 The next item of business is a statement by Nicholas Sturgeon on COVID-19 update. The First Minister will take questions at the end of her statement, and so there should be no interventions or interruptions. I call on Nicholas Sturgeon, First Minister. I will give an update on the latest Covid situation and our best assessment of the current course of the pandemic. I will also follow on from last week's statement set out a proposed change to the current Covid certification scheme and a rationale for all of the decisions reached this morning in relation to the scheme. First, though, today's statistics, 2,527 positive cases were reported yesterday, 11.6 per cent of tests carried out. 743 people are currently in hospital with Covid seven fewer than yesterday and 60 people are receiving intensive care one more than yesterday. Sadly, a further 17 deaths have been reported over the past 24 hours, which takes the total number of deaths registered under this daily definition to 9,495. Once again, I send my condolences to everyone who has lost a loved one. More positively, the progress of the vaccination programme continues to be very good. 4,340,162 people have now had a first dose and 3,940,314 have had both doses. In total, 88 per cent of all those aged over 18 are double vaccinated. In addition, 77 per cent of 16 and 17-year-olds and 58 per cent of 12 to 15-year-olds have had a first dose. In line with updated JCVI advice, we are now preparing to offer second doses to 16 and 17-year-olds. As of now, on first, second, third and boosted doses, I am pleased to say that Scotland is still the most vaccinated part of the UK. I want again to record my thanks to everyone involved in organising and delivering the vaccine programme. Looking across Europe, we can see very clearly that the Covid situation is deteriorating again. As a result, Covid measures are being tightened or reintroduced in many countries, for example Ireland, the Netherlands, Germany and Slovakia. At the most severe end of the spectrum, Austria is now back in full lockdown and also mandating compulsory vaccination. All of that is a start reminder that the threat of the pandemic, unfortunately, is not yet behind us. Covid is continuing to force Governments everywhere to take really difficult and invidious decisions. Of course, that is also true here in Scotland. While, thankfully, we are not at this stage seeing the rapid rise in cases that others are experiencing, the situation remains precarious. Cases are on the rise to a greater or lesser extent in countries all around us, including here in the UK. We are also entering a period when, understandably, people will be socialising and mixing more than normal. Even though our position now is relatively stable compared to some other countries, we must continue to take care and we must not allow ourselves to be lulled into any false sense of security. Let me now give some more detail on the recent trends that we are seeing here. Last week, I noted that cases had increased gradually over the previous fortnight from just over 2,500 new cases a day to just over 3,000. Since then, the situation appears to have stabilised again. In the past seven days, the average number of new cases being recorded each day has fallen from just over 3,000 to just under 3,000. It has been a fall of around 3 per cent. However, there continues to be quite a marked variation between different age groups. In the over-60s, cases fell by 19 per cent, and that, at least in part, is very likely to reflect the good progress of the booster programme. In the under-60s, though, there was only a very slight decline. A small fall in cases in those aged under 25 was almost balanced out by a very small increase in the other age bands under 60. In younger age groups, cases have been broadly static over the past week. That said, a number of different factors will be at play over the next few weeks, and the combination of those makes it quite difficult to be certain about the course that the pandemic will take over the festive period and into January. On the one hand, the booster programme will continue to gather pace, and more people in younger age groups will receive their primary vaccinations, so we can expect the combined effects of vaccination to bear down on transmission, and we hope to reduce the numbers that will become seriously unwell as a result of getting the virus. On the other hand, we can expect more indoor mixing to take place as the weather gets colder and, of course, as we head towards the festive season. In addition, there is likely to be some waning of vaccine immunity, which is why booster jags matter so much, and those latter factors will increase the risks of transmission. Of course, although the cases are broadly stable just now, it is also the case that infection rates remain too high and higher than we would want them to be. All of that is putting significant and sustained pressure on the NHS. In the past week, the number of people in hospital with Covid has fallen only slightly, from 779 to 743, and the number of people in intensive care has risen very slightly from 57 to 60. The number of patients in hospital with Covid is still high. The NHS is also dealing with the backlog of care that was created by earlier phases of the pandemic and, of course, the peak of the winter flu season, coupled with other winter pressures, possibly still lies ahead of us. Taking all of that into account, and adding the fact that the R number is hovering at or slightly above one, leads us to this conclusion. Our situation is definitely more positive than we might have expected it to be at this point, but it is still precarious. We need to get the R number back below one, and that means having in place a range of proportionate protections to keep the country as safe as possible while we continue to live as freely as possible. That is why the Cabinet decided this morning to retain for a further period all the remaining legal protections, such as the requirement to wear face coverings, and, subject to a change, I will set out shortly to keep in place the Covid certification scheme and also to intensify our public information campaign in the weeks ahead. I want to now set out and really emphasise today the range of protections that we judge to be essential. I want to stress that word essential if we are to navigate this winter as safely as possible and crucially without the need to reintroduce more onerous restrictions. As we approach the festive season, I am appealing afresh to everyone across the country to comply with all of those protections with renewed care and commitment to keep ourselves safe, but also to show our solidarity to those around us. Firstly, vaccination. The duty of government is to deliver the vaccine programme, especially at this stage boosters, as rapidly as possible. Right now, that is my Government's top priority. More than 1.4 million people—just over 30 per cent of the total over 12 population—have so far had a booster or third dose. Within the most vulnerable groups, 87 per cent of over 70s and 76 per cent of those at highest clinical risk already have the protection of a booster or third dose. As I mentioned earlier, we are already seeing the positive impact of boosters in the case numbers, so the programme is going exceptionally well, but we are doing everything possible and will continue to do everything possible to speed it up further. Delivering the programme as quickly as possible is, of course, the Government's responsibility, although, of course, we are reliant on and eternally grateful for the commitment of NHS workers in delivering it. The duty and responsibility, though of all of us as citizens, is to get vaccinated as soon as we are able. If you have not yet had a dose of vaccine that you are eligible for, please make arrangements to get it now. This is even more vital if you are planning to socialise at all over the festive period. If you are meeting up with loved ones and you are not as fully vaccinated as you could be, you are putting them at unnecessary risk. To be blunt, you could be putting their lives in danger. The most precious gift that we can give anyone this Christmas is to be vaccinated and tested, which I will say more about shortly, before we meet, hug or spend any time with them. If you have not had a first or second dose yet, it is not too late, so please do so now. Please also get your booster as soon as you are able. A booster jag reduces the risk of symptomatic infection by more than 80 per cent. Let me stress this. It is not just a small top-up. Getting your booster is every bit as important as getting the initial vaccinations. If you are aged over 50 or are in one of the higher risk groups and are over 24 weeks from your second jag, you need to book an appointment online via NHS Inform or via the helpline. The helpline number is 0800 030 8013. If you live in many parts of the Highland area or on one of the island areas that does not use online booking, you will be contacted separately by your health board, but for everyone else, please use NHS Inform or call the helpline. Please book the booster for as soon as you are eligible, which is 24 weeks after your second dose. Do not, for example, wait until after the Christmas holiday period is over. For those aged 40 to 49 who are next in line for boosters and for 16 and 17-year-olds who will now be offered a second dose, information on booking appointments will be available very soon. Above all today, I want to reinforce this vital message to every person eligible for vaccination, including pregnant women. Whether for a first, second, third or booster jag, please book an appointment without delay and get your flu jag too if you are eligible for that. Getting vaccinated does remain the single most important thing any of us can do to protect ourselves, our loved ones and our communities. You could well be saving your own life and the lives of your loved ones. You will be helping the NHS and you will be maximising our chances of getting through this winter without the need for further restrictions. The vaccine programme is the bedrock of our fight against Covid, but other protections are vitally important too. The Scottish Government will be intensifying our public awareness and information campaigns over the winter period to ensure that everyone knows what is being asked of us. When you see those ads, please take a moment to listen and remind yourself of the protections that will help to keep you and others safe. What are those other protections? Firstly, as well as vaccination, we are asking everyone to take regular lateral flow tests. We have been asking people to do this routinely twice a week. However, over the festive period, we are asking for extra effort, so this next request is vitally important. On any occasion that you are socialising with others, whether that is going out for drinks or dinner, visiting someone at home or even going shopping somewhere that might be crowded, please take an LFD test before you go. If it is positive, do not go. Instead, get a PCR test and self-isolate while you wait for the result. That way, you are minimising the risk of inadvertently passing the virus on, even if you do not have symptoms. Please continue to wear face coverings on public transport in shops and when moving around in hospitality settings. That remains a legal requirement, but it is also a vital protection. A study that was published just last week suggested that face coverings may reduce the risk of transmission by over 50 per cent. Remember that good ventilation also reduces risks in indoor spaces, so please open windows if you have people around. Lastly, please continue to work from home whenever possible. I know that this is not always easy for workers, nor is it convenient always for employers, but it does make a difference and it will help us to navigate our way through this difficult winter period. The average number of contacts that people are having in the workplace has doubled in recent weeks, and as we head deeper into winter, that will create an increased risk of transmission. The virus transmits as we know when people interact, and when people go to work they interact in a number of ways, including through travel, during lunch breaks and after work. Support for home working whenever possible remains one of the most effective protections that we have at our disposal just now. Let me turn now to the Covid certification scheme, which Cabinet also discussed this morning and set out the decisions that we reached and the rationale for them. For context, it is worth bearing in mind that Covid certification is far from unique to Scotland. Similar schemes are in place in many other parts of the world. In fact, in recent weeks, certification schemes have been announced, reintroduced or extended in Denmark, Norway, Sweden, Northern Ireland and elsewhere. Many cover a wider range of premises than Scotland does. However, we must reach decisions based on our own circumstances, so I can confirm that the judgments that we arrived at this morning are as follows. Firstly, for at least a further three-week period, we will retain vaccine certification for the venues and events that are currently covered by the scheme. That is late night licence premises with a designated area for dancing, unseated indoor events of 500 people or more, unseated outdoor events of 4,000 people or more and any event with 10,000 people or more. Given the current state of the pandemic, it is our judgment that it would not be appropriate at this stage to remove this protection against transmission. Secondly, however, we have decided that from 6 December it will be possible to access venues or events covered by the scheme by showing either proof of vaccination as now or a recent negative lateral flow test result. When we first launched the scheme, one of its primary objectives was to help drive up vaccination rates. That is still important, obviously, but actual and projected uptake rates mean that we judge it possible now to include testing. Doing so will also ensure that the scheme remains proportionate going forward and also help our wider efforts to stem transmission through greater use of LFD tests more generally. Finally, as I indicated last week, Cabinet also considered the possible extension of the scheme to a much wider range of premises, including indoor theatres, cinemas and other hospitality venues. Let me stress that this was a very, very finely balanced decision. However, I can confirm that at this stage we have decided not to extend the scope of the scheme. We have taken account of the fact that although our situation is precarious, cases are currently stable and indeed slightly declining. We have considered the inevitable impact vaccine certification has on the operation of businesses and concluded that at this stage extension would not be proportionate. We were also mindful of the need over the coming weeks, as I have already alluded to, of getting across the message that it is important to be vaccinated and tested ahead of socialising in any setting, including in homes and shopping centres, for example, not just in those that might be covered by a certification scheme. I said last week that we would take this decision with utmost care, and that is what we have done. It is important to stress, however, that we must keep it as we do all possible protections under review. If our situation deteriorates, it may yet be that extending Covid certification is a more proportionate alternative to the reintroduction of any more onerous restrictions on, for example, hospitality. We will continue to deal closely with businesses about this and about what they must do in the coming weeks to minimise that risk. To begin to conclude, it is an understatement, I am sure, to say that all of us are sick and tired of this virus and the impact, although less than in previous months, is nevertheless still having on our lives. I understand that, indeed, I share that sentiment, but I am also deeply grateful for all the sacrifices that everyone has made and continues to make. Thanks to those sacrifices, we are in a much stronger position now than I would have dared hope for just a few weeks ago. However, I can emphasise strongly enough that our position is still precarious. The next few weeks pose risks, cases are rising in countries around us and the festive period will bring more travel and more socialising. Of course, that is to be welcomed. We all desperately want a more normal Christmas than was possible last year, but we must, all of us, take sensible proportionate measures to reduce the risk of a new year hangover of surging cases, more pressure on the NHS and an inevitability of renewed restrictions. We can all play our part in avoiding that. To everyone watching, my request in a nutshell is as follows, and please pass that on to your friends and family as well. That is what all of us—government, businesses and individual citizens—must do together as part of a social compact to keep each other as safe as possible and allow us all to live as freely as possible. Over the next crucial weeks, please wear your face coverings and follow all advice on hygiene and ventilation, wash your hands and surfaces and keep windows open when you have people around. If you have eased up on this recently, as I know many of us will have, now is the time for all of us to tighten up again. Work from home if you can. If you think that you could be working from home and you aren't, raise this with your employer. To employers, please facilitate home working for a bit longer as far as possible. To all of you, make sure that you get any and all vaccine doses that you are eligible for, including flu. For my part, I will continue to make sure that the Government keeps rolling out the vaccination programme just as quickly as possible. Finally, on any occasion that you intend to socialise or mix with people from other households, whether that is in a pub, a restaurant, a house or a shopping centre, do an LFD test first. If it is positive, do not go, self-isolate and get a PCR test instead. Government has made sure that you can order those tests free through NHS Inform or get them at a local test site or pharmacy. If you do not have them already, it is now the time to order some and keep your supply topped up over the next few weeks. All of those precautions really matter. They are part of our social compact, they will help protect us and all of those around us and they will help us protect our NHS and all of those working so hard on its front line right now. Please, I ask everybody across the country to stick with those protections so that we can, I hope, have a much more normal Christmas but do so without jeopardising our prospect of a much brighter new year as well. The First Minister will now take questions on the issues raised in her statement. I intend to allow around 40 minutes for questions after which we will move on to the next item of business. I would be grateful if members who wished to ask a question were to press their request to speak buttons now and I call Sandesh Gulhani. I would like to begin by encouraging absolutely everyone who can do so to go out and get their Covid-19. The vaccine is our best protection against this virus as we enter the most difficult Christmas that Scotland's NHS has ever faced. We also welcome that the booster-jack scheme has been expanded and I would like to thank all the fantastic front-line staff who helped to make this roll-out a success. Even with numbers already vaccinated, we are hearing examples of people who are being forced to travel long distances to get the jag and people waiting long hours in the cold and rain. We have called for the reopening of mass vaccination centres to help speed up the roll-out. The First Minister said that she would consider it, but will she finally back that call today? It is also welcome that the vaccine passport scheme is not being extended, but the uncertainty that this Government has left hanging over businesses for the past two weeks has been unnecessary and unacceptable. The Scottish Government released its so-called evidence paper on Friday, yet in almost 70 pages it was unable to offer clear proof of the scheme's effectiveness. It seems more and more likely that they are making it up as they go along. Businesses are scunned, making them wait even longer to hear if they will be facing extra costs and added burdens in the weeks before Christmas, which is a slap in their face. These businesses are not crying wolf as an SNP MSP claims. They are raising legitimate concerns. The First Minister's statement says that we will continue to liaise closely with businesses about this, but almost every business group from the Scottish Chamber of Commerce to the Federation of Small Businesses to the Scottish Beer and Pub Association have problems with the scheme. When is the First Minister actually going to listen to Scotland's businesses? Finally, the Covid app south of the border has the capability of registering a booster jag. The Scottish Government decided to develop their own app at an estimated cost as high as £4.5 million. When exactly will Scotland's app display booster vaccination status? The member says that we are making it up as we go along. We are not doing that. We are trying to take the best, most balanced and most proportionate judgments as we go, not always getting it right. I have said all along that a situation as complex and unprecedented as this mistakes and errors of judgment will be made, and I will always be candid about that. If we are making it up as we go along, where it is taking us right now—and I am not complacent—is to a position where we have the lowest infection rates in the UK and the highest vaccination rates in the UK. I suspect that, along the way—I am being told from a sedentary position that we wanted the highest—there has been a couple of periods where we have had the highest rates, but overall throughout this pandemic we have a lower infection rate than any other part of the UK. Everybody is grappling with a difficult situation. We are all taking difficult decisions, but we are taking these decisions in the interests of keeping the country as safe as possible. Let me briefly address the detail points on the issue of the booster programme. Our booster programme is going exceptionally well. We are looking every day at how we accelerate the pace and progress of that further. We are using the available workforce as effectively as possible. At the moment, our judgment is that the way that the programme is being delivered is the correct way. Of course, we keep open-minded to other approaches. It is worth noting that mass vaccination clinics, although they have played an enormously important part in the programme in previous phases, also had the highest do not attend rates of all the settings in which we did vaccination, I think, if memory serves me correctly. We are progressing with the vaccination programme and we will continue to take those judgments based on best considerations. It is the biggest, most complex vaccination programme ever conducted—that is true, I am sure, for all countries—so there will be issues, problems with it and we will address those problems as quickly as we can when they arise to make sure that it is not just happening quickly but that it is as accessible and as convenient for people accessing it. I want to thank everybody who is delivering it and everybody who has so far come forward for vaccination. I think that it is absolutely right that we have the system in place right now that is in place. Equally, it is right now that we have vaccination rates at a certain level to move it to a situation where it is open to testing as well as vaccination or as an alternative to vaccination. We were right to consider extending it further and we are right to keep that under review. In the face of the virus, the most foolish thing that any Government could do is rule things out before we have the evidence of that. It is always difficult to draw lines between cause and effect with a virus, but sometimes we have to use common sense about what does reduce transmission and what has been proven to be successful in reducing transmission. On the issue of the Covid app, as I said last week, we are doing work right now to include boosters in the app. The reason, of course, why we developed our own app was that we were told by the Department of Health south of the border that to be part of the English app, which we explored initially perhaps doing, would take 12 months. Against this virus, we do not have 12 months. That is why we moved ahead to develop our own app and I think that that was the right thing to do. Anna Sarwar Presiding Officer, can I start by sending my condolences to all those that have lost a loved one. The virus has not gone away and we must redouble our efforts to make sure that we are in coming through this pandemic together. From the start of this pandemic, the world health organisation and experts have been clear that the most effective way to reduce transmission of the virus is testing, but when the Government lost control of this pandemic, they were determined to be seen to be doing something rather than doing the right thing, so the Government chose to pursue vaccine passports. We know that the vaccine works, it reduces deaths, it reduces hospitalisations and it reduces incidents of long Covid, but the First Minister talks about common sense. That includes knowing that even if you have had the vaccine, you can still get the virus and you can still spread the virus. The most important way to reduce transmission is having a negative test. Now, with winter fast approaching, the First Minister says that we are in a precarious situation. We have spent months pursuing the incorrect priority. The Government's own evidence shows that there is no real evidence of an increase in the uptake of the virus. At the same time, we have seen that transmission has not fallen. In actual fact, transmission is up. We have wasted that time, so I welcome the change to include a negative test from now on, but frankly we are in this position because the Government could not accept that it was wrong and move in the right place. Despite the warnings from the World Health Organization, despite the warnings from medical professionals, despite the warnings from public health experts, some of the experts who the First Minister likes to selectively quote, and also despite the warnings of businesses. Now that we have accepted that we have done the wrong thing, let us focus on testing and look at where we are getting the biggest rises in transmission. The largest increase in cases is in the 0 to 18-year-olds, those that are not included in the Covid vaccine scheme. Within that, the largest increase is from 5 to 11-year-olds. That is because there is a spread of the virus in our schools, and that is directly linked to a lack of adequate levels of ventilation and virus protection. Asking pupils to open the windows is in itself not a way of reducing transmission for adequate levels of ventilation, particularly as we head into the winter months. What urgent support is the First Minister going to give those schools so that we can have adequate levels of ventilation? We know that the effectiveness of the vaccine reduces after six months of the second dose. There are more than 800,000 people who are past the six months and who have not yet received their booster. What urgent action are we taking to make sure that all those people have adequate levels of protection as we head into the winter months? First, on vaccine certification, I think that Anasawad is fundamentally wrong. The error that he makes is to suggest that you can just always pick one thing over another and not at different stages have a combination of things. In the early stages of the vaccine certification scheme, one of the primary objectives was to drive up vaccination rates. He says that it did not work. Vaccination rates went up. We are now the most vaccinated part of the entire United Kingdom. Self-evidently, we have increased vaccination rates. Had we at an earlier stage included testing as an alternative, we would have undermined the central primary objective of the scheme. As we have got vaccination rates up and we move into a different phase, we include testing. Anasawad oversimplifies things to the point where, in my view, it is dangerous if we had followed the advice that he would have given us over the past number of weeks. In terms of his other points about testing, we are testing extensively and we will continue to do that through PCR tests and, of course, increasingly, I hope, through LFD testing. Transmission has been falling from the latter of the two peaks that we experienced over the winter. That is a good thing. We now again have the lowest infection rates in the UK, although we are not complacent about that. We have got to use all of those tools and all of those levers and, as smart and nuanced a way as possible, to bear down overall on transmission. Right now, the combination of things that we are doing is effective. What we have got to ask ourselves is whether it will continue to be effective as the other risks accumulate over the winter. That is what we have got to be vigilant around. In terms of ventilation, if it was the case that we were simply saying to schools to open windows in that was all, then Anasawad might have a point. However, of course, we have invested with local authorities in carbon dioxide monitors and assessments of ventilation in schools so that local authorities can take steps to improve ventilation. We are doing similarly with businesses. Last week, I confirmed the opening of a £25 million scheme to help businesses to improve ventilation. We are doing all of those things. We will continue to do all of those things. I suspect that the one thing that will stay consistent is that the Opposition will continue to oppose all of those things that we are doing to stem transmission. For two months, the Scottish Human Rights Commission has been asking for the scientific evidence base. Behind the assertion of the Scottish Government made again today that vaccine passports prevent transmission. We got that evidence paper on Friday and it was mince. We know that lateral flow tests have always been superior to vaccine certification, because they allow venues to understand who is sick and who is well. It is gratifying that the Government has finally realised that today, but only after weeks of uncertainty and panic caused to Scottish businesses. We are in a situation in which one scheme has been proven not to work, combined with one that we know works well. We were told at the start that the fundamental reason behind vaccine passports was to drive up vaccine uptake because of their mandatory nature. Now that they are no longer mandatory, that reason falls away. Is it just embarrassment that is preventing the Scottish Government from accepting that they were wrong to begin with, abolishing vaccine passports altogether and building a scheme around lateral flow testing at large-scale events? I suspect that Alex Cole-Hamilton lost the thread of his own logic if he ever had it in that question. I am afraid that I certainly lost the thread of it. There might be some force to this that the Scottish Government is against all of the evidence that has dreamt up a vaccine Covid certification scheme. There might be some force to that if it was not for the fact that countries, increasing numbers of countries across the UK, Northern Ireland and Wales and across Europe and the world are doing likewise. Faced with a virus, it is very difficult to provide the hard evidence that intervention X leads to effect Y, because an effect is a very difficult thing to prove absolutely. We know that vaccines reduce transmission. They do not eradicate transmission, nothing completely eradicates it, reduces transmission. Therefore, in a setting like a nightclub, if we ensure that everybody is vaccinated, we reduce transmission. By, over the last couple of months, insisting on it being vaccination, we have helped, among other things, to increase rates of vaccination. All of that is a good thing. Now that we are going into a winter period where we want to suppress transmission or keep it suppressed overall and we are trying to encourage people, as I have been doing today, to use LFD tests more generally and more regularly, then it makes sense now to include testing in that. Those decisions are not easy. Those decisions are not straightforward. Those decisions are never black and white, but if we had been listening and basing our decisions on the oversimplified oppositionalists, we say black, they say white approach of the opposition, this country would be in an even more difficult situation in this virus than we already are. I call Fiona Hyslop to be followed by Rachel Hamilton. First Minister, it is essential in tackling the pandemic that people take up the vaccination, including the latest booster vaccination. Is she aware that there is still a persistent problem with the national vaccination appointment system and how it operates in Lothian? I first contacted health authorities on 28 October. Issues in the portal booking system and the national vaccination helpline, as both have difficulty in identifying local appointments for my constituents, fail to distinguish between each. Postcodes and West Lothian constituents are directed to East and Mid Lothian, and that is up to two hours for public transport. Constitutions are able to arrange new appointments easily through the local NHS Lothian Covid helpline, which has additional appointment slots to the national booking service, but it is not well publicised for vaccination booking purposes. I am aware of the overhaul of the portal on Friday, allowing constituents to self-select venues, but the delay between the policy announcements that are made by ministers right here in the chamber and the implementation of the vaccination policy changes needs better communications. People who are willing, able and wanting vaccinations are not frustrated when they try to use the system. Can the First Minister instruct improvements to the system so that those who are keen to get vaccinated can do so in a straightforward and efficient manner? The First Minister is right to identify the fact that it has been acknowledged that some individuals in Lothian have suffered inconvenience in having to travel beyond their local area for booster vaccination appointments. NHS Lothian is working to keep patients' appointments within the local area wherever that is possible, while also accelerating the number of boosters being administered. If unsuitable, appointments can be rescheduled through the NHS-informed website or through the national Covid vaccination helpline. Lothian residents who may face difficulty attending an appointment due to mobility issues can contact the NHS Lothian flu and Covid inquiries line for help with arranging support. We are also currently exploring how and when it is best to begin offering second doses to 16 and 17-year-olds and, of course, we will continue to prioritise vaccinations for those most vulnerable. There is always attention, and this has been the case since day 1 of the vaccination programme between the speed of delivery and local accessibility. We will try to ensure and work with health boards to ensure that that balance is the right one, but overall, the quicker we get through the vaccination programme, the better protection everyone will have. Rachael Hamilton, to be followed by Siobhan Brown. Every week, we come to this chamber with hope—hope that the First Minister will instruct her Government to do the right thing. In the past few weeks, I have raised flaws with the digital self-tracing form. I have raised issues about constituents obtaining vaccination certification. I flagged 7,000 outstanding incorrectly recorded vaccination records. Furthermore, my colleague, Sandesh Gahani, has highlighted the English app recording the booster scheme and not the Scottish one. This is a really frustrating place to work in. In light of those unresolved issues, does the First Minister not think that the best Christmas gift that she could give to the NHS and to the people of Scotland is to sort out those issues here and now? We know that many Conservatives find parliaments frustrating places to work in, which is possibly why so many of them have second jobs outside of Parliament, of course. Or, in the case, second and third jobs outside of this Parliament. More seriously, on the issue of the incorporation of the booster vaccine, last week, I said this week that work is under way so that we can incorporate boosters into the Scottish Covid certification app. That is important, it is right that that happens. I am not sure what the Conservatives are suggesting, that we should have waited 12 months in order to be part of an English app that does that, because if we had done that, we wouldn't have any Covid certification app right now. We are doing those things properly and effectively. We are also addressing issues that arise, as issues will arise in a scheme as large and complex as this. Members who have issues that constituents raise should write to me, to the health secretary, to the relevant minister, and we will address those issues as we go along. Let me just not, in any way, seek to underplay the importance of rectifying any issues. Let me remind members across the chamber, and indeed the public, of this central fact again. As we stand here right now, Scotland is the most vaccinated part of the entire UK on first doses, on second doses, on third doses and on booster doses. I am sure that there are issues that will arise that we need to address, but something that I think in the Scottish vaccination programme is going extremely well and perhaps the Conservatives might want to acknowledge it. Siobhan Brown, to be followed by Katie Clark. Thank you, Presiding Officer, and the First Minister for the update this afternoon. As a general public, we are still being encouraged to do two lateral flow tests a week, and in light of this afternoon's announcement from the First Minister that we are now encouraged to test before we go out. Can I ask, when somebody tests positive for Covid and self-isolates for 10 days and therefore has a certain immunity, when should the individual resume doing the lateral flow test? The answer, of course, is based on clinical advice. The clinical advice is that people who have had a positive PCR test within 90 days need not participate in twice-weekly LFD testing. The clinical view is that, in the 90-day window after a positive test, given the low rate of reinfection, it is significantly more likely that a positive LFD test would be a false positive result rather than someone being reinfected. That might cause people to isolate unnecessarily. If you recover from Covid and later develop new symptoms, you must book a new PCR test at NHS Inform and follow advice on self-isolation and household isolation again. You should not use LFD if you have symptoms or are self-isolating and anybody who wants to see further guidance on when to use an LFD test and when to use PCR tests can find that detail on the NHS Inform website. First Minister knows that the vaccine starts waning around 10 weeks after the second dose. Given that and the number of people who are still waiting for their booster dose, does the First Minister accept that testing is a safer option? I really, really, really want to strongly emphasise that we should not be telling people either or get vaccinated and test yourself regularly. It is really dangerous to start to pose this false choice. Yes, there are points at which we want to emphasise vaccination, which is what we have done to drive up rates in the early part of the certification scheme. However, that did not mean that we were telling people not to test with LFD tests. Both are important. On the issue of waning immunity—this is a serious point, my apologies, I think that I omitted to answer this part of Anna Sarwar's question—it is not a cliff edge thing with waning immunity. Immunity begins to wane as the distance between the second dose increases. Twenty-four weeks is the interpretation of the GCVI six months advice that we are working to. Many people were already over that when we got the GCVI advice, so we have always been doing catch-up. Currently, we are getting through the catch-up quicker than other parts of the UK, but we are seeking to accelerate that all of the time. At 24 weeks, it is not a case of immunity falling off the cliff edge, but it is important that people get their booster vaccination as close to the 24 weeks as possible. As I said earlier on, the impact of that is significant. 80 per cent increase in immunity is not marginal. That point about immunity is a really important one. I am grateful for the question, because it gives me a chance to underline the importance of getting the booster as soon as you are able to do it. A constituent of mine contacted me and commented that many disabled and vulnerable people in Scotland like me have been left unable to safely participate in society with no end in sight. They said that they would feel safer with the extension of the vaccine certification scheme. Many of us today are relieved that it has not been extended further, but we have to acknowledge our very worried vulnerable people out there who are constituents of ours. Does the First Minister agree with me that the very least that we can all do is to follow the baseline measures in place to help to reduce the spread and impact of Covid-19 and to offer at least some degree of reassurance to those who remain at particular risk? That is a really important question. I want to make it very clear that that consideration is always very high up in the mind of the Cabinet when we are reaching those decisions. For those of us who are fit, healthy and relatively young, all of those protections that are still in place are an inconvenience and we cannot wait to get rid of them. For people who are much more vulnerable, either by dint of their age or by other clinical conditions, those protections are just that. They are vital protections without which people would be less able to enjoy all the freedoms that we all are enjoying right now. Often when we are considering protections, we are considering them from the perspective of the most vulnerable because we want everybody to be able to participate in normal life. There are people who would prefer to see Covid passports being used in all settings. I understand that. We have to take proportionate and balanced decisions, which is what we are seeking to do. For those of us who are fit, healthy and relatively young, it is worth bearing in mind sometimes that we have to bear a bit more inconvenience for the sake of the more vulnerable. We should all make sure that we comply with all the protections that we have been asked to comply with because it is not only helping us, it is helping everybody else and in particular those who are most at risk. As members would expect, there is a great deal of interest in this statement and I would be grateful if we could pick up the pace of questions and responses. I call Dean Lockhart to be followed by Stephanie Callaghan. Accident and emergency waiting times at 4th Valley Royal Hospital have been the worst in Scotland for the past 12 weeks running. Staff at the hospitals are doing their best, but are facing enormous Covid-related pressures and need urgent assistance now. We have seen the British Army offering valuable assistance in other health boards. Given the situation in 4th Valley, will the First Minister and her Government be taking any action to arrange additional support for NHS 4th Valley? In terms of whether to request military assistance—let me record my thanks again to the military for the assistance that they have been given to Scotland and indeed to health services in other parts of the UK—any health board requesting that it would initially be a decision of the health board, as far as I am aware, there has not been such a request from 4th Valley. If that is forthcoming, we will consider that in the normal way and should we consider it appropriate to submit that to the military for proper consideration. More generally, we are taking steps additional funding and other ways of supporting health boards to redesign access to urgent care and to help ease the flow of patients through hospitals to release the pressure on accident and emergency, and that will continue right throughout the winter period. All of our accident emergencies are working under significant pressure. What we can all do to help, though, is do all of the things that we know will help to get Covid cases down, because above all, that is what is going to ease the pressure on our NHS. While Scotland's vaccination programme is the most successful in the United Kingdom in public uptake, 21 per cent of Scotland's age between 18 and 29 remain unvaccinated. Has the Scottish Government quoted any information on the reasons why these young people have not yet come forward? Is the First Minister considering any new initiatives to encourage more young people to get vaccinated? A really good and helpful question, yes, we consider on an ongoing basis how we can reach those parts of the population where uptake rates are not as high as they are overall in one of those groups is of course young people. There are a variety of reasons why people will not yet be vaccinated. Some people will have chosen not to be vaccinated and I would urge them to think again. There will be some people of course who are not vaccinated yet because they have recently had Covid and as we know if you have had Covid there is a period of four weeks between having the virus and getting vaccinated so some people right now particularly in the younger age groups will be facing that but we are continuing to take steps to say to people if you are not vaccinated yet with the first, second or booster doge if you are eligible then it is not too late come forward and do that and I would encourage MSPs across the chamber in their own constituencies to do everything possible to reiterate and emphasise that message. Chillian Mackay to be followed by Rora Mackay. Thank you Presiding Officer. I welcome the First Minister's emphasis on testing and the addition of a lateral flow test to the vaccination certification scheme. Could the First Minister outline what the Scottish Government is doing to widen the range of venues and settings that packs of LFD tests are available in to make it easier for more people to test themselves and if we have sufficient supply of tests to cope with any resulting surge in demand? In relation to the second part of the question the short answer is yes. We keep supplies under very close monitoring. Obviously one of the things that we are keen to do working with the other Governments across the UK is to keep supply of LFD tests accessible and free of charge well into the new year and there are discussions on going about that. I should say that there is no immediate prospect of that change but we want to make sure that that is the case for as long as necessary. We will as part of our discussion with businesses about how we all work together to keep transmission rates under control. We will look at whether there are settings. We can more routinely make LFD tests available in. Of course they are very accessible already through NHS Inform. If you order them one day they tend to come the next day or you can go to a local pharmacy or a local test site to pick up those tests. So the inability to get them should not be a problem or the ability to get them should not be a problem and should not be a barrier to their use but we will consider whether there are other settings where we can make larger numbers of tests available for people turning up at those settings to use. Maurice Golden, to be followed by Kenneth Gibson. Thank you, Presiding Officer. Mass gatherings for adults are allowed now, so will the First Minister let children have fun this Christmas and lift the ban on school nativity plays and Christmas shows? I really would hope that notwithstanding the political divides and debates between us all perfectly normal in a democracy, none of us would suggest that the motivation of the Government is to stop children having fun. All of us want children to have fun, but we want children, like adults, to have fun safely. The guidance around schools has been kept under review. We do not want any restrictions in schools or early year settings to be in place for any longer than necessary. We take advice from our education advisory subgroups so that we are basing those decisions on the best available information. I hope that children, like the rest of us, will have a much, much more normal Christmas than was the case last year. I hope that children more than any of the rest of us have a more normal Christmas this year than they did last year. My apologies to Rona Mackay, who will be followed by Kenneth Gibson. Thank you, Presiding Officer. I think that it might have been my fault that I did not have my button press. My question was about school pupils, quite like Maurice Golden's school pupils, who will be taking part in Christmas events and the holidays approach. In light of the continued threat that the virus poses to family members at home, can I ask the First Minister what guidance has been provided to schools to ensure that such events can take place safely? If my memory is wrong, I will correct it in writing to Rona Mackay, but guidance is already available to local authorities in relation to seasonal events in terms of Christmas concerts, nativity plays within schools. The current guidance advises that there should not be live audiences, but I know that schools are having alternative means of making sure that they are available and accessible to parents. However, that guidance remains under review and will continue to be informed by the educational advisory subgroup. Kenneth Gibson, to be followed by Colin Smyth. On 12 November, NHS Ayrshire Narn advised that Cumbria residents would receive their booster on Saturday 27 November in Millport. There is no indication that only folk aged 70 and over would be included. However, it now transpires that islanders under 70, many with disabilities, are expected to travel by bus or car to catch a ferry, then traverse large, possibly in the Coal and Dark, to obtain their job. Does the First Minister agree that the health board should think again, not least because providing boosters in Millport will obviously increase uptake amongst islanders? I think that all health boards, including Ayrshire Narn, should think very carefully about how they design the scheme so that it is as accessible as possible. As I said earlier on, there are always going to be tensions between that and getting the programme done as quickly as possible. I do not think that it would be right for me to dictate in every local circumstance how that should be done because local health boards know their local areas better. Of course, there are particular considerations in island communities. I certainly believe that NHS Ayrshire Narn should consider the points that Kenny Gibson has made about Millport and make sure that it is giving islanders, in particular, the ability to be vaccinated without the additional inconvenience that going off island would entail. The health secretary, I am sure, would be happy to follow that up directly with Ayrshire Narn. Colin Smyth, to be followed by Christine Grahame. Thank you, Presiding Officer. We were too slow to introduce testing for key workers such as carers, too slow to introduce testing in our airports, and now we have been too slow to introduce testing as part of our Covid passports. There has not been a case of test-test test. It has been slow, slow, slow. With PCR tests half the number that we were two months ago in LFD tests is still not high enough, is the First Minister really saying that we are doing enough to make what she called for earlier on that routine twice weekly test the norm instead of the exception, because it is simply not the policy of mass testing that we really need to deliver a real robust response to this pandemic? I think that Colin Smyth is misunderstanding or perhaps not misunderstanding but misrepresenting, I am sure, inadvertently, the point of testing in or out of a vaccine Covid certification scheme, because we have not included testing up until now as one of the proofs that get you into a venue does not mean that we have not been encouraging people to use LFD tests. We have. Every time I have stood here, I have repeatedly encouraged people to use LFD tests twice a week. We are now asking them to go beyond that and do LFD tests whenever they are going socialising in whatever settings. I have set out clearly people, of course entitled to disagree with it, but the idea that we have not set out clearly a rationale for relying in the certification scheme up until now only on proof of vaccination is not the case. We have set that out clearly but, alongside that, we have also been encouraging people to test. Uptake of LFD tests is good. We think that it can be higher. We need it to be higher if we are asking people to test more regularly than has been the case. Testing overall has been very strong, which is why we have been able to record as many positive cases as has been the case in recent weeks. All of this, we continue to work hard at that. I do not stand here ever and say that there is not more that we can do on all of this, but I do occasionally think that the opposition should perhaps give a bit of credit for the work that has been done not by us but around the country to deliver testing, to deliver vaccination and deliver some of the excellent progress that we are seeing. Christine Grahame to be followed by Alexander Stewart. First Minister, I refer to the public information advertisements to go ahead in the coming weeks with the importance of mandatory face coverings in Scotland on public transport and now new recommendations on lateral flow tests. Can I ask if those will run across all the UK terrestrial channels, especially as more people will be crossing the border from England like I hope one of my sons and his family to visit relatives over the festive period and many of whom may not be aware of the differences and the different requirements and statutory requirements in Scotland? First Minister. Adverts and campaigns are as widely circulated and seen as possible. I cannot stand here and say exactly what channels those adverts will be on, but we will make sure that that is as extensive as possible. We cannot always have those Scottish Government adverts shown south of the border, obviously, but we do try to make sure that people travelling into Scotland are absolutely clear on what the advice and guidance is in Scotland and we will continue to try to do that to the best of our ability. Alexander Stewart to be followed by John Mason. In the statement, First Minister, you comment and encourage pregnant women to get vaccinated. I also encourage them to do so. What action is the Scottish Government taking to ensure that this message is being communicated across the country to protect pregnant women? A range of different actions have been taken and it is really important that we do not let up on that. I know that the Royal College of Midwives has been active in the space. The Royal College of Obstetricians and Gynaecologists has also been active. The Government, through our clinical advisers, is trying to get this message across directly to pregnant women as often and as loudly as we can. I would again appeal to everybody across the chamber to amplify that message in the local constituencies. It is vital that pregnant women come forward for the vaccination. It is giving them protection, given their on-board child protection. There has been some concern about vaccination in that group and it is really important that we continue to use all methods to allay those fears and encourage as high an uptake as possible. John Mason to be followed by Pam Duncan-Glancy. The vaccination programme clearly has been very successful. Last week, the British Society for Immunology reminded us that somebody who has not been vaccinated is 32 times more at risk of dying if they catch Covid. However, some people are still hesitant and especially perhaps in poor areas and amongst ethnic minorities. Can the First Minister say if anything has been done to help them get vaccinated? We address that on an on-going basis and will continue. As long as there are groups of people unvaccinated or not fully vaccinated, we will not let up and try to persuade people to come forward. In terms of minority ethnic communities, there has been outreach work done in particular communities through different faith and voluntary organisations. We have deliberately cited some vaccination centres in places where they are more accessible, Glasgow central mosque being one obvious example. We will continue in every way possible, whether it is the location of vaccination, the messages and the location of messaging to get the message across as widely as possible. Everybody out there, if you are not vaccinated yet, is not too late and makes sure that you take the opportunity to do so. To get to the truth and to make the change needed, the Covid-19 inquiry must support those hit hardest by the pandemic to participate in it. It must ensure that duty bearers are held accountable and it is essential that it is carried out in a way that does not discriminate and that its work seeks to determine whether decisions and actions taken this year had a disproportionate impact on some groups of people. Can the First Minister confirm what the plans are to ensure that the inquiry is based on human rights and do those things? We have already given a commitment to the inquiry being one that is fully based on and informed by human rights inequality principles. I repeat that commitment today. We are in the process of identifying and will shortly confirm the appointment of a chair of the inquiry and the terms of reference and the principles that will guide and drive that inquiry. We have given a commitment to having it established by the end of this calendar year. Once the inquiry is established, its conduct will be entirely the responsibility of the chair and it will be important that ministers do not interfere with that, but the work to establish it is well advanced and we will set out details to Parliament shortly. With just over a month to go to Christmas, can the First Minister confirm whether families should expect to be able to enjoy a more normal Christmas this year? I certainly hope so. At this stage, I am very optimistic about that and that would be my expectation. I am conscious that we ended up last year with an unexpected development in the virus. I really hope that that does not happen this year. I am very much hopeful that all of us will have a much more normal Christmas. Of course, to make that possible, we need to comply with all the protections in place now and continue to do that through Christmas so that we do not just have a better, happier, more normal Christmas, but we also have a brighter new year. That concludes First Minister's statement COVID-19 update. There will be a brief pause before we move on to the next item of business.