Chamber and committees

Today, I will give an update on the general Covid situation. In addition, I will share the most up-to-date information that we have on the omicron variant—both its transmission in Scotland and the world’s developing understanding of it—and set out the steps that we must take to slow its spread and to stem transmission of the virus more generally.

First, I turn to today’s statistics. There were 3,060 positive cases reported yesterday, which is 9.2 per cent of all tests carried out. There are currently 576 people in hospital with Covid, which is 15 fewer than yesterday, and 38 people are in intensive care, which is five fewer than yesterday. Sadly, a further 12 deaths have been reported over the past 24 hours, which takes the total number of deaths registered under the daily definition to 9,661. Once again, I send my condolences to everyone who has lost a loved one.

I am pleased to report, however, that the vaccination programme continues apace: 4,355,063 people have now had a first dose; 3,962,203 have had two doses; and 1,922,604 have had a booster or third dose of vaccine. On first, second, third and booster doses, Scotland is still the most vaccinated part of the United Kingdom. At this stage, on booster doses, we are comfortably ahead of the other UK nations, with around 40 per cent of the over-12 population having had a booster jag to date. Again, I record my thanks to everyone who has been involved in organising and delivering the vaccine programme.

Today’s weekly update coincides with the latest three-week review point for all the remaining Covid regulations. I can confirm that, at our meeting this morning, the Cabinet agreed to keep all the current protections in place, with no immediate changes.

Given the very significant risks that are posed by omicron, and the continuing high, and once again rising, number of cases in Scotland overall, our judgment is that it would, at this time, be inappropriate to lift any of the protections that are currently in place. On the contrary, we agreed that, at this stage, it is vital to strengthen compliance with all the existing protections. We also agreed that, in the light of the rapidly developing omicron situation, it is important to keep the need for any additional protections under daily review. The importance of doing that will be clear from the latest data, in particular the data that I will shortly share on omicron.

First, I will summarise the overall situation. After two weeks of falling case numbers, the past seven days have seen a rise in the overall number of Covid cases. Last week, I reported that the number of new cases being recorded each day had fallen by 14 per cent over the preceding seven days. However, in the past week, cases have increased by 11 per cent, and we are currently recording just over 2,800 new cases a day on average.

Encouragingly, cases in the over-60 age groups have continued to fall, in the past week by a further 8 per cent. There is little, if any, doubt that that reflects the effectiveness of booster vaccines. However, in all age cohorts under 60, cases are rising again. In total, the number of cases among under-60s increased by 13 per cent in the past week and, given that people under 60 currently account for more than 90 per cent of all cases, that has inevitably driven an increase in the total number of cases recorded.

More positively, the number of people in hospital with Covid has fallen further in the past week, from 706 to 576, as has the number of those in intensive care, from 54 to 38. That is of course welcome news. However, we should not be in any way complacent about that—first, because we know that there is always a time lag between rising cases and rising admissions to hospital, and secondly, because the national health service continues to be under very severe pressure, not only from direct Covid pressures but from the backlog of work created during the pandemic.

On top of all that, as we head further into winter, the NHS may soon face additional pressures from, for example, flu. There has always been the potential for Covid cases to rise during December—as may now be happening—as a result of more people mixing indoors more often.

In any circumstances, we would be concerned about the current high level of cases and the impact that it might have on the NHS, but the emergence of the omicron variant is now an additional and very significant, cause for concern. From tomorrow, Public Health Scotland’s weekly Covid report will provide more detail on both confirmed and probable omicron cases in Scotland. It will include data on not only confirmed cases, but the number of polymerase chain reaction tests showing what is called the S-gene dropout. That is not conclusive evidence that a case is of the omicron variant, but it is highly indicative of it. The report will also contain data on the age, sex and health board area of omicron cases. In weeks to come, and as soon as the quality of data allows, the reports will also provide detail on the vaccination status of, and hospital admissions and deaths associated with, omicron cases.

For now, I will summarise what we currently know about the presence and spread of the new variant in Scotland. I confirm that, as of 5 pm yesterday, there were 99 confirmed cases here. That is an increase of 28 since yesterday. To give a sense of the speed of increase, albeit at this stage from a low level, the figure that I reported this time last week was nine. Therefore, we have seen an increase of more than tenfold in the space of a single week.

A low—around 4 per cent—but steadily rising proportion of cases also now shows the S-gene dropout that, as I said a moment ago, is highly indicative of the omicron variant. At this stage, our estimate is that the doubling time for omicron cases may be as short as two to three days, and the reproduction number associated with the new variant may be well over 2.

I can also report that there are now confirmed cases in nine of our 14 health board areas, suggesting that community transmission is becoming more widespread, and possibly more sustained, across the country. Our health protection teams are working hard through contact tracing, testing and isolation to slow the spread of omicron cases. That work will obviously continue. I thank the teams for their excellent efforts. However, given the nature of transmission, I expect to see a continued and potentially rapid rise in cases in the days ahead, and that omicron will account for a rising share of overall cases. All that explains, I hope, the requirement for Government to review the situation daily, rather than weekly, at this stage.

I turn briefly to the developing global understanding of the new variant. The first point is that there is still a great deal that we do not yet know. However, data on cases worldwide, including here at home, gives a reasonable degree of certainty at this stage that omicron is more transmissible than the delta variant, and perhaps significantly so.

Early—albeit, again, unconfirmed—data also suggests that omicron is more capable of reinfecting people who have had the virus previously. In other words, it has some ability to evade natural immunity. Of course, there is also a concern that it may evade to some extent the immunity that is conferred by vaccination. However, I stress that, even if that latter point proves to be the case, getting vaccinated will still be vitally important. Vaccines being slightly less effective is not the same—nowhere near it—as vaccines being ineffective. Being vaccinated will still give us much more protection against omicron, particularly from severe illness, than we will have if we are not vaccinated.

Further data and analysis are needed to confirm all the hypotheses about the transmissibility, immunity evasion and severity of omicron. We will learn more about its characteristics and implications in the days and weeks ahead, and that developing understanding will inform and shape our response. However, we can assume already that the emergence of omicron is a significant challenge for us all. A variant that is more transmissible than delta, and has even a limited ability to evade natural or vaccine immunity, has the potential to put very intense additional pressure on the national health service.

A key point that we must understand, and which I underline, is that the sheer weight of numbers of people who could be infected as a result of increased transmissibility and some immune evasion will create that pressure even if the disease that the new variant causes in individuals is no more severe than that caused by delta.

There is no doubt, unfortunately, that this is another serious moment in the pandemic. I will talk shortly about what that means for all of us. First, I will outline the principles that will guide any decisions that Government might have to take in the days and weeks ahead.

It is worth noting that the period ahead might, as we learn more about the new variant, involve very difficult judgments for Governments everywhere. Indeed, many Governments around the world are already taking decisions that we all hoped were behind us for good.

For the Scottish Government, our first principle will be that we will seek to do what is necessary to keep the country as safe as possible, even if that is sometimes at the expense of being popular.

Secondly, we will strive to strike the right balance between acting proportionately and acting preventatively. We know from experience—sometimes bitter experience—that with an infectious virus acting quickly can be vital. If we wait too long for data to confirm that we have a problem, it might already be too late to prevent the problem. Indeed, acting preventatively is often the best way of ensuring that action can remain limited and proportionate.

However, after two years of restrictions, with the accumulation of social and economic harms that previous restrictions have caused, we also know that it is ever more important that we minimise further restrictions as far as is possible. While recognising that it is never a perfect science, we will seek to get that balance right.

I turn to the action that we have taken so far and what we are asking everyone to do now. First, in line with the other United Kingdom nations, we have tightened travel rules. In the past week, Nigeria has been added to the travel red list. That means that anyone arriving in the UK from Nigeria—or from the 10 countries that are already on the list—must enter managed quarantine for 10 days.

In addition, since this morning, anyone aged 12 or over who is travelling to the UK from outside the common travel area will be required to take a Covid test shortly before they leave for the UK. That is in addition to the requirement to take a test on day 2 after arrival in the UK and to self-isolate pending the result.

My advice to anyone who is planning travel between Scotland and countries that are outside the common travel area is that they should check on the Scottish Government website for detailed guidance and check the requirements of the country to which they are travelling, because the requirements there might well be different to those that are in force here.

At this stage, travel restrictions have an important part to play in the response to the new variant. However, given that we already have some community transmission in Scotland, what we do domestically is also important. That is why the Cabinet decided this morning to keep in force all existing protections. However, we also agreed that it is vital not just to maintain but to strengthen compliance with the protections.

It is time for all of us to go back to basics and ensure that we are taking all the steps that are required to minimise the risk of getting or spreading the virus. Indeed, it is through heightened compliance with current protections that we will give ourselves the best possible chance of avoiding the need for any additional protections. I am asking everyone to make an extra effort to do so from now through the festive period and into January. Obviously, that means wearing face coverings in indoor public places, ventilating rooms by opening windows whenever possible and ensuring good hand and surface hygiene.

However, there are two important protections that I want to emphasise particularly strongly today. The first protection is working from home. We already advise people to work from home wherever that is practical. Today, I am asking employers to ensure that that is happening. To be blunt, if you had staff working from home at the start of the pandemic, please now enable them to do so again. We are asking that you do that from now until the middle of January, when we will review the advice again. I know how difficult that is, but I cannot stress enough how big a difference we think that it could make in helping to stem transmission and in avoiding the need for even more onerous measures.

The second protection is testing and isolation. Test and protect is deploying enhanced contact tracing for all cases with the S-gene dropout that is indicative of omicron. For those cases, household contacts of close contacts, rather than just the close contacts themselves, are being asked to test and isolate. If you are asked to do that, please comply.

More generally, for non-omicron cases, if you have symptoms of Covid, please get a PCR test and self-isolate until you get the result. If your result is negative you can end isolation at that point, if you are double vaccinated. If it is positive, you must isolate for the full 10 days.

Crucially, please remember that you can have the virus even if you have no symptoms, so testing regularly and repeatedly with lateral flow devices is essential. We are asking everyone to do a lateral flow test before mixing with people from other households, and on every occasion on which they intend doing so. That means testing before going to a pub or restaurant, before visiting someone’s house and even before going shopping.

Let me make it clear that I am not excluding myself from that. I am currently doing a test every morning before coming to work. I will do a test on any occasion when I mix with others over the festive period and I will ask anyone visiting my home over Christmas to do likewise. I am asking every member of Parliament to lead by example and to do that, too. LFD kits are easy to get through NHS inform or from local pharmacies or test centres and are easy to use, so please do that. It will help us significantly in breaking chains of transmission.

I hope that if we do all those things, difficult though they are—as I appreciate—then even with a more transmissible variant we can avoid the need for further measures. I cannot guarantee that, however; no responsible person in my position could guarantee it, at this stage. Given the situation that we face, it is important that we remain open to any proportionate measures—for example, extension of vaccination certification—that might help us to reduce the risks, should the situation deteriorate.

The Government will carefully analyse the data in the days ahead. I hope that it will not require us to take any decisions ahead of my next scheduled statement, a week from today, but if it does I will, obviously, return to Parliament.

I end by reiterating the vital importance of vaccination. Scotland is currently the most vaccinated part of the UK. We have, more quickly than other nations, implemented the Joint Committee on Vaccination and Immunisation’s advice to reduce the gap between second doses and boosters, but we are not complacent.

We are identifying and training additional vaccinators. So far, we have added the equivalent of more than 300 additional full-time staff to the vaccination workforce. We are also working to increase vaccination capacity further. A number of health boards—NHS Fife and NHS Tayside, for example—are now using drop-in centres to make vaccination even easier, and we are in the process of increasing use of mobile vaccination units that are being provided by the Scottish Ambulance Service.

In addition to those efforts, which are intended to improve the supply and availability of vaccine, we are also working to increase demand by encouraging even more people to take up the offer of vaccination. In the past week, therefore, text or e-mail messages have been sent to people aged between 40 and 60, encouraging them to book their booster jag. I ask those who are now able to get a booster jag—anyone over 40 who had the second jag 12 or more weeks ago—to arrange an appointment as quickly as possible, please. You can book through NHS inform or by calling the vaccination helpline. If you are 16 or 17, you can and should book your second dose in the same way.

Last week, we also sent blue-envelope letters to all 50 to 59-year-olds who have not yet been vaccinated at all. A similar letter is being issued over the course of this week to everyone aged between 40 and 49 who has not yet been vaccinated. Take-up of the vaccine has been exceptional, but a significant number of people in those age groups have still not been vaccinated. To anyone in that position, let me be clear: it is not too late to get vaccinated. In fact, it is now more important than ever that you get your first jag and start to get that essential protection.

To conclude, I say that omicron is a really concerning development; it is the most unwelcome of developments at this stage in the pandemic. However, the more positive aspect is that the actions that have helped us against other variants will also help against omicron. That means that we all know what we need to do in the days and weeks ahead, so my request to everyone is to follow those steps.

Please go back to basics and make sure that we are all doing everything that we are being asked to do. That is the best way that we have of making Christmas and the new year as safe as possible, and of maximising our ability to navigate this next unwelcome but unavoidable challenge without additional protections being necessary. That will also help us to protect the NHS and the people who are working so hard in the NHS and social care to keep us all safe. Please—get vaccinated.

Secondly, test regularly and on any occasion before socialising or mixing with people from other households.

Finally, make sure that you comply with all the existing protections. Wear face coverings on public transport, in shops and when moving about in hospitality settings. Keep windows open—which is not easy in the weather that we are currently experiencing—when meeting people indoors, and follow all the hygiene advice. If you were working from home at the start of the pandemic, please do so again for the next few weeks.

None of that is what any of us wants, two years into this ordeal—I know that—but it is the best way of slowing the spread of the virus in general, and omicron in particular. By doing that, we will give ourselves the best possible chance of enjoying a Christmas that is more normal but which is also safe, and of avoiding a new year hangover of spiralling case numbers.

Please—I really hope that this will be for one final time in this pandemic—let us all pull together, do what is necessary and get each other and the country through the winter and into what we all hope will be a much brighter spring.

I am making very clear today what the Government is asking of employers. Do not get me wrong—I understand how difficult this is for employers. I also understand that—much different from what was the case at the start of the pandemic—there may be increasingly mixed views among workers about the desirability of home working versus office working. I appreciate that many people who have been working at home for long periods in fact want to get back to the office. However, we know that maximising home working and therefore reducing some of the contacts around office working can help stem transmission, which is very important at this point.

To support workers to work from home, we are today sending a very clear message to employers that they should make sure that that is being facilitated wherever possible. To make that message easier for people to understand, if your staff were working from home at the start of the pandemic, please enable staff to work from home at this stage. At the moment, we are saying that that should be for the next few weeks, until mid-January, when we can review it again having come through this next very difficult period. I believe that, as we have seen before, home working can make a significant difference, and I hope that it will help us avoid the need for any more onerous restrictions.

As I said last week, local authorities are planning—I am sure that some are doing this already—to make lateral flow devices accessible in shopping centres, garages, garden centres and anywhere that they think is appropriate and convenient for people. I appeal to all members, including Pam Gosal, not to give the suggestion to the population that lateral flow devices are not easily accessible right now, because they really are. You can order them online one day and they will arrive through your letterbox the next, and you can pick them up from local pharmacies and test centres.

We should be uniting to tell people that it is really easy to get LFD tests and to ask people to use them before mixing with other people. LFD tests are really easy to use. I repeat my request to members across the chamber to lead by example and say publicly that they are testing themselves every day, and that they will do so before socialising with others over the festive period. Please let us get the message across that LFD tests are easy to get and easy to use, and that using them regularly and repeatedly will help us to break the chains of transmission.

I said last week that we will, through local authorities, make LFD tests available in shopping centres and garden centres, so I am not arguing against that for a moment. However, I repeat what I said to Pam Gosal. I agree entirely with the member that we should extend access to LFD tests, but please let us not inadvertently send a message to the public that LFD tests are not easily accessible, because they are. Let us say to people that they should get them now and not wait until they become available in shopping centres and garden centres. LFD tests will become available there during the festive period, but people should go on to the NHS inform website now, order the tests and use them. Next to vaccination, it is possibly the most important thing that we can do to try to stem transmission.

We will keep under very close review the protections that are in place around care homes. The most important protection for people in care homes now is the vaccination programme, which is why we have prioritised care homes in its roll-out. However, vaccination is even more important to anyone—staff or visitors—who is accessing a care home right now than it is to anyone else. It is vital for every person to make sure that they are vaccinated and that they test themselves before they go.

We must ensure that we minimise the risk of the virus getting into care homes. That has always been important, but it is particularly important in the face of the omicron variant.

That is a very fair and legitimate point. We need to consider a range of different ways, because there will not be one particular measure. The point is so serious that I want to ask the health secretary to consider it more and see whether, as well as extending the accessibility of LFDs, we can provide ways in which those tests for people with particular disabilities can be taken and processed. If Jeremy Balfour is willing to wait, we will look at that quickly over the next couple of days and come back to him with more detail afterwards.

Right now, small businesses in certain sectors in Scotland have 100 per cent rates relief, which they would not have if they were situated south of the border under the Conservative Government. We can therefore take from the actions in place just now that that is a key priority for the Government. I also know that it is a particular priority for the Cabinet Secretary for Finance and the Economy, who will of course set out the budget to Parliament later this week.

We have said that our clear aim and target—we have a lot of confidence in delivering this, given the progress of the booster programme so far—is to complete the booster programme for those who are over 18, including for under-40s, by the end of January, and that is what we are working to do.

That involves doing all the things that I spoke about in my statement, including increasing the vaccination workforce—we have already increased it, and we will seek to go further—and increasing the capacity for vaccinations but also making sure that we are doing what is necessary to generate the demand. That involves making sure that, when people are eligible, they come forward and get vaccinated. All of that is important work, and of course all MSPs can help us with that by getting those messages out in their constituencies.

Yes, I support the calls of the People’s Vaccine Alliance, and I certainly call on the Prime Minister to take whatever action he can to ensure that we get vaccines equitably to the population of the world as quickly as possible. I also take very seriously the responsibility that is on the shoulders of my Government to make sure that we are doing everything possible.

It is understandable that we often focus on the implications for ourselves and our country, but Covid is an unprecedented global crisis. Earlier in the pandemic, the Government allocated funding for our international development budget to provide Covid support for our partner countries Malawi, Rwanda, Zambia and Pakistan. The UK also participates in COVAX, which is an important way to help other nations to access vaccines. However, it is fundamentally the case that, as omicron reminds us, until everybody across the world is safe, none of us is truly safe, so we are keen to explore further routes that support equitable access to vaccines. I will write to the Prime Minister on the issue to encourage him to take whatever action is necessary and offer the full co-operation of the Scottish Government in doing so.

I will come back to the clinical guidance on GP access. Let me run through the other points.

On accident and emergency, as in probably every country in the world right now, the pressure of the pandemic is creating challenges in unscheduled care, as well as in scheduled and planned care, in our NHS. We are no different from other countries in that respect. Notwithstanding that, although our A and E performance is nowhere near where we want it to be, our A and E units are still performing better than their counterparts in the other UK nations. We will continue to support our A and E departments and our NHS in general to cope with the current pressure and then to recover to normal as we come out of the pandemic.

In order to do that, it is really important not just that we first contain, then—I hope—drive down Covid case numbers, but that we take measures to keep the NHS as safe as possible from the ingress of Covid cases.

Let me come to the issue of GP clinical guidance. It is clinical guidance, not a Government policy. It is about screening patients to ensure that, if they are physically accessing general practices, we minimise the risk of Covid getting into the practices and creating outbreaks. GPs have expressed some concerns about that. We will listen to those concerns to see whether the process can be done more flexibly. However, in the midst of the pandemic and dealing with a variant that might be significantly more transmissible than any previous variant, it is inescapable that we need such protective measures.

I am not surprised to hear Douglas Ross oppose what we have in place, because he has opposed pretty much everything that we have done up until now to keep the country safe from Covid. We will continue to take appropriate and proportionate protective measures to keep our NHS and the country safe.

Finally, on schools, it is absolutely the case that protecting the education of children remains a top priority. We are not discussing the national closure of schools; the Government will do everything that can be done to avoid that. That is a really important principle that will drive everything that we do.

However, that means doing other things that, again, Douglas Ross has opposed time and again. First, it means ensuring that there are sensible mitigations such as face coverings in schools. Nobody likes that, but such mitigations are essential. Douglas Ross has repeatedly opposed the use of face coverings in schools. Secondly, we must do what is necessary in the wider community to keep control of Covid. Again, most of the things that we have done in trying to achieve that have been opposed by the Conservatives.

We need to continue to take sensible and proportionate actions. We are, again, at a really serious juncture of the pandemic. It demands serious government and serious decisions; it certainly not does demand opportunistic opposition.