Elderly care home residents were treated like exhibits in a "reptile museum" and "effectively imprisoned" during the pandemic, the Scottish Covid inquiry has heard.

The opening day of the long awaited inquiry heard harrowing accounts of people with dementia being "physically restrained" from hugging relatives and of children with autism driven to suicide attempts as their mental health nosedived.

A lawyer for the Scottish Government insisted that there were "few, if any, harm-free decisions open to governments" as he stressed that ministers will "listen and learn".

EXPLAINER: Scottish Covid inquiry - what can we expect? 

The first stage of proceedings - the health and social care impact hearings - are expected to continue off and on until Easter next year, focusing on those most affected by the pandemic and its consequences.

Amber Galbraith KC, speaking on behalf of Care Home Relatives Scotland, said care home residents had suffered an "unnecessarily disproportionate impact on their lives" as visiting was banned, then restricted by social distancing rules.

She said: "One member spoke of visiting her mother with advanced dementia in late summer 2020.

"She had to sit two metres away and watch her mother by physically restrained from walking towards her for a cuddle. A carer could sit beside her and hold her hand, but not her daughter."

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The group has campaigned for a change in the law to guarantee residents "meaningful contact with one nominated person" in any future pandemic.

She said that current Scottish Government proposals "fall far short" of what they want to see. 

During Covid, Ms Galbraith said too many frail and elderly care home residents with no understanding of what was happening had been "suddenly left alone with no visits, no touch, not even allowed to see others in the home", only to be "paraded out for visits behind glass like an exhibit at a reptile museum or a prisoner".

READ MORE: What have we learned so far from the UK Covid inquiry?

David Di Paola, representing CrossReach - which operates care homes for the Church of Scotland - described how managers were "besieged by complaints from relatives" after visiting was suspended and forced to buy their own PPE from private companies at "up to seven times" the standard rate.

Access to healthcare for residents also became problematic, he added.

"Those who would ordinarily have required hospital treatment for the many problems that the frail elderly can face were stuck in care homes," said Mr Di Paola.

"At one stage there was a resistance to provide healthcare to these individuals even in acute situations. Key healthcare support suddenly became very difficult to access, even on a remote basis."

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The impact of school closures and the withdrawal of services such as face-to-face counselling on children with additional support needs was also highlighted.

Rachel Holt, representing Families of Children with Additional Support Needs, spoke of the case of one boy with autism, ADHD and anxiety who had enjoyed a "happy life" before the pandemic but "progressively declined" over the two years following the first national lockdown.

She said the youngster believed that anyone who caught Covid would die or "end up in hospital hooked up to machines" and "became obsessed with following the myriad rules".

He was given a consultation for his anxiety with Child and Adolescent Mental Health Services (CAMHS) via webcam but Ms Holt said this meant that the counsellor "could not see him picking his fingers until they bled".

After a third suicide attempt, the boy was eventually referred to a psychiatrist.

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Ms Holt said it was the view of the boy's mother that CAMHS "used the pandemic as an excuse not to see children in person" and that the overall approach to the pandemic was "too focused on the clinically vulnerable".

She added: "[She]believes that had her son been seen face to face when his anxiety levels first increased, it would have allowed a more proactive approach to his treatment."

The inquiry also heard from Joseph Bryce, who is representing the 258 members of the Scottish Vaccine Injury Group who have been disabled or bereaved as a result of rare but severe adverse reactions to the Covid vaccines. 

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Mr Bryce said its members had faced "systemic barriers to diagnosis", adding: "There are people who have been diagnosed with vaccine injury and other people with identical symptoms who have not.

"There is an experience by the vaccine injured of resistance by the medical profession, by NHS Scotland, to identify their injuries."

Jeffrey Mitchell KC, acting on behalf of Scottish ministers, said there were "legitimate questions" about whether the loss and suffering experienced by many Scots during the pandemic "needed to be so great". 

The aim of the Scottish Government's non-pharmaceutical interventions (NPIs), such as masks and social distancing, "was to minimise the overall harm of the pandemic", said Mr Mitchell.

READ MORE: What did we learn from Nicola Sturgeon's debut appearance at UK Covid inquiry?

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It focused on balancing "four harms" - Covid deaths and disease; the broader health harms for the NHS and social care; social harms such as school closures; and economic harms. 

Mr Mitchell said: "It quickly became apparent given the nature of the challenges posed by the virus that there were few, if any, harm-free decisions open to governments, including the Scottish Govt.

"Measures designed to curtail the spread of the virus reduced the direct health harm but on the downside risked causing isolation and loneliness, economic upheaval, and disruption to education.

"On the other hand a decision not to impose or to lift restrictions might be said to lessen wider harms, but only at the risk of possibly increasing harm to health.

"The four harms were interlinked and this was well understood by the Scottish Government at the time.

"For example, the increase in unemployment and poverty over time would have physical and mental health implications.

"The challenge for the Scottish Government and other governments was to balance risks and benefits and take decisions to reduce overall harm as much as possible."