Just days ago, NHS Scotland issued a poster telling adults who are not in a high risk group that “social contact can take place between friends and family if you are all symptom-free”.
It was shared on Twitter the next day by the Scottish government’s National Clinical Director, Jason Leitch.
The advice caused confusion on social media, with users pointing out that it seemed to be at odds with other guidance from NHS Scotland to “avoid gatherings with friends and family”.
On Monday, the Scottish government told FactCheck that the poster has now been removed, and that the change “simply reflects the fact that expert advice is being constantly updated”.
But evidence from social media shows that the contradiction between the poster and the wider NHS Scotland advice was there from the start.
Let’s take a look.
In a poster issued on 19 March, NHS Scotland set out advice for different groups according to the level of risk they face from the coronavirus.
Those in what they call “Group 4” – people under 70 without underlying health conditions who are not pregnant – were told that they can see friends and family “if you are all symptom-free”.
The contradictory advice
But the statement that people without symptoms can see family and friends runs contrary to other advice issued by the Scottish government and NHS Scotland.
“Social distancing measures are for everyone,” NHS Scotland advice says. The guidance is clear: we should all “avoid gatherings with friends and family”.
It continues: “We strongly advise everyone to follow these measures as much as they can, and to significantly limit face-to-face interaction with their friends and family.”
We contacted the Scottish government about the poster on Monday, 23 March, and asked them why the two sources appeared to contradict one another.
A spokesperson told FactCheck: “The poster dated 19 March has been removed from the toolkit as advice to the public has changed – this simply reflects the fact that expert advice is being constantly updated.”
But it seems that even at the time the poster was published, it was at odds with NHS Scotland advice.
Ordinarily, we’d look to the Internet Archive to check this claim, but it does not contain old versions of this particular NHS Scotland page.
Nevertheless, there is evidence from social media that can shed some light.
On 20 March, Jason Leitch, the National Clinical Director for the Scottish government shared the poster on Twitter, with the caption: “New graphics to explain the guidelines for the different groups. Please share and use wisely.” So far, the post has been retweeted nearly 2,000 times and has not been deleted.
On the same day, a Twitter user replied to Professor Leitch’s tweet with a screenshot of NHS Scotland guidance, highlighting the section that reads: “Avoid gatherings with families and friends”.
You should be socially distancing even if you don’t have symptoms
The UK government advice is that everyone, whether they are in an at-risk group or not, and regardless of their symptoms, should avoid unnecessary social contact.
FactCheck spoke to Dr James Gill, who’s a Clinical Lecturer at Warwick Medical School as well as being a GP, explains why.
“Social isolation is advised to protect everyone. Not you who feels well. Not you with diabetes. Everyone.”
One of the reasons for this is that it seems some people can get and pass on the coronavirus without showing any symptoms at all.
Dr Gill says “originally, we thought that 1 per cent of people were asymptomatic and able to spread COVID-19”.
But over time, that figure has been revised up.
He points to a study of the Diamond Princess cruise ship, which seemed to show 17.9 per cent of patients with the virus had no symptoms. And more worryingly, “a study looking at Japanese evacuees from Wuhan places that number at a shocking 33 per cent”.
Dr Gill continues: “This suggests that some members of the public could be feeling completely fine but may still be infected with the virus and might be able to infect others.”
He cautions that none of this is concrete fact: “we have educated guesses and strongly suspected hypotheses”. But nevertheless, Dr Gill is clear: “For now, keep it simple, keep it safe, and self isolate. Please!”
There is also evidence that even those who do fall ill with the virus can have it for several days before symptoms start to show.
Jason Leitch has been contacted for comment.