IT is hard to fathom, given what we know now, that as recently as March care home operators were being told that they were “very unlikely” to experience an outbreak of Covid.

The Public Health England guidance, first issued on February 25 and adopted UK-wide, twice states that people receiving care in the community or in residential homes were “very unlikely” to become infected.

The document was finally withdrawn on March 13 –coincidentally the same date that Scotland’s first Covid patient died – though the majority of care home providers in Scotland had already closed their doors to visitors two days earlier as the scale of the potential threat became clear.

READ MORE: Huge spike in deaths at home in Scotland during Covid outbreak

So far, 46 per cent of all of Scotland’s Covid deaths have occurred in these facilities – a death toll of more than 1,600 residents.

The recurring defence is that the tragedy unfolding here is in line with patterns seen elsewhere; that it is nothing abnormal.

Given that care homes are packed with elderly people at the end of their lives, many with chronic health conditions such as diabetes, high blood pressure, and respiratory ailments, it might seem inevitable that this group would end up accounting for a significant share, if not the bulk, of Covid-related mortality.

A report this week by the European Centre for Disease Prevention and Control (ECDC) would appear to back that up.

When it compared countries according to what share of their Covid deaths came from care homes, they found that it ranged from a low of 37% in Germany to 66% in Spain, where nearly 18,000 deaths were in long-term care facilities as of May 11.

In Belgium, which has the highest Covid death rate in the world per head of population, 51% of its fatalities are among care home residents; in Norway, which had reported just 224 Covid deaths, 61% were in care homes; and Sweden – praised by some for its controversial, no-lockdown approach to the pandemic – 50% of all Covid deaths among the over-70s had occurred in care homes.

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On this basis, England and Wales, where just 27% of all Covid deaths have been attributed to care homes, looks out of step with the norm.

This anomaly was the basis for Nicola Sturgeon to suggest they were undercounting the number of Covid deaths in this setting, triggering the predictable partisan squabbles between the pro-Indy and pro-Union camps.

But she is right inasmuch as it appears to be an outlier, and not just by European standards.

In the US, care home residents make up half of all Covid deaths in the 14 states which include these facilities in their data; in Australia, around a third.

Around the world, lack of protective gear, lack of infection control training, staff moving between sites and working while infectious (including before symptoms appear), and a lack of testing have been blamed for outbreaks.

The ECDC has recommended periodic virus testing of all residents, regardless of symptoms, and weekly testing of all staff. With deaths now in decline, this will come too late for most homes.

Worst of all, there is growing evidence from Asia that these huge death tolls could have been prevented.

Hong Kong, South Korea, and Singapore have had no deaths from Covid within care homes at all - although 20 South Korean care home residents have died in hospital following infections presumed to have been contracted in nursing homes, representing 8.1% of the country's total deaths.

READ MORE: Number of excess deaths during Covid running 20% lower in Scotland than England and Wales 

Now, the caveat might be that all three countries combined have recorded just 289 deaths from the virus, but that would be unfair given that they have also recorded more than 40,000 cases of the infection.

In South Korea, residents’ temperatures are regularly checked for signs of fever. Any resident showing possible Covid symptoms is immediately isolated and then transferred off-site to central quarantine facilities if they test positive.

Care workers then deep-clean the resident’s room and they can only return once they have tested negative after a two-week isolation period.

Similar steps have been followed in Singapore, where there have been just 22 Covid deaths in a population the same size as Scotland’s.

In Hong Kong, care home residents are isolated in their room even if there is no outbreak on the premises and must wear a face mask to leave their room.

The territory has also been vigilant to stopping the spread of the virus from hospitals to care homes, with any patients who test positive isolated in hospital for three months, with their close contacts isolated and tested regularly in quarantine centres as a precaution for 14 days.

Visitors to care homes were banned early on in the outbreak, many homes had a three-month supply of PPE on standby, and all nursing homes in Hong Kong have a trained infection controller among the staff who undergoes emergency outbreak drills four times a year so infection control becomes “a well-worn practice”.

These were nations who had learned from SARS and reacted to the spread of a new coronavirus both quickly and seriously. Meanwhile, the UK was preparing as if for a flu pandemic – and herd immunity.