SCOTLAND’s national clinical director has praised islanders for their pandemic response – and issued a reminder about the importance of getting a Covid-19 vaccine, taking regular tests and following national guidelines.
Speaking at Scalloway Health Centre during a visit to Shetland on Tuesday, Professor Jason Leitch said Scotland was now in a “downward slope” following the third wave of the pandemic but could not afford to become complacent.
Six weeks ago cases peaked at over 7,000 in a single day and Leitch took to the nation’s airwaves voicing fear that case numbers could double again within a week.
Thankfully that did not transpire and instead cases have come down, with 2,370 infections recorded on Tuesday.
“That is still too high and a year ago we’d have been locked down for that, but vaccination has completely changed the game,” Leitch said.
“I think Shetland has done really, really well. I’ve visited a lot of the health service today, the care service, and I’ve met nothing but people who are committed to look after the wellbeing of the citizens of Shetland.
“The population of Shetland now understand much more about the virus than any of us did 18 months ago. We know how to protect ourselves and protect each other: get vaccinated, test twice a week and follow the guidelines.”
So far the return of further and higher education does not appear to have caused “a big blip” and Leitch believes the country is now “in a good position”.
He said the main thing keeping him and other healthcare professionals awake at night was the danger of further pressure on NHS Scotland when those working in the service are tackling Covid-19 cases along with a treatment backlog while heading into the winter months.
Leitch remains wary about the risk of importing a new variant that could potentially evade the protection offered by vaccination.
He said there appeared to be a split between optimistic virologists, who see the dominant Delta variant representing the peak “fitness” of Covid-19, and more pessimistic virologists who believe there is a real risk of a “vaccine escape variant”.
Leitch expects some “baseline mitigation” including limited distancing measures in settings such as healthcare, hand gel and face coverings in some indoor settings to remain in place over the winter.
“I think in the spring things will begin to change, and it will depend entirely on what happens. I don’t think we’ll wear face coverings in this country forever, I think we might get into the habit of not going to work with coughs and colds, maybe wearing face coverings if we’re feeling a bit poorly.”
As to why Scotland has fared so badly in terms of case numbers during the third wave, Leitch believes it is partly down to lower immunity within the population having had a “better 18 months” relative to other parts of the UK, though vaccination has since eliminated the variation in immunity.
Meanwhile, Leitch was also full of praise for the efforts of Scalloway Health Centre to put in place a new model for managing patients’ long term health conditions, such as diabetes, heart conditions and high blood pressure.
The village practice is part of a pilot for the “house of care” model whereby surgeries take a proactive approach, contacting individuals and their families to ensure they are able to access the most appropriate level of care for their conditions.
Leitch said it was about “trying to catch deterioration long before it happens”, involving patients in decisions and making sure they are routed to the most appropriate level of care for their condition.
“What you need is sometimes a pharmacist, a dentist, a healthcare assistant – it might be a GP, but if you’ve got a mental health problem…what you might need is a community support worker, or a walking group, or a book group.
“It might be the GP at some point to make those choices for you… [if you take] a more rounded approach to health and care, you’ll get better outcomes.”
Leitch said that while the Daily Mail might characterise such an approach as being about “rationing GP time”, the reality is that NHS Scotland has a duty to use its resources as efficiently as possible.
He accepted it would take time for particularly older generations, many of whom instinctively want to see a doctor when they feel unwell, to understand that it makes sense to “get the GP to do only what the GP can do, the pharmacist to do only what the pharmacist can do”.
“You can only do that over time by proving we haven’t taken anything away, you can still get you prescriptions, come for your GP visit, but we’re going to replace that with a better system that’s more responsive – you’ll get the appropriate care and you won’t have to wait for three referrals.”
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