Coronavirus: Chile, Israel, and the lockdown exit lessons for Scotland

It is the most significant easing of lockdown since pupils began returning to school on February 22, although the really major changes - shops and hospitality - remain three weeks away.

The fact that Scotland, and the rest of the UK, is able to embrace these new freedoms at all, while our European neighbours including France face fresh lockdowns, is entirely due to the success of the vaccine rollout.

READ MORE: Why Brazil's Covid variant turned herd immunity on its head

Where we go from here depends on continued high uptakes, keeping variants out - and not moving too quickly.

We want to be on the same trajectory as Israel - not Chile.

Chile's intensive care units are close to capacity despite previously having won praise for its vaccine rollout

The South American nation's over-reliance on immunisation while allowing casinos and gyms to reopen and international travel to resume has proved disastrous.

Its intensive care units are 95 per cent full, leaving just 169 beds for a population of 19 million, and on Thursday it reported 7,830 new infections - the highest single daily count of the entire pandemic.

From Easter Monday, the country will close its borders for the whole of April in a bid to bring the crisis under control.

Chile has one of the world's most advanced Covid immunisation programmes, well ahead of the South American average and the EU

The vast majority of citizens are now living under a strict home quarantine after measures first introduced in Greater Concepción - the third largest metropolitan area - on March 4 were extended to the capital, Santiago, home to 40% of Chileans, last Saturday.

The rules ban them from leaving home at the weekend, even to pick up groceries or medicines.

During the week residents are given permits which allow them only two short trips out of the house to buy essentials or to exercise.

This by @HMcArdleHT is well worth a read. What is happening in Chile just now serves as a warning of what will happen if restrictions are eased too quickly and before we have vaccinated sufficient numbers of people. Care and caution will get us back to normality more safely. https://t.co/iM7rdXsJes

— Nicola Sturgeon (@NicolaSturgeon) April 3, 2021

Chile's second wave has occurred during the tailend of the southern hemisphere's summer, and in the midst of one of the world's fastest vaccine rollouts: already 24% of Chileans are fully inoculated with both doses, using either the Pfizer or China's Sinovac vaccines, compared to 8% in Scotland.

READ MORE: Why a return to normal life is high risk for Scotland's island communities - even when cases are low

So what went wrong?

Chile began its immunisation programme on Christmas Eve, focusing initially on frontline healthcare workers before working down through the age groups.

However, unlike the UK, Chile stuck to administering first and second doses 28 days apart rather than risk the unknown of inoculating more people with one dose.

As a result, while Chile has fully vaccinated a quarter of its population, only 37% of all Chileans have had at least one jag compared to 46% of Scots.

Meanwhile, the UK gamble has paid off with growing evidence that a single dose offers substantial protection against infection and serious illness for at least 12 weeks.

Crucially, Chile was also quicker to lift restrictions.

By December 30 it was issuing holiday permits which enabled tourists to enter subject to providing a negative test and completing a 10-day (self-supervised) quarantine.

Meanwhile, Chileans took advantage of cheap flights to Miami and Brazil.

By January 20 - despite less than 1% of citizens having had a first dose (mass vaccination of the elderly did not get underway until February 3) - Chile's 'Paso a Paso' (Step by Step) routemap out of lockdown allowed theatres, cinemas, and circuses to reopen, albeit at reduced capacity.

Casinos and gyms followed a few weeks later.

Chile has had one of the world's fastest vaccine rollouts, but it is now facing a crippling second wave

Between December 30 and March 31, the average daily Covid rate in Chile tripled from 120 to 357 cases per million.

Over the same period in the UK it plummeted, falling from an average of 598 to 70 cases per million, per day.

Both the Brazil and 'Kent' variants have been detected in Chile, helping to accelerate the spread.

READ MORE: Postcode lottery over self-isolation grants revealed

Dr Ximena Aguilera, an epidemiologist who advises the Chile government on Covid, told the Guardian that these new strains were like having "one pandemic on top of another".

She added: “Unlike before, we are seeing serious cases among younger people too, and there is a sense that some people had become complacent towards the end of the summer with the vaccinations going so well.”

Meanwhile, Israelis will mark the end of Passover tomorrow in a country where the economy is almost fully open, with packed out bars and restaurants, and the epidemic is rapidly shrinking.

Its example offers us real cause for optimism - but also clear evidence for the benefits of easing slowly.

In Israel, life is largely back to normal as a result of the world's fastest Covid vaccination programme and a careful exit from lockdown

By the time Israel began to lift restrictions on February 6, 40% of its population had had at least one dose and70% of over-60s had had both.

Even still, easing was limited to opening hairdressers and beauticians, restaurant takeaway services, and national parks and heritage sites.

Only by mid-March - by which time nearly everyone over 50 was fully vaccinated and the vast majority of those aged 20 to 39 had had at least one dose - had life largely returned to normal, except for a Green Pass scheme limiting access to certain public spaces such as gyms and cafes to those vaccinated.

READ MORE: Scotland has highest infection rate in the UK 

The R number has dropped to a record low of 0.55, daily cases are down 90% on the mid-January peak, and Covid wards are closing.

Scotland's exit strategy lands somewhere in between Chile and Israel.

On first dose coverage, we are ahead of where Israel was (46% versus 40%) on February 6, but most under-50s will still be waiting for their first jag when the economy starts to seriously reopen here on April 26.

The average number of new cases in Scotland each day levelled off in March after previously being in steep decline

The decline in cases already plateaued during March, largely due to a spike infections among those aged 20-45, and Scotland's Covid prevalence has been the highest in the UK for three weeks.

High vaccine uptakes among the elderly and vulnerable should shield us from a surge in hospitalisations even if infections climb, but the catastrophe unfolding in Chile should also serve as a rebuke to those who would push for a faster, less cautious exit.

It would be tragic to reach this point only to take a wrong turn now.