Hansard

I will be providing the update to Parliament on the latest Covid-19 situation today. In giving the update I will provide an assessment of the current course of the pandemic, an update on the pressures on the national health service looking ahead to the winter, a report on the progress that we are making in delivering the vaccination programme and an update on the changes to the rules around international travel. I will also be giving an update on the risks of transmission in and around the 26th United Nations climate change conference of the parties—COP26.

First, though, I will report on the most recent statistics. Yesterday, 2,010 positive cases were reported, which is 13.5 per cent of all tests that were conducted. There are 932 people in hospital with Covid, which is one more than yesterday, and 63 people are receiving intensive care, which is five fewer than yesterday. Sadly, a further 26 deaths have been reported over the past 24 hours, which takes the total number of deaths registered under the daily definition to 9,189. I send my condolences to everyone who has lost a loved one.

More positively, the vaccination programme continues to make good progress. I confirm that 4,320,370 people have received a first dose, 3,910,253 have had both doses and 36,759 have received a third primary vaccination. In total, 88 per cent of the over-18 population is now fully vaccinated with two doses. That includes 96 per cent of over-40s, 77 per cent of 30 to 39-year-olds and 68 per cent of 18 to 29-year-olds. In addition, 76 per cent of 16 and 17-year-olds and 55 per cent of 12 to 15-year-olds have had a first dose. For most people in those age groups, a single dose only is recommended at this stage.

Cases remain much lower than the previous peak around the start of September, but the decline in new cases has halted in recent weeks and, at around 2,500 new cases per day, it is still at a level well above previous lows. There are early signs that case numbers may increase again hereafter, so the situation remains precarious.

As would be expected, the Scottish Government continues to explore all options for how it will respond to the evolving pandemic and we will not hesitate to strengthen the protective measures that are in place if it proves necessary to do so. The uncertainty and risk that we face as winter progresses mean that now is certainly not the time to relax our approach. We all need to redouble our efforts to adhere to the protective measures that are in place and follow the appropriate guidance.

Over the past week, cabinet secretaries have been engaging closely with business and sectoral organisations right across the country as part of our continuing conversations to encourage compliance with the existing measures and guidance. Our appeal to everyone is: please wear face coverings when required; ventilate indoor spaces wherever possible; wash your hands and surfaces regularly; use lateral flow device tests regularly; and book a polymerase chain reaction test if one of those shows up positive, if you have symptoms of Covid or if you are identified as a close contact of someone who has tested positive.

Please also continue to give your contact details when visiting pubs and restaurants, and show your Covid certificate if you are visiting a venue where that is required. The Covid certification scheme was introduced on 1 October and has been enforceable by law since 18 October. I am grateful to the businesses that have worked so hard to comply with the scheme. Critically, please continue to work from home wherever possible—that continues to be an important way of reducing transmission. I know that they are not easy, but it is vital that those efforts continue to help us to control the transmission of the virus.

The entire health and care system is currently under considerable pressure. Right across the country, hospitals are at or close to capacity. The social care system is also under pressure and is reporting an increase in the number of people requiring care packages. The continued high number of cases means that the national health service remains under more pressure than at any time during its 73-year history.

As of today, Covid-related hospital occupancy—the number of patients in hospital with Covid at any given time—is 932, compared with 917 a week ago. Hospital admissions also remain high. There were 632 people with Covid being admitted to hospital in the latest week and admissions to intensive care units have also increased over the past month.

That means that NHS staff are dealing with significant numbers of Covid patients alongside providing other patient care, while also preparing for and responding to wider winter pressures and dealing with the backlog of care that has built up in earlier stages of the pandemic. Essentially, our health and social care services have already been dealing with demand that is usually experienced only in winter for many months.

Facing those challenges, health and care staff on the front line continue to give their all to keep us safe, and I take this opportunity to reiterate my appreciation and gratitude for their enduring efforts.

Pressures are, however, likely to intensify during the winter. Bonfire night is this week, and protests and demonstrations are taking place and will continue to take place during COP26. Scotland rightly has a strong tradition of peaceful protest and demonstration. However, I take this opportunity to encourage everyone to think very carefully about their behaviours and their impact on services, as well as the risk of spreading the virus to others.

Of course, people should seek urgent medical help when it is needed. However, if a health-related matter is not critical or life threatening, the advice of clinicians remains for people to call NHS 24 or contact their general practitioner, pharmacy or local out-of-hours service.

We know that, with people meeting indoors more often as it gets colder, there are more opportunities for Covid to circulate. We are also approaching the winter flu season, which could put further pressure on the NHS. We are therefore working closely with health boards as they deal with those pressures.

I have announced today an additional package of winter support backed by a further £10 million to bring in a range of measures to get accident and emergency patients to the right care as quickly as possible. That includes the deployment of physiotherapists and occupational therapists at A and E units to help to triage and treat patients who would otherwise wait to see nursing staff. That will prevent people from being admitted to hospital unnecessarily.

The new funding will provide more specialists on hospital rotas, such as social care workers and allied health professionals, and extended opening hours for pharmacy and diagnostic services such as scanning and ultrasound, in order to speed up referrals. It will also help to support extra staff for peak public holidays.

That is over and above the £300 million package of measures, which is largely focused on social care and supporting the reduction of delayed discharges in order to create more capacity in our acute and community hospitals.

We are working closely with boards and health and social care partnerships to support and implement improvements. A discharge without delay improvement programme is rolling out right across Scotland, which aims to improve flow through hospitals and reduce the level of delayed discharges. Work started recently with five health board pathfinder sites, including NHS Lothian, prior to that national roll-out. All health boards continue to work closely with their health and social care partnerships to develop alternative care pathways that support hospital discharges, including the use of interim care options.

Vaccination remains one of our most effective public health interventions against the pandemic. The first phase of the programme delivered more than 8 million Covid-19 vaccinations in 10 months. With Covid boosters, flu vaccines and jabs for new groups having been added, we now need to deliver roughly the same number of vaccines—7.5 million—over the autumn and winter period alone. That is a mammoth undertaking that started ahead of the Joint Committee on Vaccination and Immunisation providing advice on boosters.

Our approach has sought to reduce the need for people to attend multiple appointments by maximising the availability of scheduled appointments and ensuring the efficient vaccination of people against both Covid-19 and seasonal flu. This is a huge job for our NHS and we have asked the people of Scotland to help us where possible by coming to appointments, and rescheduling where necessary.

It is important to bear in mind that, by the time the JCVI offered advice on the booster programme, a large number of people were already eligible for their vaccines. Nonetheless, we started delivering boosters a week after receiving that advice, and we have been continually ramping up activity since then to ensure that we deliver a consistently high number of vaccinations.

I am delighted that, since 6 September, we have delivered over 2 million vaccines, including almost three quarters of a million Covid-19 boosters. To illustrate the sheer volume that is being delivered, I note that, in the week ending 24 October, almost 488,000 vaccinations were administered. That is more than we have achieved in any week since the programme began back in December last year.

We are therefore confident that we continue to be on track. We will offer vaccines to what were JCVI groups 1 to 5—covering those who are aged over 70, those who are clinically extremely vulnerable, and front-line health and social care workers—by the end of this month, and to the remaining groups, including everyone over 50, by early next year.

Every part of the UK is working at pace through the priority groups, and letters are now being sent to those who are aged between 60 and 69 and people with underlying health conditions. They are being invited to appointments at their local community clinics, which have been running since late October and will continue throughout November. Our approach will continue to prioritise the most vulnerable by protecting those appointments for those key groups.

We also intend to move towards a system that enables online self-booking. The portal for adults aged 50 to 59, those aged over 16 who are unpaid carers, and household contacts of the immunosuppressed will open from mid-November. That will allow those groups to book booster appointments online.

We know that the autumn and winter programme is the biggest and most complex that it has ever been. That is why a guide has been included on the NHS Inform website to help individuals to understand whether they are eligible for a flu vaccination, a Covid booster or both and how and when they will be invited.

We continue to ensure that our delivery model is person centred and meets the needs of local communities, tailoring our approach by learning from what works. As the First Minister outlined last week, we are also urgently exploring how we can quickly increase capacity, for example by establishing additional clinics, particularly at evenings and weekends. Given the record volumes of vaccines that are already being delivered, we need to augment our dedicated workforce. That is why we are supporting NHS boards to identify, recruit and train additional staff, including healthcare students and staff in primary care such as GPs, GP practice staff, dentists and pharmacists. I also thank our armed forces for agreeing to support our vaccination effort by complementing our current workforce.

By being vaccinated and boosted, we can protect each other and help our NHS through another exceptionally busy winter period—in fact, the busiest winter period in the NHS’s existence, I suspect. That will allow us to ensure that a sustainable service is in place for the future.

I will now update members on recent changes to arrangements for international travel. The final seven countries have been removed from the international travel red list, which means that travellers to the United Kingdom from those destinations will no longer have to stay in a hotel to quarantine for 10 days on arrival. The decision was made on a four-nations basis and took effect at 4 am on 1 November. It affects arrivals from Colombia, the Dominican Republic, Ecuador, Haiti, Panama, Peru and Venezuela.

The red list policy nonetheless remains in place but, at this time—with the delta variant dominant across the world—we do not consider that any countries meet the very high risk threshold to be on that list. The situation will be monitored closely and reviewed regularly. If the situation demands it, we will not hesitate to reimpose restrictions on international travel to safeguard the health of our citizens and protect Scotland’s recovery. Some managed quarantine capacity will stay in place in Scotland to enable us to react to any change in risk assessment that would see a country being added quite suddenly to the red list.

That is a further sign of the success of the Scottish Government’s vaccination programme and it will enable the travel and tourism sectors to take another step back towards normal operation. In addition, vaccination certificates from a further 35 countries and territories will now be recognised to allow quarantine-free travel to Scotland. That list will be reviewed regularly.

The UK Government unilaterally announced on 15 October that fully vaccinated travellers returning from non-red-list countries would be able to take lateral flow device tests with photo verification instead of PCR tests for their day 2 tests from 24 October. For practical reasons, as the First Minister previously outlined, we have aligned with those changes and that came into force from 4 am on 31 October. Wales also confirmed that it would align from 31 October; I understand that Northern Ireland is still to confirm that.

Travellers have been able to book the tests from the list of private providers on the gov.uk site from around 5 pm on Friday in advance of their arrival into Scotland. They cost between £20 and £30 per test compared to £55 to £65 for a PCR test, which makes it cheaper for people who are returning from international travel. If an individual receives a positive result, they are required to follow it up with a confirmatory PCR test that can be booked on gov.uk or by calling 119.

As we are all aware, COP26 is under way in Glasgow. We are working tirelessly to ensure that it is delivered safely and successfully.

The next fortnight is a critical moment for Scotland and, indeed, for the world as we look to see hard commitments on reducing emissions, climate finance and promoting international and intergenerational fairness that supports the people who are most vulnerable to the impacts of climate change.

The Scottish Government has been working closely with the UK Government and partners in Scotland, including Glasgow City Council, Transport Scotland, NHS Scotland and Police Scotland—and with the United Nations, of course—to ensure the successful delivery of the COP26 summit. Covid-19 continues to present significant challenges to staging this unique event. The scale and worldwide draw of COP26 poses risk of spread of Covid-19 both among delegates and to or from the local population of Scotland and the UK. A comprehensive and exceptional package of mitigation measures has been put in place to ensure that the event can be delivered safely, helping to protect the welfare of everyone involved and the wider community. In addition to vaccination, measures include a robust testing regime, contact tracing, hygiene measures and ventilation.

Health boards have planned and prepared for the COP26 event, and various arrangements, including additional staff, are in place to support delegates and other visitors while maintaining and protecting key health services. The UK Government, as the event organiser, has put in place measures to manage access to the blue zone. Once people are inside the site itself, managing queues is the UN’s responsibility. However, we are liaising, alongside the UK Government and Glasgow City Council, to encourage the UN to put in place additional measures to avoid queues such as were seen in media reports yesterday and, to a lesser extent, today. Of course, although public health measures can mitigate the spread of Covid-19 to an extent, there remains a risk that COP26 could increase the spread of the virus. That is why Covid-19 continues to be closely monitored by all relevant agencies and why the Scottish Government will be closely involved in operational decisions during the event.

Vaccination is allowing us to live with far fewer restrictions and mitigations than at earlier stages in the pandemic, and case numbers are much lower than in August and early September. However, they are still high and, as we head into winter, there are some factors that could drive them up further. Hundreds of people each week are still being admitted to hospital with Covid and, as I have said, our NHS is under intense pressure. We must therefore remember that, however much we all wish otherwise, the virus has not gone away. Covid remains a real threat and we all need to play our part in helping to keep the virus under control. For that reason, I will close with a reminder of the three things that we can all do to help protect each other.

First, please get vaccinated if you are eligible and have not yet done so, which includes going for a booster jab when you are invited for that. It is never too late to get vaccinated and it remains the single most important thing that any of us can do. Secondly, please test regularly with a lateral flow device, which can be ordered through the NHS Inform website or collected from a local test site or community pharmacy. If you test positive, are identified as a close contact or have symptoms of the virus, please self-isolate and book a PCR test.

Thirdly, please comply with the mitigations that are still in place. Wear face coverings in indoor public places, such as shops, public transport and when moving about in hospitality settings. Wash hands and surfaces thoroughly. Meet outdoors if you can. I know that that will be increasingly difficult as we get into the depths of winter, but we know that outdoor environments are safer. When meeting indoors, open windows and do anything else that you can to improve ventilation. Try, where possible, to keep a safe distance from people in other households. Those precautions do make a difference and will protect you and the people around you, and help to ease the burden on our NHS. Thank you, once again, to everybody for all your efforts.