Chamber and committees

I think that that is not the case at all. I will come on to the most recent data in a second.

First, I will deal with the “outlier” question. When the changes to self-isolation for indexed cases were first announced, they applied only to England, so for a time England was an outlier. I think that it was last week when Wales and Northern Ireland decided to introduce similar changes. We are doing likewise today.

At various times in the pandemic, we have sometimes come to different substantive views and sometimes to the same views but on different timescales. For example, on protection, right now Wales, Scotland and Northern Ireland are in similar positions, with restrictions on gatherings and with some of the restrictions and protective measures in hospitality. England is an outlier in that regard—not just in the UK but, arguably, in a European sense and a global sense.

We all have responsibilities to reach judgments that are based on clinical advice and to keep the public as safe as possible in this most challenging of situations. That is what I will always do, to the best of my ability.

On the impact of the protective measures that we have in place, it always has been and always will be very difficult—sometimes impossible—to prove causation between a measure and an outcome in virus rates. Common sense, however, tells us that if we did not, right now, have restrictions on large potential superspreader events, if we did not have measures in place to try to stem—at least to some extent—transmission in higher-risk settings such as hospitality, and if we were not advising the public and the public were not responding so magnificently well to advice to cut contacts, the high rates that we are seeing would likely get even higher, and the pressure on the NHS more significant. We are right to be applying brakes, notwithstanding the high levels of infection that we face.

I agree that it is not a competition. At times, Scotland has had lower levels of infection, and at other times, we have had higher levels. Right now, the levels of infection are lower here than they are in England, and are perhaps slightly lower than they are in Wales but not much lower than in Northern Ireland. That is, however, likely to change.

Yesterday, the Deputy First Minister used the most up to date Office for National Statistics data. In my statement today, I cited data that I understand have been updated, while I have been speaking, by data that are a week more up to date. There will always be a lag in data, but data will still show that our one in 20 rate, although it is very high, is certainly still lower than the rate in England.

However, it is not a competition. We all have to take the decisions and to make the judgments that we think are best so that we can navigate the safest possible course through the pandemic. I will always seek to do that. I will be held accountable and I will be subjected to scrutiny, which is the nature of the job that I am privileged to do.

That is an important issue to raise. It is for individual countries to determine what requirements travellers need to meet for entry into their territory, so it is for the French authorities to decide whether and when to follow, for example, Germany and reopen access to UK nationals. There is no doubt that post-Brexit arrangements have been a factor in the French decision to temporarily prevent UK nationals from transiting France to homes or destinations elsewhere in the EU. That is one of the many damaging consequences of the UK no longer being a member of the EU, and it is one of the long list of reasons why I regret that decision, and I think that many people across Scotland regret it, too.

Elena Whitham is right to cite East Ayrshire as an exemplar partnership; it does really good work. However, like all partnerships at the moment, it is under significant and increasing pressure, which is likely to remain the case for the foreseeable future as we continue to navigate our way through the latest phase of the pandemic.

We have already allocated significant funding to all health and social care partnerships to support them through the winter. That includes, for example, £40 million for interim care for people who are leaving hospital, £20 million to enhance multidisciplinary working and a further £15 million to recruit additional health support workers, which is on top of more than £60 million to enhance care at home capacity and funding to increase the hourly rate of pay in order to make those jobs more attractive.

We continue to work really closely with councils and health and social care partnerships to collectively navigate our way through the current situation, but it is not easy now and it will not be easy in the weeks to come for the NHS or social care.

That brings me back to my central point: difficult though it is, if we can all follow the guidance and abide by the protections that are in place right now, we will help to some extent to stem transmission and ease the pressure—even if just by a bit.

No—I do not think that I have any need to do that. I did not and do not intend to misrepresent anybody. As I heard it, Dr Gulhane suggested that the restrictions and protective measures that have been in place for some time lacked evidence. I said and I say again that I thought that the reasons for those targeted interventions are so obvious—particularly to someone who is clinically qualified—that all other countries in the UK, apart from England, and many other countries across the world are implementing similar measures.

I heard what Dr Gulhane said to me as being indicative of him not agreeing with those protective measures. If that is not what he intended to say, I accept that and the position that he has put on the record, but I repeat that I presume that he, of all people, understands the rationale and the evidence base for the targeted measures that are in place in Scotland.

We continue to do all that we can to support education settings, including early years settings, that are experiencing reduced staffing levels, because we know that this is a difficult and stressful time. The changes to self-isolation that I have announced today will help with that and will help the early years and childcare sectors, as well as other sectors. The changes mean that the sectoral exemption process that came into effect before Christmas is no longer required.

In relation to the second part of the question, and to be clear, I say that children who are under the age of five are required to get a test when they have Covid symptoms. We encourage but do not require children under five years who are identified as close contacts to be tested. I hope that that distinction is clear.

The majority of the money has been allocated and work is under way to get it into bank accounts as soon as possible. I have covered all that today. However, we continue to consult sectors that perhaps have not had support before, or which need more targeted support, about how we can best use the remainder of the money. We will do that as quickly as possible.

It is worth saying, just for the record, that in the part of the UK where Jamie Halcro Johnson’s party is in charge, such funding is not available to the extent that it is available in Scotland. We want to consult properly in order to target the money as well as we can at those who need it most, and we want to get it into bank accounts as quickly as possible. However, it is money that, were it not for the actions of the Scottish Government, would not be available at all

First, let me say that I inadvertently misquoted Donald Macaskill last week, when the line between, I think, Willie Rennie and I broke up a bit. I have apologised to him privately for that and take this opportunity to do it publicly, as well. I will take care not to do that inadvertently again today.

Paul O’Kane has raised legitimate concerns about, first, the need for safe visiting to continue in the interests of the mental health and welfare of care home residents and families, and, secondly, about the need to ensure that visiting is safe and that we are taking all necessary precautions. Of course, some of what I have announced today on self-isolation rules and testing will have an impact on care homes, so I will arrange for updated guidance to be published, either by Public Health Scotland or the Scottish Government, so that there is clarity about the rules and changes that result from what I have said today.

The final point that I will make is that we are determined to keep visiting possible and happening in care homes, for the reasons that everybody understands, but we must make sure that we are taking appropriate precautions. We are seeing an increasing number of outbreaks in care homes, which reflects the increase in community transmission, so appropriate precautions are necessary to ensure that we keep people in care homes as safe as possible.

I always seek to do so, Presiding Officer.

The data is published daily. Over the past week, there has been an 87 per cent increase in the number of recorded cases of omicron. Today, we see the fact, published by the Office for National Statistics, that 1 in 20 people in Scotland probably has Covid—the rate is probably a bit higher than that, now, because those statistics are from a few days ago. A rising number of people are in hospital because of or with Covid. That is the data that informs the decisions.

Data about the increased transmissibility of omicron is also developing, which does not need the Scottish Government to publish it because it is published by people globally. That data is there, and it is available not just to members of the Parliament but to anybody across the country.

We take that data and the evidence of the impact of omicron and apply our judgment to what measures will help us to stem transmission. As I have said, the increased transmissibility means that that involves, regrettably, restricting large, potentially superspreader events, and trying to contain transmission in settings that we know have a higher risk because of low ventilation or the kind of behaviours that happen in those settings.

I am therefore not sure what evidence and data are missing. We continue to publish evidence. The fact that many other countries are doing similar to, or the same as, us suggests that it is not just the Scottish Government that thinks that the evidence justifies those actions.

I take those important issues seriously. We agonise over decisions, and I spend most waking hours thinking about the right balance of judgments to apply, as is my job. I do not try to misrepresent people. However, I, too, ask people to go back and listen to Dr Gulhane’s question. My impression from the question was that he is not in support of the measures that are in place; that is legitimate, so I answered the question on that basis. If that was not the impression that he intended to give, I accept that and hope that he will, in turn, accept that I did not seek to misrepresent him. To be frank, I think that we all have more important things to deal with, right now, because of the really significant challenge that the country is facing.

I will take those issues in turn. They are all important issues, Presiding Officer, so I hope that you will forgive me for taking time to provide substantive answers.

I return to the issue of the distinction between people who are in hospital with Covid and those who are in hospital because of Covid. Anas Sarwar’s points are not unimportant, and I am not suggesting that they are. However, with regard to his question about severity, I also ask him not to oversimplify things.

As I said in my statement, all the evidence that we have so far, including evidence from intensive care admissions in Scotland, which are not rising at the rate that hospital admissions are rising, suggests that the impact on individuals of omicron is less severe than that of previous variants. We do not know for sure whether that is an inherent effect because omicron is a milder version of the virus, or whether it is because of the effects of vaccination, but all the evidence points to that.

We need to make two caveats, the first of which is that, so far, the evidence is largely based on circulation of omicron within younger populations, which throughout the pandemic have been less likely—although not completely unlikely—to fall seriously ill. We need to continue to monitor that if, as is happening now, the spread moves from younger populations to older age groups.

The second caveat is to do with volume. Even if the rate of hospitalisation and, therefore, the severity is much less, the sheer volume of cases will add up to—indeed, it is already doing so—significant pressure on the NHS. That is not abstract or academic in terms of people’s health. If the hospitals are so full of Covid cases that they cannot treat other conditions including heart disease in the way that they want to, that has an impact on people’s health. Even if not all the people who are in hospital are there because of Covid, that does not mean that we should be complacent in any way, or for any reason, about the mounting pressure on our hospitals.

I hope that that is clear. I recognise the points that have been made, but I appeal to Opposition leaders not to oversimplify the issues, because I do not think that that helps anyone.

I turn to testing. With community transmission as high as it is at the moment, there will, periodically, be pressure on the testing system. We are working on a four-nations basis, because most of our testing capacity comes through the four-nations system, although we also have considerable NHS Scotland testing capacity. We work daily to resolve issues and to flex the capacity as far as possible.

Right now, there is no shortage of LFD tests in Scotland, and we are monitoring their supply very carefully. The situation as regards issues that were being experienced with turnaround times has improved and turnaround times have again become much shorter. There is the essential workers route to prioritise PCR testing. In addition, the sectoral exemption process is available to NHS workers and key workers in other sectors.

Lastly, we will ensure that there is guidance on the latest testing advice. I think that I made this point clear in my statement, but if I did not, let me repeat it. If you have symptoms of Covid, even if you have taken an LFD test that has produced a positive result, the advice is that you should still book a PCR test. It is only if you have no symptoms and your LFD test is positive that there is no need to take a PCR test. That is not just because we are trying to maximise testing capacity, but given the levels of transmission at the moment, it is a pretty safe assumption that someone in that position is positive because the false positive rate is so low. Working on the basis of a positive LFD test allows the contact tracing process to kick in as quickly as possible.

We still want, for a variety of reasons, people who have symptoms to take a PCR test and to allow us to assess patients who are most likely to benefit from there being more antiviral treatment, as we get it.

I make no apology for considering such things very carefully. Until now, my clinical advice has been that it was possible that the risks of releasing people from self-isolation too early and, thereby, contributing to a greater increase in transmission, outweighed the benefits. That balance has now changed and, after careful consideration, we are making this judgment today.

None of those things is straightforward. I doubt that any Government anywhere is making such decisions lightly. They certainly should not be. Governments sometimes arrive at different judgments for good reasons. I will always be accountable for, and open to scrutiny on, the judgments that I make. I will continue to make judgments very carefully using the best possible clinical advice.

Although the changes that we are announcing today are proportionate at this stage in the pandemic—because they balance the benefits of isolation with the disruption that isolation causes—they are not without risk. That is why it is really important that we communicate them properly and that people understand not just the easing of some of the rules, but what we are asking people to do in place of that. That applies to the changes on self-isolation and on confirmatory PCR testing after an asymptomatic LFD positive result.

Douglas Ross and I have had exchanges on the matter in the past. I say this non-pejoratively: this is the stuff of scrutiny and democracy, but had I, in the past, followed Douglas Ross, we would have removed the requirement for face coverings prematurely and we would not have put in place some of the mitigations in schools that are now seen to be important. There have been differences—there will, no doubt, always be differences—but the trust that is placed in me and the responsibility that placed on me by the Scottish people means that my ministers and I have a duty to weigh things up carefully and, of course, to be accountable for the judgments at which we arrive.