MEDICAL leaders in Scotland are today urging the public to have worrying symptoms investigated now, amid fears that key tests, screening, and procedures could be paused again in a second wave.

The presidents of all three Scottish medical Royal Colleges said people would have a “better chance of receiving potentially lifesaving treatment” if they did not delay seeking help until until winter.

It comes as the number of new coronavirus cases detected in a single day surged past 1200 for the first time, with Nicola Sturgeon stressing that the virus was too dangerous to “just allow [it] to spread unchecked”.

The latest figures, confirmed hours before pubs and restaurants across the Central Belt were forced to closed in a 16-day crackdown on infections, also show that there have been 18 Covid deaths in the past week compared to 25 in the whole of September and three in August.

The number of patients in hospital with the disease has more than doubled in the past week, from 175 to 397.

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Scottish Government advisors said the two-week hospitality shutdown “will reset the trajectory of the virus in Scotland and reduces the risk of cases in the Central Belt overwhelming the NHS”, with the First Minister repeatedly framing the restrictions as necessary to ensure health service can be safely re-mobilised without a return to blanket suspensions of operations and acute services.

However the leaders of the Royal College of Physicians of Edinburgh, the Royal College of Physicians and Surgeons of Glasgow, and the Royal College of Surgeons of Edinburgh have issued a joint appeal to the public to seek non-Covid medical advice now if they feel unwell or have health concerns.

The Colleges are concerned that if people put off seeking non-Covid medical advice, opportunities for early diagnosis, treatments such as chemotherapy, and emergency procedures could be lost.

Professor Mike Griffin, president of the Royal College of Surgeons of Edinburgh said: “Whether it is a fear of catching Covid-19 or not wanting to be a burden on the NHS during the pandemic, we are acutely aware that many patients have been reluctant to use NHS services.

“This means that many patients are potentially missing out on key diagnosis and life-saving, or life changing treatments.”

In the first phase of the Covid-19 pandemic, all non-urgent elective procedures were postponed for approximately three months to free up beds, with chemotherapy or immunotherapy also delayed for many cancer patients due to the risk of infection while the prevalence of coronavirus was peaking.

Cancer screening programmes for breast, cervical and bowel cancer wer paused and some cancer operations indefinitely halted.

These decisions resulted in a backlog of patients waiting for consultations or treatment.

The Colleges warned that this “could happen again, during the peak of a second wave of Covid-19 infections – which would likely come this winter”.

They urged the public to “seek medical advice now if they need it, before a possible second peak, to have a better chance of receiving potentially lifesaving treatment”.

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Prof Griffin has been pushing for the creation of ‘green sites’ so that cancer patients in particular can be treated in hospitals free from Covid patients and where the likelihood of staff bringing in the virus is minimised through regular Covid testing.

He said: “Patients should be reassured that the risk of catching Covid-19 in hospitals is slight, and the risks of not being treated for existing conditions is far, far greater.

“There is profound concern that the latest surge of Covid-19 could potentially overwhelm the NHS.

“It is absolutely crucial that everyone strictly follows the hands, face and space guidance and adheres to all local lockdown measures.

“We must maintain services for urgent care and cancer treatment and the recent spike in the number of cases and hospital admissions must not be allowed to impact this.”

Data from the Office for National Statistics on October 2 shows that 42 per cent of UK citizens who had a new or worsening health problem in the previous seven days did not seek professional health advice.

Of those surveyed, 13% said they were worried about catching Covid-19 while receiving care and 20% said they wanted to avoid putting pressure on the NHS.

Professor Angela Thomas, acting president of the Royal College of Physicians of Edinburgh said: “We welcome the resumption of many NHS services, which is vital as our hardworking healthcare staff continue to manage the backlog of patient consultations and treatments.

“Robust measures to improve patient flow at hospitals right across the UK are being implemented as we understand it, and contingencies should be in place should we have a surge of coronavirus this winter – coupled with seasonal flu.

“We of course want people to seek medical advice as soon as they possibly can if they feel unwell.

“However, patients must feel secure that their risk of contracting Covid-19 is as low as possible when coming into contact with healthcare facilities, healthcare workers, or other patients.

“Similarly, those working in health and care must not be put at any additional risk through unprotected contact with patients or their families.

“Key to achieving these aims is the extension of the availability of COVID-19 testing, for patients and staff alike.”

“We believe that government in all parts of the UK must be very transparent with people – through their public health messaging – that the NHS is still open to the public and that the risk of catching Covid-19 at a hospital or other care setting is relatively low.”

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She added that patients should be given clear advice about the procedures to follow when visiting hospitals and other healthcare settings, including social distancing, face mask wearing, hand and respiratory hygiene and self-isolating and booking a test if symptoms of Covid-19 appear.

In Scotland, overall cancer referrals - including those from GPs, A&E and screening services - fell 22% between April and June this year, according to Public Health Scotland.

The number of patients joining waiting lists for treatment as a result of a positive bowel cancer screen was down by 58.5% compared to previous years, with eligible referrals as a result of breast screening down 56% and from cervical screening down 23%.

PHS stressed that these were patients who had been referred for follow-up tests and scans before the screening programmes were paused.

However, even then many patients faced long waits for investigations such as colonoscopies, with some health boards cancelling the procedures in all but emergencies.

Only 46% of bowel cancer patients whose tumours had been picked up by screening prior to lockdown were able to undergo tests and begin treatment within 62 days of initial referral, compared to 65.5% between January and March.

In September, NHS Ayrshire and Arran reported making a “very cautious” restart to endoscopy and colonoscopy, with NHS Grampian faced with a backlog of “over 900 patients” waiting for these procedures.

Professor Jackie Taylor, president of the Royal College of Physicians and Surgeons of Glasgow said: “It is of significant importance that patients come for medical treatment as soon as possible.

“Delaying seeking help puts people at risk and may increase pressure on the NHS further down the line.

“It is much harder, and sometimes impossible, to restore patients to full health when they don’t come forward quickly.

“The overall message to all of our patients is: don’t wait too long to seek treatment – delays can be damaging.”

The Scottish Government says scientific modelling indicates that there are around 2,900 new coronavirus infections occurring daily, and that without intervention the outbreak is on track to match the levels last seen in the March peak by the end of October.

There has been particular concern about the virus spreading into older age groups, with cases among 70-79-year-olds up 120% in the week to Wednesday.

A Scottish Government spokesman said: “Pausing some healthcare services was one of the most difficult decisions taken at the start of the pandemic, however we were clear with the public that it was necessary in order to stop the spread of COVID-19 and to protect NHS Scotland.

"We were also clear that it could lead to some issues including a backlog of operations.

“The majority of the new restrictions have been introduced to protect NHS Scotland and allow us to safely mobilise services as far as possible, in order to provide healthcare to those who need it.

“NHS Scotland remains open with public health measures in place to protect staff and patients.  

"It is as important as ever to seek advice from NHS Inform whenever you feel unwell, or speak with your GP at the earliest possible time if you have serious health concerns or symptoms.

"Emergency Departments are available for people requiring medical attention in emergencies.

“We would strongly encourage anyone with symptoms they are worried about to follow public health guidance and seek medical advice.

"It is essential for everyone across Scotland to follow the necessary restrictions and guidance which we have put in place to slow the spread of Covid-19. By complying with these restrictions we can all support our NHS.”