Meeting of the Parliament (Hybrid)

Meeting date: Tuesday, February 2, 2021

Official Report 853KB pdf

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Covid-19

The next item of business is a statement by the First Minister on Covid-19.

14:22  

I will update the Parliament on the Cabinet’s review of the current lockdown restrictions, which took place earlier today. Let me say at the outset that—with a limited but very important exception in relation to some early years and school education, which I will come to later—the Cabinet has decided that the current lockdown, including the requirement to stay at home except for essential purposes, needs to remain in place until at least the end of February.

In the course of my statement, I will give an update on the current state of the epidemic, which provides the context for that decision, I will give an update on our vaccination programme and I will set out some of the additional measures that we intend to take to get and keep the virus under control in the months ahead. Finally, I will set out how and when we hope to begin the process of getting children back to school.

First, I will very briefly cover the latest statistics. Yesterday, 758 positive cases were reported. That represents 7.4 per cent of all tests that were carried out, and it takes the overall number of confirmed positive cases to 181,291. Currently, 1,939 people are in hospital, which is a decrease of 19 from yesterday, and 143 people are in intensive care, which is the same number as yesterday.

I regret to report that, over the past 24 hours, a further 69 deaths were registered of patients who first tested positive over the previous 28 days. The total number of deaths under that measurement now stands at 6,181. Yet again, I send my deepest condolences to everyone who has lost a loved one.

As is evident from those figures, the level of Covid infections clearly remains too high. However, the most recent figures provide further evidence that lockdown restrictions are working to improve the situation. That is positive. Average daily case numbers have more than halved in the past three weeks. In the most recent week, up to 29 January, an average of 1,062 confirmed new cases were reported each day. Three weeks ago, the average daily number was more than 2,300. Weekly case numbers per 100,000 of the population have also fallen from 302 in the week ending 8 January to 136 in the most recent week.

Test positivity has also reduced. In the seven days up to 29 January, it averaged 6.6 per cent. That is still higher than the 5 per cent that the World Health Organization considers to be indicative of an outbreak being under control, but it is closer to that level than it has been in recent weeks.

Pressure on our national health service continues to be severe. The number of Covid patients being treated in hospital remains around 30 per cent above the high point of the first wave last April. However, hospital admissions in this wave appear to have peaked on 12 January. They have now stabilised and are starting to reduce, albeit slowly. ICU numbers are more volatile, but they did not reach the peak of the first wave and also appear to have peaked in this wave on 18 January.

All in all, the statistics show real progress. However, that progress is down to compliance with the lockdown restrictions. I thank everybody across the country for that.

The situation continues to be fragile. Case numbers remain higher now than in the week before Christmas. That means that, if we were to ease restrictions too quickly, there is a risk that infections would rise again very quickly. That risk is increased by the fact that the new variant of Covid, which is more infectious, now accounts for, we estimate, around 73 per cent of all new cases in Scotland.

I can also advise Parliament that Public Health Scotland is examining evidence suggesting that there may be an increased risk of hospitalisation for people who are infected with the new variant. However, at this stage, there is no statistically significant evidence of any increased risk of death. Public Health Scotland is continuing to analyse the evidence on both those points, and we will keep Parliament updated.

I can also advise Parliament that, to date, there have been five cases of the new South African variant identified in Scotland. However, all those cases have links to travel, which means that there is no evidence so far of community transmission of that variant.

All of what I have set out underlines the need for continued and very extreme caution in our fight against Covid, especially if we want to get some children back to school later this month. That is why the Cabinet has reached the conclusion that the lockdown restrictions must stay in place until at least the end of February.

However, if our progress continues, I am cautiously—I stress the word “cautiously”—optimistic that, as more and more people get vaccinated, and with the protection of some of the additional measures that I will cover shortly, we may be able to begin looking towards a careful and gradual easing around the start of March. I will give an update on that in two weeks.

Let me now report on the progress of our vaccination programme. I can confirm that, as of this morning, we have given a first dose of the vaccine to 610,778 people in Scotland. That includes 98 per cent of all residents in older people’s care homes, which is a truly extraordinary uptake, and 83 per cent of the number of over-80s we estimate to be living in the community. I will return to that point shortly.

In addition, I can advise that 21 per cent of over-75s have already received their first dose. We are on track to have vaccinated with the first dose all over-70s and all adults who are classed as being especially clinically vulnerable by the middle of this month. Vaccination of the 65 to 69-year-old age group is also under way from this week. Those aged 60 to 64 and unpaid carers will start to receive appointments from the third week of February.

Therefore, we are making rapid progress in protecting those who are most at risk from Covid. Nevertheless, I expect that there will be legitimate questions today about the overall number of vaccinations in Scotland compared to the numbers in other parts of the UK. That is reasonable. However, I will make two initial points.

First, we have been very deliberately trying to achieve as high an uptake as possible in the top priority groups, and we believe that we are achieving a higher uptake than elsewhere. For example, we have not just offered vaccination to all older people in care homes; we have achieved an actual uptake of 98 per cent among residents and 88 per cent among staff working in older people’s care homes. That really matters in reducing the burden of illness and deaths.

The situation is similar in the over-80s group. The 83 per cent that I reported earlier is based on a cohort number that we think is overestimated. The work that we have been doing with health boards to refine those numbers suggests that the actual uptake among over-80s is already closer to 90 per cent. Those uptake figures are way beyond anything achieved in the flu vaccine programme.

Vaccinating the most vulnerable to the greatest extent possible is very important, even if it takes more time to do so, because it will help to save more lives.

All that said, though, it is clearly the case that overall volumes also matter, and that leads to my second point. As we make more use of mass vaccination centres for the younger age groups, we expect the daily rate to increase. For example, the figure reported today shows that just under 35,000 first-dose vaccinations were given yesterday, which reflects in part the opening of new centres. That is our highest daily number so far, and it is 55 per cent higher than last Monday.

Having achieved greater depth in the programme so far, in the form of high uptake among priority groups, our challenge now is to accelerate on breadth, in the form of numbers overall, and that is what we will be doing. It is right, however, that this is all subject to close and on-going scrutiny, and we will continue to provide the daily figures that allow that to happen.

As we continue to suppress the virus within our own borders and increase the protection of the vaccine, it is also essential that we guard against the fresh importation of cases from overseas. That is particularly important as the virus mutates and new, more infectious and potentially more severe variants emerge. As we look ahead, we must learn from past experience.

For example, we now know that, by early July last year, we had almost eliminated Covid in Scotland but then allowed it to be reseeded from overseas travel. We must guard against that happening again. It is to that end that the four United Kingdom nations have already agreed that travellers who are coming into the UK from countries that have a travel ban in place will be required to quarantine in hotels. That is a necessary measure but, in the Scottish Government’s view, it does not go far enough.

First, very few people should be coming here from countries that have a ban in place anyway. Secondly, that approach leaves open the possibility that people will travel into the UK from those countries via third countries. Thirdly, an approach to managed quarantine that includes only countries where new variants have already been identified is too reactive, because often by the time a new variant has been identified through genomic sequencing, it will already have spread across borders.

The firm view of the Scottish Government is that, in order to minimise the risk of new strains coming into the country, managed quarantine must be much more comprehensive. I therefore confirm today that we intend to introduce a managed quarantine requirement for anyone who arrives directly into Scotland, regardless of which country they have come from. Obviously, we cannot unilaterally implement immediate managed quarantine for people who arrive in other parts of the UK before travelling on to Scotland, so we will continue to urge the UK Government to adopt a similarly comprehensive approach. If it does not wish to do so, as is its prerogative, we will ask it to work with us to reduce the risk among people who are travelling to Scotland via ports elsewhere in the UK. We will set out more detail of how and when the managed quarantine system will be operational as soon as possible.

I understand how tough restrictions are for our travel and aviation industry, as they are tough for individuals, so we will also work with the UK Government to ensure that the sector gets the support that it needs until such time as we are able to start to ease travel restrictions.

It is vital that we guard against the importation of new Covid cases. However, it is also crucial that we continue to identify cases and break chains of transmission here, in Scotland. We are already increasing the accessibility of testing, for example, by increasing the number of mobile test facilities that are available, creating additional local and regional test centres, and making more use of fire service stations for testing in rural areas. Today, I can set out a further expansion of regular, routine testing of those without symptoms.

From later this month, we will widen the regular testing of healthcare workers so that it covers primary care workers in patient-facing roles, such as general practitioners, dentists, optometrists and pharmacists. From mid-February, regular testing will also be available to all staff who work directly with patients in hospices. We also intend to expand the availability of regular testing in other health settings such as addiction and mental health services. We will introduce targeted testing to support some essential public service functions, including emergency service control rooms and NHS 24.

Staff and patients in certain health settings obviously face an elevated risk of transmission, which is why it is right to focus on those. However, we know that some industries, such as food production and distribution, also have higher transmission risks. We are therefore working with businesses in those sectors with a view to introducing routine testing for their workforces over the course of this month.

Alongside those proposals to test people whose work potentially puts them at risk, we will expand targeted community testing whereby testing is made available to everybody in a local area regardless of whether they have symptoms. That can play a particularly valuable role in communities where prevalence is stubbornly high or starting to rise again.

In recent weeks, local councils have submitted proposals for community testing. We have been considering those in the light of the lessons from the pilot projects that were conducted at the end of last year. Community schemes have already been agreed across seven local council areas in the health boards of Fife, Grampian and Ayrshire and Arran. By the end of this week, we will have agreed community testing plans across the majority of mainland local authority areas. In addition, mobile testing units are already being used for targeted community testing in the Ayrshire and Arran, Dumfries and Galloway, Scottish Borders and Forth Valley health boards. Those testing units, which offer tests to people regardless of whether they have symptoms, are already finding cases on a daily basis that would otherwise not be identified. The health secretary will, in due course, set out more detail of everything that I have announced.

One of the purposes of increased testing is, of course, to help to break more chains of transmission. However, that requires good support for self-isolation. The latest available survey evidence, which is UK-wide, suggests that there is good compliance with self-isolation, but we know that we need to do more. I therefore confirm that we intend to extend eligibility for the £500 self-isolation payment to everyone on an income below the level of the real living wage. More details of that and the other steps that we intend to take to support people who are required to self-isolate will be set out shortly by the social security secretary.

I now turn to education, which I am sure is what the many parents who are watching most want to hear about today. It is a statement of the obvious that all of us want to see children and young people back in full-time, face-to-face education as soon as possible. The closure of school premises to most pupils right now is, unfortunately, necessary in the interests of protecting the country overall from the harm of the virus. Evidence of the wider health, developmental and social harms that are being experienced by children and young people concerns all of us, and—I know that this will resonate with parents, in particular—it concerns us more with every day that passes. I am also acutely aware of the pressure that school closures are putting on working parents and on family life more generally.

I have to be candid and say that our room for manoeuvre, given the current state of the pandemic, is limited. However, I want to be equally candid, as I have been before, about the Government’s determination to use every inch of headroom that we have to get children back to school, even if that means adults living with restrictions for longer. In short, the judgment that the Cabinet arrived at this morning, which is based on and takes full account of the advice of our expert advisers, is that, if we all agree to abide by the lockdown restrictions for a bit longer so that our progress in suppressing the virus continues, we can begin a phased, albeit gradual, return to school from 22 February, following the mid-term February break.

The decisions that I am about to outline are intended to give young people, parents and teachers as much notice as possible, but I must stress that they are subject to continued progress in suppressing the virus and will be subject to final confirmation in two weeks’ time. However, as of now, our intention is that, from the week beginning 22 February, there will be, first, a full-time return of early learning and childcare for all children below school age; secondly, a full-time return to school for all pupils in primaries 1 to 3; and, thirdly, a part-time return, albeit on a limited basis, for senior-phase pupils, to allow in-school practical work that is necessary for the completion of national qualification courses. Initially, though, it is intended that there will be no more than around 5 to 8 per cent of a secondary school roll physically present at any one time for those purposes. We also intend to enable small increases in the existing provision for children and young people with significant additional support needs where there is a clear and demonstrable necessity.

We will, hopefully, confirm those decisions in two weeks’ time. I also hope that, at that stage, we will be able to set out the next phase of the gradual return to school and even an indicative timescale for the return of in-person learning in our colleges and universities.

Before I leave the topic of education, I will make an additional point. I spoke earlier about testing, and that is relevant to education, too. I can confirm that there will be a significant expansion of testing in educational settings to support the return to nurseries and schools in the weeks ahead. It is our intention that those who work in schools and in early learning and childcare settings that are attached to schools will be offered at-home testing twice a week. All senior-phase secondary school students will be offered that as well. The testing offer will be in place for schools as soon as possible, to support their return on the basis that I have set out, and we will extend that to the wider childcare sector in the weeks that follow.

I think that I speak for everyone in the country when I say that we are determined to get our children back to normal schooling and, by extension, as much normality back in their lives just as quickly as it is safe to do so. That is our overriding priority, and I think it is right that that is the overriding priority for us all. I again thank young people and their families, as well as teachers and school and nursery staff more generally, for the patience and understanding that they are showing during these incredibly stressful times.

We are making progress in suppressing the virus and getting people vaccinated, but we need to do more on both of those fronts in the weeks to come. The path ahead remains difficult—it is important to be candid about that. The virus is still circulating not just here but across the UK, Europe and the world. Of even greater concern is the fact that it is mutating. We must remain vigilant and disciplined. To get the virus more under control, and so that we can prioritise every bit of headroom that we create to get children back to school, unfortunately, we must all stay at home except for permitted, essential purposes for a bit longer, which will be at least until the end of this month.

When we are able to start the process of slowly easing lockdown, to give us all more normality in our day-to-day lives, we will have to accept that some mitigations, such as physical distancing and face coverings, will be necessary for a while yet. I am afraid that we will also have to accept that the price of greater domestic normality is likely to be, for a period at least, not going on holiday overseas. Those are not easy trade-offs, but they are essential as we continue our journey through and, hopefully, out of the pandemic.

I am grateful to everyone for their continued sacrifice, and I ask everyone to stick with it. Please stay at home, protect the NHS and save lives.

A return date for nurseries and early primary and for part-time schooling for older year groups is welcome and it will allow parents across the country to plan. However, it is clear that heavy restrictions will remain in place until enough Covid-19 vaccine is delivered to enough people.

At the moment, all the evidence shows that the Scottish Government’s roll-out is slow, stuttering and lagging way behind that of the rest of the UK. Although we saw record highs elsewhere this weekend, on Sunday Scotland saw the lowest number of jags administered since the start of the mass roll-out more than a month ago.

As we said last week, the new mass vaccination centres, which are already open elsewhere, will help pick up the pace. However, throughout January, the First Minister has disputed any and all criticism. She has rubbished suggestions from GPs, patients and even the British Medical Association Scotland that Scotland’s roll-out was sluggish and missing targets that it needed to hit.

The First Minister’s argument today is that we are starting to catch up on vaccinating the over-80s, but the same problem is happening with the next cohorts. Today’s statement indicates that 21 per cent of 75 to 79-year-olds have received the vaccine, which is good news for them, but that is still just a quarter of the proportion vaccinated south of the border.

The problem extends to all the over-70s. They are writing to us in huge numbers about another missed target. Last Friday, Jeane Freeman said that they would get invitation letters

“by the end of this week”.

Those people have been waiting, but that has not happened.

By what date will all over-70s get their letter, or be otherwise contacted? Will the First Minister now accept further offers of support from the armed forces? Will she now finally explain why the roll-out in Scotland is so far behind?

Every single one of those questions is a fair question—I do not dispute that—and I will address each and every one of them. Indeed, whether all of them are accurate is another matter, but they are all fair, and it is incumbent on me and the Government to make sure that we address them.

I have not rubbished the concerns of anyone. In fact, we have worked with GPs and others to make sure that any issues that are being raised are appropriately addressed and that any challenges that are being faced are overcome.

The notion that we will be living with restrictions until all of us across the UK, and further across the world, have vaccinated significant numbers of people is right—to a point. It is also important for all of us to be candid that, given what we do not yet know about the impact of the vaccine on transmission, we might be living with some degree of restriction even after we have vaccinated significant proportions of our population. It is because of what we do know about the impact of the vaccine—that it operates to reduce severe illness and death—that it is so important that all of us have focused first on vaccinating those who are clinically most vulnerable.

On Ruth Davidson’s specific question on over-70s, every adult in the clinically extremely vulnerable group will have had a letter by the end of this week at the latest. More importantly, we are on track to meet the target that we set, which was to have vaccinated everyone in those groups with their first dose by the middle of February. We have got to a higher uptake among over-80s ahead of the target that we set for that group than I thought was possible even just a week ago.

I am not denying that we want to accelerate our overall progress—I will come back to that point in a second—but neither will I apologise for having deliberately focused on maximising uptake among our clinically most vulnerable groups. I can stand here and say that of the older residents in our care homes it is not just the case—as is being said elsewhere—that they have all been offered vaccination; 98 per cent of them have had their first dose of the vaccine, as have 88 per cent of the staff who work with them. That is important, because it will help us to save lives and reduce the burden of illness. Similarly, although, as I said in my statement, we are refining the numbers that we believe are in the over-80s cohort, we think that we are probably close to 90 per cent of over-80s having had the vaccine. We will see the number in the over-70s group grow day by day over the course of this week.

I come on to the point about the overall rate of progress, which is a legitimate one. I want to see the daily rate grow and accelerate, which is why I look at today’s number and will look even more closely at tomorrow’s number and those for the rest of this week. The number that we are reporting today, which covers the number of people who were vaccinated yesterday, is 55 per cent higher than the number reported last Monday. It is also the highest daily number that we have recorded so far.

Having achieved depth in those top clinical priority groups, our challenge is now to get breadth in the overall acceleration of progress in the programme. That is what we are absolutely focused on.

I thank the First Minister for advance sight of her statement. I welcome the expansion of community testing, which I raised with her previously. I, too, send my condolences to families who have lost loved ones.

Almost a year into the pandemic, we are all too aware of the negative impacts that lockdown and school closures are having on children and young people. Last Thursday, the equality and fairer Scotland budget statement cited challenges for attainment and career progression. We know, too, that those from disadvantaged backgrounds will feel such challenges even more acutely. Yesterday, the Institute for Fiscal Studies set out that, by the time that the pandemic is over, most children will have missed more than half a year of normal, in-person schooling. The lifetime cost of that could be as much as £40,000. The effect of Covid on lost learning could therefore translate into lower incomes and higher inequality.

Education Scotland is now releasing weekly reports detailing all the issues that pupils and teachers still face. I say to the First Minister that significant remedial action is still required, over and above what is already being done. What more will the Scottish Government do to address that concern? Further, councils and parents have highlighted significant difficulties in ensuring provision for pupils with additional support needs, the consequences of which have been hugely detrimental to their wellbeing. What increases in such provision will be offered, and what criteria will be used to decide which pupils will benefit from them?

I do not think that anyone is anything other than deeply concerned—I know that I am—about the on-going and cumulative impact on young people of having their school lives so seriously disrupted. That is why the Scottish Government’s most important objective is to get young people back to school.

I hope, based on what we have set out today, that that process will begin on 22 February. I do not know what plans other Governments will set out, but I think that we are the first Government in the UK to set out the start of that phased return. We will want to accelerate that as quickly as we can. That is the most important thing that we can do to help young people not to experience any further impact from Covid in that form.

We will also—for some time, I think—be requiring to invest more and to provide more support to schools, teachers and indeed parents to help children to catch up in terms of the impact of lost time in school over the past year. The education secretary continues to discuss with the Convention of Scottish Local Authorities and with education interests exactly what form that will require to take over the medium to long term.

In the here and now, the Deputy First Minister has already set out additional funding to give councils the flexibility to do more, for example, around digital access to learning or to provide greater support directly to parents. We will continue to do that.

Similarly—and I will ask the education secretary to make more information on this available—we are looking on an on-going basis at those with additional support needs. That is why, as well as the phased return that I set out today, we are also trying to increase the provision within the existing arrangements for those with significant additional support needs.

In a situation that has been difficult in every respect for literally every person in the country, the impact on young people is the one that certainly grieves me the most and, I think, is the one that we will be requiring to pay attention to for the longest. Let us focus on not only getting them back to school but doing everything that we can to make sure that there is not the lifelong impact that some have expressed concerns about.

Expanding eligibility for the self-isolation grant is welcome, but there is clearly a need for a wider support package. The Greens will bring that debate to the chamber tomorrow.

Quarantine measures for international travel are welcome, too. Such measures could have prevented so much harm if they had been in place over the past months, but it is good that they will finally be there.

Parents, pupils and teachers all want schools to get back to normal, but that cannot be at the cost of safety and the Educational Institute of Scotland is continuing to urge caution. The Greens have called for the expansion of regular testing for school staff for months now, and the Parliament backed that position in November. Therefore, having announced a system of twice-weekly home testing today, can the First Minister tell us whether that will be fully in place by the 22 February return date?

Given that social distancing will be needed in classrooms, because we still do not know enough about transmission of the new variants and, in any case, many pupils will continue to need to self-isolate, is it not clear that even a phased return must also be based on blended learning, with resources in place to ensure that teachers’ workload is manageable?

The arrangements that I have set out for twice-weekly home testing will be in place for schools as they return on a phased basis from 22 February. In the weeks thereafter, it will be further extended across other educational settings such as early years.

There is also an existing provision that has been in place since schools returned last August. Any member of school staff who believes that they have been exposed to the virus, even if they do not have symptoms, can access polymerase chain reaction testing. I take this opportunity to remind people who are working in our schools that that is available.

On the general questions about the safety of schools, if I was not so concerned about making sure that everything that we did was consistent with that paramount requirement to keep schools and everybody in and around schools safe, we would be making sure that every young person got back into school as quickly as possible, because the impact on young people of being out of school is significant. However, it is because we need to do that safely that we are taking a careful, gradual and phased approach to the return to school.

The new variant definitely makes it essential that we continue to be cautious. I am happy to ask the chief medical officer for Scotland to arrange a further briefing for MSPs as soon as possible on what we are learning about the new variant. I have certainly not seen any evidence that suggests that the new variant is disproportionately affecting young people more than other groups but, because it is more infectious, it is liable to infect all age groups more than previous strains of the virus did.

As I said, Public Health Scotland is doing further analysis of some initial evidence that suggests that there might be a statistically significant increased risk of hospitalisation—not particularly for young people but for the population generally—associated with the new variant. For all those reasons, we need to continue to be cautious.

On Patrick Harvie’s question about blended learning, although we want young people back in school full time with as much face-to-face provision as possible, we will need to have blended learning available as a contingency as we go through the next phase of the pandemic. The senior phase return that I spoke about earlier will be on the basis of blended learning. It will involve limited in-school face-to-face provision for essential practical work that is necessary for exam courses. We need to have those contingencies to ensure that, as we get young people back to school, we do so in a way that is consistent with overall safety.

I have been raising the issue of routine testing for weeks—in fact, months—so I am pleased that it will be rolled out more widely, including in schools. However, it is not clear whether the First Minister will ensure that the routine testing is available before pupils go back or when they go back, so I would like clarification on that.

The First Minister has been very controlled today, but previously she has been irritated by comparisons with England on the roll-out of the vaccine. However, it is a fair benchmark to use. We need to be ambitious and think about what could be done. We are way behind where England is, and we need to work harder to catch up. The First Minister clings on to the care homes explanation for the slow roll-out, but there was no reason to hold back the rest of the programme while we did the care homes, so she should ditch that explanation from now on.

I praise the teams for vaccinating 35,000 people yesterday. At last, we are moving in the right direction, but it has taken seven weeks to get there, and we are still behind England by a margin of 200,000—that is what could be done if we were keeping pace with England. Therefore, what new steps will the First Minister put in place to close that gap?

I am not clinging on to anything. People can make their own judgments on the issue, which is perfectly legitimate, but I am trying to explain rationally the trade-offs in the early part of the programme. I described it in shorthand in my statement as a trade-off between depth and breadth. As we go further into the programme, we do not have the same trade-off, as we are now trying to do both. However, in the early stage of the programme, it is about making sure that we absolutely maximise uptake in the most clinically vulnerable groups, which means not just those in care homes but the over-80s.

The information that we are publishing daily on the breakdown of vaccinations is, I think, much more detailed than the information from other parts of the UK, so I do not have comparable figures. However, saying that 98 per cent of people in care homes have actually been vaccinated is different from saying that 100 per cent have been offered vaccination. I do not know what the actual vaccination rate in care homes is elsewhere in the UK. Similarly, on the over-80s, I suspect that we are now getting to uptake among the over-80s that will be at least the same as and possibly even higher than it is in other nations in the UK. Work is still going on to refine some of the overall numbers in the cohort, but we estimate that we are getting close to 90 per cent of over-80s having actually had the vaccination. Those are extraordinary uptake figures, and it is a great credit to the people who are coming forward so enthusiastically for vaccination.

That matters, because those are the groups who are most likely to become ill and die, and we know that the vaccine has an impact on that, whereas we do not yet know whether it has an impact on transmission of the virus, although we hope that it does. That is why, in the early part of the programme, we have concentrated on that depth. Now, in the numbers that I have reported today, we see that that is starting to be replicated in the breadth of the programme, although obviously we have to monitor the situation this week and into future weeks.

The member raises legitimate questions, and a legitimate argument can be made that we should just have gone for breadth rather than depth. I accept that, but my judgment is that we have approached the issue in the right way. However, it is right that we are under serious scrutiny to make sure that the pace of the programme is what people expect. I do not complain about that for a single second. For every one of the questions and every ounce of the scrutiny that has been rightly applied to me, the health secretary and I are making sure that that is applied in the system as well, so that we get it moving at the speed that we need it to.

As regards the question about what additional work we are doing, that is all in the planning and the deployment plans that the health secretary has set out. As we move into the younger age groups, we will bring more of the mass centres on stream, as has happened this week. Such mass centres are not necessarily as appropriate for members of the older age groups, who prefer to be vaccinated in their GP surgeries. However, as we move down the age groups, the mass approach to vaccination will become much more important.

I not only expect but encourage Parliament to keep intense scrutiny on the issue, because it is in all our interests that we get the vaccination programme going at the speed that we all want it to go.

I am conscious of the fact that about 16 other members want to ask questions.

The extension of lockdown to at least the end of February will come as little surprise to my Cowdenbeath constituents. However, I believe that people want to know where we are headed, so that they can have some hope. Can the First Minister confirm that, when lockdown is lifted in due course, we will revert to the strategic framework tiers approach, with the consequent possibility of moving down from tier 4 to lower levels, and therefore having greater normality in our lives?

Yes. We hope that, as we come out of the lockdown restrictions that we are under at the moment, we will move back to a levels system, in which the restrictions that we apply in different parts of the country will be dependent on the prevalence of the virus in different parts of the country.

We are conducting a review of the levels system that we applied previously to ensure not just that we have learned from the experience of that, but that the content of and the indicators for that levels system remain appropriate in light of where we are now and, in particular, in light of the new faster-circulating variant of the virus. Over the next couple of weeks, we will provide an update on that review and start to look ahead to when we might be able to come out of a national—or virtually national—lockdown into a more varied approach, depending on how the virus is behaving in different parts of the country.

As I said in my statement, we hope to be in a position in which, around the start of March, we can start to look ahead to what may be a gradual but nevertheless a definite easing of the restrictions that we are under, but that will depend on our progress on vaccination and on suppressing the virus now. It will also depend on our having sufficient headroom to do that beyond the headroom that we need to get children back to school. At the moment, we want to use any headroom that we think that we have to get children back to school. Once we think that we have got enough, we can move on to easing restrictions for the rest of the population.

In summary, right now, all of us, as adults, have to be prepared to live with some restrictions for longer in order to get children back to greater normality first.

Last week, in an answer to my written question, it was revealed that 14,000 pupils did not have access to devices for online learning. Many of those pupils are in our most deprived communities; they include 1,800 in Renfrewshire, 1,700 in West Dunbartonshire and 1,300 in Dundee. Why is that the case?

We have already made additional money available to local authorities to help them to fill those gaps. We have always recognised that a number of young people were not being reached through the existing digital provision. We made money available earlier on to get devices and connections to a number of households across the country. The additional money is intended to help local authorities to go further and to continue to close those gaps. We will continue to try to do that on an on-going basis while doing the even more important task of getting children back into face-to-face learning.

Will the First Minister clarify the focused role of GPs in delivering the vaccine roll-out? Does she expect that to change over the next three-week reporting period?

GPs have a very important role to play in the delivery of the vaccine, and that will continue to be the case throughout the progress of the vaccine programme.

In the initial stages, GPs have been focused on vaccinating the most vulnerable. In the past couple of weeks, that has been the over-80s, because we judge that, for the older, frailer members of our communities, access through GP surgeries is the best way of getting them vaccinated quickly. As I said earlier, we think that close to 90 per cent of the over-80s have already been vaccinated.

As we get down into the younger age groups, we will make—and are already making—more use of mass-vaccination centres, where people’s appointment letters will tell them to go. It might not be the Edinburgh International Conference Centre or the NHS Louisa Jordan, for instance; it might be a local village hall or community centre where they will get vaccinated, while GPs focus on people who are more vulnerable or older, for whom it is considered that general practices are the best places for vaccination to happen.

A mixed approach will be taken throughout. If GPs were asked to do the whole of the programme, they would not be able to do anything else. Likewise, if we did not have GPs as an integral part of it, we would miss a lot of people who would otherwise be vaccinated that way. We will continue to pursue a sensible approach, and GPs will always be integral to that. I take this opportunity to thank them for the incredible work that they have been doing so far.

Today’s report from the Poverty Alliance is only the latest one telling us that remote learning, while necessary, has widened the attainment gap. East Lothian Council has partnered with Queen Margaret University and the STV children’s appeal to launch a tutoring initiative to support 300 senior pupils, mitigating the effects of lockdown on learning. With lockdown continuing for most pupils, why are the Scottish Government and Education Scotland not ensuring that such support is available everywhere?

A tutoring arrangement is available through the e-Sgoil platform. We will be interested to look at the approaches that local authorities are taking to see whether we can do more to extend them across the country.

Everybody recognises the impact that the situation is having on young people, and I, the Deputy First Minister and everybody in Government want to do everything possible to help young people to minimise that impact and to catch up with learning that they have lost. The tutoring arrangements are available, but we will be open minded about anything that we can do to extend such opportunities further.

Does the First Minister agree that the most complex and challenging stages of the vaccine programme lie ahead, as we seek both to increase the pace of the roll-out and to ensure that second doses are timeously administered to the most vulnerable? Now that more than 610,000 of the first vaccine doses are in people’s arms, we need to ensure that adequate supply is available to administer the second dose. What assurances can the First Minister provide in that regard and on the future roll-out programme?

Every stage of the vaccination programme will bring its own challenges—Bruce Crawford is right. As I have tried to reflect, we have an obligation and a challenge to go deep into every cohort, maximising uptake, while going through the bulk of every cohort as quickly as possible. Breadth and depth cannot be trade-offs as we go through the rest of the programme; we have to achieve both, and that is what we are focused on.

As regards the need to start the second doses, I note that some second doses are now being administered on a daily basis but, as we get to the 12-week point for the bulk of people who have been being vaccinated so far, we must ensure that the modelling of our supply versus uptake is sufficient. I can give the assurance that that is fully factored into all the assessments and assumptions that we make in our modelling of the rate at which vaccination will happen over the weeks to come.

It is undoubtedly true that the attainment gap is now at serious risk of widening, especially in our most deprived communities. What is being done to help pupils to catch up with their lost education? Why are so many supply teachers—newly and recently qualified teachers—still contacting us to say that they are looking for work? Why are they not out there, helping those who have been hardest hit by absences? Should there not be a national call for anyone who is able to help to come forth and do so?

Yes. There should be no reason why supply teachers are not able to get work right now. We have already made £45 million available to local authorities to employ additional staff. Local authorities should be making full use of any offers of supply teachers that come their way, because the funding is there for that—let that message go out loudly and clearly.

A range of things is being done to support children while they are out of school and to try to minimise the on-going impact on their education—I spoke about digital provision, including the resources that are available on the e-Sgoil platform. There is a range of ways in which we will support local authorities to make sure that they have in place the staffing and resources to support children as they start to return to school.

All that is vitally important, but I come back to the central point that, what matters most right now in this phase of dealing with the pandemic, is that we act in a way that opens up the space to get children back to school as quickly as possible.

As the vaccination programme progresses and the country begins to move out of lockdown, will consideration be given to prioritising the opening of sports and leisure activities? It was a cause of great consternation to many of my constituents that pubs were open before folk could go to the gym or take part in sport that could be operated safely and positively contribute to physical and mental health.

That is a reasonable question. Obviously, all of us want to get everything back to normal as quickly as possible, but we learned last year that we cannot do everything at once, and therefore we have to prioritise. Perhaps we did not always make the right choices when it came to prioritising things last year.

That is not to say that it is not perfectly legitimate for pubs and restaurants and other parts of the economy to want to open, because it absolutely is, and I want to see them back to normal as quickly as possible. However, as we continue down this difficult path and as headroom opens up, we have to be very clear what our priorities are.

I have been very clear again today that the first priority for the Government is getting children back to education; I think that that has widespread support across the country. Ruth Maguire raises a valid point: after we have done that, what is the order of priority? If we have limited headroom, then other facilities that help with the health and wellbeing of the population absolutely have to be there in our thinking. It will not be an easy balancing act this time round, any more than it was last time round. However, we have the experience of last time and we know what we think that we perhaps did right and what we wish that we had perhaps done differently and we will be seeking to apply that.

Today’s announcement about getting children back to school on 22 February is most important and is very welcome news.

We know that online learning is very patchy across the country. Some pupils have the opportunity to speak to their teacher daily, but others have not spoken to their teacher for weeks. What are the Cabinet Secretary for Education and Skills and the Scottish Government doing to improve the situation and to make it more sustainable for children who do not have that contact?

That is another important question. That will be a challenge for us for as long as children remain out of school. The first overview report on remote learning has been published; it indicates that there have been some important improvements on the experience last year. Anecdotal feedback that I have received from many people across the country is that the experience of online learning is much better in this second period out of school than it was in the first.

I recognise that there will be variation among the different parts of the country, so the education secretary continues to work with local authorities to make sure that provision is of a uniformly high standard. One of the reasons why additional resources were committed to local authorities was to allow them to invest in areas that they think are important.

For as long as children are out of school, we will continue to make sure that provision is as good as it can be, but we must acknowledge candidly that it will never be as good as having children in school, learning face to face. That is why I come back to the central point, which is that getting back to that as quickly as possible is our driving priority.

I welcome the extension of the £500 self-isolation grant to people who earn less than the living wage. What additional resources would be required to extend that, as many of us would like, to people on average earnings or less, many of whom have families to support?

I do not have to hand exactly how much that would cost, but I am happy to have the suggestion costed and to make that information available. We will continue to consider extensions to eligibility when we think we have resources to support that.

We are still looking at the overall quantum of support and at other practical ways in which people who have been asked to self-isolate can be helped to do that. As I said, the Cabinet Secretary for Social Security and Older People will set out more detail on that shortly.

I absolutely recognise—as, I think, we all do—that being asked to self-isolate is, especially for people with children, a really difficult thing to do, so we have to support people as much as possible.

At the end of the week ending Sunday 24 January, 7,932 new cases of Covid were identified, with 20,555 contacts having been traced. What proportion of that figure does the First Minister’s Government expect have self-isolated, and how many contacts is it estimated have not been traced? Does the First Minister believe that it is important that those data are tracked in order to increase the numbers who are self-isolating and to break the cycle of transmission?

On the survey data that we have on self-isolation, some UK-wide work was published quite recently. I am trying to see whether I can find it in my papers; I cannot immediately do so. I will make it available to members. That University College London data suggests that self-isolation compliance is relatively high—higher than I had thought it might be.

The data also suggests that some people are still expressing that they have difficulty self-isolating. Our focus is on ensuring that we understand the reasons why people are finding it difficult to self-isolate, that we understand what groups of people are finding it difficult, and that we try to target more support at that. Extending eligibility for financial support is a very important step forward. It is not the first step that we have taken, however; we previously widened eligibility to include parents whose children had been asked to self-isolate.

We continue to consider how we can support more people. Often, support is not just financial. The outreach service that councils operate, for example, is dependent on people giving their permission to be contacted. All members could help by encouraging their constituents to do that. That means that councils will telephone people and offer more practical support—with delivery of shopping and medicines, and up to and including provision of alternative accommodation, if that is needed.

We need to focus on the reasons why people are struggling and we need to help to solve those problems, which is what we continue to do.

I welcome the extension of the quarantine requirements to anyone who arrives directly in Scotland, no matter where they travel from, and I understand why the Scottish Government cannot unilaterally extend that to people who travel here via other parts of the UK—for example, England. However, given that importation of the virus is crucial and that we nearly had it eliminated in the summer last year, will the First Minister, using the current travel restrictions, tighten checks on people who cross the border?

We talk to Police Scotland on an on-going basis about its approach to enforcement, and it continues to take what it considers to be a sensible and proportionate approach. However, I will ensure that we relay the sentiment behind Christine Grahame’s question to the chief constable, and will ask him to consider whether more steps can be taken.

I know that nobody likes the idea of travel restrictions. I hate travel restrictions as much as all the other restrictions, but if there is one overriding lesson that we need to learn from last summer—there is probably more than one lesson that we need to learn from it—it is about the danger of suppressing the virus here in Scotland, as we did successfully, then allowing it to come back in. That is why it is so important that we have in place much tighter restrictions this time.

There will always be difficulty with the border between Scotland and England if Scotland and England do not take the same steps. We will continue to support the four-nations approach as much as possible, but where it is not possible, we have a duty to do as much as we can at our own hand, which is what we intend to do.

I am sure that the First Minister will join me in urging everyone to accept vaccination once it has been offered. I appreciate that she might not have the number immediately to hand, but does she have an indication of how many people so far have refused a vaccine after they have been offered it? What is being done to convey to the public the importance of being vaccinated?

I do not have that number to hand. Obviously, the number who have not been vaccinated in any group, once we have got through the whole group, will not include just people who refuse to be vaccinated; it will also include people who are not vaccinated because of health conditions. In care homes specifically, I think that the 2 per cent who have not taken up vaccination will include people who are very close to the end of their life. We need to be cautious and not assume that the people in any group who do not get vaccinated are all refuseniks or people who are sceptical about vaccination. However, the general point, which is important, is that it is incumbent on us all to encourage people to come forward for vaccination.

The figures speak for themselves. Uptake is very high in the cohorts that we have almost completed. If I had been told a few weeks ago that we would get 98 per cent of older care home residents vaccinated, I do not think that I would have believed it, and if I had been told that we would get to 90 per cent of over-80s, I would have been equally sceptical. The figures suggest that there is enthusiasm and willingness to come forward for vaccination. The number of people who are refusing to do so is very small; we must all work hard collectively to ensure that the number is as small as possible.

Local authorities and teaching unions are key partners in making a success of roll-out of routine asymptomatic testing for school staff and senior-phase students, and in getting schools back safely, even if that is initially on a phased basis. Has the First Minister had any discussions on those matters with councils and teaching unions that could reassure not only people who are currently working in schools but—which is just as important—staff who might return to schools shortly?

The education secretary in particular has on-going discussions with the education unions and representatives of education staff and councils, through the education recovery group.

I apologise because I think that I omitted to answer a question that I was asked earlier—it might have been by Iain Gray—about the timing of testing starting, in relation to schools going back on 22 February. We intend that the beginning of testing will align with schools going back. The Deputy First Minister will write to members with details of when and how that will be introduced. However, Bob Doris is right that the people who work in our schools are key partners, so it is important that we continue to work closely with them.

It has taken a full year to provide schools with home testing, and we keep being told that the Government is “looking at” vaccinating those who work in schools. What does “looking at” mean, and will school staff—who are on the front line—have to wait a similarly long time to be vaccinated?

On vaccination, I would have assumed that Neil Findlay, having shadowed the health portfolio for a lot of time—I am not sure whether he still does—would know what “looking at” means. It means considering and taking account of advice from, for example, the Joint Committee on Vaccination and Immunisation. The JCVI has given us advice on the first groups, based on clinical priority—to be blunt, those who, in descending order, are most likely to become ill and die. As the health secretary said earlier, as we go into the wider population, the JCVI will consider whether it wants to advise on priority. We will consider that advice and, in all likelihood, we will—as we always have in the past—adopt that advice.

It is important to stress that there will be teachers who have been, are being and will be vaccinated as part of those priority groups—people who are part of the clinically extremely vulnerable groups, for example. That is the way in which any vaccination programme should proceed: it should be based on clinical advice, which is based on clinical priority. We want to reach, as quickly as possible, the point when the whole adult population has been vaccinated.

The First Minister will be aware that the JCVI’s clinically extremely vulnerable list includes everyone who is in receipt of carers allowance, and all unpaid carers of elderly and disabled people who would suffer should that care be withdrawn if the carer tested positive or was required to isolate. Can the First Minister offer that group reassurance that they will be vaccinated with the rest of the clinically extremely vulnerable group this month? Is she confident that the system has been able to identify them all?

I will ask the health secretary to write with more detail on the answer that I am about to give, but yes—we are confident that everybody in the clinically extremely vulnerable group will be vaccinated within the timescale that I set out earlier.

With all such cohorts, there are definitional challenges in ensuring that we are properly capturing people who need to be in them, and identifying everyone who is in them. I have talked a bit today about the over-80s group, which we think we slightly overestimated; we might also have slightly underestimated the numbers of front-line health and care staff. If Joan McAlpine looks at the figures, she will see that we have vaccinated more front-line health and care staff than we said was in that cohort. There will be challenges that we need to make sure we address.

Unpaid carers will be getting their vaccination appointments starting from the third week in February, but anybody who is in the clinically extremely vulnerable group will be vaccinated in the timescale that I set out earlier.

I apologise to Graham Simpson and Alex Cole-Hamilton, but I am afraid that there is no time for any more questions.

Before we move on to the next item of business, I encourage members to observe social distancing, to wear their masks when they leave the chamber and to follow the one-way systems around the Parliament building. Thank you.