AS many as 4,500 people could end up in hospital with Covid within two weeks if virus transmission continues to rise, according to a worse case scenario drawn up by Scottish Government epidemiologists. 

The forecast, outlined in the latest Modelling the Epidemic report, is based on positive test data reported up to September 1 following a string of record-breaking daily infection counts which took the total to more than 40,000 for that week. 

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The projection of 4,500 Covid hospital patients by around September 18 is based on modelling which "assumes that transmission increases, and this results in accelerating growth in infections".

It combines estimates for cases that would be confirmed through testing as well as asymptomatic and undetected infections. 

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Even in their 'better - continues' scenario, where transmission is assumed to remain at its current level, the modellers forecast that Scotland's hospitals would be dealing with around 3000 Covid patients in two weeks' time. 

The peak during the second wave in January - before most of the population was vaccinated - was 2,053, but the latest figures reflect the extremely high prevalence of the virus since nearly all restrictions were lifted compared to winter, when the country was in lockdown. 

READ MORE: Covid hospital patients surge and 'out of control' A&E admissions putting pressure on NHS

The report notes that the R number is now estimated to be between 1.3 and 1.6, a signal that the epidemic is growing, with the upper estimate of 1.6 being the highest since October 2020. 

HeraldScotland: The projections are based on estimates for infections, which could peak at around 80,000 per day, once undetected and asymptomatic cases are taken into account The projections are based on estimates for infections, which could peak at around 80,000 per day, once undetected and asymptomatic cases are taken into account

However, the actual R is likely to be even higher now, as the report stresses that it is a "lag indicator", adding: "R is an indicator that lags by two to three weeks and therefore should not be expected to reflect recent fluctuations, such as the increase in reported cases that has been seen in the last two weeks."

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The report also states that Covid-19 levels in wastewater "are currently at the highest reported since the start of the pandemic".

Sewage samples have been analysed for Covid in Scotland since June 2020 to gauge more accurately the true prevalence of the virus within the wider community.

HeraldScotland: There is some evidence that the surge in infections may be slowing, based on positive cases by specimen date (when the sample was submitted for testing) but it remains unclear whether cases will fall or plateau at a high levelThere is some evidence that the surge in infections may be slowing, based on positive cases by specimen date (when the sample was submitted for testing) but it remains unclear whether cases will fall or plateau at a high level

The report outlines a third scenario - where transmission returns to previous, lower levels over the next week and infections fall.

However, even in this scenario over a 1000 patients would be in hospital with Covid by around September 18, as a result of the recent spike.

There are currently 653 patients in hospital who have tested positive for Covid - up from 312 two weeks ago - with the number who are in intensive care having risen over the same period from 34 to 60.

A separate report published on the Scottish Government's website today also warned that the number of people in hospital with Covid "will soon reach a level that will prove challenging for the recovery in NHS services" and "increasingly displace other, non-emergency activity".

It showed that nine of the 11 mainland territorial health boards - with the exceptions of Grampian and Tayside - are already assessed as ‘red’, the second highest warning level after black, meaning they are facing a "significant impact".

It added that "wider Covid-related morbidity (including Long Covid) and mortality can also be expected to rise as a consequence of rising infections".

HeraldScotland:

A number of health boards have already suspended non-urgent elective operations in recent weeks to free up beds for a spike in urgent non-Covid patients being admitted via A&E, Covid patients, and due to staff shortages caused by self-isolation, sickness and annual leave.

Today NHS Borders confirmed that it was extending its suspension of routine procedures - first implemented on August 11 - for a further three weeks amid a rise in Covid patients and "significant pressure" at Borders General Hospital.

In a statement, the health board apologised adding that it would "continue to carry out all emergency and urgent cancer procedures as planned".

HeraldScotland: Borders GeneralBorders General

It came as a further 6,711 Covid infections were reported yesterday, although the statistics also contained the first hint of a potential slowdown since early August after the total case count for the past seven days fell from a peak of 42,298 in the week to September 2 to 42,174 for the week ending September 3.

MSPs will vote next week on proposals for vaccine passports which the Scottish Government says could curb the virus and avoid the need for further restrictions.

The plan would require proof of vaccination for entry into nightclubs, adult entertainment venues, or other large events from the end of September.

Currently around one in four people aged 18 to 29 in Scotland remain unvaccinated, and only half are fully vaccinated.

Outlining the plan on Tuesday, First Minister Nicola Sturgeon said the surge in cases during August had been “extremely concerning” and that “the next few days will be crucial” in determining whether some restrictions should be reimposed to protect the NHS.