���˿���

Again, that is a difficult question for me to be precise about. We are constantly reviewing the situation, looking at many data streams regarding levels of infection, pressures on our hospitals, the effectiveness of the vaccination programme and so on. Many factors must be borne in mind. At this stage, I would say to people that adhering to the advice that has been given so far about reducing social interaction before and after the Christmas period is the most effective contribution that people can make towards ensuring that we can enjoy and appreciate some time with our families over what we might call the formal Christmas period.

Obviously, the last thing that we want to do is inflict further disruption on people at this time. Sadly, that had to happen last year, and we want to avoid it this year, if at all possible. In any decision making that we undertake, we will be mindful of the plans that people will have made.

The guidance is being formulated as we speak. Given the pace at which we are operating, we are trying to discuss its detail with a variety of interested parties, and I expect it to be available in the course of Friday. In essence, it will provide the information that those obliged to have reference to the guidance will be able to take forward. We need to consult the business community, faith leaders and other relevant organisations, and that work is under way so that we can, to the greatest possible extent, act in a manner that enables activity to continue but which contributes to a reduction in the possibility of the virus circulating.

We would dearly love to be able to rule that out, but I cannot in all honesty do that at this stage. Mr Fraser is absolutely right about the severity of the situation that we face, and I welcome his acknowledgement of that point. I also entirely accept his point that the public are responding accordingly to the challenge. We all look at evidence, but we are also all influenced by anecdotes, and I have to say that I have noticed that my journeys into Edinburgh on Tuesday and Thursday this week have both been much easier in terms of traffic volumes than the ones that I made last week, and today’s was significantly easier than Tuesday’s. That suggests to me that more people are working from home and fewer are commuting, in response to the situation.

I hope that we can avoid applying further constraints on the way in which people are able to enjoy Christmas, but the message that the First Minister issued on Tuesday was deliberately phrased to get people to understand that, if we want to be able to carry on with our family plans around Christmas eve, Christmas day, boxing day and so on, the best way to ensure that that happens is by making sure that we are all Covid-free by taking lateral flow tests before we gather in family groupings and by reducing our social interactions before and after that period.

I think that that is the safest way to proceed, but I have to acknowledge that, in light of the rapid pace of the increase in omicron cases and the data that was shared by the Prime Minister and the United Kingdom’s chief medical officer yesterday, which reinforces the points that the First Minister made on Tuesday about the severity of the threat, I cannot rule out that we might have to apply further constraints in the period ahead.

Those measures are actively being pursued. The committee will be familiar with the fact that the Government has already recruited 350 full-time-equivalent additional vaccinators. As a consequence of the decisions that we took at the weekend and on Tuesday, we are accelerating the vaccination programme, which means that we need to ensure that more vaccinators are available to deliver vaccinations. That will, of necessity, require us to prioritise vaccination over other aspects of activity in the health service.

That capacity is increasing. The data shows that, on Tuesday, about 77,000 vaccinations were undertaken, 18,000 of which were flu vaccinations. The Government has taken the decision to deprioritise the flu vaccination programme, because we have got to very high levels of flu vaccination in the most vulnerable categories. We believe that deprioritising the remainder of the flu vaccination programme is a clinically safe risk to take. That frees up capacity within the Covid vaccination programme.

Basically, we need to get to about 75,000 to 80,000 Covid vaccinations a day to fulfil our objectives. On the combination of Covid and flu vaccinations, we were at 77,000 on Tuesday. We need to increase the tempo of that. There will obviously be days when it is difficult for us to deliver that volume, with the Christmas break and all that goes with it. We are expanding capacity and the vaccination programme. Derek Grieve is operational director of the vaccination programme. He is on the line, and he may wish to add to what I have said.

On delayed discharge, there is an intense focus on supporting individuals who do not need to be in hospital to be released and to be supported at home. I have to be candid with the committee that the availability of social care staff is challenging in that respect. Some people simply cannot be released from hospital to be sent home without a care package. Just last night, I discussed with local authority leaders the steps to be taken to expand at-home care capacity, and the Cabinet Secretary for Health and Social Care has been doing that, too. That work is under way, although I have to be open with the committee that there are challenges in relation to the availability of social care staff to support packages at local level.

Derek Grieve may wish to add to my comments on the vaccination programme.

We will look carefully to the recommendations that come from the JCVI in that respect.

You raise the fundamental dilemmas that we wrestle with all the time. That is why I said in my opening remarks that we are taking a proportionate and precautionary approach to handling the situation.

Modelling of the pandemic’s likely course is undertaken regularly, and a variety of variables are considered. A few weeks ago, the modelling looked at the potential impact of the 26th United Nations climate change conference of the parties—COP26—and it has covered the impact of winter and all sorts of scenarios.

The modelling gives central, better and worse scenarios, on the basis of the virus’s prevalence and circulation. We hope for the better scenario, we prepare for the central scenario and we hope that we do not reach the worse scenario. Different actions are required if we face the better, worse or central scenario. That is why I used the word “proportionate” in talking about our judgment.

The precautionary approach is important, too. If we look at the pandemic today in Scotland, we see that case numbers are high but fairly flat. The figures for the past seven days are slightly down on those for the previous seven days. The hospitalisation rate of Covid patients today is slightly lower than it was, although the figure is still more than 700. If those 700 people were not in hospital with Covid, we could provide other treatments for 700 patients.

There is a careful judgment to be made about the proportionate steps to take. If omicron turns out to be more transmissible than delta, there will be more cases. If the level of serious illness from omicron is no different from that of delta, a relatively small percentage of cases will be hospitalised, but that will involve more people if the number of cases is higher. That will place even more pressure on the national health service and will mean that services are under pressure.

If the level of serious illness does not change but the volume changes significantly, we will have to take more dramatic action. I have no justification for that today because, although I can look at the omicron scenarios, a compelling evidence base does not yet exist for taking more severe measures. It might well exist in the future, so the Government will keep the situation under constant review.

I accept those points and that is why I make my plea to people. I do not think that it is just 18 and 19-year-olds—

That is nothing new. However, I am taking tests more frequently because of the degree of interaction that I now have in the course of my responsibilities.

That is a very significant and legitimate question. In my answers to Mr Rowley’s completely legitimate questions about expanding the scale of the vaccination programme, I made the point that one of the options could be turning down the dial on elective work and putting more resource into the vaccination programme. If I do that—I do not wish to personalise this, but I will use these distinguished members of Parliament to illustrate my point—Mr Rowley might be more happy, but Mr Whittle will not be. Mr Whittle’s primary concern is the treatment of what I will call non-Covid conditions that are perhaps leading to early mortality because health services are unable to undertake all that we would ordinarily hope they would be able to.

That is why we have to invest in all the precautionary measures possible to avoid the virus circulating. We are not in any shape or form powerless with regard to omicron circulating, because people can come forward for vaccination, which they are doing in substantial numbers, and they can observe the baseline measures on a routine and rudimentary basis in order to put up barriers to circulation.

There are all sorts of steps that we can take. It is incredible to watch what our contact tracers are doing in response to the early cases of omicron. It is jaw dropping to see the degree of intensity with which they are looking at where people have been, whom they have been close to and what is happening around them, to try as much as possible to interrupt the circulation of the virus.

We have to use a variety of devices because, the more we do that, the more activity we will have to try to address the core point that Mr Whittle puts to me.

Yes, the issue has been resolved. I very much regret that some individuals had that experience yesterday. The guidance has changed and it should have been applied in all vaccination centres and scenarios.

In light of what emerged yesterday—I am advised that the issue arose in a limited number of cases—we have reiterated the guidance to all health boards to ensure that all vaccination centres are operating to the new updated guidance, which emerged only at the start of the week.

I regret that some individuals were inconvenienced in that way. The fact that people are so willing to come forward for the booster jag at such an early stage after the change of guidance is an indication of public attitude to participation in the programme, which is welcome. That makes it doubly disappointing that people were inconvenienced in the way that they were.