Chamber and committees

That is obviously an important issue. I think that everybody understands and agrees that protecting people in care homes, who are often the most vulnerable to Covid, is an overriding priority. The measures that are currently in place enable loved ones to have meaningful contact with care home residents while balancing the Covid risk. The need to keep people safe in line with public health advice, especially given omicron, very much underpins the decisions that we take.

Given the changes to isolation that I set out last week, we have already commissioned public health experts to review the guidelines that are currently in place on self-isolation for care home residents. We expect to be able to update the position imminently, and I undertake to ensure that the Parliament is notified of that as quickly as the work allows us to.

This is a difficult time for travel agents, as it is for businesses in different sectors across the economy. Through the measures that we have in place, we are trying as hard as we can to target funding at sectors that are most immediately and severely impacted. We have recently announced additional support for businesses and we are working with different sectors, including the travel sector, to get that money to affected businesses as quickly as possible. That work will continue for as long as there is a necessity to have such measures in place.

Public Health Scotland is providing information on the relative risk of vaccination and non-vaccination—I am sure that Murdo Fraser has seen that information in past Public Health Scotland reports. As I said in my statement, the up-to-date data shows that people are at more than four times greater risk of being hospitalised if they are not fully vaccinated than if they are fully vaccinated.

Public Health Scotland will continue to consider how best to present information, but there is no dubiety—there is no doubt whatsoever—about the fact that, for people who are fully vaccinated, the risk of serious illness is significantly lower than is the case for those who are not fully vaccinated. We should be giving out that message loudly and clearly.

On the last part of that question, yes, I do think that it is important that we get the balance right. We all want to move back to normality as quickly as possible. However, we know from past experience that, if we do that too quickly or in the wrong order, it can set us back rather than take us forward. Those judgments continue to be made as carefully as possible.

On lateral flow testing, I think that living with Covid is likely to involve the need to test ourselves in particular situations for some time. Therefore, for that to be effective, it is essential that we continue to make lateral flow tests available as widely as possible and free of charge. That is a really important principle for the effective working of any testing strategy.

The UK Government has been at pains to say that it is not thinking of removing free access to lateral flow devices any time soon. I hope that we see that assurance solidify and be replaced with a clear commitment to continuing with free lateral flow devices for as long as necessary.

On self-isolation, after careful consideration, we have moved from 10 to seven days. Having done that, I think that it would be a mistake to go further before we have had a chance to assess the impact of that change. We will continue to keep all those issues under review, which will be informed by the best clinical and expert advice possible.

I am certainly glad that the member has been clearer on that point this week than he managed to be last week. The national clinical director is possibly the most misquoted person in Scotland at the moment, and I suspect that that applies in relation to the member’s question.

It is not the case that there is secret data that we take decisions on. The member is a doctor and understands more than most the difference between data, evidence and judgment. We publish all the data that is there and relevant. Data is case numbers, hospitalisation numbers and the numbers who sadly die—we publish that data.

The evidence is about where the risks are highest in terms of transmission, which we know is where ventilation is most difficult, where people come together and, often, where alcohol is involved. We take all that and apply our judgment to how best to stem transmission. That is what we do every week. It is what we will continue to do. It is difficult—I wish it was easier—to draw absolute causative links between measure A and outcome B, but all of what we are seeing right now, not just in Scotland but, I would suggest, in many other countries as well, is that it is a combination of vaccination, behavioural response and proportionate, balanced measures in higher-risk settings that are helping to blunt the edge of the omicron wave. There is no magic wand to be waved, but it is that combination that is helping us through and it is that balanced combination of measures that we will continue to seek to take.

Public health and the protection of public health is very much a devolved competence in my view, Presiding Officer. People across the country are aghast at the revelations about Downing Street’s conduct. It appears that there was not just one isolated breach but serial breaches of guidance that people were following through painful sacrifices throughout the pandemic, and a Prime Minister who apparently is not being truthful about his knowledge of those matters. It will not surprise anybody to hear my view that not only the office of Prime Minister but the interests of the United Kingdom would be greatly enhanced by Boris Johnson’s departure.

When this issue is raised, the groans that come from those on the Conservative benches suggest that they are out of touch with the feeling and sentiment across the country. Over the past two years, people have been unable to see loved ones on their death beds or go to funerals and comfort other loved ones during bereavement, and they have had long periods of absence from those who are nearest and dearest to them. To find that it appears that those making the rules in Downing Street were, on a serial basis, breaching those rules is deeply angering and upsetting to people. That must be understood and acknowledged.

I understand the anger but, as First Minister with the chief responsibility for trying to protect the public health of the country, I say to people across the country that, notwithstanding anger at politicians—wherever and whoever they are—the guidance is there to keep them safe and to keep the country collectively safe. Therefore, I ask people to continue to do the right thing, as the vast majority have been doing throughout. Once again, I take the opportunity to thank everybody for the painful sacrifices that have been made.

Action to reduce waiting times is currently being taken in the form of additional investment and efforts to maximise capacity as the NHS recovers. In the NHS recovery plan, we set out the medium to longer-term commitments on increased capacity. That includes the commitment to national elective treatment centres. It also involves increased recruitment.

Recruitment in health, social care and across the economy is a challenge. One significant reason for that is Brexit and the end of free movement. We must ensure that we do not lose sight of that. We will continue supporting the national health service in a range of ways to try to avoid unnecessary admissions, to reduce delayed discharge at the other end of the hospital system and to ensure that we get waiting times back down as quickly as possible. Getting Covid under control is crucial to that. Reducing that pressure on the NHS will enable it to focus fully on recovery work.

I am happy to provide an assurance about the safety and efficacy of the vaccine for pregnant women. A woman who is pregnant might not want to hear that from me, as someone who does not have clinical qualifications. I would point them to their midwife, to the Royal College of Obstetricians and Gynaecologists or to the Royal College of Midwives. All those expert voices are not only giving assurance about the safety of the vaccine for pregnant women but actively encouraging pregnant women to get vaccinated.

I repeat that call. If you are pregnant and are not yet vaccinated, take steps to do that. It provides you with protection and also provides protection for your unborn baby.

Thank you, Presiding Officer. First of all, let me give you that assurance. Aside from the matter of showing disrespect to Parliament—which is a very serious matter—let me assure you that there is no benefit or advantage to the Scottish Government in the contents of these statements being known in advance of my delivering them to Parliament. I have asked my officials to look into the matter, and I can advise the chamber that the Scottish Government’s chief information security officer will undertake appropriate inquiries to establish whether there has, indeed, been a leak of some of the contents of the statement in advance of my delivering it—and, if so, the circumstances and source of that leak. I undertake to keep your office advised of the progress and outcome of that, Presiding Officer. However, let me assure you that I take very seriously my obligations and responsibilities, and those of my Government, to this Parliament. I hope that you will accept that assurance.

Today, I will report on the current course of the pandemic. I will assess the latest data and set out our tentative view that, although significant uncertainties remain in both the data and the immediate period ahead, there are nevertheless some grounds for cautious optimism that a combination of the protective measures that were introduced before Christmas, responsible action on the part of the general public and the rapid delivery of vaccine boosters has had a positive impact. As a result, I will indicate that, from next week, we will begin to lift the measures that were introduced before Christmas, but in a phased and careful way, starting with the removal of attendance limits on live outdoor events from Monday.

First, though, I will run through today’s statistics. Yesterday, 10,392 positive cases were reported as a result of polymerase chain reaction tests, which was 27.7 per cent of all PCR tests that were carried out. There are 1,479 people in hospital with Covid, which is 47 more than yesterday. Of them, 65 people are in intensive care, 11 of whom have been in intensive care for more than 28 days. Sadly, a further 16 deaths have been reported, which takes the total number of deaths under the daily definition to 9,950. Again, I send my condolences to everyone who is mourning a loved one.

The increased transmissibility of the omicron variant is still causing very high levels of infection in Scotland, across the United Kingdom and in many countries around the world. However, although the situation remains very challenging, not least for the national health service, some very early indications in the data offer some encouragement.

First, although it is always difficult to prove a direct causal link between any specific action or measure and subsequent outcomes, there is reason to be optimistic that protective measures, the behavioural response of the general public and the vaccination programme have helped to mitigate, to some extent, the impact of the omicron wave. For instance, our central projection last month was that new infections could reach 50,000 a day by early January, which has not, so far, materialised. Instead, we estimate that the total number of new infections per day in early January—not only those recorded through positive PCR tests—may have been around 30,000. In other words, it is very likely that the situation that we face now, although serious, would have been even more challenging without the renewed sacrifices that have been made by people across the country over these past few weeks.

Further, although we need to be cautious in our interpretation of the daily case numbers at this stage, for reasons that I will set out, we can see from those numbers and from hospital data some early indications that the situation might be starting to improve. Over the past week, an average of just over 12,700 new cases a day were confirmed through PCR tests. That is down by 17 per cent compared to the daily average in the preceding seven days. Indeed, on that measure, cases have fallen in the past week across all age groups except the over-85s. That is encouraging and gives us some hope that cases might be at, or close to, the peak.

However, as I said a moment ago, caution is required in interpreting the figures. The changes to the guidance on testing that I set out last week—to the effect that people without symptoms who test positive with a lateral flow device no longer need to get a confirmatory PCR test—mean that the current daily numbers are capturing fewer positive cases than before. To address that, Public Health Scotland will augment its daily reports in the future. I advise the Parliament that, from Thursday, in addition to reporting the number of people who test positive for Covid through a PCR test, it will report a combined figure for the number of people who have recorded a first positive PCR or lateral flow test.

Given the increased complexity—and, not least, the need to avoid duplication—there will initially be a time lag in that reporting, so the data that is released on Thursday will cover the period up to today. Public Health Scotland will work to reduce that time lag in the coming period.

The additional data will allow us to assess the trend in cases more accurately than we can do now. Of course, that is dependent on all of us actually recording our lateral flow results, whether they are positive or negative. Therefore, let me take this opportunity to remind everyone that that can and should be done through the UK Government website. You can find the page easily by searching for how to report a lateral flow test.

One further piece of data gives us some grounds for optimism at this stage. Although the number of people in hospital with Covid has continued to increase over the past week, putting significant additional pressure on the NHS, there are signs that the rate of increase might be starting to slow down. The number of people in hospital with Covid increased from 594 two weeks ago to 1,147 this time last week—an increase of 553. Since then, it has risen further to 1,479—a smaller increase of 332. It is important to note, however, that the number of people with Covid in intensive care has increased more rapidly in the past week than in previous weeks. However, that is likely to reflect the time lag between people becoming hospitalised and then requiring intensive care.

In summary, the situation just now is undoubtedly serious but perhaps less so than it might have been, and there are some signs that we might be starting to turn a corner.

That said, the position is still fragile and significant uncertainties remain. I have already explained the uncertainties in the data that mean that the picture is not yet quite as clear as we would like it to be and as we hope it will be in the next week or so. Of course, we do not yet know what impact the post-Christmas return to work and school will have on the level of infection.

What we do know is that staff absences resulting from high levels of infection are causing disruption in the economy and in critical services and that the NHS remains under very severe pressure indeed. Continuing to slow down transmission therefore remains a vital imperative.

The conclusion from all of that, in my view and in the view of the Cabinet, is as follows. It is reasonable and right to be hopeful on the strength of the latest data, but, for the period immediately ahead, it is prudent to remain careful and cautious. That is the balance of judgment that has informed the decisions that the Cabinet reached this morning.

As I indicated, from Monday, we will begin to lift the protective measures that were announced before Christmas, but we will do that in a phased way that will allow us to form, in the days ahead, a clearer picture of the trends in infections and the associated impacts.

As a quick reminder, the measures to which I am specifically referring are limits on attendances at live public events, the requirement for distancing between groups in public indoor places and the requirement for table service in hospitality venues that serve alcohol on the premises.

I expect to confirm further dates next week, but I can confirm today that the attendance limit of 500 at large-scale outdoor events will be lifted from Monday 17 January. That means, for example, that spectators will again be permitted at major outdoor sporting events including the football fixtures that are scheduled for early next week and the forthcoming six nations rugby matches.

The Covid certification scheme will remain in place for those and other events and venues previously covered, but with two important changes. First, our guidance will now stipulate that the organisers of large events of 1,000 or more people should check the certification status of at least 50 per cent of attendees, rather than the current 20 per cent, or at least 1,000 people—whichever figure is higher. Secondly, from Monday, the requirement to be fully vaccinated, for the purposes of Covid certification, will include having a booster if the second dose was more than four months ago.

The NHS Scotland Covid status app for domestic use will be updated from Thursday so that its QR code includes evidence of booster vaccination. It will also be possible to order updated paper and PDF copies of vaccination status, which are now valid for three months, and it will still be possible to gain admission to events and venues covered by the certification scheme by providing proof of a recent negative lateral flow test.

The Cabinet will next review the data at our meeting a week today. I hope that that will allow us to lift the other protective measures—limits on indoor live events, table service in hospitality and distancing in indoor public places—from 24 January. However, I will confirm that in my statement next week.

There is a related point that I want to draw to Parliament’s attention. As we lift those other protective measures, it will be necessary to consider again whether extending the scope of Covid certification to other venues might be a necessary protection. To be clear, we have not yet taken any decisions on that, and it will require careful judgment. However, I want to be clear to Parliament that it is something that we feel bound to give appropriate consideration to.

What I have just set out gives our direction of travel in relation to the additional measures that were set out before Christmas in response to omicron. The baseline measures that were in place before the emergence of omicron, such as the requirement to wear face coverings in indoor public places and to work from home when possible, will remain in place for now. So, too—for at least the immediate period ahead—will the advice to the general public to try to limit contact with people in other households and, in particular, to limit the number of households in any indoor gathering to a maximum of three.

We are not advising or asking people to cut all social interaction. That simply is not practical, and it would have a serious impact on mental health and wellbeing. However, trying to limit social interactions remains a sensible step at this stage. It helps to stem, to some extent, increases in transmission. It therefore not only has a collective benefit but helps to protect us as individuals. At a time when 1 in 20 of us could have the virus, the risk of becoming infected when we mix with others is significant, and cutting back on contacts, where possible, and prioritising those that are most important to us helps to reduce that risk. If we make sure that there are no more than three households in any indoor gathering that we do have, and take lateral flow tests before we go, we further reduce the risks. All of that remains important for now.

There are four further issues that I want to touch on before I conclude. The first is to underline, as I alluded to earlier, that staff absences caused by the virus are having a significant impact, not just on the NHS and the wider economy but on other vital public services—most notably, for the purposes of my comments today, social care. We are working closely with local partners to maximise the resources available for social care so that vulnerable people get the care that they need. In order to give priority to social care, some local authorities and partners may require to make difficult choices that involve temporarily pausing or reducing other services. Those decisions, which will be taken by front-line partners, will be made only when absolutely necessary. The recent changes to self-isolation rules will help to alleviate some of the pressure, but where such decisions prove necessary, I hope that members and the wider public will understand that they are driven by the needs of those who depend on social care services.

My second point is about ventilation in schools and early years settings. Before Christmas, we published revised guidance for those settings. That included updated material on ventilation, which, among other things, made clear the circumstances in which use of air cleaning devices may be appropriate. I can confirm today that we will allocate an additional £5 million of capital funding to local authorities and funded early learning and childcare providers. That is in addition to the money previously provided for CO₂ monitors and will support any remedial work that councils need to do to improve air flow and comply with the new guidance.

The third issue that I want to cover is the continued importance of vaccination and booster vaccination, in particular. The programme continues to go exceptionally well. Scotland continues to be the most vaccinated part of the UK in terms of first, second, third and booster doses.

However, there are still too many eligible people who are not yet fully vaccinated. If you are one of them—and if you have no good reason not to be vaccinated—the reality is that you are putting yourself and others at unnecessary risk. The latest available data, adjusted for age, suggests 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 a third dose of vaccine. Whatever age you are, getting boosted is the single most important thing that you can do to protect yourself from the worst impacts of Covid and reduce pressure on the NHS.

Even though being fully vaccinated does not completely eradicate anyone’s risk of getting Covid, it reduces that risk and that reduces the risk of passing it on to others, including those who may be more vulnerable to serious illness. In short, being fully vaccinated could save your life or the life of someone you love.

The inescapable flipside of that is this: if you are choosing without good reason not to be fully vaccinated, you are putting your own and other people’s lives at unnecessary risk. If you have not been able to get your booster or third jag yet because you have been self-isolating or have tested positive in the past 28 days, or because you have not got round to it, please come forward as soon as possible.

If you have not had a first or second dose yet, please get it without delay. Do not run the risk of later regretting—or of leaving your family to regret—that you did not get the protection against illness and death that vaccination gives you. There is plenty of capacity in vaccination centres, and you will always be welcomed. So, please go along. It is not too late.

The final issue that I want to touch on briefly is the work that I mentioned last week on a revised strategic framework. The framework is intended to set out how we might adapt, in the medium to longer term, to living with the virus in a way that still mitigates the harm that it does but without the kind of restrictive measures that we are all tired of and that we know do harm in other ways.

Living with the virus—a phrase that we hear more and more—is what we all desperately want to do, but it is worth reflecting on what that does and does not mean. Unfortunately, it does not mean waking up one morning soon and finding that Covid has disappeared or that we no longer need to think at all about mitigating the harm that it can do.

Hopefully, we are on a path from Covid being an epidemic to it becoming endemic—in other words, existing at more manageable and consistent levels—but that is not a shift that any Government, anywhere, can just declare or wish into being. Although it seems that the impact of the omicron variant on individual health is milder than past variants, it is not harmless. It still causes serious illness in some people and it still takes lives. To be blunt, the virus remains a significant threat to public health.

So, trying to live with the virus, as we all want to do, will involve, for all countries, careful thought and possibly some difficult choices. It will also involve consideration of, and empathy for, everyone in our society, including those who are at the highest clinical risk from Covid.

We know that we cannot continually rely on restrictive measures to manage the virus, because we know the harm that that does. Equally, we cannot be indifferent to the continued risks that Covid poses to health and wellbeing. We need to consider what adaptations we can make to manage those risks in a way that is much less disruptive to our lives and much less of a daily presence in our minds.

Those are important issues not just for the Government but for all of us to consider. As we prepare the revised framework in the days to come, we will consult across Parliament and with business organisations and other partners across society. Our aim is to publish the revised strategic framework within the next few weeks.

As that final point emphasises, we remain in a highly challenging phase of the pandemic. Case numbers are high, the impacts of that are severe and, as I set out, the future trajectory remains uncertain at this stage. However, largely because of the efforts that everyone has made, we are in a better position than I feared would be the case when additional measures were announced in December, and I hope that we are now seeing signs of improvement. That is allowing us to start the process, from Monday, of lifting the additional restrictions, and I hope that, next week, I will be able to confirm the further steps in that process.

In the meantime, we can all continue to act in a way that keeps things moving in the right direction, so I will close with a reminder of what we can all do to help stem transmission.

First, get fully vaccinated as soon as you can. If you have not done that already, please do so and do it this week.

Secondly, try to limit your contacts for a further period. With infections at such a high level just now, every interaction comes with a significant risk of catching the virus, so prioritise the contacts that matter most to you.

Thirdly, if you are meeting other people socially, test before you go, every time, and take the test as close as possible to the time that you will be seeing other people. Remember to record the result, whether that is positive or negative.

Take all the other precautions that we know make a difference. If you are meeting indoors, limit the number of households in the group to three at most, and keep windows open. Work from home whenever that is possible—employers should enable their workers to work from home whenever it is practical. Wear a face covering on public transport, in shops and when moving about in hospitality settings. Make sure that the face covering fully covers your mouth and nose, and follow all advice on hygiene.

Those steps do make a difference. They are making a difference to each person’s individual safety and to the collective safety of all of us, so I urge people please to stick with them, and my thanks go, again, to everybody who is doing that.