Was lockdown avoidable? Yes - had we 'followed the science'

Modelling by Edinburgh University previously estimated that, had lockdown been imposed two weeks earlier, the death toll from Covid by the beginning of May 2020 would have been slashed by 80% from 2795 to 577.

But lockdown is not a solution; it is a stop-gap when containment fails.

The lesson for future pandemics should not be "lockdown earlier", but "how do we avoid locking down at all?".

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Helpfully - away from the more headline-grabbing WhatsApp row - there has been plenty of evidence over the past three weeks covering exactly that. 

One of the reasons we fared so badly was that we failed to test, trace, and isolate.

As early as January 10 2020, Professor Mark Woolhouse - an infectious diseases epidemiologist at Edinburgh University - was anticipating, based on evidence of human-to-human transmission emerging from Wuhan in China, that the world was headed for a pandemic.

He warned Scotland's then-chief medical officer, Dr Catherine Calderwood, that it would probably be "fuelled by mild cases" making it "very difficult to track" if you relied on testing only people with symptoms.

A system of surveillance "needs to be put in place in advance of the arrival of the virus, so the sooner the better", he added in an email dated January 25.

In the end, Scotland began testing for Covid on February 10 when 57 samples - all negative - were processed.

However, as the inquiry has also heard, Scotland's testing capacity remained low - going from an ability to process 350 per day in mid-February to 780 by mid-March, by which time lockdown had become inevitable.

Nicola Sturgeon leaves the UK Covid inquiry in Edinburgh on Wednesday after a day of giving evidence (Image: PA)

The testing capacity was so limited that hospital patients were being transferred into care homes untested, and community-level testing had been abandoned. 

Professor Devi Sridhar, a chair of global public health at Edinburgh University who - like Prof Woolhouse - went on to become one of the Scottish Government's Covid advisers contrasted Scotland's approach to other parts of the world.

Denmark kept schools open "because they were testing four times as much per capita as Scotland".

South Korea avoided lockdown altogether through a strict containment policy reliant on test, trace and isolate.

While the UK's stay-at-home lockdown "treated everyone as infectious", countries capable of mass testing limited restrictions to the infectious, said Prof Sridhar.

"If you were infectious you were not allowed to go out, there were strict penalties, but you kept the majority of people able to circulate, to mix, to live freely," she told the inquiry.

The inquiry has heard that lockdown could have been avoided had an effective system of test, trace, and isolate been in place sooner (Image: PA)

The nations which fared best in 2020 were those contacting biotech companies by mid-January to order "millions of tests" while imposing border controls to test or quarantine all arrivals on entry, before community transmission had taken hold.

The UK dithered over the former and ruled out the latter so that - exactly as Prof Woolhouse had warned - by the time we started ramping up surveillance it was already too late.

There is no scenario in which mitigations could have been avoided, but they could certainly have been lessened with an effective test, trace and isolate regime.

For Prof Woolhouse, a combination of case isolation, infection control, contact tracing, public messaging, and some form of social distancing (indoor hospitality curbs, limits on gatherings) would have been necessary until a vaccine arrived.

However, outdoor activities - from walks in the park to trips to the beach - should never have been banned, he said.

"There was never ever an outbreak of Covid-19 anywhere in the world linked to a beach." 

Schools were "contributing a little to the spread", added Prof Woolhouse, but "so little that there was essentially no danger in re-opening" them from May 2020.

Another key point, made to the inquiry by social psychologist and Scottish Government adviser Professor Stephen Reicher, is that the whole point of test and trace is "to get people to self-isolate".

Yet in some areas compliance was, he said, as low as 18%.

The UK Government scheme - a £500 grant - was too small an amount, only one in eight workers qualified, and 67% of people who applied didn't get it.

A Scottish scheme "did a little bit more", he said, but "not enough".

This was "one of the major failures", he added.

"In other places like New York they had a wraparound system whereby not only did you give people more money, you offered them hotel accommodation, you even offered them support to walk the dog."

As for the summer of 2020, the evidence points to a tragically missed opportunity to get a handle on the (inevitable) second wave, save lives, and avoid a second lockdown.

Finding more cases and strengthening compliance with self-isolation should have been priorities, said Prof Woolhouse.

When the Office for National Statistics began its household survey in August 2020 it became clear that Scotland's Test & Protect system - which still relied on people presenting with symptoms - was detecting only half of cases.

Had mass testing using lateral flow devices been rolled out in autumn 2020 instead of during the Omicron wave at the end of 2021 "we wouldn't have needed a second lockdown" in January 2021, he said.

"We could have tested our way out of it."

Meanwhile, Prof Sridhar bemoaned the failure to use those months for "maximum suppression" of the virus through test-trace-isolate and border controls pending the imminent rollout of vaccines.

Instead we opted for "get back to normality".

She added: "When the winter wave came and the winter lockdown and the numbers went up, it was predictable and it was really depressing because in January vaccines rolled out and you think: 'how many of those people would have lived, had they just been able to delay infection by two months, a month?'"