Cancer screening paused to relieve pressure on NHS
●Scans for breast, bowel and cervical halted to free up vital staff and lab time
Vital cancer screening programmes across Scotland have been cancelled as the NHS ramps up its capacity to deal with the coronavirus crisis, including the creation of a temporary hospital in Glasgow’s SEC which could hold 1,000 patients.
Screening for breast, cervical, bowel and other cancers has been “paused” to cut down potential transmission of Covid-19 and to “free up”’ NHS staff and laboratory time to increase numbers on the frontline and ensure quicker testing as infected patient numbers rise.
The cancellation of screening programmes was revealed by Nicola Sturgeon at her daily briefing, where she also disclosed that there had been a further six deaths from Covid-19, taking the numbers to 47.
Overall there have been 1,563 positive cases confirmed, an increase of 179 from the previous day, with 108 people in intensive care, a rise of 13.
Chief Medical Officer Dr Catherine Calderwood said it was now estimated more than 100,000 Scots – one in 50 – are now likely to have been infected.
Ms Sturgeon confirmed that to deal with the expected increase in cases, a
temporary hospital was being constructed within the SEC, although it was still “entirely possible we will not have to use it”.
She said the hospital could become operational within a fortnight with 300 beds, but it could expand to deal with 1,000 patients. However, she stressed that currently there were 3,000 beds within Scotland’s hospitals “already available for coronavirus patients”.
“Our NHS is on an emergency footing and all health boards have been undertaking extensive work across Scotland to maximise the capacity available to manage expected rise in demand due to Covid-19,” she said.
“There are currently approximately 13,000 beds in NHS hospitals across Scotland and health boards are working to ensure we have capacity of at least 3,000 available for Covid-19 patients. They are also quadrupling intensive care unit capacity to 700. We expect this to provide sufficient treatment capacity to meet the rise indemand.asasafeguardand to provide extra flexibility, we have been working closely with the military to plan and build this facility [SEC hospital] which initially will be for use by those who have been through hospital treatment and are recovering from their symptoms.
“I hope this facility will not be needed as, alongside the public’s contributed efforts to stay at home and the steps we are already taking to increase the number of NHS beds, we should have the beds we need.”
Health secretary Jeane Freeman said the SEC had been “assessed as the best option for accessibility, security and established transport links” and would be staffed by NHS workers and run by Jill Young, chief executive of the Golden Jubilee hospital.
Ms Sturgeon also revealed that to ensure the NHS had enough capacity the “difficult decision” had been taken to stop cancer screening programmes. She added: “This is not a decision taken lightly, but it is important to maximise the ability of the NHS to cope in forthcoming weeks.”
The affected programmes are breast screening, cervical screening, bowel home pack tests, abdominal aortic aneurysm screening and diabetic retinopathy screening. Pregnancy and newborn screening will continue as normal.
Dr Calderwood said the decision to “pause” screening had been taken with “careful thought”, and that it was a “balance of risks”.
“There was concern people wouldn’t attend appointments,” she said. “We were also concerned that because of staff absences there would have been a reduced service. The mobile breast screening vans, for instance, would not have been able to be used because of risk of transmission.”
She said staff would now be repurposed, in particular in laboratories to help with coronavirus testing, and that a dedicated helpline would be set up to help people with screening inquiries, but people with symptoms should still contact their GPS.
Tom Berry, head of Scotland at Breast Cancer Now, said the cancellation of screening was “necessary” and encouraged women to call the charity helpline for advice. He added: “The difficult decision to suspend breast screening in Scotland in light of the coronavirus outbreak may cause significant concern for many women and we now need to do all we can to support them through the coming months.
“This is not a decision that will have been taken lightly, but it is a necessary step in both limiting the risk of infection for women of screening age and helping free up emergency resource for the NHS to respond to the crisis.”
Dr Calderwood said she expects the number of Covid-19 cases to “peak” in the next two to three weeks as the impact of the lockdown begins to take effect, and it was unlikely the stringent measures would be lifted early.
Last week she said it was estimated that 65,000 had contracted Covid-19, but yesterday she said: “More than 100,000 people in Scotland will have this virus by today.
“We’re expecting a peak of the virus in around two to three weeks, so I would be pessimistic that there will be any change to these stringent measures. It’s also entirely possible that having lifted the measures we would have to place them back down again, perhaps not all of them, perhaps not as stringently.”
Dr Calderwood had warned that the lockdown could last 13 weeks, but admitted it could be longer, with the Deputy Chief Medical Officer in England warning that measures could last up to six months.
“I would want people in Scotland to be aware that actually this 13 weeks is one figure and it seems a very long time,” Dr Calderwood added. “But unfortunately, unless we really have got this virus under control, we may not even be able to return to normal even after that.”
“As a safeguard and to provide extra flexibility, we have been working closelywiththemilitary to plan and build this facility [SEC hospital]”
NICOLA STURGEON
This Women’s History Month, we remember those executed for witchcraft in early modern Scotland and nearly 4,000 people accused between 1550 and 1700.
Of these, 85 per cent of them were women and a third to a half of those accused were executed.
The Church of Scotland heavily influenced witch hunts, seeing witchcraft as a sin and a threat to Christianity. Suspects would be imprisoned and interrogated with the aim of obtaining confessions, sometimes tortured with sleep deprivation.
During the panic of 1649-50 more than 600 people were accused of witchcraft across southern and eastern Scotland. Six of those were from the parish of Dirleton in East Lothian.
In June 1649 the widow Agnes Clarkson confessed to witchcraft after being held prisoner in Dirleton Castle.
It’s likely she was held in the castle’s pit prison. She was interrogated by a presbytery, or church court, including Johne Makghie, minister of Dirleton.
Agnes confessed that 18 weeks previously she had been visited at her home in Dirleton by a woman from Longniddry who had recently been burnt to death as a witch. She testified that the woman “did use fearefull curses and execrations, intysing the said Agnes to become the devill’s servant.”
Later the same day, the devil appeared to her “in the liknesse of a black dun dogge and went up and doun the hous, and seised upon the said Agnes her cloths, and therafter, turning into the liknesse of a black man, had carnall copulation with her.”
It is unclear whether black referred to his clothing, hair, or skin, but the colour was associated with evil. Through this act she renounced Christ and became, it was believed, a witch.
A few days later, at twilight, Agnes attended “a meeting of the devil and sundrie others with him upon the green of Diriltoun” with the accused telling the court they all danced together.
There she recognised fellow witches Patrik Watsone of nearby West Fenton, his wife Manie Halieburton, and Bessie Hogge. Agnes’s statement was sufficient evidence for the presbytery to instigate a trial.
Manie was likewise held prisoner in Dirleton Castle before being questioned. She had been accused by Agnes and by her own husband, Patrik.
She confessed that 18 years before, when their daughter was sick, the devil had appeared in the likeness of a man. He tricked the couple, “calling himself a phisition (physician)”.
The couple gave him bread and ale and paid him two English shillings for his service.
One morning, when Patrik was out, the devil ‘had carnall copulatioun’ with Manie who was then forced to become the devil’s servant, it was claimed.
Both Manie and Patrik were taken before renowned ‘witch pricker’ John Kincaid in the great hall of Dirleton Castle.
There, he searched their bodies for the devil’s mark, a place on the body that was insensitive to pain and which the devil allegedly marked when he made his pacts with witches.
Kincaid testified that he found the devil’s mark below Patrick’s left shoulder and on the left side of Manie’s neck.
Three further Dirleton women were accused of witchcraft in 1649: Bessie Hogge, who had been seen dancing with the devil, Marione Meik, and Margaret Goodfellow, with all put to trials.
Although evidence of the outcome of these trials hasn’t survived, they were very often a formality, and the witches’ confessions almost guaranteed their execution, usually by strangulation. This is what we think happened to Agnes, Manie, Patrik, Bessie, Marione, and Margaret.
This article first appeared on the Historic Environment Scotland blog