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Due to the prolonged incubation period of COVID-19, it has not so far been possible to report with the accuracy required how many cases of healthcare associated infection (HCAI) involving COVID-19 have occurred in each NHS board.

The normal definition of a HCAI is an infection, not present or incubating on admission, which then arises after 48 hours from admission. Current estimates for COVID-19 suggest a median incubation period from 5–6 days, with a range from 1–14 days. This means that COVID-19 arising before day 14 in hospital may not be HCAI.

Health Protection Scotland (HPS) is however working with UK counterparts, taking into account recent discussions at the European Centre for Disease Prevention and Control, to establish UK-wide HCAI definitions for COVID-19. It is hoped then to publish information about data collected in NHS Boards based on these definitions as soon as is possible, and I will write to the member when this information is available.

Clinical waste is regularly collected from Health Board sites. This arrangement means clinical waste is not stored for prolonged periods.

Information on the number of people who have received cancer treatment in each week since 1 January 2020 is not available yet from Public Health Scotland. Quarterly Information on the number of referrals who started first treatment up to the end of 2019 is available for the ten main cancer sites from the Cancer Waiting Times dataset. The ten main cancer sites are: breast, cervical, colorectal, head & neck, lung, lymphoma, ovarian, melanoma, upper gastro-intestinal (hepato-pancreato-biliary and oesophago-gastric), and urological (prostate, bladder, other). Quarterly information up to end of March 2020 will be available from 30 June 2020 .

That information is not held centrally. Between 1 March 2020 and 27 April, over 97 million items of PPE have been distributed to NHS Boards.

Each board now has a single point of contact for supply and importantly distribution of appropriate PPE to each clinical setting in hospital and to ensure any issues are speedily addressed.

All Health Boards have produced mobilisation plans which set out the steps they are taking to maximise intensive care capacity while maintaining essential services, such as emergency, cancer and maternity care. All Health Boards have now implemented plans to increase ICU capacity to treble their baseline. This increase in ICU bed capacity includes increased staffing delivered through internal redeployment supported by education and training which is being locally provided to meet the needs of each Board. The Chief Nursing Officer issued guidance to all Health Boards to support the deployment of Nursing, AHP, Pharmacy and other staff in Critical Care last month.

Guidance is based on reviewing the available published evidence and informed by expert opinion drawn from a wide range of sources, including from behavioural sciences. Guidance and advice for the public is available through NHS Inform, a substantive media campaign is underway to raise awareness of these resources.

The Scottish Government COVID-19 Advisory Group has discussed this issue and is following the research being carried out on a UK-wide basis by SAGE. Further to this, discussions are ongoing with Public Health Scotland on understanding variance in rates of infection and death from Covid-19 by a range of factors, including ethnic minority status. The four CMOs across the UK are also working with Public Health England to explore the impact of COVID-19 on people from minority ethnic backgrounds.

The COVID-19 data and trend charts for Scotland are published daily and provide a range of information, including the number of care homes notifying cases of COVID-19 and the number of suspected cases of COVID-19 in care homes. These data are available from 11 April 2020 and are updated daily. There are also data on the number of people that have been tested for COVID-19 in Scotland, these are available from 2 March 2020 and provide a cumulative number. There is no breakdown of how many of these tests were for care home staff or residents.

Data are broken down by NHS board for:

• the cumulative number of cases that have tested positive for COVID-19;
• the number of patients in intensive care with confirmed or suspected COVID-19; and
• the number of patients in hospital with confirmed or suspected COVID-19.

The link to the daily data update is:

https://www.gov.scot/publications/trends-in-number-of-people-in-hospital-with-confirmed-or-suspected-covid-19/

The group was first convened on 26 March 2020 and has met every Monday and Thursday since then. Further information about the group, including notes of the discussions which have taken place, is available here: https://www.gov.scot/groups/scottish-government-covid-19-advisory-group/ .

The Scottish Government set out our approach to contact tracing on 4 May in the Test, Trace Isolate, Support Strategy . We will establish an enhanced COVID-19 contact tracing service in every Board. Recruitment and training of new staff will be managed by existing health protection teams who have high quality skills and experience in delivering contact tracing, and of which some are already undertaking COVID-19 contact tracing work. Recruitment has commenced in a phased approach, to introduce as necessary a national contract tracing team managing routine work and supporting local contact tracing teams. Initial workforce education resources for staff supporting the contact tracing programme have been developed in partnership with Health Boards and made available to all Health Boards before 25th May. All staff who will be recruited to undertaken Contact Tracing activity either at a national level or local level, will use these core materials to help ensure consistency across Health Boards in Scotland. As of 18 May 2020, c 680 staff have been identified locally and over 8000 notes of interest have been received nationally, in addition to those NHS returners who are being considered for deployment.