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Coronavirus / SIC leader stresses importance of Covid guidelines amid tension with NHS

Councils yet to persuade government of case for local variations

SHETLAND Islands Council leader Steven Coutts has rejected the suggestion that a public rift between NHS Shetland and the local authority over island councils’ approach to the Scottish Government risks sending out mixed messages over coronavirus.

On Thursday morning leaders of Shetland, Orkney and Western Isles councils had a virtual meeting with islands minister Paul Wheelhouse and national clinical director Jason Leitch to discuss the possibility of local variations on the Covid-19 guidelines.

Afterwards Coutts conceded that the island authorities had yet to persuade the SNP government or health officials of their case.

It comes as chief executive of the Shetland and Orkney health boards Michael Dickson told Shetland News that there was a “very real danger” of confusion among members of the public over the messaging.

SIC political leader Steven Coutts.
SIC leader Steven Coutts: Photo: Shetland News

Coutts said the “relatively short and sweet” meeting on the back of a letter sent to ministers last week was aimed at establishing the principle of local variations, which have been enacted in other island communities such as the Isle of Man and Faroe. 

“We’re looking for agreement on principles before we consider what any variation is,” he said. “This is not about ignoring the fact that Covid-19 remains a real health risk, there’s absolutely no doubt about that.

“Clearly we need to observe FACTS guidance – wear face masks, social distancing – but from my perspective we need to reflect on local circumstances, and clearly there’s significant variation across Scotland in terms of the spread, across the UK, across the globe.

“The guidelines and what’s in place, I’ll reiterate, we’d expect the community to follow that guidance.”

There is particular frustration within the council that Dickson has spoken speculatively in public about specific measures that might be considered – with Coutts at pains to stress that the council has not tabled any detailed proposals at this stage.

Dickson and Leitch have both expressed a strong preference for sticking to national guidelines as the safest means of combating Covid-19.

The chief executive, in turn, is frustrated that island health boards were not afforded the opportunity to give their input prior to the councils’ letter being sent.

“To not involve the health boards before making an approach to the national clinical director would seem to be a misstep as the public health teams have the knowledge and skills to advise what steps we could take to keep our communities safe,” Dickson said.

“If the council leaders didn’t feel they were able to discuss the matter with the public health teams, then making sure the chief executives and chairs of each NHS board and the IJBs [integrated joint boards] were aware of their letter would have been helpful.

“In no way would we seek to stifle debate – it’s right that we discuss concerns and issues about how restrictions apply in an island community – but it is difficult to do this if all partners aren’t fully engaged with the experts in the field.”

But Coutts pointed to the responsible approach taken locally back in March when an early outbreak of Covid-19 cases saw the community voluntarily shutting schools and cancelling Up Helly Aa events in advance of a nationwide lockdown.

Some 54 of the 60 cases so far in Shetland occurred in March and April, with seven deaths recorded. But recently the infection rate has been among the lowest in the country – three cases were recorded just under a fortnight ago, but there have been no further cases since.

Western Isles’ cumulative number sits at 30, while Orkney has seen 23 cases.

There has been some dismay within the community since regulations were tightened to preclude visiting households, except in certain circumstances, given the very low prevalence of infections in Shetland in recent weeks and months.

“The social isolation and ability to visit other households is one that’s coming up again and again,” Coutts said.

NHS Shetland chief executive Michael Dickson. Photo: Chris Cope/Shetland News

Anecdotally it appears that many are simply choosing not to observe that particular guideline, and while not encouraging that, the SIC leader acknowledged it was an issue: “Again I’d go back to early doors, the Covid-19 spike and the Shetland community response to that. What they perhaps don’t respond to is measures that might not make too much sense to them at this current time.”

But Dickson continues to point to the rapid pace with which the virus can spread, sounding a reminder that Covid-19 is a “highly contagious virus for which there is currently no vaccine and no cure”.

The return of schools and universities in August and September have seen a substantial upsurge in infections across much of the UK. That has included outbreaks in Aberdeen, Edinburgh and Glasgow – three of the four mainland cities through which people travelling to and from Shetland are passing.

“All it takes is one or two people to come into Shetland or Orkney with Covid and, should we have adopted different rules, it will enable the virus to spread rapidly,” he said.

“It is naïve to think because we live on an island this virus somehow won’t find its way here again. We live in the remotest corner of the UK yet, in Shetland, we were among the first communities in the country to have cases.

“Our response to date has been exemplary and recognised as such; it would be unfortunate if we chose to put this at risk without fully considering the consequences.

“It is right to discuss the impact of any restrictions and how we can manage the situation locally and that needs open communication and a commitment to working together.”