OPERATING theatres in Scotland were still carrying out fewer than half the number of planned procedures they normally would even before the resurgence in coronavirus.

The latest figures also indicate that more than 100,000 patients have had surgery called off during the first five months after lockdown.

Strict infection control measures designed to curb the spread of the virus in hospitals, such as high-grade PPE for surgeons and deep-cleaning of theatres between patients, have dramatically slowed turnaround times and driven up waiting lists.

But new research has cast doubt on the dangers of anaesthetic procedures and the need for such tough restrictions after finding that medics in theatre were exposed to a fraction of the particles they would be from a normal cough

At the height of the crisis in April, the number of elective operations scheduled across NHS Scotland was slashed to 3,406 - just 12.6 per cent of normal turnover.

By August this had climbed to 13,831, but that remains 54% below the four-year average for the month.

In some health boards, it is even lower: NHS Borders had scheduled just 18% of the procedures it normally would, with just 34% planned for theatres in NHS Lanarkshire.

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According to Public Health Scotland data, between the beginning of April and the end of August 39,565 operations were booked into theatres, compared to an average of 142,787 over the same five-month period from 2016 to 2019.

This suggests that around 103,000 “non-urgent” operations, including hip and knee replacements, will have been put on hold.

From June 19, as Scotland exited lockdown, health boards were instructed begin rescheduling cancelled surgeries, but by early September hospital admissions for Covid-19 were on the rise again.

Nicola Sturgeon is now set to announce fresh restrictions after the number of people in hospital with the virus triple to 262 in less than two weeks, with more than 5,100 new cases detected in the past week.

Ahead of today’s announcement, however, the First Minister stressed that the Scottish Government is “not about to halt the re-mobilisation of the NHS”.

She said: “It is vital that our National Health Service is there for non Covid conditions as well as there for everything we have to deal with in relation to Covid.”

Professor Jason Leitch, Scotland’s national clinical director, added that winter planning is ongoing.

“We had 800 new positives today. Some of them will be hospitalised in a few weeks’ time - it’s a lag indicator - so we will have to keep capacity in our health service for Covid cases.

“That means winter is harder this year - in planning and in the actual reality - than it has been for some time.”

Scottish Labour's health spokeswoman, Monica Lennon, said the Scottish Government has been "too slow to remobilise the NHS".

She said: “Patients who are living with severe pain or conditions affecting their life chances are right to question when they will get treatment.

It comes as research carried out in Bristol suggests that operations carried out under anaesthetic are being wrongly classified as 'aerosol-generating procedures' (AGPs).

It was thought that inserting and removing a tube from a patient's airway during surgery would produce a fine spray, potentially containing virus particles.

As a result, theatre staff must wear high-grade respirators, a long sleeved gown, gloves and eye protection during surgery, with operating rooms deep-cleaned between patients.

Despite the presumed risk, the volume of aerosols released by intubation and extubation had never been measured.

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Researchers carried out environmental monitoring in four NHS operating theatres in Bristol over a three-week period were surprised to discover that tube insertion generated approximately one thousandth of the particles released by a single cough. Tube removal produced less than a quarter of the aerosols compared to a cough.

The findings, published today in the journal Anaesthesia, "should trigger a re-evaluation" of infection control measures which have "reduced operating theatre turnover, decreased hospital productivity and

increased waiting times for elective and cancer surgery", write the authors.

The study was led by Dr Jules Brown, of North Bristol NHS Trust, and Professor Jonathan Reid of Bristol University's Aerosol Research Centre.

"De-escalation of these high-level protective measures would have a substantial impact on our ability to deliver healthcare to patients within the NHS and internationally,” they add.

“If we can agree these procedures do not generate aerosols we can reduce the PPE we wear and we can eliminate the major delays that currently exist between one patient leaving the operating room and starting the next case.”

Professor Michael Griffin OBE, President of the Royal College of Surgeons of Edinburgh, said: "This is certainly a positive move forward and the findings of this research could help speed up waiting times for patients, however, it will still take a long time to fully recover from the large backlog of elective surgery which has built up over the course of the pandemic.

"It will be very welcome news if this contributes to reducing waiting times for elective surgery at a time when many hospitals are operating at a vastly reduced capacity."