Chamber and committees

That is not the case. We have published an action plan and have rightly devoted resources to it, and health boards are taking forward a number of the actions in it. Clinics are a part of that, but not the only part. Health boards have to ensure that they have in place holistic support services for people who are suffering from long Covid and that, as far as possible, they are provided with services from routine healthcare up to and including specialist healthcare. That work is under way and it will need to continue alongside on-going efforts to ensure that we continue to understand the causes of long Covid and its impact on the health of individuals. That is all set out in the action plan, which will continue to be updated as appropriate.

I have set out the funding constraints within which we operate, but within that, of course, we seek to take decisions on the basis of public health advice and considerations. I have set out our approach to testing, which is about ensuring that, as we transition to an end-state testing approach—a steady state, I would hope—we do so in a careful way, with an appropriate transition.

I have set out the timescales for ending routine testing with lateral flow devices in the general population and in education settings. However, I have also said that, for any purpose for which the Government continues to advise and recommend testing—I have set out the broad categories now, but they might change over time depending on the development of the pandemic—we will ensure that access to tests, whether those are LFD or PCR tests, remains free of charge for those who are advised to use them.

That is something that clinical experts keep under very close review. The data on vaccine effectiveness is scrutinised closely. Emerging evidence demonstrates that boosters continue to provide strong protection against serious illness. Recently published Health Security Agency data indicates that initial vaccine effectiveness against hospitalisation among older people increases to around 90 per cent two weeks after a booster and remains at around that level for more than 10 weeks, although there will continue to be strong protection after that. That is why we continue to encourage people to come forward for vaccination, even if they have not had boosters so far. It is not too late to do so, and it gives significant protection.

I mentioned Hong Kong in my statement. For people who are interested, it is worth looking at the data. Omicron is causing very severe illness there, and the death numbers are spiralling because vaccination rates are relatively low. That underlines the importance of vaccination and the fact that it is immune protection that is making omicron less severe rather than any inherent mildness of the variant.

Thank you, Presiding Officer. Before I turn to Covid, and with your permission, I would like to give a brief update on our efforts to welcome refugees from Ukraine.

The response of the public across the United Kingdom in offering support has been truly outstanding, and I thank everyone who has volunteered. Under the UK scheme—with the exception of cases in which people already know someone who is seeking refuge—it may be some time before most of those who are offering help will be able to welcome someone from Ukraine. The Scottish Government’s super-sponsor proposal is intended to short-circuit that and allow Ukrainians to get here and be safeguarded and supported more quickly.

I am pleased to advise that the UK Government has now indicated support for the proposal in principle and has committed to working with us towards its immediate launch, alongside the wider UK scheme. That is a positive development. I hope that—assuming that we can agree details—as a start, it will allow us to welcome 3,000 Ukrainians to Scotland very soon. I will update Parliament more fully on these matters tomorrow.

Let me turn to Covid. I will confirm Cabinet’s decisions on lifting the limited measures that remain in law, and I will set out our intentions for the testing programme. First, though, I will give a brief overview of the state of the pandemic. Public Health Scotland has had server problems over the past 24 hours, so no daily figures were published yesterday—and, of course, figures are no longer published at weekends. The case number that is being reported today—38,770—is therefore the cumulative total for the past four days. For context, the total for the equivalent four-day period last week was 36,051.

The figures reflect the recent increase in cases. The Office for National Statistics survey suggests that, in the week to 6 March, one in 18 people in Scotland had Covid. Three weeks ago, an average of 6,900 new cases a day were being reported; the average now is just over 12,000 a day. There has also been a rise in the number of people who are in hospital with Covid. Three weeks ago, that stood at 1,060; today it is 1,996. The increase in cases over the past three weeks has been driven by the BA.2 sub-lineage of the omicron variant, which is estimated to be significantly more transmissible, with a growth rate since mid-February that is perhaps 80 per cent greater than that of the original omicron.

BA.2 is now the dominant strain in Scotland, accounting for more than 80 per cent of all reported cases. It has become dominant in Scotland earlier than in England and Wales, hence the more rapid increase in cases here than south of the border in recent weeks, although the numbers of cases and hospital admissions are now rising sharply again in England, too. Encouragingly, there is no evidence that BA.2 causes more severe illness than BA.1 or that it is more effective at evading natural or vaccine immunity. Indeed, immune protection means that the recent rise in cases and hospital admissions has not translated into a commensurate increase in cases of severe illness requiring intensive care. In other words, even though the weight of numbers of infections is putting significant pressure on hospital capacity—which is a real concern—we continue to observe strong evidence that the link between infection and serious health harm has weakened considerably.

It is likely that that is due to immune protection—not least from vaccines—more than it is due to omicron being inherently milder. That is borne out by current experience in Hong Kong, where relatively low rates of vaccination, particularly in the older population, mean that omicron is causing very significant levels of severe illness and death. That underlines the continued vital importance of vaccination. If you have not yet had doses that you are eligible for, please get them now.

Extension of the programme is on-going, in line with Joint Committee on Vaccination and Immunisation advice. Letters inviting five to 11-year-olds who are not in higher-risk groups to be vaccinated started arriving at the end of last week, and the first vaccinations are scheduled for Saturday. Additional booster jags for older adults in care homes started last week, and appointments will start next week for everyone aged 75 and over. Additional boosters for those who are immunosuppressed will start from mid-April. I know that people who are immunosuppressed and, indeed, others on the highest-risk list are concerned about high case rates at a time when regulations are being eased. It is important to stress, therefore, that significant protection is provided by vaccination.

The higher transmissibility of omicron poses challenges, but protection from vaccines and the increasing availability of effective Covid treatments are important factors. Using the approach that is set out in our revised strategic framework, and on the basis of clinical advice, our assessment is that the virus continues to present a medium threat. However, we remain optimistic that it will move from medium to low over the spring. As a result, we consider that the overall transition signalled in the strategic framework remains appropriate. We should—and will—continue the transition away from legal requirements to advice and guidance instead. Therefore, I can confirm, first, that from Friday, and in line with other UK nations, all remaining Covid-related travel restrictions will be lifted. Although we have some concerns about that, UK travel patterns mean that diverging from the rest of the UK would cause economic disadvantage without delivering any meaningful public health benefit. We do, of course, retain the ability to reintroduce travel measures if, for example, a new variant emerges.

Secondly, from next Monday, 21 March, the remaining domestic legal measures—with one temporary, precautionary exception—will be lifted and replaced with appropriate guidance. That means that, on Monday, the requirement for businesses and service providers to retain customer contact details will end. So, too, will the requirement for businesses, places of worship and service providers to have regard to Scottish Government guidance on Covid. They will, instead, be expected to take reasonably practicable measures set out in the guidance.

The exception relates to the requirement to wear face coverings on public transport and in certain indoor settings. Given the current spike in case numbers, we consider it prudent to retain that requirement in regulation for a further short period. I know that that will be disappointing for businesses and service providers such as day-care services, but ensuring the maximum continued use of face coverings will provide some additional protection—particularly for the most vulnerable—at a time when the risk of infection is very high, and it may help us to get over this spike more quickly. We will review the regulation again in two weeks, before the Easter recess, and our expectation now is that that regulation will convert to guidance in early April.

The other issue that I want to cover today is testing. Regrettably, our freedom of manoeuvre here is severely limited by the fact that our funding is determined by UK Government decisions that are taken for England. However, we have sought, as far as we can, to reach the right decisions for Scotland. It is important to note that we are aiming for the same long-term position as England on testing. However, we consider that the transition should be longer. In England, testing for people without symptoms ended in mid-February and will do so at the end of this month for those with symptoms.

We intend the transition to last until the end of April. That is as far as we can go within funding constraints, but it allows us to take account of current case numbers and to better support the shift in our overall management of the virus. A paper that sets out the detail has been published on the Scottish Government’s website. In summary, for the next month—until Easter—there will be no change to our testing advice. If you do not have symptoms, you should continue, for now, to use a lateral flow test twice weekly, daily for seven days if you are a close contact of a positive case, and before visiting someone who is vulnerable. If you have symptoms, you should continue to get a polymerase chain reaction test, either at a testing site or by post.

Following the Easter weekend, from 18 April, we will no longer advise people without symptoms to test twice weekly. With the exception of health and care settings, the advice to test regularly will end from 18 April for workplaces, early learning and childcare settings, mainstream and special schools, and universities and colleges. However, until the end of April, we will continue to advise the use of LFTs daily for seven days for people who are a close contact and on each occasion when visiting a hospital or care home, and we will continue to advise people with symptoms to get a PCR test.

Contact tracing of positive cases will continue until the end of April. PCR test sites will remain open during this period, although opening hours and locations might change during the transition. Although, as with all measures, we will keep this under review, our intention is that, from the end of April, all routine population-wide testing will end, including for people who have symptoms. Contact tracing will end at that point, too, although people with symptoms of respiratory illness will be advised to stay at home.

Physical test sites will close at the end of April, although mobile testing units and lab capacity will be retained for our longer-term testing purposes. During the transition, we will do everything that we can to support the people who have worked on the testing programme. I thank all of them for their invaluable contribution over the past two years.

From 1 May, in place of a population-wide approach, we will use testing on a targeted basis to support clinical care and treatment and to protect higher-risk settings and for surveillance, outbreak management and responding to significant developments such as a new variant. I stress that, for any purpose for which we continue to advise testing, access to tests will remain free of charge in Scotland.

Today marks steady progress back to normal life and a more sustainable way of managing the virus. However, while cases are spiking, there is still considerable pressure on the national health service and concern among the most vulnerable, in particular. Therefore, I ask everyone to be patient for a little while longer on face coverings and to continue to follow all advice on hygiene, ventilation, testing and, of course, vaccination.

I take the opportunity to again thank everyone for their continued efforts.

That is an important question. I am not able to give that information right now because we depend on, and we follow, JCVI advice.

The advice that we have is what I have set out in my statement today. There will be additional boosters for certain groups of the population, when that has been recommended, and, of course, the offer of vaccination for all five to 11-year-olds. I encourage everybody in those groups to take up those offers as soon as they are available.

We await further JCVI advice on what might be required as we go into next winter. My expectation, and the Scottish Government’s planning assumption, is that there will be a regular vaccination programme, but we still await final advice from the JCVI on exactly what the frequency will be, at whom exactly it will be targeted and how many doses might be involved. We will, of course, keep the Parliament updated on that as soon as the advice becomes available.

The point of having a lengthier transition plan than we are seeing south of the border is to ensure that we migrate smoothly and effectively to the end state. As we have seen in recent times, the pandemic will continue to throw up challenges for us. The plan is intended to ensure a smooth transition, and the timeline that we have set out allows us to do that.

With regard to wider pressures on the NHS—including NHS Lanarkshire, although many other health boards are experiencing those pressures—we need to see the number of hospital cases come down again. As of today, there are just under 2,000 patients in hospital with Covid. They will not all be in hospital because of Covid, but they are in hospital with Covid, and that brings additional challenges.

Part of the reason for being slightly cautious on face coverings to date is to help us—we hope—to get the spike under control. As we get the spike in cases, which is driven by the sub-lineage of omicron, under control, we will start to see the number of hospital cases come down again. That will then allow NHS Lanarkshire and other health boards to get back on track in restoring services to normal. I hope that we will see that happen very soon. The steps that we have set out today are intended to support that process and have it happen as quickly as possible.

Yes, I think that the decisions that we have taken to try to avoid the number of Covid cases being even higher and the harm that is caused by Covid to be even greater than it has been will be shown, in time, to have been worth it. Obviously, we are about to have a public inquiry, which will look at all such issues and will hold the Government to account. That is right and proper.

Every time that somebody says that we should not have taken a particular step—in this case, introducing vaccination passports—and should have avoided those costs, they also have to consider the potential implications of not taking the step, such as higher numbers of cases, more people in hospital and more people becoming seriously unwell. All of those decisions would have a cost, too, and not just a financial cost. [Interruption.]

Yes, I agree strongly with that; it is borne out by evidence. Right now, many people across Scotland and, indeed, the UK are suffering public health-related adverse impacts because of the poverty into which they have been plunged by the removal of the universal credit uplift. Unfortunately, those effects will be exacerbated by inflationary pressures and the increasing cost of living. As well as restoring that universal credit uplift, I call on the UK Government and the Chancellor of the Exchequer, when he makes his spring statement next week, to deliver significant support for people who are living in poverty, because that will help their health as well as ensure that their quality of life is better.

Given that I know the age of people to whom we are now offering the additional boosters, I am too scared to suggest whether Christine Grahame is likely to be included in those groups, so I will err on the side of caution on that front.

Testing is an important issue. As I set out in the chamber a couple of weeks ago, we are developing a managed transition plan to ensure that Scotland continues to have an effective, albeit proportionate, testing response and an effective surveillance infrastructure. Access to polymerase chain reaction and lateral flow tests will continue to be supported throughout the transition phase and they will remain free of charge for any purpose for which we continue to advise that testing is required.

The health secretary and I have been in regular dialogue with the UK testing programme but, unfortunately, we still do not have clarity on the impact on Scottish Government funding. We continue to engage urgently with the UK Government to gain that clarity and I hope that we will do so soon.

First, I understand that what is a new United Kingdom-wide set of retrofit standards has created challenges in the Western Isles. Over the past week, we have followed that up with the housing provider and the council, restating our commitment to finding a solution that enables them to continue to improve the warmth and ventilation of people’s homes. I know that Dr Allan has raised the issue before and I believe that he has received a copy of the most recent correspondence.

Officials are also working with the British Standards Institution to further improve the new retrofit standards to ensure that circumstances in remote rural and island communities are taken fully into account. We value the housing work that is done in the Western Isles and hope that the issue can be reconsidered now, in light of our further discussions, and that we will continue to see that expertise applied in the Western Isles.