SCOTLAND might have fared better during the Covid pandemic if it were "an island in the North Sea that could manage its own affairs", one of Nicola Sturgeon's key scientific advisers has suggested.
Professor Devi Sridhar said attempts to pursue a "maximum suppression" strategy in Scotland in 2020, before the second wave struck, were hampered by a lack of control over measures such as furlough and border controls.
However, Prof Sridhar conceded that Scotland also benefitted from access to vaccines acquired by the UK Government.
The prominent public health expert, who is a member of the Scottish Government's Covid-19 Advisory Group, shared her views in her new book, 'Preventable: How a Pandemic Changed the World and How to Stop the Next One'.
It comes as the number of people in hospital with Covid in Scotland reached an all-time high of 2,128, with the latest surveillance from the Office for National Statistics estimating that one in 14 Scots are infected - the highest since its records began in autumn 2020.
Prof Sridhar, chair of global public health at Edinburgh University, said scientific advisers in Scotland had urged the government at Holyrood to pursue a strategy of "containment and maximum suppression" with the objective from April 2020 being to "to get cases down to the lowest possible level and hold them there, with the explicit aim of having no one intentionally exposed to the virus".
She added: "In June 2020 the advice from several group members was to push to eliminate the virus with the first lockdown and then seal off travel to the rest of the world until scientific solutions could be rolled out, such as a vaccine."
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However, Prof Sridhar said this had been complicated by UK politics which meant that border controls and funding for the furlough required to mitigate economic restrictions were reserved to Westminster.
She writes: “A large land border with England meant that cross-infections (both ways) could occur.
“It would have been easier if Scotland had been an island in the North Sea that could manage its own affairs tightly.
“On the flip side, being part of the UK gave Scotland access to the vaccination programme negotiated by Number 10.”
Island nations such as New Zealand adopted a Zero Covid strategy, closing its borders and only reopening as vaccination coverage increased.
To date, it has recorded 163 confirmed Covid deaths compared to 164,000 in the UK.
Prof Sridhar said the UK Government's "mitigation and 'herd immunity'" plan at the outset of the pandemic - basically treating the virus like flu and simply slowing its spread through the population - "was clearly a mistake, considering the loss of life and the multiple lockdowns it entailed".
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Scotland has fared worst, with the highest excess death rate of any of the UK nations.
Since Spring 2020, Scotland has averaged 23.9 excess deaths per million per week compared to 22.9 in Wales, 18.6 in England, and 18.8 in Northern Ireland.
The measure compares the total number of deaths from all causes against the annual average for the five years before the pandemic, providing a signal of the overall impact from Covid infections as well as delays to diagnosis and treatment for other conditions.
High levels of chronic illness, especially in areas of entrenched deprivation, is believed to have made the situation in Scotland worse.
In evidence to MSPs on Holyrood's Covid-19 Recovery Committee, hospice charity Marie Curie said many people had ignored symptoms or struggled to access timely diagnostic services resulting in them "being considered palliative rather curative" by the time disease was detected.
Medics also reported cases where the main blood vessel from the heart had ruptured because patients had not had surgery to repair their artery walls in time.
New #COVID19 data shows infections increased across most of the UK, with record levels seen in Scotland.
— Office for National Statistics (ONS) (@ONS) March 18, 2022
High levels of infection are driven by the rapid rise of the Omicron BA.2 variant https://t.co/QKzckBeY0o pic.twitter.com/uIzWyRxxGr
Prof Sridhar has previously admitted in interviews that getting the guidance right on schools “kept me up at night”.
In ‘Preventable’ she writes that there were “no easy answers on schools”, but that planning for future pandemics “must include how to keep schools safely operating for in-person learning and incorporate the use of outdoor spaces, face coverings, testing, bubbles, distancing and other measures”.
“Home and remote schooling just doesn’t work and shouldn’t be seen as an acceptable outcome for children,” she adds.
Prof Sridhar - who has been a vocal critic of delays to vaccinating five to 11-year-olds in the UK compared to other nations - said high levels of community transmission were the key driver behind outbreaks in schools.
“The best way to keep schools open was to keep cases as low as possible in the community,” she said.
However, Prof Sridhar is also critical of fellow academics, saying the schools debate “became unnecessarily personal and ego-driven for many scientists, who seemed intent on proving their own hypothesis instead of looking at what would be best for children, teachers and families.”
'Preventable: How a Pandemic Changed the World and How to Stop the Next One' goes on sale on April 21
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