Self-isolation advice Glasgow NHS

NHS board gave different Covid-19 isolation advice to councils

Health officials for Glasgow and Clyde issued different Covid-19 isolation instructions to those in place in the rest of Scotland, The Ferret can reveal.

NHS Greater Glasgow and Clyde (NHSGGC) told local councils that identified contacts of Covid-19 cases do not need to self-isolate if they themselves have been infected in the previous six weeks.

The Scottish Government, however, told The Ferret there has been “no change to national guidance on self-isolation,” which does not include a ‘six-week’ exemption.

Opposition MSPs insist that adherence to consistent, national advice on self-isolation rules is essential to controlling Covid-19 infections. They have requested that NHSGGC publish any evidence supporting its differing position.

NHSGGC covers six local authority areas: Glasgow, East Dunbartonshire, West Dunbartonshire, East Renfrewshire, Renfrewshire and Inverclyde.

The board has recorded more than 36,000 confirmed Covid-19 cases, greater than the combined total for eleven of Scotland’s fourteen health board areas.

The Ferret contacted the other NHS boards in Scotland, all of which advised that they follow national advice on self-isolation and do not apply a six-week rule.

‘Advice varies’

NHSGGC was asked to confirm when its advice had been issued, whether it applied only to schools, and whether it had been made public.

The board declined to respond to The Ferret’s questions directly, but issued a statement which said: “Our Test and Protect service carries out individual risk assessments for contacts of positive cases, so advice may vary from person to person when all relevant circumstances are taken into account.”

However, the councils covered by NHSGGC confirmed, both directly and through FoI releases, that they received the new advice.

Internal emails from East Dunbartonshire Council cite NHSGGC advice stating that “if a person has a confirmed positive test and it is subsequently identified as a contact for another positive case, they are not required to self isolate if it is within six weeks of their positive test result.”

Another email refers to this exemption as the “six-week rule”.

Ann Davie, deputy chief executive of education, people and business for East Dunbartonshire Council, said the advice was provided as part of “liaison work” between themselves and the public health protection unit of NHSGGC.

She said: “We work closely with the NHSGGC public health protection unit (PHPU), including regular video-conference meetings and case conferences as required on individual cases, when circumstances of individuals are discussed. This advice was provided as part of that liaison work.”

Davie also confirmed that this exemption has been used, but added this had been the case with fewer than five individuals. However, she also stated that the new guidance “would be followed through all contact tracing activities – within the education sector and in the wider workforce.”

Consistent public health advice on isolating should be in place across Scotland because the virus has no respect for council or health board boundaries.

Monica Lennon MSP

Further material released by Glasgow City Council reveals the new advice has been in place for more than a month.

On 9 November, the council’s head of education, Maureen McKenna, issued an email to all teaching staff regarding “Advice from Public Health”. This communication confirms that the six-week isolation exemption originated from “the director of public health” at NHSGGC.

Glasgow City Council was unable to confirm whether the six-week exemption had been applied in any of the authority’s schools.

Renfrewshire Council confirmed it had made use of the exemption but could not provide specific incidences, stating only that the “numbers will be low”.

A spokesperson for East Renfrewshire Council confirmed it had been “made aware of this potential change in guidance” but said it would continue to follow national rules. The council added: “If any formal change to the national guidance is introduced then we will adhere to this.”

West Dunbartonshire Council said the self-isolation exemption had been used on two occasions.

Inverclyde Council said it was “aware of” the new local rules but confirmed it had not made use of them.

Urgent review

Scottish Labour’s health spokesperson, Monica Lennon MSP, said that Scottish Government guidance makes no mention of a six-week exemption, adding she was surprised that some local authorities are being guided by NHS Greater Glasgow and Clyde “to take a bespoke approach”.

“Consistent public health advice on isolating should be in place across Scotland because the virus has no respect for council or health board boundaries,” Lennon added.

“The Scottish Government guidance is crystal clear that it remains unknown how much immunity people develop after having Covid-19 and how long immunity lasts for.”

She called for transparency over clinical reasons to depart from national advice, adding: “Instead of being secretive, NHSGGC should be open about the instructions it is giving to local authorities.

“We need an urgent review of the advice that health boards and local authorities are actually following and how many times the six-week exemption, or other variations, have been applied.”

Scottish Greens MSP Ross Greer echoed these concerns, calling for the publication of any relevant evidence and arguing for a national approach to self-isolation rules.

He said: “We know that self-isolation is extremely challenging, and the limited information available suggests most people who should be isolating are not doing so. Scottish Government guidance is clear on this and consistently applying it is essential.

“NHS Greater Glasgow and Clyde has not published evidence to support their departure from national guidance. I’ve now asked that this be published immediately.

“Self-isolation is not an area where ‘local flexibility’ should apply. The approach deemed most effective should be taken across the country, without exceptions.”

A Scottish Government spokesperson said: “There has been no change to national guidance on self-isolation however local health protection teams may implement measures which differ from national guidance if it is decided locally, following a risk assessment, that such measures will assist with the handling of specific outbreaks.

“In these instances, people should follow the local health protection team’s advice rather than the national guidance.

“We will continue to review national policy decisions as we continually review the scientific evidence and our understanding of the virus improves, including better understanding antibody longevity and immunity after somebody is infected.”

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