Chamber and committees

Information on the numbers in different age groups who have been vaccinated with the booster is regularly published. That information is available.

It has been reflected in some of the questions and answers today that there is mixed provision of access to booster vaccinations. That is right, because not every part of the country is the same, and there has to be a reflection of the geographical position. We continue to address and resolve any localised issues whereby access has been difficult.

Overall, it is really important to stress that the vaccination programme is going incredibly well. I think that most people across the country recognise that. I think that, from yesterday’s figures, just over 34 per cent of the over-12 population have been vaccinated with booster jags; that compares with Wales, at 31.5 per cent, or England, at 31 per cent. We are therefore significantly ahead. Of course that does not mean that everybody is having a flawless experience, and we will address that as often, as far and as quickly as we can.

Those who are working in the programme are literally saving lives every single day. They are doing that at pace and with the utmost determination, and all of us owe them the most immense debt of gratitude.

Annabelle Ewing’s first point is important. There is no absolute one-size-fits-all approach to how health boards are delivering vaccinations; some are, at different stages, using drop-in clinics, and that is appropriate. It is about getting to people as quickly as possible through a variety of routes, and that will continue to be the approach.

On public awareness, we already have television, radio, digital and outdoor campaigns to remind the public of the key protections that are in place and the need to comply with them. We will intensify those campaigns over the winter, to ensure that everybody knows what is being asked of them. We will put particular stress on the request to people to test themselves before they go to the pub or a restaurant, before they visit someone in their house over Christmas and before they go Christmas shopping. That is really important and can do a lot to help us to break chains of transmission.

Local authorities and the police, too, continue to take action to raise awareness in particular settings. There will be a big focus on making sure that people understand what we are asking them to do.

All that is important, but after two years, I think that we all know what works against this virus; we are all just tired of doing it—and I include myself in that. That is why this is an important moment for all of us to up our compliance again, so that we can stop not just the new variant but the virus generally in its tracks and mitigate the risks over winter.

I will not repeat my answer on mass vaccination centres; I set out the rationale and the thinking on them. I underline the point that we are currently the most vaccinated part of the UK, in particular on booster jags.

On the important issue about getting uptake—in all age groups—some 50 to 59-year-olds are not vaccinated yet, and until yesterday, when the gap between the second dose and the booster dose was reduced, some were not yet eligible for their booster. I am in that category: I would not have become eligible for my booster until later in December, but because of yesterday’s change I have been able to go online and book an earlier appointment. Lots of appointments are becoming available every day. That will continue to be the case. I say to everyone who is in a similar position to me: try now to bring forward your booster appointment.

We cannot vaccinate everyone on a single day or even in a single week. This will take a number of weeks for us to work through. We will do it in the order of priority that the JCVI recommends. We will get through this as quickly as possible, because it is our best line of defence in the period ahead.

Like all health boards, Greater Glasgow and Clyde will judge what health facilities it needs, and if any health boards want to discuss with us the establishment of a vaccination centre on that scale, we will discuss that and the resource implications. There is no doubt that the Louisa Jordan did a fantastic job. What I am about to say is not intended as any criticism of those who did so much work there—it is in the nature of those very large centres—but I think that it had the highest “did not attend” rate in the country.

Members have heard me say this many times: there is a constant balance that needs to be struck between big throughput and speed of access and local accessible availability. Many members raise the inconvenience of people having to go somewhere such as the Louisa Jordan. Health boards are striking that balance really well, but with the kind of extension that we have had as of yesterday, we have to rethink whether any of those different approaches are appropriate. That process is under way right now and will continue right throughout this programme and into the next one, which I fear will come before we know where we are.

We have a range of data about compliance with different measures. If memory serves me correctly, we publish some of that regularly—if we do not, I will see what we can provide. We have regular discussions with the transport operators, the retail sector and businesses in general. The finance secretary had a round-table discussion with business organisations just yesterday about all the different ways that they can help, including facilitating working from home wherever possible.

Because we are sick and tired of it and because we have been in a period where the perceived risk has been reducing and we all feel stronger because of vaccination, as we should, we have all—I include myself in this—been letting our guard slip a bit in relation to those basic mitigations. That is understandable. However, we are now at the moment to tighten that up, not just because of the new variant—although that is definitely increasing the need for caution—but because of the risk that winter poses anyway. Over the next period, which might be really challenging, if we do all those basic things, all of them added together will make a difference.

If we have been forgetting to do some of those things in recent weeks—I am sure that we all have—now is the time to stop, think about what we need to do and make sure that we do it. That will really help us to get through the winter much more safely than would otherwise be the case.

We have to continue to judge the proportionality of all the measures, protections and restrictions. There is no doubt that having some protections in place now will avoid the need for restrictions later. However, it is not possible—legally and in other ways—to give a blanket commitment to keep anything in place indefinitely. We have a legal requirement to test the proportionality of measures on an on-going basis, which is why we have three-weekly reviews.

I take the point that Gillian Mackay makes about the importance of measures to detect whether new variants are coming into the country. The new variant appears to have been detected very quickly. It has been detected in southern Africa—all credit to the Governments there for doing that so assiduously and so quickly. That does not mean that the variant originated in any of those African countries—we do not know about that yet. However, it underlines the importance of having good surveillance and detection measures in place. Testing will always be a part of that, but we have to ensure that any measures remain proportionate and are not kept in place for any longer than necessary.

We have published guidance on face coverings, and that guidance is certainly kept under regular review. A face covering can be a covering of any type, except a face shield that does not fall within the definition, that covers both the nose and the mouth. Due to equality and accessibility considerations, we do not mandate certain specifications, but we recommend that face coverings are made of cloth or other textiles, that they are two or, preferably, three layers thick, and that they fit securely around the mouth, nose and chin while, obviously, allowing the person to breathe easily. Our guidance is in line with the WHO recommendations.

What has had a chilling effect on people—if that is the case, although it is not terminology that I would use—is the emergence of a new variant; it is not anything that we are trying to do, sensibly, to limit the spread of that new variant so that further restrictions on people’s freedoms and way of life are not necessary in the weeks to come. Thankfully, the Labour First Minister of Wales seems to take a more constructive and sensible approach to these issues than some of his colleagues in this chamber.

We have discussed travel restrictions many times before. I am not averse to doing things unilaterally, where that make sense. However, as anybody who understands travel patterns knows, many people travel to Scotland and Wales via airports in England. If we had travel restrictions only here, they would not be effective. It would not get us the public health benefit but would do disproportionate damage to our airports, which is why the protections that we have been discussing, which are only really effective on a four-nations basis, are better.

I and the First Minister of Wales are in agreement. We hoped that the measure would be temporary. However, right now we need to do two things. We need to try to limit transmission of the variant, which is already in Scotland. While we are doing that, though, we need to try to ensure that we are not exacerbating the difficulty by importing more of the variant here. That is why such measures are important. We will continue to have what I hope are constructive discussions about these issues in the days and weeks ahead.

I remain more positive about the situation than I was a few weeks ago, notwithstanding the emergence of the new variant. As I have set out today, the overall trend of infections in Scotland is downwards. A few weeks ago, I would not have dared hope that that would be the case. We know that there are risks in the weeks ahead—I said that last week—in socialising around the festive period and in colder weather pushing us all indoors more. There is an additional risk now, potentially, in the form of the new variant. However, we are in a stronger position to confront all of that than would have been the case at this time last year or even a few weeks ago.

Vaccination is the best line of defence, which is why there is no lack of urgency on the part of the Scottish Government. Nor do we rule out any options. We discuss, on an on-going basis, appropriate ways in which we can accelerate the progress of the vaccination programme. We have had questions—and I would always expect such questions—about the deployment route that we chose for 12 to 15-year-olds, for example, and on the deployment routes that we have chosen for the first stages of the booster campaign. The routes that we have chosen have taken us to where we are today, as the most vaccinated part of the UK. On booster vaccination, so far, we are quite a way ahead of any other nation in the UK.

Of course, we want to go further. That was true before the JCVI updated its advice, yesterday, on those who are eligible. It is even more true now, when so many more people are eligible. We are currently considering all possible options for doing that, and we are not alone in that. The UK Government, the Welsh Government and the Northern Irish Government are having to do the same.

There is no shortage of staff. We have in place staff to do the roll-out that we had planned on the basis of the old advice. However, given that, as of today, more than a million people are eligible who were not eligible at this time yesterday, we clearly have to find more staff and more facilities in order to speed things up. That work is under way right now. We will focus ourselves, get our shoulders to the wheel and work with health boards—whose shoulders are also to the wheel—to get that to happen as quickly as possible. All four UK nations are going to be doing that.

The good news is that we have adequate supplies of vaccines, although developments in the past few days remind us all that we need to get vaccines distributed more equitably across the whole world, because—as we are being reminded right now—until the whole world is vaccinated, none of us is out of danger. The vaccination programme is the most important thing that the Government is doing right now, and we will continue to push it forward as fast as we can.

Today, as well as giving an update on the general Covid situation, I will share the latest information that we have on the recently detected omicron variant. I will outline the steps that we are taking to slow its spread and to curb transmission of the virus more generally.

First, however, I will set out today’s statistics. Yesterday, 2,569 positive cases were reported, which is 11.5 per cent of all tests. Currently, 706 people are in hospital with Covid, which is nine fewer than yesterday, and 54 people are in intensive care, which is two more than yesterday. Sadly, a further 10 deaths have been reported over the past 24 hours, which takes the total number of deaths registered under the daily definition to 9,572. Once again, I convey my condolences to everyone who has lost a loved one.

More positively, the progress and pace of the vaccination programme continues to be very good: 4,346,736 people have now had a first dose and 3,949,736 have had two doses. In total, 88 per cent of all those over 18 are now double-vaccinated, and 77 per cent of 16 and 17-year-olds and 59 per cent of 12 to 15-year-olds have had a first dose. From today, 16 and 17-year-olds can book their second dose of the vaccine online, and I encourage them to do so.

On first, second, third and booster doses, we remain the most vaccinated part of the United Kingdom. That matters because, as we know, vaccines save lives. According to a study that the World Health Organization published last week, there might be more than 27,000 people in Scotland who are alive today only because of vaccines. I again record my thanks to everyone involved in organising and delivering the vaccine programme.

In last week’s statement, I expressed the view that our overall situation was much stronger than I had dared hope. Case numbers, although still too high, had stabilized and, indeed, had started to decline. Since then, the data has become, if anything, even more encouraging. However, although case numbers here have continued to fall, the world has, of course, received the deeply worrying news of the new omicron variant.

I will say more shortly about our current understanding of the new variant. Before doing so, I will give a bit more detail of the current overall trends in infection levels.

In the past week, the average number of new cases that are being recorded each day has fallen from just under 3,000 to just over 2,500, which is a reduction of 15 per cent. As in the past few weeks, the biggest decline has been in older age groups, with cases in the over-60s having fallen by 27 per cent. That is very likely to reflect the on-going success of the booster programme.

Encouragingly, cases in the under-60 age cohorts, which account for the significant majority of cases in Scotland just now, have also fallen in the past week, by 13 per cent. In fact, during the past week, cases have fallen in all age groups. The number of people in hospital with Covid has also fallen, from 743 to 706, as has the number in intensive care, from 60 to 54.

All of that is really positive news, which indicates that vaccination, together with continued compliance with the protections that are still in place, is applying a firm downward pressure on transmission, and therefore helping to reduce the overall health harms that the virus causes.

All of that said, the national health service is still under significant and very severe pressure. Although case numbers are falling, they remain very high, and higher than we would want them to be going into the winter period. We know that a combination of factors poses a real risk that transmission will increase again through December and into the new year, as colder weather forces us indoors more and festive socialising gets under way. That risk remains very real and, if it materialises, it would put significant additional pressure on the NHS. Of course, the risk has now been significantly increased—at least, potentially—by the emergence of the omicron variant.

I turn to what we currently know about the new variant. Perhaps the most important point to make at this stage is that most of the key questions about the impact and implications of it have not yet been answered. However, the number of mutations that it has and the nature of those, together with some of the very early indications from southern Africa, have raised the concern that it might be more transmissible than the delta variant, which is currently the dominant variant in Scotland and many other parts of the world. Further data and analysis are needed to confirm that, and to assess what impact, if any, the new variant might have on the effectiveness of vaccines and on the risk of reinfection.

It is worth stressing that there is no evidence at this stage to suggest that the disease that is caused by the omicron variant is more severe than that which is caused by other variants but, again, further analysis is required before we can be certain of that.

Thanks to the work of the global scientific community, we will find out much more about omicron in the days and weeks ahead. As our knowledge and understanding expand, we will be able to assess with much more certainty the implications for our response to the pandemic. I very much hope that, as we learn more, our level of concern will diminish rather than increase.

However, while hoping very much for the best, it is prudent at this stage to contemplate and prepare for something less positive than that. The fact is that any variant that might be more transmissible than the delta variant—which, in turn, was more transmissible than any variant that came before it—and which could, even if to a limited extent, evade vaccine or natural immunity, must be taken very seriously. That is why we have responded, and will continue for now to respond, in a way that is proportionate but also highly precautionary.

I turn to our current understanding of the presence of the omicron variant here in Scotland. I can confirm that, as of 5 pm yesterday, there are nine confirmed cases in Scotland: five in Lanarkshire and four in Greater Glasgow and Clyde. We have preliminary information on all nine of those cases, which is the basis of the information that I am about to share with the Parliament. However, I stress that health protection teams are continuing their investigations.

None of the people who have tested positive for the new variant has so far required hospital care. All nine were tested on or around 23 November and, because they had tested positive, they have all been self-isolating. A surveillance look-back exercise had identified that the polymerase chain reaction test results in those cases showed what is called the S-gene dropout. That is not conclusive evidence of the omicron variant, but it is indicative of it. However, whole genome sequencing of those positive samples has now confirmed that they are indeed the omicron variant.

As far as we know, none of the individuals concerned has any recent travel history to, or known links with others who have travelled to, the countries in southern Africa where the variant was originally detected. However, while the contact tracing exercise is still on-going, health protection teams have established that all nine cases are linked. They all trace back to a single private event on 20 November. Indeed, over the coming days, we fully expect that more cases will be identified that are also linked to that event.

In summary, the lack of any known travel or overseas connection to the cases suggests that some community transmission of omicron is already happening in Scotland. However, the fact that all known cases so far are linked to a single event suggests that community transmission might still be limited. Indeed, so far, there is nothing in the wider look-back exercise that Public Health Scotland has undertaken to suggest that community transmission of the new variant is either sustained or widespread.

The look-back exercise has examined PCR test samples dating back to 1 November to identify any that have the S gene dropout. A number have been identified and, where the sample makes it possible, subjected to whole-genome sequencing. The exercise has resulted in the nine cases that we have reported.

Given the nature and scale of the 26th United Nations climate change conference of the parties—COP26—the surveillance work that Public Health Scotland is doing is also looking at any potential links to it. At this stage, however, there is no evidence whatsoever of any such link. Although it is not impossible that one will emerge, the timelines that are involved make it improbable.

In short, Public Health Scotland is working hard to identify any and all cases of omicron in Scotland as quickly as possible. I am very grateful to PHS for its efforts.

Given the nature of transmission, I consider it highly likely—indeed, almost certain—that more cases, perhaps many more cases, will emerge. However, the enhanced surveillance gives us the best possible chance of identifying cases quickly and then, through the isolation of index cases and close contacts and targeted testing, of breaking transmission chains and containing spread while we learn more about the variant. That is key. While so much about the new variant is unknown, it is important that we act on a highly precautionary basis.

That is certainly true for the steps that Government must take, and it is equally true for all of us as citizens. We all have a part to play—this has been true throughout the pandemic—in stemming transmission of the virus in general. Let us not forget that, although we are talking right now about nine cases of a new variant, 2,500 cases of the delta variant are still being recorded each day. Suppressing the transmission of delta remains important, and it is now important to suppress and contain transmission of the new variant, in particular.

Some of the protections that the UK Government announced at the weekend in relation to England, for example a requirement to wear face coverings in some settings, are already in place and more extensive here in Scotland. Therefore, at this stage, rather than introducing new protections, we are asking people to significantly step up and increase compliance with existing protections such as face coverings, hygiene, home working, ventilation, vaccination and regular testing.

Enhanced domestic compliance will complement the UK-wide travel restrictions that were confirmed over the weekend, which aim to reduce the risk of additional cases of the new variant entering the country. Ten countries in southern Africa have been added to the travel red list so far. Anyone travelling back to Scotland from any of those 10 countries must enter managed quarantine for 10 days on their arrival. In addition, anyone arriving in Scotland from anywhere outside the common travel area is now required to take a PCR Covid test on or before the second day of their arrival—we advise that that should be on the second day—and to self-isolate until they get the result of that test back.

Given the incubation period of the virus, the Scottish Government’s judgment is that it would be sensible on a precautionary basis for the travel rules to be tightened further on a four-nations basis. Yesterday, the First Minister of Wales and I suggested to the Prime Minister that, until we know more about omicron, people arriving in the UK from overseas should be asked to self-isolate for eight days and to take a PCR test on day 8 after their arrival, as well as on day 2. We look forward to discussing that further. We suggested to the Prime Minister that the convening in early course of a COBR meeting to discuss that and other issues would be appropriate.

Although certainty is not possible at this stage and will not be possible until we know much more about the new variant, my strong hope is that, beyond temporary travel measures, no additional restrictions will be required. However, that will depend partly on what information emerges about omicron in the days to come. It will also depend, significantly, on all of us complying rigorously with all the protections that are currently in place to stem transmission.

Of course, it remains the case that our first and most important line of defence against the virus is vaccination. Yesterday, we received updated advice from the Joint Committee on Vaccination and Immunisation. Its recommendations are as follows: all adults over the age of 18 should be eligible for a booster; the gap between second doses and boosters should be reduced from six months to three months; people who are immunosuppressed and who have already had three doses should also now be eligible for a booster; those who are immunosuppressed and have not yet had a third jag should get that now, regardless of when their second dose was administered; and, finally, 12 to 15-year-olds should now be offered a second dose. The JCVI had, of course, already recommended second doses for 16 and 17-year-olds and, as I said, from today, anyone in that age group can book an appointment online for their second dose.

The Scottish Government has accepted the JCVI’s updated recommendations and we will now put its advice into operation as soon as possible. Urgent modelling work is being done to inform the operational response—for example, that involves assessing the additional capacity that will be needed in terms of workforce and facilities. As the JCVI has advised, we will continue to prioritise booster jags on an age and clinical risk basis. However, the bottom line is that many more people than was the case last week—at least 1 million more—are now eligible for a booster, and that is good news in our fight against the virus.

Information will be provided as soon as possible for those who have become newly eligible. However, I say to those who are already eligible that, if you have not had your booster yet, please book to get it as soon as possible. Uptake in the over-60s is now at 84 per cent, which is high, but we want to get it higher still so, if you have yet to get your booster, please do so now. Similarly, if you are aged between 40 and 59, please book online at NHS inform.

I know that there is a concern that the vaccines will be less effective against the new variant. I stress that we do not yet know whether that is the case but, even if it is, vaccination will still matter. Less effective does not mean ineffective. Of course, the vaccines will remain just as effective as they are now against the delta variant, which is still the dominant one circulating in Scotland. A booster will significantly improve our protection against all variants. It really is the most important thing that any of us can do to protect ourselves and our loved ones. Similarly, if you still have not yet had your first or second dose, please arrange to get that. It is now more important than ever to get an appointment and to get the protection that vaccination will offer you.

In addition to getting vaccinated, as I said, all of us should now step up and significantly increase our compliance with existing protections such as face coverings, ventilation and hand hygiene. We are also strongly encouraging everyone who can work from home to do so. We are asking everyone, from now through the festive season, to do lateral flow device tests on any and all occasions before mixing with people from other households, whether that is in a pub, restaurant, house or shopping centre.

From Monday, subject to Parliament’s approval this week, proof of a recent negative lateral flow test or vaccination will be accepted by venues and events that are covered by the Covid certification scheme. It is already very easy, and free, to get lateral flow tests. They can be ordered online or collected from pharmacies and test centres. For secondary school pupils or members of staff at schools or early learning centres, test kits are available free of charge from schools and early years centres. I can confirm today that, in the run-up to the festive period, local authorities will make lateral flow tests available in many more locations. Obviously, the locations will vary in different parts of the country, but they will include shopping centres and supermarkets, garden centres, sports grounds and Christmas markets. We are also working with transport partners to provide access to tests in transport hubs.

Although it is already easy to get lateral flow tests, we are taking steps to make it easier still. Please make sure that you get a supply, keep it topped up and use it. It is worth mentioning that the newer devices are much easier to use than the older ones, as they require nasal swabs only rather than nasal and throat swabs. Therefore, if you have previously tried lateral flow tests and given up because you found them too uncomfortable to use, please try again now. Remember also to report the result of tests online and, if a test shows positive, isolate at home until you have had a confirmatory PCR test and got the result of that.

If we all do that over the next few weeks, it will make a big difference, because we will all massively reduce the risk of infecting others, particularly if we have the virus but would not otherwise know about it because we do not have symptoms. Please test yourself before mixing with others and on every occasion when you intend to mix with others.

There is no doubt that the emergence of the new variant is a blow, or certainly a potential blow. It is potentially the most concerning development in the pandemic in recent months. However, even if our developing knowledge about the variant confirms some of our worries—let us hope that it does not—we are still in a much better position than we were in this time last year, thanks to the vaccines. We know what we need to do to stem transmission, because we have done it before and we know that it works. It is down to all of us to make sure that we do it.

If, in recent weeks, we have been sticking a bit less strictly to the public health advice, now is the time to follow it rigorously again. First, get vaccinated. That is the single most important thing that we can do. Secondly, test regularly and before any occasion when you will be socialising or mixing with other households. Finally, comply with all existing protections. Please wear face coverings on public transport, in shops and when moving about in hospitality settings. Keep windows open to improve ventilation. Follow all advice on hygiene. Wash hands and surfaces. Work from home if you can.

The discovery of the new variant makes those measures more important than ever before. If we treat the news of the new variant as an opportunity to raise our guard again, I hope that we will protect the progress that we have made in recent weeks, and we will give ourselves the best possible chance of enjoying not just a more normal Christmas, which we all want, but a safer Christmas too, and of avoiding any tighter restrictions in the weeks ahead.

Please get vaccinated, get tested and comply with all the protections that are in place. If we all do that, we will play our part in slowing the spread of the virus generally and the new variant in particular.