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Scotland’s superior approach to COVID-19: policy or circumstance?

Helena Norman

While England and Scotland are neighbouring countries and tied together under the title of Great Britain, there has been a shocking disparity in the devastation that has been caused by the coronavirus pandemic. As of the 26th July, Scotland had a rise of just 4 new cases, whereas England had 91 more cases than the previous day. While Scotland watches as the UK government flails at the expense of people’s lives, it begs the question, how has Scotland soared miles ahead of England and succeeded so well thus far?

Between January and March, when coronavirus began to globalise at a frightening pace, England and Scotland treated the situation much the same, and carried on business as usual, despite the backdrop of European countries being exponentially overwhelmed by the virus. But from the start of the nationwide lockdown on 23rd March, the Scottish government chose to honour their rights of devolved governance within the United Kingdom, by diverging their healthcare strategy from that of England and Wales. Right from the start, while England’s feeble attempts in halting the virus prioritised preventing hospitals spilling over full capacity, Scotland worked on eliminating cases altogether. First Minister Nicola Sturgeon chose to assemble a panel of scientific advisors, primarily epidemiologists, to work separately from the UK group and to advise the best route for Scotland in the eradication of COVID-19, with input from a German health official; alongside the UK level Scientific Advisory Group for Emergencies (SAGE).

In accordance with the Scotland-focused advice given, as the UK government began to ease lockdown, Sturgeon decided to not be as hasty as Boris Johnson and take a more cautious approach. Face coverings became mandatory in shops in Scotland two weeks ahead of England. Pubs reopened a few days later in Scotland, and with stricter rules. Sturgeon stated “No beer garden or cafe should feel the same as it did before”, a stark contrast to England, which broke out in celebration at being allowed into their beloved local pubs, prompting local resurgences causing numerous pubs to close their doors only days after reopening. Additionally Scotland chose not to exempt the hard-hit Spain from a 14 day quarantine upon entry to the country, unlike England, which came to regret the decision after a spike in cases in Catalonia forced the two week quarantine to be reinstated for travellers coming to the UK, a decision made with 5 hours warning, coming into effect on the 26th July.

Scotland also chose to differ from England in the format of their Test and Protect scheme, opting to increase the efficacy of the programme by recruiting contact tracers from communities, as opposed to using private contractors as the UK government decided to do. Sturgeon also diverged from Johnson’s plan for England, releasing a concise and intelligible four step strategy for exiting lockdown safely, and when England was given the rather irresolute ‘Stay Alert’ message, Scotland stuck with ‘Stay Home’; preferring, sensibly, to err on the side of caution.

Despite the wary approach taken by Scotland, its apparent successes may also be circumstantial. The most obvious factor is the relative population sizes and densities of England and Scotland. England has a population of 56 million people, a severe contrast to Scotland’s 5.5 million, and Scotland has no city remotely comparable to the sprawling metropolis which is London. With larger cities encouraging more cut-throat house prices, business districts and suburbs are just as tightly packed with people, which makes a virus like COVID-19 difficult to control, a situation which is not as applicable to much of Scotland. To add to this, the UK had over 40 million tourists in 2019, with only 3.5 million of those travelling to Scotland. The level of globalisation in England, primarily in London, created an ideal place for a virus to fester and spread.

Mark Woolhouse, a University of Edinburgh professor of epidemiology and part of a government COVID-19 advisory group, also stressed the importance of timing in how both countries have been affected by the pandemic. Scotland’s infection rates were “6 or 7 days behind England’s.” In England, the lockdown was imposed a full 18 days after the first death in the country, whereas in Scotland, while lockdown was enforced on the same date, it was only 9 days after the first fatality there. “That is a very long time, if the epidemic is doubling every three or four days”, Professor Woolhouse elaborated.

There are even further complexities when debating just how successful Scotland has been in the battle against the pandemic. The criteria of a death caused by COVID-19 has rapidly changed over the course of the pandemic, creating statistical uncertainties, alongside calculating death rate predictions using baseline death rates which differ between countries, making national comparisons more complicated.

Circumstantial or not, Scotland has had increasingly encouraging tests results, and experts say that if not for the 154 km border with England, they could be close to eradicating coronavirus. But with Sturgeon announcing the opening of schools and the reviewing of lockdown measures, a second surge could be equally as likely.

Image: Scottish Government via Flickr

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