‘The virus has not shaken my faith’

“IT’S been hard. Businesses, jobs and loved ones, all lost to this virus.”

Professor Jason Leitch is National Clinical Director of Healthcare Quality and Strategy and advisor to the Scottish Government. Our first interview was cancelled at the last minute because he was called in to an urgent meeting with Scotland’s First Minister, Nicola Sturgeon.

A few days later, the Aberdeen outbreak of a resurgence of Covid-19 was confirmed, prompting a temporary reversion into earlier lockdown restrictions.

But that’s Jason’s life at the moment. He never knows what tomorrow will bring. “I’ve been in meetings with the executive leaders of Scotland’s retail sector to discuss PPE and face coverings, and the executive heads of the tourism and airports industry.

I’ve done three media interviews today, and after this interview, I’m meeting the managers and captains of the Scottish Premiership, and I’ve another two interviews in the evening. It’s full-on,” he says.

It’s a life Jason probably did not imagine when he took the job in 2015.

“I’ve never known a time like it,” he says. “But then that’s true for all of us.”

Born in Airdrie, Jason’s parents moved during his childhood to Leicester for a few months, and then to north Devon until he was seven years old, at which time the family returned to Scotland.

As Baptists, Jason and his family were always involved with their church, and Jason says he can’t remember a time when it wasn’t part of his life.

“I was always very involved with the church,” he says. “And still am to this day. I was in the youth choir, all kinds of groups and took on a leadership role in Airdrie Baptist Church, a role I’m still proud to have today.” You can’t help think, as you speak to this active man, that even he might be pushed to keep up with the always changing face of the Covid-19 pandemic.

Jason attended Airdrie Academy and later Glasgow University, where he studied dentistry.

“I guess I chose dentistry because I was looking for a profession and something that was interesting and provided a career path. Dentistry seemed to be a reliable job. People are always going to need dentists! “I loved my time at university. I made lifelong friends there.”

Jason wasn’t a regular dentist for long though – after a post-qualification year on the ‘High Street’ – he took a post at Glasgow Dental Hospital and worked in the Victoria Infirmary in Glasgow, where he honed his skills and trained to be an oral surgeon. “I became an Oral Surgery Consultant,” he says. “Some consultants are medical, some are dental and some have both qualifications.”

He stayed there for around 15 years but realised he was reaching for something else in his life.

“I was feeling I was getting a bit stale.” He smiled. “In 2005, I was offered the chance to go to the USA and study for a Fellowship at the Harvard School of Public Health in Boston and the Institute for Healthcare Improvement. It gave me a great deal of insight into systems improvement and how they affected health and care systems. I don’t think I had a plan as such, but when I began I think my ambition was to improve hospital dentistry and surgery initially.

“It was great helping people individually, but once you start working with public health systems, you can help people from a population perspective, and make life better for everyone.

“We studied system design, and worked on trying to improve what systems were currently working and what could be improved, and how they could be tweaked to make them more efficient.

“Gradually I began to see the bigger picture, how everything was connected, and when I got back to Scotland, got a part-time job with the Scottish Government as the National Clinical lead for Patient Safety while still maintaining my job as a surgeon for half the week. The bulk of that job involved designing the Scottish patient safety programme, being part of the team that designed what was probably the largest patient safety programme in the world at that time.”

It was the tragic outbreak of Clostridium difficile infection at the Vale of Leven’s Hospital in the years of 2007 and 2008 that killed a number of elderly patients that set Scotland and Jason on the course of tackling patient safety.

Professor Jason Leitch Credit: The Scottish Government

It was great helping people individually, but once you start working with public health systems, you can help people from a population perspective, and make life better for everyone.

“The Vale of Leven tragedy was terrible and when the SNP Government was newly elected, Nicola Sturgeon was given the post of health minister and a new Head of Policy, Derek Feeley, was appointed. As we worked together he became a great friend of mine. We made a decision to concentrate on patient safety, particularly in hospitals, which was a global problem, but we decided to really focus on Scotland and I became the Clinical Lead for Patient Safety as a result.

“When you begin to see the results of the changes we put in to place with the collaboration of the health boards, doctors and nurses, the government – when you see all of them working together to bring about changes, we were able to see real change, and genuine reductions in infection rates, reductions in mortality, reductions in stillbirths, and a lot of the data began moving in the right direction, it’s really worthwhile.”

Gradually Jason moved into different and more senior advisory roles within the Scottish Government, becoming the Clinical Lead for Quality, not just safety that took him into a broader set of challenges so he started to do things like person centred care like more open visiting and other elements. More recently he became the National Clinical Director.

“It’s one of the three clinical leaders who provide advice to the politicians,” he says of his role. “We work for the Chief Executive of the National Health Service. There’s also a Chief Medical Officer and a Chief Nursing Officer. We all have slightly different roles but we have responsibility for the clinical advice to the Government of the day. It’s not a political role. As an advisor to politicians, I’ve had to learn to work in the civil service environment but I’ve never wanted to be ‘in party politics’. I have come to really appreciate the nature of what government, and government alone, is able to do. My particular responsibility is for safety and quality, the CMO for medical leadership and the CNO for nursing leadership, so we’re all busy, even in ‘peacetime’.”

Asked if he believed the battle with Covid-19 was a ‘war’, he said: “I’m not sure that’s the right metaphor.”

He added: “We’re certainly fighting against something, and it’s a unique situation – no one has ever faced this before. So far about 20 million people worldwide have had a positive test for this virus – and nearly 750,000 people have died.

“It’s unprecedented. It’s not like anything we’ve had to combat before. And remember, we’re only six months in to it. No one has seen a global pandemic in the modern era like this.”

Jason is having to get used to being seen on the national news too. He’s a regular at the side of the First Minister when she does her briefings and Jason is often called upon to speak directly to the cameras to talk to the public directly

“This virus is touching every sector, every single individual,” he says. “When you have something of this scale, it has affected every person in the country. No one’s life should feel normal yet. It should still feel odd, and restricted, and that’s necessary to keep the population safe.”

With the schools reopening it feels like a step forward – but even then Jason urges caution.

“Travelling to and from school will not seem normal and even school itself will feel different to how it felt before this horrible virus.

“We decided on the basis of our advice and research that it is safe for the schools to reopen, but I appreciate it is not without risk. There may be some element of an increase in numbers over the next little while but Test and Protect, which is our mechanism for looking for outbreaks will hopefully be able to catch any outbreaks quickly and stamp on them.

“Test and Protect is precision public health – it is a way of finding the individual causing the cases and isolating both them and their contacts and thus stopping the transmission of the virus.

“It’s a crucial tool on the road out of lockdown, and in Scotland, so far, it’s going well. We can’t be complacent because it doesn’t take much for this virus to reignite unfortunately, but so far, Test and Protect is doing well.

“People talk about ‘herd immunity’ but that will only come, in my opinion, with a vaccine, and not with allowing the population to mix.

“A vaccine is vital, as is, quite frankly, a way to treat this virus. It principally attacks the respiratory system, causing breathing problems, especially among the elderly and those with pre-existing conditions that will open them up to it. It is very complex in its make-up and the way it affects the body. It seems to hit those with vascular disease – the circulatory system – or condition, like heart failure, those who are obese, and those with especially Type 2 diabetes.

Professor Jason Leitch Credit: The Scottish Government

It’s unprecedented. It’s not like anything we’ve had to combat before. And remember, we’re only six months in to it. No one has seen a global pandemic in the modern era like this.

Professor Jason Leitch Credit: The Scottish Government

“We are learning a lot more about it all the time.

“Since the first World Health Organisation reports in January and February, about a novel coronavirus from China, we very quickly started to pay attention. As four countries (in the UK) we have a range of groups who provide early warnings, committees like SAGE (the Scientific Advisory Group for Emergencies), another one called Nervtag that looks specifically for respiratory viruses appearing around the world, so we often pick up signals from global public health organisations, including the WHO, and it quickly became apparent that the virus was beginning to spread around the world and we now know the virus came to Scotland about that time, maybe February, or the beginning of March.

“Realising the actual severity of the virus was something of a gradual process. There wasn’t a specific ‘moment in time’ but the news coming out of Wuhan and the spread to other parts of China and then it began to attack Europe. When Spain and Italy were overwhelmed and we saw how their intensive care systems were unable to cope, we began to prepare the NHS and the population. There were some very difficult choices which needed to be made both to prepare the NHS and the populations for what became a global pandemic. The WHO helped us do that and guided us and provided us with as much knowledge as we could gather.

“To be fair, the population has reacted and responded in the main, very well to what they’ve been asked to do. Some people have lost everything – including loved ones – but this is a very, very serious illness. We absolutely should not underestimate what it has done – and what it could potentially do.

“The population behaviours, which has been our principal ‘treatment’, because we don’t have a cure, have been the changes to the way we behave. That has worked; it has reduced the viral numbers; reduced the number of deaths; reduced the transmission rate – but it has been at a price. It has caused other harms. It’s caused great economic suffering and affected people in other health ways.

“We’re trying to find a way of opening up the economy while still protecting the population.”

Somehow though, Jason still finds time to spend on the two charities he holds close to his heart – the Indian Rural Evangelical Fellowship, which runs children’s homes, schools and colleges in India and as a Trustee of the Nazareth Trust, a UK charity that runs a hospital in Nazareth for the Arab-Israeli population.

“This virus has not shaken my faith in the least,” he says. “It has, in some ways, made me more reliant – more relentless. It’s taken a toll for sure, on my family life and my leadership role in the church. My wife, Lynn, is a teacher, so she’s on the front line herself. We’ve both been working from home more, but at the moment, my life is absolutely full-on and quality time together is scarce.

“We will all get through this,” he said.

“But we might have to accept that we will get a new version of ‘normal’.

This article appears in the October 2020 Issue of Life and Work

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