Chamber and committees

I will give an update on the latest Covid situation. As part of that, I will summarise changes to the rules on international travel, some of which will take effect tomorrow and others in early October. I will also provide an update on the development of the Covid certification scheme, ahead of further details being published later this week.

First, I will summarise today’s statistics. Yesterday, 2,870 positive cases were reported, which was 11.7 per cent of all tests. Currently, 1,107 people are in hospital with Covid, which is 19 more than yesterday, and 94 people are in intensive care, which is three fewer than yesterday. Sadly, a further 18 deaths have been reported in the past 24 hours, which takes the total number of deaths registered under the daily definition to 8,396. As always, I send my condolences to everyone who has lost a loved one.

Good progress continues to be made on the vaccination programme. As of this morning, 4,160,835 people have had a first dose and 3,813,547 have had both doses. That includes 96 per cent of people aged 40 and over, 74 per cent of 30 to 39-year-olds and 62 per cent of 18 to 29-year-olds. As I indicated last week, more than three quarters of 18 to 29-year-olds have had a first dose, so the proportion in that age group who will become fully vaccinated will continue to increase. In addition, 70 per cent of 16 and 17-year-olds have now had the first jag, which is five percentage points higher than at this time last week.

Additionally, the programme of booster vaccinations is now under way, in line with the advice received from the Joint Committee on Vaccination and Immunisation last week. Care home residents started to get booster jags yesterday. From the end of September, people aged over 70 and those on the highest risk list—which was previously the shielding list—will start to get booster jags. Notification of appointments will be by letter or from general practitioners.

Vaccinations for 12 to 15-year-olds also started this week. Such vaccinations were available at drop-in centres in six health board areas yesterday and will be available in all mainland health board areas from tomorrow. Next week, appointment letters will be sent to all 12 to 15-year-olds who have not already been vaccinated. Parents and carers will be encouraged to accompany their children to appointments.

I again encourage all 12 to 15-year-olds, and parents or carers, to read the information about vaccination that is available online, so that an informed decision can be made about getting the vaccine. In addition, any questions or concerns can be raised and addressed with vaccinators when attending appointments. All that reflects our determination, as I stressed last week, to make sure that the programme for 12 to 15-year-olds is based on the principle of informed consent.

Last week, I indicated that we were seeing early signs that the number of new cases in Scotland might be starting to fall. I am glad to say that I am even more confident about that now. The early signs that I spoke about last week have become much firmer over the past seven days.

Members will recall that, in the week to 28 August, new cases increased by more than 80 per cent. In the week after that, the rate of increase slowed to 11 per cent, and, last week, we were able to report that cases had fallen by 12 per cent over the previous seven days. In the most recent week, which is up to 18 September, new cases have fallen further, by 31 per cent. That is, of course, a very encouraging trend. In addition, and in contrast to previous weeks, the fall in cases is spread across all age groups, with declines of more than 10 per cent in every age group.

One interesting point is that the steepest fall in cases has been in the 20 to 24 age group, with cases having fallen by around three quarters in the past three weeks. It is always hard to clearly identify cause and effect for changes like that—multiple factors might well make a difference—but it is worth noting that a significant proportion of people in that age group received their second dose of the vaccine during August and early September. It is likely that we are now seeing the positive impact of vaccination in that age group, as we have seen in older age groups previously.

In any event, I am very grateful to everyone—organisations, businesses and individuals—who has taken extra care in recent weeks to try to halt and then reverse the spike in cases. It seems that those efforts are making a significant difference. Of course, it is important to point out that, despite that welcome improvement, the position continues to be fragile. New cases remain high—higher than we would want them to be—and they are still above the previous peak in early July.

In addition, universities have been returning for the new academic year, and it may be too early for any impact from that to be evident in the data—although, as I set out last week, universities, colleges and students themselves have been working hard to reduce the risks of transmission on campus and in student accommodation. More generally, as we move into autumn and winter, there continues to be a risk—as there is in all countries—that cases will rise again, and we must do all that we can to guard against and seek to mitigate that risk as much as we can.

The national health service is, of course, already under considerable pressure. As I have indicated many times before, vaccination has significantly weakened the link between new cases and serious harm to health, but it has not broken that link, neither here nor in any country. The recent surge in cases has caused a rise in hospitalisations. On 20 August, there were 312 people in our hospitals with Covid. Today, as I have just reported, the figure is 1,107. The number of people in intensive care has also increased, from 34 on 20 August to 94 today.

As we know from past experience, fluctuations in the number of people in hospital tend to lag behind—by around two weeks—any rise or fall in the number of new cases. We would hope, therefore, that the recent fall in cases will, over the next couple of weeks, start to ease the pressure that Covid is placing on the NHS.

Indeed, there is already some evidence that the rise in hospital occupancy is beginning to level off. Today’s figure of 1,107 people in hospital with Covid is an increase of 43 from last week, but in the previous week, the increase was 259. Given that cases have been falling for more than a week now, we would hope to see a fall in Covid-related hospital occupancy soon. That said, admissions and occupancy remain high, and the need to avoid that pressure intensifying is the reason—or, at least, one of the reasons—why we need to keep cases on a downward track.

In addition—it is important to keep on stressing this point—looking only at hospitalisations does not take account of the harm that Covid does in other ways, for example through long Covid. The virus, although it is again retreating somewhat, is still causing health harm to a significant number of people. In addition, NHS staff are dealing with a large number of Covid cases at the same time as they are gearing up for winter and dealing with the backlog that has built up during the pandemic.

As the chief medical officer highlighted over the weekend, that level of activity is exhausting for those who work in the health service, especially when it follows on from everything that has been asked of them since March last year. Later, I will stress again the need for us all, as individuals, to do what we can to get and keep the virus under control. However, I emphasise that when we do that, we are not simply protecting ourselves and others from Covid, although that is important. We are also helping those who work so hard in the national health service, and we are protecting their capacity to provide care and treatment to anyone who needs it. That should provide us all with an extra incentive—if one is needed—to get vaccinated, to test regularly and to keep complying with all the measures that are necessary for us to get and keep the virus under control.

Cabinet secretaries are continuing to engage on all those aspects with representatives from business, the public sector and wider civic society. I am, once again, grateful to all businesses and organisations for all the efforts that are being made to follow and promote measures such as the wearing of face coverings, good ventilation and, wherever possible, continued home working. Those efforts are making a difference—we can see that in the most recent data—so please, let us all stick with them for the period ahead.

We are also continuing to assess the appropriateness and effectiveness of measures on international travel, which is the first of the two substantive issues on which I will update Parliament today. Last week, the United Kingdom and Scottish Governments confirmed that, from 4 am tomorrow, eight countries will be removed from the red list, including Turkey, Egypt and the Maldives. Those countries will move on to the amber list, which means that fully vaccinated travellers will not need to self-isolate when they return from there. However, people who are 18 or over and who have not been fully vaccinated will still need to isolate for 10 days.

We also confirmed that, from 4 October, the range of countries that is covered by the eligible vaccinated traveller programme will be expanded. At the moment, for the purposes of travel regulations, someone is recognised as vaccinated only if the vaccination took place in the United Kingdom, the USA or a country that is a member of the European Union or the European Free Trade Association. However, from 4 October, 17 countries, including Canada, Australia, Israel and New Zealand, will be added to the list of countries that are recognised in that way. The change recognises the reliable standards of vaccination certification that apply in those countries, and it will make it easier for people who have been fully vaccinated in those countries to travel to and from Scotland.

From 4 October, we will amend the traffic light system for international travel. Again, that is consistent with changes that are being made by the UK Government. In effect, the green and amber lists are being merged so that, from 4 October, there will be only two categories of country: those on the red list and all other countries. The amber list rules will apply to all countries that are not on the red list. As I mentioned earlier, that means that only people who have not been fully vaccinated and are over 18 will require to self-isolate on returning from those countries.

The UK Government has announced that it intends to change the requirements on taking tests before and after international travel for people travelling to and from England. Scotland, like Wales and Northern Ireland, has not yet taken a final decision on that, but we will do so within the next couple of days. We have concerns about easing the requirements on tests because we still need to guard against new variants of the virus being imported into the country and we need to have a way of identifying quickly if a new variant does enter the country. Testing, both before someone’s departure for Scotland and soon after their arrival here, can help us to do that. Without it, we will be much less able to pick up the presence of new variants.

We believe that the polymerase chain reaction tests and other highly sensitive tests that are required for testing are more effective at guarding against the risk of new variants than alternative tests. They are more likely to identify positive tests than most lateral flow tests, although lateral flow devices are, of course, valuable, and PCR tests make it easier for new variants to be sequenced and identified.

On the other hand, we fully understand and agree with the desirability, wherever possible, of adopting a four-nations approach to travel restrictions. However difficult it might be for us, we must recognise the reality that, if Scotland adopts more stringent requirements than England, people living in Scotland who want to go abroad might decide to fly from airports in England. In those circumstances, we could face the economic cost of stricter rules without gaining enough public health benefit to justify the cost. We must weigh up the public health risks of making the change—I will discuss those further with the chief medical officer—with the pragmatic considerations that I have just set out and the understandable concerns of the travel industry. It is not an easy decision, and it will have implications either way. As I indicated earlier, we will confirm our decision in the next day or so.

The final issue that I want to provide an update on is the Covid certification scheme. Further details of the scheme will be published later this week, but I will provide some information now.

Everyone under the age of 18 will be exempt from the requirement to provide proof of vaccination, as will people who are taking part in vaccine trials, the small number—and it is a very small number—of individuals who cannot be vaccinated for medical reasons and people who work at or perform in a venue that is subject to certification.

The scheme will come into force at 5 am on Friday 1 October. As previously indicated, it will apply to nightclubs and similar venues, live indoor unseated events of more than 500 people, live outdoor unseated events of more than 4,000 people and any event of more than 10,000 people.

In recent days, we have been working to finalise the definition of nightclubs and similar settings. Our intention is that certification will be required for any venue that meets all the following conditions: it is open between midnight and 5 am; it serves alcohol after midnight; it provides live or recorded music for dancing; and it has a designated space, which is in use, where dancing is permitted. I stress that certification will be required only if all four factors apply.

Detailed draft guidance will be published ahead of the regulations and will clearly set out what each sector needs to do. A pragmatic and sensible approach will be taken to each piece of guidance. In legal terms, venues will be required to take “all reasonable measures” to implement the scheme. In plain terms, that boils down to using common sense.

For example, a venue that has a dance floor operating after midnight and that meets the other criteria that I outlined will have to operate the certification scheme. However, it will not need to check people who come in for a pub lunch 12 hours earlier. That clearly would not be reasonable; it would be reasonable to check customers as they arrived in the evening. That is what we mean by common sense. A pragmatic approach will be encouraged, so that businesses can make sensible judgements.

Regarding other practicalities, the NHS Covid status app will be available for downloading from 30 September. The app will provide a digital record of a user’s vaccination status, including a quick response code for each vaccination that a person has received. Each of us can already request a paper copy of our vaccination record, which has specific features to prevent it from being forged. That paper copy also provides a QR code, so anyone who does not want to use the app will be able to obtain and use a paper copy.

Once the scheme is launched, anyone going to a venue or event that requires certification will be required, if asked, to show their vaccination record. Venue staff will either scan or visually check the QR code. The NHS Scotland Covid check app that venues can use is already available for download. At a venue such as a nightclub, or at a relatively small event, we expect that it will be possible to check the vaccination certificates of everyone in attendance. At larger events, organisers will be expected to carry out a reasonable number of checks. We are working with businesses and environmental health officers to provide specific advice and guidance on the level of checks that should be considered both reasonable and effective to fulfil the public health objective of certification.

I hope that that information, together with the details to be published shortly, will provide further clarity on how the scheme will operate. I stress that, even after the scheme has started, we will keep the operational details under review and be prepared to make changes in the light of experience and as upgrades and improvements are made to the operation of the app. We consider it to be an important part of our overall approach to controlling the virus to have a certification scheme in operation soon.

As I have underlined, the position remains fragile despite the recent fall in cases. The NHS is under sustained pressure and there is a risk that cases will rise again as we enter winter. We view a vaccination certification scheme as a proportionate measure that will play a part in helping to reduce transmission risks and encourage uptake of the vaccine while keeping nightclubs and large events open for business. I note that the Welsh Government has decided to introduce a Covid certification scheme that is similar to the one that is proposed in Scotland.

Let me close by emphasising again the steps that we can all take to get and keep the virus under control. First, please get vaccinated if you are eligible and have not yet done so. That remains the single most important thing that any of us can do. Secondly, please test regularly with lateral flow devices, which can be ordered through the NHS Inform website or collected from a local test site or pharmacy. If you test positive, or if you are identified as a close contact or have symptoms of the virus, please self-isolate and book a PCR test.

Thirdly, please comply with the mitigations that are still in place. Wear face coverings in indoor public places such as shops, on public transport and when moving around in hospitality settings. Meet outdoors as much as possible. I know that that will get harder for us as we move into autumn and winter, but outdoor meetings remain safer. When meeting indoors, open windows wherever possible. Try to keep a safe distance from people from other households, especially when indoors. Wash your hands and surfaces thoroughly.

All of that makes a difference and, as we can see from the recent data, it is working. So, please, stick with it to get cases down even further.

No, I cannot. People have a right to expect their Government to do everything that is reasonable and proportionate to protect them from the risk of Covid over the winter and to protect our NHS from the risk of Covid, and to do all that while keeping businesses open and trading. As countries across Europe are finding out—often through going much further than we propose to go—vaccination certification can play a big part in that. It is also preferable to the alternatives.

Let me turn to the detailed points. We have always indicated that exemption for under-18s would be likely. The impact on different sectors is exactly why we are taking care with definitions. The definitions of a nightclub and similar settings are to try to avoid, for example, pubs that operate in the same way as nightclubs not having to check certification, which might damage nightclubs that are subject to checking certification. We are rightly and properly taking time to get the definitions right.

Similarly, we are making sure that there is proportionality in relation to spot checks, so that we fulfil the two objectives of not putting undue pressure on events while making sure that spot checks and the number of checks that are done fulfil the public health objective. The amount of spot checks will not be the same in every size and shape of event, so those details continue to be finalised as we engage and discuss with businesses.

On fraud, the paper copy has anti-fraud and anti-forgery measures built into it. The QR code is a significant part of that. It is not helpful for members to continue to suggest wrongly, as some have, that vaccination certificates can be forged or fraudulently produced.

Yes, we will raise the issue with health boards—that may have already been done. Health boards should be vaccinating seafarers. It is important to make the general point that the minimum recommended gap between first and second doses is eight weeks. That has been subject to debate, discussion and controversy over the past few months. However, the data and the evidence are now showing us that the eight-week gap has helped us to prolong the protection of vaccines in a way that a shorter gap might not have done.

There needs to be flexibility. In the situation where a seafarer is going back to sea, as long as the gap is within the guidance for the particular vaccine, flexibility should be shown in a pragmatic and sensible way. I will ensure that the issue is raised with health boards so that they know to offer that flexibility.

We would expect night clubs to do checks on everyone who enters them. We are talking about spot checks for events—rather than venues—that are significantly bigger and where there may be thousands or at least several hundred people in attendance.

The issue of definitions is important, but if we do not have a definition of the type that I have set out, some venues may end up operating almost as nightclubs but without the need for the certification that nightclubs will need. We are trying to avoid market displacement, which is an important issue for nightclubs.

Let me stress that I set out four criteria for such a venue. A pub that is not a nightclub would have to meet all four of those criteria to be subject to the certification requirement. That is the best, most reasonable and most proportionate way of proceeding, and it ensures that nightclubs, in particular, are not disadvantaged, because some pubs can operate in an analogous way to them without the same requirements that they will be under. We will continue to discuss, as we have been doing, all the detail of that with the affected sectors.

Test and protect is responsible for the contact tracing that arises out of positive cases in schools. As I set out in my statement last week, I think, there are two categories. There are higher-risk contacts where the young person or their parents will be notified and asked to self-isolate pending a PCR test. Test and protect will judge whether somebody is a high-risk contact. Examples of situations that would fall into that category are where there has been an overnight stay or very close contact, or where siblings are involved.

For lower-risk contacts, letters will be sent when positive cases are identified. There will not be a request to self-isolate pending a PCR test, but advice will be given. A key part of that advice will be a recommendation for the young person, teacher or member of school staff to do an LFD test before they next go back to school.

We have made sure that that is as clear as possible for parents, young people and school staff, but it is driven by test and protect and the work that it does.

Six health boards started drop-in clinics for 12 to 15-year-olds yesterday, and all mainland health boards will have drop-in clinics operational by tomorrow. The island boards will, as they did with the main programme, go about things slightly differently because of their smaller and often more sparse populations.

The health boards that did not start yesterday have taken a bit more time to make sure that the vaccinators have the information that they need and are prepared, for example, to answer any questions that will help children and their parents or carers to arrive at informed consent, which is important. If a health board felt that it needed to do that, I understand why. However, across all mainland Scotland, drop-in clinics will be operational for that age group from tomorrow, and I would encourage everybody in that age group and their parents or carers to read all the information, ask any questions and get vaccinated.

First, it is important for all of us to be clear and to take every opportunity to reassure people that vaccines do not cause Covid infection—vaccines help to protect against Covid infection. We know—again, the data shows this—that for people who are particularly clinically vulnerable, a first dose of the vaccine offers protection, just as it does to somebody who is not clinically vulnerable.

We see high uptake rates among the highly clinically vulnerable group, which used to be referred to as the shielding group. I think that uptake rates in that group here are higher than those in other parts of the United Kingdom. However, we continue, as we do across all population groups, to try to boost the levels of vaccination up as far as possible. My message to anybody who has a clinical vulnerability is that it is important for everybody to get vaccinated, but it is perhaps even more so for them, because it provides them with that important protection against Covid.

On vaccination passports, it has been said:

“I really do defend these in principle ... I mean, if you think about ... where we were last September ... we would have been able”,

with certification,

“to keep open businesses that had been forced to close”,

which

“would’ve been a total game changer, a lifesaver, last year. And so I think that they’re an important part of our repertoire, and it’s great that loads of events have been working to use them. People have been making the system work.”

Those are the words, from just last week, of Boris Johnson, the Prime Minister.

We are being straight with people in saying that we are introducing vaccination passports because we think that they can make a difference, and we are doing the work to make the system operational. That is preferable to keeping businesses hanging on and saying, “Maybe we will introduce them and maybe we won’t,” as Craig Hoy’s colleagues south of the border are doing.

Ventilation is a really important part of what we are doing. We have made funding available to parts of the public sector, and ventilation guidance has been made available to businesses. We have also established a ventilation expert group to give us further recommendations and advice. One of the things that we will consider over the coming days is whether funding can and should be made available to help businesses to make necessary improvements in ventilation. We will set out more detail on that in due course.

That will be done partly in relation to age, as in the initial programme. The booster programme for older people in care homes started yesterday. As I said in my statement, boosters for those in the over-70 age group will start at the end of September. People will be notified either by letter or directly by their GP, as was the case in the original programme. Letters will begin to go out and there will be notifications from GPs over the next few weeks. The approach will be similar for other age groups.

An important point that I ask people to remember is that the JCVI, amidst all of its other recommendations around the booster programme, recommended a gap of six months between a person’s second vaccination and the booster vaccination. In my case, that would mean that I would not be eligible for a booster for some weeks yet.

The timing will be in line with advice and the order of priority, which is age and condition based. People will be notified in a way that is similar to how they were notified for the first and second doses of the vaccine.