Chamber and committees

An adequate testing regime is in place. All senior pupils can access tests, and many do. Although we cannot mandate and force young people to take a test, all of us—I include all members of Parliament—can, in our own constituencies or regions, encourage young people to do that.

Like many members, I have family members in the age cohort that Annie Wells mentioned. I know that taking a lateral flow test is not something that we—young people or anyone else—really want to do, but it is important because it helps to determine whether someone might have the virus even if they are not showing any symptoms, and all the other protections can flow in behind that.

As is the case in much of this situation, I do not have a magic wand. I cannot make 100 per cent of young people take the tests, but I will encourage them to do so. The tests are easily available and it really matters that people take them. I ask that Annie Wells and other members echo and add their voices to that so that we can get uptake as high as we possibly can.

We have always relied on a range of indicators and criteria, and we combine that information with clinical advice, local intelligence about the state of the epidemic and, of course, judgment, in order that we can construct a full, reliable and robust picture of the threat that Covid is posing across all four harms. We continue to monitor cases, obviously, but we also monitor numbers of hospital admissions, lengths of stay and deaths.

As and when we become increasingly confident, as I hope will be the case, that vaccinations are breaking the link between case numbers and serious illness, we will, although we will not ignore case numbers, be able to change the balance of factors that we take into account, and our response will perhaps, as I have said before, be driven less purely by case numbers—or, rather, it will be less driven by case numbers, because it is not driven purely by them.

However, we have to do that carefully; we have to allow the data to emerge so that we can properly assess it, and we have to not act prematurely in a way that would cause a significant burden of ill health and pressure on the NHS.

I will address most of those points.

I make this point sincerely. At First Minister’s questions last week Anas Sarwar—as he is entitled to—posed a series of questions in which he criticised me for a characterisation that I would not necessarily accept: he said that I was simply following what had happened south of the border during an earlier stage of the pandemic. Now he asks why I am not doing exactly the same as is happening south of the border.

We must take the decisions that we think are right, based on our own clinical advice. I recognise that people see perceived inconsistencies. Sometimes they will be right. We have amended things in the past, particularly where there seemed to be genuine inconsistencies for some premises. Sometimes the inconsistency will be perceived—for example, there is a good reason why soft play cannot open in level 2 areas while other things can. I absolutely accept that there is a need to communicate such things as clearly as possible but I also understand that running a business that has to remain closed will always be very difficult to accept. I appreciate that, but it is important that we try to navigate our way through this as safely as possible.

It has been the case at every stage that if we had simply opened everything up we would have overwhelmed our ability to cope. We sometimes have to limit what we do, recognising that we must work with people and compensate them, as Anas Sarwar said. I accept that, and we will continue to do it.

We are vaccinating people as quickly as our supplies allow. I would love us to do more, but supply is the constraining factor. The latest seven-day rolling total number of new first and second doses is 343,548. We will get above that number if supplies allow. Supply is what limits the speed of vaccination, but that speed is fast. If we look at first doses, we can see that people aged over 60 are pretty much 100 per cent done; those aged 50 to 54 are 93 per cent done; those aged 40 to 49 are at 86 per cent; and those who are 30 to 39 are at 58 per cent. Even in the 18 to 29-year-old group, 27 per cent have had their first dose. Among the over-50s, 50 per cent have had a second dose and are fully vaccinated. In the younger age groups, 29 per cent of those aged 40 to 49 have already had a second dose, as have 20 per cent of 30 to 39-year-olds and 14 per cent of 18 to 29-year-olds. We will speed that up as quickly as supplies allow us to.

The next review of easing will be on 28 June. I know that Anas Sarwar simply made a slip but, to be clear, the date is 28 June. On 21 June, I will set out in Parliament our expectations in relation to going ahead or not, or the extent to which we will go ahead. That will be informed by the latest data. Between now and then, as far and as quickly as supplies allow, we will get as many people as possible vaccinated, with not just one but two doses.

The advisory group on education, which is a sub-group of the overall Scottish Government Covid-19 advisory group, looks at those issues on an on-going basis. It is important that it does so and that it gives ministers its views. Ministers, through the education recovery group, have reached positions on the mitigations that are required.

We all want mitigations such as face coverings to be no longer necessary; I think that that is particularly true when we are talking about young people in schools. However, right now, they are an important added mitigation. We will continue to review that, as the situation overall and our understanding of the new variant and the wider impact of vaccines develop.

I would absolutely love to stand here and give that commitment. I know of Katie and I know how important it is to her and her family, and the families of young people like her, to get vaccinated as quickly as possible. I also know that people would agree that it should not be for me, as someone with no clinical qualifications, to decide who gets vaccinated when. That is why expert advice is really important.

There are a couple of issues. First, we have to wait for the JCVI advice. It will advise on whether, in what order and to what extent we should commence the vaccination of children over the age of 12. The other issue that means that I cannot give a commitment right now about vaccinating before the return of schools is that the speed at which we will do it will be dependent on the supply of the vaccine. I hope that that changes towards the upside, but at this stage the MHRA advice relates only to the Pfizer vaccine. Therefore, only that one manufacturer’s vaccine would be available, and supplies are not limitless. We do not yet know exactly what the supplies would be, so we cannot set out exactly how long it would take to vaccinate that section of the population.

It may be—I do not know, because I have to wait and see the advice—that, just as with the adult population, the JCVI recommends an order of priority for children over the age of 12, and that might take account of underlying health conditions and other factors. As soon as we have that advice and we have a clear line of sight about supplies, we will inform Parliament of our expectations and what the timescale for any such extension is likely to be.

Of course it matters. It will be a small minority, but every individual cares deeply about their vaccination. NHS staff work to absolutely minimise any errors in recording and to rectify issues when they are identified. We are aware that a small number of users have faced challenges with the service, such as when the first dose has been recorded twice in error. Where such cases are identified, the NHS works to resolve them as quickly as possible. We understand that, even in cases where an individual’s first dose has been marked on their record twice, that should not prevent an appointment for a second dose being generated.

Wider work is under way to ensure that records are accurate and are amended in ways that are auditable and have clinical oversight. Our focus right now is on vaccinating people but, in due course, we will want to have a review of this first Covid vaccination programme, because I suspect that it will be a regular vaccination programme in the years ahead.

As, I am sure, Donald Cameron is aware—because I am pretty sure that I said it during last week’s statement—we are currently undertaking a general review of physical distancing and will set out the conclusions of it as soon as possible.

The toolkit that I spoke about in my previous answer is available to NHS Lothian and to local authorities across the NHS Lothian area. They have plans in preparation for walk-in vaccination clinics and are using testing as appropriate. At the height of the Glasgow outbreak, NHS Greater Glasgow and Clyde communicated very effectively with local MSPs—of whom, of course, I am one. I will ask the Cabinet Secretary for Health and Social Care to ensure that NHS Lothian does likewise with local members so that there is understanding of all the outbreak measures that are being taken to bring transmission back under control.

At the outset of the statement, I confirm that there will be no immediate changes to the Covid levels of protection that currently apply to different parts of Scotland. I will provide a general update on the state of the pandemic and I will, of course, address any questions that members have.

First, I will report on today’s statistics. The total number of positive cases reported yesterday was 695, which is 5 per cent of the total number of tests, and the number of confirmed cases in Scotland is now 241,864. There are currently 121 people in hospital with Covid-19, which is one fewer than was announced yesterday, and 12 people are in intensive care, which is the same number as was announced yesterday. I am pleased to report that no deaths were reported yesterday, which means that the total number of deaths registered under the daily definition remains 7,677. Once again, I send my deepest condolences to all those who have lost a loved one.

I turn now to the vaccination programme. It is exactly six months since the first Covid vaccine was administered in Scotland, and progress since then has been remarkable. As of 7.30 this morning, 3,403,866 people in Scotland had received their first dose of the vaccine. That is an increase of 17,545 since yesterday’s announcement and, most important, it means that almost exactly three quarters of Scotland’s adult population has now received a first dose.

In addition, 30,944 people received a second dose yesterday, which brings the total number of second doses administered to 2,282,203. That means that more than half of the adult population is now fully vaccinated with two doses. Those are significant and heartening milestones, and, as ever, I want to thank everyone involved in delivering the vaccination programme across the country.

Last week, the Medicines and Healthcare products Regulatory Agency approved the Pfizer-BioNTech vaccine for use among 12 to 15-year-olds. That is good news, as it indicates that that particular vaccine is safe for use in children of that age. The Scottish Government is now awaiting advice from the Joint Committee on Vaccination and Immunisation on the vaccination of children in that age group. I am sure that everybody agrees that it is vital that we continue to rely on expert advice in all our vaccination decisions. Vaccination may well be an important way of giving children greater protection, minimising any further disruption to schooling and further reducing community transmission of Covid. So, I confirm that, if the JCVI recommends the use of the vaccine for children aged 12 and over, we will move as quickly as is practicably possible to implement its advice.

However, for the moment, we continue to focus on vaccinating all adults as quickly as possible. That remains crucial in the race that we are in between the virus and the vaccine. As today’s figures show, case numbers in Scotland continue to rise. In the past week, in fact, they have increased by approximately 50 per cent. Over the past seven days, there has been a net increase of 5,475 new cases, which is a rise from 3,728 over the seven days prior to that.

That will partly be a consequence of restrictions easing—it is always the case, as we have always made clear, that, as we start interacting more, the virus has more opportunities to spread—but the recent rise is also being driven by the more transmissible delta variant, which now accounts for the majority of all new reported cases. Although case numbers are rising, the key question is the extent to which vaccination is weakening the link between an increase in new cases and an increase in serious health harms. We continue to assess that data closely, and, at this stage, it is important to be clear that we remain optimistic that vaccination will allow us to move progressively to a less restrictive way of dealing with Covid.

We have evidence that having two doses of vaccine gives protection against serious illness, even with the new delta variant. As I confirmed earlier, more than half of the adult population in Scotland has had two doses, including more than 90 per cent of people aged over 60 and more than 80 per cent of those who are over 50. They are the age groups in which people are most at risk of falling seriously ill if they get the virus.

As I said last week, vaccination appears to be reducing the proportion of people who require hospital treatment as a result of Covid. At the start of the year, about 10 per cent of new Covid cases were admitted to hospital; in May, that figure was 5 per cent. However, it is important that we continue to monitor the data so that the full impact of the delta variant can be properly assessed.

There is also encouraging evidence that the time that people spend in hospital is reducing. When we take all of that into account, as we all hoped, vaccination might well be giving us more scope to ease restrictions and therefore reduce the social, economic and wider health harms that the response to the virus so far has caused.

All those signs are positive, but continued caution is needed—especially while a significant proportion of the population has not yet had both doses and so remains more vulnerable to becoming ill and needing hospital treatment. The number of people in hospital might not be rising as quickly as the number of new cases, but, even so, it has roughly doubled in the past month. If case numbers continue to rise, that trend will continue.

On average, people might be spending less time in hospital, but it is still the case that, if someone ends up in hospital because of Covid, the virus has made them seriously unwell. Some people, such as those who suffer from long Covid, can be seriously ill without ever having to go to hospital.

In summary, our position is still fragile. Case numbers are higher than we would like. The virus still causes serious health harm, and it still has the potential to put pressure on our health service. That is why we must continue to assess the data carefully as we make decisions about whether and when to ease restrictions further.

On the upside—I stress that it is a significant upside—the vaccines appear to be doing their job, which should give us all firm grounds for optimism. That is why our top priority, and a key consideration in our future decisions, remains the speed at which we can vaccinate people, so that as many as possible get the added protection against serious illness as quickly as possible.

The vaccines offer us hope for the future, but it remains the case that we all have a role to play in getting us back to normal, so I will finish by reiterating the three key requests that are being made of all of us. First, please get tested regularly. Free lateral flow tests are available through the NHS Inform website so that you can take a test twice a week, which I strongly encourage everyone to do. Taking a test tells us whether we might have the virus, even if we do not have the symptoms. If you test positive, please self-isolate and get the lateral flow result confirmed through a polymerase chain reaction test—that is vital. The more we all do tests, the more cases we will find and the more we will break chains of transmission.

Secondly, get vaccinated when you are invited to do so, and please attend for both doses. If you need to rearrange an appointment, if you think that you should have had an invitation by now and want to check that, or if you are aged 18 to 29 and have not yet registered for your appointment to make sure that all your details are up to date, please go to the vaccinations section of the NHS Inform website.

Getting vaccinated is in our own best interests—whatever age we are, vaccination makes it less likely that we will become seriously ill from Covid. Getting vaccinated also helps us to protect one another. It is likely to be the single most important thing that most of us will do this year to protect our family, friends and neighbours, so please, when it is your turn, roll up your sleeve and get the jags.

Finally, please continue to stick to the rules where you live and follow all the public health advice. I know that that becomes more and more difficult as time goes on and that, as restrictions ease—bit by bit—and we try to get back to normal, any apparent anomalies in the rules and advice can be frustrating. We are trying to strike the best and most appropriate balance overall, but I readily concede that it is not perfect.

However, there are some principles that we can and should all follow. People should meet outdoors as much as possible. No environment is ever entirely risk free in any sense, but, in relation to Covid, meeting people outdoors poses less risk than meeting indoors. If you are meeting others indoors, please stick to the limits and make sure the room is as well ventilated as possible. Please continue to follow advice on physical distancing, hand washing and face coverings. We all long to see the back of those mitigations, but, for now, basic measures to prevent transmission are really important and effective against all variants of the virus.

In summary, please get tested regularly, get vaccinated when you are asked to do so and continue to follow the public health guidance. If we all do that, we will help to keep the virus under control while the vaccination programme continues to do its work. That will help to keep us and others safe, and it will maximise the opportunity for a summer of fewer restrictions and much greater freedom.

I will do my best to address all those points. In an overarching sense, none of this is easy. Such decisions require good-quality clinical advice, but they also require judgment. Sometimes we need to make decisions that people do not want to hear, because this is really difficult, and to navigate our way through the pandemic in a way that shows as much leadership as possible. That is what I will continue to do. I will continue to be accountable and to do my best to explain decisions to people across the country.

We are already doing the planning to extend the vaccination programme to children over 12, should the JCVI recommend that. It is the MHRA that opines on the safety, on balance, of vaccination. The JCVI has to look at the clinical implications of vaccination and the priorities in terms of the order in which the population is vaccinated versus supply and other such matters. All four nations of the UK follow the JCVI advice, and it is right and proper that we do so.

In anticipation of the JCVI giving the go-ahead to vaccination of over-12s, we have already started that planning. As I said in my statement, we will implement any such advice as quickly as possible. It is important that we continue to follow clinical prioritisation. That is why we started with the frailest, oldest people and have worked our way down the age cohorts, while ensuring that people of whatever age with underlying health conditions get vaccinated as quickly as possible.

I have to say that I struggle to understand Douglas Ross’s second point, but I will do my best to address it. As I said last week—I do not think that there is a leader of a Government anywhere in the UK or the rest of the world who would say anything different from this—while we are still learning about the efficacy of vaccination, rising case numbers, particularly when a significant proportion of the population is not fully vaccinated, could lead to a significant burden of illness, hospitalisation and death. The operative word is “could”. Clearly, I do not ever want to be standing here, that statement having been borne out—I really hope that that does not happen.

Douglas Ross said that he has not heard anything from the Government since I made my statement last week. That is factually wrong. Every day, we publish the number of people who are in hospital, the number who are in intensive care and the number who are losing their life to the virus, so people can see what is happening daily in terms of the burden of hospitalisation, the number of people needing intensive care and the number of people who are dying from this illness.

In my view, one person losing their life is one too many, but we can see, at this early stage, a weakening of the link between rising case numbers and the burden of illness. We need to be cautious, because it is too early to be definitive that the new variant will not change that dynamic. Even if that link continues to break, for as long as a proportion of the population is not fully vaccinated, a proportion of those people ending up in hospital would place a significant burden on our health service.

We have to look at the situation carefully. All the evidence so far is positive, but it would be utterly irresponsible to deny the reality that the current rise in case numbers could cause that increased burden. We monitor the situation and publish data daily. If Douglas Ross wants to listen to the Prime Minister and the Prime Minister’s clinical advisers south of the border—I suspect that he is more likely to listen to them than he is to me—he will hear that pretty much the same calculations and considerations are under way, as they have to make a decision next week on whether to go ahead with the next round of easing in England, which is planned for 21 June. We are all grappling with the situation. Doing that to the best of our ability requires that recognition and an attempt to show people strong and clear leadership. That is incumbent on all leaders, not just those of us in government.

The Government’s clinical advice is that the indoor environment of soft play centres—there is a big difference between indoor and outdoor environments—coupled with their particular characteristics, means that soft play centres continue to pose a risk. Of course, soft play centres in level 1 areas can reopen, and we hope that more parts of the country will go to level 1 over the next few weeks. The Cabinet Secretary for Finance and the Economy set out our intention to continue to provide financial support in the meantime.

I wish that everywhere could open immediately, but I have a duty to open up in a way that keeps people as safe as possible, which means continuing to consider things in the round. There will always be apparent anomalies—I wish that there were not—but we try to avoid them. As we try, bit by bit and step by step, to get the country back to normal, we have to ensure that we strike the right overall balance. I am afraid that that is not easy, but it is necessary, and it is the job that I am determined to continue to do.