Health risks and civil liberties – the real lessons from Catherine Calderwood breaking her “own” advice

April 6, 2020 Nick Kempe 17 comments
The car park in Pollok Park, Glasgow. This was closed towards the end of last week. I had been running in the park every day and the car park had been far less crowded than usual with most people walking, running and cycling there. For some, however, a car journey enabled them to enjoy the Park, which was much less crowded than Queen’s Park which is close to where I stay. There is no justification for closing car parks like this.

I will come to National Parks later, but Dr Catherine Calderwood is no fool.  She didn’t get to become to be Scotland’s Chief Medical Officer by not have a clue about how viruses work.  Her drive to Fife, her stay overnight in her second home and subsequent resignation tell us, I believe, four things:

  • First that driving your car on a one hour journey, whether round the town or out into the countryside is NOT going to spread the COVID 19 virus.
  • The second is that is that both she and the Clinical Director of the NHS, Jason Leitch, in an interview afterwards, stressed that she had kept to the social distancing rules.  That is what really matters in this crisis.
  • Third, a more subtle message, Catherine Calderwood knew that a change of scenery would be good for her and her family.  So important for their well-being in fact that, as it later came out, she had also taken a break the previous weekend.
  • Fourth, and following from the previous three points, the health messages being put out by the state are political and not health based.

This post takes a look at at the implications of all four lessons and, while our National Park Authorities, like many other organisations,  become almost irrelevant in the current crisis, briefly touches on how they could be responding.

Travel by car is not what spreads COVID 19

Cars are not what spreads the Coronavirus, as long as people from different households don’t share the same vehicle. In terms of the risks of spreading COVID 19, travel in a car is as safe as being at home.  Its what happens when you get out that matters and, as Catherine Calderwood stressed, she and her family followed the social distancing rules when she got out.   There is NO health reason therefore why anyone should be banned from travelling to a second home or somewhere else in a car as a consequence as long as you can observe the the social distancing rules.  , stay in it till you can!.

Cars are thus totally different to public transport where you have no choice but to travel with other people who may or may not be carrying COVID 19.  Its transport systems where people are cooped together for lengthy periods – the science says 15 mins is the important risk threshold – that has spread the virus around the world.  In that respect the failure of our governments to shut down the airlines and to enable people to travel on public transport while observing the social distancing rules are what really matters. Part of the explanation for the extent of the crisis in London comes down to the London tube and crowded commuter trains into Glasgow will have played a similar role in Scotland.  The UK government has been victimising young people for lying out in the sun while failing to stop the virus spreading through the earth below (and indeed as the news revealed today people are still flying in from America without being put in quarantine).

The lesson, for all those who enjoy our National Parks and the wider countryside, is that there is NO reason for you not to travel TO or WITHIN rural areas if, at the end of the car journey you can get out of your vehicle and observe the social distancing rules. That’s true whether you are stepping out into a second home, as Catherine Calderwood did, into a self-catering cottage or going for a walk in the countryside. If your destination, say a car park in on Loch Lomond, is too crowded to observe the rule either stay in your car till people have dispersed or go somewhere else.   Simple!

Yet what’s happened over the last ten days is that all over the country measures have been taken to stop people travelling anywhere by car.  The Scottish Government has shifted from saying it was perfectly fine for Prince Charles to travel to Balmoral to saying no-one should travel to their second homes.  The Coronavirus (Health Protection) (Restriction) (Scotland) Regulations 2020 specifically exempted car parks from closure but what’s been happening over the last week is that Public Authorities and landowners have taken it upon themselves to block off car parks across the country and there is even some evidence of public roads being shut (see Iain MacWhirter’s fine piece on his drive to Glen Coe last week and how we could soon be living in a police state here).

Some of this is unlawful, and all of its unhelpful because it’s concentrating people into ever smaller spaces.  That is exactly the opposite of what we should be doing to halt the spread of this virus.

 

Being outside is NOT dangerous – as long as social distancing rules are observed

Closure of Great Glen Way.  This is unlawful

Accompanying the closure of carparks signs have been going up all over the countryside telling people not to take access.   There are even signs from farmers telling people not to come onto their land because if they catch Covid 19 all food production will stop.  We are back to the Foot and Mouth crisis of 2001 where the countryside was closed down for months, completely unnecessarily – vetinary advice was that restrictions should have only affected areas with outbreaks, not the whole countryside – and with serious social and economic consequences.

So what Catherine Calderwood said in justification of her journey is crucial, she knew it was not dangerous because she and her family could observe the social distancing rules.  The implication, if you think about it, is that the countryside is the best place we could go yet we are closing it down.

The stupidity of this was epitomised to me on Friday on BBC Scotland’s “Nine” where police officers were shown charging into a river to remove an angler.  That man was probably in the safest place he could be.  There was absolutely no chance of even a solitary walker absorbed in thought breaching the social distancing rules for a second, yet he was arrested and in doing so the police breached ALL the social distancing rules.  If you had tried to describe a dystopian authoritarian state three weeks ago, this would be it, but here we are.

Angling of course, like sitting in the sun, has been made illegal by the Coronavirus Regulations because its not “exercise”.   While I believe the police should be using a bit more discretion and commonsense in cases like this, the problem is the law.  It is truly disastrous that the Scottish Government ten days ago copied the UK’s Coronavirus Restriction Regulations, which were designed for London, and applied these to Scotland where there is lots more space.   There is no rational reason to criminalise people for going outdoors to undertake activities where they can observe social distancing.

Even in crowded London, the threat of transmitting Covid 19 outdoors could have been far better managed.  Closing crowded parks, as the authorities have done, makes matters worse, not better as it concentrates people in the remaining open places.  At the weekend there were photos in the media of people sitting on the grass in London Parks. To me, almost all of them looked well spaced, i.e people were trying their best.  However, if public health experts are worried about people sitting 2m apart from others for longer periods than the 15 minute risk threshold, then rather than threatening to remove people’s rights to go out of their homes even further, which is what Matt Hancock the UK Health Secretary is doing,  the rational response is to bring out further social distancing guidelines.  For example, to supplement the core 2m social distancing rule there could also be guidance that says when stationary in the outdoors keep 5m apart (as the angler in the river was doing!). That would enable people to sit in the sun safely or have a picnic.

What’s then needed on top of this is that in busy outdoor places, like London’s parks, and certain visitor hotspots in Scotland, appropriate management measures are put into place.  Unfortunately, this is being left to the police, when what we need is people like countryside rangers and park wardens to help do the right thing (although the police could help if they offered advice instead of being instructed to enforce these draconian laws).  As I argued in a previous post (see here), in Scotland we could be taking on temporary rangers to help with this and our National Parks could be showing the way.

 

The importance of getting out for mental well-being

When Catherine Calderwood went with her family to her second home for the weekend, she was doing what she knew was good for her and a family. Stressful job, difficult week, the last thing you want is to be in a restricted space, even though I suspect her accommodation in Edinburgh is likely to be bigger than most people have.   I suspect too her second home may have had a garden, in other words giving her and her family some space to get out and recuperate.  What’s good for the CMO and her family is good for the rest of us and, when all the places that people normally go to get out (from other people’s houses, to pubs and cafe, to concert halls and theatres) are necessarily closed, being able to get outdoors in particularly crucial.

I have just received through the door a letter from the UK Government – it appears we no longer have any devolved government in Scotland – saying I MUST stay at home and only go out for exercise once a day.  That contravenes everything what we know about mental health and well-being and indeed the Chief Medical Officers’ own guidance on Physical Exercise (extracts in my last post on the corona crisis).  For people living in flats, rather than houses with leafy gardens, its an absolute disaster.

The draconian Coronavirus Regulations only allow us to go out for physical exercise, not for our mental health and well-being.  Activities that are covered by Access Rights that don’t involve exercise, such as sitting in the sun, birdwatching or having a picnic have become criminal offences. So have other activities that take place in the countryside and are not covered by access rights, such as trail biking, angling or motor boating.  Besides standing in a river like an angler, I can’t think of a safer place to be at present than a boat on Loch Lomond or a tent in the middle of the Cairngorms.

Last week David Attenborough, no less,  talked about the importance of the “solace of nature” during  this crisis.  Ironically, this was just as our governments were making this illegal for most people who don’t happen to have large private gardens to take any solace in nature at all.  I know who I would rather trust.

So, as a start, let’s make all activities that are covered by access rights legal again by removing the restriction that only allows people to get out for physical exercise.  That would enable all those staff working for in the NHS and other services to get out and recuperate, just as Catherine Calderwood appears to have done at the weekend.

The politics of health messages

Unfortunately, what the Chief Medical Officer tells says to the public is not just governed by medical science, its also governed by politics.  Doctors like Catherine Calderwood do not get their jobs by just providing medical advice, they do so by telling politicians what they want to hear.  The best example of this is the failure of our CMOs to speak out about the impact of cuts on the NHS and how this might affect the NHS’ ability to respond to a crisis like a pandemic (or say a nuclear accident on the Clyde).  That of course has contributed greatly to the current crisis.  As another example, public health doctors continue to be sidelined in this crisis and our governments, both in the UK and Scotland, continue to have no plan for how they will get us out of lockdown.  More specifically they have done nothing to set up the teams that would be necessary to conduct contact tracing despite the calls of public health experts (see here).  Which doctors and scientists get listened to, that’s political.

With politicians also under pressure to be seen to be doing everything they can to reduce the number of deaths, many of which result from their failure to act in time,  we then have Chief Medical Officers telling us to do things that they know are not necessary to prevent the spread of the virus.   The proof of that is Dr Calderwood’s visit to Fife.  I am not saying  we don’t need to have restrictions, we do, but at present these restrictions are about social distancing and the closure of indoor venues, not leaving the house.

There is, I believe, another element at play here, our rulers don’t trust the people.  So Dr Calderwood could rationalise to herself advocating things she knows are not needed on the basis that because it it would need a bit of effort to manage popular areas in the countryside, for example, the easiest thing to do is shut it down.  That possibly explains why Dr Calderwood, instead of taking the opportunity of being found out to admit that the rules are over the top, tried to buttress the status quo in her resignation statement:

The most important thing to me now and over the next few very difficult months is that people across Scotland know what they need to do to reduce the spread of this virus and that means they must have complete trust in those who give them advice.  It is with a heavy heart that I resign as Chief Medical Officer.”

Dr Calderwood’s own actions show that the last thing we need to do is have complete trust in our governments.  All our government’s advice and the measures it puts in place to respond to this crisis need to be subject to open and critical scrutiny and the testimony of one health expert critically compared with the testimony of others.  Let’s separate what’s necessary to prevent the health disaster from getting worse, from what’s not and will have other consequences for people’s health.  That’s even more important now our governments are talking about social distancing going on for months, not weeks.

What needs to happen

I would like to see the Scottish Parliament, which last week successfully prevented the Scottish Government’s attempt to abolish trial by jury, subjecting the “The Coronavirus (Health Protection) (Restriction) (Scotland) Regulations 2020” which introduced some unnecessary and draconian measures to critical scrutiny.  As part of that they could  cross-examine Dr Calderwood about what her trip to Fife says about what the real risks are.

At this stage I believe their focus should be on:

  •  Why the Scottish Government has simply copied the restrictions that were adopted by the UK Government, which appear designed for London, and how Scotland could take a different approach
  • Amending the legal restrictions in the Regulations so that people can go out from wherever they are living for their mental well-being, as well as physical exercise.  In effect that would restore access rights.
  • Enabling people to travel by car, whether those living in town or rural areas, for a reasonable distance (say 1 hour, following Dr Calderwood’s example) to get into the outdoors.
  • Alongside this, putting a duty on public authorities to keep car parks and toilets open and to develop plans for any places or paths that they think might get too crowded for people to observe the social distancing rules
  • Giving a clear message to Access Authorities that all the unlawful signs currently going up in the countryside come down as a matter of urgency.  Since the current procedures are so cumbersome, any new regulations could include new powers for access authorities to remove such signs without consultation

Our National Park Authorities, the Scottish Countryside Rangers Association and organisations like the Ramblers and Mountaineering Scotland could then play a key role in making this happen.

An approach such as I have outlined is obviously needed if we are to re-open the countryside again  What Dr Calderwood’s visit to Fife tells us is that we could safely be doing this now the for physical and mental health of the population as a whole.

17 Comments on “Health risks and civil liberties – the real lessons from Catherine Calderwood breaking her “own” advice

  1. The policy of not travelling anywhere in the countryside is completely over the top for all the reasons you give, Nick, but ij my view not if it’s going to involve overnight stays. People in rural areas are angry and worried that a holiday home /self catering accommodation occupant who was fine when (s)he left home may become ill, need admitting to hospital and add to the demands on an already overburdened health service in that area. Unless people going to the countryside for more than the day bring absolutely all their food with them they will be increasing the already inflated demands on shops.
    However, Catherine Calderwood had to go because she is no ordinary second home owner, but the spokesman for the Scottish/Uk government’s conronaviru policy and had ignored that very policy not once, but twice. A policy to which she’d been castigating us daily to conform. By flouting it twice she had stripped it of any credibility it might have and undermined public trust in her office.

    1. Hi Susan, I appreciate the pressure on local health services and my piece wasn’t saying overnight stays should re-start immediately, but I think the risks of visitors being a burden on health services are exaggerated. Boris Johnson took ten days between feeling ill and being admitted to hospital (there are exceptions of course like the nurse who dropped dead after getting back from work). The Boris case is I understand by far the most common so people starting to feel ill could travel home and I am sure almost all would want to partly because hospitals are bigger but also to be near families. Nick

    2. Where do I start why would rural people be angry about the people that make their (windows fuel phones washing machines cars chainsaws everything)becoming infected after they travelled to a loch to relax why would they be worried about their local rural hospitals (there are no rural hospitals) your last point about food is also irrelevant as most people prefere the vast extravagant selections way cheaper than rural convience shacks as for cc if she had a spine and a brain she would have admitted her response regarding travel to outdoors as no longer required as I’ve been checking weekly and see no harm in fact my conclusion would be that everyone in Scotland gets out to battle the nationwide vitiam d deficiency

      1. There’s a hospital in Fort William that serves the rural hinterland as well as the small town itself . Oban has a similar one . Just two examples .

  2. Thought the peace was a good read and highlighted the anomalies that the STATE have endeavoured to implement. As for getting the VIRUS it can happen anywhere but it doesnt hit you all in one go. You will have the so called symptions which gives you a clue that you need to be at home. Unlike Prince XXXXXX who knew he had symptoms but didn’t stay at HOME. There is no reason for someone to go outdoors responsibly it’s the others who act irresponsibly are the problem such as PRINCE XXXXXXX

  3. I totally disagree. This article is basically saying if you are middle class and have a car, fill your boots. If you don’t have a car and live in a city, XXXX you and stay in doors. The lock down strategy we have adopted only works because everybody plays by the same rules. No one is made to feel that they are ‘missing out’. If everybody starts going out again then you end up with a situation where social distancing is essentially impossible and rural communities and infrastructure gets put under unnecessary strain. Imagine being an NHS doctor in the Highlands who volunteers for a mountain rescue team, you get home exhausted from a 12 hour shift and instead of going to bed you have to respond to an emergency up Ben Nevis because some XXXXX from the central belt has decided that their mental health requires them to go hill walking. What Calderwood did was selfish, hypocritical and totally unforgivable. Yet another example of one rule for the elite, and another for the rest of us.

    1. Actually, Henry, as the article I hope makes clear the biggest mental health issue is for people without leafy gardens, the people who are living in the tenements and tower blocks round where I live many of whom don’t have cars. For all of them local greenspace is vital but the problem at present is that in some places this greenspace is getting crowded and there has been no attempt to manage it. If people who do have cars could get out to the countryside the people who don’t could spend much more time in our local parks. We need to disperse people not concentrate them and until we find a safe way to get public transport going again, the car is the one safe way of doing this. To claim that social distancing is “essentially impossible” in the countryside is totally wrong. If its possible to do social distancing in shops its a thousand times easier to do it in the countryside. The likelihood of someone going for a walk in the countryside – which was up until a few weeks ago promoted across the country as one of the best things we could do for our physical and mental health – creating demand on rural health services is minute. That doesn’t mean to say that it might not be sensible at present to limit some activities where there is a high accident rate, most obviously mountain biking, but actually people undertaking such activities had already been producing guidance on this, only to have it overturned in the centralised top down solution. I met someone yesterday in my local park who had been doing 12 hour shifts during the crisis and, comopletely unprompted by me, they were bemoaning the fact that they couldn’t drive out after work to somewhere quiet and take a walk. Are you really saying that all those health staff working so hard for us should be confined in their homes too once they leave work?

  4. Least those that are landed are not getting the blame for a change.
    Anyway back to the discussion.
    1. Social distancing or whatever you wish to call it. We all know that there are honeypots for outdoor recreation, where after folk may have driven for2 hrs or whatever they are simply not going to say ” oh look that carpark does not have 2 m apart, those toilet facilities look spotless etc, we will just drive home”
    Aye right. Get with the game this is to reduce the CHANCES of spread.
    2. If you are unfortunate to have an incident that requires a response, the current situation is meaning resources are committed for longer than previously due reducing the CHANCES of spread.
    Whilst we are are aware of civil liberties and the risks to them, personally I would rather welcome everyone back wheñ the risks
    CMO maybe was good at here job but she and probably her husband had a poor understanding of human nature, maybe not middle class entitled human nature right enough.

  5. Some farmers in South Lanarkshire are taking advantage of the situation by blocking lay-bys and other possible parking spots. The nature of the barriers is clearly intended to be permanent!!

  6. Excellent article. For the record Earlsferry is served by the Victoria Hospital, Kirkcaldy – it has an A & E Department. It is politically inconvenient to promote the car since car ownership is seen as privileged. Again, for the record, the regulations are the Health Protection (Coronavirus) (Restrictions) (Scotland) Regulations 2020. The other point to note is that all you need to have to leave your house is to have a reasonable excuse (section 8 (4)) – going fishing appears to me to be reasonable, but it is debatable. Some people might think that going for a run is not a reasonable excuse, but even if they are correct section 8 (5) has specifically made “taking exercise, either alone or with other members of their household” a reasonable excuse, along with 12 other excuses. Finally the regulations do not require anything to be “essential” nor do the regulations require social distancing in outside locations (social distancing is only encouraged in premises which are open to the public, such as shops, crematoria, hospital canteens, food banks etc.).

    1. Hi Sandy, you are spot on here but the problem is the politicians keep ramping up the interpretation of what is allowed day by day – hence no soon were the regulations introduced than they started to define what essential meant. Catherine Calderwood definitely ignored her own guidance last weekend but whether she did the week before was a moot point. Nick

  7. How many old people who were living solitary life’s because of old age and are now dead. Having died because of the home carers going to their homes now a care workers died the press are not asking the right questions. You Nick do ask the right questions. You got it spot on about Catherine Calderwood your four points and its the Scottish government under Nicola surgeon who calls the shots .Sturgon wanted to have trials without jury she was stopped sturgon is a solicitor whats that say about her not long ago Glasgow had a chief constable called Seven house and this idot stop Tens of thousands of drivers daily stoped ad searched as many people as they could even children under ten years of age put guns in the hand of police officers with out the consent of the Scottish government many police officers resign rather than work under him I suspect the same will again police officers resign rather than pull anglers from rivers last week some one jet ski down loch lomond this will be the start of unrest and rightly so but if the police have taken away his jet ski will they take Catherine Calderwood second home People should and can use their own cars The Scottish government said they help but they not freezed our council TAX. Draconian rules Sum up Scotland for years scotts say their friendly no their not they want the money only for years they have blocked laybys put rocks across parking spots keep asking the questions Nick our press dont

  8. A thought provoking article, Nick. It would be interesting to find out what advice the medical experts actually gave our politicians on minimising social contact to reduce the spread of Covid-19. I believe the problem is that our politicians decided that they couldn’t trust their electorate to behave logically and responsibly and so the rules (guidance) they laid down are based on the lowest common denominator. Yes there will always be some people who will think that they are invincible and above adopting sensible guidance, both in the cities and in the countryside – so the politicians introduced strong and simple rules. Our Scottish Government has been building a nanny state for some time. The tougher measures introduced are yet another example of this.
    My concerns are for people living in the heart of cities, especially families with no garden. These restrictions are likely to continue for a few months now. To keep people constrained in their own homes, and limit the places they can go for their ‘daily’ exercise cannot be enforced for long without draconian police measures and a possible backlash. I think the message on social distancing has got through, so now, or in a week or thereabouts would be the right time to permit people to travel short distances (especially by car) for exercise and well-being, including sun bathing or even fishing or golf. Some further, relatively simple guidance on social distancing whilst parking up, walking and participating in safe recreational activities, especially in popular areas including parks, could accompany these minor relaxations. As you say, Nick, car parks (and parks) should not be permitted to arbitrarily close, and some enforcement effort should be placed in that direction.
    I am concerned, along with many others, that the authorities will be reluctant to give up their emergency powers and our politicians will be nervous about being criticised for relaxing restrictions too soon.

  9. Well, I’m afraid I have to disagree rather profoundly with what you say in this piece. Catherine Calderwood is, without a question, a fool. If everybody did what she did, the traffic levels on our roads would be largely the same as in normal times. This means, the chances of a road accident would be non-negligible. This means the chances of taking away essential resources from the NHS and the police would be non-negligible. It is irresponsible in the extreme of you to suggest that Dr Calderwood didn’t engender anyone by her actions. What if their car had broken down? In what way would social distancing have been possible in that situation? Moreover, simply by being in Elie with her entire family she increased the risk of spreading the virus, since they may all have been already infected without knowing, and, no matter how careful one is, it is always possible to sneeze in the vicinity of someone “with underlying conditions”. Apparently, they used the local shops too. ‘Nuff said. You have got an agenda, but you should think carefully about the facts of the matter before defending the indefensible.
    And there’s more. You say there’s nothing wrong with a change of scenery. Tell them to my local farmers who find human crap everywhere. If you travel some distance away from your home, and public conveniences are closed, where exactly do you defecate or pee? And if the public conveniences are open, in what way can you practice safe social distancing? There are so many holes in your “argument” that it’s hard to know where to stop. Every single point you make is completely out of line.
    And of course, you haven’t touched on the supreme hypocrisy of someone in charge of public policy telling everyone to do what she doesn’t do in the first place. And lest we forget: if Dr Calderwood had provided good advice, we’d have been in lockdown three weeks earlier, when it would have made a difference.

    1. Hi Andy, if you are determined to enforce a complete lockdown, there are dozens of reasons you can bring up to justify this – like the possibility of Dr Calderwood breaking down. However, I think its incumbent on people who make these argument to also look at the costs of keeping people confined to their homes, these are economic, social and emotional. So, we already know that incidents of domestic violence are spiralling, alcohol consumption is increasing (despite the pubs being closed), suicides are according to certain police officers increasing and I confidentally predict that the longer older people are confined to their houses, the more will lose muscle tone, and suffer falls. All of these things place demands on the NHS. So how do you weigh the costs against each other? Your point about people crapping on farmer’s land, rather confirms my point. It should not be difficult to observe social distancing in public toilets, in fact its know different to my corner shops in Glasgow where people wait outside until there is space to go in. To add a new point to the discussion, I understand farmers are getting concerned people who live in farmland are now walking out of their houses onto the farmland because they have been told not to drive a a couple of miles to somewhere they could walk without causing any bother. So, because people are claiming any driving is dangerous with end up with dogs in fields on lambs. We are making problems far worse than they need be.

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