Donald MacLeod: Our NHS is not fit for purpose

IT HAS been yet another nightmarish week before Christmas for Scotland’s struggling hospitality and tourism sectors, in which damaging, unfiltered comments from Public Health Scotland and negative messaging from the UK and Scottish Governments, over the exponential spread of the mild Omicron virus and its possible threats to our stressed NHS, triggered a tsunami of booking cancellations and a tidal wave of customer no-shows, now estimated to have cost businesses a staggering £1billlion in lost income.

Eyewatering losses which, despite the surprising £100 million in government aid unearthed from the back of a Holyrood sofa, a meagre £4.5k per business, will sadly force many businesses to call last orders.

As we continue to descend into an almost inescapable vortex of doom and gloom, with further restrictions and a possible lockdown looming, it was heartening and uplifting to speak, on a personal capacity, with a public health expert, Helen Colhoun, a professor of Medical Informatics & Epidemiology at Edinburgh University. She believes the “blunt instrument of lockdown” with all its attendant harms, is no longer our only route and that another course might be charted.

READ MORE: Omicron rules: Can I still go Christmas present shopping?

Professor Colhoun, a highly respected academic, who has chaired the epidemiology of Covid-19 research cell for Public Health Scotland since the start of this crisis and conducted many studies in epidemiology and vaccine efficacy and safety, emphasised the importance of debate.

A moot point, as there are those amongst us who are so arrogant, scornful and blinkered in their outdated views that they believe that you can only have an opinion or make comment if you are alumni, academic or have string of letters after your name.

Helen and her peers believe that with advances in treatment and medicines they now understand how this virus is spread. She says that the settings that combine high transmission conditions and the most vulnerable people is where the most serious infections are generated. Notably care homes, long stay institutions and hospitals. And here was me thinking it was hospitality, retail, or sports settings.

She adds that there is a massive variation in susceptibility to severe Covid-19 and that vulnerability can be predicted, with more than 85% of hospitalised infections in the double vaccinated now attributed to persons with known risk conditions, whose illnesses can be treated with new antiviral drugs.

Rapid lateral flow tests that allow highly sensitive detection and are more than 99% sensitive in picking up infection is another important advance. Incredibly, though, just at the very moment the Scottish Government and health authorities promote and encourage their use, supplies run out. Last year’s panic buying of toilet rolls has been replaced by this year stampede for lateral flow tests.

Professor Colhoun argues that there should be a shift in emphasis which should be strongly focused on protecting the vulnerable. She suggests:

1) Widespread direct provisioning of lateral flow tests to all households, with supply meeting demand.

2) An enhanced national education campaign on regular self-testing with emphasis on taking responsible decisions to protect the vulnerable.

3) A clear pathway for rapid provisioning of antivirals and other effective treatments for the most vulnerable.

4) Enhanced provision of social and income support to those most vulnerable and their family members during periods of high transmission.

5) A rapid escalation in providing ventilation and air cleaning solutions within health care settings

6) Separately located triage for respiratory infections to take the pressure off acute care hospitals and GPs, in which preventive therapies can be administered.

The Scottish NHS has been run “hot”, at maximum capacity for years, there is no resilience for upsurges in demand. Despite a record £16 billion, 13% of our GDP, one of the highest amounts spent in Europe, we have one of the lowest proportion of consultants, an inefficient procurement and distribution process, a crisis in social care, the ambulance service and on our wards. Complex problems but, as Professor Colhoun rightly says, while we are trying to figure out the solutions, lets now capitalise on what has been learned so far.

In other words, invest and future protect the NHS and make it fit for purpose.

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