AN exercise in 2018 simulating a coronavirus outbreak in Scotland showed a “clear gap” in preparedness to such an epidemic, it has emerged.

Last year, the Scottish Government shared the report into Exercise Iris with the UK Government’s NERVTAG expert group on emerging respiratory virus threats and its findings revealed unease among frontline staff over personal protective equipment and "the need for substantive progress". The lack of PPE at the start of the Covid-19 outbreak across the UK was one of the key problems in tackling the infection in its early stages.

Professor Devi Sridhar, Chair of Global Public Health at Edinburgh University, who is a member of the Scottish Government’s Covid-19 Advisory Group, said a failure to publish the report felt like a “lost opportunity" as she suggested that members of SAGE, the UK Government's scientific advisory group, did not discuss its findings when, at the start of the year, they considered the latest coronavirus outbreak, which began in China.

The table-top exercise at a hotel in Stirling in March 2018 simulated an outbreak of Middle East Respiratory Syndrome[MERS-Cov], which is a coronavirus like Covid-19 but has different characteristics.

Like the current virus afflicting the UK it causes a respiratory disease with symptoms including a cough and a fever but its transmission rates are thought to be much lower but death rates much higher.

The Scottish Government published the findings of the report on Wednesday - the BBC reported it had done so after it had lodged a Freedom of Information request in April - "given understandable interest in activity around preparedness or planning for infectious disease outbreaks".

One scenario in the exercise featured "escalating resource requirements for contact tracing and follow-up". As a result, health boards were asked to consider the impact of extensive contact tracing.

The report concluded that Exercise Iris was "well-received by the participants who engaged positively and constructively in support of the aims and objectives of the day".

It pointed out there were "no great surprises in the issues identified as priorities". 

Some 14 actions were identified across a broad range of themes.

The report explained: "In the event of a large scale crisis, Boards will appreciate strong, national co-ordination and clear guidance. Scottish Government and Health Protection Scotland should endeavour to ensure that relevant guidance is up to date and communicated effectively and that processes are in place for standing up and accessing national coordination structures and that these processes are widely agreed and understood.

"Amongst frontline staff there is unease at the lack of clarity on PPE availability, training and testing. This is a clear gap in Scotland’s preparedness for MERS-Cov and other outbreaks and needs to be addressed as soon as possible." 

Prof Sridhar said: "It feels like a lost opportunity. On the positive side, it's good that these exercises were conducted because it meant that they were thinking beyond flu, they were thinking about coronaviruses.

"But on the negative side, it's surprising, it seems that SAGE members were unaware or at least didn't discuss this exercise in their thinking in January or February, which would have been crucial in making steps to actually prepare for an eventual outbreak."

She added: "It's the whole purpose of these exercises to learn from them."

The Scottish Government has made clear it shared the report's findings with everyone who took part.

The Department for Health and Social Care stressed how the UK Government regularly tested its preparedness for emergencies enabling it to respond to the current crisis.

A report detailing the findings of an exercise simulating pandemic influenza, Exercise Cygnus, which took place in England in October 2016, was also not published.