I am technically starting day four of a 10 day isolation after a member of our tour party tested positive in Orkney. I have actually returned from Scotland but am resting up after 48 hours we would like to forget.
For the first time since March 2020, I have broken guidance laid down by a public health authority and in this blog I explain the complex issues we faced. Our railway touring company have had to face the same issues. We understand that the Health Authorities have their own issues, but if there is one lesson we need to learn, it is that guidance needs to be consistent. In this case, our guidance was not just inconsistent with what we get in England, it was inconsistent with what the Scottish Government had issued days before.
I have taken two PCR tests and four lateral flow tests in the past week, all tests have been negative. Twice jabbed and having had the virus this year, I was not surprised to have my second PCR (like the one on Thursday) come back negative
I was surprised by what followed my inputting this test into my phone,
— Henry Tapper (@henryhtapper) August 22, 2021
Confusing as this might be, I will try to make some sense of what has happened to me and my fellow passengers over the past few days.
The story so far
On Wednesday night, a member of our party felt unwell and took a lateral flow test which turned out positive. All the remaining party and our driver took flow tests and six others tested positive. The Orkney health authority was informed but they gave the tour no guidance and a decision was taken that those in immediate contact with those with positive LFTs should remain in contact and the rest should continue on the tour to our next destination- Inverness
The average age of the party was well over 60, I and my partner being among the four youngest of the 41 passengers
At 11.30pm on Thursday , Orkney Health told our tour operators that all those in Inverness should isolate and take a PCR test. This instruction proved impossible as we could not get a PCR test in our Inverness hotel rooms. So at 3.30 pm on Thursday, we were allowed to walk down to the PCR testing site and test. The bombshell hit us later that evening.
Later that evening, the guidance changed and we found ourselves part of special measures applied not just to those positive in Orkney but to those who had tested negative – now in Inverness.
For whatever reason, we were instructed by Scotland’s NHS Health Protection Team that we were part of an “outbreak” and that information from Scottish Government states that
‘Specialist Health Protection teams with Health Boards may, in the handling of an outbreak, also implement measures which differ from national guidance, if it is decided at a local level that such measures will assist with outbreak management and control’.
The local level decision was taken either in Orkney or Inverness. Rather than travel back to England after a negative PCR, we were told that
Regardless of your vaccination status and whether your are in receipt of a negative PCR test, you should isolate for ten days from the date of our last exposure.
For us, this meant that despite being doubly vaccinated and in my case having had Covid this year, despite having taken three lateral flows in the previous week, despite having no symptoms and despite having a negative PCR (we got the results very speedily), we were expected to find a new hotel and extend our staycation for 7 days, in a hotel room.
Many of our party were unfamiliar with phone technology and will have struggled to register a PCR. We can only imagine their stress of managing the consequences of this change of circumstances from a hotel room.
I have self-isolated on several occasions over the past 18 months. Now – 2 days after my and my partner’s negative PCR tests and with 5 consecutive days of negative lateral flows, I have at last been pinged by my NHS Covid-19 app. I am wondering just what threat I am to those around me.
Those who would like to explore the issues around Test and Trace in more detail, , may wish to listen to Dr John Lee. My experience over the past five days has driven me towards his thinking. Do these “special measures” protect me and others or are they being used for other purposes?
YouTube have blocked our film with Dr John Lee we are in the processing of appealing.
— Unlocked 🔑 (@Unlocked_UK_) May 2, 2021
What would you do?
We asked our tour operator whether this was a legal requirement or guidance. We were told that it was up to each person whether to comply and it was not the responsibility of the tour operators to enforce compliance.
We had no access to lawyers but it seemed to us that we were being given guidance and were not under a legal requirement to stay in our rooms. Indeed we could not stay in our rooms as the hotel told us we could not stay with them over the weekend or next week.
We had to take our own risk assessment and these are the conclusions we came to.
Despite being asked for the guidance in print, the railway tour company have only had a verbal instruction of the special measures in place. Passengers on the tour have received no detail of the guidance and why a person with a negative test should be isolating. Our conclusion was that this was guidance that was being made up on the spot and that it did not make common sense.
The logistical impact of compliance would be that we would need to find a new hotel, break isolation to get there and incur considerable personal expense with no likelihood of reimbursement from a travel insurance policy. We would also need to pay for alternative transport home, discarding pre-paid tickets to London available yesterday. We concluded that the logistics and financials made no sense – we were as much a risk staying in Scotland as we were going home (frankly no risk either way)
The impact on our well-being of this extra period of isolation would be serious, let’s not forget we were on holiday and trying to relax. Sitting in a hotel room for 8 days after being cleared by both LFT and PCR would have a negative impact on our well-being for no benefit to ourselves, the community or our fellow passengers. Most of the passengers we spoke to were on medication which would run out over the period of isolation (this included me – I am on blood thinners). We considered complying with Scottish Public Health guidance would put our health at risk
Whatever damage had been done by the outbreak had been done in Orkney, we were in Inverness and the best place for us, was away from guidance that seemed to have no evidence base.
Finally and conclusively for us, moving to another hotel would have caused us to meet with other passengers, our driver and pass through public areas which would have created the same risks as sitting in an empty railway carriage and walking home from Kings Cross. Staying in Scotland presented no advantages, other than to hoteliers with vacancies and train/plane operators.
What we did
We packed our cases, walked half a mile to the station and went home. The Orkney authorities remained in Orkney , our hotel in Inverness welcomed our departure and several other passengers (independently) took the same action. The remainder of those who have negative tests are following us.
We cannot see ourselves as any threat to anyone. We have complied with all testing requirements and clearly are Covid free. We are now at home in London and able to resume our working lives. We feel stressed by 48 hours of uncertainty, where we were made to feel pariahs by the Orkney and by the Public Health and Health Policy team in Inverness.
Subsequent to returning to London, we have now been pinged by the NHS app. We are now under UK rules and – having taken yet another lateral flow test (negative) and with a 2 day old PCR test (negative) registered are wondering whether the UK rules now apply
As of Monday (16th August) , double-jabbed individuals and under 18s who are identified as close contacts by NHS Test and Trace will be advised to take a PCR test as soon as possible to check if they have the virus and for variants of concern. People can order a PCR home test online or by calling 119, or going to a test site.
As double-jabbed people identified as close contacts are still at risk of being infected, people are advised to consider other precautions such as wearing a face covering in enclosed spaces, and limit contact with other people, especially with anyone who is clinically extremely vulnerable. They will not be required to self-isolate while they wait for the results of the PCR test.
Double-vaccinated adults will no longer be required to self-isolate from Monday, as long as they received their final dose of an MHRA-approved vaccine in the UK vaccination programme at least 14 days prior to contact with a positive case.
Problems with testing data on Orkney
Ironically, the positive cases in this “outbreak” are unlikely to be recorded against Orkney’s Covid figures. This is because of the practice on the islands of only recording Orkney cases for Orkney residents – even those with second homes are not regarded as Orkney residents.
Hence the number of cases in Orkney, recorded this week do not include those that occurred with our party. Our cases are being recorded as being “contact traced”
However it seems they will not appear in the official figures for the Islands. The two articles in the Orcadian (above and below) appeared on the same day but refer to two separate groups; those Orcadians with a positive test (below) and foreigners -like us and other migrants – who are triggering “contact-tracing”.
It is clear that Orkney’s 12 cases , represent a spike – as the average number of Covid Cases in the previous 75 weeks is barely above 2.
Our Orkney cluster has exposed a blind spot in official figures which could obscure the location of new outbreaks in workplaces or hospitality providers that draw immigrants from several health board areas.
Orkney has the third highest proportion of second homes in Scotland, behind Argyll and Bute and the Western Isles. A positive test would be registered to the patient’s primary address.
Problems with getting tested on Orkney
The Scottish government said that it had no plans to publish the number of people who tested positive in each testing centre.
This may be why, despite there being only 12 reported positive cases, there is alarm in Orkney.
Michael Dickson, chief executive of NHS Orkney, said: “NHS Orkney is responding to a significant Covid public health issue and we are profoundly concerned that the virus is spreading rapidly across our community. We believe there is a real risk to the people of Orkney and urge them to take care.”
In the week we were on the island , two large cruise-ships were docked in Kirkwall , each had around 1,000 passengers being bussed around the island. (just as we were).
It seems that the impact of tourism on the islands is vital to their economic well-being and that it is in the interests of all parties to work together.
We feel, individually and collectively (we have spoken to fellow passengers by phone) that Orkney Health is not working with our holiday company or with us as passengers, but is pursuing a brand of contact tracing into Scotland and beyond which is at odds with general practice and at odds with common sense.
This suggests to me that Orkney is inexperienced at dealing with the impact of migrants – especially tourists. This may account for the inconsistencies in their approach to us, but it is worrying for the organizers of large groups coming off the cruise ships.
In applying special measures , Orkney Health may believe it is going above and beyond. But it is also creating confusion and there is little evidence on how much testing is going on.
When one passenger reported symptoms, we had no immediate help from the local hospital ( pretty well adjacent to our hotel).
Nor did our tour party get any immediate guidance as to how to proceed, nor help with LTFs. We had to scramble around to ensure we had sufficient LTF kits because the local hospital could not supply us with any.
Having collated our own tests, those who had negative LTFs – were allowed to proceed to Inverness the next day without hindrance , our tour leader took a pragmatic approach consistent with English guidelines. The majority of our party will never show on Orkney’s test figures as we tested elsewhere.
I suspect that the vast majority of tourists who contract Covid are double jabbed and that their symptoms are mild to asymptomatic. I doubt that many who are positive are recognized as such, partly for this reason and partly because testing facilities in Kirkwall and elsewhere are so inaccessible.
What is more, by not publishing the total numbers being tested on the island, Orkney is risking creating a false sense of security. Orcadians may be in for a lot worse than a few cases from a fishing boat or a coach party.
Our experience of local Orkney bars and restaurants suggest they are taking an English view on face-masks. The response we saw from the Orkney Health Authorities and those in hospitality suggests that Michael Dickson has a right to be concerned. Orkney is a very wealthy place, having benefited from the oil boom and having substantial public reserves.
As one of my correspondents on this matter put it
They should perhaps spend some of that money on better health systems and practices
As one commenter on the Times article put it
Par for the course with Scotland’s testing numbers which are clouded in secrecy it seems. Test and trace figures which were supposed to have been published before schools returned, now won’t be until the end of August. What is there to hide? Well for one our testing figures barely reach 35% of our capacity on a daily basis. Even to find these figures you have to go to three different websites.
Our farewell to Stromness
In conclusion, we look back on our time in Orkney with a mixture of pleasure and pain. Our pain is for passengers who are left behind with Covid and for their well-being. Our pleasure is the memory of the beauty of the land, the kindness of people like John the Trike and for the astonishing sense of history that surrounds Orkney’s heritage
As for our time since leaving the islands, we are in recovery. Though we have done nothing wrong, we feel we have broken guidelines we never new of and we would not have taken this tour if we realized this could happen.
Frankly we feel we are being punished for creating a problem for the Orkney Health Authority which we had no control of. The special measures placed on us seem arbitrary as we have seen no justification for them.
We worry that though we have absolutely no chance of having spread the infection, people who met us may be considered for isolation. There seem to be no controls in place and QR scanning seems to be pretty well non-existent.
There has to be a way for Orkney to differentiate between those who are at risk and those who aren’t and that means getting PCR test information from Kirkwall and Inverness. We are not confident that Orkney Health have access to our data as there were no controls in our PCF testing. We are happy to share our negative results but what controls do they have in place for those who may have tested positive,
We are conscious that we have breached isolation to get to London but we would have done so to move hotels (which we would have had to do). We are comforted that we hear the rest of our party is following our lead and hope that as I write, most of those with negative PCRs will have exercised their normal privilege to do what they choose.
The impact of our, and our fellow Covid-free passengers actions in returning south seems to be entirely positive, both personally and it terms of the communities we are leaving. But we remain mystified at the treatment we have received and concerned that tourists about to embark on travel to Orkney , have no idea what to expect, should they find themselves in our position.