Simulation found 'clear gap' in coronavirus preparedness

An exercise simulating an outbreak of coronavirus in Scotland noted a “clear gap” in the country’s preparedness, according to a report.

The exercise held in March 2018 simulated an outbreak of Middle East respiratory syndrome coronavirus (Mers-CoV) to assess NHS Scotland’s readiness to respond to a suspected outbreak.

The Scottish Government said it published the report this week “given understandable interest in activity around preparedness or planning for infectious disease outbreaks”.

Mers, first identified in the Middle East in 2012, is a rare but severe respiratory illness which can start with a fever and cough and can develop into pneumonia and breathing difficulties.

The table-top exercise, known as Exercise Iris, was delivered by the Scottish Government and involved NHS Scotland boards, NHS 24, Health Protection Scotland and the Scottish Ambulance Service.

Held at a hotel in Stirling, the exercise simulated three different scenarios in an outbreak.

The report said it was recognised the availability and use of personal protective equipment (PPE) would be a “key consideration in the early stages of the outbreak”.

It said the profile of PPE within the day’s discussion “underlined the need for substantive progress on PPE use within Scotland”.

The report concluded: “Amongst frontline staff there is unease at the lack of clarity on PPE availability, training and testing.

“This is a clear gap in Scotland’s preparedness for MERS-CoV and other outbreaks and needs to be addressed as soon as possible.”
Scottish Government ‘Exercise Iris’ Report

“This is a clear gap in Scotland’s preparedness for MERS-CoV and other outbreaks and needs to be addressed as soon as possible.”

One of the scenarios featured “escalating resource requirements for contact tracing and follow up”.

It said: “Board plans will need to have considered this in detail and – as in the previous discussion – national coordination may be required to organise surge capacity and mutual aid.”

In an interview on BBC Radio Scotland, justice secretary Humza Yousaf was asked whether he rejected the conclusion of the report that Scotland was not prepared.

He replied: “No, I’m not. I’m saying the exercise, said ‘well, here are some gaps’ and of course we’ll be looking to address those gaps.

“We have had and continue to have good stockpiles of PPE for example. That was one area that was addressed as potentially being one of the gaps.

“There was certain items of course, because of a global pandemic, that everybody is trying to get at exactly the same time.”

Asked why Scotland was not prepared for the outbreak despite the simulation, he said: “I reject that suggestion that we weren’t prepared.

“First of all, the fact that we’re doing these desktop exercises in itself shows that of course we’re looking to be prepared right across, not just government, but across the public sector if possible.

“And second of all, we had good stockpiles of PPE. Not only do we have and continue to have good volumes of PPE, we’re now manufacturing that PPE here in Scotland.

“But if you’re asking me could we have had a crystal ball, regardless of any desktop exercise to understand every single complication, in relation to a pandemic of this scale, then I’m afraid it doesn’t matter how good your desktop exercise is, it cannot quite prepare you for every single eventuality that a virus of this nature, and pandemic of this nature, brings.”

A Scottish Government spokeswoman said: “As the First Minister said at the briefing yesterday, we have been working right from the start of this outbreak to make sure we had PPE for those who need it and at no point have we run out of any item.

“Since the start of March, over 158m items of PPE have been delivered to hospitals in Scotland.

“Since the beginning of the outbreak, the Scottish Government has worked closely with NHS Scotland to ensure health service capacity, trebling the number of ICU beds and suspending non-urgent elective operations, while vital services continue.

“On contact tracing, we launched NHS Scotland’s Test and Protect system last week with capacity for 15,500 tests and we want anyone who has symptoms to self-isolate and come forward for testing.”