Chamber and committees

On the issue of vaccination certification, the difference between the Scottish Government and Alex Cole-Hamilton is that we assess the proportionality on the basis of the evidence, and we make balanced judgments. If the evidence shows us that certification is a less restrictive option than other measures, we will consider it. Alex Cole-Hamilton takes a fixed, ideological position, which, in the face of an infectious virus, is not appropriate. That is perhaps the key difference.

None of us wants to go back to restrictions. Even the further protective measures that have been in place over the past few weeks were far less restrictive than those at earlier stages in the pandemic, because, as we have been doing for most of this year, we are gradually learning to live with Covid in a greater way. However, we need to continue to assess matters on the basis of the evidence.

The Government has been totally transparent—we publish figures every single day. People say, “Show us the data,” but we publish the data every day. The evidence is in how the virus behaves, and we know from epidemiological evidence that the virus spreads when people come together—more so in particular settings. We will continue to enhance the data as our knowledge becomes more developed.

On the freedom of information issue, the commissioner actually found that the information being withheld was of a type to which the exemption that covers development of Government policy applied. He accepted that the information was intended to assist in developing policy in relation to a possible second wave, but he took a different view in assessing the public interest issue. We will consider the commissioner’s decision carefully and respond appropriately.

I agree that NHS staff should not have to pay to park their cars when they turn up to work. I was the health secretary who removed car parking charges at NHS-owned car parks, and, at the start of the pandemic, when Jeane Freeman was health secretary, she managed to secure the removal of car parking charges from the private finance initiative car parks that still had them. That is an important principle.

I will ask the Cabinet Secretary for Health and Social Care to engage with the health board on that particular issue so that we can ensure, particularly at this exceptionally challenging time for those who work on the front line of our NHS, that they are not being penalised unfairly.

I will report on the current and, at this stage, much more positive course of the pandemic. I will explain why, although significant pressures and uncertainties remain, the latest data nevertheless gives us confidence that we have turned the corner on the omicron wave. I will then confirm our next steps in lifting the protective measures that were introduced before Christmas. I will also indicate what we can all continue to do in the immediate period ahead to keep cases on a downward trend and reduce the pressure on the national health service and the wider economy. Finally, I will provide a further update on the vaccination programme.

First, though, I turn to today’s statistics, which show that 7,752 positive cases were reported yesterday through both polymerase chain reaction and lateral flow tests. There are 1,546 people in hospital with Covid, which is 21 fewer than yesterday. There are 59 people in intensive care, including 17 who have been in intensive care units for more than 28 days. That is one more than yesterday. Sadly, a further 31 deaths have been reported, which takes the total number of deaths under the daily definition to 10,093. Once again, I send my condolences to everyone who is mourning a loved one.

As we can see from the data, omicron is continuing to infect large numbers of people here in Scotland, across the United Kingdom and indeed in many other countries around the world. Hospital admissions and overall hospital occupancy associated with Covid also remain high.

However, notwithstanding the very real challenges that Covid continues to present, the evidence that I set out last week suggesting that the situation was beginning to improve has significantly strengthened over the past seven days. A combination of booster vaccinations, the willingness of the public to adapt their behaviour to help to stem transmission and the temporary protective measures that were introduced in December has helped to blunt the impact of the omicron wave.

Last week, I said that the data indicated that cases were falling across most age groups. I can report today that that trend has continued. Some caution still needs to be applied in interpreting case data at this stage, given the recent changes to guidance on PCR and lateral flow testing. However, data for the past 13 days, taking account of both PCR and lateral flow tests, shows a significant fall in the number of new positive cases.

To put some detail on that, I note that, on Sunday, Monday and Tuesday of last week, 36,526 new positive cases were recorded through PCR and lateral flow tests. This week, on Sunday, Monday and today—Tuesday—20,268 cases have been reported. That represents quite a significant drop. If we look just at PCR tests, although I ask everyone to bear in mind the limitations in doing so, we see that cases have fallen from an average of almost 13,000 a day to just over 4,600 a day. That is a decline of 64 per cent, and cases have fallen across all age groups. Test positivity in PCR tests has also declined, from almost 30 per cent in early January to under 20 per cent now.

The most recent data from the Office for National Statistics, which covers the week to 7 January and therefore has a time lag associated with it, reinforces that more stable and positive assessment. It indicates that the number of people with Covid in that week—around one in 20—was broadly the same as in the previous week.

Taking all of that into account and triangulating the various sources of data allows us to say with some confidence that the rise in cases that was driven by omicron peaked in the first week of January and that we are now on the downward slope of that wave of cases.

That assessment is reflected in the data on hospital admissions. Hospital occupancy—the number of patients who are in hospital with Covid at any given time—is higher than it was seven days ago, having increased from 1,479 then to 1,546 today; however, that increase of 67 is significantly smaller than it was in the previous seven days. In addition, encouragingly, admissions to hospital of people with Covid, albeit still too high, are nevertheless now falling. In the week to 7 January, 1,040 were admitted; in the week to 14 January, that was down to 960. The number of people in ICUs, which, this time last week, was rising, has also fallen slightly over the past seven days—from 65 to 59.

All of that is very positive news and comes as an enormous relief, I am sure, to all of us. Of course, we need to recognise that there are still some uncertainties ahead, and that throwing all caution to the wind would therefore be a mistake. For example, the full impact of the return to work and school after the festive break will not yet be apparent in the data, so it is possible that we will see case numbers tick upwards again in the next couple of weeks. In addition, just as the introduction of some protective measures may have helped to slow down transmission, it stands to reason that the lifting of those measures could have the opposite effect. That is exactly why it makes sense to lift measures on a phased basis. Lastly, although cases are now falling, the NHS remains under acute pressure, and staff absences are still causing some disruption across the economy and our critical services.

Therefore, although we can take great heart from the latest data, we know from experience how important it is to be responsible and appropriately cautious in the face of the virus. That is the context for the decisions that the Cabinet reached this morning.

Yesterday, the limit on attendances at outdoor public events was lifted. The remaining statutory measures that were introduced in response to omicron are as follows: limits on attendance at indoor public events; the requirement for 1m physical distancing between different groups in indoor public places; the requirement for table service in hospitality premises that serve alcohol on the premises; and the closure of nightclubs. Given the improving situation—and as I said last week that we hoped to be able to do—I can confirm today that all those measures will be lifted from next Monday, 24 January. From that day, we will also remove the guidance that advises adults against non-professional indoor contact sports, so that those can resume as normal, and we will lift the guidance that asks people to stick to a three-household limit on indoor gatherings.

However, it is important to stress that, notwithstanding the improving situation, the level of Covid infection that is circulating in the community is still high. To minimise the risk of getting the virus, therefore, it would be sensible for all of us to remain cautious in our social interactions at this stage. Even though, from Monday, we will no longer recommend a fixed upper limit on numbers of households, if we all continue to keep gatherings as small as our circumstances allow for now—and, I suggest, until the end of this month—we will reduce our chances of getting infected.

Of course, we should continue to take lateral flow tests before meeting up with people from other households. I ask people please also to remember to record test results, whether those are positive or negative, through the UK Government website. I stress that that is even more important now that we are no longer advising confirmatory PCR tests for those without symptoms who test positive through lateral flow devices. Recording those results ensures that we are able to make better assessments of the trends in infection.

Finally, we will continue to ask people to work from home whenever possible at this stage, and for employers to facilitate that. However, we will engage with business now about a return to a more hybrid approach from the start of February.

The baseline mitigation measures that were in place before omicron, and the requirement for businesses, service providers and places of worship to take reasonable measures to minimise the spread of Covid on their premises, will be retained at this stage to help keep Covid contained as this wave recedes.

That means that face coverings must still be worn in public indoor settings and on public transport, that businesses and other organisations should continue to have regard to guidance and take reasonable steps to minimise the spread of Covid, and that hospitality premises should continue to collect contact details for customers, which is important for the effective operation of test and protect.

In addition, the Covid certification scheme will continue to apply for now to large indoor and outdoor events and to late-night venues—all settings where transmission risks can be higher. As of yesterday, guidance stipulates that organisers of events with 1,000 or more in attendance should check the certification status of at least 50 per cent of attendees or 1,000 people, whichever is higher.

I indicated last week that the Cabinet would consider and decide today whether to extend the certification scheme to other premises, such as licensed hospitality venues. That was undoubtedly the most difficult decision that we faced this morning and—yet again—the judgment that we have arrived at was finely balanced.

On the one hand, extending Covid certification could offer public health benefits. Ensuring that people attending certain venues are vaccinated or tested reduces, to some extent, the risks of transmission and the risk of serious illness should an individual contract the virus in one of those settings. On the other hand, we understand that extending certification could create additional costs for businesses at an already very challenging time—and, of course, the smaller the business, the more difficult those costs can be to bear.

The task for the Cabinet today was to weigh those considerations and decide what—in the current circumstances—would be proportionate. Given that cases are now falling quite rapidly and that the current wave is receding, we decided that we will not at this stage extend the Covid certification scheme to other premises.

We will of course reconsider that should circumstances—and therefore the balance of judgment—change in any significant way. If cases were to start to rise very sharply again, extension of certification may well be a more proportionate alternative to other, more restrictive measures. However, our conclusion today, given the improving situation, is that extending certification would not be proportionate at this stage.

However, we will propose one reasonably minor change to the certification regulations. At the moment, nightclubs and other late night venues must apply the Covid certification scheme if they have, in use, a designated area for dancing. We intend to amend the definition here to provide greater clarity and to prevent premises from avoiding certification simply by having tables on a dance floor—and therefore claiming that it is not a dance floor—but nevertheless permitting dancing to take place. That change will take effect from Monday when late-night venues are able to reopen.

Finally, let me say a few words about the updated rules on self-isolation after a positive Covid test. Those rules, which were confirmed two weeks ago, remain in place. If you test positive, you will be advised to self-isolate for 10 days. However, if you do not have a fever and you take two negative lateral flow tests more than 24 hours apart on day 6 and day 7, you can end self-isolation on day 7.

Last week, the United Kingdom Government announced further changes to self-isolation in England. That was publicised as allowing people to end self-isolation after day 5. In essence, however, that change simply brings England’s rules into line with those already in force in Scotland. That is because, in Scotland, we count the day of a positive test as day 1 of isolation; in England, that is counted as day zero. In addition, in England, you can end self-isolation only after day 5; in Scotland, you can end it on day 7.

The slightly different ways of defining the beginning and the end of the self-isolation period has therefore given the impression of difference. However, the substance—the period that people are actually required to self-isolate for—is, in fact, the same in Scotland and England. It is important that people are clear about that.

The lifting, from Monday, of the protections introduced in response to omicron is possible, in part, because of the efforts that everyone has made—voluntarily and as a result of guidance and statutory measures—to help stem transmission. I put on record again today my thanks to people across the country.

It is also, of course, down to the success of vaccines. At this stage of the vaccination programme, we continue to offer boosters and implement the latest advice from the Joint Committee on Vaccination and Immunisation.

Just before Christmas, the JCVI recommended that booster jags should be offered to 16 and 17-year-olds, 12 weeks after their second jags. Therefore, any 16 or 17-year-old who had a second jag 12 weeks ago or more, or who is just approaching that point, can now book a booster appointment online through NHS inform. They can also turn up at a drop-in centre and get the booster there.

In addition, second doses of the vaccine are now available for 12 to 15-year-olds who had a first dose at least 12 weeks previously. Again, appointments can be booked online. Alternatively, young people can choose to go to a drop-in centre. Parents and carers are, of course, welcome to attend with them.

So far, the JCVI has recommended that booster jags should be offered only to those 12 to 15-year-olds who are at particular clinical risk from Covid. Any 12 to 15-year-old who is in that position will receive a letter inviting them for a booster 12 weeks after their last primary dose. There is no need to book an appointment.

Finally, 5 to 11-year-olds with specific medical conditions that put them at greater risk from Covid will be invited for their first vaccination from this week onwards. Again, I stress that they will be contacted directly: there is no need for them—or, more appropriate, their parents or carers—to book online. In due course, 5 to 11-year-olds who are household contacts of people with immune suppression will also be invited to receive vaccination. Of course, we stand ready to quickly implement any updated advice from the JCVI about vaccinating all 5 to 11-year-olds.

There are good reasons why the JCVI has given different advice for different age groups, but I realise that it can be confusing. The NHS inform website now has a self-help guide for parents, carers and children, which sets out what young people need to do to get vaccinated, and when they can do it. People who cannot get online can get that information by phoning the vaccination hotline on 0800 030 8013.

The final point that I want to make relates to vaccinations for adults. Scotland has achieved very high rates of vaccination. We are the most vaccinated part of the UK in terms of first, second, third and booster doses. However, there are still more than 600,000 people over the age of 18 who are eligible for a booster but have not yet had it, and there are hundreds of thousands more who have not yet had a first or second dose. I encourage anyone who falls into one of those categories to make an appointment as soon as possible or go to a drop-in clinic: there is plenty of capacity and you will be made welcome.

The latest available data, adjusted for age, shows that someone who is not fully vaccinated is at least four times more likely to require hospital treatment than someone who has had a booster or third dose. Although being fully vaccinated does not eradicate the risk—for any of us—of getting Covid, it reduces that risk and therefore reduces the risk of our passing Covid on to others.

Therefore, if you choose, without good reason, not to be fully vaccinated, you are putting your own and others’ lives at unnecessary risk. If you have not had a booster or third jag yet, please come forward as soon as possible, and if you have not had a first or second dose yet, please do so without delay. It is never too late to get the Covid vaccine and to start getting the protection that the vaccines offer.

The situation that we face today is undoubtedly less severe and much more positive than it might have been without the sacrifices that everyone has made over the past few weeks, although, despite what people might be hearing from media commentary, we have not yet moved from the epidemic to the endemic phase of Covid. I hope that that transition is under way.

We are, I hope, once again entering a calmer phase of the epidemic. That then allows us to consider the adaptations that we might need to make to build our resilience and manage the virus in a less restrictive way in future, as we move into an endemic phase. As I have indicated in previous weeks, we have started work on an updated strategic framework; we will consult on that over coming weeks.

All that gives us much cause for renewed optimism. That said, we are still in a challenging position. The NHS remains under very significant pressure. Indeed, as is reflected in today’s accident and emergency waiting time figures, the past couple of weeks have probably been the most difficult that the NHS has ever faced, as Covid-related staff absences have compounded the other pressures with which it is dealing.

The number of Covid cases across Scotland, although declining, also remains high, and because omicron is so infectious, there is still a significant risk attached to social meetings and interactions. That is why, although we can be increasingly optimistic at this stage, we must all still play our part in helping to further slow the spread of the virus.

I highlight again the steps that we can all take to help to do that. First, as I have just talked about at length, please get fully vaccinated if you have not already done so. Secondly, take care when socialising. Until Monday, keep indoor gatherings to a maximum of three households. I suggest that, after that, for the rest of this month, try to keep indoor gatherings as small as your circumstances allow. Test before you go, every time. Lastly, please take all the other precautions that we know make a difference. If you are meeting indoors, keep windows open. Continue to work from home for now if you can. Wear a face covering on public transport, in shops and when moving about in hospitality settings, and follow all advice on hygiene.

Those measures make a difference. The fact that so many people have stuck with them has helped to make it possible to lift the protective measures that were put in place before Christmas. If we continue to stick with those measures, we can all continue to do our bit to keep each other safe, protect the NHS and keep us firmly on the path—even if only metaphorically speaking—to a much sunnier spring and summer.

Care homes should ensure appropriate visiting for residents and make full use of PPE and testing. I know that they are working hard to do that.

Specifically on self-isolation, although decisions have understandably been subject to question and criticism, our overriding priority throughout the pandemic has been to safeguard and protect residents and staff in care homes. At times, during the pandemic, those have been some of the most difficult decisions with some of the most challenging and difficult outcomes. However, it remains really important that we take very careful decisions on the matter, given the frailty and vulnerability of the people we are discussing.

The measures that are in place ensure that loved ones can have contact with residents while balancing the Covid risk and the need to keep people safe, in line with clinical and public health advice. That is especially true given the emergence of omicron, which is much more infectious. However, as I think that I said in the chamber last week, given the recent changes to self-isolation more generally that we announced two weeks ago, we had already commissioned public health experts to review the guidelines that are in place for care home residents. We expect to be able to announce an updated position on that imminently, but I hope that Monica Lennon and, indeed, all members will accept that it is important that we do so on the basis of quality clinical and expert advice.

Yes, I confirm that. It is an important point to raise. Isolation remains a really important part of our response to the virus to help us to break the chains of transmission. That is obviously particularly the case when someone has tested positive. One of the unanswered questions in what the Conservatives called on us to do yesterday—which, as I read it, was just to remove everything and take our chances with Covid—is whether they were actually suggesting that we should remove self-isolation for people who test positive. Perhaps they will take the opportunity to clarify that.

We will keep in place support for people who are self-isolating, because we recognise the financial challenges. None of this is easy or what any of us wants to be doing but, particularly at this stage—almost two years into the pandemic—it is really important that we take basic precautions to avoid, as far as we can, the situation going into reverse again.

The money that we have made available across different sectors is in the process of flowing to businesses. As I said in response to Paul Sweeney’s question—or it might have been Daniel Johnson’s question—we will publish outturn information on each of the strands of business support that will show exactly how much of it has been allocated. We will publish that information at the end of January. We will continue to ensure that we are doing as much as possible to support businesses—whether it is B and Bs or businesses in other parts of the hospitality and leisure sectors—that have been very badly affected by the pandemic generally, but in the past few weeks in particular.

I repeat a central point: the most important thing that we can do—perhaps it is not the most important thing, because in the immediate term that is providing financial assistance but, overall, the most important thing that we can do—is keep Covid under control. That is why I appeal to everybody across the chamber to understand why a careful and cautious path out of this wave is really important in the wider economic interests, as well as the health interests, of the country.

I have made my views clear, as many other people have, about the reports of repeated—serial—breaches of the Covid rules on the part of the Prime Minister and those working for and around him. I absolutely understand the intense anger that people feel about that, given the very painful sacrifices that so many people have made over the past couple of years.

Of course, all that has the potential to undermine compliance with the things that we are still asking people to do. However, this is what I would say to people: the reason for complying with any guidance or protective measures that are in place at any time during the pandemic is not because a Prime Minister, First Minister or any politician tells you to do so; the reason for all of us to do that is to keep ourselves, those we love and the whole country as safe as possible.

While we are still in the pandemic, I appeal to everybody not to allow understandable and justified anger at politicians to get in the way of doing the right thing for themselves and their loved ones.

I give the assurance that we will keep vaccination open, available and accessible. It will never be too late to get vaccinated.

I will not stand here and say that every single centre that was open and necessary while we were vaccinating large numbers of people on a daily basis will remain open because, as we go through different phases of the vaccination programme, different models of provision will be more appropriate. A large vaccination centre, when we are dealing with more of a trickle of people rather than a big flood of people, would not be a good or efficient use of resources. We will judge that on an on-going basis, as we have done throughout.

I do not pretend that, on any aspect of handling the virus, we have got everything right all the time; manifestly, we have not. However, right now, on first, second and booster doses, we are the most vaccinated part of the UK. That would suggest that the approaches that we have taken so far have been effective, and we have a responsibility to ensure that they remain so.

On the central question, we will, of course, absolutely make sure that anybody who is not already vaccinated and wants to come forward to be vaccinated is able to do so.

It is brilliant to have Ruth Maguire back with us as a friend, a colleague and, indeed, the MSP for my home town. It is absolutely brilliant to see her back in Parliament and looking so well.

Ruth Maguire has raised an mportant issue. It is important to stress that Covid continues to pose a serious risk to unvaccinated pregnant women and their babies. Data from Public Health Scotland shows that 98 per cent of pregnant women with Covid who required intensive care in Scotland were unvaccinated. The decision was therefore taken by ministers to temporarily defer fertility treatment for women who are not fully vaccinated.

I fully understand that undergoing fertility treatment is an emotional experience for those involved. Treatment centres provide counselling to women who want to discuss vaccination in more detail, and they are in touch with patients to provide further information on treatment and vaccination. Public Health Scotland has also produced information leaflets and online information to encourage vaccine uptake among pregnant women, and additional guidance on fertility and vaccination can be found on our Parent Club and NHS Inform websites.

Paper certificates are available, as I set out again last week. They are accepted at domestic venues where the certification scheme is in operation, and they are accepted by most countries around the world for entry through borders. Boosters were added to paper certificates on 13 December. People should request a new copy if their certificate was issued before that date. In addition, QR codes are regularly updated for security reasons, and paper copies should be renewed every three months to ensure that a valid QR code is used.

We encourage people to use the app where possible for domestic purposes and for international travel certification requirements, as it updates all QR codes each time the app is activated. However, paper copies continue to be available.