Chamber and committees

Thank you, Presiding Officer. I wish you and everyone in Parliament and across the country a happy new year.

Today, I will report on the continuing rise in Covid cases and will outline our approach to managing this stage of the pandemic. As part of that, I will set out immediate changes to the requirements for self-isolation and testing. Although we are not proposing any additional measures at this stage, I will confirm that existing protections and guidance will remain in place for the coming week, pending further review.

Finally, given that omicron might not be the last new Covid variant that we will face, I will also signal some longer-term work to consider the adaptations that are necessary to enable us to deal more proportionately and sustainably with any future phases of the pandemic.

First, though, I will give today’s statistics. Yesterday, 16,103 positive cases were reported, which is 26.9 per cent of all tests that were carried out. There are 1,223 people in hospital with Covid, which is 71 more than yesterday and 544 more than were in hospital at this time last week. Of them 42 are in intensive care, which is the same number as yesterday. Sadly, another five deaths have been reported, which takes the total number of deaths under the daily definition to 9,872. Once again, I send my condolences to everyone who is mourning a loved one.

The surge in cases, which is driven by the extremely infectious omicron variant, is continuing here in Scotland, across the United Kingdom and in many other countries around the world. In Scotland over the past week, the total number of new reported cases has increased by 87 per cent. Tomorrow’s figures will almost certainly see us pass 1 million reported cases since the start of the pandemic.

However, the rapid and very widespread transmission of omicron is such that the daily recorded tally of cases—which has always been an underestimate of the true level of infection—now gives us an even less comprehensive indicator of how prevalent the virus is. The weekly survey that is published by the Office of National Statistics gives a better indication. It suggested, in the week to 23 December, that one in 40 people in Scotland had Covid. The results in the most recent ONS survey, which was published just a few minutes ago, suggest that, in the week to 31 December the proportion had risen to one in 20. The proportion of people with Covid is likely to be even higher than that now—a few days later—and I anticipate that we will see continued growth in the level of infection as work and school resume after the holiday period.

In short, Covid is significantly more widespread now than it has been at any stage in the pandemic so far, and will almost certainly become even more so in the days to come. That, of course, has extremely serious implications for the national health service and social care, but it also has a severe and increasing impact on the economy and on other critical services. That impact is primarily due to there being very high numbers of people being off work with Covid, but it is compounded by the wider requirements for self-isolation. As I said last week, we have been considering very carefully the risks and benefits of changes to self-isolation requirements. I will give an update on that shortly.

More generally, as I said a moment ago, we are not proposing any new protective measures today. However, because the virus is so prevalent, we consider it to be important that we continue to apply some brakes on transmission, particularly in settings that pose the highest risk.

Accordingly, I confirm that the restrictions on large gatherings and the requirements for distancing between groups in public indoor places, and for table service in hospitality venues that serve alcohol on the premises, will remain in force for now and, I expect, until 17 January.

In addition, although it is not a legal requirement, we continue to strongly advise the general public to limit contact with people frm other households as far as possible, and to limit to a maximum of three the number of households in any indoor gathering that takes place.

After two long years of this pandemic, I know that asking people to cut all social interaction is not feasible, and that it would be damaging to people’s mental health and wellbeing. However, limiting contacts insofar as we can, and thinking carefully about the interactions that matter most to us, are important just now. That helps to stem, at least to some extent, increases in transmission, so it has a collective benefit and it helps to protect us as individuals. When at least one in 20 of us has the virus, as is now the case, the risk of getting it when we mix with others is significant. If we limit the occasions on which we mix, we reduce our risk of catching a virus that we know could have a nasty impact on our health.

Trying to stem transmission—at least to some degree—is also important for the NHS, which is under increasing pressure. On the upside, the evidence that omicron causes less severe illness than previous variants, at least among the under-60s, where the virus is most prevalent at the moment, appears to be strengthening. Indeed, the fact that the numbers in intensive care are so far remaining stable, while the numbers in hospital are rising quite sharply, might be indicative of that.

We know for certain that a booster jag provides strong protection against serious illness for people of all ages. However, notwithstanding the success of the booster programme and the apparently lower rate of hospitalisation from omicron, the sheer volume of people becoming infected means that more people with Covid are being admitted to hospital. There is also remaining uncertainty about the impact on hospital admissions if omicron continues to spread from younger age groups, in which the risk of falling seriously ill from Covid has always been lower, to those in older age groups.

As I reported last week, work is under way to better understand the detail behind the headline hospital numbers. I can advise Parliament that the first results from analysis to differentiate those who are in hospital because of Covid from those who are in hospital with Covid, but were admitted for different reasons, will be published on Friday. Work is also being done to assess whether the average length of hospital stay that results from omicron is any different from that which is associated with other variants.

In short, our understanding of the precise nature and extent of omicron’s impact on hospitals and the wider health and social care system is still developing. However, it is beyond doubt that it is already having a considerable impact. The number of people in hospital with Covid has increased from 679 to 1,223 in the past week, which is a rise of 80 per cent. That is putting significant additional pressure on the NHS.

Indeed, the NHS is facing increased pressure on three fronts. First, it is dealing with non-Covid backlogs that have built up over the course of the pandemic. Secondly, many NHS staff are absent and self-isolating because they have Covid or are close contacts of people who have it. That means that the increasing pressure on the NHS is being managed by a depleted and ever more exhausted workforce. At this stage, we owe every one of them an enormous debt of gratitude. Thirdly, as we keep saying, even with a lower rate of hospitalisation, the sheer volume of cases that is being caused by the much greater transmissibility of omicron will lead—is leading—to more patients with Covid ending up in hospital.

With reference to the analysis that will be published on Friday, and which I spoke about a moment ago, it is important to remember that even if Covid is not the primary reason for a person’s admission to hospital, the fact that they have it means that enhanced infection control measures are necessary, which further constrains the capacity of the NHS and exacerbates the pressure on it.

We continue to support health boards and staff to manage that pressure, which includes working with councils to reduce delayed discharge and targeting additional capacity, where that is possible.

Work is, importantly, also under way to develop alternative patient pathways for people with Covid in order to enable them, where it is possible and appropriate, to remain at home with appropriate monitoring and advice rather than be admitted to hospital. That work will also help to identify, at an earlier stage, patients who are likely to benefit from new antiviral treatments.

Of course, we can all help the NHS by taking steps to reduce as much as possible transmission of the virus. Although abiding by current guidance and protections is vitally important at this stage, we know that measures that restrict our lives are not sustainable indefinitely. We also know that, with a variant that is as infectious as omicron, the kind of protections that are possible within our financial resources—while they are still very important—without causing greater harm in other ways, will not control transmission to the extent that they would have controlled transmission of other, less transmissible, variants. In the light of that, coupled with the facts that Covid will, unfortunately, not suddenly disappear and that omicron is unlikely to be the last new variant that we encounter, we need to continue to adapt our thinking about how to manage the virus and to become more resilient to it in the future.

At this stage, let me be clear that that does not, in my view, mean giving up on trying to control Covid completely; its impact on individual health and on our collective wellbeing is too significant for that. It means seeking ways of doing so that are more proportionate, more sustainable and less restrictive.

There are no easy answers, but adapting to the on-going challenge of Covid is inescapable. The Scottish Government is therefore currently working on—and will publish over the next few weeks—a revised strategic framework that will set out more fully how that process of adaptation can be managed, with a view to building greater resilience. We will seek views from across Parliament, as we develop that new framework in more detail. However, the changes that I am about to confirm to the requirements on self-isolation and testing are an early indication of a response that is already adapting.

Last week, I said that it was important to consider carefully changes to self-isolation rules. We wanted to ensure that such changes will be made only when, in the view of clinical advisers, their benefits outweigh their risks. I also want, as far as possible, to make changes in a coherent rather than piecemeal manner, given the importance of clear public understanding of what is required. As a result of that consideration, we are proposing two changes to the self-isolation rules and one change to the requirement for polymerase chain reaction testing. All the changes will take effect from midnight tonight.

The first change to self-isolation applies to people who test positive for Covid. Although the initial advice when someone tests positive will still be that they self-isolate for 10 days, now there will be an option to end isolation after seven days, as long as, first, they have no fever and, secondly, they record two negative lateral flow tests—one no earlier than day 6 after testing positive and another at least 24 hours after that.

The second change applies to close contacts of positive cases. That includes household contacts who are either under the age of 18 years and four months, or who are older than that and are fully vaccinated. Let me be clear that, by “fully vaccinated”, we mean having had first, second and booster, or third, doses. For close contacts in those categories, the requirement to self-isolate will end and be replaced by a requirement to take a lateral flow test every day for seven days. Obviously, if one of those tests is positive, self-isolation will be required. Anyone who is identified as a close contact and who is over 18 years and four months and is not fully vaccinated will still be asked to self-isolate for ten days and to take a PCR test.

Those changes are significant and are not completely without risk. However, at this stage of the pandemic, they strike an appropriate balance between the continuing importance of self-isolation in breaking chains of transmission and reducing the disruption that self-isolation causes in the economy and in critical services.

We are also proposing an important change to the advice on testing. Let me again be clear—that has been very carefully considered. Scotland and the UK as a whole have among the most extensive PCR testing systems in the world. However, with infection levels being as high as they are, we must fully utilise all available testing capacity—for PCR and lateral flow tests—and we must ensure that isolation and advice happen as quickly as possible.

For people who have symptoms of Covid, the advice remains that they book a PCR test, even after a positive lateral flow test. The advice to everyone is to test regularly with lateral flow devices, especially before meeting others. However, from tomorrow, if your lateral flow test is positive, and if you do not have symptoms, you will no longer be required to take a PCR test to confirm the result. Instead, you must isolate immediately and must also report your result online so that test and protect can commence the contact-tracing process and give you advice as quickly as possible. You will also receive an online form that you must fill in—as would happen after a positive PCR test—to ensure that your contacts are notified. Other countries, including Canada, have already made that change. That has been made possible because lateral flow tests are now widely available and work well.

Also, and importantly, the test and protect system in Scotland can start contact tracing on the strength of a reported positive lateral flow result as well as after a positive PCR test. Crucially, at times of very high levels of infection, the risk of a false-positive lateral flow test result is very low indeed, at around just three in 10,000. Therefore, the safest thing to do at this stage is to treat a positive lateral flow test as confirmation of Covid, even if you have no symptoms. That will allow us to maximise testing capacity and to ensure a speedier start to the process of contact tracing and advice.

I will touch on a few more brief points. First, the situation continues to take its toll on everyone—especially on businesses. Last week, I confirmed the allocation of more than £200 million of the £375 million in business support that we are making available. Today, I confirm the allocation of a further £55 million. Up to £28 million will be allocated to taxi and private-hire drivers and operators; £19 million will support services such as beauticians and hairdressers; £5 million will be provided for sport; and there will be an additional £3 million for tourism. Local authorities are working to get money into bank accounts as quickly as possible.

Secondly, in the light of the widespread community transmission of omicron in the UK, discussions are taking place today between the four UK governments about possible changes to travel rules, including to the requirement for pre-departure testing. If those discussions result in proposed changes, we will inform Parliament as soon as possible.

My third point relates to education and the start of the new term. All secondary school children are being asked to take a lateral flow test on the night before, or morning of, their first day back, and thereafter to test twice a week and in advance of mixing socially with people from other households.

Likewise, university and college students should take a lateral flow test immediately before travelling from home to term-time accommodation, and thereafter should test twice a week and before socialising with people from other households. Staff in all educational and early years settings should take a lateral flow test just before starting back at work and should test in line with broader advice, after that.

Our priority is to keep schools open and to minimise further disruption to education. With community transmission high, the next few weeks will be challenging for pupils, staff and parents. Using lateral flow tests will help. So, too, will the changes to the isolation rules, and updated education guidance reflecting those changes will be issued shortly. We will also work with councils to ensure that the guidance that was issued before Christmas is followed in order to keep schools not only open, but as safe as possible.

My final update today is on vaccination. I am immensely grateful to everyone who is involved in delivering vaccines and to everyone who has been vaccinated. By the bells on hogmanay, around 3 million people—77 per cent of those who are eligible—had received their booster, or third, dose.

If you are not one of those people and are eligible, please come forward now. You can arrange an appointment online or go to a drop-in clinic. There is plenty of capacity; you can get details at NHS Inform or on your local health board’s website. Getting a booster does not mean that you will not get Covid—although it will reduce the chance of that happening—but it will significantly enhance your protection against serious illness. It could literally save your life.

Now, 12 to 15-year-olds can go to drop-in centres to get their second dose. I encourage everyone in that age group to do so. If you are the parent or carer of someone in that age group, you can go with them to the vaccination centre.

The vaccination programme has been an outstanding success, but there are still many people who are eligible but not yet vaccinated. If you are one of them, please rectify that for your own sake and for the sake of us all. It is not too late and no one will judge you for not having done it before now; on the contrary, you will be welcomed with open arms.

This phase of the pandemic is possibly the most challenging that we have faced. The most infectious variant so far is creating a volume of cases that, notwithstanding its possibly reduced severity, still has the potential to overwhelm us. Two years in, the kind of measures that have helped us to control transmission in past phases are becoming less tolerable and are causing more harm. Although it is not easy, we need to continually adapt our ways of managing the virus. We will do that but, in the meantime, we must continue to do what we know makes a difference.

First, get fully vaccinated as soon as you can. Please do it this week. The more of us who are boosted, the less severe the impact of omicron will be for each of us as individuals, if we get the virus, and for society as a whole.

Secondly, limit your contacts. Right now, with infection levels at 1 in 20 at least, every interaction that we have comes with a significant risk of catching the virus, so we should prioritise the contacts that matter most to us.

Thirdly, if you are meeting other people, test before you go—every time.

Finally, take all the other precautions that make a difference. Work from home whenever possible. As the new working year gets under way, I appeal again to employers to enable that. Wear a face covering on public transport, in shops and when moving about in hospitality settings, and make sure that the covering fully covers your mouth and nose. If you are meeting indoors, limit the number of households in your group to three at most and keep windows open. Follow all advice on hygiene.

I again record my thanks to everyone across the country who continues to do all that and to play their part in helping us through this latest very challenging phase of the pandemic.

I am, of course, happy to take questions.

We have published acres of data and evidence and will continue to do so. I return to my point that data and evidence do not make decisions; they inform decisions.

I know that the member is a clinician. I would hazard a guess that he is in a minority of clinicians who do not think that protective measures are required. Scotland, Wales, Northern Ireland and many countries across Europe and the world are all in a similar position of having proportionate but necessary protections to try to stem, even to some extent, the rise in cases. There is a rationale behind that. We know, given the greater transmissibility and infectiousness of omicron, that large-scale events have the potential to quickly become superspreading events. That is why we have, regrettably, placed a temporary restriction on large events. We know that the hospitality environment, where people come together in places that are often poorly ventilated and with alcohol lowering their inhibitions, also raises the risk of transmission, particularly of a more transmissible variant.

That is the rationale for the particular targeted measures that we have in place. We know from the evidence that face coverings are perhaps more helpful than many other measures in reducing transmission. I would expect someone who is clinically qualified to understand that better than most people. All the targeted measures that are now in place are in place in many other countries. They all flow from our understanding of how a virus spreads and in particular, given its greater transmissibility, the risk that is presented by the spread of omicron.

I do not think that anyone is seeking to do that. This is not a competition. However, because I have been asked about those matters, I will lay out the facts again. The Deputy First Minister cited ONS statistics yesterday. I did not say that he did not do that. What I said was that he had cited the most up-to-date ONS statistics—the ones that he cited were, until 2 o’clock today, the most up-to-date figures. We have further data today. I have already cited that, so I will not go into detail again.

I urge significant caution with the seven-day rolling average of cases up to 3 January in any part of the UK. Because of the disruption to reporting over the Christmas and new year holiday period and the different pattern of testing that we know happens during a holiday period, I would treat those figures with significant caution. As I said, we also know that the numbers of daily reported cases in all countries are significant underestimates of the true prevalence of the virus.

If Jackie Baillie wants to make this point and get an assessment of Scotland’s overall performance to date—although that might change next week or next month—she can go on to the UK Government Covid dashboard to see for herself that, overall, throughout the pandemic to date, levels of infection in Scotland have been lower than they have been in all other parts of the UK. They are certainly lower than those in England and Wales; I cannot recall whether that is the case for Northern Ireland. Does that say that we have managed our way through the pandemic perfectly? It absolutely does not, but it does suggest that the balance of the judgments that we have taken, which we sometimes get more right than we do on other occasions, has led us to that position.

However, I am not complacent about that. We face a really difficult period ahead of us. That is why my responsibility is to apply my judgment—that is my job—to the data and evidence in order to take the decisions that are likely to get us through this situation as safely as possible. If those decisions accord with decisions elsewhere in the UK, that is all good and well, but if they do not, that will be for a good reason, which it is then my responsibility to set out for people and allow them to decide on.

It is important that the support is targeted. As I covered last week, there is a generic element to our hospitality support, but we are also looking at how we target other sectors in a more tailored way. Overall, we are providing, I think, £113 million to support hospitality and leisure sectors that are impacted by the latest public health measures. Local and family-owned businesses absolutely must receive that support.

All eligible hospitality businesses that previously got support through the strategic framework business fund will receive a top-up payment and will be contacted directly by the local authority. That work is already under way. Such businesses do not have to make a new application. Hospitality premises with a rateable value of up to and including £51,000 will receive a grant of £4,500, and those with a rateable value of £51,000.01 or above will receive a grant of £6,800.

We will continue to consider suggestions such as that. We have a separate fund available to help businesses with ventilation, so we will certainly look at the scope of that and the eligibility for it. As Gillian Mackay knows, we have provided councils with additional funding for CO2 monitoring. Councils should already be acting on the outcomes of that to make improvements to ventilation, including through the use of air filtration systems, where that is necessary. We understand the impacts on councils, so we will continue to talk to them about what support we can provide.

I also acknowledge how anxious a time this is for young people who are going back to school, and for teachers, other school staff and parents. This is not the position that any of us wanted to be in. For reasons that we all understand, keeping young people in school with as normal a school experience as possible is really important, but that requires steps and mitigations to be taken to keep schools safe, or as safe as possible in the situation that we face. That also makes it important that those in the 12 to 15-year-old age group who are eligible for a second dose of vaccination come forward to take that up. We will continue to pay close attention to future advice from the Joint Committee on Vaccination and Immunisation on extending vaccination to other groups of young people.

We have no indication further to what was announced by the Chancellor of the Exchequer before Christmas of any additional support being in the pipeline from the UK Government for businesses in England, which would then flow to businesses elsewhere in the UK. My views on the constraints of the funding arrangements in general and, in particular, for the situation that we face right now are well known, and Willie Coffey has articulated them again. We are providing as much support as we can from within our own resources. It is right that we do that, but there are limitations to it.

Some of the businesses that Willie Coffey referred to—barbers and hairdressing salons, for example—will benefit from the allocation that I spoke about earlier. Although it will not fully compensate such businesses, I hope that it will go some way to easing the pressure that they are dealing with.

That is a good question, which relates to one of the most important issues that we will grapple with over the next few weeks. In the light of what we have experienced so far with different variants, we have taken steps to better understand and detect these things earlier. For example, we have made investments in waste-water sampling and genomic sequencing. Those are really important resilience steps to take so that we are better equipped and prepared to, I hope, pick up new variants more quickly and try to contain and suppress them.

We are two years into a pandemic and, partly because of the financial constraints that devolved Governments work within and, more generally, because of the harm that restrictions do, we cannot go on managing the virus by using restrictions only. To be fair, I point out that we have not been doing that for some time. Increasingly, we must find different ways of managing the virus. I am not of the “Just let it rip” mentality—we must try to control and manage it, but we need to find more proportionate and sustainable ways of doing that. That is not easy, but it is essential. That is the work that we are doing now.

We do not know whether this will be true of future variants, but it is certainly the case that the kind of measures that would have suppressed earlier variants—difficult though they were—will not do that to the same extent with omicron because it is so much more transmissible. Using restrictions or protective measures is becoming less tolerable and less affordable and is doing more harm. It might also be less effective with omicron because of its greater transmissibility.

The changes that we have announced today are about different judgments of risk and benefit and must be applied across different areas of society. I say in particular to businesses, who often and understandably call on me and on the Government to let us live with Covid, that they will need to continue putting in place the adaptations that enable us to do that.

That is the kind of work that we are doing now. We will give more detail about exactly what that means in practice as we get to the conclusion of the work that I spoke about earlier.

I have wished for many things during the pandemic. One of those is a crystal ball that would let me see into the future with certainty. I am not saying that to be in any way facetious. It is difficult, particularly at this stage of a wave of the virus, to be certain about the future. That is why we must monitor things closely.

Throughout the pandemic, we have had good discussions with the Scottish Rugby Union about matches at Murrayfield. The SRU has been constructive in working with us to enable games to go ahead. I know how important clarity is for those who cater for big sporting events, not least for matches at Murrayfield. That is very much in our minds as we take decisions.

I hope that the current restrictions will not have to go beyond 17 January. We all, including me, want to be able to cheer Scotland on at Murrayfield in the six nations, but I will not do anybody any good if I try to give certainty before we are able to do that. We will continue to use data and evidence to reach judgments that will give clarity and certainty as quickly as possible. I firmly hope that the matches will go ahead and will do so in front of crowds of supporters.

Unfortunately, Presiding Officer, I am not sure that I heard enough of the question even to make an educated guess about it. Is it possible to ask Stuart McMillan to repeat it?

Let me just be clear that the change for fully vaccinated close contacts, including household contacts, is that the requirement to self-isolate at all will be replaced by daily lateral flow tests for seven days. As long as, on each day, your lateral flow result is negative, you do not have to isolate, but on any day that your lateral flow result is positive, you have to start isolation. Again, we have considered that carefully, and we think that the benefits outweigh the risks. None of this is risk free, of course, but we think that overall that is a proportionate change, at this stage.

The change means that the supply of lateral flow devices, which has always been important, is even more important. We are working through all the various routes—with UK colleagues, and with colleagues in the community pharmacy network and in local testing centres—to make sure that there is a good supply of LFDs. There is no shortage at the moment. Procurement is on-going to ensure that supplies continue to be topped up. Right now, people can mail order LFDs and they can get them from local pharmacies or local testing centres, and a number of councils are making lateral flow devices available in other places as well. There is also workplace testing for key workers; businesses that are part of that know how to access the devices.