Meeting of the Parliament (Hybrid)

Meeting date: Tuesday, February 8, 2022

Official Report 1011KB pdf

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Covid-19

The next item of business is a statement by Nicola Sturgeon on Covid-19.

14:21  

Today, I will set out the latest assessment of the Covid data and its impacts, and I will give brief updates on some key issues: the on-going consideration of guidance for schools and early years settings, surveillance of the BA.2 sub-type of omicron, and the progress and current focus of vaccination efforts. I will conclude with a reminder that there are still some basic steps that we can and should continue to take, even in an improving situation, to curb transmission and thereby reduce pressure on the national health service, the economy and wider society.

I start with a brief account of today’s statistics. Yesterday, 6,630 positive cases were reported from polymerase chain reaction and lateral flow tests; 950 people are in hospital with Covid, which is eight fewer than yesterday; and 31 people are in intensive care, which is five fewer than yesterday. That figure includes 13 patients who have been in intensive care units for more than 28 days. Sadly, a further 14 deaths have been reported, which takes the total number of deaths under the daily definition to 10,447. Once again, my condolences go to everyone who is mourning a loved one.

Over the past fortnight, case numbers have remained broadly stable. Last week, I reported that cases had risen slightly, by around 2 per cent, in the preceding seven days. By contrast, over the most recent week, reported case numbers have declined again, from around 7,400 cases a day to just over 7,000 a day, which is a fall of 5 per cent. Although that continues a positive overall trend, it is important to note that it masks some significant variations between age groups. Among the under-15s, which is the age cohort in which cases have, in recent weeks, been rising even as they declined overall, there was, in the most recent week, a fall of more than a quarter. Cases also fell by 6 per cent in the 25 to 44-year-old age group, and by more than 10 per cent in those aged 75 and over. However, in other age groups, recorded cases have increased over the past week. The biggest increase, of more than 50 per cent, was seen in the 15 to 24-year-old cohort.

As I have noted in recent weeks, it was always likely that we would see some uptick in recorded cases as a result of the return to work and school after Christmas and, more recently, the lifting of protective measures that had played a part in stemming transmission. We should not, therefore, be overly surprised by the increase in some age groups, nor, at this stage, should we be unduly concerned. However, we will continue to monitor those trends and any associated impacts from them.

In addition to the daily data, we continue to pay close attention to the findings of the Office for National Statistics weekly survey. Although it is not as up-to-date as the daily data, it offers reliable information. The most recent report suggests that, in the week to 29 January, around one in 30 people in Scotland had Covid. Although that is an improvement on the earlier part of January and the lowest level of infection of all four UK nations, it also represents something of a plateau compared to the week before and it is broadly in line with what the more recent daily data has been indicating.

The decline and subsequent plateauing in recorded cases in recent weeks is being reflected in a slight easing of the direct Covid pressure on our hospitals. In the week to 27 January, 682 patients with Covid were admitted to hospital. In the following week, that fell to 550.

Hospital occupancy—the number of people in hospital with Covid at any given time—has also fallen. Around mid-January, more than 1,500 people were in hospital with Covid. This time last week, that had fallen to just under 1,200. Today, it is back below 1,000, at 950.

The number of people with Covid in intensive care has also reduced from a recent peak of 70 in January to 42 last Tuesday and 31 today. Indeed, the number in intensive care is now at its lowest level since early July of last year. We are also now, thankfully, starting to see a decline in the number of deaths of people with Covid. Those are all positive trends that we hope to see continue in the weeks ahead.

Finally, on data, I take the opportunity to flag an imminent change to the rhythm of our reporting. This coming weekend will be the last—at least for now—when we will report data for new cases, vaccinations and hospitalisations on Saturdays and Sundays. In the future, figures for Saturday and Sunday will be published on Monday. That reflects the move into what we hope is a calmer phase of the pandemic, so there is a less urgent requirement for immediate data over weekends. However, we will be able to move back to weekend reporting should that become necessary at any stage in the future.

The situation remains much more positive than it was at the turn of the year. That is evident from all the data, and it is the case thanks to a combination of vaccination, targeted protective measures and the responsible reaction of the public. The situation is much more positive than we feared it might be at this stage.

Based on the data, it seems reasonable to conclude that we are now through the worst of this wave of omicron. That has enabled removal of virtually all the additional measures that were introduced in December, and a return to normality in much of our everyday lives. In particular, the updated guidance on home working has supported a partial return to the office in recent days, with hybrid working where appropriate. I am sure that those changes have all been positive for individuals and businesses, and they mean that we are on a good track at this stage. However, to stay on that track, continued care and caution remain necessary and prudent. Although it is much more stable than it was, the virus is still widespread—at this stage, one in 30 remains a high level of infection.

Although the number of people who need hospital care is reducing, it is still in the hundreds each week, and pressure on the NHS remains significant. Therefore, continuing to take some basic precautions will help us to keep the virus under control while enjoying the return to normal life. That is why some baseline protective measures, such as Covid certification and the requirement to wear face coverings in certain settings, will remain in force for now. It is also why we continue to recommend that we all take lateral flow tests before mixing with people from other households.

As well as reducing our own individual risk of getting Covid, and therefore helping to stem transmission overall, those basic measures will also provide some reassurance for those who are at the highest risk of serious illness if they get Covid. I am sure that we all agree that it is important that everyone gets to benefit from a return to greater normality.

Collective behaviours that could force those who are at highest risk into effective isolation while the rest of us get back to enjoying normal life would not be acceptable. People in the higher risk category already carry a lot of responsibility for protecting their own health, and they rely on the advice of general practitioners and other clinicians to reduce risks of infection. As we enter the next phase of the pandemic, regular communication from the Scottish Government and the chief medical officer will seek to support that. However, we all have a part to play in making the environments in which we work and socialise as safe as possible for everyone. Complying with basic protective measures helps to do that.

Employers, of course, have a particular responsibility to consider the needs of people on the high-risk list in their plans for hybrid working. We have added specific workplace guidance for people at highest risk on the mygov.scot website, so anyone on the high-risk list who is worried about a return to the workplace is encouraged to check that advice and discuss it with their employer.

Finally, I am pleased to say that there has already been good take-up of the distance aware scheme that was launched two weeks ago. The scheme provides badges and lanyards that can be worn by anyone who wants or needs additional space and consideration when they are out and about in public places. The badges and lanyards are available at Asda stores and in libraries for anyone who would feel safer with a bit more space around them. If anyone sees someone wearing a distance aware badge or lanyard, please respect that and give them the space and consideration that they are asking for.

There are three further issues that I want to briefly cover. First—as I indicated last week—the advisory sub-group on education is meeting this afternoon. It will consider again, based on up-to-date data, whether secondary school children should continue to wear face coverings in the classroom. The Scottish Government will consider carefully any further advice that the sub-group provides, and confirm any decisions as quickly as possible and in advance of the return to school after the February break.

Secondly, we continue to monitor the BA.2 sub-type of omicron. Last week, I indicated that 26 cases of that sub-type had been confirmed in Scotland through genomic sequencing. Today, I can report that the number of confirmed cases has risen to 103. Not all tests are or can be genomically sequenced, so we know that that will be a significant underestimate of prevalence. Indeed, in the past week, there has been a further increase in the number of PCR test results showing positive for the S gene and a corresponding fall in the number that do not have the S gene. That is likely to reflect an increase in BA.2 cases, which, like delta, are S-gene positive. Of course, in cases of the main omicron variant, the S gene is absent.

Encouragingly, there remains no evidence at this stage that the disease caused by the BA.2 sub-type is any more severe than that caused by the main omicron variant, nor does it appear to be any more capable of evading the immunity that is conferred by vaccination or prior infection. However, there is evidence—from more than one country now—of a growth advantage for BA.2 compared with the main omicron variant, which may mean that it is more transmissible.

All in all, however, there are no grounds at this stage for any significant concern about BA.2 and no reason to change our approach in response to it. We will, though, continue to monitor it carefully.

The final issue that I want to address is vaccination. We are continuing to offer and encourage vaccination for any five to 11-year-old who has an underlying health condition that puts them at higher risk should they get Covid, and also for any five to 11-year-old who is a household contact of someone who is immunosuppressed.

All parents and carers of children in those categories have been contacted about vaccination. I would strongly encourage anyone who has been contacted, and whose child has not yet been vaccinated, to book an appointment. Case rates in younger age groups, while now falling, as I indicated earlier, are still relatively high, so vaccination is an important way of providing better protection for children who might be at higher risk.

A new marketing campaign is also being launched today to stress again the importance of vaccination, including booster vaccinations. Invitations to scheduled appointments have been going out to all 18 to 59-year-olds who are eligible for a booster but have not yet received it. If you are one of those people, please go along to your scheduled appointment, or rearrange it for a more convenient time. You can do that through the NHS Inform website, or by phoning the vaccination hotline.

It is beyond any doubt that getting the booster significantly reduces the chances of falling seriously ill from Covid. It is not an exaggeration to say that it could be the difference between life and death for someone who contracts Covid, so, please, go and get your booster if you are eligible. It is the most important thing that any of us can do to protect ourselves from Covid, and also to protect the NHS.

The on-going use of vaccination in our efforts against Covid will be a key part of an updated strategic framework, which will set out in greater detail our approach to managing Covid more sustainably and less restrictively in the remaining phases of the pandemic, and then as the virus becomes, I hope, endemic.

We continue to engage with a range of interests on the contents of the updated framework. However, I can confirm today that we intend to publish it on 22 February, immediately following the February recess. Parliament will subsequently get an opportunity to debate and vote on that.

For the moment, I will end by reflecting again on our increased optimism about the period ahead. After almost two years of this ordeal, I know that getting back to normal for short periods followed by further disruption to our lives is not what any of us want. A return to normal that is sustained is what we want and are striving for, and that is what the updated strategic framework will aim to support.

However, we can all help to keep things on a more even keel now by taking all the reasonably straightforward precautions that we continue to advise. First, I give a reminder to please get fully vaccinated as soon as you can, if you have not already done so. Secondly, continue to take care when socialising and, in particular, to take a lateral flow test before meeting other people socially.

Finally, please take the other precautions that we know are making a difference: talk to your employer about a return to hybrid working and follow the guidance and precautions that they adopt to make workplaces safer; wear face coverings on public transport, in shops and when moving about in hospitality; keep windows open if possible when meeting indoors; and follow all the advice on hygiene.

All of those measures will help us to protect each other while we return to more normal lives and, I hope, they keep us all on the right track. So please, stick with them.

The First Minister will now take questions on the issues that were raised in her statement. I intend to allow about 30 minutes for questions, after which we will move on to the next item of business. Members who wish to ask a question should press their request-to-speak buttons now or enter R in the chat function.

I start by urging everyone who can do so to come forward for their Covid vaccine booster. It is the single most important thing that everyone can do to tackle Covid.

I turn to the First Minister’s statement. For the second week in a row, the Covid update has contained little new information. The biggest update is that the Government will finally publish its new strategic framework, but not until after the February break—more than six weeks after it was promised.

Today, the Scottish Conservatives have published our blueprint for starting to move beyond Covid. Our policy paper “Back to Normality” contains a series of recommendations for protecting public services and accelerating Scotland’s recovery from the pandemic. We believe that it is time to move on from blanket legal restrictions to an approach that emphasises personal responsibility. We must get Scotland back to being as close to normal as possible for as many people as possible.

Therefore, I ask the First Minister about the mandate for face masks in classrooms, which continues to hamper young people’s education. Pupils are wearing their masks for seven hours a day, while adults can sit in a pub freely without a face covering. Does the First Minister not appreciate what the Government is putting kids through by keeping that rule in place?

Another crucial part of our policy paper, and an issue that is of personal concern to me, is on there being more support for the tens of thousands of Scots who are affected by the debilitating condition long Covid. It is five months since the Scottish Government published its long Covid strategy, but we still do not have a network of long Covid clinics for patients to access. Will the First Minister tell me when patients will be able to access that service?

Finally, I will ask about the test and protect system. It was incredibly useful in the early stages of the pandemic, but it has been far less effective since omicron emerged. Meanwhile, front-line NHS services are in desperate need of more resources, waiting times are growing longer all the time and fewer operations are going ahead. Will the First Minister consider moving resources from test and protect to front-line health services in Scotland’s NHS?

I will answer on the various points that have been raised. I believe, from the feedback that I get on the back of statements such as this one, that people out there want to know what the latest trends in infection are and what advice they are being given to keep themselves safe and protected. We will continue to communicate regularly, and as clearly as possible, with the public throughout the country.

In the past few weeks, we have been lifting measures—we have now lifted virtually all of them—that were introduced in December in the face of the omicron variant. We will continue to take responsible steps to return the country to normal, as far as that is possible.

On face masks, the advisory sub-group on education is, as I have said, meeting this afternoon. It is really important that we take expert advice, particularly when we are discussing the safety of children, so that is what we will do. Until now, the expert advice has been to continue with the position on face coverings, given the risks and given the rising level of infections, until this week, among young people of school age.

There is a difference—I think that most people understand it—between adults being in pubs and children being in schools. The former is voluntary and the latter is not. In addition, there is a higher vaccination level among adults than there is among young people, because we started vaccinating young people later than adults. That is why it is, and has been, right to take a different approach.

We are already taking action to ensure that people with long Covid are supported in the most appropriate way. The £10 million long Covid support fund is targeted at areas where additional resource is needed. We continue to implement the 16 commitments in the long Covid service plan. Long Covid clinics are one model that boards will consider, but no single approach is likely to fit all areas and circumstances, which is why we support a range of approaches and will continue to do so.

In relation to the strategic framework, it is right and proper—especially given that we have now lifted most of the measures that were in place—that we think carefully about the medium-to-long-term approach that we will take. This is a time when we need to think fundamentally about the approaches that are right for the future. It is important that we think carefully about that.

There is a temptation—which I understand—to say that, because Covid is now more under control, we should lift all the basic protections. However, it is those basic protections that have helped us to get Covid under control and which will help us to keep it under control. That is true of the test and protect system. There are, of course, decisions to be made about it for the longer term, but right now contact tracing and the universal testing offer are the key ways in which we are helping to keep infection levels under control and, crucially, give additional assurance to the most vulnerable people. If I am contacted by test and protect to be told that I have been a close contact of a positive case, that will help me to behave in a way that breaks transmission chains generally, and in a way that does not put people who are most vulnerable at high risk. The measures are important interventions at the moment, so we will consider their future carefully.

We will look carefully at the proposals that are published by the Conservatives and Labour. We will take responsible and proportionate actions to support the country through the pandemic and back to normality in a safe and sustainable way.

I send my condolences to all those who have lost a loved one.

Nowhere have there been greater failings during the pandemic than in our care homes. However, yet again, there has been no mention of care homes in the First Minister’s statement. From the transfer of positive and untested patients to the lack of personal protective equipment, the Government allowed care homes to become the epicentre of the pandemic, with tragic consequences. A third of all deaths in the pandemic have been in our care homes.

Then, for months, despite restrictions starting to ease, care homes remained locked down. We know of the harm and trauma that were caused by keeping care home residents cruelly cut off from their loved ones, but families are being locked out even now. Residents who test positive are still required to isolate for 10 days, and homes in which there are outbreaks must close for 14 days, with only named visitors being allowed to visit. Heartbroken relatives have said that that leads to rolling lockdowns that can last for weeks.

The campaign group care home relatives Scotland has repeatedly pleaded with the First Minister. Almost daily, I have read heartbreaking personal stories that members of the group have shared. They have been pleading with the First Minister to make it easier for them to see their loved ones. The Government promised to implement Anne’s law—proposals to give family care givers a statutory right of access to care homes—but three months after the consultation’s having closed, relatives say that there has been too little progress. What will the First Minister do to guarantee access for families right now, and when will her Government finally deliver Anne’s law so that residents are never again cut off from their loved ones?

Few people have borne a bigger impact from the virus than people in care homes and their relatives. For anybody who has not had a loved one in a care home during the past two years it is very difficult to understand just how anxious and distressing a time it has been. I readily acknowledge that.

The situation in care homes at all stages of the pandemic will be one of the key areas of focus for the public inquiry that will shortly get under way. That is right and proper.

As the person who has led the Government’s response since the outset of the pandemic, I can say that we have sought to take the best decisions, based on the best evidence that we have had at any given time, to keep people in our care homes as safe as possible. One feature of the political scrutiny of the Government has been that we were, at an earlier stage, criticised for not acting vigorously enough to protect people in care homes. At later stages, it has sometimes sounded as if the criticism is that we are acting too protectively and too rigorously.

We have, inevitably, had to strike balances along the way to try to get what we do right. We want to get the situation in care homes back to complete normality, as far as that is possible. In recent weeks, changes have been made to isolation periods and to testing requirements, which are bringing their situation more into line with the one for the general population. We will continue to support change in order to allow people to visit their loved ones in care homes normally.

We have given a commitment to introduce Anne’s law, but it is proper that we do that carefully, considering all the responses to the consultation and fully setting out the way forward in due course, but as soon as possible.

It is clear from this afternoon’s statement that we might be looking forward to a life beyond face masks in our schools. On one hand, that is very welcome for wellbeing and cohesion in our classrooms. On the other, however, teaching unions have expressed some anxieties—not least because we learned last week of significant problems with air quality in our classrooms. We also learned this week that, in Edinburgh schools alone, infection rates have quadrupled since Christmas. Schools are still very much on the front line of the pandemic.

The teaching profession and health and safety bodies have said that the best way to remove CO2 and infections from our schools is installation in every classroom in Scotland of high-efficiency particulate air filters. Rather than pursuing her Government’s baffling adventures in woodwork, does the First Minister recognise the importance of installing air-cleaning devices in all of our classrooms in order to drive down infection and to improve attainment?

Where the judgement and assessment of people who are qualified to make the assessments is that HEPA filters or other filtration systems are required, they should be installed. That is why we have provided funding to local authorities to facilitate and enable that. It is not the case that filters will be required in every learning space: in some, mechanical ventilation systems are important. Through additional funding, we have enabled local authorities to take the decisions that they consider to be appropriate, while taking health and safety advice along the way. That is the right and proper way to support schools to be as safe as possible.

A range of measures—face coverings being one—have been necessary and will continue to be necessary in the future. We do not want any of the measures to be in place for longer than is necessary, but the safety of young people is the Government’s overriding priority in making decisions.

Businesses can now allow staff to return to workplaces including offices, either full-time or using a hybrid approach. That can be hugely beneficial to health and wellbeing, but some people have concerns about returning to face-to-face work environments. Businesses have contacted me about the cost of having offices risk assessed for Covid, and of any associated changes. Will the First Minister outline what guidance the Scottish Government is offering to businesses to ensure that workplaces are Covid safe?

It is positive that a return to offices and other workplaces it is now more possible. There is a lot to commend hybrid working, but it is important that workplaces are safe environments. Although the majority of us are keen to get back to normality, there are some people, particularly people in the high-risk groups, who are anxious about that and are nervous about the risks that it might pose. That is particularly true in the workplace so—as I said in my statement—it is incumbent on employers to ensure that they follow all the guidance and take appropriate steps to make their workplaces as safe as possible.

As I also indicated, guidance has been published on the www.gov.scot website to help employers to make their workplaces safer. That is updated regularly in consultation with stakeholders and enables employees to get advice that they can discuss with their employers.

This is a crucial period for building people’s confidence to get back to work, as well as back to normality in other ways. Employers have a particular responsibility to help us do that.

I received the following message from a constituent with a child in fifth year at school:

“The impact of face masks on hearing impaired pupils has been catastrophic and disproportionately affects them. Face masks not only take away their vital method of communication—lip reading and facial expression—it also reduces sound and distorts normal speech which as hearing people we all take for granted.

The whole impact of wearing face masks in schools for these pupils will not be felt for years to come when the life chances of hearing impaired pupils will be less than their hearing peers and yet again they fall further behind and are disadvantaged.

Every single day this policy is in place, it’s taking away future hopes, dreams and friendships of hearing impaired pupils.”

What is the First Minister’s message to that parent?

I understand the views of that parent. I could come here any week and read out messages that I receive that have similar sentiments to the one that has just been read out. Equally, I could read out lots of messages that I receive from the other perspective, from parents, pupils and teachers saying, “Please don’t remove the requirement for face coverings prematurely, because we believe that that will put us at greater risk.” The point I am making is that there are, understandably and hardly surprisingly, different opinions here, and those opinions are, I think, particularly sincerely expressed when it is around children with hearing impairments or other learning disabilities.

Of course, there have always been exemptions from the wearing of face coverings, and generally there is a need to support children, whose education has been disrupted because of the experience of the past two years, but it is important that we do not take some sort of politically ideological approach to this. It is the case that we need to take careful decisions and listen to parents, teachers and young people themselves, but we need to come to balanced views that recognise the risks and dangers of the virus, and to recognise our responsibility to try to navigate a way through it that keeps young people, in particular, as safe as possible. These are serious responsibilities and the Government will continue to take them extremely seriously.

The launch of the distance aware campaign will have been welcome for those who have been at higher risk of Covid or who feel very anxious about going out in public. Will the First Minister outline the steps that are being taken to publicise the campaign and encourage shops and other venues to share the messaging so that consumers have the confidence to return to going about their daily lives?

We are working with a range of organisations and businesses to promote the initiative among their staff and customers. There is a bespoke online awareness-raising toolkit, and posters have been sent to stakeholders across Scotland.

As I indicated in my opening remarks, early uptake has been good, which I think suggests that there are many people who want that added bit of reassurance to give them the confidence to get back to normal, whether that is in workplaces or while they are shopping or socialising. If it helps, that is a good thing, and we should all try to respect that when we see people wearing the badges or lanyards. It is totally voluntary and people are not required to do it, but anybody can request the materials if they think that it would help.

We are in a transition back to normality. I hope that it will be sustained and sustainable normality, but some people are more nervous about that than others, and some people, of course, remain at higher risk of Covid than others. If we all pull together, as we have done through the earlier stages of the pandemic, and we support each other in that way, it will make the transition all the easier, but it is likely to make it more sustainable as well.

The Daily Record reported that four children who are aged between five and 11 and are clinically vulnerable were given Covid vaccine overdoses of more than twice the approved amount, in NHS Lanarkshire. They received adult doses rather than those that are designed for children. At least one of the children was very seriously ill for a whole week as a result. I have since been contacted by a mother whose 11-year-old daughter was given the wrong vaccine dosage, this time in NHS Greater Glasgow and Clyde. Her daughter was desperately unwell for two weeks, but months later the symptoms returned and she ended up in hospital.

Given the unfortunate side effects that those children experienced, and to ensure that there is confidence in the vaccination programme, which is so important, will the First Minister order an urgent review of the administration of vaccinations to children and at least ensure that the different doses for children and adults are colour coded in order to avoid future error?

In the face of any such incident, we will take any steps that we consider to be appropriate.

A small number of children were incorrectly administered a higher-than-recommended dose of the Pfizer vaccine, instead of the paediatric formula. NHS Lanarkshire has apologised for that error and has undertaken the appropriate monitoring that should always be carried out when someone is given more than the recommended dose of a vaccine.

We have already been assured that the error was quickly identified and reported and that actions were put in place to ensure that the affected parents were fully informed of what had happened. There is guidance from the UK Health Security Agency about the steps that should be taken. The parents should be reassured that, in this case, it was not harmful; nevertheless, we will ensure that there is a proper review and that any appropriate steps are taken as a result.

I draw the Parliament’s attention to the fact that a number of education authorities in England are advising that masks remain in place, at least in school communal areas, for the time being, despite the change in England’s national guidance. That is because of a significant rise in new Covid outbreaks in English schools. Does the First Minister think that the Scottish Tories’ impatience to remove protections in Scotland and to follow their leader Boris Johnson, for reasons that I simply cannot comprehend, would put at risk the safety of our young children and teachers?

I leave it to other political parties to explain their positions. The Scottish Conservatives have tended to oppose every reasonable measure that we have advocated to control the virus, and it is for them to explain that. We will continue to take the steps and the decisions that we consider to be appropriate and responsible. That is the case in general, but it is particularly important that we do that where children are concerned.

Nobody wants face coverings to be a requirement in schools for longer than is necessary. However, until this week, there had been rising numbers of cases in the younger age groups of school-age children; infection levels—although, thankfully, now falling—remain relatively high; and there are outbreaks in schools, which is disruptive to education. We have to get the balance right and to take expert advice as we do so. That is why the meeting and the deliberations of the advisory sub-group this afternoon are so important in reaching the right decisions on all of that.

I am aware of instances in which children between the ages of five and 11 have been unable to receive a Covid vaccine despite being in regular close contact with an immunosuppressed person, because they are not classed as household contacts. I am sure that the First Minister will appreciate that, often, childcare arrangements mean that children are in prolonged contact with family members such as grandparents, although they may not live with them. What flexibility is there to allow the giving of the vaccine to children who are close contacts but not household contacts of immunosuppressed people?

An appropriately flexible approach should be taken to that. I undertake to discuss that point with clinical advisers and to write to Gillian Mackay—and to make the answer more widely available.

The position that we take should reflect the lived reality of the children who may be more vulnerable through their own health conditions or through contact with people who have compromised immune systems, rather than any overly rigid definitions.

That said, the advice on such matters comes from the Joint Committee on Vaccination and Immunisation, and it is important that we honour and respect that advice. I will discuss the point with clinical advisers and revert to Gillian Mackay as soon as possible.

I very much welcome progress in overcoming Covid. However, it is now important that the public—particularly those over 65—are reminded of the importance of the flu vaccine. I therefore ask, if someone is over 65 and did not receive their flu vaccination along with a Covid vaccination, how do they now access it?

As I reported to the Parliament, we took the decision to pause flu vaccinations in order to allow the prioritisation of the immediate challenge of delivering Covid booster vaccinations. However, local health boards are now offering flu vaccines again to the following high-risk groups that had not already received it—although uptake was high when we took the decision to pause it. Those who can now access the flu vaccination again are people aged over 65, people with an eligible health condition, pregnant women, front-line health and social care workers, adult unpaid carers, and the household contacts aged over 16 of someone who is severely immunosuppressed.

The flu season runs until the end of March, so it is essential that people get vaccinated, to get the protection that they need. There is still time to do so. Further information on how to go about arranging a flu vaccination is available through NHS Inform.

The Coronavirus (Recovery and Reform) (Scotland) Bill includes permanent powers to close schools and businesses, enforce lockdowns and release prisoners early. Although we must account for the possibility of future variants, we cannot accept legally enforced restrictions as the new normal. Why does the First Minister not scrap this Orwellian bill?

That question is utterly ridiculous, and I think that it will be treated by people as ridiculous to describe anything in that way. The bill is not an emergency bill; it will go through the full process of scrutiny by the Parliament. In some respects, the Conservatives are at risk of misrepresenting some of the contents of the bill. Every provision in it will be subject to full and proper scrutiny and to a decision through votes of this Parliament.

The challenge is to get the right balance between having the powers and levers that any Government needs to respond quickly to public health emergencies and not having any emergency powers on the statute book for longer than is necessary. I am sure that everyone across the Parliament will rise to the challenge of getting that balance right.

Symptoms associated with long Covid can have a significant impact on quality of life. Will the First Minister comment on the emerging impact and give an update on the care and support that are available to people with long Covid in Scotland?

I covered some of that in my response to an earlier question. Long Covid has an impact on both physical and mental wellbeing, so it is important that we take a range of actions to give people the right support. As I said earlier, we have already launched the long Covid support fund, which includes £10 million of funding to support the implementation of the 16 different commitments that are contained in our approach paper. We have also launched a long Covid information platform on NHS Inform, which helps people to manage symptoms and signposts people to the available information and advice. NHS National Services Scotland is also establishing a strategic network, which is bringing together clinical experts, NHS boards and people with lived experience to support the on-going development, resourcing and implementation of services for people who have long Covid.

Twenty-nine-year-old Callum Boulazreg is an in-patient at Gartnavel hospital. Visits from family are crucial to Callum’s care. However, despite changes to self-isolation periods for the general population being made from 6 January, Callum has been required to isolate for a full 10 days, and he has been required to do so no fewer than seven times in the past year. On each occasion, Callum’s progress is destroyed. He experiences the kind of cognitive setback that was previously observed in care homes and has been rightly condemned as a scandalous abuse of human rights. His family is desperate to help him.

Although the review that was announced by the Cabinet Secretary for Health and Social Care earlier today is welcome, does the First Minister agree that that self-evidently excessive, and even cruel, practice must end in mental health wards, and that long-term patients have a fundamental right to social and physical contact with their families?

Yes, I agree, but I also recognise—as, I am sure, Paul Sweeney does—that healthcare professionals have to make difficult decisions and strike difficult balances to keep people safe from the risks that the virus poses. I am sure that he will accept that nobody is seeking to be cruel in making those decisions. They are difficult decisions that have a difficult impact on patients and their families.

I absolutely agree that the human rights and wellbeing of patients, particularly long-term patients in our hospitals, are paramount. I am happy to ask the health secretary to look into the constituency case that Paul Sweeney has raised and to come back to him with any further reflections once I have had the opportunity to do so.

There have been suggestions that, at some point, we might need a fourth jag or a second booster, either before the summer or perhaps before next winter. Will the First Minister update us on the thinking on that?

That certainly cannot, or should not, be ruled out. It might even be probable that further doses of the vaccine will be required and that Covid vaccination will become a regular vaccination programme, just as flu vaccination already is.

However, it is for the Joint Committee on Vaccination and Immunisation to consider the emerging evidence about the virus. On the strength of that evidence, it will advise the four Governments across the UK on how we can continue to use vaccination to prevent severe illness and hospitalisation. We will continue to be guided by the JCVI. We stand ready to consider any further recommendations that it makes and to set out to Parliament how we intend to implement them, as and when they come.

Almost two years into the pandemic, day-care centres for people with disabilities have still not reopened. Those centres used to be a lifeline for people with disabilities and their carers. A lot of charity-run day services have been open for almost a year, with proper protocols in place. Does the First Minister agree that day-care centres should reopen immediately? Will she discuss the matter with her council colleagues to ensure that services open sooner rather than later?

I want centres to get back to normal, as I want the economy and society generally to get back to normal. There is no reason—subject to all the on-going precautions—why local authorities cannot open centres such as the member describes, and I encourage them to look carefully at doing so. There have been previous phases during which 2m physical distancing made that practically difficult, but physical distancing has now been reduced and some of the wider precautions are no longer in place.

I encourage local authorities to get those services back to normal as quickly as possible for the people who rely on them.

As the First Minister recognised in her statement, this is a particularly anxious time for people who have been shielding. I welcome the Scottish Government’s focus on encouraging workplaces to adopt hybrid forms of working. Does the First Minister agree that it is essential that employers engage constructively with employees and trade unions to introduce a safe and effective mix of flexible and hybrid working, particularly for people who feel more vulnerable?

Yes, I agree with that, and I have made comments to that effect today. I think that many employers are and will be engaging closely with workers, workers organisations and trade unions, in particular, and I encourage all employers to do that. There are particular issues that need to be taken into consideration for employees in higher-risk groups, and it is important that plans for hybrid working properly reflect that.

As I said, guidance is available on the Scottish Government website to assist employers and workers in reaching the right decisions, to allow people to get back to work—as I think that most people want to do, to a greater or lesser extent—and to do so safely, with their needs properly catered for.

That concludes the First Minister’s statement on a Covid-19 update.

As there will be a brief pause while people move seats, I take this opportunity to remind members that Covid-related measures are in place and face coverings should be worn as you move around the chamber and across the campus.