Meeting of the Parliament (Hybrid)

Meeting date: Tuesday, December 22, 2020

Official Report 1260KB pdf

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Covid-19

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

14:04  

Today’s statement is a bit different from those that I have made in recent weeks, mainly because the most important decisions for the period ahead were set out on Saturday. I will, of course, reiterate those decisions and the reasons for them in the course of this statement. I will also share with the chamber the latest information that we have on the new strain of Covid that is causing us such concern, and I will reflect on the on-going impact of the closure of the United Kingdom-France border to accompanied freight.

However, I will start, as usual, with a brief summary of the latest Covid statistics. The total number of positive cases reported yesterday was 1,316. That represents 7.5 per cent of all tests carried out, and the total number of cases now stands at 114,366. There are currently 1,045 people in hospital, which is a decrease of 33 from yesterday, and 60 people are in intensive care, which is one more than yesterday.

I also regret to report that, in the past 24 hours, a further 43 deaths have been registered of patients who first tested positive over the previous 28 days. The total number of deaths under that measurement is now 4,326. Those figures continue to be a sharp reminder of the grief, heartbreak and overall toll that the virus is causing. Once again, my deepest thoughts and condolences go to all those who have lost a loved one.

Today’s statistics, like those that we have been reporting over recent weeks, underline a couple of points. First, Covid is still circulating in Scotland at a higher level than we would wish. However, and I appreciate that this may be less obvious, the case data from recent weeks also shows that the levels system has until now been effective. In late October, Scotland was recording more than 160 new cases of Covid per 100,000 people on average every week. Two weeks ago, that had fallen to around 100 and it is now around 116 per 100,000. That level of incidence is significantly lower than the level in other parts of the UK; for example, it is around half that of England and around a fifth of the current case incidence in Wales.

However, after a sustained period of decline, our case numbers are now more volatile again and have risen by around 15 per cent in the past couple of weeks. The number of people with Covid who are in hospital and the number in intensive care have also risen slightly again, after a period of quite marked decline.

In any circumstances those trends would be a cause for concern and merit close analysis, but they would probably not on their own justify the actions that I announced on Saturday. What has changed our thinking and approach significantly is the information that we have received over the past eight days or so about the presence and impact of a new variant of Covid. It is important to stress again that there is no evidence at this stage that the new variant causes more severe illness than previously circulating strains, nor is there any evidence so far that it will undermine the effectiveness of vaccines or treatments.

However, the new variant seems to be much more transmissible—perhaps up to 70 per cent more transmissible—which means that it can spread far more quickly and easily. As a result, there is now a significant degree of confidence among experts that it increases the R number and that the scale of increase could be 0.4. Given that the R number in Scotland is already hovering around 1, that is obviously a very real concern. Analysis was published yesterday by the Office for National Statistics of the results of the weekly ONS Covid infection survey, which uses polymerase chain reaction testing on a random sample of people in Scotland, looking for a proxy marker known as the S-gene dropout.

There is continuing technical work under way on the use of the S-gene dropout as a marker for the new strain and it is not absolutely definitive that every case with that marker will be the new variant. However, the analysis suggests that, in the week beginning 9 December, around 14 per cent of positive cases in Scotland already had the S-gene dropout, which compares to just 5 per cent at the end of November. It is not unreasonable to assume that the proportion may be higher by now; Public Health Scotland is carrying out further analysis.

Fourteen per cent is, of course, still a significantly lower level than the level in England, where it is thought that the new variant already accounts for 36 per cent of cases, and that may be even higher in London and the south-east. The very rapid spread in London and the south-east serves as a warning of what we could face here if we do not take firm action to suppress the virus.

We have a real concern that, without significant counter-measures, we could be facing another period of exponential growth as we enter the new year. That would mean many more people catching Covid and, even without the new strain causing more severe illness, that would result in many more people needing hospital and intensive care treatment, which would put an enormous strain on the national health service and lead to much more loss of life. To be blunt, that is what we have to act now to stop. In an ideal world, it would be good to wait a few weeks until preliminary analysis becomes more concrete and confidence intervals narrow. However, if the concerns that we have now prove to be well founded, by then it would be too late—we have learned that we must act firmly in the face of the virus. That is why we announced significant additional measures on Saturday. I know how tough those are, but we believe that they are essential to avoid an extremely serious deterioration in the situation as we move into the new year.

Let me recap now on what those measures are. First, Orkney, Shetland, the Western Isles and the other relatively remote islands that have had restrictions relaxed in recent weeks will move to level 3 from 1 minute past midnight on boxing day. At that point, the rest of Scotland will move to level 4 for a period of 3 weeks. There will be a review after 2 weeks. That means, for example, that hospitality will require to close, with the exception of takeaway services, and so too will non-essential retail.

There are three further points that it is important for me to make today about level 4 restrictions. First, given the severity of the situation that we face and the need to limit interactions as much as possible, we intend to define essential retail more narrowly than we have done recently. In short, that means that homeware stores and garden centres will be classed as non-essential and will therefore require to close, with the exception of click and collect. Secondly, in level 3 and level 4, the law currently prohibits non-essential travel outside your local authority area. However, for those who are living in level 4 areas—which from Saturday will be the vast majority of us—our strong advice is to stay as local as possible and at home as much as possible. We will be considering in the days ahead whether we need to place that advice in law.

Thirdly and more generally, as more evidence of the impact of the new strain becomes available, we will consider whether there is a need to strengthen level 4 restrictions any further. Again, I need to be blunt with the Parliament and the public: the current level 4 restrictions are not as stringent as the March lockdown and until now that has been a good thing. However, it seems that we may be facing a virus that spreads much faster now than it did in March, so we need to consider whether the current level 4 restrictions will be sufficient to suppress it in the weeks ahead.

That will be analysis that the Government undertakes urgently as our understanding of the new strain of the virus develops, and I will keep the Parliament updated as necessary, including over the recess period if that is necessary. The second decision that we took on Saturday was to maintain the current ban on travel to and from Scotland and the rest of the UK. Again, that was a decision that we did not take lightly. However, as we seek to suppress the new strain in Scotland, we must also guard against importing more of it from areas where it is already circulating more widely. The travel ban will remain in place throughout the festive period, including, unfortunately, on Christmas day, and as the chief constable has set out, the police will be enhancing their enforcement of it.

Regrettably, we also tightened other restrictions for the Christmas period. It is now possible to meet in a bubble of up to eight people from three households on Christmas day only and in Scotland only, rather than over a five-day period across the UK. However, our strong advice remains not to meet indoors at all if possible. When it comes to indoor celebrations this year, by far the safest option is to stay in your own house with your own household. If you plan to see people from other households on Christmas day, please try to stay outdoors if you can, but if you are indoors, please keep the numbers as low and the duration as short as possible, keep a safe distance as far as possible, wash your hands and surfaces regularly and keep windows open.

I cannot tell you how sorry I am to be standing here saying these things, and there is no part of me that is oblivious to the impact of it. I do not just understand that impact; I feel it, as everyone else does. However, it is necessary to keep ourselves and our loved ones safe at this extremely difficult and challenging time. I want to thank everyone from the very bottom of my heart for making these sacrifices.

The final, but extremely significant, decision that I announced on Saturday relates to schools. Keeping schools open has been a priority for the Scottish Government since August and it remains a priority, as far as is possible. However, the recent developments—and all aspects of them—mean that we need to take a precautionary approach and give ourselves some time to assess the situation. As a result, we have taken the difficult decision to delay the start of the new school term. It was a difficult decision for us, but even more so for the young people and parents affected.

Schools had been due to reopen from 5 January onwards. Now, they will reopen from 5 January for children of key workers and for particularly vulnerable children only. Local authorities identified key workers at an earlier stage in the pandemic and updated guidance was published last night. For all other pupils, the school term will start on 11 January. However, the first week of term, at least, will take place online. At this stage, our intention is that schools will get back to normal from 18 January. Of course, we will require to keep that under review.

I know that all the measures are harsh and are very difficult for people and businesses. For so many businesses, the announcements represent a horrible end to a terrible year. Financial support will remain available for businesses affected and the Cabinet Secretary for Finance is urgently assessing what more the Scottish Government can do, in particular for the sectors that are most acutely affected.

I also know that the developments of the past few days, while worrying for everyone, will cause particular anxiety for those who were shielding. The chief medical officer has written to everyone on the shielding list who will enter level 4 on Saturday, setting out the advice that applies to them. That advice has also been sent by SMS text message and is available on the Government website. The level 4 advice is restrictive, but it still encourages those who were shielding to find a balance that is right for them. Among other things, the letter will advise people on the shielding list that, if they cannot work from home, they should speak to their employer, who must put precautions in place to keep them safe. However, the letter also serves as a fit note, which can be used to obtain statutory sick pay if someone cannot safely go to work. The letter also provides details of how to get help, for example if someone has difficulties accessing food or groceries in this period. I say to those on the shielding list: please do not hesitate to ask for support if you need it.

I know that many people may question whether the measures are strictly necessary, especially given Scotland’s relatively low level of prevalence of the virus compared to other parts of the UK. My firm judgment is that they are absolutely necessary. They are not simply a response to our current situation but are necessary precautionary measures to avoid a significant deterioration in our situation over the next few weeks, caused by the new strain of the virus. In short, the measures are essential to protect our national health service and save lives. I do not expect a single person to be happy about them, but I ask everyone to try to understand that those decisions would not have been taken if we did not consider them to be essential.

Before I close today, I want to address the impact of the decisions made by many other countries to close their borders to the UK in response to the new strain of the virus. By far the most serious impact derives from the closure of the UK-French border to accompanied freight. I took part in a COBRA meeting on that issue yesterday and also chaired a meeting of our own resilience committee. I was hoping that there would be another COBRA meeting later today, but that had not yet been confirmed when I came to the chamber to speak—I still hope that that meeting will take place.

The situation is serious, urgent and, for our food exporters, rapidly deteriorating. The UK Government needs to reach agreement with France, without delay, to get freight moving again. There is no time to lose.

I want to stress at the outset that we have no concerns about medicine supplies at this stage. That issue was covered in detail in the COBRA meeting and at the Scottish Government resilience committee meeting yesterday. We also have no immediate concerns about food supplies. Supermarkets are well stocked, so there is no need for anyone to buy more than planned in the run-up to Christmas. Of course, if the situation is not resolved in the next day or so, we may start to see pressure on some fresh produce after Christmas. However, that is not a concern right now and I hope that it is an issue that will not arise at all.

However, what is of real and immediate concern is the impact on our food exporters, especially those in the Scottish seafood sector. This is the peak time of year for seafood exports, and the Christmas export trade is now almost certainly lost. That is devastating for our world-class seafood businesses, which need—and will get—our support. We are liaising with the sector on the need for immediate financial support, and I raised the issue of compensation at the COBRA meeting yesterday.

What the sector needs most of all is for the UK Government and France to agree a protocol to get freight moving again without delay. If that does not happen almost immediately, the sector stands to lose its new year export trade, too. I very much hope that a protocol will be agreed between the UK and France today—indeed, I hope that we might even get movement during this statement—but that is not yet certain. What is even less certain is how long it will take to put any agreement into operation.

The Scottish Government is pressing, and will continue to press, the UK Government to give the matter the utmost priority, and we stand ready to help in any way we can. Given that any solution is likely to include mass testing of freight drivers, that willingness to help includes a willingness, if the terms of the agreement allow, to provide testing facilities for our sector here in Scotland. I assure the sector, Parliament and the public generally that my ministers and I will remain fully and actively engaged on those matters until they are resolved.

Let me conclude. We are now, of course, just three days away from Christmas, and I am acutely aware that today’s update has not had a festive feel to it at all. We have known that our path out of the pandemic would not always be smooth and straightforward, and that it would bring dark days and challenging periods. I know that Saturday felt like a very dark and difficult day for all of us, and I know that it is not possible for me to take away the heavy burden that we all feel just with some hopeful words.

Nevertheless, I want to end on a hopeful note, because—hard though it is to feel it just now—there is hope on the horizon, and we must try not to lose sight of it. First, it is possible that we have found out about the new variant of Covid at an early enough stage to take effective preventative action. By moving quickly, we might be able to minimise its worst effects. All of us have a role to play in that. I know that it sometimes seems as though we are powerless in the face of the virus, but we are absolutely not. None of us can guarantee that we will not get or transmit the virus, but we can all make choices that will make that less likely.

That remains true of the new variant. It seems to transmit more easily, but it can still be stopped in its tracks by the FACTS advice that we have emphasised so many times before: wear face coverings; avoid crowded places; clean your hands and surfaces; keep a 2m distance from people from other households; and self-isolate and get tested immediately if you have symptoms. All those things still work in reducing the transmission of the new strain of the virus. The new variant has made them more important than ever; they are how we keep one another safe. I ask everyone, wherever they are, to assume that the virus—especially the new strain of it—is with them, and to act in a way that will minimise the chances of spread.

That is especially important because—this is the real reason for hope—tens of thousands of people in Scotland have already been vaccinated against Covid. The updated figures will be published tomorrow. Of course, those who have been vaccinated include many of the people who were most at risk of dying from the virus.

As we do the difficult things in the weeks ahead to suppress the virus all over again, this time we are buying time for the vaccination programme to pick up pace. Though it might feel in the next few weeks that things are getting worse—I know that, in terms of health, jobs and living standards, that will be a reality for many—the fact is that things will also be getting better. The vaccines will be making sure of that, and they promise a route back to greater normality for all of us.

In the past nine months or so, we have come through a lot together, and I know that the realisation that we have tough times still to come is hard to bear. It is hard emotionally, it is hard practically and, for so many, it is very hard financially. The Scottish Government will continue to do all that we can to offer help and support.

However, brighter days will come. Yesterday, in fact, was the shortest and darkest day of the year. From now on, the days will get longer and lighter. Spring is on its way. Let us try to hold on to that.

For the moment, let us remember that the best gift that we can give this Christmas to those we love is to keep them safe, so please follow the rules, remember FACTS and look out for one another. At Christmas, just as we have done throughout the year, let us treat one another with kindness, compassion and love. I fully appreciate that this might not be the happiest of Christmases for everyone, but I take this opportunity to wish everyone a peaceful and healthy Christmas.

The First Minister will now take questions on the issues raised in her statement. I intend to allow around 45 minutes for questions, after which we will move on to the next item of business. It would be helpful if members who wish to ask a question could press their request-to-speak buttons now.

This week’s news has undeniably been a setback when we thought that a corner had been turned in the fight against this virus. The promise of a vaccine and the chance to see loved ones again over Christmas—even for only a brief time—gave people real hope of respite.

It seems doubly cruel to have plans snatched away from people, even if they understand why. Most people do understand. They understand the need to make sacrifices to suppress this new strain, but in return they are demanding as much clarity from this Government as is conceivably possible.

The national tier 4 lockdown, scheduled for boxing day, will have come as an even greater shock to the people in tiers 1 and 2 who had no idea that they would face the most severe restrictions seen since March. They are asking whether the tier system has now been abandoned for good or whether we can expect a return to more localised restrictions and, if so, when?

Parents everywhere who are now scrambling to cancel Christmas plans and find ways to balance work and childcare well into the new year need clarity on exactly what is expected of them now that the return to schools and nurseries has been suspended until 18 January. Not only does that impact on their family life; it affects their ability to work and pay the bills.

People accept that there is much about this new strain of the virus that we do not yet know. However, they are growing weary of seeing supposedly time-limited firebreaks stretch into months. They will be rightly concerned to have heard the First Minister say that the 18 January return date is under review. Can the First Minister give parents at home an idea of how likely it is that children will return to classrooms from 18 January? Do they need to start preparing now for a long haul of blended learning at home?

I will do what I have tried to do every day during the past 10 months, and that is give people as much clarity as I possibly can. I will do that every day over the Christmas and new year period if that is what is necessary and if there are updates that I can reasonably give people.

I have also tried to be frank. We are dealing with a virus that we have always known to be unpredictable, but only in the past few days have we discovered how unpredictable it can be. We do not yet understand everything about this new strain.

Literally as we speak, we have scientists trying to understand to what extent it is more transmissible than other strains and who it might be more likely to transmit to, and to understand—and hopefully be able to confirm beyond any doubt—that it does not cause more severe illness or undermine vaccines or treatments. During the days to come—literally days—we will learn more about that. We also have to give ourselves assurance during the next period that the restrictions and measures that we have in place are sufficient to suppress it.

It took a really strict lockdown earlier in the year to get the R number back below 1—it got to about 0.6. We now face a situation where it is at around 1 again, although it is lower in Scotland than in some other parts of the UK, and a virus strain is transmitting more quickly that might add 0.4 to the R number. That shows the scale of the challenge that we have. We have to give ourselves time to know that we are taking the right actions to suppress it. We will learn more and I will share as much as we know with the public as openly as possible.

In response to the other two specific points, I know how devastating it would have been last Saturday for everybody to hear that we were going to level 4 across most of the country this Saturday. That would have been particularly devastating for those areas that are currently in the lower levels. However, it is important for me to be clear that the action that we are taking is not in response to current rates of prevalence: this is preventative action because we see a train coming rapidly down the track at us and we are trying to get out of its way. That is why the whole of mainland Scotland has to go to level 4; it is to prevent what we think will be a rapidly deteriorating situation.

If it is at all possible, we will get schools back open again on 18 January. That has been and continues to be a priority for all the reasons that we understand and that I think we all agree on. If that means the rest of us living under more severe restrictions, we will not shy away from saying so. However, we have to give ourselves the time to understand this virus a little bit more.

Scientists are now exploring whether that strain of the virus is transmitting more easily to young people. There is no consensus or definitive conclusion on that yet, but it is one thing that the scientific community is currently exploring.

We will do everything we can to get the whole country back to normal as quickly as possible, but it is important that, in this next period, we all do all the things that can help to bring that about.

I will keep the country updated, as far as possible, throughout the Christmas period.

It is clear that the Government’s strategic framework, launched less than two months ago, was abandoned at the weekend. The decision to move every part of mainland Scotland to level 4 from boxing day and for an indefinite period means the closure of all hospitality, pubs and restaurants, non-essential retail, public buildings, gyms, indoor tourism attractions, museums and galleries. That is a drastic move. Three weeks does not sound like three weeks this time; it sounds considerably longer.

The First Minister has told us that this is a proportionate public health response, given the virulence of the new strain of the virus. Will she also make a proportionate response in other ways? Will she step up Government support for businesses, workers and families across Scotland that have been directly affected by that Government decision? Will the Government step up levels of support for mental health and wellbeing services?

If the new strain of the virus is 70 per cent more transmissible than the original one, will the Government urgently increase the number of tests carried out in Scotland by 70 per cent daily? Will it improve the capacity, utilisation and performance of test and protect by 70 per cent? Will the First Minister commit, as soon as is practically possible, to a 70 per cent acceleration in the roll-out of the vaccination programme?

I am, like many people, overtired at the moment, but words almost fail me in responding to that.

I am sorry: I should have given part of this answer to Ruth Davidson. We have not abandoned the strategic framework. We will try to get back to applying different levels to different parts of the country—depending on the prevalence of the virus—as quickly as we can.

We have not abandoned our strategic approach, but we have not stood there, clinging to that approach, when a train is coming down the track to run us over. We have decided to respond to the evidence that we have a new strain of the virus that none of us saw coming or predicted. This is happening in all other parts of the UK and in other countries. Ireland has just decided on stringent new measures even though it does not yet have any identified cases of this strain.

We have decided to respond in a preventative and precautionary way in order to make sure that, by the end of January, we do not have an overwhelmed health service and that we have not run out of hospital and intensive care unit beds, but that we have managed instead to ward this off and to suppress the virus again.

I am so sorry that we have to do this, but I would be even sorrier, and people would have every right to be angry with me, if I did not take this action or if I let the country deal with the impact of what is coming down the track at us. I will continue to take difficult but necessary decisions to keep us as safe as I can.

We will continue to look at how we can step up support. I said in my statement that the finance secretary is already looking urgently at business support to see what more we can do. That will be true across a range of responsibilities.

It is when I reach Richard Leonard’s final two points that words begin to fail me. We have plenty of testing capacity and we are building it up. These are not simple equations in which the fact that a virus is 70 per cent more transmissible means that we need 70 per cent more test capacity. The reason why I can give some of the detail that I give every day is because we are testing so many people. We will continue to make sure that we have the capacity to do so. We are also rolling out lateral flow testing, although we must assure ourselves that lateral flow testing is sensitive enough to the new strain.

We will roll out the vaccine just as quickly as supplies allow us to do so. Nobody would love it more than I would to be able to magic vaccine supplies out of nowhere. I cannot do that, unfortunately. We are working hard to make sure that we act as soon as supplies come. We have the Pfizer vaccine supplies that we expected this year, and tens of thousands of people have already had their first dose. We are hoping that other vaccines will get approval in the UK shortly, and as soon as those supplies become available, we will get those vaccines to people and get those doses of vaccines into as many arms as we can. We are dependent on the vaccine developers, the companies and all the supply chain allowing us to do that. I really would hope that Richard Leonard would understand that.

Of course, I share the dismay that we all feel at the increasingly dangerous situation. It seems clear that, if the new strain is established and growing in Scotland, much of the country must be prepared to deal with a heightened threat over the months ahead, not just the weeks ahead.

As the First Minister said, it remains an open question whether the new strain could be more infectious in children and young people. The Greens have consistently backed measures to improve safety in schools, and we welcome the announcement of the delay to the new term. We all want to keep schools open, but not at all costs.

Does the First Minister recognise that many teachers and school staff already feel that their safety has not been prioritised during the pandemic and that, at the very least, their call for widespread routine testing should be accepted? How does the First Minister respond to the recent comments by the Educational Institute of Scotland that moving back to level 4 should result in the Government considering

“moves toward blended or remote learning”

and that

“Schools cannot stay open at any cost; the safety of pupils and staff has to be the priority”?

Can the First Minister update the Parliament on the action that is being taken to protect vulnerable teachers when schools finally return?

Those are all important issues. First, I accept that many teachers feel that their safety is not being prioritised. I do not accept that that is true from the Government’s perspective, but, if teachers feel that, I recognise and accept that we continue to have work to do to assure and reassure them, and we will continue to do that.

For the past few weeks, we have been developing plans for more mass testing in schools in the new year. We are trying to do that sensibly and on a sustainable basis. Some of the plans that have been set out in other parts of the UK, as we have seen from the reactions of teachers in recent days, perhaps do not give that sense of deliverability and sustainability, but that is very clearly a part of our thinking.

As I said in my response to Richard Leonard—and it is worth repeating—at the moment, one question that we are seeking to have answered is whether lateral flow testing devices are effective against the new strain of the virus. I hope that that will be clarified in a positive way very soon.

The safety of pupils and everybody who works in our schools is a priority, and we have taken public health advice at every step of the way. Although I recognise the concerns, I think the fact that we have managed to keep schools open while keeping the prevalence of the virus at a lower level than in many other areas is a success. However, the new development means that we have to be precautionary until we learn more about the virus—not least its transmissibility among young people. We will be precautionary and we will take great care over the decisions that we make.

On blended learning, I think that it is in the interests of young people to be back in school full time as quickly as possible. However, you will have heard everything that I just said about precaution and safety. The fact of the matter is that blended learning has always been an option on a school-by-school basis if it is required, and that will continue to be the case. We will not compromise or gamble with the safety of teachers and young people, but I think that everybody recognises that it is in the interest of young people to be in school full time if that is at all possible. That is what we want to get back to as quickly as the virus allows.

We appreciate the reasons for the decisions at the weekend. When the science speaks so starkly, plans need to change. Will the First Minister be reviewing the range of indicators as we learn more about the new strain of the virus?

At least 135,000 operations were cancelled during lockdown earlier this year, and we know that, for safety reasons, hospitals have limited the number of elective surgeries since then. However, I am concerned about reports that ever greater numbers of operations have been cancelled, that some hospitals have cancelled all non-urgent procedures and that more NHS boards are considering following suit. What more can the First Minister tell me about that? Does she expect that more NHS boards will cancel all non-urgent operations in the near future?

We were already reviewing the indicators—I think that I set that out in my statement last week—and we will continue that process over the Christmas period. Obviously, we will come back to Parliament with the outcome of that. We were taking the opportunity to review not just the indicators but also the content of each level. As I have said today, the new development makes it all the more urgent that we look at the content of level 4 restrictions and whether the current restrictions are sufficient.

On health board capacity and decisions on elective treatment, we want as much elective treatment to continue and to get as much of that back to normal as possible. That is a priority, and we discussed the issue at the Cabinet meeting earlier today. However, that depends on our ability to suppress the virus. To put it bluntly, the more patients require hospital and intensive care treatment for Covid, the more staff will be required to support that. Of course, the greater the levels of infection, the more hospital and NHS staff generally are likely to be off sick—like the rest of the population, they are more likely to be taking time off sick—and the less able the NHS will be to do normal business.

We are supporting the NHS to get the balance right as far as possible. I cannot guarantee that no NHS board or hospital will postpone elective treatment, but we are trying to support the NHS through this as much as possible, to reduce this year’s backlog and to prevent its rising any further.

I make a plea to everyone. All of us can help the NHS right now. During the early part of the pandemic, we all acted in a way that protected the NHS. The NHS needs us to do that again. It needs us all, in our personal behaviour, to do everything that we can to suppress the virus. That is what we can all do to keep our NHS safe.

I am keen to get in every member who wants to ask a question if I possibly can, and I would appreciate the assistance of all concerned to achieve that.

At this crucial time, when we are dealing with a deadly and unseen killer virus, with what importance does the Scottish Government view the relationship between the European Centre for Disease Prevention and Control and the expert medical and scientific community in the United Kingdom? Is it not foolhardy in the extreme to sever that important relationship because of Brexit at this crucial time, when, as a country, we are dealing with a deeply serious public health emergency? For that reason alone, an extension to the Brexit transition period would make common sense.

In my view, it is vital that the UK maintains its current access to the European Centre for Disease Prevention and Control, which is an important network of cross-border health expertise. It is also a source of valuable data—there is probably not a day goes by when I do not look at the data on its website, because it is extremely important. However, the centre is important for many more reasons than that.

It is a fact that a no-deal Brexit will jeopardise that access, which is highly concerning as we continue to fight the Covid pandemic. The Scottish Government is working with the UK Government to maintain access and to ensure that practical arrangements are in place as a stopgap in the event of no deal.

The consequences of ending the Brexit transition period during a pandemic were predictable and predicted. Those concurrent risks, which add up to a perfect storm, are starting to become real before our very eyes. That was evident in yesterday’s COBRA meeting as we were dealing with all the implications of the closure of the border that are happening now, with Brexit and stockpiling plans being activated, which is a situation that we may face again in just a few days’ time.

I really hope that, although the UK Government yesterday rejected the call for an extension, it will think again and act responsibly. Businesses and citizens need, preferably, a deal now—everybody does. More important, they need a period in which we will not have any self-inflicted disruption, given that we have so much inevitable and unavoidable disruption to deal with.

I have read many of the letters about access to learning hubs that are today being sent to parents. It is clear from those that the definition of a key worker is vague and varies from one council area to another, which will undoubtedly result in a postcode lottery in childcare, come January. The letters also state that both parents must be key workers if their children are to qualify for access to the hubs, which would put many of our front-line workers in an impossible situation. Why is there no clear country-wide guidance over access to hubs? What is the First Minister’s message to families who face the unenviable choice of being either out of pocket or out of a job?

The guidance is as it is because local authorities requested flexibility to put in place their own local arrangements. I appeal to them to continue to liaise closely with parents to ensure that their arrangements are as they need to be. This is an incredibly difficult time for everybody, but particularly for parents who are, again, trying to juggle the demands of work and childcare. Even in level 4, if there are no other options, there is access to childminding and informal childcare arrangements. However, we encourage local authorities to ensure that they are as expansive as possible in their definition of a key worker.

The most important aim for us all—led, of course, by the actions that the Government is taking—is to get the virus, and especially the new strain, under control and suppressed as much and as far as we can so that the next period, which will involve the most stringent restrictions, which will impact particularly on schools and childcare, will be as short as is feasible.

People in my Cowdenbeath constituency, across Fife and across Scotland will want as much clarity as possible about the weeks that lie ahead. Will the First Minister therefore confirm the date on which a review will take place of the three-week level 4 regime that will apply to the whole of mainland Scotland from boxing day? Will she confirm the criteria based on which the review will be conducted, and when the upshot of the review will be communicated to the public?

We will carry out a review two weeks after commencement of the restrictions on boxing day, and I will set out its outcome in the Parliament on that day. Forgive me if I get the date wrong; I think that that will be on 12 January. We will be as clear as we can be about the reasons for the decisions that we take in the review, and we will try to keep the level 4 restrictions to as short a period as possible.

I want to give people as much clarity as possible. However, although I understand the desire for clarity—it is a normal human desire, which I share and on which I want to deliver—I do not think that people want me just to say things that they want to hear right now but which might have to be reversed later. We have to try to set out the situation as clearly as possible, and to explain the implications and the difficulties as we go along. That is what I will try to do, especially over the coming period, when people will be worried about the situation that will pertain at the start of the year.

The First Minister has said that scientists are investigating claims that the new variant of the virus spreads more easily among children. They have said that it could account for a significant proportion of the increase in transmission in the south of England. Given that, what steps will the Scottish Government take to examine such evidence?

What action will the Government take to ensure that there is effective teaching and learning through blended methods if further delays to the return to school are necessary? What steps will the Government take to provide greater support for those who are in most need and at greatest risk while our schools are closed?

Rightly, the operative word in the early part of Alex Rowley’s question was “could”. Among experts, there is not yet definitive consensus on whether the new strain of the virus is more likely to infect children, but that is under active exploration. The chief medical officer updated the Cabinet on that subject today, and he made it very clear that we cannot be definitive about it right now. Just this morning, I have read scientific opinion—some is pretty certain that that is the case and some that it is not. We therefore need to wait and see what consensus will emerge. We have contingency arrangements in place for blended learning.

One of the reasons why we have taken a precautionary approach to the start of the new term is the uncertainty about the new strain. We will have arrangements for blended learning for as long as it is necessary—although we hope that that will be as short a time as possible. We have already taken steps to help people in more deprived communities with online access, and in other ways. We will continue to do that, particularly if we are facing a lengthier period—although I hope that we will not—when children are not in school full time.

The First Minister stated that the incidence of Covid in Scotland is half what it is England, and that the cross-border travel ban will be in place on Christmas day. Given that the chief constable has ruled out road blocks and check points—I appreciate that those are operational decisions for him to make—is the First Minister satisfied that the law can be enforced, and has she been advised on what policing is taking place on the English side of the border?

I will just be clear on one point, because I am aware that how I express this might give rise to a misleading impression. It is not the case that the travel ban between Scotland and the rest of the UK is in place only on Christmas day; it is in place for the foreseeable future, including on Christmas day. The travel restrictions are being lifted on Christmas day in Scotland—although we are encouraging people not to travel to meet indoors, if at all possible—but that does not apply to travel between Scotland and the rest of the UK.

It is, of course, an operational matter for the chief constable to decide how and to what extent to enforce the law. Obviously, I have discussed that with the chief constable, who joined me yesterday for the daily update. He has decided to double patrols and has set out clearly the approach that the police will take. I have confidence in the ability of the police to enforce the law where necessary, just as they have with regulations throughout the pandemic. It is not for me to comment on policing on the English side of the border, but I am sure that the police there are also cognisant of the arrangements.

My last point—it is a point that I made yesterday and will continue to make—is that people should abide by the restrictions not because they are likely to get stopped by the police if they do not, but because the restrictions are there to keep us all safe. I think that when we put on a seat belt when we get in a car these days, not many of us do so only in case we are caught not wearing a seat belt. We do it because we know that it could save our lives. People should see the travel restrictions in the same way. They are a tough aspect of what we are being asked to do right now, but they are necessary in order to stop, as far as we can, any more of the new strain of the virus coming into Scotland, just as all the difficult things to suppress it are necessary.

The First Minister might be aware of reports that the University hospital Wishaw has closed a number of wards to new admissions following a spike in Covid-19 admissions. Can the First Minister provide the Parliament with an update on the general capacity in our hospitals, given that standard admissions being suspended puts more pressure on the NHS because of the already significant backlog in operations and appointments?

I will ask the Cabinet Secretary for Health and Sport to write to the member with an update on hospital capacity and what pressures there are on that capacity before we get into the Christmas period, and to copy that update to all members.

It is, of course, for individual health boards to manage capacity pressures. We know that NHS Lanarkshire, like NHS Greater Glasgow and Clyde and, more recently, NHS Grampian, is experiencing significant pressure from Covid generally. That has been the case for NHS Borders in recent days, as well. Overall, if we look at the numbers that I have given today for people in hospital and in intensive care, they are significantly below overall capacity. They are also below the peak levels that we saw earlier in the year. There are some parts of the UK where both those things—certainly in relation to hospital capacity and, in some cases, ICU capacity—have already exceeded that peak.

We are not in a position to be complacent; we are working with the NHS to manage the situation. However, I come back to the central point that the more we do to stop the new strain of the virus taking hold, the better able we will be to ensure not only that our NHS can cope with Covid patients but that, as it is doing that, it can continue to treat people with non-Covid conditions.

Can the First Minister elaborate on the discussions that her Government has had with the UK Government regarding temporary closure of our major ports and transport links? Will the First Minister call on the UK Government to take some responsibility and work to reach agreement with France on the protocol that she mentioned earlier, which will get freight moving again, in order to protect Scotland’s valuable seafood sector? The situation is becoming critical.

I took part in a COBRA meeting yesterday at which those issues were discussed. I was concerned yesterday, and remain concerned today, that the timescale for the agreement of a protocol with France and, perhaps more especially, implementation of that agreement might be longer than our seafood sector has, to be frank.

We will continue to press the UK Government to take all necessary steps, but more important is that we will ensure that we are offering help and support. There might, since we have been in the chamber, have been developments that I am not aware of. If the solution involves mass testing of drivers—as it almost certainly will—we do not know whether it will be polymerase chain reaction testing or lateral flow testing. Once we know that, we can consider what arrangements we can put in place to test drivers in Scotland before they start their journeys. We will do everything that we can to help, and we will continue to liaise with the seafood sector. It is in everybody’s interests that the issue be resolved as quickly as possible.

Hospitality and tourism businesses in my constituency and across Scotland face huge bills in January, including for payment for self-assessment, deferred VAT or national insurance and pension contributions for staff who are currently on furlough. Further, those businesses will have no income over the next three weeks, which is normally their busiest period. They are saying that they need greater support from the Scottish and UK Governments, and that they need it now. Will the First Minister adopt a targeted approach and increase the help that is being provided?

As I said in my statement and as I think I have said since then in response to questions, the Cabinet Secretary for Finance is urgently looking at what more we can do. Significant financial support is already available; I encourage all affected businesses to apply for it. The details are available on local government websites and, I believe, on the Scottish Government’s website. We recognise that businesses will need more help, given the implications of what we are now dealing with, and are likely to be dealing with into the new year. The finance secretary will report back on that once she has completed the assessment.

The First Minister knows that Gretna is the wedding capital of Scotland. It is also in a lower-prevalence area. I have been contacted by a number of constituents in Gretna and east Annandale who are concerned that wedding guests are travelling from higher-prevalence parts of the UK, such as the south of England, despite the cross-border travel ban, because weddings and small receptions are permitted in Dumfries and Galloway, which is in level 1. Can the First Minister explain how moving to level 4 across Scotland will protect my constituents in the Gretna area? Given that many local jobs are involved in the wedding industry, how will it and its supply chain be supported under level 4 restrictions?

This is a really tough time for the wedding industry across the country, and that is undoubtedly particularly true in Gretna. We have recently allocated funding for the sector and its supply chain, and we will seek to ensure that those who have had little or—as in some cases—no support since March are targeted for that support.

I deeply regret the impact on cross-border trade and on particular sectors and businesses, but it is unavoidable, because stopping travel within Scotland and from Scotland to other parts of the UK is a key part of trying not to spread the new strain any further. We know that it already exists in Scotland, and we have to suppress it here, but we think that it is still at lower levels; therefore, it is important to stop importing any more of it. That is true for the entirety of Scotland, but, obviously, it has particular resonance in the border parts of Scotland and England. We do not want the restrictions to be in place for any longer than necessary, but they are necessary right now, which is why I encourage everybody to strictly abide by them.

The increased restrictions that the First Minister announced on Saturday are causing a great deal of concern for Scotland’s tourism businesses, many of which were already worried, even with the latest support for the sector that the finance secretary announced a couple of weeks ago. When will the first payments from that support be in the hands of those businesses? Will the impact of the increased restrictions be reflected in the package and in any future additional packages of support for our beleaguered tourism industry?

The restrictions that, regrettably, we announced, reflect restrictions that, unfortunately, are in place in all parts of the UK and, indeed, in many other parts of the world. We must be clear about the fact that, although the impact on business is understood and is severe and heartbreaking, we would make that impact worse if we did not act appropriately to suppress the virus. Obviously, that places responsibilities on us to ensure that businesses are appropriately supported. I have already said that the Cabinet Secretary for Finance is looking again at additional support for business. She has recently announced additional funding for tourism, in particular, and the processes are under way to get that money flowing to businesses as quickly as possible.

The support that will be required for the tourism sector is likely not only to be greater than for any other sector in our economy but for the longer term. The sector has been deeply affected, which is why the tourism task force looked at not just immediate measures but medium and long-term support. The tourism minister and the Cabinet are fully engaged in ensuring that we respond appropriately.

Given that no ferries will run on Christmas day, will islanders and their loved ones on the mainland be allowed to visit one another from Christmas eve to boxing day? Only a very small minority of people will travel, so the risk must be tiny. It is surely unfair that that minority of islanders and their families will be denied the same opportunity as everyone else is getting to spend Christmas day together. A number of my island constituents, as well as a number of my mainland constituents, have expressed their dismay in the event that they are unable to do so.

I know that it is unfair; the virus is unfair to everybody. That is the point—it is not fair. We are having to take decisions that are extremely difficult for people. We cannot make exemptions to the rules, because any small exemptions that we made—other than really necessary ones for people who need to care for people—would all add up to greater risk of the virus spreading.

As I said yesterday, on Saturday night, when I got home after making these horrible announcements, I spent quite a lot of time reading emails that people had sent me. Most of them were from people who understood the necessity of the measures, but they set out—often in heartbreaking terms—the impact on them and their families. I cannot take away that impact for everybody, though I dearly wish that I could. However, I want people to know that I understand it and that we will do everything that we can—within the bounds of what we need to do to keep the virus suppressed—to mitigate the impact of it. None of this is fair on anybody right now.

Can the First Minister share the modelling for the vaccine roll-out? I am aware from questions and answers yesterday that the clinical director, Jason Leitch, has said that we plan to vaccinate more than 4 million Scots, but can the First Minister share any information on where we might expect to be in January, February and March? Is the Government aiming for a date in June, for example?

I fully appreciate that I am asking for modelling when we are talking simply about plans. Could the First Minister at any point share with us information on where we might expect to be?

I am not sure that that is a question about modelling; it is about how we match the supply of the vaccine to those groups that we need to vaccinate. I believe that information that set out those timelines was circulated to members last week or the week before. The Cabinet Secretary for Health and Sport will make a statement tomorrow in which she will provide up-to-date information.

In broad terms, our objective—assuming that we get the supplies that we are expecting in the timescale in which we expect to get them—is that, in line with the priority list that has been published by the Joint Committee on Vaccination and Immunisation, everybody aged 50 and above will have been vaccinated by the spring of next year, although that is obviously still subject to uncertainty because of the inherent uncertainties around supply.

We hope that, after that, as we move into the summer, we will be in a position to move on to the rest of the population, because the vaccination programme is intended to reach everybody in the adult population. However, we are dependent on the supplies coming through. We will keep Parliament updated as we get greater certainty and clarity around that and as the information becomes more concrete.

What discussions has the Scottish Government had with the United Kingdom Government on the security of medicine supplies in the event of a no-deal Brexit? Many families will be concerned by the scenes in Kent at the moment. Does the First Minister agree that the most pragmatic approach—and the safest approach for everyone—would be for the UK Government to seek a Brexit transition extension so that we could avoid some of the problems that we are seeing?

We discussed the issue of medicines supply at length both in COBRA yesterday and at the Scottish Government resilience committee, and I think that the health secretary is indicating to me that she will have further four-nations discussions on the issue later this week. As I said in my statement, we have no immediate concerns about medicines or medical supplies, and we have no immediate concerns about supplies of the Covid vaccines.

Obviously, we require to keep all of that under very close review. The discussions that we had yesterday were, to some extent, inevitable. The new strain of the virus has led other countries to respond, and the issues around the border are part of dealing with that particular crisis. I think that we all understand the necessity of that. What is, I think, less easy for us to understand—and certainly for us to accept—is that we are having to discuss these things in the context of something that is completely self-inflicted.

Therefore, I hope that we see measures—whatever they require to be—being taken to avoid any disruption caused by Brexit over the next two-week period. Frankly, the country has got enough on its plate to deal with right now. We are dealing with Covid and with a new strain, and we are trying to get a vaccination programme rolled out. We are going into winter, and over the next few weeks we may be dealing with severe weather as well. We do not need the disruption that Brexit will bring, and I really hope that the UK Government will do whatever it takes to avoid that.

The Equality and Human Rights Commission said recently that it had found clear evidence that, during the pandemic, the rights of Scotland’s care home residents and staff have been ignored by Scottish Government ministers. It said that the need to uphold residents’ rights to be treated equally, with dignity and with respect has not been taken into account. Meanwhile, care home staff, despite their best efforts, have been ill-equipped to provide vital support and care to residents, many of whom have been nearing the end of life. The Scottish Conservatives agree with the Equality and Human Rights Commission that there must be a public inquiry into the matter. What progress has been made on establishing such an inquiry?

We have already committed to a public inquiry, and the health secretary is progressing the plans for that. No public inquiry on any issue can simply be set up overnight. There are matters that take time to get right, including the appointment of the judge who will oversee it, the remit and all the other preparatory actions.

As, I think, the chief executive of Scottish Care said not that long ago, those are all really important matters, but nothing matters more right now than dealing with the daily reality of the pandemic. That matters for vulnerable people in our care homes, it matters for the relatives and it matters to the whole country, and that is what I am going to keep my focus and my Government’s focus on, 100 per cent of the time, right now.

I previously asked for a review of the level 4 restrictions in the hope of seeing greater flexibility for gyms and health and fitness facilities, given their positive mental health impacts. As the First Minister has suggested that a further toughening of the level 4 restrictions may be required—and I absolutely understand why—that flexibility is clearly unlikely to be introduced over the next few weeks. However, as we emerge from the latest challenge—and we will do so—will she consider future flexibilities at level 4, even though that is understandably not the current direction of travel?

Yes, of course we will. I absolutely understand the importance of physical exercise and activity not only to people’s physical health but to their mental health. Although the focus in tackling the pandemic is on protecting people’s physical health, we may well live with the mental health impacts for longer. Nobody is in any way oblivious to the real importance of having gyms open and encouraging and supporting people to take care of their physical health so that they can support their mental health.

Unfortunately, I suspect that, over the immediate period, we may have to look at tightening the level 4 restrictions rather than easing them. However, hopefully, as we go further into next year, the opposite can be true, and making sure that people have access to physical activity will be at or very near the top of the list of priorities.

The final question will be from John Scott. I ask him to be brief.

Given the concerns about bed capacity, particularly in intensive care, in Ayrshire and across Scotland and about the lack of available staff for the Louisa Jordan units in the worst-case scenarios, what reassurance can the First Minister give that ICU beds will be available to the people of Ayrshire and Scotland? Can she provide details of how the Louisa Jordan hospital will be staffed if it is needed?

We will continue to give details of that. We have in place very robust plans for escalation in intensive care. Right now, there is, of course, pressure on intensive care, but we are not near running out of intensive care beds. We still have plans that would allow us to increase ICU capacity.

That is true across Scotland as a whole for ICU capacity and hospital beds. Individual health boards will face pressures at given times. In recent weeks, Lanarkshire has faced probably the most acute pressure in that sense. Of course, mutual aid arrangements between health boards will kick in as well.

Thus far, we have not required to use the Louisa Jordan hospital for Covid-related matters. At this stage, we still do not consider that we will require to use it, but we will keep that under review. Should the position change, we will set out the operational plans for that. The Louisa Jordan hospital has, of course, been seeing patients—thousands of patients, actually—to help to reduce the backlog.

If I or the health secretary stood here and said that we do not have concerns about hospital capacity, that would not be true. Part of what is driving the very tough action that we are taking is the need to protect our hospital capacity for Covid patients and non-Covid patients. Right now, the health service is operating within that capacity, and we will continue to support it to do so.

That concludes questions on the statement. We will move on to the next item of business in a moment.

I remind members that social distancing measures are in place in the chamber and across the Holyrood campus, and I ask members to please observe them during the course of this afternoon’s business, including when entering and exiting the chamber.