Dozens of hospital patients who tested positive for coronavirus were sent to care homes as the pandemic began to grip Scotland.
However, a report from Public Health Scotland (PHS) concluded that there was no “statistically significant” link between discharges and Covid outbreaks.
The figures show 78 people who tested positive in hospitals were discharged to care homes between March 1 and April 21. Ten of those patients tested negative before they were discharged while the remainder did not.
Thousands more were transferred without being tested during that period, the report said. Of those 3599 people, only 650 were given tests, with official guidance at that time stating they were only required if symptoms were showing.
The report noted that on April 21, Health Secretary Jeane Freeman said Covid-19 patients being discharged from hospitals to care homes should have given two negative tests before being moved.
Between April 22 and May 31, there were 1605 discharges from hospitals to care homes, with 93% of them (1493) being tested for Covid-19, in line with changes in clinical guidance.
A total of 45 patients did not have a negative test before they were discharged during this period.
Nearly 350 care homes suffered a Covid outbreak between March 1 and June 21, according to the report, with around half of the 4400 virus-linked deaths in Scotland accounted for by the facilities.
PHS said discharges from hospitals did not create a “statistically significant” risk of outbreaks, adding that the size of care homes was a bigger contributing factor.
First Minister Nicola Sturgeon said further work would take place to give a more detailed understanding of care home outbreaks.
She said: “Nothing in it [the report] detracts from the tragedy of the deaths that have occurred in care homes over the course of the pandemic, and nothing ever will detract from the heartbreak of those bereaved.
“Where the report’s conclusions highlight the need for additional measures, we will act on that.
“I want people to know we take this very seriously.”
Opposition politicians, however, said the report revealed a “scandalous dereliction” of public health duties.
Scottish Conservatives shadow health secretary Donald Cameron said: “Families who lost loved ones after Covid-positive hospital patients were knowingly discharged into care homes have been waiting months for answers from this SNP government.
“Today’s overdue report reveals a scandalous dereliction in the provision of public health to some of the most vulnerable people in our society.
“To see people’s worst fears confirmed by these statistics only adds to the need for full and frank disclosure from the SNP.”
Scottish Care, which represents private homes, said the report only told “part of the story”.
Chief executive Dr Donald Macaskill said: “The statistical analysis is thorough and highlights that the risks to care homes in terms of outbreaks are related to the size of a care home.
“This is because larger care homes tend to be nursing homes, dealing with more frail residents and those living with dementia; they have larger numbers of staff members and environmentally because of size present greater risks.
“What is missing amongst all the data and statistics, the numbers and charts, is the story of those who cared for residents in our care homes.
“I hope the researchers can take some time to listen to the experience of staff in care homes where there have been significant outbreaks.
“At the moment we have one side of the story, what is missing is the frontline experience of our care sector and its staff, the voices of those who received care and their families.”
He added: “The report is a reminder of the pain we have all endured. Its insight should become the energy to ensure that the whole health and care system really does support the care home sector in the weeks ahead, that it becomes each of our responsibilities to protect by our everyday action, putting the needs of the residents rather than the protection of any system or organisation at the heart of that shared focus.”