Covid Scotland: Glasgow has lowest virus rate in Scotland despite COP26 spike fears

In contrast, the Orkney islands now have the highest Covid rate in Scotland on 638 cases per 100,000.

The pattern is a sharp turnaround from the pattern earlier this year when Glasgow found itself at the epicentre of the Delta outbreak as the strain first took hold in May, while a spike in infections in Dundee in July saw Tayside emerge as Europe's Covid hotspot.

Glasgow and Orkney have experienced very different trends in cases since the beginning of October.

Orkney now has the highest virus rate in Scotland, and Glasgow city the lowest, but the scale of the difference between regions is less pronounced than it was earlier this year

Orkney has gone from detecting an average of 1.6 cases per day around October 1 to 23.1 per day by November 7, when the islands' cases peaked at their highest level of the entire pandemic. There has been a small dip in more recently to 20.7 per day by November 11.

Meanwhile, in Glasgow, Covid cases have gone from averaging 272.7 per day on October 1 to 206.9 by November 11, with cases having remained flat from mid-October onwards.

While the statistics for Scotland as a whole are now showing signs of a clear upswing - rising 18% between November 1 and November 11 - that is not yet being reflected in Glasgow despite concerns that the COP26 climate summit would fuel a spike in cases in the city.

Taking Scotland as a whole, cases have been on the rise since the beginning of November based on positive cases by the date of testing (ie. specimen date)

The divergence between Glasgow and Orkney comes despite both regions having very similar antibody levels.

According to the most recent seroprevalence surveillance - which estimates antibody rates for local populations as a whole based on blood samples gathered in primary care - around eight in 10 Orkney islanders and Glasgow residents had Covid antibodies as of the week beginning October 11.

In NHS Greater Glasgow and Clyde, the estimate was around 79.5% (ranging from 76.5% to 82.6%) while in NHS Orkney the estimate was 80.4% (although the confidence intervals were wider - 71.3% to 89.5% - reflecting the greater uncertainty of a smaller sample size).

Source: Public Health Scotland seroprevalence surveillance (antibodies in blood), primary care, Covid-19

On vaccinations, Orkney actually has higher coverage than Glasgow based on the percentage of their populations who are fully vaccinated with two doses: 84.7% in Orkney compared to 74.8%.

On boosters for the over-50s, however, Glasgow is ahead with 36.9% of those eligible having had a third dose, compared to 27.3% in Orkney.

Source: Public Health Scotland

It comes as Scotland's chief medical officer, Dr Gregor Smith, said that "two distinct epidemics" are starting to form in Scotland.

Writing on Twitter, Dr Smith said case rates were decreasing in the over-60s but increasing in the under-60s "most markedly [but] not exclusively in the under-20s", adding: "This effect in >60s is almost certainly due to boosters and replicates experience in Israel. This is really encouraging but shallow rises in 40-49 concerning."

1/ We’re now in a period of growth of COVID19 cases again and have seen around 11% increase in 7 day case rate from 325/100k (1/11) to 362/100k (8/11). This masks the different picture across age groups though, with two distinct epidemics beginning to form in Scotland pic.twitter.com/APJ8G4IMEy

— Gregor Smith (@DrGregorSmith) November 13, 2021

Dr Smith described the trend in Glasgow as "striking", writing: "Again we see geographical variation across the country, with some [local authorities] like West Lothian showing decline, others like Angus significant growth. Especially striking is relatively static picture in Glasgow City, previously hit hard, whilst many more rural communities now seeing growth.

"Vaccination remains our most important & critical defence- completing our primary doses & taking booster when eligible. I can’t overstate the importance of this, especially entering winter.

"Progress is amazing but there remains a significant susceptible pool without protection."

Dr Smith noted that cases are rising in the under-60s, and falling now in the over-60s

There are around 430,000 adults in Scotland who have not yet been vaccinated at all.

The Scottish Government has confirmed that it will follow guidance from the JCVI to extend booster doses to all adults over 40. Most people in this age group will not become eligible until January, however, as the boosters are being administered no earlier than six months after a second dose.

Prof Neil Ferguson, the Imperial College London scientist whose modelling precipitated the UK's first lockdown in March 2020, told BBC Radio 4 there was "no reason" why boosters should not be rolled out to all younger adults once the priority groups - including those with underlying health conditions had been protected.

In Israel, everyone over 12 is being offered boosters and uptake of a booster vaccination is now part of the criteria for the country's Covid passport scheme.

Prof Ferguson said data from countries including Israel shows that people are "very substantially protected" after receiving a booster - both from serious illness as well as infections and mild disease.

He added that modelling from the London School of Hygiene and Tropical Medicine indicates that extending boosters to younger groups "could make quite a big difference to driving down transmission to low levels".