Meeting of the Parliament (Hybrid)

Meeting date: Tuesday, November 16, 2021

Official Report 986KB pdf

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Covid-19 Update

The next item of business is a statement by Nicola Sturgeon, who will give a Covid-19 update. The First Minister will take questions at the end of her statement, so there should be no interventions or interruptions.

14:19  

I will give an update on the latest Covid situation and provide an assessment of the current course of the pandemic. First, though, I will give today’s statistics. Yesterday, 2,771 positive cases were reported, which is 12.8 per cent of all the tests that were carried out. There are 779 people in hospital with Covid, which is eight more than yesterday, and 57 people are receiving intensive care, which is the same number as yesterday. Sadly, a further 17 deaths have been reported over the past 24 hours, which takes the total number of deaths registered under the daily definition to 9,406. I again send my condolences to everyone who has lost a loved one.

More positively, the vaccination programme continues to make very good progress. I confirm that 4,331,574 people have received a first dose and 3,930,317 have now had both doses. In total, 88 per cent of all those over 18 are now fully vaccinated with two doses. In addition, 76 per cent of 16 and 17-year-olds and 56 per cent of 12 to 15-year-olds have had a first dose. Until now, only a single dose has been recommended for those age groups but, following yesterday’s updated advice from the Joint Committee on Vaccination and Immunisation, we are now preparing to offer second doses to 16 and 17-year-olds.

I will say a bit more about the progress of the booster programme later. However, it is worth pointing out that, on first, second and booster and third doses, Scotland is currently the most vaccinated part of the United Kingdom. That is down to the incredible hard work of everyone who has been involved in organising and delivering the programme, and I record my thanks to each and every one of them.

Today’s weekly update coincides with the latest three-week review point for the remaining Covid regulations, and I confirm that, at our meeting earlier today, the Cabinet agreed to keep the current regulations in place with no immediate changes. However, we also considered, although we have not yet reached final decisions, the possibility of future changes to the vaccination certification scheme. I will say more about that shortly.

The numbers that have been reported in recent days here in Scotland, which I will come on to talk about in more detail, illustrate the need for continued precautions, and so, too, does the challenging situation that is again being experienced across Europe. Several European countries are dealing with a sharp increase in cases. Infection rates in Germany have reached their highest level since the pandemic started. The Netherlands reintroduced some Covid measures last week and Ireland has done so today. Austria has just introduced extremely tough restrictions on people who are not fully vaccinated.

All of that is a reminder that Governments everywhere are grappling with the same issues and dilemmas as we are. The threats that are posed by Covid are still very much with us, even though they have been mitigated by vaccination, and the race between the virus and the vaccines has not yet been won. The situation here, in Scotland, also bears that out.

Before I give an update on the overall trends in Scotland, I will say a few words about the impact of recent events in Glasgow. I will reflect more generally on the 26th United Nations climate change conference of the parties—COP26—in a further statement to Parliament later this afternoon. However, while we cannot yet draw final conclusions, I confirm that there is no sign so far of any significant spike in Covid cases associated with COP26. Rigorous measures were put in place to minimise the risks of transmission. For example, everyone who entered the main summit site—the blue zone—had to provide evidence of a negative lateral flow test result.

Information that was published earlier today by Public Health Scotland suggests that, of the people who were officially affiliated with COP26, approximately four in every 1,000 tested positive for Covid through routine lateral flow testing. That contrasts with survey data for the Scottish population as a whole, which suggests that, last week, 12 people in every 1,000 had Covid. In total, since 15 October, 291 people with Covid across Scotland reported attending a COP-related event. That includes satellite meetings and demonstrations as well as the main summit. That represents less than half of 1 per cent of all those who tested positive for Covid over the past month and reported through test and protect.

All of that, at this stage, suggests that the mitigations that were put in place for COP26 were effective. I put on the record my thanks to delegates for their compliance, and indeed to everyone who worked so hard in the run-up to and during COP26 to secure the safest possible environment.

More generally, across Scotland, we have seen a gradual increase in cases over the past two weeks, from just over 2,500 new cases a day to approximately 3,000 a day at this stage.

It is important to note that that headline figure masks some distinct variation between different age groups. For example, cases among the under-60s increased by 14 per cent during the past week, and much of that increase was in people under the age of 20. By contrast, cases in the over-60 age group fell over the past week by 11 per cent. That is likely to be due, at least in part, to the success of the booster programme, which is, of course, prioritised among the older population. I will say more about that shortly.

The decline in cases among older people may also explain why, despite the overall increase in cases, the numbers in hospital with Covid have reduced slightly in recent weeks. Three weeks ago, 917 patients were in hospital with Covid; today, there are 779. The number in intensive care has also fallen—albeit very slightly—during that time, from 59 to 57.

However, all of that said, the number of patients in hospital with Covid is still extremely high. If cases continue to increase, notwithstanding the age profile, we are likely to see hospital admissions and occupancy start to rise again.

In addition, the national health service is currently treating people who are in hospital for care that had to be delayed by earlier Covid countermeasures. As we go further into winter, we can expect other seasonal pressures—for example, flu—to increase.

All of that means that the NHS is under extreme pressure. We continue to work closely with health boards to address and mitigate those pressures as far as we can.

The vaccination programme continues to be critical in reducing the direct health harm that is caused by the virus. A moment ago, I mentioned that the decline in Covid rates in older age groups and the fall in hospital admissions may well reflect the impact of the vaccine booster campaign. I can confirm that more than 1 million booster jags have now been administered. More than 70 per cent of people in the over-70 age group have now had a booster. We know that a booster jag significantly increases the effectiveness of the vaccine. That high level of uptake is therefore extremely important, and we will continue to push it up as far as possible.

The programme took a further step forward yesterday with the launch of the online booking portal. Everyone aged 50 to 59—together with unpaid carers and household contacts of the immunosuppressed, and anyone eligible for a vaccine who has not yet had an appointment—can now book online at NHS Inform. Since yesterday morning, more than 54,000 people have made online bookings, and more than 8,000 people have made bookings through the national helpline, which can be called on 0800 030 8013.

It is, of course, important to remember that boosters can be given only from 24 weeks after someone’s second jab; therefore, for many in the 50 to 59 age group, appointments will only be possible from December onwards.

It is also worth pointing out that people living in Orkney, Shetland, the Western Isles and the NHS Highland health board areas will not use the online booking system but will instead receive information direct from their health board about local arrangements for appointments.

As I mentioned earlier, the JCVI updated its advice yesterday. In addition to recommending second doses for 16 and 17-year-olds, it recommended booster jags for people in their 40s. I very much welcome that, and the Scottish Government will move to implement that new advice as quickly as we can. We continue to work with health boards to ensure that the overall programme is delivered as rapidly as possible.

However, it is worth taking stock of the situation as of now. This winter vaccination programme is the largest and most complex that has ever been undertaken in Scotland. However, since the first week of September, more than 3 million flu and booster jags have been administered, and take-up rates have been encouraging; that is providing vital protection as we head into winter. Once again, I am hugely grateful to everyone who is helping to get jags into people’s arms as quickly as possible.

I take again the opportunity to urge every single person who is eligible for vaccination—whether a first, second or booster or third jag—to please take up the offer without delay, and to get the flu jag, too, if they are eligible.

Getting vaccinated remains the single most important thing that any of us can do to protect ourselves, our loved ones and our communities. It is impossible to overstate how important it is to get vaccinated, so, if you have not already done so, please do so now. You could be saving your own life or the lives of your loved ones. You will be reassuring others, including those most at risk—some of whom have clinical conditions that mean that they cannot get vaccinated themselves. You will be helping those who are working in the NHS, and you will be maximising our chances of getting through the winter without the need to reintroduce any restrictions. In my view, choosing—without good reason—not to be vaccinated is deeply irresponsible. Getting vaccinated, on the other hand, is a civic duty and the most precious gift that we can give to others at this time.

The vaccination programme is, and will continue to be, the bedrock of our efforts to control Covid. However, other baseline mitigations remain in place, and they, too, are important. As I mentioned earlier, lateral flow testing appears to have been effective in limiting transmission during COP. That should remind all of us that those tests are an important way of detecting infection, particularly in those without symptoms, and therefore preventing onward spread.

I therefore again encourage everyone to take a lateral flow test at least twice a week—especially if you are attending events or mixing with people in other households. The tests can be ordered free through NHS Inform or collected from test sites and local pharmacies. Face coverings also continue to be a simple but important mitigation, and they remain a legal requirement on public transport, in shops and when moving around in hospitality settings. Please also continue to work from home when that is practical. I today ask all employers to look again at whether more workers could be supported to do more work from home over the winter period. Lastly, good ventilation is vital. If any of us are having people visit our homes, we should open a window, even slightly, to let some air flow through the room.

Within the public sector, we have taken significant steps to improve ventilation—for example, through funding for carbon dioxide monitors in schools. In September, we announced the establishment of a £25 million fund to help businesses to improve ventilation. That fund opens for applications next week. Businesses such as restaurants, bars and gyms will be able to claim back costs of up to £2,500 for measures such as the installation of carbon dioxide monitors or improvements to windows and vents. More information on eligibility has been published today on the Find Business Support website.

All those basic mitigation measures are important at this stage. However, some of them are also valuable long-term investments. For example, better ventilation will not only reduce the spread of Covid but will help to reduce the spread of other airborne viruses, now and in the future. There is an important point here that is worth stressing. When we talk—as many do these days—about living with Covid, it is important that we do not think of it as simply giving in to the virus. Instead, it is about making sensible changes that allow us to return to both greater normality and better health.

The final mitigation measure that I will talk about today is the vaccination certification scheme. It is the strong view of the Scottish Government that the scheme—together with the other measures that are still in place—makes an important and proportionate contribution to stemming Covid transmission. The value of certification is also recognised in other countries, many of which require certification for access to a much wider range of services than is currently the case in Scotland. Wales, for example, expanded the scope of its scheme yesterday, such that it now applies to theatres, cinemas and concert halls, in addition to the same range of venues as in Scotland.

The Cabinet discussed possible changes to the current certification scheme at our meeting this morning. We intend to take a final decision next Tuesday, in the light of the most up-to-date data. In the meantime, later this week, we will publish an evidence paper and consult businesses on the practicalities of implementation, should any changes be made. Although final decisions have not yet been reached, I will provide an update on the issues under consideration. I should also say that we provisionally intend that any changes that we decide to make to the scheme will take effect from 6 December.

When the scheme launched, on 1 October, we judged that it was not appropriate at that time—given the imperative to drive up vaccination rates—to include testing as an alternative to proof of vaccination. However, we indicated that that would be kept under review. We will therefore be assessing, in the coming days, whether, on the basis of current and projected vaccination uptake rates, we are now in a position to amend the scheme so that, in addition to showing evidence of vaccination to access a venue, there will also be the option of providing evidence of a recent negative test result. That is already a feature of many other countries’ certification schemes.

We are also considering whether an expansion of the scheme to cover more settings would be justified and prudent, given the current state of the pandemic. Again, let me stress that we have not at this stage taken a decision to extend the reach of the scheme. However, to allow us to engage openly with businesses in the coming days about the pros, cons and practicalities, I confirm that the kinds of setting that might be in scope are indoor cinemas, theatres and some other licensed and hospitality premises.

We would, of course, retain exemptions for people under 18, people who cannot be vaccinated or tested for medical reasons, people on clinical trials, and people who work at events or in venues that are subject to the scheme. Exceptions would also be retained for worship, weddings, funerals and related gatherings.

I will give a further update on that in next week’s statement. If we decide to propose any amendments to the regulations on certification, Parliament will have the opportunity to discuss and debate those amendments.

I am acutely aware that many businesses want us to remove mitigations—including certification—not extend or tighten them. I understand that. However, all our decisions are and must be motivated by a desire to keep people safe and to get through what will be a challenging winter without having to reintroduce restrictions on trade. We want—if possible—businesses to stay fully open over Christmas and through the winter, while keeping Covid under control. If an expansion of vaccination certification can help us to do that, it would be irresponsible not to consider it.

As the detail of this statement makes clear, and as the situation across Europe shows, the need to carefully manage this pandemic still deprives us of easy options. Although we hope very much to get through the winter without reintroducing further restrictions, as some other countries are now starting to do, we have a duty to keep proportionate options under review, and we will do so.

To assist with and give an insight into the factors that guide our considerations, we are today publishing an updated strategic framework, which covers in more detail many of the issues that I have summarised. One of the points that it reiterates is that all of us across society—individuals, businesses and other organisations—must continue to play our part in helping to curb the spread of the virus.

For that reason, cabinet secretaries are continuing to work with the Convention of Scottish Local Authorities, individual local authorities and businesses on the actions that we need to take to reduce transmission—preferably without additional restrictions.

I will close by reiterating what we can all do to protect ourselves and one another.

First, please do get vaccinated if you are eligible and have not yet done so. As I mentioned earlier, that includes going for a booster jag when you are invited. It is never too late to get vaccinated, and it remains the single most important thing that any of us can do right now.

Secondly, please test regularly with lateral flow devices. Devices can be ordered through NHS Inform or collected from local test sites and pharmacies. If you test positive, if you are identified as a close contact or if you have symptoms of the virus, please self-isolate and book a polymerase chain reaction—PCR—test.

Thirdly, please comply with the mitigations that are still in place. Work from home when that is possible. Wear face coverings in indoor public places—for example, when you are in shops, on public transport or moving about in hospitality settings. Wash hands and surfaces thoroughly.

Meet outdoors if that is possible. That gets harder through the winter, obviously, but it is the case that outdoor environments are safer than indoor environments. When you meet indoors, try to open windows—anything to improve ventilation will help.

All those precautions still make a difference. They will protect us and those around us, and they will help to ease the burden on our NHS. I ask everyone to continue to stick with them, and I thank everyone for doing so.

The First Minister will now take questions on the issues raised in her statement. I intend to allow around 40 minutes for questions, after which we will move on to the next item of business.

It is vital that everyone who can have the Covid jag goes out and gets it as soon as possible. The vaccine, including the booster jag, is our best weapon against the virus. That is why we have called for the reopening of mass vaccination centres, alongside the current local delivery programme, to ensure that we maximise opportunities for people to get their vaccine boosters. Will the First Minister agree to reopen mass vaccination centres, so that we can speed up the booster jag roll-out and protect people more quickly?

Today, the public were expecting a statement that delivered clear decisions. We all were. That was the message that the Deputy First Minister was sent out to give the Parliament last week. Instead, we are being told once more to wait until next week. The Government has delayed again, thereby creating wholly avoidable uncertainty.

Businesses are, once again, being left in the dark and are being treated as an afterthought. They might have less than two weeks to adapt to changes to the vaccination passport scheme at one of the busiest times of the year for the hospitality industry. That has a big impact on staff, too. The Government is showing a total lack of respect for Scottish businesses, which the Scottish National Party expects to shoulder the costs of its vaccination passport scheme.

Last Tuesday, the Deputy First Minister said that the Government would

“discuss options with business sectors in the course of this week.”—[Official Report, 9 November 2021; c 11.]

Can the First Minister give a clear answer and tell us the outcome of those discussions over the past week? The Government must know who might be impacted, so let me ask the First Minister the same question as I asked the Deputy First Minister last week. To which businesses, exactly, is the Government still considering expanding the vaccination passport scheme? She mentioned in her statement “some other ... hospitality” venues. Which hospitality venues will have to prepare for that added burden?

The First Minister has just said:

“We want—if possible—businesses to stay fully open over Christmas”.

We know that the Government wants to keep its options open, but will the First Minister be clear for Scottish businesses and the jobs that depend on them? Does that statement mean that the SNP Government is considering closing businesses and premises over the winter months?

It pains me to say this, but Douglas Ross’s immaturity and irresponsibility in the face of the virus continue to be utterly breathtaking. I know that he has had other things on his mind in recent days, but is he oblivious to what is currently happening across Europe, where the virus is on the rise again and Governments everywhere are, once again, having to grapple with the most difficult decisions? We are seeking to do that in a responsible way. That is what we have done throughout, and we will continue to do it in the period ahead.

Two particular issues were raised. The first was vaccination. We are organising the current phase of the vaccination programme in the way that makes best use of resources and vaccinates people as quickly as possible. One of the things that I have learned in recent weeks is that, whatever we decide to do, Douglas Ross will probably oppose it. When we introduced a vaccination programme for younger teenagers that was not principally school based, that was criticised, but it turned out that we managed to vaccinate those younger teenagers more quickly than any other part of the UK did.

In respect of every dose of the vaccine, Scotland is right now the most vaccinated part of the UK. We are not complacent about that. We continue to press to speed up the vaccination programme every day, although the programme is going extremely well. Perhaps, once in a while, Douglas Ross could find it within himself to thank those who are working so hard across the country to ensure that people are vaccinated.

On Covid certification, it is simply not an option right now for any Government across Europe or much of the world to do nothing in the face of the virus. The easiest thing, of course, is to oppose everything that Governments decide to do to try to keep people safe. Douglas Ross bemoans the fact that the Cabinet has not taken a final decision yet. If I had stood up today and said that we had taken a final decision to expand the reach of the certification scheme, he would, of course, have criticised that and said that we were acting too quickly and that we were not taking account of up-to-date data.

We have decided to consider the matter carefully, to take account of up-to-date data and to reach a decision next week. In the meantime, we will publish an evidence paper and consult businesses on the practicalities and the pros and cons. We will decide which businesses might be affected on the basis of the data and the evidence. In order to give people an update on what we are considering, I have set out today the sectors that we are considering. People need only look around the UK—there is such a scheme in Wales, and Ireland is extending its Covid certification scheme—and to many countries across Europe to see that most Governments are grappling with the same difficult decisions.

The easiest thing in the world right now, as Douglas Ross has found out, is to oppose everything. However, when we have a duty, as the Government does, to try to keep people safe, the decisions are harder than that. We will continue to take them with an intense degree of responsibility.

I start by offering my condolences to all those who have lost loved ones and by recognising all those who continue to put in every effort on the front line to keep us all safe. I urge the Government to do more than just applaud and thank those people—it should recognise them and reward them when they come forward with pay disputes.

The Government has still not fixed the tools that it already has but is instead now considering expanding a system about which the Deputy First Minister has said that he has no evidence that it is reducing cases of Covid. The vaccine works: it reduces hospitalisations, death rates and cases of long Covid. However, it does not prevent people from getting the virus or from spreading it.

In her statement, the First Minister said that lateral flow testing helped to reduce transmission at COP26. She had been arguing the opposite in relation to the vaccination passport scheme. At every point in the process of developing vaccination passports, we have argued the importance of a negative test. Every scheme that the First Minister mentioned in her statement and response includes use of a negative test.

The First Minister should accept that she got it wrong and admit that testing should always have been at the heart of our Covid reduction strategy. She should also commit today to including a negative test in any reformed or expanded scheme, to engaging meaningfully with the sectors that will be impacted, to sharing evidence, to considering the practicalities and to providing a financial package that prevents businesses from going under and people from losing their jobs.

On rewarding those who have worked so hard in our national health service, I would dearly love to be a position to give them a higher pay rise than we have given. We will always seek to maximise that. However, it is important to put on the record that, this year, NHS agenda for change workers in Scotland are receiving the highest pay increase of any NHS workers in any part of the UK, including where Labour is in Government. Perhaps we should judge the Labour Party on what it does rather than on what it says.

The issue of inclusion of a negative test in the vaccination certification scheme is a finely balanced judgment. When we take a decision to introduce a scheme with the express objective of using it, at least in part, to drive up vaccination rates, it makes no sense to have an alternative to vaccination as an initial part of the scheme. It can be argued that our being currently the most vaccinated part of the UK is, at least in part, down to our vaccination certification scheme, which has helped to drive vaccine uptake.

There comes a point at which our consideration must change because we make a judgment that we have already got all the gains of increased vaccine uptake and can therefore move to include LFD tests. I understand the importance of LFD tests as part of a package of measures. That is why, every week as I stand here, I talk about the importance of those tests.

We have made judgments carefully up to now. We will not always get judgments right, but we will continue to make them responsibly and to take account of all of the evidence. As I said in my statement, we will publish an evidence paper this week. We will continue to talk to businesses and we will continue to arrive at the difficult decisions as carefully as possible.

I know that the Opposition parties want to say that we need to do nothing, and want to oppose everything that we put forward. That is an easy option. However, in Government, there are no easy options, particularly in the face of a global pandemic.

If any proof were needed that vaccination certification is unnecessary and that there are better alternatives, it can be found at COP26. The First Minister just said that it was the safest possible environment. Using daily LFD tests, attendees were three times less likely to test positive for Covid-19 than the general population, in which vaccination certification is at large.

We know that LFDs are superior to vaccination passports in two significant ways. First, they provide an on-the-day snapshot of someone’s Covid status, rather than their vaccination status. That helps venues to ascertain who is sick and who is well. Secondly—and, perhaps, most important—it prevents the need for people to pass part of their medical history or evidence of recent treatment to someone who is not their clinician.

A mixed bag or combination of the two schemes will not cut it. Will the First Minister abandon vaccination certification entirely and instead build a scheme around lateral flow testing?

No, I will not, because my duty to keep the population of Scotland as safe as possible means that I cannot take the easy options that Alex Cole-Hamilton puts forward.

He misunderstands the package of mitigations that were in place at COP26, for which one of the protections was that delegates were asked to be double vaccinated before they arrived. We offered vaccination to people who were coming from countries where that was not available, and LFD tests were an additional precaution. It is easy to be selective, but it is better to look at the whole package of measures that were in place.

In relation to the wider issue, when there is a scheme that is partly about driving up vaccination rates, it makes no sense to offer an alternative to being vaccinated, because that undermines the objective of the scheme. That is important. Although they are hugely effective, vaccines have limitations. LFD tests are effective but also have limitations.

We need to use all the tools that are at our disposal to drive Covid rates down as far as possible and to keep people as safe as possible. That is the obligation and responsibility that the Scottish Government will—even when it means taking unpopular decisions—continue to take seriously every single day that we are in the pandemic.

A significant continuing impact of the Covid pandemic is the restriction on face-to-face meetings with general practitioners, which is impacting on people in my Cowdenbeath constituency and across Scotland. Can the First Minister advise what steps are being taken to improve patient access to GPs and whether the need for the current 2m infection control requirement in healthcare settings will be kept under review?

Our recovery plan includes working with GPs to restore face-to-face consultations and surgeries. Public Health Scotland has published updated guidance for primary care settings that covers key issues such as physical distancing, which is now 1m not 2m, access for patients and wider infection prevention and control. That will be kept under review.

We aspire to return to a greater availability of face-to-face appointments, but a number of patients will wish to continue with phone or video consultations. Where clinically necessary, the option to have a face-to-face consultation should always be available. Our winter funding package, which includes funding for accelerated recruitment to aid general practice, will help to increase NHS and social care capacity over the winter.

In her statement, the First Minister recognised the substantial concern that exists in the business community about any extension of the vaccination passport scheme when some hospitality businesses are already reporting a 40 per cent loss of trade. Other businesses could face a similar loss of trade and additional costs for providing extra staffing with just two weeks to prepare for changes. If the Scottish Government goes down that route, will it provide a package of additional financial support for affected businesses, which is already badly required?

We will continue to consider additional financial support as necessary; in fact, I have just confirmed additional financial support on a different issue to enable businesses including bars and restaurants to improve ventilation. We will continue to look favourably at any argument that is made for that.

Murdo Fraser and others have to be careful with the argument that trade being down is a reason not to take measures to make settings safer. I appreciate that this is not a unanimous view, but I have spoken to many people who say anecdotally that the reason they are not going back to pubs and restaurants is that they do not yet feel safe enough, and that people’s vaccination records being checked would make them feel safer and more likely to go back. There are arguments in both directions on the issue.

I understand how difficult it is for hospitality, the tourism trade and other sectors that have been badly affected, but the key to getting back to normal is keeping Covid under control and building people’s confidence to start going back to normal life. We have to use every tool at our disposal to do that.

A number of constituents have contacted me to raise concerns about the lack of access to general dental practitioners for all but emergency treatment and the fact that such treatment is often framed around minimum interventions. People moving to Carrick, Cumnock and Doon Valley have also had issues registering with a dentist. When will general dental practices resume more routine services?

From early November last year, when the full range of care and treatment was made available, we have been working to increase patient access to NHS dentistry. That has included additional funding for ventilation and improved dental drills.

We are in discussions with the British Dental Association to support dentists and put patients at the centre of building a sustainable NHS service. From February, we will bring in enhanced fees for a range of treatments, including a more comprehensive examination, supporting NHS dental teams to clear the backlog in routine care that built up during the pandemic. We have already provided £58 million of financial support, plus an additional £35 million-worth of personal protective equipment, to ensure that dental services can emerge well placed to care for patients across Scotland.

A constituent contacted me after the instructions with a lateral flow test kit advised her to record the results through an NHS Scotland website. The UK Government website sends confirmation of her result within minutes, but my constituent discovered that the Scottish website can take up to 24 hours, which is useless when they require confirmation on the same day as the test in order to visit loved ones in a care home. Why are the wait times for the Scottish website so long? Is there a need for a separate Scottish system when the UK Government system works?

I am genuinely more than happy to look into that in a bit more detail. The advice for people doing LFD tests is for them to record the results of those tests through the UK website—I have been doing that myself every day for the past couple of weeks and I do it regularly. That is the advice, so I am not exactly clear what website is being referred to, but, if the details can be passed to me, I am happy to look into that and provide any further information and advice once I have had the opportunity to do so.

Aberdeenshire’s Covid case numbers are some of the highest in Scotland at the moment. What Government support is being given to the local authority and health and social care partnership as they try to mitigate any staff absences in schools, nurseries and care facilities and ensure the continued delivery of public services?

I certainly recognise the impact of the current situation in Aberdeenshire and other areas. We have made available to local authorities significant resources specifically for challenges such as those narrated by Gillian Martin. In schools, for example, we have provided local government with more than £200 million of additional funding over the past two years specifically for the recruitment of more school staff to support education recovery; Aberdeenshire received around £12 million of that funding. Our guidance for schools and early learning centres, including on at-home asymptomatic testing, is contributing to keeping transmission rates among staff low.

In all settings, adherence to mitigations makes a difference and everyone has a part to play in continuing to minimise transmission.

Several constituents continue to contact me about confusion around the booster roll-out in mainland Argyll and Bute, which comes under NHS Highland. People have received letters inviting them to attend vaccination centres that either are nowhere near them or do not exist at all, leading to considerable distress, particularly for older and vulnerable people, who are unsure where and when they will receive their booster. Given the importance of the vaccine booster campaign, will the Government act immediately to sort that out?

I know that officials have been talking to Argyll and Bute in the past day or so to resolve some of the issues that have been experienced. I will ask the health secretary to write to the member with an update following those discussions.

Will the First Minister provide an assurance that, should it be deemed necessary to introduce measures such as an extension of mitigations or vaccination certification to avoid the kinds of restrictions that are being seen in Austria and the Netherlands, that will be done with as much notice as possible, guidance for venues to support the implementation, and continued engagement with affected sectors to understand the impact of any changes? [Interruption.]

“Not with her”—he is a charmer, the leader of the Opposition.

The answer is yes, we will continue to discuss with individuals, businesses and other sectors the very difficult options that will lie ahead of us if we continue to see Covid cases rise over the winter period.

Across Europe and in parts of the British isles, we are seeing the emergence of another very challenging situation. One of the lessons that we have learned throughout this pandemic is that often we have to take very unpalatable decisions in order to stop a situation deteriorating. The earlier we act to, for example, increase compliance with the basic mitigations that are in place, and do things such as improve ventilation, the more chance we have of avoiding some of the measures that we are seeing in countries such as the Netherlands and Austria, and, as we have seen even today, in Ireland, much closer to home.

If we all step up our compliance with basic mitigations, recognise the vital importance of vaccination and get vaccinated as soon as we are able to do so—which measures worked during the previous peaks that we experienced in recent weeks—I hope that we will be able to get through the winter without having to reimpose any further restrictions. That is the Government’s aim, but no responsible Government minister could stand here, in the face of a pandemic, as we go into another winter, and give empty promises about what might or might not be possible. Our solemn duty is to act in a way—however unpopular it might be—that keeps the country as safe as possible, and that is what we will continue to seek to do.

Previously, I asked about flu vaccinations for those who are not prioritised for the Covid booster but are normally eligible for the flu vaccine. The NHS Inform website gives no information about how someone can get their flu vaccine if they are not in one of the Covid priority groups and are in an age group for which the JCVI has not approved a booster. How can those who are susceptible to flu get their vaccine?

It is possible to book a flu vaccine. I will ask the health secretary to write down and put into the Scottish Parliament information centre the detail of exactly how to do so, because we want to ensure that people fully understand the process.

For those in priority groups for the booster campaign, we are advising that, where possible, they get their flu vaccine and booster at the same time, which is better for them and allows us to get through the programme even more quickly.

For those whose booster will not fall due until later this year, which is the category that I am in, the advice is that it is safe to wait to get the flu vaccine at that time, in order to get both together. NHS Inform provides further information and advice.

With regard to those who are not in the priority categories for the booster, but are eligible for the flu vaccine—and there is a significant overlap between the two categories of eligibility—I will ensure that the health secretary provides information for the benefit of constituents about how stand-alone flu vaccines should be accessed.

I have been contacted by constituents who are past the six-month guidance date for their Covid-19 booster vaccination and are concerned about the waning efficacy of their primary vaccine doses. Has the Scottish Government received advice from clinical advisers on the efficacy of the primary vaccine protection, and what reassurance can be given to those who are awaiting booster appointments? I remind members that I am part of NHS Dumfries and Galloway’s vaccine team.

The JCVI advice is that the vaccine booster should be offered no earlier than six months after the completion of the primary vaccine course, which means no earlier than six months after a person has the second dose. As, I think, I have said previously in the chamber, the Scottish Government is interpreting that as 24 weeks. By the time that the JCVI advice was received, many people had already passed the six-month—24-week—period, so we are in a catch-up situation. However, the catching up is going well and we continue to do it at pace.

The advice from clinicians is that the immunity from the primary course does not suddenly fall off a cliff when someone gets to the six-month point, but there is concern about gradual waning. Therefore, we want to get the boosters done as quickly as possible, which is what the programme is working hard, and successfully, to do.

My constituents are having problems in accessing vaccine boosters and the passport. For instance, if a constituent has had one dose in England and one in Scotland, I have been advised to tell them to update their address with their old vaccination centre in England in order to have their Scottish status updated. Constituents who have been vaccinated in Northern Ireland have been told to follow the advice for foreign vaccinations, and others who have been fully vaccinated in other parts of the UK cannot get their vaccine boosters because NHS Scotland does not hold the details.

Will the First Minister say what the Scottish Government is doing to fix what is an opaque and confusing system for many of our constituents?

I am happy to do so, and I will ensure that the health secretary writes to the member.

It is entirely my fault, but I am not sure that I was following all the examples that the member put to me. It is important that people understand what to do in all circumstances, such as when someone has had one dose in England and another in Scotland or when they are having their booster somewhere else.

There is a portal whereby people can update their vaccination certification, but, to ensure that we give clear information on what people should do and to ensure that I am answering the question properly and in full detail, I will answer in written form. As I said in a previous answer, I will also put the information in the Scottish Parliament information centre.

All medical advice has indicated that the transmission rate, including the number of people who are unfortunately in hospital, is higher among people who have yet to receive the vaccine. As we head into the winter months, will the First Minister elaborate on some of the concerns that clinical advisers have about the pressures that the NHS will face if the trend continues as it is?

That is a really important factor in all our considerations. As we all know, the NHS is working under extreme pressure right now—possibly the most extreme pressure that it has faced in its entire history. Much of that pressure comes from Covid. However, the NHS is also working to catch up on the backlog of care caused by earlier restrictions.

The combination of events—before we are properly into a possible flu season—means that we are likely to see significant pressure on the NHS over the whole winter. We know that the more Covid cases there are, the greater the pressure will be. People who are not vaccinated are at greater risk of getting the virus and becoming seriously ill from it. One of the things that we all can do to try to reduce the pressure on the NHS is get vaccinated with our first and second doses if we have not done so already, and, when we are able to, with our booster dose.

If cases rise, as they are doing gradually at the moment, notwithstanding the variation in the age profile, hospitalisations will increase as well. As the pressure on the NHS is already so acute, that would be a seriously concerning development. Vaccination is one of the things that we all can do to try to ease that pressure as much as possible.

The updated Covid strategic framework emphasises the importance of testing and anticipates a significantly increased demand on testing capacity this winter. Will the Scottish Government provide assurances that sufficient testing resources are in place to meet demand over the coming months?

Yes. We work hard every day to show that the capacity exists. We also work with the UK Government, given the fact that much of our testing capacity—not all of it—is delivered through the four-nations Lighthouse programme. Those issues get close attention from the Cabinet Secretary for Health and Social Care, me and the Government as a whole every day.

I ask the First Minister whether autism is classed as a neurodisability. If so, will young people on the spectrum who are aged between 12 and 16 be invited for a second vaccination?

The JCVI has already advised that children and young people aged 12 to 17 who are at an increased risk of severe Covid infection should receive a full course of vaccination. That means two doses. Eligibility covers severe neurodisabilities, including autism, and vaccination is already being offered to that cohort.

At present, a Covid booster vaccination record is not available to people who wish to travel to certain countries that have recently imposed a 270-day limit on post-second vaccination travel. In effect, that means that people who had received both vaccinations by the spring of 2021 will be denied entry to those countries despite having had the third vaccination.

My understanding is that, currently, NHS Scotland cannot provide evidence of a third vaccination, which is becoming increasingly important for international travel. If that is the case, will the First Minister commit to resolving the issue as a matter of urgency?

Unless I am wrong—in which case, I am sure that it will be pointed out—the position in Scotland is the same as it is in other parts of the UK right now. We are currently looking at how we incorporate booster vaccinations into the app and vaccination certificate. Indeed, we discussed the issue at Cabinet this morning. Steps will be taken to ensure that people are not disadvantaged, particularly for international travel, for which we are dependent on other countries’ requirements, and that the benefits of booster vaccinations are properly reflected.

I have been contacted by a constituent who will soon travel to Austria. To do so, they require proof of their vaccination or booster vaccination within nine months before entry. Will the First Minister expand on vaccine boosters being recorded on vaccination status records and the NHS Scotland app?

As I said in response to the previous question, we are committed to adding boosters to vaccination certificates and we are considering the steps that must be taken to do that. It is important to point out the additional piece of information that there is no international standard on how to display booster information on vaccination certificates, and work is under way to develop the appropriate systems to meet the requirements.

Until we have an international standard, there is no guarantee that any solution will be accepted in all other countries. It is important to do this in the proper way. In the interim, any individual who is looking to travel should check what is needed for entry into the country that they are to visit. We will provide updates on progress to incorporate booster vaccinations regularly and as soon as possible.

The Scottish Government confirmed on 8 November that, as of 15 October, 40,768 ventilation inspections had taken place across learning, teaching and play spaces. The First Minister has—rightly—confirmed the importance of ventilation. How many of those spaces failed the inspection under the Government’s criteria? What does the First Minister expect to happen to spaces that failed?

We provided funding for local authorities to inspect and assess the quality of ventilation and to take any follow-up steps. I am happy to write to the member about the detail, to the extent that we have it—information about the outcome of assessments is held by local authorities. To ensure that the assessments were done, we provided funding for carbon dioxide monitors. I know that all local authorities have taken seriously the need to improve the quality of ventilation in schools and early learning centres.

People—including some who have loved ones in hospital with Covid—have recently expressed their frustration at seeing the Prime Minister with no mask on in a hospital. What is the Scottish Government doing to ensure that people understand the importance of adhering to guidelines—regardless of their vaccination status—particularly in the winter months?

Yesterday, we launched the next phase of our marketing and communication programme to support compliance with the baseline measures that are still in place, including wearing face coverings, to reduce the harms that Covid causes. I say to everybody that, as we go into winter, it is important that all of us try to increase our compliance. All of us slip up from time to time on such things, and I understand how tiresome and inconvenient the measures are, particularly after so long. However, as we go into winter, wearing face coverings and reminding ourselves to do so is important. I will do that and I call on everybody to do likewise.

The First Minister told Parliament that she would listen to businesses before introducing Covid vaccination certification, but she did not. Now she is considering extending the scheme. We learned this morning from a survey of 700 businesses conducted by the Scottish Chambers of Commerce that one in four Scottish businesses will face immediate financial peril if Covid restrictions are expanded. Will the First Minister confirm that, if businesses respond with a resounding no to her creeping plans—the Scottish Chambers of Commerce has done that and has called such a move a giant step backwards—she will abandon any extension of the scheme?

We listen and will continue to listen to businesses, which are an important voice but not the only voice. I also have a duty to listen to those who work in the front line of our national health service, who say that we need to do as much as we can to reduce the risks of Covid transmission, and I need to listen to people across the country who want to go back to pubs and restaurants but want to feel safer before they do so, particularly when transmission rates are rising. I must also listen to those who are particularly clinically vulnerable, who want to feel safe when they go about their normal lives.

That is one of the difficult things, but I accept that part of the responsibility of taking decisions—as opposed to deciding on a position and sticking to it—is that we must take account of and listen to a range of views and come to a balanced, sensible and responsible decision. Businesses are an important voice, but we must take account of the wide range of considerations and factors that lead to the decisions that we take in what is an inherently difficult and complex set of circumstances.

This morning, a concerned constituent of mine whose daughter has Covid contacted me about a potential flaw in the Scottish contact and trace system. She received a text, which said:

“You will be sent a link to a digital self-tracing form ... to list close contacts”.

When the link did not appear, my constituent chased up the matter. She was then told that she might not receive the link and that she would be contacted by a contact tracer. That, too, did not happen.

My constituent called test and protect, which admitted that there is a problem with sending text messages with links to the contact tracing forms. Does the First Minister agree that that is a dangerous shambles that must be urgently addressed?

No, I do not agree. In fact, I think that that is an insult to all those who are working so hard in test and protect across our country.

I am happy to look at the individual case—it certainly sounds as though something has happened that should not have happened. If that is in any way indicative of a more systemic issue, we will take that on board and seek to address it. I ask the member to send me the details.

The people across test and protect are working really hard every single day. The contribution of test and protect in helping us to keep Covid under some control at this stage is enormous. I end my answer by placing on record again my grateful appreciation for all that test and protect is doing.

That concludes the First Minister’s Covid-19 update. There will be a brief delay before the next item of business.