Coronavirus outbreak simulation in Scotland noted ‘clear gap’ in preparedness

An exercise simulating an outbreak of coronavirus in Scotland shared with a UK Government advisory group noted a “clear gap” in the country’s preparedness, according to a report.

The exercise in March 2018 mimicked a Middle East respiratory syndrome coronavirus (Mers-CoV) epidemic to assess NHS Scotland’s readiness to respond.

The Scottish Government was forced to publish the report after the BBC requested the findings under the Freedom of Information Act.

Mers, first identified in the Middle East in 2012, is a rare but severe respiratory illness that can start with a fever and cough and develop into pneumonia and breathing difficulties.

The report was shared with the Nervtag group – New and Emerging Respiratory Virus Threats Advisory Group, a group of scientists advising the UK Government, in long-hand – at a meeting in June 2019.

Asked whether it was discussed by the Scientific Advisory Group for Emergencies (Sage), the Prime Minister’s official spokesman said: “I don’t know – Nervtag obviously feeds things into Sage, I don’t know anything beyond that it was shared with Nervtag.”

When put to the spokesman that the report represented a missed opportunity to act earlier on the availability of personal protective equipment (PPE), the PM’s spokesman said: “I think we’ve acknowledged that the UK Government did face challenges in securing PPE at a time when there was unprecedented global demand across the world.

“We have now made good progress, both in terms of getting more PPE from overseas but also in increasing domestic (supply).”

The table-top exercise, known as Exercise Iris, was delivered by the Scottish Government and involved NHS Scotland boards, NHS 24, Health Protection Scotland and the Scottish Ambulance Service.

Held at a hotel in Stirling, it simulated three different scenarios in an outbreak.

The report said it recognised the availability and use of personal protective equipment (PPE) would be a “key consideration in the early stages of the outbreak”.

It said the profile of PPE within the day’s discussion “underlined the need for substantive progress on PPE use within Scotland”.

The report concluded: “Amongst front-line staff there is unease at the lack of clarity on PPE availability, training and testing.

“This is a clear gap in Scotland’s preparedness for MERS-CoV and other outbreaks and needs to be addressed as soon as possible.”

One of the scenarios featured “escalating resource requirements for contact tracing and follow up”.

It said: “Board plans will need to have considered this in detail and – as in the previous discussion – national coordination may be required to organise surge capacity and mutual aid.”

In an interview on BBC Radio Scotland, Justice Secretary Humza Yousaf was asked whether he rejected the conclusion of the report that Scotland was not prepared.

He replied: “No, I’m not. I’m saying the exercise said ‘well, here are some gaps’ and of course we’ll be looking to address those gaps.

“We have had and continue to have good stockpiles of PPE, for example. That was one area that was addressed as potentially being one of the gaps.

“There was certain items of course, because of a global pandemic, that everybody is trying to get at exactly the same time.”

Asked why Scotland was not prepared for the outbreak despite the simulation, he said: “I reject that suggestion that we weren’t prepared.

“First of all, the fact that we’re doing these desktop exercises in itself shows that of course we’re looking to be prepared right across, not just Government, but across the public sector if possible.

“And second of all, we had good stockpiles of PPE. Not only do we have and continue to have good volumes of PPE, we’re now manufacturing that PPE here in Scotland.”

A Scottish Government spokeswoman said: “As the First Minister said at the briefing yesterday, we have been working right from the start of this outbreak to make sure we had PPE for those who need it and at no point have we run out of any item.”