Meeting of the Parliament (Hybrid)

Meeting date: Wednesday, December 30, 2020

Official Report 838KB pdf

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Covid-19

The next item of business is a statement from the First Minister Nicola Sturgeon on Covid-19. The First Minister will take questions at the end of her statement. I encourage all members who wish to ask a question to press their request-to-speak button.

15:45  

I will give a report on today’s statistics and then a short update on some other issues.

As has been published this afternoon, the total number of positive cases reported yesterday was 2,045. That represents 11.3 per cent of the total number of tests and takes the total number of confirmed cases in Scotland to 124,831. That is a significant number of new cases—a record high for a single day—and it demonstrates the severity of the situation that we face right now.

There are 1,133 people in hospital, which is 41 more than yesterday, and 69 people are in intensive care, which is four more than yesterday.

I am sad to report that 43 additional deaths have been registered in the past 24 hours of patients who had tested positive. In total, 137 deaths have been registered in the past seven days. That takes the total number of deaths under the daily measurement to 4,510.

National Records of Scotland has not published its usual weekly update today because not all registration offices have been open throughout the festive period. However, the figures that were published last week showed that the total number of deaths is now more than 6,000. Each one of those deaths is heartbreaking, and so again I send my condolences to all those who have lost a loved one.

There are three other issues that I want to cover today. The first is the University of Oxford-AstraZeneca vaccine that, earlier today, was authorised for supply in the United Kingdom by the Medicines and Healthcare products Regulatory Agency. That is obviously extremely good news. It means that there are now two effective Covid vaccines available for use in the UK. The Oxford-AstraZeneca vaccine is logistically easier to deliver than the Pfizer one and the UK has secured a much higher number of doses of that vaccine.

It is also now recommended that the second dose of both vaccines can be given up to 12 weeks after the first, rather than three. That means that we can now prioritise providing a first dose to as many people as possible, rather than providing the required two doses in as short a time as possible. That will allow more people to be vaccinated more quickly.

We have been preparing for the deployment of the Oxford-AstraZeneca vaccine for some time and I can confirm that it will be administered in Scotland from Monday 4 January. As of last Sunday, more than 92,000 people had already received their first shot of the Pfizer vaccine, but today’s news means that more people will get their first dose of a Covid vaccine sooner than anticipated.

The second issue that I want to touch on is the restrictions that are now in place across the country. On boxing day, Orkney, Shetland, the Western Isles and some other island communities moved to level 3, while the rest of Scotland—the vast majority—moved to level 4. That is not the way that any of us wanted to end 2020 or start the new year, but the new restrictions reflect the severity of the threat that the new variant poses. Analysis that has been done by Public Health Scotland shows that, yesterday, 42.8 per cent of the positive tests that were processed for Scotland in the Lighthouse lab network had the S gene dropout that is indicative of the new strain. That is higher than the 38 per cent that was suggested by Office for National Statistics analysis for the week beginning 14 December, which in turn compares to just 6 per cent at the end of November.

The new strain therefore appears to be fast becoming the dominant one in Scotland, which is obviously a cause for concern, given that it is thought to be significantly more transmissible. As I indicated before Christmas, the severity of the challenge means that we simply cannot rule out the need for restrictions that are even tighter than the current level 4 restrictions. We continue to assess the situation carefully and on a daily basis, and we will keep Parliament updated should any changes be required over the remainder of the festive period.

As we learn more about the new variant, we continue to review when pupils can return to classrooms. The new strain has already made a normal scheduled return impossible, but we continue to assess whether it will be possible to reopen schools as planned on 18 January. I think that that is what we all want and, to be clear, it remains our planning assumption, but we will continue to put the safety of pupils, teachers and staff first. Of course, we will ensure that parents are given as much notice as possible of any changes that we consider to be necessary.

For now, of course, it is vital that we all do as much as possible to suppress transmission. That means limiting our interactions with people in other households beyond those that are absolutely essential. I remind everyone that our very strong advice right now is that people should stay at home as much as possible and, when we go out, we should stay as close to home as possible. With a few limited exceptions, none of us should be visiting other people’s homes and none of us should be travelling to another local authority area, unless it is for an essential purpose. There must be no non-essential travel between Scotland and other parts of the United Kingdom, and that advice also applies to overseas travel.

We should also remember the FACTS advice, which is to wear face coverings; avoid crowded places; clean hands and surfaces; keep 2m distance from people from other households; and self-isolate and get tested immediately if you have symptoms. Let me take the opportunity to stress that testing centres are open throughout the entire festive period so, if you experience Covid symptoms, please do not wait—book a test immediately. It is very important that you do so.

It is worth noting that the NHS 24 mental health hub is also open throughout the festive period. Support of that kind is particularly vital at a time when so many of us are missing our loved ones and normal social interaction. Therefore, if you feel that the restrictions are affecting your mental health and if you need help or advice, please do not hesitate to call 111.

Finally, I want to say a few words about Hogmanay, which is tomorrow. I know that most of us will be glad to see the back of 2020—I certainly speak for myself when I say that. Today’s news about the new vaccine should, and I think will, give all of us greater hope for the year ahead. However, for now, it is vital to do everything that we can to suppress the virus, particularly given the risk of the new variant. That is important to keep ourselves and our loved ones safe, and to protect the national health service.

We therefore must mark this new year responsibly and in line with the restrictions that are in place. To be clear—I take no pleasure in saying this—that means no gatherings, no house parties and no first footing. Instead, we should bring in 2021 in our own homes with just our own households. I cannot stress enough that the new strain is very serious. Our prospects for the rest of the new year will be better if we get off to a safe start, so I urge everyone to be responsible on Hogmanay. I know that it is hard, particularly for young people, but it is how we best protect ourselves and our loved ones.

It also helps the NHS, and it needs our help just now. In Scotland, so far, the numbers in hospital and intensive care units are not at the levels of the peak of the first wave, but the NHS is under pressure. Everything that we do as individuals to stop the virus spreading helps to reduce the number of people who will end up in hospital and ICU beds over the next few weeks. Obviously, that really matters, for a number of reasons.

As this awful year draws to a close, I again thank everyone across Scotland for your sacrifice and patience, and for looking out for one another. We have every reason to believe that the spring of 2021 will bring better times, but we must first get through these difficult few weeks of winter, so let us stick with it and keep looking after one another.

I end by wishing everybody, across the chamber and at home, a better, brighter and happier new year when it comes.

I thank the First Minister for the advance copy of her statement.

We all welcome the news of the Oxford-AstraZeneca vaccine being approved and look forward to Scotland’s share of the 100 million doses that have already been purchased by the UK Government being delivered. Despite the positive development of a vaccine becoming available with fewer logistical challenges than the Pfizer one, people across Scotland will be concerned by the rising rates of transmission that have been caused by the new variant of Covid and its advance to becoming the dominant strain here. That troubling news makes today’s vaccine announcement welcome and timely.

People will want information. The list of vaccination centres that was published on 23 December included hospitals, clinics and general practitioners’ surgeries across Scotland, which it is intended will be used from January to vaccinate all over-80s who are not resident in care homes. We must be hopeful that the next phase of vaccination can be concluded as quickly as possible and that we can move on to wider cohorts of the population. As that will almost certainly require a greater level of infrastructure than that which was announced, can the First Minister update us on the work that is being undertaken to identify and secure venues for mass vaccinations and on when a list of those venues will be published?

We also know that the national figure of trained vaccinators is around 4,000 people, but every health board will need enough staff to deliver across its region. What confidence does the First Minister have that each area has the staff that it needs? Can she publish a breakdown of the numbers of trained vaccinators by health board?

We will look to publish updates on all of that to Parliament as soon as possible and then on an on-going basis as regularly as possible.

I have confidence in the centres and the infrastructure where the vaccine will be delivered, as well as in our estimates of the numbers of people who will be available to do that. I say that I have confidence, but we take nothing for granted—there is not an ounce of complacency. I and the Cabinet Secretary for Health and Sport receive daily updates on the progress of the vaccination programme. It is going well so far, but we need to make sure that we can pick up the pace to meet the increased supply that we are now likely to have with the AstraZeneca vaccine coming on stream and because of the increased availability resulting from the fact that it is now not required to deliver two doses within a three-week period. That will give us the ability to vaccinate many more people much more quickly.

We are still awaiting certainty on the delivery schedules for the Oxford-AstraZeneca vaccine, and we will provide an update as quickly as we can on our expected timescales. As well as the advantages that it offers with regard to vaccine centres, because the new vaccine is logistically easier to deal with, it can be got to GP practices more easily, which will allow us to speed up the vaccination of—in the first instance—those over the age of 80 who are not in care homes.

We take nothing for granted, but we will get people vaccinated as quickly as possible, and we will update Parliament as regularly as we can about our expectations as our knowledge of the certainty of delivery becomes more concrete—as, I hope, it will in the coming days.

We are at a critical moment in our response to the pandemic. The welcome approval of the Oxford vaccine, which has been announced today, means that the challenge is now to accelerate the vaccination programme and to do so with urgency. However, the recent increase in cases and the spread of the new strain demand clear and rigorous control measures in the meantime.

As the First Minister has said, teachers and other school staff are due to return to work in a few days’ time even though routine testing is still not in place and despite the fact that they are not a priority for vaccination. They are still concerned about the full return on 18 January being safe. Parents will hear the First Minister’s comments today and wonder whether schools really will be able to return to face-to-face teaching after 18 January. Many of them are worried about the implications of a return to home learning.

Can the First Minister tell us more about how and when she will engage with school staff and parents to address those genuine concerns? If changes relating to schools are to be announced, can she be a bit clearer about the point at which that will happen?

We face a severe situation, given the new strain, the fact that it is becoming the dominant strain and the fact that it is a strain that spreads more quickly. That is why it was so important that we took the very cautious and precautionary action that we took.

It is not that long ago that Richard Leonard was urging me to reduce restrictions here, in the city of Edinburgh, for example. Yesterday, the implication of an article that he wrote appeared to be that we should open pubs again. It is really important that we do not follow such advice and that we take really cautious and sensible action in an effort not to allow the virus to transmit any further or any more quickly than it is already capable of doing.

The decisions on schools are very sensitive and important decisions for us to take. We have, of course, already taken the decisions to delay the return of schools and to enable pupils to have the first week as online learning, as opposed to in-school learning. We want to see schools back normally on 18 January, but, over literally the next few days, we will assess the up-to-date situation and, if there are changes to that, as I said in my statement, we will set those out as early as possible to give parents and, obviously, teachers as much notice of that as possible.

I will make two final points. First, we are working on plans for greater use of testing in schools once the new term gets under way. We have already been doing that, and the health secretary has shared some details of it.

Secondly, on vaccination, as I am pretty sure Richard Leonard knows, it is not politicians or Governments who decide the order of priority for vaccination; we accept recommendations from the Joint Committee on Vaccination and Immunisation. It comprises the experts, and they tell us, on the basis of what they know about the protections that the vaccines give, the correct order of priority. We will continue to take those recommendations, and, if they suggest a different order of priority, we will reflect that in our planning.

I am grateful for advance sight of the statement.

Like others, I stand in continued awe of those who have worked hard to make vaccines available within the timescale in which they have done so. However, we clearly still have weeks and months, rather than days and weeks, to live with the current heightened danger from the pandemic.

The First Minister said in her statement that the Scottish Government will put the safety of pupils, teachers and staff first. Does that mean that it will place a higher priority on safety than on sticking rigidly with the pre-planned reopening dates? If we are putting safety first, it is surely clear that schools should not reopen until the virus is under control.

Speaking of those pre-planned dates, I note that the First Minister said that the Government continues to assess whether it will be possible to reopen schools as planned. What metrics will be used as the basis for a decision on reopening? What additional safety measures have been identified as being needed in schools to successfully address the risk that is posed by the new strain? Are those measures already being put in place, or are schools unclear about what they will be?

In relation to the final point that the First Minister made in replying to Richard Leonard, what advice is the Government receiving on whether teachers and school staff should have prioritised access to the newly increased vaccine capacity?

First, we have always put safety first when it comes to schools and to the country more generally. Perfectly understandably, there will be differences of opinion, in the case of schools, between some teachers and the Government about what putting safety first means, but safety has been and always will be the driving imperative. Part of ensuring children’s safety overall, of course, is having them in full-time education, as far as possible, and learning with their peers in a way that is as close to normal as possible. Nevertheless, we will not compromise on safety.

The figures on transmission in schools, both for young people and for Covid cases among teachers compared with people in other professions—from memory, I think it is Office for National Statistics analysis—suggest that we have been able to have schools open safely. The new strain changes some of the assumptions, however, because of its faster-spreading nature, which we have to take into account.

On the metrics, we look at the overall rate of community transmission. Right from the outset, we have said clearly that one of the conditions for schools being open as normal is having community transmission under control, so that will be part of the judgment that we make. Let me be very clear that the safety of pupils, teachers and other staff in our schools has always been and will always be paramount, but, to make sure that we have the conditions for schools being open, the rest of us have to do all the other things to suppress the virus. I made the point to Richard Leonard that part of the reason why some places that adults enjoy going to have to be closed right now is that broader effort to suppress the virus.

On the advice about vaccination, the JCVI advice is published and we have the phase 1 order of priority. Obviously, there will be teachers in some of those categories, such as people with health conditions. If the advice changes, we will reflect that in our planning. Once we go into the next phase, which will cover people under the age of 50, there will be advice, which we will consider, on the order of priority among them. We will continue to take advice and act on the basis of that advice, because that is what the experts say is the most sensible approach, given what we know about the vaccine, how it operates and the protections that it delivers.

The First Minister talks about the NHS being under pressure. I have a letter dated 21 December from John Connaghan, the interim chief executive of NHS Scotland, which states that

“Boards can pause all non urgent elective and routine services during January and February”.

Waiting lists and times are already very long, and people are suffering pain and discomfort. Can the First Minister indicate how many boards will be pausing all those services?

That will vary depending on the prevalence of the virus in different areas. We want that to be kept to a minimum, and we want health boards and the health service generally to get back to normal as much as possible. The remobilisation of services process has been under way. Obviously, there is a need to have in place greater infection prevention and control procedures during Covid, and that will continue to affect the numbers of patients who are being seen. We are working with health boards to try to keep that process going, while we also deal with, treat and care for patients with Covid.

That takes me back to the central point: we will be more able to do that in every health board area and across the country as a whole if we get and keep the levels of infection down.

Our health service is working under extreme pressure. I want to take the opportunity again today to thank everybody working in it. Many of them will never have experienced pressure like this. Right now—obviously, this is not something that we can be complacent about—our numbers of Covid patients in hospital beds or in an ICU are below the peak that we saw in April. The ICU numbers in particular are quite significantly below that peak; hospital bed numbers more generally are less so, but still below it. If we suppress the virus and keep it suppressed or suppress it more, we can continue that, which will create the space for us to open up and remobilise more of the services that NHS boards want to be doing.

The Equality and Human Rights Commission’s report, “Equality in residential care in Scotland during coronavirus (COVID-19)”, which was published this month, has a number of recommendations for Government, health and social care partnerships and care homes. They are all worthy of consideration and action, but my question is specifically about visiting and family contacts. Family relationships are so important for health—I know that we all understand the devastating impact that isolation can have on people. The report recommends that all homes

“Carry out person-centred risk assessments for each resident to ensure that visits can safely resume.”

What will the Scottish Government do to ensure that that is happening at all homes, at all times, so that the resumption and continuation of crucial family contact can go ahead?

Everybody, without exception, is deeply sympathetic to the situation faced by people who are desperate to see loved ones in care homes. Again, I want to give an assurance that we are doing all that we can to allow people to visit safely, while also ensuring the safety of residents, which everyone accepts is of vital importance.

The visiting guidance is clear that care homes need to undertake a risk assessment prior to facilitating any form of visiting in a care home. In addition, care homes should undertake an assessment of the views and needs of each resident, and that should be documented in their care plan.

The move to level 4 for mainland areas means that visiting is restricted to essential visitors for indoors and outdoors visiting. It is important that essential visits continue to be supported. They include circumstances in which it is clear that a person’s health and wellbeing is changing for the worse, where visiting might help with communication difficulties, to ease significant personal stress, or in other pressing circumstances, which obviously includes when someone is approaching end of life.

We will continue to approach all those issues with the utmost sensitivity, within what I know that everybody accepts is an incredibly challenging situation, particularly for those working on the front line.

The First Minister mentioned giving parents as much notice as possible on the plans for schools, but the 18th is just three weeks away. By what date will a final decision be made, to allow parents to plan? Can the First Minister confirm that key worker hubs, which we welcome, will stay open for as long as they need to, while schools are closed to all pupils? Does the Government have any plans for mass asymptomatic testing of pupils and staff in schools, colleges and universities? If not, why not?

The arrangements for vulnerable children and the children of key workers will remain in place for as long as necessary. I am always grateful that people remind me of how many days there are between now and a particular date in future. I am acutely aware of that, and of the pressures that parents are under and their understandable and legitimate desire for as much certainty as possible. We are trying to balance doing what is required and not shying away from difficult decisions. However, we will not take decisions that will have a massive impact on young people and parents before we think that those are necessary.

As I think I have said twice today, we will give as much notice as possible. However, we are literally assessing the situation on a daily basis. I think that some announcements are being made south of the border today about schools in England. All Governments are in the same position.

Whatever the situation is, the arrangements in place for vulnerable children and children of key workers require to continue and will continue.

I am aware of a paramedic who is concerned by the increase in Covid numbers going to hospital and resulting in delayed handover times. On boxing day, the London Ambulance Service recorded one of its busiest days on record, as the number of coronavirus patients receiving hospital treatment in the south of England heads towards the April peak as a result of the rapid spread of the new strain of the virus.

The First Minister touched upon Hogmanay in her opening statement. Will she reiterate the best ways for people to keep themselves and their loved ones safe tomorrow and prevent our NHS and the Scottish Ambulance Service from being overwhelmed?

I acknowledge the job that our paramedics and Ambulance Service staff do all year round, particularly at this time of year, when, even without a global pandemic to contend with, all our emergency services are particularly busy. I know that they have the gratitude and appreciation of us all. This Christmas and new year period, they are particularly busy because of the pressures of Covid. We—I know that our emergency services share this view—do not want any unnecessary delays in ambulance staff transferring patients to hospital. We continue to work closely with health boards and the Ambulance Service in real time to resolve any issues that arise there.

In response to Stuart McMillan’s question, let me reiterate that the best way for us all to protect front-line staff, including the Ambulance Service, is by minimising the transmission of Covid. Again, my message for Hogmanay is tough—it is difficult for everybody—but it is simple and vital. We should not mix indoors with other households. Please, please bring in the new year in your own home, with your own household only. That is the best way that we can protect the NHS and get ourselves into the new year on as safe a basis as possible.

I have listened carefully to the First Minister’s thinking on schools, but one of the things that parents and school staff are worried about is reports that the new strain of Covid not only spreads more quickly, but more readily affects young people. Will the First Minister update us on the evidence that she has on that, and on how it is shaping her thinking with regard to reopening schools?

I do not yet have definitive or conclusive evidence one way or the other on that. I talked a bit about the matter in our last meeting of Parliament before Christmas. Experts are exploring and investigating the issue.

That situation is absolutely among the things that are influencing our thinking about schools and is making us even more cautious on that front. There is no doubt about that. Because of the faster spread of the new strain, we would be more cautious anyway, but the suggestion that it might be more likely to infect young people adds to that caution. That is why we are continuing to take decisions with the utmost care. If there are changes to what we have set out, we will act on them as quickly as possible, and will give as much notice as possible. We will do that with the safety of children, their teachers and other staff absolutely at the forefront of our minds.

There was a sharp rise in positive cases of the new strain of Covid 19 across Wigtownshire and south Annandale in Dumfries and Galloway over Christmas. Will the First Minister provide an update on what additional steps are being taken by the Scottish Government and NHS Dumfries and Galloway in the light of that increase, and say whether there is any indication of the causes and cases being connected, as they are 96 miles apart?

Given that we are seeing evidence of the impact that travel in and out of the country is having on spread of the virus, would the Scottish Government consider asking the United Kingdom Government to close or tighten external borders to all but essential travel?

The incident management team in Dumfries and Galloway is meeting daily to address the situation. I also understand that the local resilience partnership is meeting this afternoon to consider the concurrent risks that arise from the outbreak. There has been an increase in testing capacity to provide an additional 200 testing spaces per day in Stranraer and the Stranraer area for this week. A number of steps are being taken; more will be taken as required.

On travel, I could not be clearer: people should not travel unless doing so is absolutely essential. There are a number of layers to that. None of us, unless it is essential, should travel far from home at all. People should stay at home, or as close to home as possible. There is a legal restriction on travelling outside one’s local authority area unless doing so is essential. Again, I say that people should not travel across the England-Scotland border or between Scotland and the other parts of the UK and vice versa unless it absolutely cannot be avoided for essential purposes. That applies to overseas travel, as well. We are in a global pandemic, so we must take very seriously all advice on travel. I ask people, please, to stay at home or close to home, because that will help us to get through the next difficult few weeks until—we hope, through the news about vaccines today—we get to the brighter times in spring next year that we are all desperate to see.

In the light of the welcome news today about the Oxford vaccine, what steps is the Government taking to ensure that health boards are co-ordinating delivery of both available vaccines, especially in rural and remote parts of Scotland, including the Highlands and Islands? Can the First Minister be more specific about the role of GPs in wider community vaccination?

Delivery of different vaccines that have different logistical requirements is part and parcel of the vaccination plan. That is mainstreamed in the plan and hardwired throughout it. As everybody knows, the Oxford-AstraZeneca vaccine is logistically in many ways much easier to deliver than the Pfizer one, so that will make it easier to get it to rural communities and general practices, and opens up much speedier vaccination of different groups.

We will also use mobile vaccination units where necessary and appropriate, which will help health boards to take the vaccine to the more remote and rural parts of the country. There is a fully integrated plan that recognises the different requirements of the different vaccines. I hope that there will, before too long, be more vaccines approved for supply.

A point that I should perhaps have made earlier, in response to a question about the numbers of vaccinators, is that we are starting to get to the end of the flu vaccination programme, so people who are doing the flu vaccination are switching over to the Covid vaccination. The plans are well developed and will be kept under daily review. We are absolutely focused on getting the vaccine to as many people as possible, as quickly as is feasible and as supplies allow.

Although Covid-19 is quite rightly at the forefront of people’s minds, it is crucial that we encourage anyone with a health concern not to put off accessing the NHS. Can the First Minister provide support for that message, which I am giving out, and give assurances that our NHS is open to everyone who has health concerns?

Before I come to that question, I will round off my last answer by saying that the Cabinet Secretary for Health and Sport has reminded me that she is writing today to all MSPs with an update on the vaccination programme, and will do the same again next week. I am sure that that information will be helpful.

On Sandra White’s very important question, it is vital to stress that, although the NHS has been restricted in what it has been doing in the past few months, it is open for those who need it. General practices remain open and accessible for patients and are at the forefront of our community services to deal with non-Covid medical care. NHS 24 also continues to support people when their general practice is closed, and people with urgent but not life-threatening conditions who would usually visit accident and emergency departments can now call NHS 24 day or night, which means that people should continue to call 999 or go directly to A and E in emergencies.

For people who are receiving treatment, strict infection prevention and control measures are in place when they attend appointments. If anyone has concerns about safety, clinical teams are there to provide the necessary assurance so that patients feel safe.

Public messaging is currently being delivered via NHS 24’s campaign, “Show you care. Prepare”. The campaign on getting the right care in the right place will also increase its reach across the public over the course of January.

The main message to people right now is this: the NHS is open if you need it, and if you need it you should use it.

Does the wonderful news about the AstraZeneca vaccine bring closer the end of the time for full roll-out of vaccination? Am I right in thinking that the Government’s detailed modelling says somewhere that the Government hopes to get there—or to 65 per cent—by March, April or May? I note that the First Minister said that it is expected that adults over 50 will be vaccinated by the spring, but when I checked I realised that “spring” means as late as 21 June. It would be helpful to get confirmation of that, and to hear what the First Minister thinks we can all do to maximise take-up of the vaccine.

The news today will allow us to accelerate significantly the JCVI’s first-priority list, which we had hoped to deal with during the spring. Some of the flexibility around the dates is due to the fact that we still do not have complete certainty about the supplies that we will get and when we will get them. That is true for the AstraZeneca vaccine, but as we get it we will be able to make predictions and expectations much more concrete. I remind members that the JCVI’s first-priority list covers everyone over 50. After that, we will move on to the rest of the population.

There have been two good-news stories today—the new vaccine, which will provide more doses for us to use, and the new advice on the interval between doses. The JCVI had previously advised that we should hold back 50 per cent of available doses and give the second dose within three weeks. We no longer have to do that, so more doses of our existing supply are available to give more people the first shot of the vaccine. Once we have greater certainty about delivery schedules, we will work out exactly what that means for numbers and over what timeframe. There is, however, no doubt that today’s news means that more people will be vaccinated more quickly than we had anticipated when I spoke to Parliament last week.

The current level 4 travel restrictions allow an exception for travel up to 5 miles from a person’s local authority boundary for outdoor and informal exercise. Some people are interpreting that as 5 miles as the crow flies, not as the odometer reads. This week, the car park at Flotterstone, in my constituency, was jammed as folk took to the Pentland hills. That was in conflict with the First Minister’s entreaty to people to stay close to home. Will that travel exception be reconsidered if there is a review of level 4, as it does not seem to be essential?

We will keep all such things under review, given the circumstances that we face. On exemptions to the restrictions on travel for exercise, we have tried to strike a balance between the steps that we need to take to prevent the spread of the virus and a recognition of the health and wellbeing benefits of exercise. That balance allows local, informal, outdoor exercise, such as walking, cycling and running that starts and finishes at the same place. That can be up to 5 miles from the boundary of a person’s local authority area, but I appeal to people only to do that if it is necessary and to exercise as close to home as possible.

I cannot stress enough the importance right now of all of us staying at home and as close to home as much as possible. That really will help us to avoid the spread of the virus. I say in direct response to Christine Grahame that we will keep all these matters under on-going review.

Although the new variant strain of Covid-19 is on the rise, which is immensely concerning, intensive care unit and other hospital beds are, thankfully, not overwhelmed. Will the First Minister tell us what impact the arrival of the new variant has on detecting and treating other—regrettably more routine—diseases, such as cancer, particularly in Ayrshire? Will other diseases continue to be treated in Ayrshire and across Scotland?

The more that we can suppress this strain of the virus, the more that we can protect our NHS from being overwhelmed; that was also true of the previous strain of the virus.

I gave the figure of there being 60-something patients in ICU as of today; the peak number of people in ICU in Scotland back in April was 200. We are therefore significantly below that number. However, the figure has been rising again and, with the case numbers that we are seeing—particularly yesterday and today—we have a concern that it will rise quite significantly in the period ahead. That makes it all the more important that all of us take our responsibility to suppress the virus very seriously.

It is also really important that health boards prioritise non-Covid care. I will not repeat everything that I have said previously about NHS remobilisation, but it has been made clear to health boards that they must maintain urgent, elective and vital cancer services, which now include national cancer screening programmes.

Unfortunately, we have had to make lots of invidious trade-offs during the course of the pandemic. However, the vaccine will help us. The priority list for the vaccine recognises that we do not yet know whether it limits transmission, but we do know that it suppresses severe disease. Therefore, as it rolls out, it should help us to keep the Covid pressure off our NHS and particularly off ICU.

None of this is straightforward, and those on the front line of our national health service are bearing the burden. It is for all of them, as well as for ourselves and each other, that I continue to appeal to people to do the right thing, particularly over the next period.

Will the First Minister publish the rate of progress in relation to vaccination in our care homes? Many relatives of those in care homes are still understandably anxious, and being able to see how many people—both staff and residents—are being vaccinated would be important for morale.

We will publish more of a breakdown of the progress of vaccination. Right now, we publish on a weekly basis the total number of people who have received the vaccine. As of Sunday, the figure was more than 92,000; it will be a fair bit higher than that as of now.

We have to make sure that any figures that we publish are robust and reliable. As we do that, we will provide breakdowns in relation to different settings, which will include care homes. As vaccination in care homes was one of the first parts of the vaccination programme to get under way, it will be one of the first that is completed, which we hope will be very soon.