Why Scotland’s Covid cases drop is good news for England

Downing Street health experts are hoping that declining Covid-19 infection rates in Scotland signal an impending end to the fresh wave of infections hitting England.

Latest data from the Office for National Statistics shows that infection levels in Scotland have fallen from 2.3% of the total population in mid-September to about 1.3% last week. By contrast, infection rates in England rose from about 1.1% to 1.6%.

England driving UK spike

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Overall, Covid cases in the UK are increasing, with 49,156 reported new infections on Monday – the highest total since mid-July.

But the majority of infections are in England, where health leaders are calling on the government to implement its “Plan B” for coronavirus restrictions to “avoid undermining” efforts to tackle the NHS backlog, said the Financial Times (FT).

At a press conference yesterday, Health Secretary Sajid Javid said the government would not be implementing its plan B strategy for England, which would include wearing mandatory face coverings and advice to work from home, “at this point”.

Although the NHS was already facing “huge pressures”, they were not yet “unsustainable”, he said. But warning that cases could rise to up to 100,000 a day, he added: “If we feel at any point it’s becoming unsustainable… we won’t hesitate to act.”

If “not enough people get their booster jabs” or “wear masks when they really should”, and “if they’re not washing their hands and stuff, it’s going to hit us all”, said Javid. “And it would of course make it more likely we’re going to have more restrictions.”

Scottish success

According to Professor Mark Woolhouse of the University of Edinburgh, the differences in infection levels on both sides of the border – as well as between the UK and the rest of Europe – can largely be explained by two factors.

The infectious diseases expert told The Times that the first is what the paper described as “changing behaviours”, with people in general becoming “more relaxed” about the virus and taking measures to prevent infection. The other is immunity, built up through both natural exposure to the virus and vaccination.

“Both of these forces are pushing the epidemic really hard but in opposite directions,” said Woolhouse. “Even small differences from place to place can lead to quite big differences in trajectory.”

A key behavioural difference between England and Scotland is levels of mask-wearing, said the BBC. Global surveys by YouGov and Imperial College London have found that overall, UK residents are “significantly more likely” to say they are no longer wearing a mask in public than people in Germany, France, Spain and Italy.

Within the UK, the recommendation to wear face masks indoors has been removed in England, while Scottish guidelines still recommend covering up inside.

However, while “study after study has shown face masks can help stop the virus from being passed between people”, said the broadcaster, measuring how much mask wearing reduces an outbreak is “a lot more difficult to pin down”. And despite lower infection rates overall, Scotland has seen a “spike in hospital admissions in recent weeks”.

A separate “plausible explanation” for Scotland’s falling case rates, said The Times, is immunity levels, which have been high enough there in recent weeks for the pandemic to “shrink”.

As the paper pointed out, schools in Scotland returned from the summer holidays three weeks earlier than in England, which may have allowed the “highly transmissible” Delta variant to “rip through schools”. Unvaccinated school children were able to “catch up” with vaccinated adults through natural infection, experts have suggested.

“That wave appears to have passed in Scotland,” said Woolhouse. “Whereas England doesn’t seem to have reached the downside of it yet... I would expect to see it turnaround in England quite soon.”

But not all epidemiologists are “entirely convinced”, said the paper.

Professor Graham Medley, who chairs the government’s Spi-M panel of modellers but “who was speaking in a personal capacity”, told the paper there were no “clear signal of differences in immunity” between the two nations. Differing infection rates could also be explained by “differences in contact patterns”, he said.

Variant of concern

Coronavirus infection rates remain low in Scotland, with 2,768 new cases reported by Nicola Sturgeon’s government on Wednesday. But a new “descendent” of the Delta variation of Covid “is causing a spike in infections” here, said Glasgow-based paper The Herald.

Latest official data suggests that overall in the UK, the new AY.4.2 variant, also known as Delta-plus, accounts for around 6% of new Covid cases.

First Minister Sturgeon tweeted on Tuesday that her cabinet had discussed “the need to monitor” the new mutation.

“More generally, cases here – though lower than few weeks ago – remain higher than we’d like,” she added. “So please take care: wear masks, wash hands, ventilate indoor spaces, and get vaccinated.”