Chamber and committees

The Scottish Government will provide the necessary funding across health and care services to recognise the additional costs of responding to COVID-19, to support remobilisation of services, and to ensure that patient and staff safety remains the top priority at all times.

We have extending asymptomatic testing for designated visitors as an added measure alongside PPE and Infection Prevention Control. We are distributing testing kits, and associated training, to all care homes across Scotland.

In addition, we have allocated a total of £150 million this year to support care homes with the additional requirements of PPE, testing and safety reporting.

Our Winter Plan recognises that to ensure winter preparedness this year, that additional resources will be required and the Plan is being supported by further funding of up to £112 million. We are working with COSLA, and wider partners, immediately on effective allocation of this funding through mechanisms that promote additionality of services and value for money.

The number patient deaths in intensive care units there were between 1 September and 31 October 2020, and how this compares with each of the previous five years can be found in the following table.

Table 1. Number of deaths in Intensive Care and Combined Units in Scotland
‎ (1 September – 31 October for each year from 2016 to 2020).

PCR tests are used to detect the presence of viral genetic material in a sample and the cycle thresholds (Ct) can be used as an indicator of the concentration of viral genetic material in a patient sample. A typical PCR assay will have a maximum of 40 thermal cycles.

Ct values are not directly comparable between assays and may not be reported by some PCR platforms in use. Individual laboratories will hold details of the Ct reached for each individual specimen who will have quality systems in place to ensure the veracity of the results.

Staff members who test positive for COVID-19 following a PCR test do not require a confirmatory retest.

No laboratory test is 100% accurate. The laboratory tests being used to detect the SARS-CoV-2 virus in Scotland are real-time RT-PCR (Reverse Transcription Polymerase Chain Reaction) assays which are the gold standard for respiratory viruses.

The likelihood of false positives arising is dependent on a number of factors such as the overall prevalence of infection in the population, the clinical presentation of disease in the person sampled, and quality of the sampling method.

NHS Scotland Laboratories have a protocol in place to carry out confirmation testing (or repeat testing) in certain circumstances to confirm whether low positive test results should be reported as positive or negative. Public Health Scotland have produced guidance for sampling and laboratory investigations to minimise reporting of false positives occurring: https://www.hps.scot.nhs.uk/web-resources-container/covid-19-guidance-for-sampling-and-laboratory-investigations

UK Government Laboratories (Lighthouse) also have similar quality procedure systems in place to minimise false positives but are unable to repeat test low positive results.

A clinical and Scientific Review of our testing strategy was published on 23 October in light of the latest evidence of the state of the epidemic in Scotland and the latest understanding of testing capacity and demand forecasts in the next three months. We will continue to keep our testing strategy under review in line with the changing nature of the epidemic in Scotland. Further information on the review of the strategy can be found here:

https://www.gov.scot/news/clinical-and-scientific-review-of-testing/

The cycle threshold (Ct) can be used as an indicator of the concentration of viral genetic material in a patient sample; a typical PCR assay will have a maximum of 40 thermal cycles. Ct values are not directly comparable between assays and may not be reported by some PCR platforms in use. Individual laboratories will hold details of the Ct reached for each individual specimen who will have quality systems in place to ensure the veracity of the results.

The information required is provided through the following link: https://www.gov.scot/publications/coronavirus-covid-19-daily-data-for-scotland/

Pillar 1 is NHS Scotland labs

Pillar 2 is UK Government testing programme

The Scottish Government is not currently planning to test everyone who has been diagnosed with Covid-19 for antibodies.

There is currently no clinical certainty around what proportion of people may have a detectable antibody response following infection, and also how long detectable levels of antibodies remain following infection. Therefore a negative antibody test result does not confirm that a previous diagnosis of Covid-19 was incorrect.

Polymerase chain reaction (PCR) tests being used for diagnosing Covid-19 detect the viral genetic sequence of the causative virus SARS-CoV-2. These tests are very sensitive and the gold standard for respiratory viruses. They are specific and shown not to detect other coronaviruses and have been tested on large panels of negative clinical samples.

In Scotland we are using antibody tests to improve our understanding of COVID-19, and in the clinical management of patients, where appropriate. Clinicians have the discretion to request an antibody test for an individual if they determine the result will be of benefit to the treatment or clinical management of a patient.

NHS Scotland Laboratories are UKAS accredited and thus have quality procedures in place to minimise and guard against cross contamination of samples, and protocols in place to communicate and organise retesting if found to have occurred. Public Health Scotland have provided guidance which can be found here: -

https://www.hps.scot.nhs.uk/web-resources-container/covid-19-guidance
-for-sampling-and-laboratory-investigations

It is not normal practice to spike patient samples with positive control synthetic sequence and then subject them to sequencing. The Scottish Government does not hold information on the number of samples where this procedure has been carried out.

NHS Scotland Laboratories have a protocol in place to carry out confirmation testing (or repeat testing) in certain circumstances to confirm whether low positive test results should be reported as positive or negative. NHS Scotland Labs have instigated a method for ensuring veracity of low positive results and can be found at the following link: -

https://www.hps.scot.nhs.uk/web-resources-container/covid-19-guidance-for-sampling-and-laboratory-investigations

UK Government Laboratories (Lighthouse) also have similar quality procedure systems in place to minimise false positives but are unable to repeat test low positive results.