 3,000 existing hospital beds ring-fenced for coronavirus were never fully required.
The number of Covid patients in intensive care peaked at 221 on April 12, with overall hospital admissions for the virus topping 1,866 on April 21.
But while frontline NHS services coped much better than expected, a crisis began to emerge in social care.
Visiting to care homes had already been banned across Scotland on March 12 – before most hospitals, and nine days before lockdown.
Until then, official guidance UK-wide had perceived care home residents as being “very unlikely” to become infected.
But little thought appeared to have been given to the prospect that staff could bring the virus in with them and inadvertently spread it among a highly vulnerable population.
During the first seven days of the UK lockdown, Covid was mentioned for the first time on the death certificates of five care home residents in Scotland.
By April 12 – just as intensive care admissions were peaking in hospital – 243 Covid deaths had been registered among care home residents.
READ MORE: Orthopaedic surgeon warns it will 'be years' before waiting lists return to normal
Today the death toll is 1,917 – eight more than the total in hospitals, and nearly 47 per cent of all deaths where Covid is noted on a death certificate.
Based on the most recent available care homes’ census, that would mean that six in every 100 residents have lost their lives to the virus since lockdown began. The reality is probably even higher.
As the scale of the emergency became clear, whistleblowing care workers spoke out about shortages of protective gear. There were claims that they had been told not to wear face masks because it might scare the residents, that supplies were being rationed, or that they could not afford to skip work and self-isolate at home even if they did have possible symptoms.
Meanwhile, care home operators hit out, accusing the Government of using care workers as “canon fodder” or leaving social care workers feeling like “second-class citizens” compared to their colleagues on the NHS frontline.
To date there have been 17 deaths among social care workers, with the profession as a whole twice as likely to die from the disease compared to their NHS colleagues.
But there was also criticism that some major chains had been paying staff less than the living wage or failed to invest in stockpiling their own PPE while funnelling profits for years into offshore tax havens or paying bosses multi-million pound salaries.
One lasting legacy of the pandemic is that it may usher in a properly integrated National Health and Care Service – or at the very least, trigger a serious conversation about it.
Ms Freeman has committed to a social care review which she said will focus on “if it should be changed, in what way – and in what way should that be funded”.
READ MORE: Scotland reaches New Zealand-style testing benchmark as only one in 200 tests comes back positive
Testing has been a repeated flashpoint during the 100 days since lockdown. In the past week, a total of 30,288 tests were processed by NHS labs as well as from drive-thru centres and mobile units.
That is well short of Scotland’s 12,000-a-day Covid testing capacity, leading to calls that the resource should be deployed to help stave off a second wave – though routine surveillance carries with it a high risk of false negatives.
In the past week, just 80 people in Scotland tested positive for Covid: three in every 1,000 tests. That puts Scotland well under the 2% threshold considered to be “on the safe side” of suppressing the virus.
During the pandemic, Scotland has recorded 33% more deaths – from all causes – than normal.
But for 2020 as a whole, including January, February and the first half of March, mortality is around 15% above average. If a second wave can be avoided, our excess deaths toll could still be reduced further.
However, the long-term consequences may be much tougher. In the past week, The Herald has reported on fears that the orthopaedic waiting lists could take “years” to recover – yet they were already buckling under demand even before the virus struck.
Dr Grant Baxter, the Royal College of Radiologists’ representative in Scotland, also warned of “inevitable and significant” scanning delays as the NHS restarts after NHS Fife revealed that patients could be waiting up to 20 weeks for a routine MRI.
All this is likely to be the tip of the iceberg. The ripple effect from Covid will continue to be felt long after the last coronavirus patient is discharged.
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