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In a moment, I will ask Professor Leitch to deal with the question of epidemic and endemic, because judgment with a clear scientific basis has to be applied to that, and it is appropriate that he provides the committee with that advice.

On the second question, there is one point of detail in Mr Fraser’s analysis on which I part company with him. From my recollection, I do not think that the projection or suggestion was made that omicron would lead to a significantly greater number of deaths. The fear of omicron was that a huge volume of cases would give rise to a large volume of hospitalisation, which would place a burden on the national health service. In the emerging evidence from South Africa, it appeared that omicron, although generally a milder version than delta, would still give rise to a sizable number of cases in the population that would result in hospitalisation.

I would contend that the combination of the measures that the Government put in place, the response of members of the public and the change in behaviours that took place in the run-up to Christmas enabled us to flatten the omicron curve. The number of cases was of a magnitude that would have led to much more acute measures being taken with previous variants; it was much higher than the number that resulted in the lockdown of 4 January 2021, for example. In the position that materialised, the combination of the vaccination strategy, the measures and restrictions that were put in place by the Government and the change in public behaviour and participation enabled us to flatten the worst effects.

However—we must be really careful about this point—we still have huge demands on the NHS as a consequence of omicron. We have more than 1,500 patients in hospital with Covid just now. That is a very high number, which is putting acute pressure on the national health service.

On Mr Fairlie’s first question, the Scottish Government’s position on the wearing of face coverings—whether in crowded public places, on public transport or in schools—has not changed in the light of yesterday’s announcements by the Prime Minister. There is absolutely no change in the Scottish Government’s position, of which Parliament was advised on Tuesday. If there was to be any change in that position, Parliament would be advised. As things stand just now, the Scottish Government is crystal clear that the requirement to wear face coverings in public spaces, on public transport and in secondary schools remains absolute.

I am struck by yesterday’s comments by the chair of the British Medical Association council, Dr Chaand Nagpaul, who said:

“It is vital that the Government”—

the UK Government—

“acts according to the data and takes a measured approach. Removing effective infection control measures like mask wearing on public transport and indoor crowded spaces will inevitably increase transmission and place the public at greater risk, especially for those who are vulnerable.”

Those are very significant words of warning, which are taken seriously by the Scottish Government.

I invite Professor Leitch to address Mr Fairlie’s second question, which was about clinical advice.

I contend that the relevant data is clearly available because Mr Whittle has just recounted it to me. The collection of such data enables us to see comparative levels of referrals for individual cancer treatments and a variety of other treatments, the number of cases that have been handled and the period and time at which they have materialised.

A sustained effort has been put in to maintain cancer services throughout the challenges of the pandemic. When other services were paused, cancer services were maintained. However, I have to acknowledge that individuals will have been more reluctant to come forward for wider health treatment during the pandemic, and the evidence and data reinforce that point. It is important to reiterate the necessity for individuals to come forward for treatment of this type. When people have concerns about their health, the national health service is open and available to deliver treatment to them. It is important that, at all stages, individuals hear the message that the health service does all that it can to deliver.

Obviously, the capacity of the health service to deliver in that respect depends on the degree to which we can suppress the effects of Covid on it. The omicron wave has essentially reinvigorated the number of patients who are in hospital with Covid. If we look back to just before omicron, we were down to about 900 patients being in hospital with Covid—I think that the number was actually lower than that—but we now have in excess of 1,500. Suppressing Covid enables the health service to devote more resources to addressing the type of condition that Mr Whittle fairly puts to me as being important to members of the public.

Essentially, that is reconciled through the four harms framework that I discussed in my answers to John Mason. I will remind the committee of the details of that. The Government has assessed the relationship between health harm directly from Covid, non-Covid health harm and economic and social harms. Although Mr Whittle is correct to say that some people who have lost their lives to Covid will have had other conditions, other people have lost their lives directly because of Covid.

The Government has been trying to enable people to experience as much of normal life as we can hope for while we wrestle with a global pandemic. That has a bearing on the extent and nature of the health treatments that are available and that can be delivered.

All the preventative health interventions that the Government supports—such as the smoking cessation programme that Mr Whittle mentioned—need to be part and parcel of what we put forward to members of the public as vital elements of the health protection that individuals ought to pursue in order to lead a healthy life. That should be sustained during Covid, and any treatment as a consequence of that needs to be sustained in that context as well.

Although it is important that we focus on additional health harms that are different from those that are caused by Covid, the hard reality is that it is inevitable that the capacity of the national health service to address those issues will be greatly enhanced if we ensure that there is less impact on the health service as a consequence of Covid.

In the interests of time, I will not put any further points on the record.

Thank you, convener. I am grateful to the committee for the opportunity to discuss a number of matters, including the updates to the Parliament on Covid-19. I will make a brief opening statement.

As the First Minister set out on Tuesday, although omicron continues to cause high levels of cases and we must maintain proportionate protective measures, the data that we are seeing gives us confidence that we have turned the corner on the omicron wave. Although the number of cases remains high, we continue to see a reduction in cases across most age groups. Admissions to hospital of people with Covid, albeit still too high, are now falling.

The success of our vaccination programme, the willingness of the public to adapt its behaviour, and the temporary protective measures that were introduced in December have all helped to limit the impact of the omicron wave. That is positive news but, given how infectious omicron is and the impact that it is having on our society, we must remain careful and cautious as we continue to lift additional protective measures in a phased approach.

The First Minister confirmed that, from Monday 24 January, the remaining statutory measures that were introduced in response to omicron will be lifted. Those include the requirement for table service in certain hospitality settings and the closure of night clubs. Non-professional indoor contact sports can also resume from Monday.

Although it remains sensible to stay cautious in our social interactions and to prioritise whom we meet, the First Minister also confirmed that the guidance asking people to limit indoor gatherings to three households will be lifted. Our advice remains to take a lateral flow test, and to report the result, whenever meeting others. Reporting test results, including those that are negative, will ensure that we are able to make better assessments of the trends in infection.

The Covid vaccination certification scheme will remain in place for events and venues that were previously covered by it, and we are asking event organisers to check the certification status of more people who are attending events. This week, the Cabinet agreed not to extend the certification scheme, given the improving situation. For the time being, baseline measures, such as wearing face coverings in indoor places and working from home, when that is possible, will remain in place. The requirement for businesses, service providers and places of worship to take reasonable measures to minimise the spread of Covid on their premises will be retained, at this stage, to help keep Covid contained as the current wave recedes.

Our vaccination programme continues, and I encourage anyone who has not yet had their first, second or booster dose to do so as soon as possible. Getting fully vaccinated is the most important thing that we can do just now to protect ourselves and each other.

The First Minister said on Tuesday that we are entering a calmer phase of the epidemic. That will allow us to consider the adaptations that we might need to make to build our resilience and to manage the virus less restrictively as we move into an endemic phase in the future. We have not yet reached the endemic phase and must remain cautious, given the uncertainties that lie ahead.

I am happy to answer questions from the committee.

The last cost that I saw was something of the order of £3 per test, but I stand to be corrected by one of my officials.

Obviously, the data will vary from area to area. I am absolutely satisfied that the Government and health boards have put in place adequate opportunities for individuals to secure the booster jag. The level of performance has been very high. We have had surplus capacity, so there has been absolutely no difficulty in getting an appointment for people.

In some circumstances, there will obviously be a time lag. If individuals were slower in coming forward for their first and second doses, they will be delayed in getting their booster dose, because of the time limits that have to be applied. We are not at the end of the booster programme by any stretch of the imagination. It is continuing to vaccinate people on an on-going basis with the appropriate 12-week gap between the second dose and the booster dose. The best way to explain it is that the booster vaccination programme is still a work in progress. I therefore expect those rates of coverage to increase.

We have to continue to intensify the message. One point that concerns me a little is that, if there is a sense that omicron is a less acute variant, that might suggest to people that they do not need to come forward to get their vaccination. However, as Professor Leitch has just explained, there is an absolute necessity for individuals to have the booster vaccination, because it will give them a level of protection that is absolutely critical in dealing with the virus. The Government’s messages will therefore remain resolute about the importance of rolling out that booster vaccination programme in all circumstances and all geographies.

I am in a slightly difficult position on that, because I am not the one making the big song and dance about that data. Mr Fraser set out to the committee that he has been demanding that information for a considerable time. The Government has to respond to demands for information and has an obligation to address issues that members of the Parliament raise. Ministers have made it clear that we take the view, which Mr Fairlie expressed, that there is no particular significance in the difference between people being in hospital because of or with Covid.

We have a massive Covid challenge in our healthcare system, and the more that we can do to tackle the prevalence of Covid, the more we will relieve the pressure on that system. The Government’s messages have been crystal clear about the dangers of Covid. We have ensured that there is an understanding of the severity of the virus, whether omicron or not, because we cannot have a relaxed attitude prevail that omicron is somehow not a big threat. Omicron is a massive threat to our healthcare system and to public health. We have to get that across to people. That is why the Government has taken strong action to protect the public.

We are not in control of all the questions that we are asked, but we are certainly in control of the key messages about the importance of tackling Covid. Your points about the advice from the clinician are correct, Mr Fairlie. If somebody has an underlying condition and Covid, their ability to deal with the underlying condition will be severely compromised by the presence of Covid. We know that clearly from the clinical advice that we have had.

Obviously, a huge amount of effort is put into securing the take-up of vaccination and boosters. I do not have in front of me the breakdown in the over-70s category—