Chamber and committees

Yes—thank you, convener. I am grateful to the committee for the opportunity to discuss a number of matters, including updates to Parliament this week and last week on Covid-19 and the incidents to which the convener has just referred.

As set out by the First Minister on Tuesday, although case numbers in Scotland have continued to fall, the emergence of the omicron variant is deeply worrying, and it requires a proportionate and precautionary response. There are now confirmed cases of omicron in Scotland and Public Health Scotland is working hard to identify any and all cases as quickly as possible.

There are indications that omicron might be more transmissible than the delta variant, which is currently dominant in Scotland. However, at present, there is no evidence to indicate that the disease that is caused by omicron is more severe than that caused by other variants. Our understanding of the new variant is developing, and we will know more—especially about the protection that is provided by vaccines—in the days and weeks ahead, thanks to the dedication of scientists across the world.

Although I very much hope that our level of concern will reduce in coming weeks, our precautionary approach is the right one for now. As the First Minister set out on Tuesday, at this stage, we are not introducing additional health protection measures beyond some necessary travel restrictions. Instead, we are asking everyone to renew their focus on following existing protections. We need people to wear face coverings where required, maintain good hygiene, work from home wherever possible, ventilate indoor spaces and test themselves regularly. Those protections are especially important as cold weather and the possibility of festive gatherings mean that we might be spending more time inside with other people.

This week, the Joint Committee on Vaccination and Immunisation updated its advice, such that 1 million more people are now eligible for booster vaccines. That is good news, as we know that vaccines are effective and save lives. Indeed, according to a study published last week by the World Health Organization, there might be more than 27,000 people in Scotland who are alive today only because of the vaccines.

With more than 88 per cent of the adult population having had two doses of the vaccine and more than 93 per cent having had one dose, Scottish ministers now consider it proportionate to amend the certification scheme to include negative test results. The change will make it possible for people who cannot be vaccinated, who are not yet fully protected, or who have received a vaccine that is not recognised by the Medicines and Healthcare products Regulatory Agency, to be able to attend venues that are covered by the scheme.

The Health Protection (Coronavirus) (Requirements) (Scotland) Amendment (No 4) Regulations 2021 make the necessary amendments to the Covid-19 certification scheme. With effect from 5 am on Monday 6 December, the scheme will allow people to show a record of a negative test for coronavirus that was taken in the 24 hours prior to attending a venue as an alternative to proof of vaccination.

Certification continues to play a role in helping us to increase vaccine uptake, reduce the risk of coronavirus transmission, alleviate pressure on our health and care services, and allow higher-risk settings to continue to operate. It is an alternative to more restrictive measures, such as capacity limits, early closing times or closure.

I am very happy to answer questions from the committee.

Essentially, we want the regulations to be in place to facilitate an increased level of protection and assurance in the run-up to the festive period. From 6 December onwards, people will be engaged in activities that are habitually associated with Christmas, including retail and hospitality opportunities. Putting in place the regulations at a moment when we are preparing for such events is the pragmatic approach that the Government wants to take to maximise protection and to maximise the involvement of members of the public in the assurance that we are trying to create.

There are a number of points in the question and scenario that you have put to me. The first point is that a key response is the necessity of ensuring that baseline health protection measures are habitually followed by everybody in all circumstances, including when going for a polymerase chain reaction test. Important measures that should be applied include ensuring that people are wearing face coverings in the appropriate settings and following the basic hand hygiene measures. All those measures are critical at all times. Members will be aware that, in our public messaging in Parliament and in our wider public messaging through television advertising and so on, the Government is regularly reinforcing those messages.

The second point is that the greatest care must be taken by individuals when going for PCR tests. In the scenario that you put to me, if a whole carload of people from the same family are being tested, it is understandable that they are all in the car. However, I encourage only the people who need a PCR test to go, and to observe all the hygiene measures that are appropriate in such circumstances.

Finally, when it comes to observing self-isolation, the requirements could not be clearer. If an individual has symptoms or cause to secure a PCR test, or if they have undertaken a lateral flow test and tested positive, that should instantaneously bring about a change in behaviour, because that person is potentially infectious. That individual must take every care in their movements and in observing the appropriate restrictions to ensure that they minimise the risk of transmission.

I assure the individuals who have contacted the committee that those messages are uppermost in the Government’s communications.

Clinical points might mean that there is no justification for doing so because there may be sufficient vaccine protection for a sufficient length of time. The disease is new, so clinicians and scientists are trying to work their way through to the best answer. Their judgment was that the gap should be six months. The JCVI has revised that to three months.

No, the lateral flow test will not appear in the app.

The app has been revised to include the booster jag; we expect that to be completed and the update to be available in early December. A critical date is 15 December, when a number of European countries will make it mandatory for booster jags to be evidenced on Covid vaccine certificates, and the update will be in place by then.

It is but, to go back to my two key words—proportionate and precautionary—it is also a recognition that, in the light of omicron, it is necessary to take the precautionary stance of moving to an earlier time for the booster jag. That strikes me as a rational decision for the JCVI to arrive at.

Perhaps Professor Leitch will want to add something.

I accept those points and that is why I make my plea to people. I do not think that it is just 18 and 19-year-olds—

You raise the fundamental dilemmas that we wrestle with all the time. That is why I said in my opening remarks that we are taking a proportionate and precautionary approach to handling the situation.

Modelling of the pandemic’s likely course is undertaken regularly, and a variety of variables are considered. A few weeks ago, the modelling looked at the potential impact of the 26th United Nations climate change conference of the parties—COP26—and it has covered the impact of winter and all sorts of scenarios.

The modelling gives central, better and worse scenarios, on the basis of the virus’s prevalence and circulation. We hope for the better scenario, we prepare for the central scenario and we hope that we do not reach the worse scenario. Different actions are required if we face the better, worse or central scenario. That is why I used the word “proportionate” in talking about our judgment.

The precautionary approach is important, too. If we look at the pandemic today in Scotland, we see that case numbers are high but fairly flat. The figures for the past seven days are slightly down on those for the previous seven days. The hospitalisation rate of Covid patients today is slightly lower than it was, although the figure is still more than 700. If those 700 people were not in hospital with Covid, we could provide other treatments for 700 patients.

There is a careful judgment to be made about the proportionate steps to take. If omicron turns out to be more transmissible than delta, there will be more cases. If the level of serious illness from omicron is no different from that of delta, a relatively small percentage of cases will be hospitalised, but that will involve more people if the number of cases is higher. That will place even more pressure on the national health service and will mean that services are under pressure.

If the level of serious illness does not change but the volume changes significantly, we will have to take more dramatic action. I have no justification for that today because, although I can look at the omicron scenarios, a compelling evidence base does not yet exist for taking more severe measures. It might well exist in the future, so the Government will keep the situation under constant review.

We will look carefully to the recommendations that come from the JCVI in that respect.