Scotland was "late and slow" to respond to the Covid pandemic and "didn't learn from" countries previously hit by SARS and MERS, according to the former chief medical officer.

Giving evidence to the UK Covid inquiry, Dr Catherine Calderwood pointed to the example of Singapore which had a taskforce on standby able to remobilise diagnostic testing and contact tracing as early as November 2019 when Covid began to spread.

Dr Calderwood, who was CMO for the Scottish Government at the start of the pandemic, said: "My feeling is that we didn't learn from countries where SARS and MERS had been an issue.

"We were late and slow and there wasn't a coordinated or formal way in which to communicate with other countries where we could have learned more rapidly."

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Dr Calderwood said the UK should have a Singapore-style taskforce able to scale up responses in the event of another pandemic, but acknowledged that the NHS "would struggle to find any spare capacity to send staff on training exercises".

Dr Calderwood, a consultant obstetrician from Edinburgh, stepped down as CMO in April 2020 following a backlash over a trip to her family's holiday home in Fife at a time when lockdown rules banned non-essential travel.

The controversy was not raised during evidence to the Covid inquiry.

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Dr Calderwood was asked about the creation of the Covid-19 Advisory Group for Scotland in April 2020 - nicknamed "Scottish SAGE".

Dr Calderwood said that communications with London-based SAGE - the group of scientists advising the UK Government response - had been beset by technical difficulties early in the pandemic.

"Unfortunately there were a lot of people dialled into meetings and of course our infrastructure for remote working was nothing like it is now," said Dr Calderwood.

"Very often the quality of the line was very poor and dropped out very frequently."

The Herald: Dr Catherine Calderwood with former First Minister Nicola Sturgeon during a Covid briefing early in the pandemic. She stepped down as CMO in April 2020 after a row over a trip to her family's holiday homeDr Catherine Calderwood with former First Minister Nicola Sturgeon during a Covid briefing early in the pandemic. She stepped down as CMO in April 2020 after a row over a trip to her family's holiday home (Image: PA)

Dr Calderwood said she wanted to ensure that Scottish SAGE included a "wide-ranging group of people" and fostered "lively scientific debate".

She added: "At my insistence some of those people were people who had been quite openly - particularly on social media - critical of some of the responses to the pandemic up until that point.

"I was very keen to have a broad range of people and not just to have people who agreed with the government and current thinking."

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Dr Calderwood said a "paucity of data" early in the pandemic also "really affected how rapidly and how effectively we could make those decisions".

This included basic information such as the number of people in hospital. 

However, the inquiry heard that Professor Mark Woolhouse - an infectious disease epidemiologist at Edinburgh University who became a member of Scottish SAGE - had written to Dr Calderwood in May 2018 warning that access to healthcare data in Scotland was "terminally dysfunctional", adding: "I dread to think of the consequences if we were ever to find ourselves facing a health emergency such as a pandemic influenza."

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Giving evidence to the inquiry, Prof Woolhouse said the balance between privacy rights and access to data had been "completely out of kilter".

This meant that major projects such as EAVE - an Edinburgh-led study which used anonymised GP records to track everything from vaccine effectiveness to Covid variant severity across the population in close to real-time - took months to set up. 

"If we'd had that in place in January, February, March 2020 we could well have produced extremely valuable data that would have improved the very early response," said Prof Woolhouse. 

"But we didn't have it in place and one of the reasons we didn't was because we didn't have the permissions."

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Prior to Covid, the UK had been ranked top "by a considerable margin" on a global index which ranked countries' ability to respond rapidly and mitigate the spread of an epidemic. 

This had turned out to be an "extremely poor predictor of actual outcomes during the Covid-19 pandemic", said Prof Woolhouse. 

He said the UK's ageing population, urban density, and obesity had made it particularly vulnerable to Covid, adding: "If we had a pandemic of a very different infectious nature...the vulnerabilities may be different."

Drawing an analogy with horse racing, Prof Woolhouse said influenza had been "the favourite" among pathogens expected to cause the next pandemic in the decade between swine flu in 2009 and Covid.

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He said: "The problem is there's an awful lot of horses in the Grand National and the chances of the favourite winning is actually quite small...if you'd asked me at the time what's the favourite, I would have said 'pandemic influenza'.

"But I did not and would not favour putting all my money on one bet. The correct strategy in my view is to hedge your bets."

He added: "We'd done our homework but it turned out we'd prepared for the wrong exam."