Scotland's route map through and out of the crisis - COVID-19 - Framework for Decision Making May 2020 - The Scottish ...
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COVID-19 – Framework for Decision Making Scotland’s route map through and out of the crisis May 2020
Contents
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Ministerial 1. Current 2. Framework for 3. Phased approach to
Foreword Position Decision Making varying restrictions
4. Partnership 5. Conclusion Annexes
Approach
Scotland’s route map through and out of the crisis 2Ministerial Foreword
Go to:
Ministerial Foreword
1. Current Position
2. Framework for
Rt Hon Nicola Sturgeon MSP
Decision Making First Minister of Scotland
3. Phased approach to
varying restrictions
From First Minister This week we have also seen what the hard work
4. Partnership Approach of lockdown has achieved, with a continuing fall in
As I said last week, we can’t live this way forever. the number of deaths and in the number of people
5. Conclusion We all want to get back to some semblance of in intensive care.
normality – whether that’s seeing our friends and
Annexes family, getting back to work or school, or just But we know the lockdown is doing harm of its
being able to spend our free time in the way we own. It is causing loneliness and social isolation,
want to. deepening inequalities and damaging the
economy.
This document sets out the steps that will take us
there. It doesn’t have all the answers and it doesn’t None of us want it to last any longer than it has to.
set exact timescales. That’s because we are still
learning about the virus. We will have to move So we are setting out the phases by which we
carefully and gradually to ensure we keep it under will aim to ease lockdown. They are gradual and
control and develop the best ways of doing so. incremental and will be matched with careful
monitoring of the virus. We may, at times, need to
Too many people have lost their lives to this hit the brakes on easing. However, it may also be
disease already and we cannot risk another peak – that we are able to ease restrictions faster than
most importantly because that would mean more we initially thought that we could.
deaths but also because it would mean another
lockdown.
Scotland’s route map through and out of the crisis 3Ministerial Foreword
continued
Go to: The biggest single factor in all of this will be how For those who are currently shielded from the
well we continue to observe advice designed to virus these balances will be particularly hard.
Ministerial Foreword control the virus. Continued hand washing, cough We know that the isolation imposed by shielding
hygiene and physical distancing will be essential – over a long period of time can itself harm physical
1. Current Position so too will compliance with our test, trace, isolate and mental health. So before the initial period of
and support system. shielding ends we will set out what comes next.
2. Framework for We will listen to your experiences and seek to
Decision Making This will mean that our workplaces and our public provide advice that allows you to improve your
transport will look different from normal – we quality of life while keeping your risks as low as
3. Phased approach to
have all got used to things being different and it is possible.
varying restrictions
going to be that way for a while.
Our test, trace, isolate and support system – or
4. Partnership Approach
It will also mean that how we see our friends and Test and Protect as we are calling it – is already
5. Conclusion family will be different – we will initially focus on being trialled and it will be a crucial tool in
catching up outside and with physical distancing. controlling the virus. It is an important part of
Annexes our integrated strategy and is crucial for infection
Unfortunately, in some ways, easing lockdown control, shielding and protecting shielders. It is
will also be more complicated than the present critical for specific issues, for example, the return
situation – with the trade-off that we will be to schools. It is absolutely vital that we are all
able to do more. Our messages will necessarily aware of the symptoms of the virus – a high
become more complicated as we begin to ease temperature, or a persistent cough, or a loss of
lockdown measures. But what we are asking you taste or smell – and that we know exactly what to
to do will allow more personal choice. Trusting do if we have them.
each other will be vital, as will recognising that
every decision we take as individuals will have an As we move through the different phases of
impact on our collective wellbeing. easing it is incumbent on us to give you clear
guidance on what that will mean for you. We
will also give you notice as to when changes are
happening so you have time to prepare.
Scotland’s route map through and out of the crisis 4Ministerial Foreword
continued
Go to: As an example of that we will be publishing I know when we see other countries where
guidance in the coming days for key sectors lockdown conditions are already easing that we
Ministerial Foreword of the economy. This will allow employers and are impatient to get there ourselves. But we have
employees to work together and prepare for to move in line with our own circumstances.
1. Current Position starting work again. We will also publish guidance
on travel and public transport. The way we make progress more quickly is by
2. Framework for being open about where we are controlling the
Decision Making The COVID-19 crisis is both complex and virus and sticking closely to the rules that are in
uncertain. We are sharing our plans with you place at the time.
3. Phased approach to
based on our current understanding about the
varying restrictions
epidemic, about the broader consequences of the We all miss our friends and family, our kids miss
crisis for our health, our economy and society, their schools and their friends and it’s a highly
4. Partnership Approach
and about how our responses are mitigating the anxious time for business owners and workers –
5. Conclusion impacts of the crisis. Both the epidemic and our so we must continue to work together to suppress
understanding continue to develop and so we too the virus further and restore a way of life that is
Annexes will continue to develop our plans, to share them as close to normal as possible.
with you and to seek your views on how they
might be improved. We may not get everything in Nicola Sturgeon
this complex and uncertain crisis right first time,
but we will continue to listen and to do everything
we can to improve our responses.
Scotland’s route map through and out of the crisis 51. Current position
Go to: Progression of the virus in Scotland The restrictions that have been imposed have
Our society is facing the biggest challenge of our been extensive but necessary in order to bring
Ministerial Foreword lifetime, with the way in which we live our lives down transmission. They have enabled us to
significantly restricted by COVID-19. The virus prepare for the next phases, where we are
1. Current Position continues to pose a serious threat to public health better able to identify where the infection is,
in Scotland. The Scottish Government is doing to give extra protection where protection is
2. Framework for everything it can to suppress the virus and will needed (shielding the vulnerable and protecting
Decision Making not change restrictions until it is safe to do so. key workers) and to create safer environments
A second surge in infection would cause further (through preparing workplaces and public spaces
3. Phased approach to
harm to our health, society and economy. To judge and delivering Personal Protective Equipment
varying restrictions
whether and when restrictions can be changed, we (PPE) where needed). People and communities
will consider a range of evidence on the progress across Scotland have played an important part
4. Partnership Approach
of the pandemic in Scotland. in this, and continue to do so, including through
5. Conclusion maintaining physical distance and hygiene.
As transmission of the virus reduces, as a However, the virus is still with us, and will be for
Annexes result of effective responses, we expect to some time to come.
see stabilisation followed by a decline in the
observed measures of the epidemic. Our most
recent data for Scotland show there has been
a welcome, sustained decline in new COVID-19
cases, hospital admissions, ICU admissions and
deaths. Data is published every day on the
Scottish Government Coronavirus webpages
https://www.gov.scot/coronavirus-covid-19/
Scotland’s route map through and out of the crisis 61. Current position
continued
Go to: Significance of both the R number and the For now, our advice remains to Stay at Home,
number of cases except for essential work that can’t be done at
Ministerial Foreword There has been a lot of discussion about the R home, going out for food and medicine, or for
number – this is the rate of reproduction and it exercise. When it is necessary to be outside, our
1. Current Position tells us the average number of people that would advice is to stay two metres from people from
be infected by one individual with the virus. If R other households, and to wear a face covering in
2. Framework for is 2, then two people would be infected by one enclosed spaces like shops or public transport.
Decision Making person on average. If R is above 1, it shows that And we continue to recommend thorough and
the virus is spreading in the population and, if it is regular hand washing. These measures helped us
3. Phased approach to
below 1, the virus is declining in the population. break the chain of transmission and reduce the
varying restrictions
number of COVID cases, hospital admissions and
The R value is calculated through modelling deaths.
4. Partnership Approach
the path of the virus, using data on cases and
5. Conclusion deaths and, as such, it is an estimate with a level
of uncertainty. R is currently estimated to be
Annexes between 0.7 and 1.0 for COVID in Scotland. At
the start of lockdown, we think it was between 4
and 6. So that is real and very positive progress.
We’ve also seen our estimate of the number
of infectious people, currently 25,000, start
to fall in recent weeks. It is vital that we keep
the R number below 1 and see the number of
infectious people continue to fall as, if we do
not, the virus will quickly spread again and any
relaxation of lockdown conditions will most
likely have to be reversed. An increase beyond 1
would risk exponential growth in the number of
cases, hospitalisations and deaths causing very
significant harm to Scotland’s health, society and
economy. That is why the Scottish Government is
exercising such care and caution.
Scotland’s route map through and out of the crisis 71. Current position
continued
Go to: Breaking the Chain of Transmission
Ministerial Foreword
1. Current Position
2. Framework for
Decision Making
3. Phased approach to
varying restrictions
4. Partnership Approach
5. Conclusion
Annexes
Scotland’s route map through and out of the crisis 81. Current position
continued
Go to: We are making progress. We will continue to monitor the evidence very
closely and on an ongoing basis. As we hopefully
Ministerial Foreword However, too many people are still dying, and the see more evidence of a downward trend in the
situation in care homes – despite the extraordinary virus, we will consider further changes as set out
1. Current Position dedication of our care workers – remains a serious in this document – but we will do so on a very
concern, so we have to be very cautious in our careful and gradual basis.
2. Framework for approach to transitioning out of lockdown.
Decision Making
There is some evidence that the current R number Box 1: What affects the reproduction number R?
3. Phased approach to
in Scotland is slightly above that elsewhere in The reproduction number (R) is affected by
varying restrictions
the UK, though comparative estimates depend several factors:
on models used and are subject to a significant
4. Partnership Approach
degree of imprecision and variation over time • the underlying infectiousness of the
organism;
5. Conclusion as new data become available. If the R number
is higher, this perhaps reflects the fact that our • how long people who have Covid can infect
Annexes first cases came later than England’s and so we others;
may be at a different – and slightly earlier –
stage of the infection curve. Differing population
• the number of people in the population that
the affected patients are in contact with, and
characteristics of Scotland relative to other parts
how intense that contact is.
of the UK, such as age structure and population
density will also affect the measurement of R. • Assuming there is a level of immunity once
you have had the virus, R should decrease
Our current assessment is that progress, while over time: as people become infected in
real, is still fragile – and that our room for a population there are fewer susceptible
manoeuvre remains limited. That is why we have people left as they are either infected, have
so far stuck with the lockdown restrictions, making recovered, or have died.
only one small change to guidance to allow people • If policies have the effect of reducing the
to leave their homes for the purpose of exercise number of people someone comes into
more than once a day. We also want to have a test, contact with, that would in turn reduce R.
trace, isolate, support system – Test and Protect –
in place before we significantly ease restrictions.
Scotland’s route map through and out of the crisis 91. Current position
continued
Go to: Test and Protect As we lift restrictions, we will need to put in
A key aspect of our strategy is the “test, trace, place public health measures to stop cases
Ministerial Foreword isolate, support” approach – or Test and Protect as becoming clusters, clusters becoming outbreaks,
we are now calling it. We will test people in the and outbreaks becoming an uncontrolled peak
1. Current Position community who have symptoms consistent with that would require a return to lockdown to avoid
COVID-19. We will use contact tracing, a enormous loss of life and an overwhelming of our
2. Framework for well-established public health intervention, to health and care system – that is what Test and
Decision Making identify the close contacts of those cases, who Protect is all about.
may have had the disease transmitted to them.
3. Phased approach to
We will ask those who test positive and their close Learning from our international partners
varying restrictions
contacts to self-isolate protecting themselves and We set out in our Framework for Decision Making
others from transmitting the virus further. We will that we will draw on WHO, European, UK, Scottish
4. Partnership Approach
provide information to the public about increases and wider international expertise to understand
5. Conclusion in transmission and significant clusters of cases. the virus and our responses to it.
And we will make sure that support is available to
Annexes help people isolate effectively. Many countries have begun to lift physical
distancing restrictions and there will be a time
However, it is important to stress that Test and lag between lifting and seeing the impact. It
Protect will be most effective when levels of is important to remember, however, that each
infection are low – lower than now – and stay low, country’s experience of the virus is different and
and that its success relies on all of us knowing and we need to consider Scotland’s population and
agreeing what to do if we have symptoms, and being characteristics as we apply lessons.
prepared to self-isolate when advised to do so.
Scotland’s route map through and out of the crisis 101. Current position
continued
Go to: COVID-19 related restrictions currently in place The physical distancing measures in place in
Scotland Scotland – a mixture of regulations and guidance
Ministerial Foreword The Scottish Government has taken decisive action can be found in the Framework for Decision
to address the pandemic, imposing measures Making: Further Information. As of Monday 11 May
1. Current Position to restrict public gatherings, business activity we removed the once-a-day limit on exercise from
and requiring people to stay at home unless it is guidance.
2. Framework for absolutely essential to go out, in order to protect
Decision Making public health and protect the NHS. The Health
Protection (Coronavirus) (Restrictions) (Scotland)
3. Phased approach to
Regulations 2020 came into force on 26 March
varying restrictions
to allow enforcement of those measures in
recognition of the threat posed to public health
4. Partnership Approach
from the coronavirus. The Regulations, unless
5. Conclusion amended, will expire after a period of six months
from the date they entered into force. They placed
Annexes unprecedented restrictions on the movement of
people and the operation of businesses across
Scotland and have a huge impact on Scotland’s
way of life.
Due to the extraordinary nature of the restrictions
placed on Scottish society, Scottish Ministers have
provided for a statutory review of the need for
restrictions and requirements contained in the
Regulations. Such a review must take place at least
once every 21 days.
Scotland’s route map through and out of the crisis 112. Framework for Decision Making
Go to: The First Minister has set out our intention to The effects of increased isolation can be
be open and transparent about the options for particularly severe for older people, people living
Ministerial Foreword Scotland in tackling this outbreak – that is why alone and people who require support, whether
we published COVID-19: A Framework for Decision at home or in a homely setting such as a care
1. Current Position Making and supporting documentation. This sets home. Harmful effects on the economy can also
out the approach and the principles that will guide impact hardest on families with low incomes and
2. Framework for us, the different factors that we will need to take people who were already experiencing the effects
Decision Making into account, the assessment framework in which of inequality. For example, the impact for women
we will take decisions, and the preparations we who take the disproportionate share of caring
3. Phased approach to
need to make now. responsibilities (paid and unpaid), means they are
varying restrictions
likely to experience particular disadvantage. This
COVID-19 is first and foremost a public health will also be a significant issue for other groups
4. Partnership Approach
crisis, and the measures to combat it have been already disadvantaged in employment terms,
5. Conclusion necessary to save lives. But those measures also particularly disabled people, minority ethnic
cause harm, and can have the most negative groups and some other groups with protected
Annexes impacts on some people in our society least able characteristics. Reductions in community support
to withstand them. We are learning that the harms can disproportionately affect many of these
caused by the pandemic are not felt equally. groups, and the impacts will intensify the longer
the lockdown continues.
Our response to this pandemic must recognise
these unequal impacts. Just as we have sought We have asked those at the highest clinical risk
to shield those most at risk, we must continue to to shield for at least 12 weeks. We do not want
provide additional support for those who need it people to shield for any longer than necessary, as
and seek to advance equality and protect human it has a clear impact on people’s quality of life. We
rights, including children’s rights, in everything will be guided by the evidence in assessing the
we do. continued risks from the virus, as well as people’s
lived experience of shielding and what matters to
them. We will clearly set out the way forward on
shielding in the coming weeks.
Scotland’s route map through and out of the crisis 122. Framework for Decision Making
continued
Go to: Our Framework for Decision Making makes clear • evidence about the impacts of the current
that the way we approach the COVID-19 crisis measures and any relevant wider evidence from
Ministerial Foreword aims to protect those most at risk and to protect other countries and scientific research.
human rights. The measures currently in place
1. Current Position are legally required to be lifted as soon as it is This document sets out some of the ways we are
considered that they are no longer necessary already making those decisions:
2. Framework for
to prevent, protect against, control or provide a
Decision Making public health response to the incidence or spread • We know that school closures are having a
of the virus in Scotland. These considerations, negative effect on many aspects of children’s
3. Phased approach to progress and development, including their
aligning with our overarching commitments to
varying restrictions wellbeing. This will be particularly so for some
human rights, equality and social justice, will be at
the centre of our thinking as we consider options of our most disadvantaged young people. That
4. Partnership Approach is why we are prioritising measures such as
to relax restrictions. As the First Minister said in
the Scottish Parliament on 13 May, they will “run provision of school-based education, early
5. Conclusion learning and childcare, youth work and adult
right through every decision that we take”.
learning.
Annexes
This document shows how we will consider and • We also recognise that in transitioning through
decide on changing restrictions. We will look at the and out of the crisis we need to take a holistic
cumulative and overall impact of those measures, approach to support those families who will
and of ongoing restrictions. We will not consider be more affected than others by the impact
changes in isolation, but in all areas, assessing of COVID-19 and the mitigation measures.
the impacts, positive and negative, across the This means asking professionals across health,
aggregate of decisions and across all four harms. early learning, schools and social work to work
We will consider: together to support families who are struggling,
and working with the third sector to provide
• the scale of impact, in terms of the numbers of
holistic, practical, well-being support for families.
people and businesses likely to benefit;
• whether the approaches will protect and support • During the pandemic, the provision of support
the groups and individuals in society most in within people’s homes may have changed to
need of support, their impact on protected reduce the risk of disease or as a result of
characteristics, and the extent to which they distancing measures. So we are supporting the
would help to reduce inequalities in outcomes; and operation of support services for at-risk adults.
Scotland’s route map through and out of the crisis 132. Framework for Decision Making
continued
Go to: • Necessary changes to the care home sector • We are making plans to restart housebuilding
such as restricted visiting and a pause on – essential if we are to meet our aspirations
Ministerial Foreword normal activities and routines in order to around reducing homelessness – and energy
protect residents, staff and visitors is having a efficiency schemes to tackle fuel poverty.
1. Current Position
significant impact on the wellbeing of residents
and their loved ones. Care homes are first and
• Necessary changes to the criminal justice
2. Framework for system have unfortunately led to backlogs and
foremost people’s homes and it is important that
Decision Making delays which have impacts, particularly on the
we find safe ways for people to reconnect with
health of victims of crime. So we are supporting
3. Phased approach to their families and friends.
the operation of the justice system and have
varying restrictions • Many households are concerned that the increased support for victims. Decisions about
COVID-19 crisis will have a financial impact the operation of courts and tribunals are
4. Partnership Approach on them or their family. We are investing ultimately a matter for the senior judiciary.
£2.3 billion into support for businesses and
5. Conclusion employers, including hardship funds for We will draw on a wide range of data and
self-employed people and the creative and expertise to understand the impacts of the
Annexes tourism sectors, and support for the SMEs who pandemic and the measures to combat it. Scottish
create so much of Scotland’s employment. Ministers have access to a range of professional
advisers and expert groups, both within and
• We know that the essential public health
beyond the Scottish Government, including the
measures we have had to take, are in
Poverty and Inequality Commission and Equality
themselves creating an economic emergency
and Human Rights Commission. We will also
which has had a significant impact on people’s
listen carefully to the voices of those affected to
jobs, living standards and inequalities in our
understand the lived experience on which our
society. We have real sympathy for those who
policies must build.
have had to close their businesses or who have
lost their jobs and we understand the need to
A wide range of research and analysis on
carefully get our economy moving again as
COVID-19 is underway across Scotland. This
quickly as we are able to do that safely and to
includes a programme of work funded by the
help people back into work.
Chief Scientist’s Office (CSO) that enables Scottish
Academic Institutions to research issues arising
from the COVID-19 pandemic.
Scotland’s route map through and out of the crisis 142. Framework for Decision Making
continued
Go to: There is a balance of harms to weigh up in • local services have developed new and
easing or re-tightening any restrictions. Public innovative approaches to reach children in
Ministerial Foreword Health Scotland and collaborators have recently their own homes, including regular telephone
published a paper on the risks of distancing and online contact, as well as practical and
1. Current Position measures negatively impacting on people’s emotional support; and
health, and how to mitigate these wider harms1.
2. Framework for It finds that the interventions in place to lower • our approach to free school meals, working
Decision Making transmission of the virus can themselves cause with local authorities, has shown that very large
a wide range of harms and that building a more numbers of children and young people from low
3. Phased approach to income families can be supported in a range of
sustainable and inclusive economy for the future
varying restrictions ways, including via a ‘cash-first’ (direct financial
will be crucial to mitigating these wider harms
payments) approach.
4. Partnership Approach
In Scotland there are approximately 170,000
people shielding. Around half are over 65 years We will take the chance, as we emerge from this
5. Conclusion period, to chart a better way forward in support of
(14% over 80 years). A quarter of those shielding
live in the most deprived areas of Scotland. all of Scotland. As we move forward we want not
Annexes simply to return to where we were, but to build
Structural inequality causes damage to our society, on the innovative responses seen throughout the
as the impacts of COVID-19 have highlighted. But crisis to build a Fairer Scotland. We will use the
the way we have responded to it as a society has lessons learned during the pandemic to help us
shown there are ways to do things differently: make progress towards our long-term outcomes of
lower, poverty levels, greater equality, inclusive
• our homelessness response focused on ensuring communities and respected and enhanced
everyone experiencing homelessness had a realisation of human rights. Our decisions in
home in which they could safely self-isolate and coming weeks and months will aim to do that.
practise physical distancing;
1 https://www.bmj.com/content/369/bmj.m1557
Scotland’s route map through and out of the crisis 153. Phased approach to varying restrictions
Go to: This route map takes an evidence-led and The Annex provides a table setting out five phases
transparent approach to easing restrictions and ranging from Lockdown to Phase 4 – when the
Ministerial Foreword sets out a phased approach towards the future. virus ceases to be a significant issue, though the
This will inevitably be a future which will not just need for some physical distancing and hygiene
1. Current Position pick up where we were before this pandemic, measures may remain for some time. The phases
but will be marked by the experiences we have contain practical examples of what people,
2. F
ramework for been through. As we move forward over the organisations and businesses can expect to see
Decision Making coming months we will recognise that the impact change over time. They also show some of the
of the virus has not been the same for everyone, things that won’t change for some time to come,
3. Phased approach to
although everyone has been affected. We will take such as the need for enhanced public health
varying restrictions
an approach that takes us steadily towards the measures.
objectives and outcomes set out in the National
4. Partnership Approach
Performance Framework. The examples set out in this table provide broad
5. Conclusion descriptions or examples of the types of changes
The route map provides an indication of the order we will make. They will be refined and augmented
Annexes in which we will carefully and gradually seek over time, including through additional guidance
to lift current restrictions, but does not attempt for people and sectors.
to specify dates for all of the different phases.
Rather, as we move beyond the first phase, Our steps will be careful, gradual and incremental.
future phases will be based on meeting particular Businesses, public services and the third sector
criteria, including those set by the World Health will need time to plan and to prepare workplaces,
Organisation (WHO). processes, supply chains and logistics in order
to introduce any changes safely and effectively.
We will continue to take a cautious approach that In doing so, they must recognise the importance
ensures that the virus remains suppressed, while of the role of trades unions and of undertaking
seeking to restore as much normality as possible risk assessments of workplaces conducted with
when it is safe to do so. We will continue to hold staff and health and safety representatives.
reviews every three weeks as a minimum, to Communities, households and individuals will also
ensure we are on track and to assess whether need to adapt.
we can accelerate or need to decelerate elements
within each phase.
Scotland’s route map through and out of the crisis 163. Phased approach to varying restrictions
continued
Go to: Our plans will need to include assessments of the Assuming no regression in our progress so far, we
steps needed to reverse each option should that believe these conditions will allow a move into
Ministerial Foreword prove justified, necessary and proportionate. Phase 1 from 28 May. Our Test and Protect system
will be in place at the end of May to support a
1. Current Position Conditionality and criteria for moving between move to Phase 1.
phases
2. F
ramework for We will use clear criteria to move between phases To progress from Phase 1 to Phase 2, we would
Decision Making as we ease the restrictions that have been put in need to have seen the R number consistently
place. Every three weeks, we will review and report below 1 and the number of infectious cases
3. Phased approach to
on whether, and to what extent we can move from showing a sustained decline. The WHO six criteria
varying restrictions
one phase to another. It may be that not everything for easing restrictions must also be met. (We will
currently listed in a single phase will happen at work closely with the UK Government to ensure
4. Partnership Approach
the same time. It might be possible to lift some that the fifth criterion is met.)
5. Conclusion measures more quickly while some may take longer
than we envisage now. A single phase may also
Annexes span more than one review period.
To progress from Phase 0 to Phase 1, we will
need to have seen evidence of transmission being
controlled. This would include the R number being
below 1 for at least 3 weeks and the number of
infectious cases starting to decline. Evidence of
transmission being controlled would also include
a sustained fall in supplementary measures
including new infections, hospital admissions, ICU
admissions, and deaths of at least 3 weeks (WHO
Criterion 1 – see Box 2 ).
Scotland’s route map through and out of the crisis 173. Phased approach to varying restrictions
continued
Go to: Box 2: World Health Organisation:
To progress from Phase 2 to Phase 3, the WHO
six criteria must continue to be met. In addition,
Ministerial Foreword Six key criteria for easing restrictions R would require to be consistently below 1 and
1. Evidence shows that COVID-19 transmission there must be a further sustained decline in
1. Current Position is controlled. infectious cases.
2. F
ramework for 2. Sufficient public health and health system
Progressing from Phase 3 to Phase 4 (the
Decision Making capacities are in place to identify, isolate,
final phase in our transition), the virus must
test and treat all cases, and to trace and
effectively have ceased to be a significant issue
3. Phased approach to quarantine contacts.
in Scotland. That might be because, for example,
varying restrictions 3. Outbreak risks are minimized in high an effective vaccine has been developed and used
vulnerability settings, such as long-term care on sufficient scale in Scotland and/or we have
4. Partnership Approach
facilities (i.e. nursing homes, rehabilitative an effective treatment available across Scotland
and mental health centres) and congregate that essentially removed the health risk from the
5. Conclusion
settings. virus and/or transmission is so low that we are
Annexes 4. Preventive measures are established in confident that the virus can be controlled without
workplaces, with physical distancing, the restrictions of Phase 3.
handwashing facilities and respiratory
etiquette in place, and potentially thermal As noted, a resurgence of cases may mean that
monitoring. we have to tighten restrictions again, potentially
reversing back through the phases and their
5. Manage the risk of exporting and importing associated packages of restrictions. We are not
cases from communities with high-risks of planning for this to happen but will respond if
transmission. necessary.
6. Communities have a voice, are informed,
engaged and participatory in the transition.
Scotland’s route map through and out of the crisis 183. Phased approach to varying restrictions
continued
Go to: As part of our collective Four Nations approach, NHS capacity and monitoring
in time we may decide to make use of the We have demonstrated during the Lockdown
Ministerial Foreword assessments made by the Joint Biosecurity phase of the pandemic our ability to mobilise
Centre that was recently announced by the UK extra hospital and Intensive Care Unit (ICU)
1. Current Position Government to inform moving between phases. capacity across our country – precisely to stop
Scottish Ministers will retain decision-making over the health system being overwhelmed. We will
2. F
ramework for any formal movement between levels for Scotland need to retain that ability, in the event of any
Decision Making and the associated package of responses required second peak, and, crucially, ensure that our public
in moving to a new level. health capacity – in particular, to Test and Protect
3. Phased approach to
– is mobilised and able to cope with the level of
varying restrictions
Within Scotland, we are keeping an open mind on transmission in the forthcoming phases.
the potential for regional variation as we move
4. Partnership Approach
through the phases of the route map, if that best And at each one of these careful, gradual, and
5. Conclusion meets the particular circumstances and needs of incremental phases we will monitor the impact of
the geographies concerned. We would engage with the transmission of the virus. As set out above,
Annexes the local communities concerned before taking any we monitor that on a daily basis on core national
geographically differentiated approach to changing surveillance measures of cases, hospitalisations,
restrictions. ICU numbers and deaths. We will continue to
monitor these core national measures. National
surveillance will also continue to include our
ongoing assessment of the reproduction rate of
the virus – R – and, importantly, our estimates of
the numbers of infectious people in the population
and the daily number of new cases. Getting this
latter measure as low as possible is important
for maximising the effectiveness of our Test and
Protect approach.
Scotland’s route map through and out of the crisis 193. Phased approach to varying restrictions
continued
Go to: The Five Phases Lockdown
This section sets out what people can expect in We begin in the Lockdown phase that is currently
Ministerial Foreword the five phases as we transition out of lockdown in place. We set out in the update to the
towards exit from the crisis. We know that our Framework to Decision-Making the various rules
1. Current Position understanding of the epidemic and our responses and restrictions, some set in guidance and some in
to it will develop over time as we progress along regulation, that are working effectively during this
2. F
ramework for the ‘infection curve’, consequently we will need to phase to reduce the virus.
Decision Making continue to ensure that the packages of measures
in each phase remain appropriate. Please note that in each of the following phases,
3. Phased approach to
the rules of the previous phase continue to apply
varying restrictions
The following descriptions of the measures and unless stated otherwise.
changes in each of the phases is therefore valid
4. Partnership Approach
only at the point at which this document was The description of the phases is summary rather
5. Conclusion published. However, the route map is intended to than comprehensive: it will not include every
be a dynamic, living document and so readers will aspect of the restrictions that is of concern.
Annexes need to check on-line for the latest version. And
it is intended to be consultative, reflecting our And the location of changes within the phases
ongoing conversation with the people of Scotland is liable to vary as the evidence develops, for
about our response to the crisis. example, about the progression of the epidemic
– and therefore what is safe to introduce at a
If people, organisations or businesses tell us given point in time – and about the impact of the
that something in the route map, or the phasing, changes themselves.
does not look right – and this is both complex
and uncertain territory – then we will listen and
consider whether any change to our plans is
appropriate.
Scotland’s route map through and out of the crisis 203. Phased approach to varying restrictions
continued
Go to: Phase 1 Seeing family and friends: we are planning in
We are set to move to Phase 1 following the this phase to change regulations to permit people
Ministerial Foreword 28 May end-of-cycle review of the COVID-19 to use public outdoor spaces for recreational
regulations, if the evidence supports that. In Phase purposes, for example to sit in a public space.
1. Current Position 1, the virus would not be fully contained. There We are also planning for one household to meet
is a continued risk of overwhelming NHS capacity up with another household outdoors, in small
2. F
ramework for numbers, including in gardens, but with physical
without significant restrictions remaining in place.
Decision Making distancing required.
To progress to Phase 1, R must have been below 1
for at least 2 weeks and the number of infectious
3. Phased approach to
cases starting to decline. However there would We expect no public gatherings except for
varying restrictions
have been sustained reductions in new infections, meetings of two households and only outdoors
hospital admissions, ICU admissions, deaths (WHO and with physical distancing.
4. Partnership Approach
Criterion 1). Test and Protect capacity will be
5. Conclusion ramped up, with staff being recruited and digital Getting around: Consistent with the reopening
systems being designed. of workplaces set out in this phase, where
Annexes home working is not possible, businesses and
During Phase 1 a number of changes to the rules organisations are encouraged to manage travel
would be made – potentially over more than one demand through staggered start times and flexible
review cycle (after 28 May, the next review cycle working patterns.
concludes on 18 June). Some of these changes
would be to guidance and some to regulations. You will also be permitted to travel short
In addition, a number of public services that had distances for outdoor leisure and exercise but
either been paused or scaled back because of the advice to stay within a short distance of your local
crisis would now be resumed or expanded. The community and travel by walk, wheel and cycle
rules set out in the previous (Lockdown) phase where possible.
apply except as set out below.
International border health measures are set to be
introduced.
Scotland’s route map through and out of the crisis 213. Phased approach to varying restrictions
continued
Go to: Schools, childcare and other educational settings: Workplaces resuming in the following phases
We are planning in this phase to change guidance can undertake preparatory work on physical
Ministerial Foreword so that staff can return to schools and for an distancing and hygiene measures in this phase.
increased number of children to access critical
1. Current Position childcare provision including the re-opening of Shopping, eating and drinking out: In this phase
child minding services and fully outdoor nursery we are planning the gradual opening of drive
2. F
ramework for provision. We are planning to make support through food outlets as well as the re-opening of
Decision Making available to pupils at key transition points, e.g. garden centres and plant nurseries with physical
those due to start P1 or S1 where possible. distancing. Associated cafes (e.g. in garden centres)
3. Phased approach to should not reopen at this stage except for take
varying restrictions away.
Working or running a business: In this phase we
are planning for remote working to remain the
4. Partnership Approach Sport, culture and leisure activities: In this phase
default position for those who can.
we are planning to allow unrestricted outdoors
5. Conclusion For those workplaces that are reopening, exercise adhering to distancing measures and
employers should encourage staggered start times non-contact outdoor activities in the local area –
Annexes
and flexible working. such as golf, hiking, canoeing, outdoor swimming,
angling – consistent with the wider rules and
We are also planning for outdoor workplaces to guidance applicable to any activity in this phase.
resume with physical distancing measures in place
once guidance is agreed. Community and public services: We are planning
the gradual resumption of key support services in
We are also planning for the construction sector
the community. We are expecting to restart face-
to implement the first two phases in its restart
to-face Children’s Hearings and for there to be
plan with a decision to move to ‘phase 2’ of the
greater direct contact for social work and support
construction sector’s plan only after consulting
services with at-risk groups and families, and for
with government to ensure it is safe to do so in
there to be access to respite/day care to support
line with public health advice.
unpaid carers and for families with a disabled
We are preparing for the safe reopening of the family member. All of these would involve
housing market. appropriate physical distancing and hygiene
measures.
Scotland’s route map through and out of the crisis 223. Phased approach to varying restrictions
continued
Go to: We are planning for the opening of Household There will be an increase provision of emergency
Waste Recycling Centres. eyecare in the community.
Ministerial Foreword
Court and tribunal buildings open, with limited We will consider the introduction of designated
1. Current Position business and public access. visitors to care homes.
2. F
ramework for Gatherings and occasions: In this phase we are The Test and Protect system will be available
Decision Making expecting no public gatherings except for meetings across the country.
of two households and then only outdoors and
3. Phased approach to
with physical distancing.
varying restrictions
Health and Social Care: In this phase we expect to
4. Partnership Approach
begin the safe restart of NHS services, covering
5. Conclusion primary, and community services including mental
health.
Annexes
We are also planning on retaining COVID-free GP
services and planning a further scale up of digital
consultations.
We expect to roll out the NHS Pharmacy First
Scotland service in community pharmacies and
increased care offered at emergency dental hubs
as practices prepare to open. We will also restart,
where possible, urgent electives previously
paused. And there will be a resumption of IVF
treatment, as soon as it is safe to do so, and
subject to the approval of Human Fertilisation and
Embryology Authority.
Scotland’s route map through and out of the crisis 233. Phased approach to varying restrictions
continued
Go to: Phase 2 People will be able to drive locally for leisure and
To progress to Phase 2, the virus must now be exercise purposes.
Ministerial Foreword controlled, R must be consistently below 1 and
the six WHO criteria described above must now We are planning for public transport operating
1. Current Position be in place. Any signs of resurgence will be increased services but capacity would still
closely monitored as part of enhanced community be significantly limited to allow for physical
2. F
ramework for distancing. Travel at peak times would remain
surveillance but the risk of spreading the virus
Decision Making discouraged as far as possible.
remains.
3. Phased approach to
During this phase, further changes are made There may be geographical differences
varying restrictions
to ease the restrictions in place and further in approaches to transport depending on
resumptions or expansions of public services are circumstances.
4. Partnership Approach
made. The rules set out in the previous phase
5. Conclusion apply except as set out below. Schools, childcare and other educational settings:
In Phase 2 we are planning for on campus
Annexes Seeing family and friends: In Phase 2, you would university lab research to restart subject to
be able to meet outside with larger groups physical distancing.
including family and friends with physical
distancing. You would also be able to meet people Working or running a business: In Phase 2,
from another household indoors with physical remote working should remain the default
distancing and hygiene measures. position for those who can. Indoor non-office-
based workplaces can resume, once relevant
Getting around: In Phase 2, consistent with the guidance has been agreed – including factories
reopening of workplaces set out in this phase, it and warehouses, lab and research facilities –
is our plan that the default position is for people with physical distancing. We are planning for the
to work from home where possible. Where that construction industry to move to later phases of
is not possible, businesses and organisations are its sectoral restart plan.
encouraged to manage travel demand through
staggered start times and flexible working We anticipate a relaxation of restrictions on
patterns. housing moves.
Scotland’s route map through and out of the crisis 243. Phased approach to varying restrictions
continued
Go to: Shopping, eating out and drinking: We expect that Health and Social Care: In Phase 2, remobilisation
previously closed small retail units will be allowed plans will be implemented by Health Boards and
Ministerial Foreword to re-open with physical distancing in place. We Integrated Joint Boards to increase the provision
are also planning on opening outdoor markets for the backlog of demand, urgent referrals and
1. Current Position with physical distancing, hygiene measures and the triage of routine services.
controls on numbers of people.
2. F
ramework for This phase will see the reintroduction of some
Decision Making Physical distancing: Pubs and restaurants can chronic disease management, which could include
open outdoor spaces with physical distancing and pain and diabetic services.
3. Phased approach to
increased hygiene routines.
varying restrictions
Prioritised referrals to secondary care will begin.
Sport, culture and leisure activities: In Phase
4. Partnership Approach
2, we are planning a reopening of playgrounds We expect to expand the range of GP services,
5. Conclusion and sports courts with physical distancing, and optometry and ophthalmology services and see an
a resumption of professional sport in line with increase in availability of dental services.
Annexes public health advice.
There will be an increased number of home visits
Community and public services: Scaling up of to shielded patients.
public services from Phase 1 where it is safe to
do so. We will continue to plan with COSLA and Scottish
Care and other national and local partners to
Gatherings and occasions: In Phase 2, we plan support and, where needed, review social care
for registration offices to open for high priority and care home services.
tasks. Places of worship would be able to open
for private prayer with physical distancing and Phased resumption of visiting to care homes by
hygiene safeguards. We are also planning to allow family members in a managed way where it is
marriages, civil partnerships and other types of clinically safe to do so.
ceremonies to take place with a limited number of
attendees.
Scotland’s route map through and out of the crisis 253. Phased approach to varying restrictions
continued
Go to: Phase 3 Schools and childcare settings: We are planning
Phase 3 will begin to feel closer to normal. The for children to return to school under a blended
Ministerial Foreword virus will have been suppressed and Test and model of part-time in-school teaching and
Protect working across Scotland means we will part-time in-home learning. Public health
1. Current Position understand where any additional local measures measures including physical distancing will be in
might be required. Many workplaces will already place. Subject to the evidence and progress of the
2. F
ramework for epidemic we expect schools to open on August 11.
have adapted, with physical distancing the
Decision Making
norm. Communities will be fully engaged and
participating in the transition back to a more open We are planning for all childcare providers to
3. Phased approach to
life and economy. reopen subject to public health measures, with
varying restrictions
available capacity prioritised to support key
This phase has a significant number of changes worker childcare, early learning and childcare
4. Partnership Approach
which impact many people, and the planned (ELC) entitlement and children in need.
5. Conclusion changes may need to happen over more than one
review cycle of the regulations. We are planning for a phased return for
Annexes universities and colleges with a blended model of
Seeing family and friends: By this stage, you will remote learning and limited on-campus learning
be able to meet with people from more than one where a priority. Public health measures including
household indoors with physical distancing and physical distancing will be in place.
hygiene measures.
Working or running a business: In Phase 3 remote
Getting around: In this phase you can drive working remains the default position for those
beyond your local area for leisure and exercise who can. Indoor office workplaces including
purposes. Public transport will be operating full contact centres can reopen, once relevant guidance
services but capacity will still be significantly has been agreed and with physical distancing.
limited to allow for physical distancing. Travel
at peak times will be discouraged as far as
possible. There may be geographical differences in
arrangements depending on local circumstances.
Scotland’s route map through and out of the crisis 263. Phased approach to varying restrictions
continued
Go to: Shopping, eating out and drinking: We are Gatherings and occasions: People can meet in
planning for larger retail to reopen with physical extended groups subject to physical distancing.
Ministerial Foreword distancing. Places of worship can open to extended groups
subject to physical distancing and hygiene
1. Current Position Pubs and restaurants can open indoor spaces safeguards.
with physical distancing and increased hygiene
2. F
ramework for routines. Personal retail services including We will relax restrictions on funeral attendance,
Decision Making hairdressers can open (with appropriate distancing marriages, civil partnership and other services to
and hygiene measures). beyond close family.
3. Phased approach to
varying restrictions
Sport, culture and leisure: Museums, galleries, Health and Social Care: We will see an expansion
cinemas, and libraries can open, subject to of screening services and adult flu vaccinations in
4. Partnership Approach
physical distancing and hygiene measures. care homes and at home. All dental practices will
5. Conclusion begin to see registered patients.
Gyms can open subject to physical distancing and
Annexes hygiene measures. All community optometry will reopen with social
distancing safeguards.
Relaxation of restrictions on accommodation
providers (including hotels, B&Bs and holiday Some communal living experience can be restarted
homes). when it is clinically safe to do so.
Live events permitted with restricted numbers and
physical distancing restrictions
Community and public services: Outside of
health and social care, the main changes to public
services will be a further resumption of justice
system processes and services.
Scotland’s route map through and out of the crisis 273. Phased approach to varying restrictions
continued
Go to: Phase 4 Working or running a business: Remote and
In this, the final phase in our transition through flexible working remains encouraged. All types
Ministerial Foreword the crisis, the virus remains suppressed to of workplaces would be open in line with public
very low levels and is no longer considered a health advice.
1. Current Position significant threat to public health, but society
remains safety conscious. All WHO criteria Shopping, eating out and drinking: All types of
2. F
ramework for outlets would be open in line with public health
continue to be met. A vaccine and/or effective
Decision Making advice. Shop local could still be encouraged.
treatment may have been developed. Test and
Protect continues to be fully operational in all
3. Phased approach to
14 Health Board areas. Scotland is open with Sport, culture and leisure: There would be a
varying restrictions
precautions and the importance of hygiene and further relaxation of restrictions on live events in
public health are emphasised. It could be many line with public health advice.
4. Partnership Approach
months, or longer, until we reach this phase.
5. Conclusion Community and public services: Public services
Seeing family and friends: We will expect to see would be operating fully, in line with public health
Annexes further relaxation on restrictions on gatherings advice, with modifications and changes to service
and the continued importance of hygiene and design, including increasing use of digital services
public health will be emphasised. where appropriate.
Getting around: Public transport would be Gatherings and occasions: Mass gatherings could
operating a full service and capacity. Physical resume in line with public health advice.
distancing may remain in place, subject to
scientific advice. All ceremonies could now take place with any
necessary precautions.
Schools and childcare settings: Schools and child
care provision would be operating with any Health and Social Care: The full range of health
necessary precautions. and social care services would be provided with
greater use of technology to provide improved
College and university campuses would be fully services to citizens.
open – including key student services – with any
necessary precautions
Scotland’s route map through and out of the crisis 284. Partnership Approach
Go to: There is an understandable desire to see a plan These ideas and comments are being used to
that will provide some certainty as we move inform the decisions we will be taking on moving
Ministerial Foreword towards the future. However, the reality is that out of the current lockdown. At its heart, the
there is much that we do not yet know about the summary shows that the people of Scotland are
1. Current Position virus and the way in which the pandemic will trying to balance the imperative of tackling this
develop. As mentioned above, not everything will virus with the very human desire to see friends
2. F
ramework for happen in one phase or necessarily at the same and family, to help our economy recover and to
Decision Making time. It may be that we can do some of the things improve our quality of life. There’s also a strong
planned for one phase, but not others. Some things sense of people taking personal responsibility
3. P
hased approach to
may happen more quickly, some will take longer. and expecting that of their fellow citizens, and
varying restrictions
We will also need to monitor Test and Protect in of the balance between asking the government
each phase. to ease the restrictions on their freedom and a
4. Partnership Approach
commitment to take personal responsibility for
5. Conclusion This is the first iteration of a consultative and their role in controlling the virus.
dynamic document. We are listening to the views
Annexes of key partners and stakeholders, to businesses, This is just the beginning of our discussions
organisations and people across Scotland as we with the people of Scotland. The World Health
develop our plans, in particular in advance of the Organization, in their strategy for transition,
next end-of-cycle review date on 28 May. emphasize that “communities have a voice,
are informed, engaged and participatory in the
The people of Scotland transition”. We are committed to that. We need to
We have initiated an open and transparent have an honest conversation about the difficult
conversation with the people of Scotland. judgements we face, and their evidential basis,
That conversation has been supported by the every step of the way. The digital platform is one
publication of the evidence we have relied upon step in a broader public engagement initiative that
to make important decisions about transitioning we are now developing and which will be set out
out of the current lockdown arrangements. Our in future weeks.
online platform was open between 5 May and
11 May and in that time we received more than
4,000 ideas and almost 18,000 comments. We are
publishing alongside this route map a summary of
what we have heard.
Scotland’s route map through and out of the crisis 29You can also read
