Chamber and committees

My simple point to Mr Cole-Hamilton is that there are a number of steps that we can take to try to avert the enormous pressure that he foresees—I agree with him on that—in the national health service in the winter. The Government is trying to take the necessary and proportionate steps to ensure that we can do that.

A lot of effort has been put in by officials, and reinforced by ministers, to discuss with individual transport providers the importance of properly applying the regulations in all transport settings. That has been the subject of a great deal of dialogue with transport providers, and it has involved direct discussion with ministers.

Having been on public transport in Scotland in recent weeks, I have heard announcements being made. On Sunday, I happened to walk through Queen Street station in Glasgow, where the adherence to wearing face coverings was very high.

Emma Roddick’s point is valid—it is essential that that approach be taken. I assure her that ministers and officials are doing all that they can to ensure that that message is heard by transport providers.

At the start of questions following my statement, Mr Ross gave a warm welcome to the steps that have been taken to deliver the vaccination programme. I thought that his comments were absolutely appropriate and valid. However, Mr Halcro Johnston is now complaining about the fact—[Interruption.] Well, he is complaining. To enable us to deliver the great performance that Mr Ross has complimented, we have to use some national health service staff. [Interruption.]

I do not know what discussion is going on between Ms Grahame and Mr Ross, but it is something to do with—[Interruption.]. I am trying to be helpful here. Mr Ross has welcomed the vaccination programme roll-out. How do we manage that? We manage it by ensuring that the priority is to give maximum protection to the population. However, when we do that, Mr Halcro Johnston comes along and moans about it. That just says it all about the Conservatives. [Interruption.]

Employment in the national health service is at a record high level. We have never had more nurses working in the NHS than we have today and that—[Interruption.]

Such issues are discussed on a four-nations basis, as are all aspects of the vaccination programme. Those issues will also be the subject of clinical advice and intervention. The health secretary will be happy to update Parliament on the steps that are taken on the matter as a consequence of the four-nations discussions.

I recognise the importance of the points that Mr O’Kane raises. However, I am sure that he will appreciate that it is difficult to take account of all the circumstances and scenarios that he put to me, which are reasonable points, in a programme of such complexity and magnitude. The online portal system, which we are putting in place for younger age groups, is designed to give people a bit of flexibility and will address some of the practical circumstances that he mentioned.

Mr O’Kane asked for some data. The flu vaccination programme has so far administered more than 1.4 million doses and is making very good progress. Taking the flu and the Covid third dose programmes together, we have surpassed 2.5 million doses in the relatively short time since the start of the flu vaccination programme. I hope that that gives Parliament some confidence, because if we have 7.5 million doses to give by the spring, 2.5 million since the start of September is a pretty substantial effort in getting to that. I assure Mr O’Kane that we are trying to be as flexible as possible, but what is critically important is ensuring that we cover the volume of vaccinations that are required. Parliament should be encouraged by the progress that has been made to date.

Mr Cameron raises an issue that the Government has considered carefully. Ministers were given the advice when the pandemic situation was deteriorating. After taking further medical advice from the chief medical officer, ministers concluded that it was better to take a more cautious approach, given that the pandemic’s wider course was deteriorating.

Throughout the discussion with Parliament, I have maintained the argument that we must make a set of balanced judgments while looking at the pandemic’s overall course. Much as we might not like components of the steps that we must take, we must use a range of measures that will avoid the need for more dramatic interventions to stem the virus’s circulation.

I explain to Mr Cameron that the Government is looking at the evidence in the round and making a judgment. If we believe that there are opportunities for us to relax the restrictions, we will take them. However, we must be mindful of the pandemic’s likely course, given what I said today about the onset of winter, the possible impact of COP and people spending less time outdoors and more time indoors.

We must wrestle with a complex picture, because nobody wants our national health service to be overwhelmed at any stage in the future. We have consistently tried to avoid that. I marshalled before Parliament today, as is shared with members regularly, the pressure that the NHS is experiencing. Nobody wants the NHS to be overwhelmed.

I will provide the update on the latest Covid-19 situation, on behalf of the First Minister. In giving the update, I will provide an assessment of the current course of the pandemic and our on-going consideration of how to respond; an update on the pressures on the national health service, looking ahead to the winter; a report on the progress that we are making to deliver the vaccination programme; an update on changes to international travel rules; and an update on the management of the risks of transmission at or around the 26th United Nations climate change conference of the parties—COP26.

First, though, I will report on the most recent statistics. Yesterday, 2,233 positive cases were reported, which is 12 per cent of all tests that were conducted. There are 753 people in hospital with Covid, which is 23 fewer than yesterday, and 57 people are receiving intensive care, which is four more than yesterday. Sadly, a further 20 deaths have been reported over the past 24 hours, which takes the total number of deaths registered under the definition to 9,313. I send my condolences to everyone who has lost a loved one during the pandemic.

More positively, the vaccination programme continues to make good progress. I confirm that 4,324,440 people have received a first dose, 3,918,528 have had both doses and 1,017,359 have received a booster vaccination or third primary vaccination. The vaccination programme is continuing at considerable pace. I am pleased to say that the United Kingdom Government’s Covid data dashboard confirms that our booster programme continues to be the best performing roll-out in the United Kingdom.

Today is also a major milestone in that programme, as we have reached 1 million Covid boosters and third doses, totalling 2 million doses of both Covid and flu vaccines. That is an amazing achievement and I thank everyone involved for their extraordinary efforts. It further demonstrates that the booster programme is performing exceptionally well.

In total, 88 per cent of the over-18 population is now fully vaccinated with two doses. That includes 99 per cent of the over-50s, 88 per cent of those aged 40 to 49, 77 per cent of 30 to 39-year-olds and 68 per cent of 18 to 29-year olds. In addition, 76 per cent of 16 and 17-year-olds and 55 per cent of 12 to 15-year-olds have had a first dose. For most people in those age groups, a single dose only is recommended at this stage.

After the most recent peak in new cases at around the start of September, the spread of the virus has not reduced to anything like the low levels that we had seen following the lockdowns. At slightly more than 2,500, the number of new cases each day is holding at a concerningly high level. The situation is precarious and unpredictable. If the previous pattern—characterised by waves of infection—is repeated, there is a risk that the spread of the virus could very quickly increase again during the coming weeks, perhaps over the Christmas period.

Starting from the current high level of infection in the community and the intense pressure that the NHS is already under as a result, some scenarios for what may happen next are very concerning. We need to avoid the most dangerous of those scenarios. There are also specific reasons to suspect that case numbers may increase in the weeks ahead: with the onset of colder winter weather, increased time spent indoors means that there will be more opportunities for Covid to circulate; COP26 has seen people from all over the world meet in Glasgow, which presents a known infection risk; and many of us will wish to spend time visiting loved ones over the festive period.

However, we are not yet able to predict with confidence what will happen next. We certainly want to avoid the sort of strict lockdowns that we saw before most of us were vaccinated. We do not want to repeat the sort of disruption to our daily lives, businesses and the economy that was required at earlier stages in the pandemic. However, we need to take appropriate measures to keep the pandemic under control.

It is because we want to avoid more difficult restrictions that we cannot rule out strengthening the baseline protective measures that are currently in place as the best way to head off any prospect of future lockdowns. Indeed, all Governments in the United Kingdom have said much the same—not least, for example, through the United Kingdom’s Government’s plan B.

We have been considering, for example, whether we may need to extend the Covid certification scheme to bring more settings into scope, such as indoor hospitality and leisure settings. Among other possible interventions, we are exploring how we can help improve ventilation, what we could do to increase home working and whether changes are needed to extend the use of face coverings. I stress, though, that we have not yet taken any decisions about strengthening the existing baseline measures and that we will discuss options with business sectors in the course of this week.

As members would expect, the Scottish Government has been exploring all options for how it will respond to the evolving situation.

We have been reviewing our strategic framework, which defines the Scottish Government’s overall approach to responding to the pandemic, and the next three-weekly review of the existing baseline measures will take place a week today. The First Minister, my Cabinet colleagues and I are, of course, watching the situation closely. We stand ready to respond at the right time, when the data indicates that that is necessary and proportionate.

The challenges that we currently face and the continuing spread of the virus mean that now is certainly not the time to relax our approach. We all need to redouble our efforts to adhere to the protective measures that are in place and to follow the guidance.

For that reason, I take this opportunity to reiterate the appeal that the First Minister, my Cabinet colleagues and others have been making to members of the public, to businesses, to transport providers and to organisations throughout Scotland. Please get vaccinated, including getting booster jabs and flu vaccinations if you are eligible. Please wear face coverings when it is required, ventilate indoor spaces where possible and wash your hands and surfaces regularly. Use lateral flow device tests regularly and book a polymerase chain reaction—PCR—test if a lateral flow test shows up positive, if you have symptoms of Covid or if you are identified as a close contact of someone who has tested positive. Please also continue to give contact details when you visit pubs and restaurants, and show your Covid certificate if you visit a venue where that is required. Also—this is critical—please continue to work from home whenever possible. The Government knows that none of that is easy. However, it is vital that those efforts continue.

The entire health and care system continues to be under considerable pressure. For many months, our health and social care services have been dealing with levels of demand that are usually experienced only in winter. Across the country, hospitals are at, or are close to, capacity. The social care system is also under pressure and is reporting an increase in the number of people who require care packages.

Indeed, the continuing high numbers of cases of Covid-19 mean that the pressure on our national health service is greater than it has been at any time in its 73-year history. As of today, Covid-related hospital occupancy—the number of patients in hospital with Covid—is 753, compared with 932 a week ago. Hospital admissions remain high, although they have decreased slightly. In the latest week, 585 people with Covid were admitted to hospital, compared with 687 in the first week of October. Admissions to intensive care units have also decreased slightly over the past month. NHS staff are dealing with significant numbers of Covid patients, alongside providing other patient care. They are also preparing for and responding to wider winter pressures, and are dealing with the backlog of care that built up in earlier stages of the pandemic.

As I have set out, there is a real risk that the pressure on the national health service could intensify further during the weeks and months ahead, including as we enter the winter flu season. The Scottish Government is working closely with health boards as they deal with those pressures. Last week, the Cabinet Secretary for Health and Social Care set out the measures that we are taking to support the NHS in preparing for and responding to the pressures now and the challenges that lie ahead.

As we know, vaccination has proved to be one of our most effective public health interventions against the pandemic. The first phase of the programme delivered more than 8 million Covid-19 vaccinations in 10 months. With Covid boosters, flu vaccines and jabs for new groups, we now need to deliver roughly the same number of vaccines—7.5 million—by early next year.

The vaccination programme is continuing at considerable pace. We have now administered, in total, more than 1 million boosters and third doses. We are, nonetheless, continuing to explore how we might increase capacity further, for example by establishing additional clinics, particularly at evenings and weekends.

We are confident that the programme remains on track. We are now sending letters to people aged 60 to 69 and to people with underlying health conditions to invite them to appointments at local community clinics, which will run throughout November. We will then, from mid-November, launch the online self-booking portal for adults aged 50 and over, people aged over 16 who are unpaid carers, and household contacts of immunosuppressed individuals, with the aim of offering vaccines to everyone over 50 by early next year.

Vaccination has been a huge job for the national health service. I again offer our thanks to the national health service staff who are working tirelessly to help keep us safe.

I also take this opportunity to reiterate our thanks to the armed forces for agreeing to support our vaccination effort by complementing our existing workforce. We have asked the people of Scotland to help us to deliver the vaccination programme by attending appointments where possible and rescheduling when that is necessary. By being vaccinated and having a booster vaccination, we can protect each other and help the national health service through what will be another exceptionally busy winter period.

I turn to international travel. Colleagues will be aware that the UK Government yesterday announced a change to international travel rules for England and recognised a wider range of vaccines. The Scottish Government will also make that change to regulations for arrivals here. With effect from Monday 22 November, we will recognise vaccines that are on the World Health Organization’s emergency-use list, as well as those that are approved in the UK by the Medicines and Healthcare products Regulatory Agency. The additional vaccines are Sinopharm and Sinovac, which are manufactured in China, and Covaxin, which is manufactured in India. Travellers who have been vaccinated with those products will be eligible for quarantine-free travel if they have a certificate of vaccination status from a country that is listed in our regulations and meets the data and security standards that are required at the UK border.

There are now more than 130 countries whose vaccine certificates we recognise, although China is not yet on that list. There is a process of engagement that is led by the Foreign Office to work with international partners so that we can bring more countries in scope as soon as possible, when we are satisfied that it is safe and secure to do so. Further announcements on that matter will be made on a four-nations basis. In addition, we will simplify rules for children under 18. All children, whether or not they are fully vaccinated, will now follow the rules for eligible vaccinated travellers. That means a test on day 2 after arrival, but no isolation and no test before departure or on day 8.

My final update today relates to the 26th United Nations climate change conference of the parties—COP26—in Glasgow. The summit is one of the most important gatherings of the century so far, and the Scottish Government has been doing everything that it can do to make it a success. We have been working closely with the UK Government and with partners in Scotland, including Glasgow City Council, Transport Scotland, NHS Scotland and Police Scotland, to ensure that the summit is delivered safely.

Covid-19 has presented significant challenges to staging this unique event. The scale and worldwide draw of COP26 poses the risk of spread of Covid-19, both among delegates and to or from the local population of Scotland and the UK. A comprehensive and exceptional package of mitigation measures has been in place to ensure that the event is delivered safely, which is helping to protect the welfare of everyone who is involved and the wider community. In addition to vaccination, measures include a robust testing regime, contact tracing, hygiene measures and ventilation.

Of course, although public health measures can mitigate the spread of Covid-19 to an extent, there remains a risk that COP26 could increase the spread of the virus. That is why Covid-19 continues to be closely monitored by all relevant agencies, and why the Scottish Government is closely involved in operational decisions during the event. As of 5 November, the cumulative test positivity results for blue zone pass holders, based on lateral flow tests, was around 0.1 per cent. However, we have only just passed the midpoint of the conference and we continue to monitor the situation carefully. We will provide a further update following the conclusion of COP26, unless there is a need to do so sooner.

The successful roll-out of the vaccination programme has been enabling us to live with far fewer restrictions and mitigations in place than were necessary a few short months ago. However, case numbers remain high and, looking ahead to the winter months, there is a real risk that they might increase again. Still, each week, hundreds of people are being admitted to hospital with Covid, and our NHS is under intense pressure.

Covid remains a threat, so we all need to play our part in keeping the virus under control. For that reason, I make no apologies for repeating the three things that we can all do to help to protect each other. First, I ask everyone who is eligible, but has not yet done so, to get vaccinated. That includes going for a booster jab. It is never too late to get vaccinated and it remains the single most important thing that any of us can do to protect ourselves and the people around us.

Secondly, I ask everyone to take regular LFD tests. Testing kits can be ordered through the NHS Inform website or collected from a local test site or pharmacy. Anyone who tests positive, who is identified as a close contact or who has symptoms of the virus should self-isolate and book a PCR test.

Thirdly, I ask everyone to comply with the mitigations that are still in place. People should work from home when possible, wear face coverings in indoor public places such as shops and public transport and when moving about in hospitality settings, and wash hands and surfaces thoroughly.

People should also meet outdoors if they can. I know that that will be increasingly difficult as we get deeper into winter, but outdoor environments are safer. When people meet indoors, they should open windows; anything that improves ventilation will help. People should also try, where possible, to keep a safe distance from people in other households.

Those precautions make a crucial difference. They will protect individuals and the people around us all, and they will help to ease the burden on our NHS.

I express once again the Scottish Government’s thanks to everyone in Scotland for what they are doing to help to protect each other, and I encourage people to continue to take the steps that are necessary to ensure that we all remain safe.

I thank Douglas Ross for his welcome of the progress on the booster vaccination programme. It is important that we acknowledge the significant landmark that has been achieved by the staff in the national health service, the armed forces and the volunteers, who have delivered an exceptional and at-pace programme, given the volume of vaccinations between the flu and the booster programme. It is an enormous physical undertaking, so I very much appreciate Mr Ross’s comments on that.

On the vaccination certification programme, throughout our handling of the pandemic, the Government has been open with the public about what we feel necessary to consider. I say to Mr Ross—I recounted this to the COVID-19 Recovery Committee last Thursday—that we are at a pivotal moment in the pandemic. We are about to approach winter. Cases are sitting at what has to be described as an uncomfortably and consistently high level of, on average, around 2,500 per day. That is much higher than when we came out of the lockdown restrictions. Admissions to hospital have still been in excess of 500 in the past seven days. We face significant threats and dangers, so the Government has to be open with the public about the fact that we may have to take other decisions—I stress the word “may”—should the situation become more challenging.

Mr Ross knows that the Government has to satisfy itself that any measures that it may take to place restrictions on individuals or businesses are proportionate and can be justified as proportionate in law. The Government is satisfied that that has been the case in what we have done so far, and any further judgment would have to pass that test.

On the question about vaccination certification, I made the point last week to the COVID-19 Recovery Committee that I cannot establish a direct connection between an individual measure and levels of the virus. We have never been able to do that and we have been very candid about that, but the Government has to be satisfied that we have adequate protections in place to safeguard the public in relation to the rise in the number of vaccinations that have taken place and the levels of hospitalisation and cases. That is the framework that we consider and we will take decisions accordingly.

The Government has judged, with the input of the chief medical officer, that it is appropriate to maintain face coverings in schools for some pupils and staff. That judgment will be subject to review and the Government will consider the issue when we undertake the three-weekly review and report to Parliament accordingly.

My one appeal would be for people to apply and follow the guidance and restrictions that we have in place. I do not think that those are, in any way, an obstacle to individuals successfully participating in COP. The routine measures that Mr Mason experienced last night are of the type that we would like to see in place across the board. They aim to minimise the risk of transmission and maximise the chances of protecting the public, and that is what we have focused on in preparation for and during COP. We are working hard with Glasgow City Council, the UK Government and NHS Greater Glasgow and Clyde to ensure that we manage any implications that arise from COP.

I acknowledge that that is a serious issue. The Government has put in place measures, in dialogue with our partners in local government, to ensure that individuals can be safely released from hospital and into appropriate settings, whether that is in their own home or in some other form of care facility.

One of the points at the heart of the matter is the availability of staff in the social care sector, which has been the subject of extensive dialogue with our local authority partners and third sector providers. One of the issues that we face, I am afraid, is as a consequence of Brexit and the loss of free movement of citizens. [Interruption.] Rachael Hamilton may feign exasperation, Mr Kerr may shout out at me and Ms Webber may shake her head, but the reality is that the evidence is staring the Conservatives in the face: we are suffering because we have lost access to people who were providing a vital support to our social care sector.

One measure that we are taking is to improve the remuneration for social care workers, which was part of the measures that the health secretary announced some weeks ago. We are working with our local authority partners to ensure that we have the maximum amount of arrangements in place to support the transition of individuals from hospitals to the community, and we are supporting local authorities with the resources to do that. However, one of the points that local authorities consistently feed back to us is their difficulty in recruiting staff to enable them to deliver those services. We will support them in those efforts, but we must have an honest understanding of what the problems are.