Chamber and committees

That is one of the most important and difficult decisions that we will take in the coming days. England has already reduced the self-isolation period for index cases, but Wales has not and I do not believe that Northern Ireland has done it yet either. That illustrates the finely balanced nature of the judgment. I will say a bit more about that in a moment, but it is also important that we understand the context for making the decision.

Douglas Ross rightly points to the more positive news in the studies that were published just before Christmas but, as the authors of those studies point out, it is important not to overinterpret them or get carried away by the initial data that they provide. Although they suggest that the hospitalisation rate associated with omicron is lower, perhaps significantly lower, than for other variants, that will not give us any benefit if the overall volume of cases cancels it out and leads to a higher number of people overall going into hospital. That is why it is really important that we do not allow the infection numbers to overwhelm us.

That brings me back to why it is important to get right the decision on self-isolation. If we release people from isolation while they might still be infectious, yes, we would relieve some of the pressure that we are seeing on the economy, which is not to be underestimated, but that relief would be short-lived because that would risk accelerating the spread of the virus, which would increase the pressure on the economy in the medium to longer term. We need to get it right.

Why did I say that we will take a few more days before making a decision? We have a rapidly rising number of cases. That is both a reason to take that measure and a reason to be cautious about doing so. Inevitably, because of the Christmas period, there is some fluctuation in case numbers. We need to see that settle a little bit over the next few days. We then need to reach a judgment that is right in terms of weighing up the risks and benefits of the measure. We expect to do that over the next few days, with any changes coming into effect immediately after the new year holidays.

Although the focus is on reducing self-isolation for index cases from 10 days to seven days, because England has already done that, that is not the only change that we should be considering. We have a situation right now in the wake of omicron in which we ask all household contacts of positive cases to isolate for 10 days. I hope that we can ease that measure as well. However, it makes sense to ensure that we are making changes in a coherent manner.

The judgments are not easy. I do not underestimate the reasons why there are calls for us to take that measure. I hope that we will take the measure, but I do not think that anyone looking at the case numbers that are being reported today, in particular, would fail to see why it is important that we take a very responsible approach and ensure that, as far as it is possible with any aspect of handling the virus, we get it as right as we can. I will keep Parliament updated over the next few days around the detail of any changes that we decide on and propose.

Lifeline ferry routes are of critical importance. We are seeing an impact on ferry services, as we are across our other transport providers. Caledonian MacBrayne is engaging with the Maritime and Coastguard Agency on, for example, allowing passengers to remain in vehicles when certain restrictions are imposed. However, other steps are being taken to try to ensure that, as cases rise, we minimise the impact on those services. I will ask the Minister for Transport to keep Jenni Minto and all members who have an interest in ferry services, in particular, up to date over the next few weeks.

I will make sure that information on testing capacity and its changing nature and volume is placed in SPICe. However, I remind people that, as I think that I said when the question was posed to me before, capacity right now is not a fixed thing. Efforts are on-going all the time to maximise capacity on a daily basis and to increase it. It is therefore important that it is not seen as something that is fixed and unchanging.

We know that capacity is under pressure. Yesterday or the day before, demand took up about 85 per cent of available capacity. That is getting to a level at which we will start to see lengthening turnaround times. We are doing on-going work on a daily basis to make sure that these issues are being resolved.

We are making business support available to the maximum of our financial wherewithal. I will say two things about the £375 million that we have already confirmed. First, it is proportionately way beyond what the UK has made available for England, even though the businesses there are facing the same or many of the same pressures.

Secondly, I know that it is not enough—I have said that all along. However, in Scotland, we do not hold the borrowing powers to extend financial support any further. The way that the Barnett formula works is that we get a flow of resource only when the UK Government takes decisions for England—which, as is its right, it is not choosing to do at the moment. We therefore need to see a response from the UK Government that will allow us to increase that support further. In the meantime, we are providing support as far as we are able.

At this point, it is not helpful to speculate beyond 17 January. I very much hope—and it is our intention—that the protections that are in place will be so only until 17 January. However, as has been the case since day 1 of the pandemic, we have to keep the situation under review.

What I said in my statement is worth repeating: yes, we have a rapidly rising number of cases, but we know that we need to judge the impact of that rise through monitoring very carefully its impact on health and the NHS. I think that we will have a much clearer picture over the next week or two that will allow us to make informed judgments about how we deal with the situation in as proportionate a way as possible.

I do not have those figures yet, but we want to publish much more detailed breakdowns across all the different factors as soon as Public Health Scotland can provide that robust breakdown for us. During previous phases of the virus, Public Health Scotland provided some breakdown of figures to distinguish between those who were in hospital because of Covid and those in hospital who had Covid but were there for some other reason. These are broad figures that may or may not bear out with omicron—I will correct myself later if these figures are wrong—but, in previous phases, very roughly, 70 per cent of patients were in hospital because of Covid and between 20 and 30 per cent of patients were in hospital with Covid but did not have Covid as their primary diagnosis.

We want to understand that breakdown much more with omicron and, as we do, we will seek to publish those figures to aid public understanding. However, that said, somebody in hospital is somebody in hospital, which puts pressure on the national health service—through, of course, no fault of their own.

On the question on vaccination, again, we will look to provide more detail on that as it becomes available. However, we know already that vaccination, with a booster jag, gives all of us significantly enhanced protection against serious illness from Covid. Therefore, if you are not boosted, you are at much greater risk of not just getting the virus but becoming seriously unwell and, potentially, dying from it. Therefore, I appeal to everybody who is eligible to be boosted but has not yet been boosted to do that now. Your failure to do so not only puts you at risk; you are denying the country the maximum benefit of the vaccination programme, because the more of us who are vaccinated, the less risk we are all at and, therefore, the less need there will be for continued restrictions on how we live our lives. I do not think that any of us can overstate the importance of booster vaccination.

Thank you, Presiding Officer. I will give our latest assessment of the spread of omicron and, in light of that, I confirm that there are no immediate changes to the protections that are currently in force or to the advice that we are giving the public.

I will also talk about the data that we will be monitoring closely in the days ahead, as we assess the likely impact of this wave of infection and the continued necessity and proportionality of our response. I will briefly summarise the protective measures that took effect earlier this week to help to slow the spread, and I will provide some further detail on the support that is available to businesses. Finally, I will report on delivery of booster vaccinations.

First, I will give today’s statistics. Yesterday, 15,849 positive cases were reported. That is 28.9 per cent of all tests that were carried out. It is worth noting that the much higher test positivity that has been experienced over recent days might be partially explained by people being more selective about when to go for a test over the Christmas period. However, it is, by some margin, the highest overall daily cases number that has been reported in the pandemic to date.

Six hundred and seventy-nine people are currently in hospital with Covid—that is 80 more than yesterday—and 36 people are in intensive care, which is one fewer than yesterday. Shortly, I will say more about the numbers of people with Covid in hospital, and about why that is an important indicator, as we judge what will be the most proportionate response, going forward.

Sadly, however, a further three deaths have been reported, which takes the total number of deaths under the daily definition to 9,836. Once again, I send my condolences to everyone who has lost a loved one.

It is clear from those figures that the wave of omicron that has been predicted is now rapidly developing. Omicron now accounts for around 80 per cent of all cases and, over the past week, the number of reported cases of Covid overall has increased by 47 per cent.

We should also bear in mind that any transmission over recent days will not yet be fully evident in the reported figures. It is therefore reasonable to assume that we will continue to see steep increases in cases in the days and, possibly, the weeks ahead.

That said, it is also important to remember that our individual and collective behaviour will influence how fast, or otherwise, the virus spreads. The current surge would almost certainly be even higher but for so many people following the advice to cut down on social interactions in the run-up to Christmas. Given the speed and extent of transmission that we are experiencing, it is vital that we continue to take sensible precautions and limit social interactions for a further period, as we learn more about the likely impact of this wave of infection and as we complete the booster vaccination programme.

Obviously, one of the factors that we are looking at most closely is the proportion of omicron cases that require hospital treatment. That will tell us more about the severity of omicron for individuals and about the overall impact that it is likely to have on the national health service. It will, therefore, inform our on-going response.

Before I say more about that, however, it is worth emphasising that there are other reasons to do all that we can, at this stage, to slow down the spread. First, whatever the overall impact of omicron turns out to be, we know that the virus will cause serious illness and death for some people. We also know that, for others, long Covid will cause on-going suffering.

Secondly, we know that high levels of infection and, therefore, sickness absence will be disruptive to the economy and to delivery of critical services. I will say more later about how we are seeking to mitigate that. However, as things stand, none of us should be complacent about getting Covid. We should take steps to avoid it if we can.

There is no doubt, however, that the data that we are looking at most closely is on conversion of cases into hospital admissions; there are, in that respect, some grounds for optimism. Over the past week, published studies have suggested that the risk of hospitalisation from omicron is lower—possibly significantly lower—than it is for other strains of the virus. What is not yet fully understood is why that might be the case—whether it is because omicron is inherently less severe, or because of its greater ability to infect people who have had prior infection or have been vaccinated, which would mean that more of those who get it carry a level of immunity that protects them from serious illness.

We do not yet know the answer to that but, either way, if it is the case that a much lower proportion of people with omicron than of those who have other strains of the virus need hospital care, that is really good news—especially as omicron is now the dominant strain—in terms of individual health and overall impact, and it would inform how we will respond in the weeks ahead.

However—this remains key—we need, for at least the next couple of weeks, to show continuing caution as we assess in real time the impact that the higher case numbers will have on the national health service. It is encouraging that the rise in cases that has been experienced over the past few weeks has, at least up to now, not translated into a corresponding rise in hospital admissions or occupancy. On the contrary, the number of people in hospital with Covid has, so far, remained broadly stable.

However, again, we need to exercise caution. The number of people in hospital with Covid in England is now rising quite sharply, which might be a sign of things to come here. Indeed, today’s reported increase of 80 in hospital occupancy here is the biggest increase that we have seen for some time.

We also know that there is a time lag between rising cases and rising hospital admissions. Also, of course, in terms of sheer numbers, the benefits of a lower rate of hospitalisation could be quickly cancelled out by the much higher case numbers that result from significantly increased transmissibility.

Therefore, we will monitor all the data very carefully in the days to come. As well as looking at headline numbers, we will interrogate the detail—for example, the breakdown between people who are in hospital because of Covid and those who are in hospital who have Covid but have been admitted for other reasons.

We will also look at whether the average length of stay in hospital for people with omicron is different from the average stay of those with other variants. All in all, I expect that we will have a clearer picture within the next couple of weeks, which will help us to reach informed judgments about the most proportionate response, going forward.

In the meantime, however, while we better understand the impacts, and while more and more of us get the added protection of booster vaccinations—which will help to reduce the impact of omicron—we must try to avoid being overwhelmed by the sheer volume of cases. That is why it is prudent—indeed, I say that it is essential—that we act to slow transmission as much as possible.

That is why additional protections were announced last week and are now in force. I will summarise them shortly. It is also why we are advising everyone, over Hogmanay and new year’s day, and for at least the first week in January, to stay at home more than normal, to reduce contacts with people outside our own households, and to limit the size of indoor social gatherings that take place so that they do not include people from more than three households. We also advise that people try to ventilate indoor spaces as a much as possible.

It also remains our strong advice that lateral flow tests should be taken just before meeting people from another household. If that test shows a positive result, it is vital that people immediately isolate and book a polymerase chain reaction test. You should also isolate and book a PCR test if you have symptoms that might be Covid.

I know that following that advice is difficult and frustrating at the best of times, and is even harder at this time of year. However, it really does help, and it will be helping already, notwithstanding the very high case numbers, so please stick with it for now.

In addition to that general advice to the public, the new protective measures relating to hospitality, public indoor places and live events that I set out last week are now in force. We will review those on an on-going basis, but at this stage our expectation is that they will be in force until 17 January. That means, for now, that there are limits on the size of live public events, although private life events, such as weddings, are exempt. For indoor standing events the limit is 100, for indoor seated events it is 200, and for outdoor events it is 500, seated or standing.

I know that some people question the rationale for that, so I will set it out again. First, the higher transmissibility of omicron means that large gatherings have far greater potential to become rapid superspreader events. Secondly, there are transmission risks associated with travel to and from such events. Thirdly, they place significant demands on emergency services, including the police and the Scottish Ambulance Service. At a time when emergency services are already dealing with high levels of staff absence due to the virus, not having large-scale public events allows those services to focus on delivering core services to the public.

As well as the limits on large events, further protections are now in force for hospitality and other indoor public places. A requirement for table service has been reintroduced for venues that serve alcohol for consumption on the premises. Guidance has been issued to the effect that indoor hospitality and leisure venues should ensure 1m distancing between groups of customers. A group—whether it is made up of one, two or three households—should be physically distanced from other such groups in the same venue.

Finally, nightclubs are unfortunately now closed until 17 January, unless they have decided to remain open, without dancing, as hospitality premises, in which case they will be required to follow the same rules and guidance as other hospitality venues.

All those protections are important to help us to deal with and to reduce the impact of the public health challenge that Covid represents. However, they also have a significant impact on businesses. Two weeks ago, I announced £100 million to support businesses that are affected by the advice to minimise contacts over the festive period. We have already detailed the allocation of that funding.

Last week, I announced a further £275 million of support. I can give more detail today on how the first £100 million of that additional support is being allocated. Of it, £16 million will be made available to support public transport providers through existing Covid support schemes, £27 million will go to the culture sector and another £17 million will go to the events sector. A further £32 million will be allocated to hospitality and leisure businesses, with an additional £10 million for the parts of the hospitality industry that are being most severely impacted by the requirement for table service only. Up to £5 million will be allocated to nightclubs that are required to close.

We are also working closely with the sports sector. Sporting events are, obviously, affected by the limit on the number of spectators and by cancellations that are due to Covid absences. However, we know that some of that impact will be alleviated by rescheduling of events. We want to ensure that the support that we provide is effectively targeted; we will confirm further details on that soon.

We have now reached decisions on the allocation of, in total, £207 million of the £375 million that is being made available for business support. Councils are now working to get that money into bank accounts as fast as possible. Decisions on allocation of the remaining funds will be confirmed following consultation of affected sectors on how the money can best be targeted.

I know how difficult all that is for businesses. I wish that it was not necessary and I hope that it will not be necessary for long, but there is, simply, no easy trade-off between protecting health and protecting the economy. If Covid continues to spread rapidly, the economic impact in the form of staff absences and diminished consumer confidence will be severe. We are already seeing those impacts. Doing nothing will not help business. We must protect public health and the economy together, by slowing the speed at which Covid is spreading while we complete the booster programme.

I will touch on two further issues. I mentioned earlier the need to mitigate the impact of staff absences on the economy and critical services. Obviously, the best way to do that is to stem transmission. However, we must also ensure that the requirements for isolation are proportionate. Last week, I indicated that we were weighing the risks and benefits of shortening the isolation period for index cases and, potentially, using the requirement for all household contacts to isolate following a positive case.

These are finely balanced judgments and we are considering the current trends in infection carefully. However, I can confirm that we hope to reach decisions in the next week. Any changes will take effect from 5 January. We will keep Parliament updated.

In the meantime, we have introduced a sectoral exemption scheme, subject to appropriate protections. Today, I can confirm a further change that will help to ensure that the exemption scheme, which is dependent on the speedy turnaround of PCR tests, is effective. The current surge in cases means that testing capacity—sampling and processing capacity—is under pressure. Therefore, we are now prioritising some slots for essential workers, including NHS and transport staff, and for people who are clinically vulnerable or are eligible for new Covid treatments. That change will ensure that essential workers will promptly get the test results that they need in order to qualify for an exemption

That is a sensible step to take at this stage. However, notwithstanding that priority being given to essential workers, let me stress that testing remains available for anyone who needs it. If you try to book a test and cannot find a slot in a location that you can get to, try again later. Additional PCR test slots are released throughout the day.

For now, test and protect is also focusing its telephone tracing on high-risk settings, such as care homes. The majority of us—if we test positive—will be contacted by text or email, rather than by phone. Therefore, if you are contacted by test and protect as either a positive case or a close contact, please respond and complete the online form and ensure that you follow all the advice that you are given.

The final and vital point that I want to provide an update on today is the progress of the vaccination programme. However, before I do so, let me address the following point. I have heard people ask in recent days what the purpose of a booster vaccination is if we still have to restrict our activities for a period. I understand that question, but it is vital that we all understand the answer.

First, getting a booster does not mean that we will not get Covid, although it will reduce the chances of that. However, it does significantly enhance our protection against serious illness. Getting boosted could quite literally save your life. Because vaccination does not completely stop us getting or passing on the virus, those who are not fully vaccinated are still at significant risk. As a country, we will not get the full benefit of the booster programme until the maximum number of us are fully vaccinated. That means that anyone who chooses not to be vaccinated without good reason is acting irresponsibly.

However, the key point is that, until the programme is completed—we are getting closer to that every day—we still need to slow down the spread. In recent weeks, there has been a huge increase in booster appointments. Again, I want to record my thanks to everyone who is involved in the delivery of the programme and to everyone who is coming forward to be boosted. Some 75 per cent of those who are eligible for a booster or a third dose have now received one. That represents excellent progress, but in order to deliver maximum benefits, we need the maximum number of people to get boosted as quickly as possible. We want to get to, or as close as possible to, the target of having 80 per cent of eligible adults boosted by the bells.

Getting there will depend on both capacity and demand. Let me make it very clear that we definitely now have enough capacity to meet that target. What we need between now and the end of the week is high demand—eligible people who are not yet boosted need to come forward now and get the jag.

High numbers of positive cases are making things more difficult, because, if you get the virus, you cannot get the vaccine for a period afterwards. Therefore, cancellation and “Did not attend” rates have been creeping up this week as case numbers have risen. However, I ask everyone out there who is not yet boosted but could be—please book an appointment now or go to a drop-in clinic. If you have an appointment booked for January, please reschedule it for this week; there are plenty of slots available. Please, please do not delay. Every single booster jag that is administered now is a step on the road back to normality. Remember that, if you have not yet had your first or second jag, it is never too late for that, either. Please make sure that you get those now.

It is an understatement to say that the situation that we face is not what any of us want. I have to be clear that the period immediately ahead will not be easy. That said, I hope that the clearer picture that we will have in the next couple of weeks will also prove to be much more positive. We can all help to make it so.

So, please, get fully vaccinated and do it this week. The more of us who are boosted, the less severe the impact of omicron will be and the sooner we will all return to normality.

Secondly, please test regularly. The advice, if you are meeting other people, is to test before you go every single time, and to take the test as close as possible to the time when you will see other people. That is really important if you plan to meet people from other households for Hogmanay, although I encourage you to minimise that.

Finally, take all the other precautions that can help to make a difference. People should work from home whenever possible, stay at home more than normal and reduce their contacts as much as possible, even over Hogmanay. If you visit indoor public places, limit the number of households in your group to three at most. Wear face coverings on public transport, in shops and when moving about in hospitality and make sure that the covering fully covers your mouth and nose. Keep windows open if you meet indoors and follow all advice on hygiene.

Sticking to that is really hard but it keeps us safer and enables us to slow down the spread of the virus as we complete the all-important booster programme.

It has been—this is another understatement—another really difficult year, but despite the renewed challenges that we face now, I firmly believe, largely because of vaccination, that 2022 will be a better year. I conclude by thanking everyone, again, for all the sacrifices that have been made over this year, and I wish everyone a very happy new year, when it comes.

First, this is a UK-wide system—I do not say that in any way to pass responsibility—and we are working closely with the UK Government to ensure that the flow of testing remains as we need it to be.

Last night, steps were taken to constrain demand in England, which I understand means that there are no bookings available today for physical test sites in England. While that change was being made last night, an administrative error was made that restricted slots in the other three nations. That has now been rectified. I went on to the system just about half an hour before coming to make my statement, and I saw that Scotland and Wales were the only parts of the UK where there was availability of PCR tests at physical sites. We monitor that on an on-going basis. Work is being done to ensure that testing capacity continues to increase, and prioritisation of that testing capacity is also being given due regard—I covered some of that in my statement.

There have been lengthening turnaround times, but we hope that they will return to normal over the course of the next couple of days. There will continue to be pressure on tests, but it is important that the system continues to flex and respond. I have confidence that that will be the case and we will continue to liaise closely with the UK Government on that.

I have one final point to make, and this might be a factor in some of the constraints that have been put on demands in England over the past few hours. The testing system, like other parts of the economy and critical services, will be suffering from absence rates because of Covid, which, of course, comes back to the earlier points about the need to take decisions—albeit careful decisions—around things such as self-isolation. Those are all interlinked matters, and that is why we continue to keep all of them under close review.

I do, which is why I will come back to a point that I am sure that Jackie Baillie clearly heard me make in my statement.

I am not sure whether Jackie Baillie is suggesting that I, as a politician with no clinical qualifications, should substitute my judgement about eligibility for that of the four chief medical officers. It is right that questions about eligibility for antiviral treatment, particularly at this stage, should be for clinicians and our clinical advisers.

We want to see the number and range of people who access antiviral treatment expand as the number and availability of those treatments increase, but I genuinely believe that those decisions are best informed by clinical advisers, not politicians. I will continue to listen carefully to what they say.

The point about the speed of access to PCR tests is an important one. I know that there was a lot of information in my statement, and that it might not have been easy to pick up on this, but I spoke about prioritisation in the PCR testing system for essential workers. I also said that we are making priority slots available for those who are clinically vulnerable and those who are eligible for the new antiviral treatments, to ensure that they get their test results timeously and do not lose out on access to treatment. That is one of the important changes that I covered in my statement.

There is at present no change to the arrangements that were set out by the Cabinet Secretary for Education and Skills not long before the Christmas recess—I cannot recall exactly when she set them out. The expectation is that exams will go ahead in this academic year. Contingency arrangements are in place and there are considerations that would inform that. Anyone can look at the detail of that but I am happy to ask the education secretary to write to the member with a reminder of and an update on those plans.

We continue working through the chief scientist office and NHS Research Scotland to invest in the research infrastructure that will support health boards in hosting and participating in a wide range of clinical research. That includes research in all clinical areas and particularly studies associated with Covid, such as those that help us to understand Covid and trials of treatments and vaccines. Support for research in specific clinical areas is provided by clinical research networks and specialty groups.

I recognise the importance of continued support for that and take the opportunity to pay tribute to everyone in our research community whose work in the past couple of years has helped us to get to where we are now, with a far greater, if not full, understanding of Covid and with advances in vaccines and treatment.

I have already covered that a number of times today, so I will recap briefly. The level of funding that is available in Scotland is proportionately far greater than is the case elsewhere in the UK, because we have prioritised support for businesses.

Of the £375 million, just more than £200 million has already been allocated. That covers hospitality, leisure, events and some of the supply chain businesses that are affected by the advice that we have given and by some of the other protections that are in place. With regard to the remainder of that funding, as I have said, we are in consultation with different sectors—including, for example, the taxi industry—to make sure that those parts of the economy that are only indirectly affected by the protections are included.

As I have said, without further significant funding being made available by the Treasury, we cannot compensate every business. That is why I hope that all members, including Sharon Dowey, will join us in calling on the Chancellor of the Exchequer to make that additional funding available, so that we can go even further than we are going from within the Scottish Government’s own resources.