OPPOSITION politicians should note that the same hospital discharge policy was followed in Labour-run Wales and in Tory England, as in the early stages of the pandemic all four nations acted on UK wide Public Health England guidance (“Pressure on Sturgeon over Covid chaos in care homes”, The Herald, October 29).

On March 19, this guidance said that "unless required to be in hospital, patients must not remain in an NHS bed", but no clinician would discharge a patient unless they thought it is safe to do so. This policy was implemented to free up hospital beds in advance of an expected tsunami of coronavirus patients.

On April 2, UK Deparment of Health and Social Care rules on discharging to care homes were clarified, saying "negative tests are not required prior to transfers or admissions into the care home… as they can be safely cared for in a care home”.

The Public Health Scotland report pointed out that 45.2 per cent of privately owned homes had a Covid=19 outbreak compared to 27.9% in local authority homes and 12.5% in the voluntary sector.

A similar independent report in Wales found that discharging patients from hospital into care homes did not increase the risk of coronavirus outbreaks among residents and also found that the size of home was a contributing factor.

Also, a leaked unpublished Public Health England study found that agency workers, often employed on zero-hours contracts, unwittingly spread the infection in care homes as the pandemic grew.

Rather than political point-scoring we all should support plans for a national care service where residents and staff will be treated with dignity.

Mary Thomas, Edinburgh EH11.

THE tragic deaths related to Covid-19 of so many in care homes across the UK, Europe and beyond, is a matter of deep concern to governments worldwide. It is therefore sadly disappointing that the British media is now so fixated on finding fault with the First Minister and the Scottish Government that at Wednesday’s Coronavirus Briefing it seemed evident that, ahead of the publication of the report into care home deaths by Public Health Scotland, headlines had already been written condemning the transfer of patients from NHS hospitals into care homes.

Interrogators from across the spectrum of British television and newspapers queued up, in some instances quite rudely, to press incorrect interpretations of the report and wrongly label the move to reduce pressures on NHS hospitals, a move which was adopted across the UK, as a “scandal”, when the evidence of the report was that there was no significant statistical data to support such a pronouncement. In fact the biggest factor identified by the report in the spread of coronavirus into care homes was not hospital discharges, whether patients tested or not, but the size of the care home itself.

What is a “scandal” is that the British media continues to turn a blind eye to the negligent operation of private care homes across the UK for the financial benefit of “investors” (among them offshore tax-avoidance vehicles of rich Tory Party donors) while poorly paid and inadequately protected staff are exploited and many of our most vulnerable elderly citizens continue to die ahead of their natural life-expectancies.

Stan Grodynski, Longniddry.

PUBLIC Health Scotland’s reporting of the impact of patients discharged to care homes on Covid-19 outbreaks is fatally flawed. Although the analysis is based on a hugely impressive feat of data linkage and aggregation, the way the results are reported is, frankly, nonsense.

The results are reported in terms of criteria of "statistical significance". Such reporting is appropriate when the data involved is a sample of a population – as when, for example, opinion polls based on a relatively small sample are used to estimate the voting intentions of all voters. However, this analysis is based on an entire population – all 5,204 hospital discharges to Scottish care homes from March to May this year. Analysis in terms of statistical significance is inappropriate and can be, as in this case, highly misleading.

The analysis shows that discharge of patients who were untested to a care home was associated, on average and after adjusting for relevant factors such as care home size, with a 27 per cent increase in the likelihood of a Covid outbreak in the care home. Discharge of a patient who was tested positive for Covid was associated with a 47% increase. That’s it. That was the reality. No need for assessment of "statistical significance".

Rather than obfuscate the result with inappropriate confidence intervals, it would have been more useful to calculate the number of cases and deaths likely to have been associated with those additional outbreaks.

Whoever led Nicola Sturgeon to feel able to state that “there is no statistical evidence” of increased risk, led her up the garden path.

Steve Kendrick, Edinburgh EH3.

THE report from Public Health Scotland states that “for hospital discharges, there was an increased risk of an outbreak observed in periods immediately after hospital discharge compared to periods without a hospital discharge”. Yet later on it is stated, in bold letters, that “in the adjusted analysis hospital discharge was not statistically significantly associated with care home outbreaks”.

Is this alchemy at work? Or is it a case of researchers torturing a data set until a specification acceptable to their political masters is mined from the data?

In the Cox proportional hazards regression model that is employed, the addition of a variable measuring care home size takes away much of the variance otherwise explained by discharges. These two variables are highly correlated, so it well nigh impossible for statistical tests to distinguish the effects of the one from the other. To pretend otherwise, as this report does, is dishonest.

Rod Cross, Glasgow G11.

IN reference to the Public Health Scotland report into hospital discharges into care homes during the Covid-19 pandemic, Nicola Sturgeon stated yesterday that "hospital discharges were not found to have a significantly higher risk of an outbreak". According to the report this includes hospital discharges of any kind, i.e. patients who have tested positive.

If Ms Sturgeon seems to be satisfied with the conclusion that the return of Covid-positive care home residents into their communities doesn't carry a significant infection risk, it needs to be asked why she otherwise bans us from normal human contact such as seeing friends and family at home?

Regina Erich, Stonehaven.

WE learn that on Nicola Sturgeon’s watch, 120 hospital patients who had tested positive for Covid-19 were discharged to Scottish care homes earlier this year, along with nearly 3,000 untested patients. Ms Sturgeon states she's unable to acknowledge the connect between this and the shockingly high Covid-19 death rate in Scottish care homes – tragically significantly higher in percentage terms than in England. No one accuses her of being wilfully negligent or uncaring, yet surely this brings into question claims made by some in print and social media that Ms Sturgeon is a safe pair of hands in the coronavirus health crisis?

Martin Redfern, Melrose.

SO the farce continues. Pubs can open until 6pm, but are not allowed to sell alcohol. You have to wonder which geniuses in the Scottish Government thought this one up.

If they are intent on destroying the hospitality trade in Scotland why just not tell us so, and why they think such a move is necessary, instead of hiding their motives behind the current pandemic?

It has been obvious for some time through your Letters Pages that many of the public are increasingly questioning the competence of our leaders in parliament. It would appear that we should also now be questioning their sanity.

Dave Henderson, Glasgow G12.

IT is often said that we do not miss things until they have gone. For the past year, Boris Johnson has been in trade negotiations with the US. He has refused time and again to put protections for the NHS into the negotiations. The US side has insisted that "everything is on the table". We already know that the US wants greater access to the NHS market for its pharmaceutical companies and for its big health care providers.

It seems that the NHS is being put up for privatisation, not all at once but via a step-by-step approach. Then one day it would be gone, sold off to big companies. We know from the experience south of the Border that handing the track and trace system to Serco was a disaster, but still Serco was paid by taxpayers for failure.

Then, as in the US, we would have to make decisions about whether we could afford treatments for ourselves and our loved ones or, if we couldn’t, have to let ourselves, and them, suffer or die.

Let’s keep the NHS in public hands. We’d miss it desperately if it wasn’t. Ask a poor American.

Bob Gillespie, Glasgow G44.

I BELIEVE that it was following the Herald of Free Enterprise disaster that it was decided that, on closed deck ferries, passengers would not be permitted to remain in their vehicles during the passage. On short crossings such as Arran and Mull, under one hour, might it not be possible to allow the master to determine, subject to conditions, if passengers could remain in their vehicles on passage? The risk of Covid transmission with passengers crowded on narrow companionways, perhaps breathing heavily after ascending the stairs and entering crowded areas, must present a much greater risk of death through transmission than that of car deck flooding. Please let experienced ships masters make that decision and, perhaps, reduce further transmission to islands. I would happily read a newspaper or book rather than be forced to move.

J Patrick Maclean, Oban.

I AGREE with Andy Stenton (Letters, October 29) regarding the Scottish Government's tier numbering system, but am sure it was devised just to be different. It was a surprise to me it wasn't in Gaelic.

Sir Brian Donohoe, retired Labour MP, Irvine.

ANDY Stenton professes himself confused by the five-tier system being numbered 0-4. I note that he lives in Glasgow. For probably a hundred years or more, a four-storey tenement has been numbered 0 (ground floor) to 3 (effectively the fourth floor). Simples.

Hamish McPherson, Giffnock.

Read more: Coronavirus Scotland: Sturgeon's spin 'letting down grieving families'