I will set out to Parliament details of the updated strategic framework on tackling Covid that the Scottish Government is publishing today, and I will give an assessment of the current state of the pandemic. I will also set out our initial priorities and an indicative timeframe for cautiously easing restrictions and restoring greater normality to our lives, just as quickly as it is safe and sustainable to do so.
First, though, I will give a brief summary of today’s statistics. The total number of positive cases that were reported yesterday was 655. That is 4.8 per cent of all tests carried out, so the total number of cases is 198,839. Currently, 1,076 people are in hospital—65 fewer than yesterday—and 93 people are in intensive care, which is six fewer than yesterday. However, I regret to report that in the past 24 hours, a further 56 deaths were registered. The total number of deaths, under that measurement, is now 7,006.
As the Moderator of the General Assembly of the Church of Scotland has just reminded us in his time for reflection, behind every one of the statistics is a life and a name—the moderator’s father-in-law, Mickey Wiley, and thousands of other names beside. Again, I send my condolences to all those who have lost a loved one.
I will provide a quick update on vaccinations. As of this morning, 1,465,241 people have received a first dose of the vaccine, which is an increase of 19,753 since yesterday. That means that almost a third of the adult population in Scotland has received a first dose, which is extraordinary progress. The headline number includes virtually everyone in the top four clinical priority groups that were identified by the Joint Committee for Vaccination and Immunisation—a milestone that is already saving lives.
We are also well on the way to reaching everyone in group 5. As of today, 82 per cent of people aged 65 to 69 have had a first jag and, as of this week, we are offering first doses to people in priority group 6. Group 6, which includes unpaid carers and people with underlying health conditions, makes up more than a fifth of the adult population.
As we anticipated, the daily rate of vaccination has slowed in the past week, due to a temporary dip in supply, the higher than expected uptake so far and the need to reserve stock so that second doses can be offered to people who received a first dose in December. However, as supplies pick up again, the rate at which we are offering first doses will accelerate once more. Indeed, if supplies allow, we will now aim to reach key vaccination targets earlier than previously planned.
Our intention, supplies permitting, is to have offered first doses to everyone on the JCVI priority list by mid-April. That includes everyone over the age of 50 and all adults with underlying health conditions, and it accounts for more than half of Scotland’s population. Beyond that, again assuming that we receive adequate supply, we will aim to have offered first doses to the entire adult population by the end of July, rather than September as we previously anticipated.
Our confidence in our ability to achieve that is testament to how the vaccination programme has progressed so far. I want again to thank everyone who has been involved in planning and delivering the programme, and everyone who has come forward to be vaccinated.
I also want to say a few words directly to people who are on the shielding list. They have all been offered a first dose, and the vast majority of them have had one. I know that some in that group are uncertain about whether being vaccinated changes the advice to them. Unfortunately, it does not do that yet. At the moment, we are advising all on the shielded list—whether or not they have had their first dose—to keep following the advice that the chief medical officer sent in recent letters. Those letters, and other information, are available in the shielding section of the mygov.scot website.
The chief medical officer’s advice means that anyone who is on the shielding list and lives in part of Scotland that is currently in level 4—that, of course, includes the whole of mainland Scotland—should not go into work, even if they have had one dose or, indeed, both doses of the vaccine. We will, of course, provide an update as and when the advice changes.
Last week, I mentioned that we believe that vaccination is already helping to reduce the number of people dying with Covid in our care homes. Last week’s report from National Records of Scotland provided early evidence for that view. Yesterday, the University of Edinburgh reported the initial results of a survey into Covid hospitalisations. It found that, by the fourth week after a first dose has been administered, the Pfizer-BioNTech and Oxford-AstraZeneca vaccines reduced the risk of hospitalisation from Covid by 85 per cent and 94 per cent. That is extremely welcome and encouraging news. The early evidence on the impact of vaccination on transmission of the virus, including that which has been published by Public Health England yesterday, is also extremely encouraging.
Although our watchwords continue to be caution and patience at this stage, there is little doubt that we now have much firmer grounds for optimism that vaccination, and the other tools at our disposal, offer us a route back to greater normality. Of course, it is by being cautious, careful and patient for the next period, while the vaccination programme has time to progress, that we will make that route as safe and sustainable as possible. Taking off the brakes too quickly will allow the virus to get ahead of us again and put our progress out of lockdown into reverse. I appreciate that that can be—indeed, that it is—a frustrating message, but it is an essential one.
The point is underlined when we consider the current state of the pandemic. On the one hand, we can and should take heart from the fact that the lockdown measures that were adopted after Christmas have had an impact. In the first week of January, an average of 300 new cases a week were being recorded for every 100,000 people in the population. That figure has fallen by almost two thirds and is now just above 100 cases a week. We are also seeing lower test positivity rates and fewer Covid patients in hospital and intensive care.
However, on the other hand, there are some signs that the decline in case numbers is slowing down. Last week, in fact, we recorded hardly any reduction at all. That is likely to be linked to the fact that the more transmissible new variant of the virus now accounts for more than 85 per cent of all cases. In addition, the new variant’s greater transmissibility means that it is harder to suppress. Therefore although the reproduction number is currently below 1, it might not be very far below 1 and it would likely not take very much easing right now to push it back above 1.
As I have said, we are very hopeful—indeed, increasingly hopeful—that vaccination will have a significant impact on the R number. However, that will take a bit more time, so the bottom line—and this is the clear message from our clinical advisers—is that at this stage we have quite limited scope for easing restrictions.
Of course, we have just made one significant relaxation of lockdown. Yesterday, children returned to early learning and childcare settings and pupils in primary 1 to 3 returned to school. Some secondary school students are also now going back to school for essential practical work. It is therefore important that we see what impact that has on transmission before we commit to further relaxation.
In short, I would summarise our current position as extremely positive and promising, and we should all take heart from that. However, it is still quite precarious and, if we are to sustain our progress, we will need to exercise care and caution. If we are to minimise the impacts of Covid while maximising our ability to live unrestricted lives, we must get the virus to as low a level as possible and try to keep it there. That is not some kind of ideological goal. We know from experience that it is when the virus is allowed to simmer at relatively high levels in the community that the risk of its accelerating out of control and causing more illness is most acute. It is also when the risk is greatest of the virus mutating and new variants emerging that could undermine our vaccines. Therefore maximum suppression is important for our chances of getting back to normal.
That is the context in which we are today publishing the updated strategic framework. The framework has been discussed with business organisations, trade unions, the third sector and others. I know that other parties took part in discussions on it at the weekend. There will be further discussions over the next couple of weeks as we put further flesh on the plans that we are setting out today.
We intend to publish a further document in mid-March, which will give more detail, beyond what I am able to set out today, on the sequencing of reopening the economy from late April onwards. However, today we set out the overall approach to, and an indicative timescale for, easing restrictions over the next few weeks with a view to more substantial reopening, particularly of our economy, from late April.
In considering the framework, it is helpful to bear this point in mind. At the moment, and for a bit longer, we need to rely very heavily on restrictions to suppress the virus. That is essential when it is so transmissible and when case numbers are still quite high. In time, though, once the vast majority of the adult population has received at least one dose of the vaccine, we hope that vaccination will become our main tool for suppression.
However, the months between now and then will be something of a transition as we gradually rely less and less on restrictions and more and more on vaccination. In order to manage that transition successfully, and so that we can start easing restrictions before the full impact of vaccination kicks in, we will need to use a range of other measures, too. For example, our test and protect system will continue to be vital in breaking chains of transmission as they arise. That is why we are supporting more people to self-isolate when they need to. It is also why we are expanding testing capacity, so that we can test more people at work—especially those in key public services and critical infrastructure roles—and so that we can use targeted community testing more, especially in areas where there seems to be a stubbornly high prevalence of the virus.
Travel restrictions are also essential and are likely to remain so for some time yet. Over the summer, we saw how new cases were imported into Scotland after the virus had almost been eliminated here. We do not want to have that happen again if we can avoid it. In particular, we want to guard against importation of new variants of the virus that could be more resistant to the vaccines that we are currently using. The strategic framework therefore rightly emphasises the importance of travel restrictions and the test and protect system, both of which will help us to ease restrictions safely.
I turn now to the priorities and indicative timeframe for easing restrictions. As I have already emphasised, the strategic framework is deliberately cautious at this stage. However, I want to be clear that, in the coming weeks, if the data allows and positive trends continue, we will seek to accelerate the easing of restrictions.
However, the framework today provides details on what—as of now—we expect our next changes to be. First, it confirms that, if all goes according to plan, we will move fully back to a levels system from the last week in April.
At that stage, we hope that all parts of the country that are currently in level 4 will be able to move out of level 4 and back initially to level 3, possibly with some revision to the content of the levels, and afterwards to levels dependent on the incidence and prevalence of the virus at that time. The advantage of the levels system is that it will allow us to let some parts of the country move faster than others, if the data supports that. Moving back to the variable levels system at that time will also be contingent on us having vaccinated all JCVI priority groups 1 to 9, which—as I said earlier—we hope to have done by mid-April.
That matters not only because those groups will be more protected but because we believe that vaccinating around half of the population will have a significant effect on reducing transmission across society as a whole; although we do not yet know exactly how big an effect there will be, we hope and believe that it will give us the headroom to carefully ease restrictions. It is therefore from the last week of April that we would expect to see phased but significant reopening of the economy, including non-essential retail, hospitality and services such as gyms and hairdressers. Of course, the more of us who are vaccinated and the more we all stick by the rules now, the faster that safe pace is likely to be; if we all stay in this together, our progress will be greater.
As I said earlier, we will set out more detail in mid-March on the indicators that will guide our decisions on levels, as well as on any revision to the content of each level, taking account of our experience and of sectoral views and the order in which we expect those parts of the economy that have been restricted to start reopening from the last week of April.
Now, though, I want to set out the journey from here to the end of April. We envisage a progressive easing of the current level 4 restrictions that apply across most of the country at intervals of at least three weeks, along with changes nationally on education and care home visiting. The immediate priority will continue to be the return of schools. All those easings will of course depend on an assessment that it is safe to proceed.?
The first easing started yesterday, with the partial return of schools.??In addition, universities and colleges are able to bring back a small number of students—no more than 5 per cent of the total—where face-to-face teaching is critical. We will also ease restrictions on care home visiting from early March and guidance on that was set out at the weekend.
?The next phase of easing will be a minimum of three weeks later—indicatively, from 15 March. We hope that that will include the next phase of school return, which will start with the rest of the primary school years, from P4 to P7, and with getting more senior phase secondary pupils back in the classroom for at least part of their learning. In that phase, we also hope to restart outdoors non-contact group sports for 12 to 17-year-olds. We will also aim to increase the limit on outdoor mixing between households to four people from a maximum of two households, compared to two people from two households, which is the limit just now.
?A minimum of three weeks after that—from 5 April—it is our hope and expectation at this stage that the stay at home restriction will be lifted. We would aim for any final phase of school return to take place on that date. Communal worship will also, we hope, restart around 5 April, albeit with restricted numbers to begin with. However, in deciding the exact date for that, we will obviously take account of the timing of major religious festivals—for example, Easter and Passover—so it may be that communal worship could restart a few days earlier.
We will also seek to ease the restrictions on outdoor gatherings further so that at least six people from two households can meet together. In this phase, we will also begin the reopening of retail. That will start with an extension of the definition of essential retail and the removal of restrictions on click and collect.
?Then, three weeks after that, as I indicated earlier—from 26 April, assuming that the data allows it—we will move back to levels. Hopefully, all parts of Scotland that are at level 4 will move to level 3 at that stage, albeit with some possible modifications, and we will begin to reopen the economy and society in the more substantial way that we are all longing for.
It is of course important to stress that that all depends on us continuing to suppress the virus now and continuing to accept some trade-offs for a period—for example, on international travel—but, if we do so, I am very optimistic that we can make good progress in returning more normality to our lives and to the economy. ?
I know that this is still a cautious approach that, although absolutely essential to control the virus and protect health, is nevertheless extremely difficult for many businesses. The Scottish Government is committed to continuing support for businesses. For example, provided that we receive confirmation of consequentials in the March budget, we will support the strategic framework business fund until at least the end of June. We will also ensure that, when local authority areas move out of level 4, businesses that are allowed to reopen will continue to receive payments from the fund for at least the next four weeks, as they transition back to trading more normally.
We are also considering some form of tapered support for businesses that may still face trading restrictions and reduced demand, even as they are allowed to reopen. The Cabinet Secretary for Finance will set out further details of that shortly. We will work with business organisations on those and many other issues as we continue to emerge from lockdown.
In addition to the concerns of businesses, I know that people across the country are anxious for as much clarity as possible. I want to give as much as possible today while avoiding giving false assurance or picking arbitrary dates that have no grounding at this stage in any objective assessment. I am as confident as I can be that the indicative staged timetable that I have set out today, from now until late April when the economy will start to substantially reopen, is reasonable.
In mid-March, when we have made further progress on vaccines and have a greater understanding of the impact of the initial phase of school return, I hope that we can set out more detail on the further reopening that will take place over April and May and into a summer when we really hope to be living with much greater freedoms than we have today.
For now, however, the most important priority that we still all have is to continue to suppress the virus. Of course, that means sticking for a bit longer to the current lockdown rules. Therefore, I ask people please to continue to stick to the letter and the spirit of the rules. Please stay at home, except for essential purposes. For now, do not meet people from other households indoors and follow the FACTS advice when you are out and about. Please continue to work from home wherever possible and, for employers, please continue to support your employees to work from home.
By doing all that, we will make it easier for children to return to school more quickly. We can suppress the virus, even as we follow the path out of lockdown. As we do all of that, we can keep one another safe and protect the NHS while giving the vaccination programme the time to do its work.
I know how hard all of this continues to be after 11 long months of the pandemic, but the restrictions are working, the vaccination programme is motoring and we can now see a firm way out of this. We can now say with confidence that, if we all stick together and stick with it, we are looking at much brighter times ahead. Please, for now, stay at home to protect the NHS and save lives.
After a year when all our lives have been put on pause, there is finally a growing sense that it might be over soon. Although it is too early to declare anything like victory, we are starting to win the race between the vaccine roll-out and the spread of the virus, and we are grateful to all who are delivering the vaccine programme.
A University of Edinburgh study that was published this week found that getting the jab can cut hospital admissions by up to a remarkable 94 per cent, which is better than we could have hoped. The success of the vaccine programme means that it is now possible to start to have those important conversations with friends and family about reconnecting, making plans and getting all our lives back on track.
We welcome the information that is contained in the statement today, particularly the details on school return and care home visits. However, there is much that is not in the statement. There is nothing for the thousands of Scots who have had medical treatments, tests or operations cancelled about when and how services will get back up to speed. There is nothing for those who have already postponed huge life events for a year. For example, for those who have postponed weddings, there is nothing about when they can walk down the aisle in front of family and friends. There is nothing about when measures such as social distancing will end so that we can do something as basic as give a loved one a hug.
The statement and the accompanying documents relate almost exclusively to the time between now and 26 April, when the First Minister intends to move the whole country to level 3 restrictions, pandemic permitting. To be clear, under current rules, that would still prevent people from leaving their council area. However, there is nothing about what happens after 26 April. This is not a route map out of Covid; it is a holding document for the next eight weeks. Everyone understands that we might not be able to give people absolute certainty, but people were expecting the First Minister to give them some kind of hope. Many will have tuned in today precisely because they were expecting to receive that; they did not tune in today expecting to be told to tune in again in three weeks’ time, and they have a right to be disappointed.
Why will the First Minister not let the people of Scotland know the plan to get them fully out of lockdown and back to their lives?
On national health service operations and treatments, NHS remobilisation is under way. The Cabinet Secretary for Health and Sport keeps Parliament updated on that, and I will ask her to write to members to give a further update on that as soon as she is able to.
On weddings, I hope that, as we go into the period after the end of April, weddings with greater numbers of people—although the likelihood is that numbers will still be restricted—will be able to take place.
As I have always done, I am trying to be frank with people. I think that we can all be much more hopeful today than we have been able to be throughout the entire pandemic, not just because we have evidence that lockdown is suppressing the virus, but because we have growing evidence that we have an alternative to lockdown restrictions that will suppress the virus instead of lockdown restrictions over the longer term—and that, of course, is vaccination. That allows us to say that we think that, by the time we get to April, we will be able to start to open up the economy and that, between now and April, we will be able to open up in a gradual and phased way some aspects of the current restrictions that are in place.
However, we must balance that with the reality—which is not one that I or anybody enjoys—that there is still uncertainty. There is still uncertainty about the impact of the vaccination on transmission, although all the evidence that is now emerging on that is positive, and we need to make sure that we do not open up while the virus is still hovering and simmering at levels that are too high for us safely to do that. Therefore, the further into the future we go, the more arbitrary any dates that we give at this stage will be. It is like putting your finger in the wind and coming up with a date that is not firmly based in the evidence. That is the balance that we are seeking to strike.
By mid-March, we will have evidence of the impact of the early return of some pupils to school, and I hope that we will have more evidence on the impact of vaccination, so by then, we will be able to go forward a little bit more and give more detail on the period from April into May. Everything is going in the right direction, but this is the moment when we have to be optimistic and positive but also patient and sensible. The last thing that I want to be doing—the last thing that any of us wants to be doing—at any point this year is going backwards. This must be a firm and sustainable route out of lockdown, and that is what I believe that we are putting in place.
I thank the First Minister for her statement and send my condolences to those people who have lost loved ones to Covid.
Most people make the reasonable assumption that, once they have had their vaccination—the second dose, in particular—they are, in effect, good to go, but the reality is that they can still get Covid, albeit, we would hope, in a much milder form and avoiding hospitalisation. That means that testing is critically important so that we can quickly identify and contain any future outbreaks. Will the First Minister issue a revised testing strategy that includes mass community testing, where that is appropriate?
I want to be optimistic and I am equally patient, but I would like to ask the First Minister what the ultimate goal is, because it is important that people understand what lies ahead. Is it suppression of the virus, using testing, tracing and vaccination, but accepting that there is some risk, as we do with flu each year, or is it elimination—zero Covid—and the prospect of continuing restrictions over a longer period, including further lockdown?
If my memory serves me correctly, I think that the document says this explicitly, but if it does not, it is certainly the intention to publish a revised testing strategy to take account of our increased capacity and the new strategic objectives for testing as we come out of lockdown.
With regard to Jackie Baillie’s point about vaccination, there is more than one unanswered question about the impact of vaccination, but the biggest unanswered question—although it is less unanswered than it was a week ago—relates to exactly what impact the vaccines have on stopping people getting and transmitting the virus. The evidence that was published yesterday and the evidence that is emerging from the pharmaceutical companies is really positive, but we still need more data to be certain about that.
The fact that it reduces hospitalisation and deaths is clearly good. That is the principal objective of the first phase of the vaccination programme. However, if the virus is still transmitting, the risk of long Covid and people becoming ill will still be there. We need to have more data that heads in the same direction as the data so far, because that will give us confidence that the vaccine is reducing transmission. The more confident we become about that, the more confident we can be that the vaccine will do the job that the rest of us have been doing for the past year in living under restrictions in order to suppress things.
On the point about elimination versus suppression, the point is that we have to try for as close to elimination as possible in order to keep the virus as low as possible. Even if we do not achieve absolutely no Covid, the very act of trying to do that will keep it at levels at which it is safer for us to open up.
There is a problem, I think, with the flu analogy, although I know what people mean when they use it. We live with flu every year and we will have to live with the fact that Covid is a virus that exists. The problem is that we know that Covid, at the moment, can be more severe for some people, particularly in the shape of long Covid, so being complacent about it would be a really dangerous thing to do.
I had a conversation with the chief medical officer this morning, and he said—I have heard other people say this, too—that a better analogy is perhaps with measles. That is kept firmly under control, but there are outbreaks from time to time that we have to deal with. We keep it really contained and suppressed and we deal with outbreaks. Vaccination or immunisation does the main job of keeping it under control. I do not think that that is a perfect analogy any more than the flu one is, but it is perhaps more accurate.
What is our goal? Our goal is to get back to normal life. Our goal is to be able to hug loved ones and go about our business in the way that we all want to do. I think that we are much closer to that, largely because of the vaccination programme, than we have been at any point in a year. We just need to make sure that we are doing this sensibly and with an appropriate degree of caution so that we do not send ourselves backwards before vaccination is doing all the work that we think it may ultimately do.
I think that there is broad consensus across the country about the caution that is required. We must never forget that there are many harms, such as the harm to mental health and education, and not just Covid. That is why we need to ease restrictions as soon as we can without allowing the virus to get out of control again. The measures that have been announced today are broadly similar to the early measures that Boris Johnson announced yesterday, with an earlier phased easing for schools and the two-person outdoors limit and a slightly later easing for shops. I support that approach.
There have been many false dawns on care home visiting. My hope is that this is not another one and that families who have been separated for months can be safely together again.
I am concerned that vaccine passports are slowly gaining traction, despite the First Minister’s scepticism when I asked about them last year. Can we have an assurance from the First Minister that vaccine passports or certificates will not be used to access public services in this country?
I would not support the access of public services being based on anything like that. I think that it is important that we do not get caught in a preconceived idea of what people mean when they talk about vaccine passports or certificates, because people mean different things. We should not close our minds to that. Yellow fever certificates exist for travel to some countries, and there may well be scope for vaccination giving people the ability to do certain things that, without vaccination, they might not be able to do.
I agree that there are a lot of things—I am not sure that there is a huge amount of disagreement on this, certainly between the different Governments in the UK—that we need to think through. First, we need to understand, as I have talked about in other contexts, exactly what protection vaccination gives people against getting or passing on the virus, and then we need to think about the ethical issues. What would be reasonable to say could be accessed by someone who has a vaccine certificate, and what would be unreasonable? Some people cannot get vaccinated for reasons that are beyond their control, and there are other ethical issues that arise from that.
It is not straightforward or simple. It is one of the things that there is a tendency to try to oversimplify, and we should guard against that. I do not close my mind to the idea but, like everybody else, we want to think it through carefully. If some such mechanism can give us back at some stage some greater normality that we would not otherwise get, let us think about it, but let us think about it properly.
On the other main point that Willie Rennie raised, nobody wants this to be a false dawn on care homes. What we are saying very clearly just now on care homes—it also applies to schools, because we do not want the children who went back to school yesterday to be out again in a few weeks or months—is that we have got to do this in a steady but sustainable way so that, with the things that we say will open up, we get to keep going in that direction. That definitely includes care homes.
Every one of us wants this to be over. We would all like nothing better than to get our lives back to normal and for us to begin tackling the deep harm that has been caused by the dreadful year that we have come through. However, the Prime Minister’s decision to present specific dates for the lifting of all public health measures four months in advance, and to describe those moves as irreversible when we do not yet know what will happen to the virus in the future, seems extraordinary. Does the First Minister share my concern that many people, including in Scotland, are already taking the UK Government’s timeline as a cast-iron promise?
Looking further ahead, I also want to ask about vaccine passports or vaccine status certificates in relation not just to public services but to their potential use in the wider economy. Does the First Minister believe, as I do, that they could risk making the social inequality that we face today even worse, and that they could set a dangerous precedent for the longer term, in that people’s civil rights would be dependent on their medical history?
On the first point, when I briefly heard the Prime Minister talk this morning, he certainly presented the 21 June date as an aspiration and candidly, but rightly, said that there were no guarantees. That is a reasonable position to take.
I would love to stand here and say that by 21 June we will all be back to normal completely, but I cannot say that with any certainty at all, because I do not know what the grounding for that is and I do not know what assessment gives confidence of that. Much as I would like to go further out with dates, I do not think that it is fair or reasonable to do that now, because we need to make sure that we have proper assessment and a proper basis for confidence that the things that we are saying, although we might not be able to guarantee them, have a reasonably good chance of being deliverable.
That is my level of confidence in what I have set out today. In two or three weeks’ time, I hope to have the same level of confidence when we look further into April and perhaps even beyond, to May. We have to continue to treat people like grown-ups. People are fed up—we are all fed up with this. We all desperately want it to be over, but we all have developed an understanding that it cannot be magicked away. We have got to get there in the right way and in a way that will prove to be sustainable.
On vaccine certificates or passports—whatever people want to call them—I do not have much to add to what I said to Willie Rennie. Suffice it to say that, yes, we should think properly, without closing our minds at this stage, about what a vaccine passport or certificate might offer us, but I would never support something that deepened social inequalities, put barriers in the way of people accessing public services or took away people’s civil liberties in the way that Patrick Harvie set out. That illustrates why we have to take care. We have to think through the practicalities and ethics, and, whatever direction we take, we have to make sure that we have a broad consensus across the country behind it.
Today’s statement gives us hope that there is light at the end of the tunnel. Will the First Minister join me in recognising the extraordinary efforts of NHS Tayside’s staff in having delivered the first dose of vaccination to more than 117,000 people, which is more than a third of the adult population of Tayside? Can the First Minister provide any further details about the most recent revised forecast of the vaccine supply as the roll-out continues, so that we can ensure that people not only receive their first dose but move on to the second dose as soon as possible?
Yes, I certainly commend the efforts of NHS Tayside and the commitment and hard work of the vaccination teams across the country who are delivering the programme.
The limiting factor in the programme remains supply. We have demonstrated that we have the ability to vaccinate 400,000 people every week and we would want to increase that even further in the later stages of the programme, but we have to have the supplies of vaccine in order to do that. The reason why the vaccination rate has fallen below that number in the past week is that the supplies have not been there to support it.
We received updated forecasts of supply late yesterday evening, and our officials are currently doing the analysis and modelling work to understand how we should flex the plans based on those forecasts so that as many people as possible can be vaccinated. Assuming that the supply, based on those updated forecasts, allows it, the targets that I have set out today will become the targets that we will work to—that is, the middle of April for groups 1 to 9 on the JCVI priority list and everybody over 50, and then the rest of the population by the end of July. That is much earlier than we originally anticipated, and it will be extremely good news and very helpful to further easing if that can be achieved.
Figures out today show that the percentage of school leavers going on to positive destinations has fallen to its lowest level in five years and that the gap between pupils from our most and least deprived communities doing that has also increased, which is worrying. Therefore, the importance of getting pupils back into the classroom now surely takes on ever more importance and urgency. By what date does the First Minister expect all pupils to be back in the classroom, based on the road map that she has announced today? If, as it seems, that clashes with the start of the Easter holidays, are there any plans to alter them?
As I set out, we hope that the next phase of the return to school will be from 15 March. We will set that out next week. I anticipate that that will be for at least the rest of the primary school years and as many of the senior phase pupils as we deem to be safe to return at that point. However, we will have some further work to do before we can set that out in more detail. The final phase of the return to school would be three weeks after that if we have not got all pupils back before then. That is what we are able to set out right now.
We will continue to consider how all of that fits with the Easter holidays. Suffice to say, we want to get every young person back into face-to-face education as soon as possible, and we think that we will undoubtedly do that with primary pupils before we achieve it for all the secondary phase on a full-time basis. Our driving imperative remains having as much in-person, face-to-face in-school education as possible as soon as possible.
I will double-check that, because I do not want to give wrong information in response to Willie Coffey’s question. I assume that patients with ME are in the group 6 category, which is the group that is starting to be vaccinated now, but I will double-check that and get back to Willie Coffey if that is not correct.
Even with the very limited dates that the First Minister has given, it will not have escaped the notice of businesses that most of them will not be reopening for many months because of the health restrictions. However, there was no real detail in the statement on additional economic support for those businesses. In particular, the First Minister will be aware that the recently launched discretionary funds that are administered by councils and are aimed at supporting businesses that are excluded from other Government schemes, such as the strategic framework business fund, which the First Minister mentioned, are already very much oversubscribed and are limiting payouts.
Is consideration being given to additional support specifically for those discretionary funds, which help many businesses that have been left behind by the funds that the First Minister mentioned in her statement?
I repeat that I hope at this stage that we will see a significant reopening of businesses across many sectors of the economy from the last week in April. The more successful we are now, the more likely we stand to achieve that in that timescale.
I set out in my opening remarks that we intend to continue the business support that is available through the strategic framework business fund, assuming that the consequentials are confirmed in the budget, until at least the end of June, and further, if necessary. We are considering further tapered support. Discretionary funding, which has already been increased in recent weeks, of course, is one of the other factors that the Cabinet Secretary for Finance will be considering continuing and extending should businesses need that for a longer period.
The more we suppress and vaccinate now—this is a bit like my answer on schools—the sooner we will get businesses open and trading properly. I know that most businesses would say that the support that we provide, however important it is, is not a substitute for their being able to trade normally.
What discussions have been had with the UK Government about the continuation of the furlough scheme to reflect the needs of Scotland’s approach to the existing lockdown that the First Minister has outlined today? Will any further discussions take place in the light of today’s announcement, and will a tailored approach for specific sectors be considered?
The Cabinet Secretary for Finance will—as she always does—have discussions with and make representations to the Chancellor of the Exchequer up to the date of the budget, in early March. I certainly hope that we will hear from the chancellor about an extension of the furlough scheme for as long as is necessary, because that is really important. There will be a requirement in England for that, just as there is in Scotland. I think that, as was the case last summer, there will be a difference of a couple of weeks in the timing of some sectors coming out of lockdown, but there will not be massive differences, so such support will be needed. It is also important that we have the ability to tailor support in ways that we think are necessary, depending on the exact shape of the path that we take.
Public compliance is the most important resource that we have for controlling the virus, and the Scottish people are stuck with restrictions and have made difficult sacrifices. After 11 months of restrictions, people need to see hope that there will be an end point. The First Minister said that, in mid-March, the Scottish Government will publish proposals for the further easing of restrictions that will be based on a local approach. However, even under level 0 of the old strategic framework, restrictions will remain. Will the First Minister confirm that, in mid-March, she will use all the data and evidence that she has at her fingertips to give us a full route map for removing restrictions entirely, and will she say why she is unable to do that right now?
I will be blunt. Anybody who stands here right now and says with any certainty that all restrictions, including social distancing, can be lifted three, four, or five months from now is not doing that on the basis of any objective evidence. I hope that that will be the case, and I did talk about the need for us to revise, as appropriate, the content of the different levels because of the vaccinations. The game changer that will get us to a position later this year when we will be able to have something close to normality is a reality. However, tempting though it is to say that by date X we will be back to 100 per cent normality and Covid will be over—I would love to stand here and say that—anybody who does that will not be saying that on any objective basis at all, and I do not think that that is fair to people.
Even if people are frustrated by not getting that kind of information, I would rather stand here and give the information that I am giving, because I can say to people that I have a reasonable and significant degree of confidence that what I say will be delivered. That approach has served us well. It has not made life easy in the past year, but it is the right approach to continue to take.
My apologies to Gil Paterson. He froze in the middle of his question—well, the screen froze; he did not freeze—and I missed the middle of it, but I think that I got the gist, which was about whether, if the data allows, we will accelerate easing. The answer is yes. We are being deliberately cautious right now because we do not have the ability to say anything with certainty. However, if we suddenly get evidence that vaccinations are having a greater effect or that we are seeing bigger drops in the rates of the virus, we will accelerate accordingly.
We all want to be out of this as quickly as possible. More than that, everybody wants to be out of this sustainably, so that, when we come to look at next winter, we are not having to contemplate another lockdown. That will continue to mean some trade-offs for a period of time. One of the biggest risks right now is the appearance of new variants that start to undermine the efficacy of the vaccine. That would be a terrible development, which is why we have to be really careful to guard against the importation of new variants—hence the current need for travel restrictions.
How will the Scottish Government ensure that care home residents and their families will have access to visits, given that that will depend on an assessment? I cannot be alone in having had heartbreaking messages from relatives of care home residents whose mental health and wellbeing has been affected by a lack of contact. What support will the Scottish Government provide to care home providers to ensure that visiting will be safe and will happen?
The health secretary has been working closely with home care providers to make sure that they have the information, guidance and support that are necessary. That will be an on-going process. I will ask the health secretary to provide more information to the member about the detail of that and to answer any further questions that she has.
I warmly welcome the Government’s announcement yesterday that all people with a learning disability will now be called for the vaccine in group 6. How will that information be conveyed to local health and social care partnerships, and are we confident that that group can all be identified through their NHS number?
First, that is an important commitment that we have made. Previously, group 6 included people with severe learning disabilities, but we have taken the decision—rightly, I think—to include in group 6 people with mild and moderate learning disabilities as well. Our vaccine team will work on making sure that health boards have the support that they need to identify those people. When I set out the commitment yesterday, I said candidly that work will be required to make sure that we are identifying and reaching all people in that group. Health boards, working with general practitioners and, in many cases, with the voluntary sector, are best placed to do that, with appropriate support from our vaccine team.
There are more than 2,000 patients waiting for elective orthopaedic surgery in NHS Highland. Even if operations were being carried out at full capacity, the number would still be increasing. Two weeks ago, a constituent told me that she had been told that she would have to wait six years for her new knees. Patients and consultants in the Highlands would like to know how the huge and ever-increasing orthopaedic backlogs will be reduced following the lockdown. Can the First Minister tell them?
That is hugely important. I do not want anybody to be waiting anything like six years for a knee replacement or any other operation, so we have to do two things. First, we have to reduce the number of beds and the amount of capacity in our health service that are being taken up by Covid right now. That is why suppressing the virus to the lowest possible levels is really important. Any increase in transmission, even if the vaccine is protecting against serious illness and death, will increase the pressure on hospital capacity. That is another reason why we have to suppress the virus as far as we can.
Secondly, we are planning—this is under way—to remobilise and invest in the capacity that will get through the backlog of cases as quickly as possible. There is a real focus in the Scottish Government on doing that. However, I cannot emphasise enough the importance of doing the first part, so that we again have a health service that is focused on the wide variety of needs and that does not have such a significant part of its capacity dedicated to dealing with Covid.
Across Scotland, the vaccination programme has been remarkably successful. However, some vulnerable 16 and 17-year-olds who are at very high risk from Covid-19 have yet to be invited for vaccination, despite the best efforts of parents and guardians. Only the Pfizer vaccine is licensed for that group, and it cannot be administered at home or in general practice surgeries. What reassurance is being given to that vulnerable group of young people and their families that their circumstances have been fully considered and that they will now be prioritised for vaccination?
Anybody who is eligible will be called for vaccination in the priority order that we are following. Group 6, which is being vaccinated as of this week, is a large number of people. It will take some time to get through all of them, but they will all be called. I am happy to look into the particular point that Kenny Gibson is raising and to get back to him with more detail.
This is not necessarily the point that he is raising, but the health secretary and I were having discussions with Pfizer yesterday—I know that other pharmaceutical companies are also looking at this—about the work that is being done to enable the current vaccines to be extended into the child population in due course. We are not in control of the timelines of that work, but we are optimistic about it for the future.
I will get back to Kenny Gibson on the specific point.
We have to prepare now for the next couple of years. As the First Minister said, new variants might emerge that may require people to have top-up vaccines, depending on the first vaccine that they received. For that reason, we need to be robust in recording data on who has received which vaccine—Pfizer or AstraZeneca—as well as the date, batch number and so on. Our health records are not as digitised as we would like them to be, and we hear stories of people receiving vaccines outwith official appointments. Can the First Minister assure me that all that data is being recorded assiduously for every vaccine that is administered?
The vaccine management tool that we use records which vaccine somebody gets. The health secretary is telling me—and I will take her word for it—that it also records which arm someone has the vaccine in. It is taking and recording the information that is required.
There are other things that we need to do to guard against new variants, such as having travel restrictions in place for a certain period and genomic sequencing. The UK is a world leader on genomic sequencing, and we are looking at how we can do much more real-time genomic sequencing so that if there are new variants in the country, we catch them before they have the chance to become more widespread. That will become increasingly important.
As well as our discussions with Pfizer yesterday, the health secretary and I have had discussions with AstraZeneca in the past few weeks. The pharmaceutical companies are already looking at how they adapt their vaccines as new variants emerge. There is a lot of complexity involved, but that kind of work will be increasingly important in the years ahead.
What measures are being taken to vaccinate those in hospital who are not technically classed as long-term patients but who are in for prolonged assessment of conditions such as dementia and whose JCVI target dates have already passed? Several constituents have contacted me to say that local hospitals have neither the supplies nor the intention to vaccinate patients in that position.
Again, I am happy to come back to Colin Beattie with more detail. The general position in hospitals—I covered this in response to a question last week—is that patients will be vaccinated before they are discharged from hospital. The clinician may decide to wait until the symptoms of whatever it is the patient is in hospital for abates, so that there is no confusion between any side effects from the vaccine and the symptoms of the illness that they are suffering from. However, the general position will be that patients are vaccinated before discharge. There will, in all likelihood, be exceptions to that where a clinician thinks that that is necessary. I will come back to Colin Beattie with more precise detail if I have missed anything by way of information that would be helpful to him.
Coming out of lockdown will inevitably focus attention on the deterioration of the country’s mental health, which was already in crisis. There is an urgent need to set out a plan that includes support for teachers to deal with pupils returning to school in a heightened anxiety state, and access to enhanced mental health services including opening up access to third sector services. What consideration has the Scottish Government given to developing a structured plan to tackle the mental health crisis?
We had already, before the pandemic, embarked on plans, which have now been taken forward, to ensure that there is access in all secondary schools to mental health counsellors, which is an important part of that support. There is no doubt that support and provision for mental health, not only for children and adolescents but for the adult population, will have to increase in the years to come.
The Cabinet Secretary for Finance set out additional funding just last week, and the Minister for Mental Health, who has already produced the “Mental Health—Scotland’s Transition and Recovery” plan, will come back to Parliament in due course with further details of how that investment will be spent and the structure that will be put in place.
On the important issue of international travel restrictions, can the First Minister advise members on the extent to which the proposed indicative timetable for the easing of lockdown is predicated on international travel restrictions remaining in place? Can she provide an update as to where on-going discussions with the UK Government currently stand on the desirable more comprehensive approach to international travel quarantine that many of us in Scotland would wish to see?
Constructive discussions with the UK Government have been taking place in the past week or so, mainly at an official level, about ways in which we can work together to deal practically with the fact that there are different approaches in Scotland and England. That is welcome and we hope to continue it. We still favour a common four-nations approach on travel restrictions, and we will continue to try to progress that but, as of this moment, that is not something that the UK Government is planning to do, as far as I am aware.
We do not want travel restrictions to be in place for longer than is necessary and I certainly hope that, as we go further into the easing of lockdown, we can ease travel restrictions within Scotland, so that loved ones who live in different parts of the country can get together again. We all want that.
I think that international travel restrictions will have to be in place for a bit longer, because of the risk of variants and the fact that different parts of the world are at different stages in vaccinating their populations. Unfortunately, no matter how well we do with vaccination here in Scotland and in the UK, we cannot get rid of Covid on our own—it is a global illness—so we need to be mindful of what is happening elsewhere in the world.
I want none of these measures to be in place for a moment longer than is necessary but, as I said last week, there are trade-offs that we need to make over this next period. The more we accept some restriction on our ability to travel overseas, the greater normality we can get back domestically—and quicker than we might otherwise be able to do.
I am looking for clarity on quarantine rules for travellers. People who arrive in the UK for health treatment, and not from a high-risk country, can self-isolate. What are the rules for people who are returning to Scotland having travelled overseas to receive medical treatment that is not available in the UK and that may be self-funded? Those people will often be frail, they will be receiving continuing treatment and they will be medically vulnerable. Do they have to quarantine in a Government-approved hotel, or will there be an exemption for people in those circumstances?
There is an exemption in the regulations for people who are travelling for medical treatment or for medical reasons. I do not have the regulations in front of me, so I cannot read out the exact wording.
As with all things, whether a particular exemption will apply in a particular case can often depend on the circumstances of that case. If Claire Baker is asking for a constituent in a particular set of circumstances, she can send us that information and we can give a bespoke answer, as opposed to a general answer. There is a general exemption in the regulations around medical treatment.
Among all the good will towards the business sector that the First Minister speaks of, one part of that community has slipped through the cracks—namely, the bed-and-breakfast sector. It is struggling hugely and is badly in need of targeted support. Will she consider this problem again and see whether a way can be found to support that sector, which is so important for my constituents in Ayr, Prestwick, Troon and elsewhere?
I am happy to take that point away and talk both to the finance secretary and to the tourism secretary. Fergus Ewing, in the latter capacity, has been assiduous in ensuring that we are trying to cater for the many different aspects of the tourism industry, and we have sought to do that for self-catering accommodation and bed and breakfasts in particular. I will take that point away and I will see whether there is more that we can do, whether there is a particular gap that we have yet to fill and what we can do to try and fill it.
The First Minister has spoken about the ambition to move most of Scotland out of level 4 towards the end of April. She will recall that Orkney and Shetland remain in level 3, and people in my constituency would be interested to know what the Government’s intentions are in relation to restrictions in our islands and regarding the business support that she has confirmed will remain in place until the end of June. Will that be similarly available to the businesses in Orkney and Shetland that have been as adversely impacted as those in mainland Scotland?
I am not saying this with absolute certainty at this stage, but at the end of April, as all of the mainland and certain other parts of the country that are in level 4 come down to level 3, we would certainly be hopeful that those parts of the country that are currently in level 3—Orkney and Shetland, for example—would also be able to come down a level. That is the advantage of going back to the level system.
We would also seek to ensure that there is business support. I do not need to tell the member this, but even those parts of the country that have slightly greater freedom at the moment are impacted by the inability of other people to travel there, so trading is restricted. The continuation of business support there will be very important, too.
The latest official statistics that National Records of Scotland has released show that the death rate among homeless people is three times higher than in England. As we come out of lockdown, what is the plan for all the homeless people who currently sit in temporary accommodation? Can the First Minister advise whether a £100 million cut in the social housing budget will help the situation or make it worse?
We are investing in the social and affordable housing budget across the Parliament in a way that delivers record numbers of new housing. We want to do more and will do whatever we can in this budget and—if we are still in government—in future ones to ensure that we maximise our housing investment.
With regard to the deaths of people who are homeless, Aileen Campbell reported to Cabinet on those statistics this morning. We had a pre-existing plan of work, which focused on the housing first approach to tackle homelessness and rough sleeping. That work has continued and, in many respects, has been accelerated during the pandemic. As we come out of the pandemic, we will need to have that firm focus, and the recommendations of the homelessness task force will be taken forward, because we do not want anybody to go back to rough sleeping.