12 May 2020

Suppressing Covid: The Next Phase

The Presiding Officer (Ken Macintosh): The next item of business is a debate without motion on suppressing Covid: the next phase. I call on the Deputy First Minister and Cabinet Secretary for Education and Skills, John Swinney, to open the debate.

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Stewart Stevenson (Banffshire and Buchan Coast) (SNP):

By this stage of a debate, much of what can be said has generally been said, but this subject is so wide—encompassing everything that we do and every person in Scotland and worldwide—that that is unlikely to be the case today.

I speak today as someone who is vulnerable by reason of age, although I am actually fitter than I have been for quite a few years. In the eight weeks that I have been absent from Parliament I have walked about 300 miles, so my body is fitter. I have been able to write a daily diary of about 62,000 words so far, so my mind is fitter. Mens sana in corpore sano.

As a parliamentarian, I am exceptionally privileged—as we all are—compared with most of our fellow citizens. My income is unaffected and I no longer have to spend 12 to 14 hours per week travelling. I am missing most of you, but some of you I barely miss at all—no names, no pack drill. My anxieties will be considerably fewer than those of members of the public.

We have heard much of the immense contribution of those—particularly those in health and care professions—who are especially at risk because of their meeting many people who are unwell. However, it is not just those people who contribute. All those who continue to support us directly—such as posties and those who work in shops—are equally valued.

My age means that it is likely that my immune system is probably less effective than it once was. People of any age with a compromised immune system need to be specially protected. However, we should have no assumptions about anyone else and they should all be treated equally. Reference has been made to people who have a range of conditions that do not create extra risk, and we should treat them with respect.

The R number has come up a number of times, most recently in Liz Smith’s speech, and I want to say one or two things about it. It is a statistically derived number that is informed by data from a range of sources, such as Registers of Scotland. The cause of death that Registers of Scotland receives may be of high certainty, informed by a positive test, or it may come from a clinical judgment, where there has been no test.

The high degree of variability in Covid-19 symptoms means that some cases will be missed. In some cases, the symptoms will falsely point to Covid-19. Many medical practitioners who are providing certification will have had no prior experience of the disease. There is uncertainty there.

The numbers also follow infection, probably by a week but possibly longer. Testing is difficult. The current tests rely on a swab from the throat—a swab from the mouth will not do. Any swab in the throat provokes a choke reflex, so it is difficult for the patient and the medical person who administers the test. The uncertainty following a test will be lower and the data more recent, but it is not zero uncertainty. Self-diagnosis by people with milder symptoms who self-isolate after experiencing them also contributes to the numbers.

Suppose that we make up a few numbers—these are not real numbers. Ninety-six per cent of reports to Registers of Scotland are correct, 95 per cent of medical practitioners get their diagnosis correct—many bits of research say that the figure is as low as 50 per cent, although I suspect that that is too pessimistic—and 80 per cent of people self-diagnosing get it right. With equal weight given to those three factors, we get 72 per cent certainty about the R number. The figures of 96 and 95 per cent sound high, so let us suppose that they are both 80 per cent; that takes the certainty down to 50 per cent.

Statisticians have vigorous debates about how much they should rely on the data that they get and the weight that they should give to each factor, so the R number cannot be the precise number that we would all like it to be. What I have said is a gross oversimplification of how we get to R. However, I hope that it illustrates why, if I hear someone come forward with a single number, I will stop relying on that number.

Business will certainly be very different in the years to come compared with a year ago. Gillian Martin spoke about people who are suffering from the effects in their business lives. However, perhaps one of the most important things that we might think about—I have not heard this spoken about yet—is what we will do about young companies that are at a stage in their development that means that they have negative cash flows. Somewhere in that lot are companies that will be the successes of the future. We need them.

Finally, I want to speak briefly about messaging. The stay at home message has been self-explanatory and widely respected. We as politicians get bored with messages much quicker than the general population does because we are constantly repeating them and hearing ourselves saying them. We get bored, but we have to tolerate that boredom more than we have been, until the public tell us that it is time to refresh the message.


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