1. To ask the Scottish Government what its response is to recent figures showing that Scotland’s daily Covid-19 cases are at a four-month high. (S5T-02386)

As we remove restrictions from the lockdown period, we expect to see an increase in the number of positive cases, because the virus has not gone away. As we are freer to go about a more normal life, the virus is freer to move about, too. We see that here, in the rest of the United Kingdom and across Europe.

That is why our public health messages, including FACTS, are so important, and it is why, in addition, we make sure that our test and protect system and our local public health teams are resourced to the levels that we need, and are in place to act on any cluster or outbreak. Last week, our proximity app went live, and there have been 950,000 downloads to date.

The objective remains the same—to suppress the virus to the lowest level possible. Alongside that, we continue monitoring to ensure that protective and preventative measures in care homes and the care and health sectors remain in place.

In the past few days, there have been a number of worrying developments with regard to Covid-19. Daily cases have hit a four-month high, there was a rise in the number of positive cases in care homes, and Scotland’s reproduction number and Covid growth rate are now the highest in the UK. We cannot afford to risk Scotland’s response to the virus going off track. Given those developments, will the Scottish Government now implement additional measures, such as mass community testing, airport testing and home testing kits in schools?

All those measures are continuously reviewed by our chief medical officer’s clinical advisory group and, for example, by the clinical and professional group that works with us on care homes.

I have obviously read his news release; I need to correct Mr Cameron. In the past seven days—from 7 to 13 September—none of the cases in care homes were care home residents. In terms of the other measures that he has asked about, such as airport testing and mass testing, I want first, along with my colleagues in the UK Government, to make sure that the current UK testing system, of which we are part, is working as efficiently as we require, and at the speed that we require, before we consider adding pressures to it.

The efficacy of, and the clinical guidance on, widening the groups that we test is constantly being considered by the CMO advisory group, as was outlined in the updated testing strategy that we published in August.

The Cabinet secretary is right to say that testing is essential if we are to tackle the virus. I will ask her about testing in Scotland by national health service boards, given the ultimate responsibility that her Government has for the NHS. What is the Government doing to increase the testing capacity in NHS Scotland, especially in the light of the developments that I mentioned and the possibility of a surge in cases over the winter?

The capacity that is controlled by the NHS boards in Scotland, and, through them, by the Scottish Government, also includes capacity in our academic nodes. We are quickly putting in place arrangements to cover the difficulties that the UK network of Lighthouse labs is currently facing, including interim arrangements that involve use of some private labs.

We are also scaling up to create three regional hubs from October, although we are looking at whether we can introduce some of the additional capacity later this month, and therefore earlier than October.

The reason why we are doing all that is, in part, because it is what we committed to, but it is also to ensure that there is significant additional resilience in the testing programmes that contribute to protection of the people who are most vulnerable. That includes care home testing; we have already begun to transition care home worker testing away from the Lighthouse labs to our NHS labs, so that we can be more confident about the speed of turnaround and more in control of the system. We will continue and complete that migration, so that all care home worker testing is run through the NHS labs.

That also includes testing of NHS workers in healthcare areas that have been initially designated as requiring testing for staff in order to protect the most vulnerable patients.

Finally, I did not answer Mr Cameron’s earlier question about the R number. I hope that we are all watching the First Minister’s daily briefing. Those who do so will hear her make the point—as the chief medical officer and our national clinical director have done—about understanding the importance of the R number in and of itself, particularly when we have low prevalence. We still have low prevalence across Scotland, so the R number is important but is not the only factor. There are several other factors to consider, all of which are published weekly by the NHS and the Government.

As the number of cases and the R number are rising, thousands of families, such as mine, are very worried about what that means for visiting loved ones in care homes. At the moment, we are reduced to one visit a week—outside. That is very undignified, both for the person who is being visited and for the family, because it is cold, wet and windy. I plead with the Cabinet secretary to move forward on this and to allow families to meet their loved ones in a dignified setting. What is going on just now cannot continue into the autumn and winter.

I will make a couple of points in response. First, I completely share the sentiment that Mr Findlay’s question expresses. I am constantly concerned about striking the balance between protecting residents in care homes from the virus and recognising that some of the measures that are taken to do that are harming them and their families, particularly in relation to family contact, residents’ cognitive functions and so on.

Right now, it is possible for care homes to have indoor visiting by a designated visitor. There are certain criteria that the care home needs to meet. It must have been Covid-free for 28 days and participating in the weekly test programme, and it must have a plan that shows that it has everything in place, including the right number of staff, available personal protective equipment, provision for taking details and so on. If the care home has all those things, the local director of public health will sign off that plan and indoor visiting can take place.

That is the case largely because I completely recognise that, on a day like this, an outdoor visit is not the kind of visit with their loved one that people want, and that if a loved one in a care home has dementia, window visiting does not work very well because they might not recognise the visitor through the window.

I assure Mr Finlay that we are looking constantly at what else we can do to normalise the situation in our care homes, which are, at the end of the day, individuals’ homes. The clinical and professional advisory group is looking again at what more we can do as we enter winter to strike a better balance between family and visitor contact for residents, activities for residents and healthcare services for residents, and protecting them from introduction of the virus into their homes.

Constituents have contacted me expressing their frustration that they cannot download the Protect Scotland app because their phone is not the latest model or they do not have the latest software. Those people still want to do their bit. Is the Scottish Government working to include people who currently find themselves unable to use the app on their mobile phones? Will the Cabinet secretary confirm that anyone who is unable to download the app will still be contacted by the test and protect service if they come into contact with someone who tests positive and is unknown to them?

On the latter point, if someone who tests positive has come into close contact, for more than 15 minutes and closer than 2m, with someone whom they do not know, the only thing that they can do is to give information to the test and protect team and tell them where that happened—it might have been in the shop or on a bus—and the team will try to track that individual down. That is why the app is very useful, and is in addition to the test and protect programme.

The people who have developed the app, along with colleagues at Google and Apple with whom we have been working, are working to ensure that we can add functionality so that individuals with older phones can download it. When we get progress in that area, I will ensure that Beatrice Wishart and, indeed, all members are aware of it.

The Cabinet secretary touched on the interim arrangements to help the UK Government. Will she give further information on the discussions with the UK Government regarding the capacity for processing Covid-19 tests and whether progress has been made on finding a long-term solution?

Members will be well aware that the Lighthouse lab in Glasgow is part of a network of UK-wide Lighthouse labs. People book tests through the UK portal and are asked to go to a mobile testing unit, a regional testing centre or one of the new walk-through centres, the second of which will open in Glasgow at the end of this week.

In relation to our agreement with the UK Government, the Glasgow Lighthouse lab should, as a minimum, give access to tests that are taken in Scotland at a level that is based on our population share. The figure fluctuates day to day, but it is anywhere between 13,000 and 14,000. On the basis of the information and data that we get, that meets the demand from those routes on most days. There have been a couple of days—when schools went back, for example—when the system was stressed above that level, but that level should be sufficient, provided that we have in place all the other facilities that I have just talked about.

However, in recent days—from about the middle of last week to now—there has been a growing backlog of tests in the Glasgow Lighthouse lab, because the network as a whole is being stressed by significant additional demand outwith Scotland. The Glasgow lab is part of that network. Care homes and others have raised the issue, which is why we are moving care home tests out of that route and into NHS labs.

I was in contact with Matt Hancock over the weekend. Our discussions were about not constraining the number of sample slots that people could access over the weekend. Yesterday, I and then the First Minister were in contact with Matt Hancock and Dido Harding about the arrangement, and we looked at measures that could be put in place to get rid of the backlog while not creating a new one. Their officials and our officials are busy working on what such measures could be, and on how we can be assured that we have, as a minimum, access to a level of capacity in the Glasgow Lighthouse lab that is based on our population share, as the memorandum of understanding says.

Parallel to that, there is the work that I touched on earlier on scaling up the testing processing capacity that we have at our own hand through regional hubs, the academic nodes and our own laboratories.