The spread of coronavirus in care homes is “heartbreaking” and “will haunt a lot of us for a long time”, Nicola Sturgeon has said.
Cases of the virus have been reported in 60% of Scotland’s care homes, with a total of 5,635 residents affected.
Ministers have come under pressure over why hundreds of hospital patients were sent to homes without being tested.
Ms Sturgeon said her government had “done what we thought was best based on the knowledge that we had at the time”.
But she said applying “hindsight” and “knowledge we have now that we didn’t have then” would lead her to “a different conclusion”.
Health Secretary Jeane Freeman has said there should be a review of social care in Scotland in the wake of the pandemic, as it had “shone a light” on areas that needed to be improved.
In the early days of the crisis, hundreds of “delayed discharge” patients were moved out of hospitals to make room for an expected wave of Covid-19 patients.
More than 900 of them were sent to care homes – before the point when coronavirus testing was made mandatory for such transfers.
Opposition parties say this raises “serious questions” about the government’s handling of the crisis, with Scottish Labour saying it was “inexcusable to discharge patients into care home without first testing them”.
As of 17 May there had been 1,623 deaths in care homes where Covid-19 was a confirmed or suspected cause, accounting for 46% of the total in Scotland.
Where have Scotland’s Covid-19 deaths occurred?
Ms Sturgeon told the BBC’s Good Morning Scotland programme that the situation in care homes across the UK was “heartbreaking” and “will haunt a lot of us for a long time emotionally”.
She said: “This is a virus that we know hits older people particularly hard, and it spreads faster in institutional settings like care homes.
“We put in place very early on risk assessment of people being admitted to care homes, we put in place guidance around isolation of residents within care home. But we have to continually review what we did as our knowledge of this virus develops.
“Its very easy and I guess understandable for those not in decision making positions to apply hindsight to all of this and apply knowledge that we have now that we didn’t have then to these decisions
“We learn as we go, but at all steps we do what we consider right to protect people from this virus.”
Asked if she believed the discharge of untested patients into care homes had exacerbated the issues there, Ms Sturgeon said “if I apply hindsight to that, I come to different conclusions”.
She said: “These older people, so called delayed discharges had no medical need to be in hospital.
“At that point we were getting ready for what we considered to be a tsunami of coronavirus cases into our hospitals, and our hospitals as it turned out were under huge pressure.
“It would have exposed older people to enormous risk to leave them in hospitals at that point.
“People say there should have been more testing and that is again a legitimate question, but what we knew then about the efficacy of testing asymptomatic people is different to what we know now.
“At every stage we have done what we thought was best based on the knowledge that we had a at the time. Of course mistakes will have been made and we learn as our knowledge of this virus increases. But the suggestion that any of us acted recklessly or without due care and attention to older people is frankly one that is not true.”
The first minister defended Ms Freeman for getting the figures about care home discharges wrong at Holyrood, saying she “made a mistake in articulating numbers” because she had been working around the clock and was “a bit tired”.
Opposition parties have called for the health secretary to step down, with the Scottish Conservatives saying she “no longer has the confidence of the public” and “simply can’t be trusted on care home coronavirus”.
Ms Sturgeon also said she was “very hopeful and optimistic” that some of Scotland’s lockdown restrictions could be lifted on Thursday.
She said: “The data would suggest that is the case, but I have to formally assess that on Thursday.
“It will be cautious step forward, because we have to keep the virus under control – but it will be the first step on a road back to hopefully a greater sense of normality.”