Meeting of the Parliament

Meeting date: Tuesday, December 8, 2020

Official Report 1042KB pdf

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Covid-19

Our next item of business is a statement from the First Minister, Nicola Sturgeon, on Covid-19. The First Minister will take questions at the end of her statement. I encourage all members who wish to ask a question to press their request-to-speak buttons.

14:25  

As the Cabinet Secretary for Health and Sport has just discussed, I am pleased to begin by confirming that, earlier today, the first vaccines against Covid were administered in Scotland. That is a milestone we have all longed for—it offers hope, at long last, that we may now be at the beginning of the end of the pandemic. I want to thank everyone involved, now and in the months ahead, in delivering what will be the biggest vaccination programme in our history.

Today, we should all allow ourselves a smile—this is a good day and a good moment—but we must not drop our guard. For now, the virus and the risks that it poses to health and life unfortunately remain with us; indeed, we can expect the winter period ahead to be especially tough. As the vaccination programme rolls out across the country, the national health service will be coping with the impact of Covid and other winter pressures, and of course we may also be dealing with any disruption caused by Brexit, the terms of which are still unclear. So, we have no grounds at all for complacency about the months ahead, and we still have every good reason to do everything that we can to keep ourselves and our loved ones safe.

The levels approach is one of the main ways that the Scottish Government seeks to achieve that. We have just completed our weekly review of the levels of protection for each local authority area, and I will shortly confirm the outcome of that review. However, I will start with a brief summary of the latest Covid statistics.

The total number of positive cases reported yesterday was 692. That represents 5.5 per cent of all tests carried out, and takes the total number of cases to 101,475. There are now 983 people in hospital, which is an increase of nine from yesterday, and 57 people are in intensive care, which is a decrease of two from yesterday.

I regret to report that in the past 24 hours, a further 33 deaths have been registered of patients who first tested positive over the past 28 days. The total number of deaths, under that daily measurement, is now 3,950. Those figures remind us yet again of the toll that Covid continues to take right across Scotland. Once again, my deepest condolences go to all those who have lost a loved one.

Let me turn to the outcome of this week’s review. In summary—I will come on to the details shortly—I can confirm today that all 11 local authorities currently in level 4 restrictions will move to level 3 from Friday. I also confirm that five other local authority areas will move down to a lower level from Friday. Before I set out those changes in detail, I will briefly update the chamber on some of the additional measures that the Scottish Government is putting in place to help us manage the pandemic in the months ahead.

Community mass testing has been, or is being, trialled in eight different locations across west and central Scotland. Early results from those trials will be published tomorrow, with further detail available next week. The purpose of that testing is to identify cases of Covid in people with no symptoms or before they display symptoms to help break more chains of transmission. University students are also being tested, using lateral flow devices, to help them return home more safely at the end of term. Further detail on that testing will be published tomorrow. We have also considered how and when students should return to campus after the holiday period, and the Deputy First Minister will set out details of that in a statement to Parliament later this afternoon. Walk-in testing centres continue to be established in towns and cities across Scotland, and by the end of next week, 22 walk-in centres will be in place.

As we expand accessibility of testing, we are also extending NHS Scotland’s laboratory testing capacity. The first of three new NHS Scotland regional hubs for processing tests is due to become operational on Saturday and will be located at Gartnavel in Glasgow. By the end of this month, NHS Scotland’s testing capacity will have increased from almost 12,000 tests a day at the moment to almost 30,000 tests a day, and our total daily testing capacity, including Scotland’s share of the United Kingdom-wide Lighthouse laboratory programme, will be 65,000 tests a day.

I confirm that, from next week, the Protect Scotland app, which is currently available for use only by people who are 16 or over, will be available to everyone across Scotland from the age of 11.

All those developments will be important in the months ahead in helping us to manage the pandemic as effectively as possible but, unfortunately, restrictions on how we meet and interact will remain essential for some time yet.

Our levels approach ensures that the restrictions that apply in different parts of Scotland are proportionate to the prevalence of the virus in each area. Over the past three weeks, 11 local authority areas have been under the very severe level 4 restrictions. I am pleased to say that prevalence in all 11 of those areas has fallen significantly—for example, in the week to Friday 13 November, Glasgow recorded 281 new Covid cases for every 100,000 people in its population, and by Friday 4 December, that number had fallen to 150. In East Dunbartonshire, case numbers per 100,000 of the population have more than halved—from 224 to 104. In both North Lanarkshire and South Lanarkshire, case numbers have fallen by well over a third.

The fall in infection rates in those areas, which are the most highly populated in the country, has contributed to an improvement in the situation across Scotland. In the week to 13 November, we recorded 142 new cases of Covid for every 100,000 people. Last Friday, that figure had fallen below 100—for the first time in a long while—to 99. Although it fluctuates daily, the national average for test positivity in the week up to last Friday was back under 5 per cent—the threshold that the World Health Organization uses to determine whether an outbreak is under control.

I am relieved to say that that progress is reflected in our hospital and intensive care statistics. When I made a statement to Parliament three weeks ago, 1,249 people were in hospital with Covid and 95 people were in intensive care. Now, as I just reported, those figures are 983 and 57 respectively.

All that puts us in a much better position to cope with the inevitable difficulties of winter. I thank people across the country for their compliance in recent weeks. However, although the improved position is positive, it does not remove the need for a cautious approach. The risks and challenges of the next few months are clear. That is why, in reaching decisions today, we have had to consider the potential overall impact of moving to a lower level of restrictions at the same time as the Christmas period begins in earnest. That has led us to a proportionate but still cautious set of conclusions.

I turn to the detail of the decisions. I remind the Parliament that all the decisions are informed by input from the national incident management team, our senior clinical advisers and an assessment of the four harms. Given the welcome decrease in Covid rates across the level 4 areas, I confirm that Glasgow City, Renfrewshire, East Renfrewshire, East Dunbartonshire, West Dunbartonshire, North Lanarkshire, South Lanarkshire, East Ayrshire, South Ayrshire, Stirling and West Lothian will all exit level 4 on Friday.

We hope that case numbers in those areas will continue to decline for another week or so as a result of the level 4 restrictions. However, there is no doubt that the easing of restrictions that the exit from level 4 involves will give the virus more opportunities to spread.

In the light of that, we have decided to take a cautious approach and apply level 3 protections to all those local authority areas for a period. We will observe the data carefully before determining in the weeks ahead whether and when those 11 local authorities should move to level 2.

When we introduced level 4 restrictions, we said that they would be lifted at 6 pm on Friday 11 December. That remains the case, with one exception. Retail premises that have been closed under the level 4 restrictions will be permitted to reopen from 6 am on Friday. That is intended to help stores and shopping centres better manage the flow of customers after the period of closure.

I appeal to everyone who lives in level 4 areas to continue to exercise care and caution. As we know from our experience of Covid so far, progress can easily go into reverse, so please continue to abide by the rules—in particular, that means not visiting other people’s houses. As I will confirm later, travel restrictions will remain in place for the next period, so travel into and out of level 3 areas will still not be permitted.

Ten local authority areas are in level 3—Angus, Clackmannanshire, Dundee, the City of Edinburgh, Falkirk, Fife, Inverclyde, Midlothian, North Ayrshire and Perth and Kinross.

Seven of those areas will remain at level 3. They are Clackmannanshire, Dundee, the City of Edinburgh, Fife, Midlothian, North Ayrshire and Perth and Kinross.

I make a particular brief mention of Clackmannanshire. Case numbers there have risen sharply in recent days, although its case positivity remains well below the national average. We are confident at this stage that the rise in case numbers can be attributed to the mass testing pilot that has been under way there. In other words, the issue is more cases being identified, rather than a rise in transmission. Obviously, we will keep that under review, but we have decided that a change of level would not be merited at this point.

However, I am pleased to say that three areas will move down to level 2 from Friday. They are Inverclyde, Falkirk and Angus. All three of those areas have reduced, and now relatively low, rates of transmission, and although Falkirk’s rate has increased very slightly in recent days, that has not changed our judgment that all three meet the criteria for moving into level 2.

We have also looked very carefully at whether Edinburgh should move to level 2 at this stage. Edinburgh is currently recording 68 cases per 100,000 people, which is below the Scotland-wide average, and its test positivity levels are also relatively low. However, cases in Edinburgh have risen slightly in recent days, and there seem also to have been increases in East Lothian and Midlothian.

The imminence of the Christmas period has also had an impact on our thinking. A move to level 2 in Edinburgh would mean opening up significantly more services in our second biggest city in the two weeks before Christmas. That move would carry significant risk of increased transmission, and for that reason we want to have as much assurance as possible that the situation is as stable as possible before we make that move. For that reason—this has been a difficult decision—we have decided not to move Edinburgh to level 2 this week, but we will consider that again next week for both Edinburgh and Midlothian.

At the moment, there are six local authorities at level 2—Aberdeen City, Aberdeenshire, Argyll and Bute, Scottish Borders, Dumfries and Galloway and East Lothian. Both Dumfries and Galloway and the Scottish Borders have had consistently low levels of Covid for some weeks now. In Dumfries and Galloway there were 23 cases per 100,000 people in the past week, and in the Borders there were 35 cases per 100,000. We have therefore concluded that both of those areas will move from level 2 to level 1 from 6 pm on Friday.

I said in last week’s statement that we were looking closely at both Aberdeen and Aberdeenshire following an increase in cases in both areas. In the past week, cases have fallen in both areas. Aberdeen has gone from 89 new cases per 100,000 people to 74 per 100,000, and Aberdeenshire’s case numbers by the same measure have decreased from 95 to 80. Case positivity in both areas has also fallen and is at or slightly over 4 per cent.

For that reason, at this stage, we intend that both areas will remain at level 2. It is worth stressing, though, that cases have not fallen in either area by as much as we would want, and there is still evidence that the levels of infection are due to transmission in the community rather than solely being due to outbreaks in workplaces and care homes. We therefore continue to monitor the situation in both local authority areas very carefully, and I cannot rule out a move to level 3 for one or both of them in the weeks ahead.

My message to both areas is—as, indeed, it is for all parts of the country—that the only way to stay at the current level and then possibly, hopefully, move down further is to suppress the virus as effectively as possible. Both local authorities have assured us that they will continue to work with local public health teams to do that. The Scottish Government, of course, will do all that we can to help, and it is also vital that local businesses and local communities continue to play a full part in those efforts.

East Lothian and Argyll and Bute will also both remain at level 2 for now. It is worth mentioning that Argyll and Bute has also seen a very sharp rise in cases in recent days. We are confident at this stage that that reflects a large workplace outbreak and is not indicative of wider community transmission. Again, however, we will continue to monitor that situation carefully.

Lastly, I confirm that Highland, Moray, Orkney, Shetland and the Western Isles will all remain at level 1—of course, from Friday, the Borders and Dumfries and Galloway will also go to that level.

From Friday, there will be a relatively small change to the rules for household gatherings on some islands in the level 1 local authority areas. At the moment, the island local authority areas—Orkney, Shetland and the Western Isles—are the only places in Scotland where it is permitted for six people from two households to meet in houses. From 6 pm on Friday, that will be extended to other inhabited islands in the level 1 local authority areas, with the exception of islands that are connected to mainland Scotland by road, such as Skye.

However, those of us who live in the rest of the country should continue to stay out of each other’s houses. I know that that is really tough, but it remains the most effective way of stopping the virus spreading from one household to another.

The overall result of today’s changes is that 16 local authorities will move to a lower level of restrictions from Friday, and the rest will remain at the same level. That is good news. It reflects the fact that the number of cases in Scotland has been falling in recent weeks. However, I know that it involves real and continued difficulties for many businesses, particularly those in the hospitality sector. I can therefore confirm that, tomorrow, the Cabinet Secretary for Finance will set out a further package of business support, which is intended to provide additional help over the winter. In the next couple of weeks, we will also consider whether any changes to the content of different levels, particularly as they affect hospitality, can safely be made.

More generally, as I have said previously, moving any area down a level is not a neutral act. Given that it allows some restrictions to be lifted, it presents more opportunities for the virus to spread, so it presents real risks. I ask everyone—especially people in areas that are moving down a level—to continue to do everything that they can to keep themselves and their loved ones safe. Be careful and cautious, follow all the rules that are in place, and please still try to limit your interactions with others as much as possible. It might be counterintuitive but, as restrictions ease, caution becomes more important, not less.

Travel restrictions, which will remain in place, continue to be a vital part of keeping the country safe, with a targeted and proportionate approach to restrictions. Nobody in a level 3 area—or, until Friday, a level 4 area—should travel outside their local authority area, except for very specific purposes, and no one should travel into level 3 or 4 areas unless it is for essential purposes. I am afraid that that means, for example, that people from outside Glasgow must not travel to the city to do Christmas shopping when retail premises open on Friday.

Today—the day when the first people have been vaccinated against this horrible virus—is, and should be, a day of optimism for all of us. It marks, we hope, the beginning of the end of the pandemic. Unfortunately, the end is not quite with us yet, so all of us must continue to think about how we keep ourselves and each other safe in the meantime.

In the weeks ahead, many of us will face choices about when or whether we meet friends indoors in a pub or cafe, and about how we celebrate Christmas. Some people will decide that their wellbeing, or the wellbeing of someone they love, is best served by meeting indoors. I understand that. That is why the rules over the Christmas period recognise that inevitability and give advice on how to stay as safe as possible. However, some of us will decide to take other options—for example, by seeing loved ones outdoors or by postponing a family Christmas gathering until the spring or summer of next year.

There is a beautiful statement by the Irish poet, Seamus Heaney, that was much quoted in the early days of the pandemic and which, I think, sums up extremely well the situation that we are in now. He said:

“If we winter this one out, we can summer anywhere”.

I suspect that that sentiment resonates with many of us more strongly now than at any previous time in the pandemic.

The route back to something much closer to normal life is clearer and closer now than it has been at any time since March, and we are all looking forward to reaching that point, but we are not quite there yet, so our priority must be to do everything that we can to ensure that, when we reach that point, all our loved ones are there with us. That means taking extra care to stay safe now, so please continue to be very cautious in the weeks ahead.

All of us should think about how we can avoid creating opportunities for the virus to jump from one household to another. We must all continue to stick to the current rules and guidance. Unless you live on an island that has no road connection to the mainland and is in a level 1 area, you should not meet in someone else’s home. If you meet outdoors or in public indoor places, please stick to the limit of six people from a maximum of two households. Stick to the travel restrictions that I have just outlined.

Finally, remember FACTS—the five rules that will help to keep all of us safe in our day-to-day lives: wear face coverings; avoid crowded places; clean hands and surfaces; keep a 2m distance; and self-isolate and get tested if you have symptoms.

Sticking to those rules continues to be the way in which we can protect our NHS and help our health and care workers. It is how we will look after ourselves and our loved ones, and it is how we will get through the weeks and months ahead, as we look ahead to the spring and the better times that definitely lie ahead.

Today’s news that 90-year-old Margaret Keenan has become the first person to receive the Covid-19 vaccine is good news for us all. It marks the first step on the road to our national recovery and feels like a big step forward. When that is coupled with the news that 11 local authorities that are under the most severe restrictions will see them being loosened, there is a real sense that there is light at the end of the tunnel.

However, we must be cautious. For people who are still unable to see relatives, who have to work at their kitchen table or who watch as the doors of their small business remain firmly bolted, the difficulties that have been brought on by tackling Covid persist. For businesses in local authority areas in which the number of cases, and every other indicator, gave them hope that they should have been placed in a lower tier, it is a bitter pill to have been told today that they will not because it is Christmas and—ironically—they might get too much trade.

News of continued restrictions means that not only does support need to be announced, but it needs to be delivered—quickly. Therefore, tomorrow’s announcement from the Cabinet Secretary for Finance will be welcome, particularly because the Scottish hospitality trade has had lower levels of support than the trade in England and Wales, but support needs to reach its intended targets.

Three weeks ago, the First Minister unveiled a £30 million discretionary fund to help people who have fallen through the cracks of Covid support, such as taxi drivers and people in the supply chain who were not forced to shut but whose business has dried up due to other closures. That fund was to be administered by local authorities and would consider applications from across the piece.

Fast forward to last week, when the First Minister repeated to Parliament that the fund’s money would flow in the near future. She went on to confirm that councils had signed off how the money would be split up last month. However, as of today, local authorities still have not received the funds and are not able to open applications. The fund is designed to help people who do not qualify for other grants and who are on their knees. They are watching the clock and are aware that many council workers will be going on Christmas leave, which means that the time for processing applications will be reduced.

The First Minister announced the fund three weeks ago, with a promise to get it up and running soon. Is she now able to give hard-pressed taxi drivers and supply-chain workers a date for when her Government will release the funds to local authorities, and when they can start applying for that support?

The allocation of the fund has been agreed with local authorities. Tomorrow, the finance secretary will give an update on the support that is available. As I said, she will set out details of additional support that will be made available to help businesses—in particular, during the winter period.

We want and are determined to do as much as we can to help businesses—especially in sectors such as hospitality, but also across the economy more generally—and to help businesses that might hitherto have fallen through the cracks during the pandemic. We have in place a comprehensive grants scheme, to which the announcement by the finance secretary tomorrow will add.

I looked carefully at the figures that were published yesterday by the Scottish hospitality group. It is important to say that the levels of support in the different nations of the UK in some respects reflect the severity and impact of restrictions. In some parts of the UK, restrictions have been significantly more severe than they have in others, and there have been national lockdowns—which, of course, has not been the case in Scotland. That will be reflected when support is averaged out.

Nevertheless, we recognise that we need to do more and we are determined to do it. As I said in my statement, and have repeated, the finance secretary will set out more detail on that tomorrow.

More generally, today brings good news to individuals and businesses across the country. There will be parts of the country, and businesses in those parts of the country, that feel disappointed and frustrated. I acknowledge that, but in trying to strike the right balance we have to take difficult decisions. I have said all along that it will do businesses no favours if we move too quickly—although I understand why they want us to move quickly—because that can risk setting areas back and doing deeper and longer-lasting damage.

I hope that we will continue to see all of the country move in the right direction in the weeks to come, but we should not underestimate the challenges during Christmas and the need for all of us to continue to comply with all the restrictions.

Scotland is in a comparatively strong position within the UK. However, we cannot afford to take anything for granted. We have to continue to work hard to keep the virus under control.

There is no question but that the decisions that are made about levels are complex. However, having seen some of today’s data, we know that people will find it difficult to understand how the First Minister and the Cabinet have arrived at some of their conclusions.

The most recent data shows that there are 81 cases per 100,000 people in Stirling and 76 cases per 100,000 people in West Dunbartonshire. Those areas have both been moved to level 3. However, in Argyll and Bute, there are 165 cases per 100,000 people and that area has been in, and will stay in, level 2. Why is Edinburgh staying at level 3 when the data clearly shows that infection is under greater control in that city than it is in other parts of the country?

People want to see the evidence. Public co-operation during the pandemic operates on the basis of public trust and confidence, which have not been helped by the confusion that was generated at the weekend by the Cabinet Secretary for Health and Sport, which left businesses, workers and communities unsure whether the level 4 restrictions would end on Friday.

Can the First Minister give us a clear assurance that there will be no last-minute Midlothian-style U-turn later this week, and that businesses, workers and communities, especially those in all level 4 areas, can plan for easing of lockdown on Friday?

I know that Richard Leonard is perfect at public communication, but the rest of us are mere mortals. On Sunday, the health secretary communicated something that she realised was not as clear as it should have been. She immediately clarified it, which was a reasonable thing to do. I am sure, however, that we will all continue to take lessons from Richard Leonard.

On the substantive issues that he raised, it is complex to apply a system of levels; it would be much easier to put the entire country on a set of national restrictions. It would be much easier, but it would be fundamentally wrong, because differing levels of prevalence do not justify it.

We deliberately and rightly go through a complex process every week to judge the best level for each area. That is, to a large extent, informed by the indicators that we publish every Tuesday. As I said from the first day when we published the information, the approach must also involve contextual judgments.

Take, as an example, three local authorities—Stirling, South Ayrshire and West Dunbartonshire—that will come out of level 4 on Friday. If we look only at the indicators we could make a case that those areas should go straight to level 2, but it would actually be overly risky to take an area directly from level 4 to level 2, at the moment. Such easing could very quickly put those areas into reverse. Therefore it is better and steadier, and is in the long-term interests of those areas, to take them more steadily down the levels.

Those are the judgments that we make. People can decide whether they agree, but the judgments are made for the best possible reasons, in trying to get the best outcomes for areas.

I went into the case of Argyll and Bute in my statement. On the face of it, Argyll and Bute has had a sharp increase in cases, but as Jackie Baillie will be aware, there has been one significant workplace outbreak in Argyll and Bute, which is what lies behind the figures—not wider community transmission. If we were to take Argyll and Bute up a level for that reason, we would be putting the wider population under levels of restriction that are not merited because we know what lies behind the figures.

Such are the complex decisions that we make in trying to ensure that what we do is as proportionate and targeted as possible. We will continue to the best of our ability to make those decisions.

I understand the particular frustration that will be felt in Edinburgh. The Cabinet agonised over some decisions—those for Aberdeen, Aberdeenshire and the City of Edinburgh. There has been a recent rise in cases. In the breakdown of today’s cases, the number in Lothian is—from memory—second only to Glasgow. There is a need for some caution. All Governments are struggling with the decisions. Cases are starting to rise again in some parts of the UK, and that might also happen in Scotland, as we ease up over the next few weeks: we cannot guarantee that it will not. We are taking a cautious approach in order to mitigate that risk.

Lastly, on Richard Leonard’s characterisation—“last-minute” U-turns—I need to remind him, again, that we are dealing with an infectious and unpredictable virus. All the areas that I have referred to will come out of level 4 on Friday, but we must remain flexible in facing the virus. If I were to stand here right now and say that, no matter the trajectory of the virus, we will not change any of our decisions, people across Scotland would take a very dim view of that, because I would not properly be doing my job of trying to keep the country as safe as I can.

Patrick Harvie joins us remotely.

Obviously, any reduction in the prevalence of the virus is to be welcomed, but it is clear that the reduction that we have seen over the weeks when Glasgow and other parts of the country have been in level 4 is nothing close to the level of suppression that we saw during the summer. It therefore remains unclear to me whether alternative approaches that the Government is being advised about would achieve that more significant level of suppression.

The First Minister said that there is a risk that cases will rise again and she knows that education is one of our areas of concern there. Elsewhere in the UK, it has just been announced that schools will be allowed to close early, specifically in order that no teacher will be contact-traced on Christmas eve or Christmas day. Does the First Minister agree that that is a reasonable protection for teachers to be able to expect to ensure that they can have the break that they need and deserve?

On the first part of Patrick Harvie’s question, it is a simple fact that a very severe lockdown will suppress levels of the virus more and faster than less severe restrictions will, but the more severe the lockdown, the greater the harms in other areas, such as harms to the economy, education, social wellbeing and isolation. We have to strike a balance.

We have been analysing our levels system generally and we think that, overall, the levels in the system are reasonably effective, but we will review the fine detail of those over the next couple of weeks. We think, for example, that there might be a differential effect in the impact of the levels between urban and rural areas and that the same level of restrictions might not have the same impact in an urban area as they will in a rural area. We are also looking at whether the restrictions on hospitality could be modified in any way to get the same effect while making things easier for hospitality, for example, by changing the hours of restriction and allowing alcohol at other times of the day. We therefore continue to try to suppress the virus in as proportionate a way as possible, because I think that everybody accepts that we cannot live indefinitely under the kind of lockdown restrictions that we were under earlier this year.

In terms of the prevalence of the virus and confirmed cases, we have the lowest level in the UK right now, which again does not give me any room or grounds for complacency but suggests that the measures that we have been taking thus far have had an impact. The challenge and priority now is to ensure that that continues to be the case. The Deputy First Minister set out last week the reasons for the decisions around the school holidays; again, like all these decisions, they are finely balanced. Arrangements are in place to take the burden of contact tracing off teaching staff and headteachers in those final days of term. The Deputy First Minister will set out more details of that in due course.

First, I thank the brilliant scientists who have made this vaccine. Science might be expensive year in and year out, but it is at times like this that we truly value the work that those brilliant people do.

I can understand the cautious easing of the levels—just doing one level at a time—but there are some puzzling decisions today that have already been referred to. People have been told that, if they did the right thing, if infections fell enough and if there was enough hospital capacity, the restrictions would be eased. However, several councils have lower infection numbers but are stuck in higher levels: Midlothian, which has already been talked about; Edinburgh, for which an explanation has been provided; Perth and Kinross; and Fife. They have consistently had level 2 indicators, but they are stuck in the higher levels of restrictions, which begs a question. I understand the need for judgment on top of the raw numbers—I get that—but the numbers seem to have been abandoned in favour of judgment only. Is the First Minister considering reviewing the indicators to bring them more in line with the judgments that she is making?

With the greatest of respect, I think that any genuine reasonable look across every local authority area would show that the indicators have not been abandoned.

Yes, as we review the content of the levels, we will also be looking at the indicators to make sure that we are learning from the weeks in which the level approach has been in place and to consider whether any modifications are necessary. That process will be under way into and during the Christmas period, so that is a legitimate question to pose.

Willie Rennie mentioned various local authority areas. If we take Midlothian for example, in the most recent seven days, the number of cases there has increased by 16 per cent and the test positivity has gone up by 1.3 per cent which, again, cautions us against taking it down a level. In Fife, in the most recent seven days, we have seen a 3 per cent increase in the number of cases. In Perth and Kinross, although there has been a bit of a fluctuation, there is no significant reduction in the number of cases. Our judgment is that taking those areas down a level at this stage—remember, doing that is not neutral; it opens things up and therefore gives the virus opportunities to transmit—would be too risky to do. We need to see more sustainable progress.

That is the judgment that we try to bring to all these decisions. They are not straightforward or easy decisions; often, they are not absolutely black and white decisions. However, it is important that we try our best to get them right.

On the other side of this, a few weeks ago, we took a precautionary decision to put Angus into a higher level at the same time as we put Perth and Kinross into a higher level. Angus has come down a level today. Therefore, areas should not see themselves as being stuck. We review the situation every week, and a number of local authorities are coming down a level today. It is important that we try to get the decisions as right as possible, because the last thing we want to do is to take an area down prematurely and then have to put it back up again almost immediately because we have triggered an increase in the number of cases because its position was not sustainable.

As I said to Richard Leonard, it would be much easier to apply a blanket set of restrictions across the country, but that would not be right. That is why I think that this system, albeit that it is more complex, is the better one to have.

The First Minister has, I am thankful to say, indicated that Aberdeen City and Aberdeenshire have avoided moving up to level 3. What commitments has the city council given to bring down the virus? What encouragement has it been given to be more proactive in taking steps to drive down the virus, including reminding people that they should be working from home, that they should not be car sharing and that they should not be meeting in the homes of others, and deploying local environmental health of officers to ensure that that is the case?

The local authority has indicated that, working in close partnership with the local director of public health and other local agencies, it will be intensifying its focus on priority areas, notably transport, particularly car sharing, ensuring compliance with restrictions in and guidance on workplaces and retail settings, and stepping up public communication. That is welcome and important.

I have said before that the virus is no one’s fault. It is not the case that, because it is going down in one area and going up in another, that means that people are doing things wrong. However, it is a reminder that getting levels of the virus down takes concerted effort and local leadership. I pay tribute to local authorities across the country for the leadership that they are showing.

We have been worried and are still concerned about Aberdeen and Aberdeenshire. There appears to be a background increase in community transmission. We thought carefully about putting the areas up to level 3 this week. However, because there has been a slight decline in recent days, we have decided to give more time to the local authorities to work with public health experts locally to try to stem that increase more sustainably. I hope that we will see that progress in the weeks ahead.

I listened carefully to how the First Minister distinguished between inhabited islands on the one hand and mainland areas on the other in relation to household mixing in some level 1 local authority areas. Has the Scottish Government considered making the same distinction in Argyll and Bute? That area remains in level 2 for the reasons that she gave, but it also contains many inhabited islands, and some island communities feel strongly that they are in too high a level.

Yes, we have. I assure the member that a voice in the Government regularly raises such points on behalf of people in Argyll and Bute. It is a serious and legitimate point, which we considered in this week’s review. Because we are confident that the situation in Argyll and Bute involves a workplace outbreak and there is not wider community transmission, we did not think it right to put it up a level. However, we also thought that the higher level of cases just for this week merited not opening up any more, but we will keep that under review in the weeks to come.

Although confirmation that Renfrewshire and East Renfrewshire will move to level 3 on Friday is welcome, among my constituents there is an understandable desire that that should be a stepping stone to level 2 and not an indefinite holding position. What role could mass testing of asymptomatic people of the kind that has been done in the scheme piloted in Johnstone over the past week play in supporting areas to progress down the levels?

I agree 100 per cent that we do not want level 3 to be anything other than a stepping stone to level 2, just as we do not want level 2 to be anything other than a stepping stone to level 1. We want the trajectory to be downwards. However, if cases are rising, we cannot ignore that, and we must take precautionary action when we deem it necessary, especially as we know that we are going into a period in which the risks of transmission will be greater. Three or so weeks ago, one factor in our decision to put those local authority areas into level 4 was that it seemed that, without such greater action, they might have been left in level 3 for a lengthy period. Although such areas are about to go back into level 3, it is to be hoped that the period that they spent in level 4 will mean that they will be in level 3 for a shorter period than they might otherwise have been.

The point about mass testing is an important one. As I think I said earlier, we will publish the initial results of the mass testing pilots tomorrow, and more results will be issued next week. Early indications are that that approach has picked up cases of the virus that would not previously have been identified, which will enable us to break the chains of transmission. Although such testing is not the whole answer to getting the numbers of cases down in high-prevalence areas, it give us another tool in the toolbox, which will make a big difference to areas such as Renfrewshire.

I welcome the declining number of new cases and the lower positivity rate in West Dunbartonshire, which is now lower than the Scottish average. I hope that it will not be long before that area moves from level 3 to level 2 at a future review. However, there is a spike of cases in Helensburgh and Lomond, which is part of Argyll and Bute, and measures are being taken to control that. For my constituents, though, it remains troubling that large numbers of people are travelling across the central belt, from level 3 and level 4 areas to level 2 areas such as Helensburgh, to eat, drink and shop. What additional measures can be taken to discourage such travel between areas?

I agree with Jackie Baillie that that is a big issue. I was therefore surprised and disappointed that her Labour colleagues—I am not sure whether she did so—voted against the travel restrictions when we debated them in Parliament a couple of weeks ago. Those are difficult for people, but they are an essential part of trying to stem the flow of people from high-prevalence to low-prevalence areas.

In many parts of the country, there are concerns that people might be travelling in that way. I will raise the particular issue with the chief constable and will ensure that Police Scotland is aware of it. Of course, it is for it to decide operationally how to police the travel restrictions. A number of fixed-penalty notices have already been issued. However, particularly now that some areas are coming down a level, I again appeal to people to remember that such restrictions are a vital part of our being able to maintain our targeted approach across the country.

As Fife is to remain in level 3, I look forward to hearing the finance secretary’s statement tomorrow on the further support that might be available to businesses, because that will be much needed. As the member for the Cowdenbeath constituency, I know that businesses there will also be keen to know what possible changes they can expect in the weeks ahead. Could the First Minister therefore clarify her intention with regard to the weekly review processes? When will be the final one in advance of Christmas, and when is the first one after Christmas likely to take place?

Annabelle Ewing raises a very important question and I will give our current planning assumption but, before I do that, I will again say that I am very reluctant to give 100 per cent certainty around anything like this, because the virus is not going to take Christmas off. It is possible that we will see developments in parts of the country that necessitate action over the Christmas period; I cannot rule that out and it is important to be frank about that.

However, subject to that caveat, in relation to the levels that we announce as part of the decisions that we take a week today on 15 December, we would seek to maintain those levels over the Christmas and new year period, along with the temporary relaxation that we announced a couple of weeks ago for the Christmas period from 23 to 27 December. What we announce next week, barring any of the unforeseen developments that I spoke about earlier, will continue until the first Cabinet meeting of 2021, on 5 January, when we will have another review. I hope that we will have that period of stability from 15 December through to 5 January but, of course, we have to be prepared to act should the picture show that that is necessary.

The First Minister will be well aware of the real pressure on Scotland’s important tourism sector and the frustration that the support that is available from the Scottish Government has, so far, been inadequate, with many operators struggling just to stay afloat. Even with the roll-out of the vaccine, there is real concern about the next few months and little confidence among some operators and others that the next summer season will be much better.

Can the First Minister offer any encouragement to our important tourism sector that her Government recognises that the sector will need support up to and possibly through next summer and that the sector’s concerns will be addressed in the finance secretary’s statement tomorrow?

Yes and yes are my answers. First, yes, we recognise that the tourism sector will need support for a significant period of time, up to and including next summer, and perhaps after that as well, as it recovers from what has been a deeply damaging and traumatic period for the sector.

Last Tuesday, the Cabinet discussed the outcome of the tourism task force and the recommendations from that. Some of those deliberations will feature in the finance secretary’s announcement tomorrow, which will set out further support for the tourism sector in the short term. Of course, we recognise that that obligation and responsibility will be there over the longer term as well.

Will the First Minister join me in recognising the sacrifices that citizens and businesses in the Stirling Council area have made to ensure a reduction in levels of infection? Will the First Minister also agree that, although that reduction is welcome, further progress is still required and that, although it is good news for non-essential shopping that Stirling is moving into level 3, long-suffering hospitality businesses still face operating restrictions? Can the First Minister therefore please tell me what conditions need to be met to enable Stirling to enter into level 2? How soon will the Government review the situation again in that regard?

I join Bruce Crawford in paying tribute to people across Stirling and, indeed, across the whole of the country for the sacrifices that they have been making for several months now. Every day, I stand and announce decisions that are difficult for people, and I do not want anybody to think that we do not fully appreciate and understand the degree of sacrifice and difficulty that people have faced and continue to face. I will probably never find the words to thank people enough for everything that they are doing to help us to suppress the virus.

Progress in Stirling has been encouraging, but we understand—I have already indicated this today more generally—that the situation is leading to continued difficulties for businesses, particularly in hospitality. Therefore, in addition to the strategic framework business support fund that has already been rolled out, the finance secretary has been developing a package of tailored support for a range of specific sectors. As I have indicated, she will set that out shortly.

We will review Stirling’s position—as we review the position of every local authority area—on a weekly basis, and we will announce the outcome of the next review next week. As I have just said to Annabelle Ewing, we hope that next week’s decisions will last through the Christmas period, but, of course, we will continue to respond to developments as they happen.

Glaswegians will welcome any progress in moving down the levels. I note that the First Minister has said today that retail can open from 6 am on Friday. I think that that is news to them, but I am sure that it will be welcome.

Does the First Minister agree that it is a harsh moment for Glasgow’s retail sector if those who live outside Glasgow are unable to come in to it to shop? I am sure that the First Minister recognises that Glasgow depends on shoppers and trade from outside the city. Given that, does she agree that, with her ministers, she should begin to engage with Glasgow politicians and businesses to discuss a plan to prevent lasting damage to Glasgow’s economy?

The Scottish Government engages closely with the local political leadership in Glasgow and with the business community, including retail, in Glasgow and across the country. In fact, the decision to enable retail to reopen at 6 am on Friday as opposed to 6 pm was the result of a specific request from the retail sector, which I think was sensible. The sector judges that the measure will enable it to manage any potential rush back to the shops better than it would if shops opened at 6 pm and the first full day was a Saturday, when people are less likely to be at work. It was a sensible suggestion and one that the Scottish Government has responded to.

I know how devastating the impact is on every part of the country but particularly, with regard to retail, in areas such as Glasgow. Glasgow is my home and I know how much the retail sector in the city centre matters to the health of the city. However, it simply would not be sensible to encourage or allow people from all over the country to come and shop in Glasgow in the run-up to Christmas. Like me, many members will have seen the scenes involving crowds of people in certain London shopping streets at the weekend. I certainly hope that we will not see that replicated here. That is why we have to manage the situation carefully. We will continue to discuss with the local leadership in all council areas and with local businesses how we ensure that support is available not just in the immediate term but as we go into the recovery phase.

It looks increasingly likely that we will crash out of the European Union with no deal or a low deal in a matter of weeks. What assurances has the First Minister had from the UK Government that its reckless decision not to extend the transition period will not have an impact on the supply of the vaccine from January?

Obviously, the end of the Brexit transition period is a key issue in all of our thinking and planning right now. That is increasingly the case the closer we get to that date, and the closer we get to it without there being any clarity on whether there is a deal, or whether, if there is a deal—as I hope there will be in the next couple of days—it will be a fairly minimalist one.

We are discussing with UK colleagues across the other nations the supply of the vaccine, which we are assured is there and will continue to flow, although obviously that is subject to the pace of manufacturing. We have taken certain other contingencies to ensure that we have supplies of other vital medicines and medical devices. However, I think that we all hope that a deal will emerge in the next couple of days that, although it might not take away all the problems that will be faced at the turn of the year, might help to mitigate them.

The Covid-19 vaccine requires two doses per person. How will people be told about their appointment for the second vaccine, which is a booster, after they have received their first?

When someone gets the first dose of the vaccine, they will be given the date for the second dose—that is part of the planning. One complication of the Pfizer vaccine, although we expect that it is not peculiar to it, is that it requires two doses rather than one. In the fullness of time, that might change. The health secretary and I had helpful discussions late yesterday afternoon with the senior management of Pfizer, at which we discussed supply and what they might hope for in terms of development of the vaccine in the longer term. However, what we have right now is very welcome, and we are working hard to overcome any of the logistical challenges that are associated with its characteristics.

The first people have been vaccinated already today, and we will publish figures over the course of the coming days and weeks as the programme develops.

Last week, I was contacted by a 27-year-old constituent who says that he has now experienced symptoms of Covid for more than 40 days since his diagnosis. Although he says that his initial symptoms were mild, he tells me that he is now constantly fatigued, his smell and taste have left him and he is experiencing brain fog. As he was previously very active, that is having a major impact on his life. I have also spoken to a nurse from my constituency who was on the front line in the Covid wards in the earlier part of the pandemic and who is still suffering from long Covid after many long months.

Both of my constituents want to highlight the fact that the virus can affect younger people, but what they have asked me to raise today is the issue of support for those who are suffering. Is there any update on research and treatment guidelines to support people who are struggling with what has become known as long Covid?

The issue that Fulton MacGregor raises is a really important one, and it is a reminder of the fact that the virus does not affect only older people and does not result only in some vulnerable people, in particular, losing their lives; it can affect younger people, and it can do so on a long-term basis. We do not yet fully understand the issues and the factors behind what has become known as long Covid, but we all need to address that in the months to come.

The NHS already delivers care that is tailored to the needs of people who are experiencing long Covid across a range of specialisms. We are also working with the Scottish Intercollegiate Guidelines Network, the National Institute for Health and Care Excellence and the Royal College of General Practitioners to develop a clinical guideline on the persistent effects of Covid, which will be published shortly. That will support clinicians to better identify symptoms and any treatments that people need and might benefit from.

In addition, we have launched a call for research to improve understanding of the longer-term effects of Covid on physical and mental health and wellbeing. Thereafter, we will develop clinical interventions to better support recovery and rehabilitation. It is an area in which we all need to understand more, and there is no doubt that much will need to be done to address the longer-term impacts.

I want to share my concern about the handling of the decision regarding Edinburgh and the uncertainties that it has caused for businesses. I ask the First Minister to comment on how we can reduce the sources of virus transmission in the city.

Yesterday, Jason Leitch identified the issue of car sharing. Will the First Minister highlight the advice on car use? In particular, will she say what the advice is for employers who still expect staff to share vehicles even when staff are concerned about their personal safety?

We advise against car sharing whenever possible. Obviously, there will be circumstances in which it is necessary and essential, as is the case for travelling from one part of the country to another, but we advise against it.

We say to all employers that they should be very sensitive to the concerns of their staff. If staff have concerns about anything that they have been asked to do in their workplace, particularly if they are workers with health conditions or worries in that regard, employers should try to come to agreements there.

The virus transmits in a range of ways, but, to put it simply, it transmits when people come together. Therefore, hard though it is—this has been the hardest part of the whole process—what we have to do to get levels of the virus down is to reduce the circumstances in which people come together. Obviously, the enclosed spaces of cars and vehicles are one environment in which the virus may well take the opportunity to spread.

I very much welcome the fact that Glasgow is moving to level 3. If the worst came to the worst, would it be possible that Glasgow could go back to level 4 again?

I cannot rule out Glasgow or any part of the country having to go to level 4 for the first time or again. I would dearly love to be able to do that, but I cannot.

However, I know that, if all of us continue to follow the rules and the guidance and to do the really difficult things—to stay out of the houses of our friends and loved ones, to abide by the travel restrictions, to reduce our interactions with other people as much as possible and to not go into crowded places, especially when retail opens again in Glasgow on Friday—all of us, collectively, can mitigate and reduce the risk of Glasgow or any other part of Scotland going back to level 4.

We are making real progress at the moment, and I do not want that to be lost in our discussions today. When I stood here three weeks ago, we were really worried that the levels of infection were just not coming down in areas such as Glasgow. They have come down significantly. That is down to the sacrifices of so many people across the country. However, we need to stick with it. Today is an optimistic day, but we are not out of this yet. The more we stick with it, the fewer people will get the virus, the fewer people will die of the virus and the more of us will come out the other end of it—hopefully, sooner rather than later.

I apologise to those members I could not call, but we have to move on to the next item of business. There will be a short pause while members and ministers change seats.