- Asked by: Alexander Burnett, MSP for Aberdeenshire West, Scottish Conservative and Unionist Party
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Date lodged: Wednesday, 16 December 2020
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Current Status:
Answered by Mairi Gougeon on 11 January 2021
To ask the Scottish Government, further to the answer to question S5W-33586 by Joe FitzPatrick on 7 December 2020, whether it will provide the information that was requested regarding how many people who have died as a result of COVID-19 since 1 September 2020 had a post mortem.
Answer
The Scottish Government does not hold this information.
Authorised post-mortem examinations are undertaken for deaths in hospitals by NHS Boards, where the cause of death is unknown, to establish the medical cause of death. Requests for information on hospital post-mortems should be made to NHS Boards.
Post mortems are also undertaken under the direction of the Procurator Fiscal (PF) for relevant cases as part of the investigation into death. This is a matter for the Lord Advocate. Requests for information on PF post-mortems should be made to the Crown Office and Procurator Fiscal Service (COPFS)
- Asked by: Alexander Burnett, MSP for Aberdeenshire West, Scottish Conservative and Unionist Party
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Date lodged: Monday, 30 November 2020
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Current Status:
Answered by Jeane Freeman on 7 January 2021
To ask the Scottish Government at what level of population infection will the COVID-19 testing strategy change from maximising sensitivity to find every possible case in high-volume throughput laboratories to a focus on maximising specificity in low-volume laboratories with high levels of quality control in order to avoid any risk of false positive over-diagnosis and a pseudo epidemic.
Answer
No laboratory test is 100% accurate. The laboratory tests being used to detect the SARS-CoV-2 virus in Scotland are real-time RT-PCR (Reverse Transcription Polymerase Chain Reaction) assays which are the gold standard for respiratory viruses.
The likelihood of false positives arising is dependent on a number of factors such as the overall prevalence of infection in the population, the clinical presentation of disease in the person sampled, and quality of the sampling method.
NHS Scotland Laboratories have a protocol in place to carry out confirmation testing (or repeat testing) in certain circumstances to confirm whether low positive test results should be reported as positive or negative. Public Health Scotland have produced guidance for sampling and laboratory investigations to minimise reporting of false positives occurring: https://www.hps.scot.nhs.uk/web-resources-container/covid-19-guidance-for-sampling-and-laboratory-investigations
UK Government Laboratories (Lighthouse) also have similar quality procedure systems in place to minimise false positives but are unable to repeat test low positive results.
A clinical and Scientific Review of our testing strategy was published on 23 October in light of the latest evidence of the state of the epidemic in Scotland and the latest understanding of testing capacity and demand forecasts in the next three months. We will continue to keep our testing strategy under review in line with the changing nature of the epidemic in Scotland. Further information on the review of the strategy can be found here:
https://www.gov.scot/news/clinical-and-scientific-review-of-testing/
- Asked by: Alexander Burnett, MSP for Aberdeenshire West, Scottish Conservative and Unionist Party
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Date lodged: Monday, 30 November 2020
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Current Status:
Answered by Jeane Freeman on 7 January 2021
To ask the Scottish Government what the cycle threshold is for the polymerase chain reaction process being used for COVID-19 tests processed at (a) NHS and (b) Lighthouse Labs laboratories.
Answer
PCR tests are used to detect the presence of viral genetic material in a sample and the cycle thresholds (Ct) can be used as an indicator of the concentration of viral genetic material in a patient sample. A typical PCR assay will have a maximum of 40 thermal cycles.
Ct values are not directly comparable between assays and may not be reported by some PCR platforms in use. Individual laboratories will hold details of the Ct reached for each individual specimen who will have quality systems in place to ensure the veracity of the results.
- Asked by: Alexander Burnett, MSP for Aberdeenshire West, Scottish Conservative and Unionist Party
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Date lodged: Monday, 30 November 2020
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Current Status:
Answered by Jeane Freeman on 7 January 2021
To ask the Scottish Government how many patient deaths in intensive care units there were between 1 September and 31 October 2020, and how this compares with each of the previous five years.
Answer
The number patient deaths in intensive care units there were between 1 September and 31 October 2020, and how this compares with each of the previous five years can be found in the following table.
Table 1. Number of deaths in Intensive Care and Combined Units in Scotland
(1 September – 31 October for each year from 2016 to 2020).
Year | Number of Unit Deaths 01 September – 31 October 1,2,3 |
2016 | 291 |
2017 | 309 |
2018 | 285 |
2019 | 280 |
2020 | 325 |
1. Data provided is crude deaths - please note that these are not adjusted for illness severity or case-mix.
2. SICSAG compares observed numbers of death against expected numbers of death to allow benchmarking. Expected numbers of deaths for each unit are derived from a validated statistical model (APACHE II). Please view section one of the latest annual report for more information, available at;
Scottish Intensive Care Society Audit Group annual report 2020
Source: SICSAG, PHS
- Asked by: Alexander Burnett, MSP for Aberdeenshire West, Scottish Conservative and Unionist Party
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Date lodged: Monday, 30 November 2020
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Current Status:
Answered by Jeane Freeman on 7 January 2021
To ask the Scottish Government whether it will implement antibody testing of everyone who has been diagnosed with COVID-19 since 1 September 2020 in order to confirm that the diagnoses were correct.
Answer
The Scottish Government is not currently planning to test everyone who has been diagnosed with Covid-19 for antibodies.
There is currently no clinical certainty around what proportion of people may have a detectable antibody response following infection, and also how long detectable levels of antibodies remain following infection. Therefore a negative antibody test result does not confirm that a previous diagnosis of Covid-19 was incorrect.
Polymerase chain reaction (PCR) tests being used for diagnosing Covid-19 detect the viral genetic sequence of the causative virus SARS-CoV-2. These tests are very sensitive and the gold standard for respiratory viruses. They are specific and shown not to detect other coronaviruses and have been tested on large panels of negative clinical samples.
In Scotland we are using antibody tests to improve our understanding of COVID-19, and in the clinical management of patients, where appropriate. Clinicians have the discretion to request an antibody test for an individual if they determine the result will be of benefit to the treatment or clinical management of a patient.
- Asked by: Alexander Burnett, MSP for Aberdeenshire West, Scottish Conservative and Unionist Party
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Date lodged: Monday, 30 November 2020
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Current Status:
Answered by Jeane Freeman on 7 January 2021
To ask the Scottish Government whether positive COVID-19 tests for NHS staff that result in them having to self-isolate have confirmatory retests performed.
Answer
Staff members who test positive for COVID-19 following a PCR test do not require a confirmatory retest.
- Asked by: Alexander Burnett, MSP for Aberdeenshire West, Scottish Conservative and Unionist Party
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Date lodged: Monday, 30 November 2020
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Current Status:
Answered by Jeane Freeman on 7 January 2021
To ask the Scottish Government, aside from statistical modelling in relation to COVID-19, what checks have been carried out to ensure that cross-contamination of a negative patient sample by the positive control synthetic sequence would not be mistaken for a positive whole genome sequence result, and how many control negative patient samples that have been spiked with the positive control synthetic sequence prior to the polymerase chain reaction (PCR) process have had whole genome sequencing.
Answer
NHS Scotland Laboratories are UKAS accredited and thus have quality procedures in place to minimise and guard against cross contamination of samples, and protocols in place to communicate and organise retesting if found to have occurred. Public Health Scotland have provided guidance which can be found here: -
https://www.hps.scot.nhs.uk/web-resources-container/covid-19-guidance
-for-sampling-and-laboratory-investigations
It is not normal practice to spike patient samples with positive control synthetic sequence and then subject them to sequencing. The Scottish Government does not hold information on the number of samples where this procedure has been carried out.
- Asked by: Alexander Burnett, MSP for Aberdeenshire West, Scottish Conservative and Unionist Party
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Date lodged: Monday, 30 November 2020
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Current Status:
Answered by Jeane Freeman on 7 January 2021
To ask the Scottish Government what measures are being taken to validate positive polymerase chain reaction COVID-19 tests with an initial value greater than 25, such as a retest after 48 hours and assuming a false positive if the cycle threshold is greater than the index sample.
Answer
NHS Scotland Laboratories have a protocol in place to carry out confirmation testing (or repeat testing) in certain circumstances to confirm whether low positive test results should be reported as positive or negative. NHS Scotland Labs have instigated a method for ensuring veracity of low positive results and can be found at the following link: -
https://www.hps.scot.nhs.uk/web-resources-container/covid-19-guidance-for-sampling-and-laboratory-investigations
UK Government Laboratories (Lighthouse) also have similar quality procedure systems in place to minimise false positives but are unable to repeat test low positive results.
- Asked by: Alexander Burnett, MSP for Aberdeenshire West, Scottish Conservative and Unionist Party
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Date lodged: Monday, 30 November 2020
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Current Status:
Answered by Jeane Freeman on 7 January 2021
To ask the Scottish Government whether it will provide a breakdown of pillar 1 and pillar 2 positive COVID-19 tests on each day since 1 September 2020.
Answer
The information required is provided through the following link: https://www.gov.scot/publications/coronavirus-covid-19-daily-data-for-scotland/
Pillar 1 is NHS Scotland labs
Pillar 2 is UK Government testing programme
- Asked by: Alexander Burnett, MSP for Aberdeenshire West, Scottish Conservative and Unionist Party
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Date lodged: Monday, 30 November 2020
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Current Status:
Answered by Jeane Freeman on 7 January 2021
To ask the Scottish Government whether the cycle threshold for the polymerase chain reaction process being used by (a) NHS and (b) Lighthouse Labs laboratories for COVID-19 tests is known, and when this information will be made public, in light of it playing a critical role in diagnosis and the development of policy.
Answer
The cycle threshold (Ct) can be used as an indicator of the concentration of viral genetic material in a patient sample; a typical PCR assay will have a maximum of 40 thermal cycles. Ct values are not directly comparable between assays and may not be reported by some PCR platforms in use. Individual laboratories will hold details of the Ct reached for each individual specimen who will have quality systems in place to ensure the veracity of the results.