Summary

  • Scotland's Chief Medical Officer, Professor Sir Gregor Smith, gave evidence to the UK Covid inquiry in Edinburgh

  • He said that Zero Covid - a strategy for eliminating of the virus - had not been a viable option in Scotland

  • He earlier told the inquiry that he regularly deleted WhatsApp messages, but that any important information was captured in emails

  • The inquiry also saw a WhatsApp conversation in which Sir Gregor told colleagues to delete messages "every day"

  • The chief medical officer denied there had been a lack of urgency in reacting to the disease in early 2020

  • NHS Scotland chief executive Caroline Lamb earlier rejected suggestions that lessons had not been learned by the time a third wave of infections hit Scotland in 2021

  • Questioned about testing and discharges from hospitals, she says there was not "great data" about who was in care homes

  1. Informal messages 'not seen as secure medium'published at 12:48 Greenwich Mean Time 22 January

    Sir Gregor Smith explains that there was advice given to Scottish government employees which specifically dealt with informal messaging and the need to delete messages on a regular basis.

    He said: "There was also advice we were given in discussion with the then director general, reminding us that official business shouldn't be done within these mediums and there should be regular deletion, partly for security purposes and that it shouldn't be seen as a secure medium."

  2. I regularly deleted WhatsApp messages - chief medical officerpublished at 12:47 Greenwich Mean Time 22 January

    WhatsApp message shown in evidence at the inquiry

    Sir Gregor says informal communications were used to arrange meetings and any information that was particularly pertinent should have been captured in e-mail form.

    Jamie Dawson KC turns to a weekly WhatsApp group where Sir Gregor said to a colleague, who appears to joke about freedom of information requests, "delete at the end of every day".

    Mr Dawson asks: "Was it your practice to delete messages at the end of every day?"

    Sir Gregor replies: "The Scottish government advice in relation to this was not to retain information for longer than was necessary."

    It was also to make sure that any information that was pertinent to decisions was kept on the corporate record, he adds.

    He says his practice was to make sure that any information which was important was captured in e-mail form.

    "My practice was when information was no longer useful it should not be retained," he says.

    The chief medical officer accepts he regularly deleted WhatsApp messages.

  3. Analysis

    Sir Gregor rejects questions around senior clinical advisors' expertisepublished at 12:41 Greenwich Mean Time 22 January

    Susie Forrest
    Health producer, BBC Scotland

    Sir Gregor rejects suggestions from inquiry counsel that there were questions around the credibility of the expertise of Scotland's senior clinical advisors.

    Jamie Dawson KC says there had been commentary around the fact that neither Professor Jason Leitch (a dentist), Dr Calderwood (an obstetrician) nor Sir Gregor (a GP) were experts in public health or infectious diseases.

    But the chief medical officer says he didn't recognise that that had been an issue which was raised at all, and that polling suggested public confidence in messaging from "authentic" clinical leaders was "very, very high".

  4. Chief medical officer: Significant priority given to harms one and twopublished at 12:40 Greenwich Mean Time 22 January

    Professor Sir Gregor Smith

    Sir Gregor addresses Mr Dawson's question relating to the four-harms strategy as to whether harm one remained a priority over others.

    Sir Gregor says: "It certainly appears to be the case that harm one and harm two were given a significant degree of priority during that time period. We recognise that in the initial response, there was a great deal of displacement in terms of other health needs within the population."

    He said that during this period, there was an attempt to try and address some of the unmet needs that existed in the population for other health concerns.

    He continues: "The advice that I gave at that time was advice that was designed to reduce harms one and two as much as possible. It was for other advisors to give advice in relation to harms three and four...which then allowed the policy to be developed and for decisions to be made by ministers."

  5. Decision-makers understood science around Covid - chief medical officerpublished at 12:26 Greenwich Mean Time 22 January

    Jamie Dawson KC asks what was it that gave Sir Gregor the impression decision-makers ultimately understood the science they were given.

    "The questions they asked me," he replies.

    Sir Gregor says the questions from decision-makers became "very insightful" at the start of the pandemic.

    He says they did follow the science, had "a thirst for knowledge" and asked logical questions about things like next steps.

  6. Analysis

    Who is Prof Sir Gregor Smith and what evidence will he give?published at 11:58 Greenwich Mean Time 22 January

    Lisa Summers
    BBC Scotland Health Correspondent

    A GP to trade, Prof Sir Gregor Smith had been a long-serving and low-profile deputy chief medical officer. But two weeks into lockdown he found himself centre stage after the previous Chief Medical Officer Catherine Calderwood was forced to resign for breaking lockdown rules by visiting her holiday home in Fife.

    Dr Calderwood has been excused from giving evidence on medical grounds and so it will fall to Sir Gregor to explain much of the scientific and medical background for decision making.

    What evidence did they follow that saw Scotland follow the lead of the UK into the first lockdown but choose a different path out?

    He may be questioned on the transfer of patients from hospital to care homes, why social care initially had inadequate PPE, and whether guidance was less clear in care homes on how to protect residents from Covid.

  7. Scotland's chief medical officer now faces questionspublished at 11:54 Greenwich Mean Time 22 January

    Caroline Lamb concludes her evidence to the inquiry.

    Chief medical officer for Scotland, Prof Sir Gregor Smith, now takes his seat for the inquiry to face questions.

  8. Why are we having an inquiry?published at 11:45 Greenwich Mean Time 22 January

    The impact of the Covid pandemic is still being felt four years on from the first reports of the virus emerging from China.

    Both the Scottish and UK public inquiries are investigating the response to the pandemic.

    This includes looking at the impact of the pandemic, how decisions to respond to the crisis were taken and how Covid policies were implemented.

    The goal is to establish the facts of what happened during the country's response to the pandemic and then work out what lessons can be learned for future public health emergencies.

  9. 'Lessons were learned' before third Covid wavepublished at 11:42 Greenwich Mean Time 22 January

    ambulance at A&E departmentImage source, PA Media

    Lawyer Heather Alridge says that in October 2021 there were more people in hospital in Scotland with Covid than in the rest of the UK.

    She says ambulances were "stretched to breaking point" and that there were problems with not being able to offload their patients in hospital because A&E were stretched beyond capacity.

    Ms Lamb said this was happening at about the time the Omicron wave hit Scotland.

    The NHS Scotland chief executive says there was a significant extra investment going into the ambulance service.

    Ms Alridge asks whether this showed that lessons had not been learned from the first two waves of Covid infections.

    Ms Lamb replied that "lessons absolutely were learned" and said that the Omicron wave had hit "earlier than we were expecting it".

  10. Was there a two-tier approach to shielding?published at 11:35 Greenwich Mean Time 22 January

    NHS Scotland chief executive Caroline LambImage source, PA Media

    Lawyer, Heather Alridge, goes on to question information previously heard in the inquiry that a "two-tier approach" to shielding began to emerge with the highest risk list of patients being given priority access to services such as online delivery slots and prescription deliveries.

    She asks Ms Lamb whether this meant others, although still vulnerable due to their disability, were then in a second tier without priority access.

    Ms Lamb said: "I don't think there was ever any intention to somehow ration support that was available.

    "Our local authorities worked through their local resilience partnerships, as did many voluntary organisations, around people who weren't clinically vulnerable but would be vulnerable for other reasons."

  11. National system of contact tracingpublished at 11:33 Greenwich Mean Time 22 January

    Questions turn to contact tracing and how decisions were made around its implementation.

    Caroline Lamb says it was important to have this as a national system.

    She says the system was an online, internet-enabled service meaning people could work remotely rather than in a call centre setting which was helpful when setting up the service.

    On the timeline of when contact tracing was implemented, she says: "I think it was a combination of getting to the point where we would have the testing capacity available.

    "My understanding is that the contact tracing, the WHO, would indicate there is a level of transmission within the community, at which point contact tracing is not really viable and not the best use of resources so we have to get back to having a lower level of transmission in the community."

  12. What did we hear in the first week?published at 11:07 Greenwich Mean Time 22 January

    Covid posterImage source, PA Media

    The inquiry heard four days of evidence during its first week in Edinburgh. Here were some of the key points:

    • We learned that the inquiry will aim to establish whether the Scottish government was operating a zero Covid strategy - which aimed to fully eliminate the disease - by late summer 2020. And if not, should it have been?
    • There was evidence that the Scottish government could have legislated to impose a lockdown earlier in March 2020, but decided instead to follow a four-nations approach.
    • Paul Cairney, a professor of policy and public policy at the University of Stirling, said ministers repeated mistakes as they dealt with a second wave of infection.
    • The chief executive of Care Scotland, Dr Donald Macaskill, said some care home residents had died unnecessarily due to the confusion in the early days of the pandemic.
    • Jamie Dawson KC said former First Minister Nicola Sturgeon appeared not to have retained any WhatsApp messages.
    • Ms Sturgeon later said she had handed over messages communicated through "informal means".

    You can read more here: Five things we learned this week

  13. Analysis

    Size of care home had stronger link to Covid deaths than patient dischargepublished at 11:05 Greenwich Mean Time 22 January

    Susie Forrest
    Health producer, BBC Scotland

    Ms Lamb tells the inquiry that although the discharge of patients from hospitals did contribute to the "extremely tragic" death rate in care homes, it was more strongly linked to the size of the care home and the prevalence of Covid in the local community.

    She cited evidence from the Public Health Scotland report while being asked about delays to testing in the social care sector.

    She says that data from the sector was not as good as it was in the NHS, because of the "fragmented" system of local authority provision.

  14. The care homes reportpublished at 10:54 Greenwich Mean Time 22 January

    This is Public Health Scotland report, external Ms Lamb was talking about when she said the size of care homes was a more important factor than hospital discharges in terms of care home deaths.

    It says "care home size has the strongest association with outbreaks of Covid-19, and this association persists after taking account of other care home characteristics including discharge from hospital."

  15. Questions turn to care homes where 'data was not great'published at 10:51 Greenwich Mean Time 22 January

    Heather Alridge, junior counsel for the inquiry, turns to the issue of testing and discharges to care homes.

    Caroline Lamb agrees the majority of deaths at the start of the pandemic were in care homes.

    She explains they did not have as good data as they would like to have had.

    "We did not have great data as to who was in care homes."

    Ms Lamb says they did not know where patients were being discharged to.

  16. Health backlogs 'were building up'published at 10:41 Greenwich Mean Time 22 January

    Caroline Lamb
    Image caption,

    The NHS Scotland chief executive, Caroline Lamb, gives evidence

    Caroline Lamb goes on to address the backlog of other diseases during the pandemic and what their impact on the four-harms strategy would be.

    She says: "We were also hugely conscious of the backlogs that were building up and the fact that ill health doesn't go away and it gets more difficult to treat.

    "Equally I think we were also conscious of the economic impact in terms of the number of people who are economically active in society but also what that means for people as well."

    She says the shift in what the strategy focused on related to the progress of the pandemic, which "went through peaks and troughs".

  17. 'Easier to understand' health impacts vs economic impacts - Lambpublished at 10:29 Greenwich Mean Time 22 January

    Caroline Lamb says it was "simpler" in the early days of the pandemic to understand the health-related harms than it was to understand the social and economic-related harms.

    "Therefore maybe there was more of a focus on just trying to understand what those social and economic harms were," she says.

    She goes on to explain that there was concern for the economic impact of Covid once health services were being remobilised.

    "To characterise us as being narrowly focused on harms one and two doesn’t take into account the fact that we’ve been had a commitment for many years to try and improve health inequalities – critical to that is good jobs, good housing, good education."

  18. Background: The four harms strategypublished at 10:26 Greenwich Mean Time 22 January

    The evidence session begins with an examination of the four harms strategy the Scottish government adopted.

    It sets out the four harms process for assessment used to establish when coronavirus restrictions could be safely lifted after lockdown and the scientific evidence underpinning the decisions.

    Here's a reminder of what they are:

    1. Direct Covid health harms
    2. Broader health harms, primarily the impact on the NHS and social care services
    3. Social harms to the wider society, like harms to the educational attainment
    4. Economic harms
  19. The UK Covid inquiry begins...published at 10:09 Greenwich Mean Time 22 January

    The inquiry gets under way and Jamie Dawson KC tells us the former Chief Medical Officer Catherine Calderwood will not be able to give evidence due to ill health.

    NHS Scotland chief executive Caroline Lamb, who is also the director general of health and social care, is sworn in.

  20. What can we expect today?published at 09:58 Greenwich Mean Time 22 January

    Dr Gregor Smith has been Scotland's chief medical officer since April 2020Image source, Scottish government
    Image caption,

    Dr Gregor Smith has been Scotland's chief medical officer since April 2020

    The Scottish leg of the UK Covid inquiry resumes today, with Scotland's Chief Medical Officer Prof Sir Gregor Smith set to give evidence.

    It comes after the former First Minister Nicola Sturgeon was accused of deleting Whatsapp messages from her phone.

    Ms Sturgeon acknowledged removing messages but says she did so in accordance with Scottish government guidance, that copies of relevant messages were made beforehand and stored in the government's electronic records system.

    Our correspondent Lorna Gordon took a look at what we learned from last week here.

    Click here for a profile on Sir Gregor at the height of the pandemic.