 ond Covid-19 update. The First Minister will take questions at the end of her statement and so there should be no interventions or interruptions and I call on Nicola Sturgeon. First Minister. Presiding Officer, I'll give a detailed update today on the Scottish Government's most recent assessment of the state of the pandemic and also on the progress with vaccination. I'll also outline the latest position on three specific vaccination related matters on which there has been significant development in the past week, namely, on-going consideration of possible vaccination of all 12 to 15-year-olds, the JCVI recommendation for booster vaccination of those who are immunosuppressed and our proposal to be debated by Parliament tomorrow, of course, for a limited and targeted system of vaccine certification. Firstly, though, I will summarise today's statistics, which have been published in the last half hour or so. 5810 positive cases were reported yesterday, 10.8 per cent of all the tests that were carried out. 883 people are currently in hospital with Covid, which is 78 more than yesterday, and 82 people are receiving intensive care, which is five more than yesterday. Sadly, I have to report a further 17 deaths that were reported in the past 24 hours, and that takes the total number of deaths registered under this daily definition to 8198. As always, my sincerest condolences are with everyone who has lost a loved one. Those figures show clearly that we are still experiencing a surge in cases and indeed a very high level of infection within the population. However, the latest data also gives us some early, albeit tentative, at this stage indication that the rate of increase may now be slowing down. That can be seen from an analysis of the last three weeks of case numbers. In the week to 22 August, based on the date, test samples were taken. An average of 3,374 new cases per day were recorded. In the week to 29 August, that had risen to an average of 5,763 cases a day, an increase of more than 70 per cent. However, figures for the most recent week, which is up to 5 September, show a daily average of 6,304, an increase of 9 per cent. The seven-day average test positivity by specimen date has also fallen back slightly from a peak of 13.4 per cent on the 29 August to 12.7 per cent as at 5 September. It is also worth perhaps providing a bit more detail about the age breakdown of the latest case figures. Over the past week, 75 per cent of all cases have been in those aged under 45. That is consistent with the broad picture that we have seen throughout this current wave of infection. However, further analysis of the under 45 shows variation between different age bands and also gives scope for some very cautious optimism. For example, in the most recent week, the number of cases in the 0 to 14-year-old age band has risen by 44 per cent. Now, while that is a significant increase, it does represent a significant slowing in the rate of increase from the previous week when cases in that age group increased by more than 150 per cent. Cases in the 25 to 44-year-old age band have also continued to rise, but again, the rate of increase has slowed quite considerably. It was 6 per cent in the most recent week, compared to almost 70 per cent in the week before. Amongst 15 to 24-year-olds, cases have fallen in the most recent week by 18 per cent from just under 11,000 to just under 9,000. That fall of around 18 per cent compares to an increase in that age group of 29 per cent in the previous week. We can take from all of that that it appears that the rate of increase has slowed. That may well suggest that the appeal to individuals and businesses over the past two weeks to improve compliance with basic mitigations and for all of us to be more cautious in our everyday behaviours is having some impact. The on-going work of test and protect is also vital and hugely appreciated. I want to take the opportunity now to say a heartfelt thank you to everyone for all of the considerable efforts and sacrifices that continue to be made, but also to issue a strong and equally heartfelt appeal to please keep it up. The data that I have just reported showing what seems to be a slowing in the rate of increase in new cases gives us more cause for cautious optimism than we have had for a few weeks, but I am afraid that that is always the hard part. Cases are still rising week on week, and they are currently at their highest levels since the start of the pandemic. Part of that reflects the significantly higher number of tests being conducted now compared to earlier stages of the pandemic and, indeed, compared to other parts of the UK. Testing rates per head of population in Scotland recently for both PCR and LFD tests have been significantly higher than in England and Wales. However, that is reflective of the fact that, since the time of our schools returning, our levels of infection have also been higher. That is the key fundamental point. The levels of infection across the country, albeit that we may be seeing some potential and very welcome signs of stabilisation, now remain far too high. That is why we must continue to monitor the situation very closely and be prepared, as any responsible Government must be, to take any targeted and proportionate action that we consider necessary to keep the country as safe as possible. Keeping the country as safe as possible means, of course, doing everything we can to protect against serious illness and death, but it also means protecting the ability of our NHS and those who work so hard in it to not just care for Covid patients, which they do with such skill and compassion, but also to catch up on backlogs and give care to everyone who needs it for whatever reason. As I have narrated many times before, vaccination has significantly reduced the link between cases of Covid and serious health harm from Covid, and that continues to be true. The proportion of people with the virus who end up in hospital is much lower now than it was before the vaccination programme started, and that continues to be hugely positive and reassuring. However, our current case numbers reflect the fact that the delta variant is significantly more transmissible than previous strains. Just as much as vaccines have been in a very good way, delta has been a game changer in a very bad way. Of course, even a much lower percentage of a very high number of cases will indeed already be put in tense pressure on the national health service. We can see the evidence of that very clearly in the latest data on hospital and intensive care admissions and occupancy. We must remember that there is a time lag between case numbers and hospital admissions. It always takes a week or so before any improvement in the number of cases feeds through into hospital data. In the seven days up to last Friday, 785 people with Covid were admitted to hospital, and that is an increase of almost 50 per cent from the week before when 530 people were admitted. As a result, hospital occupancy has also risen sharply. On Friday 20 August, there were 312 people in hospital with Covid today. There are 883. The number of people in intensive care has also increased, albeit at a slower rate, but increased from 34 on 20 August to 82 today. Of course, it is worth pointing out, as we always do, that those figures do not include other forms of serious illness. For example, people who do not require hospital treatment but suffer long Covid. That inescapable fact remains. If we do not see the rate of increase slow further and then fall, many more people will become seriously ill, and sadly some of them will die. The NHS will come under pressure even more severe than it is already dealing with. The pressure it is already dealing with in this point simply cannot be overstated is already very severe. We must not let up in our efforts to stem this current wave of cases. We continue to hope, and indeed, as I have just been outlining, recent data gives us a bit more of a solid basis for this hope, that we can turn the corner through continued care and caution and stringent compliance with existing mitigations and without having to reintroduce any tighter restrictions. However, to do that, as has been the case right throughout this whole experience, we need the help of every business and every individual across the country. We need everyone to continue to stick to the basic mitigations that we know are effective in helping to slow down transmission. Last week, Cabinet Secretary has engaged intensively with a range of representatives from business, the public sector and wider civic society. They discussed how all of us, Government employers and the wider public must play our full part in observing and encouraging maximum compliance with current mitigations. Those include the wearing of face coverings, stringent hygiene, good ventilation and support for continued homeworking wherever possible. I am once again very grateful to everyone, including businesses, for everything that is being done to follow and promote those measures. That is making a difference. While we cannot rule anything out completely, it is also reducing the likelihood of restrictions having to be reintroduced. The Government will continue to do everything that we can to encourage compliance, for example, through continued support for test and protect, on-going investment, ventilation and carbon dioxide monitors in schools and the provision of public information and advice. We are also continuing to do everything possible to maximise vaccine uptake in the groups that are already eligible and through a readiness for quick implementation of any advice on the extension of vaccine eligibility. Getting vaccinated as soon as we are able remains the single most important thing any of us can do to protect ourselves and others. As of today, I can report that 4,130,841 people have had a first dose and 3,749,767 have now had both doses. That includes 95 per cent of people over 40 who are now fully vaccinated as well as 72 per cent of 30 to 39-year-olds and 57 per cent of 18 to 29-year-olds. Three quarters of 18 to 29-year-olds have had their first dose, so the proportion in that age group who become fully vaccinated will continue to increase in light of that eight-week gap between doses. In addition, 60 per cent of 16 and 17-year-olds have had the first jag already, and that is 10 per cent of points higher than I reported this time last week. We will continue to do everything that we can to encourage more and more people to get their jag. For example, just in the last fortnight, we have written to all 16 and 17-year-olds who have not been vaccinated yet to offer appointments, although they can also attend a drop-in clinic and we are ensuring that mobile vaccination units are deployed during university and college freshers weeks. In addition to that report on progress with the current vaccine programme, I also want to briefly update Parliament on recent advice from the JCVI on possible extensions of the programme. On Friday, the JCVI updated its analysis on offering vaccination to all 12 to 15-year-olds. The JCVI has concluded that the health benefit of vaccination for 12 to 15-year-olds does marginally outweigh any risks, but because it considers children to be at relatively lower risk of serious health harm from the virus, it has decided at this stage not to recommend that vaccination is offered to all 12 to 15-year-olds. However, and significantly, the JCVI also acknowledged that it would be appropriate for Governments in coming to a policy decision to consider any wider benefits of vaccination. For example, whether vaccinating that age group could reduce any further disruption to education. Therefore, the four UK Governments have asked our chief medical officers to undertake a rapid assessment of the latest evidence and provide advice on wider benefits. We expect to receive this advice soon, I hope, within days, and the Scottish Government stands ready to act in accordance with any recommendations that we receive. Last week, the JCVI also issued advice to the effect that people with certain health conditions that suppressed their immune systems should now be offered a third dose of vaccine. This is because two doses may not be sufficient to enable those with compromised immune systems to mount a full immune response to Covid. We are now moving to implement the advice over the next few weeks, and we will provide further information to those who are affected by the advice shortly. We still await and hope to receive it very soon. The JCVI's final advice on a more general booster programme and, again, we stand ready to implement that as soon as the recommendation is available. The third point that I want to touch on relates to vaccine certification. The Parliament, of course, will debate and vote tomorrow on the principle of a limited, targeted and proportionate system of certification as an alternative to the risk of further periods of closure for higher risk settings. Ahead of that debate and to inform it, we will publish a paper setting out in broad terms how the scheme will operate and detailing the work that we are doing in consultation with business to finalise the detail and produce sector-specific guidance. As we debate this, it is important to bear in mind that Scotland is far from alone in considering such a scheme. Indeed, Covid certification has already been introduced by several other Governments of different political persuasions in countries right across Europe. Indeed, many countries have already gone much further than the Scottish Government is proposing. Indeed, Covid certification is becoming an increasingly common response to the exceptional circumstances that we are all facing at this stage of the pandemic. The simple fact is that neither we nor any other country has the luxury of doing nothing to keep Covid under control. The question, especially after 18 months of restrictions being in place to varying degrees, is how we do so in the most proportionate and least restrictive way possible. In the Scottish Government's view, Covid certification is a reasonable response to a very difficult situation and a much more proportionate response than any of the likely alternatives. Fundamentally, we believe that certification can help to reduce the overall harms caused by the pandemic. It will not eradicate transmission completely, but it will help to reduce it in some higher-risk settings and it will also maximise protection against serious illness. We believe, as has been seen already in some other countries, perhaps most notably in France, that it will help to encourage the take-up of the vaccine. It also represents a targeted way in which we can, we hope, enable certain events and venues to continue to operate at times when rates of Covid may be high and even rising. The time that I have devoted today to vaccination reflects the fact that it remains absolutely key to our progress out of this pandemic, not just here in Scotland but across the world. For each of us, as individuals, getting vaccinated remains the single most important step that any of us can take to keep ourselves safe, to keep others safe and to reduce the need for any restrictions to be reintroduced. However, the most important getting vaccinated is not the only step that all of us need to take right now, so I will close by stressing the three key things that each of us can do as we all play our part in getting cases back under control. The first of those, as I have stressed already and as I will keep stressing, is to get vaccinated if you are eligible. If you have not been vaccinated yet or if you have had your first dose eight or more weeks ago and have not had a second dose yet, please get your jag. It is straightforward to do. There are drop-in centres in every mainland health board area or you can book an appointment. Second, please continue to test yourself regularly with lateral flow devices. You can order these free through the NHS informed website or collect them from a local test site or pharmacy. The point of regular testing is this and it really matters. If you have the virus but you are not aware of that because you are not displaying any symptoms, taking a test gives you a chance of finding out that you have the virus before you inadvertently pass it on to others. Regular testing is a key and really important way in interrupting chains of transmission. Of course, if you test positive through one of these lateral flow devices or if you are identified as a close contact or if you have symptoms of the virus, make sure that you self-isolate and book a PCR test. Thirdly and finally, please continue to follow all of the remaining rules and guidelines that are still in place. For example, it is still a legal requirement to wear face coverings in indoor public places like shops, public transport and when entering and moving about hospitality settings. Face coverings are a simple but important and effective way in which we can help to protect each other. More generally, continue to think carefully about the number of contacts you are having and perhaps reduce any that are not really necessary. Meet outdoors as much as possible. If you are indoors, open the windows, good ventilation makes a big difference. Even though it is not the law anymore, try to keep a safe distance from people in other households if you can, especially when you are indoors. In addition, try to minimise physical contact-like handshaking for the time being and wash your hands and surfaces regularly and thoroughly. Having to take these steps is frustrating, but we know that they make a difference and that they help to limit the spread of Covid. Indeed, as I said earlier, it may well be that we are seeing the evidence of the difference that those measures make in our most recent data. Let me end by again thanking everyone who is helping us to turn the corner in this latest wave of the virus. Please keep those efforts up so that we can continue to keep each other as safe as possible. Thank you. 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. It would be helpful if members who wish to ask a question were to press their request to speak buttons now. I call Douglas Ross. Covid cases remain high, and therefore it is vital that our test and protect system is operating at the top of its game. However, we know that this is a system that continues to be overwhelmed. Provisional figures for this week show that just over half of cases are being traced. That follows reports that contact tracers are being advised not to repeatedly call positive Covid patients if they cannot get through to them. Our NHS is struggling to cope as well. This week's A and E waiting times are at the worst levels since current records began. We are consistently hearing of dire waits for people looking to get an ambulance and people unable to see their GPs. The SNP has not seen ready to support the NHS this autumn, let alone into the winter, when we know that the problems will get even more acute. We really need to hear from the First Minister a proper plan to deal with those issues, not the PR flimsy pamphlet that the SNP Government produced earlier on this year. We are also seeing the same problems on vaccine passports. The First Minister has just promised a paper that publishing it just hours before Parliament is expected to vote on vaccine passports is not good enough. So far, there are no details and no answers to the SNP's plans. We wanted to look at the content of the First Minister's proposals, but, quite frankly, there is nothing to scrutinise. Even the promised paper in the First Minister's statement is talking about how it will finalise the proposal rather than how the scheme will operate. It will only set out, and I quote the First Minister's words, in broad terms how the scheme will operate. First Minister, broad terms are not acceptable for an issue of such importance that you want MSPs to support in just 24 hours' time. We need specifics, but we don't have them. We don't know how the scheme will be administered or enforced. We don't know if the data concerns have been fixed. We don't know if fraud risks have even been identified. We don't know what infrastructure will be needed. We don't know if the SNP will rule out extending them indefinitely or rolling them out to further venues at its short notice. We've been asking these questions for a week now and have received no answers. This is clearly a last-minute rush job, and the more businesses hear about the proposals, the more they agree that they are an absolute failure. We need to make the public act our plans if they don't know what they are. First Minister, would you like Mr Ross to repeat the end of that question? Maybe if he was here. Mr Ross, could I just ask if you could repeat the end of your question? Of course. I was asking, can the First Minister provide details on her scheme now, and if not, how does she expect the public to back her plans if they don't know what they are? Let me take accident emergency and vaccination certification in turn. First, Douglas Ross has quoted figures today, as was done by others last week, that, frankly, do a real disservice to those working in test and protect. The publication that he has quoted, which cites provisional figures, actually tells you why it is not reliable to quote provisional figures, because the contact tracing is on-going, and therefore it is the following week when the figures are finalised are the ones that matter. If you take the provisional figures last week—I think it was Jackie Baillie that quoted these last week—the provisional figure for completed cases was up to, I think, 55 per cent this week. That 43 per cent that was quoted last week to do down test and protect in the finalised figure this week is 82 per cent. It is doing a real disservice for politicians who perfectly, legitimately want to have a go at me in this Government. In doing so, they are doing down the efforts of those working in test and protect. The provisional figures for test and protect this week show—again, I stress that those are provisional figures that will be updated and finalised next week, but in this week's provisional figures 89 per cent of cases closed within the 72-hour target, the WHO target of 80 per cent within 72 hours, 89 per cent in the provisional figure this week, up from 85.5 per cent in the provisional figures last week. That is an organisation that, yes, is under pressure. How could it be otherwise with the pandemic and the level of infection right now? It is an organisation that is working hard every single day and is playing a valuable and a vital part in helping to get this country through. I think that it is wrong for figures to be quoted in a way that unfairly undermines the efforts that test and protect staff are making. Secondly, on the NHS, this Government is supporting the NHS through the recovery plan, through the resources that have been identified to back the recovery plan, as well as the overall commitment to increase NHS funding. It is interesting though—this will be relevant to the point that I am about to make in relation to Covid certification—that the plan that Douglas Ross derides here, which is the Scottish Government plan, is to increase NHS capacity by 10 per cent, backed by investment. Douglas Ross here says that that is insufficient, yet yesterday the Conservative Government at Westminster announced its own plan. I do not know whether Douglas Ross is at Westminster right now, but I suspect that he will support it in that context. That plan was to increase NHS capacity by, guess what, 10 per cent. Again, we have Douglas Ross backing things that are done by the Conservative Government in Westminster, but criticising exactly the same things that are done here in Scotland. That takes me on to vaccine certification. We will set out the work that I have alluded to today in advance of the debate tomorrow. Parliament rightly and properly has been asked to endorse the principle. It is absolutely right and proper that, just like the UK Government for England, we continue to work with stakeholders to make sure that we take account of their views and concerns as we finalise the detail. In fact, we would be criticised if we were not to do that. Of course, vaccine certification is already being used in many countries across Europe and the world. What we are proposing here is also being proposed by the UK Government for England. I suspect that what we are hearing from Douglas Ross is a justification for the ridiculous position that he is going to end up in, where the scheme that he is opposing in Scotland is exactly the same one that he is supporting when a Conservative Government introduces it in England. By all means scrutinise this Government, but for goodness sake, try to have a single ounce of consistency as you do it. Members, I would ask that we cease commenting to one another across the aisles. I place on record my condolences to all those who have lost a loved one to the virus. The 17 deaths in the last 24 hours is a reminder that this virus has not gone away. I also want to thank our front-line NHS and care workers. They were amongst the first to get the vaccine. They safely got their second dose after four weeks. If, as some research suggests, the efficacy of the vaccine declines over time, surely they should also be considered for inclusion in the early booster programme. Is that an issue that the First Minister can address? The three issues that are covered by the First Minister in her statement today were the vaccine passports, the JCV advice on 12 to 15-year-olds and the wider vaccination programme. We will, of course, have a wider debate on the substance of Covid passports tomorrow, and we should not allow that debate to distract from the big issues and challenges that we currently face. Although I must say that there is still limited engagement with businesses about the details of the programme and how they will actually work in practice. I would also stress that, at key moments throughout the pandemic, we have supported the Government. That is not opposition for opposition's sake or an ideological opposition. It is about what works and what will make a meaningful difference. On the JCVI, I recognise what the First Minister says today, but I think that we should have the principle for any 12 to 15-year-old who, once the vaccine, should be entitled to get the vaccine. Let's look at the current tools. Test and protect is still far from meeting its standard. That is clearly a criticism of those who are in charge of running the system, not those who work in the system. Frankly, it does a disservice to the staff to hide behind them, the staff that they under-resource and under-value and then come to use them as protection. If you look at the stats for the 0 to 14-year-olds in terms of the spread of the virus, it shows you the consequence of not using test and protect in our schools and the devastating impact that it has had. On vaccines, data published today shows that there are nearly 200,000 Scots who have had their first vaccine and are now past the eight-week period for eligibility for their second vaccine, but have still not yet had that vaccine. Make no mistake, that is a colossal failure of the Government and the one that is putting public health at risk on a daily basis. Rather than creating new systems, what urgent action will the Government take to fix the systems that we have, to finally resource and fix test and protect and find the missing 200,000? On issues of vaccination, on those who have not had a vaccine yet, who are eligible either for a first dose or who have passed the eight-week interval for their second dose, they have all been written to and we continue to make efforts to encourage and persuade those who have not been vaccinated to come forward, but that is not a mandatory vaccination programme. Anna Sauer appears to be again getting himself into the position where he is setting his face against Covid certification without, as far as I can tell, looking at any of the detail or considering any of the evidence from elsewhere in the world, but seems to be getting himself into position where he suggests that we should have mandatory vaccination. It is a voluntary programme and we continue to encourage people to come forward. The uptake rates of this vaccine programme are incredibly high, but we continue to try to get to anybody who has not come forward for vaccination so that they are encouraged to come forward and will continue to do that. On the JCVI and on the issues of who is included in a booster programme and on 12 to 15-year-olds, it is important that we base all of our decisions. I am a politician, I am not a clinician, I am not a public health expert and therefore it is important that all of our policy decisions on vaccination are rooted in evidence, either from the JCVI or in the case of 12 to 15-year-olds possibly from our chief medical officer. If I was to second guess or just ignore any evidential base and say that we are going to vaccinate people without that, Anasarwar and others, with much legitimacy, I hasten to add, would be criticising us for doing that. We stand ready to implement any recommendations, but for the sake of the overall confidence in this programme, it is really important that who we vaccinate is rooted in that clinical and expert evidence. Anasarwar previously suggested that the Scottish Government should just act unilaterally to decide to reduce the interval between doses in spite of the fact that we see evidence from Israel, for example, that that is not and would not have been the right thing to do. It would actually have reduced the effectiveness of the protection from vaccination. Secondly, on test and protect, the test and protect system is working extremely well under significant pressure. Again, just to repeat the point that I made to Douglas Ross, I think that it was Anasarwar's colleague Jackie Baillie that cited last week 43 per cent of cases, only 43 per cent being completed, knowing that she was citing provisional information. This week, the final figure for that week is 82 per cent. You can already see that Jackie Baillie last week was talking down the performance and the achievements of test and protect. The provisional figures for this week will be finalised next week, and we will see the comparison then. On that WHO standard, last week 85.5 per cent provisional figure, this week 89 per cent. Again, test and protect is working exceptionally well. We have got a duty to continue to support it. For Anasarwar to say, test and protect is not working in our schools. It suggests that there is a lack of understanding of what is going on in our schools. Contact tracing is being done appropriately and in a proportionate way in our schools, so that we do not have the situation that we had before the summer holidays, where lots of children have been required to self-isolate, where there was not a need for them to do that. We now have a situation that is helping to protect the population but in a way that minimises disruption to education. Finally, on vaccine certification, I will not pre-empt tomorrow's debate, but Anasarwar says that he is not taking a position of opposition for opposition's sake. I am sorry, Presiding Officer, but anybody that, at a weekend, four or five days before a debate in Parliament can decide without considering the evidence, without looking at the detail, that they, come what may, are going to vote against it, I am afraid, is indulging in opposition for opposition's sake. Alex Cole-Hamilton Thank you very much, Presiding Officer. Rising case numbers and the uptick in admissions to ICU are both extremely worrying. The contact tracing system is broken and it is not doing down our contact traces to point out how overstretched they are. Indeed, Scottish Liberal Democrats have been warning about the system approaching meltdown all summer. Our research found positive cases waiting up to a week to be interviewed. Ministers should be recruiting contact traces, not reducing the reach of that programme. Alongside vaccines, it is the single most important tool that we have to stop people from catching Covid. Will the First Minister commit to an emergency recruitment drive now for new traces? Just in the last couple of weeks, we have recruited 100 more. We do not do emergency recruitment drives. We recruit and support test and protect as we go along, depending on the need for the system. Alex Cole-Hamilton is right. It is not talking down test and protect staff to raise legitimate concerns. It is certainly not to scrutinise the Government. My point is that it is, I think, doing down the efforts of test and protect to cite misleading figures. Figures that suggest that it is performing at a level that is not reflective of the reality and that 43 per cent cited last week that is actually in reality 82 per cent is a case in point. In today's report, more than 80 per cent, 83 per cent of positive cases have been interviewed within 48 hours of them being in the case management system. The WHO target in terms of the provisional figures this week being met, although they will be finalised next week. Yes, it is a system under pressure, but it is a system operating and performing well, and every one of us in this chamber owes every single one of them a deep debt of gratitude. Kenneth Gibson, to be followed by Miles Greggs. Thank you, Presiding Officer. First Minister, for island community's life can still be all too easily disrupted by the pandemic. Last month, 65 ferry sailings tuned from Brodick were lost over 11 days at the height of the summer season, causing massive disruption primarily due to positive Covid-19 tests among CalMac crew members. Can the First Minister advise as to the protocols being put in place to minimise further disruption as we head into autumn and winter, not least because of reports today that many mask wearing among passengers has declined significantly in recent days? First Minister, ferry operators continue to reinforce the messages around compliance with current legislation regarding face coverings. They also have enhanced cleaning measures in place and are promoting the guidance on travelling safely on public transport. Transport Scotland continues to engage with all of the lifeline ferry operators around the efforts that they are making and the wider resilience of the network. The recent spate of Covid-related incidents on some ferry routes and vessels is, of course, concerning, but we need to remember that, even though most restrictions have been lifted, the virus is circulating, and we all need to continue to take care, as I have been setting out again today, and think about our own behaviours, whether that is at work at home or while travelling. If we all comply with all of those measures, whether on public transport or elsewhere, we will continue to bear down on the number of cases that we are seeing. A tragic death of Sarah Harding has once again highlighted the devastating impact of breast cancer and has resulted in UK cancer charities seeing over 800 per cent increase in contacts. Concerns have been expressed regarding breast cancer screening programmes here in Scotland, not potentially returning to full service for years to come, with limited options for women under 50 and over 70 to self-refer. When will breast cancer services across Scotland be fully restored? For women under 50 and over 70, with a history of breast cancer in their families, what referral screening pathways will now be urgently developed? This is an important issue at any time, but given the tragic death of Sarah Harding earlier in the week, it is uppermost in many people's and particularly in many women's minds. I am going to ask the health secretary to write in detail and put the letter in spice about the different referral pathways. One of the things that is relevant to all cancers that we are in the process of doing is establishing the first three-year already operational early diagnosis cancer centres, which are intended to be an alternative to the existing urgent referral pathway to identify perhaps the less common symptoms of cancer, so that there is another route in. There is a lot of work being done there in terms of the breast screening programme. I know this because I have recently entered the eligible age group. The breast screening programme is up and running and operational. It was paused for a period at the height of the first wave of Covid but has been up and running again for some time. Work is under way. Urgent care and particular cancer care continue to be prioritised during the pandemic, but there are efforts under way in cancer care, as across all the health service, to ensure that any backlogs are addressed as quickly as possible. Given the importance of the issue, as I said at the outset, I will make sure that further information on various referral pathways is put in spice. First Minister, I note that the JCVI made the recommendation on vaccinating 12 to 15-year-olds based on being what they have called marginal gain. Many of my constituents have been in touch to ask me to put forward their concerns about their young adult children not being vaccinated and the anxieties that they have on them potentially missing more school time and have been unprotected by the vaccine in those schools. I appreciate that the First Minister advises that the chief medical officer is reporting back within days with advice, but what criteria on societal impacts will be used in addition to the clinical criteria? That is an important issue, and Gillian Martin's question gets to the heart of it. To be fair to the JCVI, it is constituted with expertise to allow consideration of health benefits and health risks of vaccination. That is what it has done in this respect, and that is the basis for the recommendation that it made. It is worth reiterating that it did conclude that the benefits of vaccinating this age group outwead the risks, but overall did not think that that was sufficient to recommend vaccination for all. However, crucially, it recognised that there were wider considerations, but not considerations that the JCVI could properly take into account, but that governments could appropriately and properly take into account. That is why the four Governments have asked our chief medical officers to do exactly that and to look at the wider benefits of possible vaccination. That will include possible minimisation of disruption to education, but that work has been undertaken by the CMOs and it is important that they are allowed to do that work, independently taking account of all the advice that they think is relevant and taking account of all the wider factors that they think is relevant. As I said earlier on, we expect to receive that advice quickly. I am hoping that we will receive that advice in a matter of days, and as soon as we do, Parliament will be informed. John Mason, to be followed by Pauline McNeill. Thank you very much. I am very grateful to NHS Greater Glasgow and Clyde for correcting my online vaccination record. I just wonder if the First Minister can say anything about how many people we reckon have the record wrongly recorded and what people can do about it and when we can catch up on that. I have a figure for how many people may have their information incorrectly recorded. I would not expect that to be a significant proportion. I will check to see whether that can be made available. More importantly, if any data on anyone's vaccination status record is incorrect, they can phone the Covid status helpline and that will be investigated and rectified as quickly as possible. To provide the helpline number, it is 08081968565. Pauline McNeill, to be followed by Emma Harper. Michael Kil, chief executive officer of the Night Time Industries Association, has warned that night life businesses will lose more than one-third of their trade overnight if Covid passports are made mandatory. He also said that contrary to popular belief, much of our core market and workforce will not accept being coerced into taking the vaccine. I wonder if the First Minister could tell the Parliament, if she considered this viewpoint and commented on her decision, that, given what the Night Time Industries has said about the impact on their sector, what mitigation will the Scottish Government offer to the night time sector, which has been closed for over 18 months during the pandemic? There is a pretty basic reality here for all countries. We can't wave a magic wand and make Covid go away. It continues to circulate. We're about to enter a winter period where it's going to pose significant challenges for all of us. The question for all of us is not, can we get away with doing nothing? How do we protect the country in a way that is as proportionate and at least restrictive as possible? In terms of night clubs and the night time industry, I absolutely recognise that nobody wants to have a system of vaccine certification and nobody wants it to be in place for any longer than is necessary. However, the alternative to that, particularly in higher-risk settings, is not doing nothing. The alternative to that may well be facing the situation of having to have further periods of closure of some of these higher-risk settings. That is, I'm afraid, the hard reality that Governments simply can't escape. That is about what is the most proportionate thing to do to keep people safe as possible and to keep those venues open even during what is likely to be a very challenging winter period. We can't escape that reality and we can't escape those choices. People who argue against vaccine certification—as I say, it's working in many countries across Europe—have to then say, well, how do you think we should keep those higher-risk settings open as cases might increase during the winter without facing further periods of closure? I'm afraid Governments have to face those hard realities. We can't simply put our head in the sand and ignore them. The First Minister, as rightly and on the basis of clinical and medical advice, decided to continue to do the requirement of face coverings when in indoor public spaces. Could the First Minister reiterate the importance of the continued need for face coverings and their benefit in helping to stop the spread of Covid-19? Could she comment on whether there is any clinical advice that suggests that the use of FFP2 face masks and appropriately fitted face coverings, particularly as we approach winter, where people will be indoors more often, whether that is the best way for people to protect themselves and others? Face coverings play an important part in stopping the spread, even as vaccine is rolled out. Scientific evidence shows that fabric face coverings of two or preferably three layers help to reduce transmission. Face coverings, of course, are most effective when they are fit correctly over somebody's mouth, nose and chin. The mandatory requirement to continue face coverings is subject to regular review, and we will continue to take account of scientific, social and economic factors, as well as latest clinical evidence. We consider, in clinical settings, the most appropriate PPE to be used, but we will continue to keep all those requirements under review. We are legally required to make sure that any requirement is necessary and proportionate, and any changes to legal restrictions will always be scrutinised by Parliament. Sharon Dowie, to be followed by Audrey Nicholl. I raised the subject of prediary appointments with the First Minister previously in June, with the health secretary writing to me as well. My constituents are still unable to access paused NHS services, not just in relation to prediary, but also dentistry. While I understand the principles of remobilised recovery redesign may take time to implement for many, that means potentially another six months of pain, isolation and the inability to stay active. Will the First Minister provide an update on when paused NHS services will fully resume, and can she also guarantee that sufficient staff and resources will be in place to ensure that there will be no shortfall in the services provided so that all patients get the treatment that they require within 12 weeks of services resuming? I will certainly undertake to provide an update. The member referred to dental services. Dental services continue to struggle, as many sectors do, with increased transmission, but operating much more normally. Podiatry services will apply to a lot of other NHS services. The continued constraint on moving back to face-to-face appointments is the continued requirement around distancing to try to reduce the risk of transmission. However, the health service is progressively getting more of those services back to normal, and that includes more face-to-face consultations. However, on podiatry in particular, I will of course ask the health secretary to give an update to his last correspondence in June. More generally, on resourcing, we have set out our commitment to NHS resourcing. We will continue to keep that under review. On staffing, we have record numbers of staff in the national health service. We have a commitment to increase the staffing complement in the national health service. I have to be frank, like many sectors of our economy right now. The health service and other public services are struggling with shortages of staff, which are largely to do with the Brexit impact and the reduction in the labour supplies that we have. Those are issues that we need to grapple with in the effect of our health service, just as they are affecting food supply and other parts of our economy. In recent weeks, a number of my constituents have inquired about the option to double up their winter flu vaccine with a Covid booster. While JCVI advice is awaited on any requirement for a Covid booster, can the First Minister confirm if consideration is being given to administering both the winter flu vaccine and, if applicable, the Covid booster at the same time? In short, yes, we are considering all possible delivery options to make it as easy as possible for people being vaccinated but also as easy as possible for the NHS administering vaccination programmes. As I have indicated already, the JCVI is still considering evidence on the benefits of booster vaccines for the wider population, so we are awaiting its final advice. The interim advice has allowed us to do some initial planning and we are trying to make sure that that operates in as much synergy with the flu vaccination programme as possible. We are also currently working with health boards to plan the seasonal flu vaccine programme and to make sure that we align those two programmes as much as possible, but that will partly be dependent on the timing of the JCVI advice on booster Covid vaccinations and the detail of that advice. However, we will continue to update Parliament as regularly as possible. I have been contacted by a constituent whose child school is currently dealing with hundreds of pupil absences and a number of staff absences due to Covid. His daughter's close friend tested positive, but despite identifying herself as a close contact, she has heard nothing from test and protect. This is a separate school from the one whose similar absence rate I raised with the First Minister last week. We know that this is happening across the country. If the First Minister believes that current guidance for schools is sufficiently reducing disruption and infections and how the Scottish Government is ensuring that funding allocated for ventilation improvements is being used in a timely manner. On the first point about contact tracing in schools, I am not able to comment on the particular case, but there is a much more proportionate approach being taken by test and protect to identify the circumstances in which a young person is considered to be a close contact or not. We know that, prior to the summer holidays, many young people had quite lengthy periods of isolation and therefore disruption to their education when, on reflection, that possibly was not necessary in terms of reducing the risk. However, it is important that we keep this under review. In the last couple of weeks, I have asked for this to be reviewed and looked at and for advice to be updated. The advice that I have is that it continues to be appropriate to have the guidance that is currently in place. However, as the situation changes, we will make sure that we keep all the guidance that is in place under review. On the issue of ventilation and CO2 monitors, there is work on-going with local authorities to make sure that the funding that has been provided for CO2 monitors is being used in all-school and education settings. Crucially, that is supporting what we have set out before, the process of assessment that we have asked to be completed before the October break to decide whether there are any longer-term changes to the ventilation systems that are required in schools. We will again report on that as regularly as possible, but the work is under way with local authorities to ensure that that is being done. Constituents have told me that online vaccine status does not record those that received elsewhere in the common travel area. Could the First Minister outline the steps that have been taken to resolve that? If you are a Scottish citizen and you have received one or more of your vaccinations outside of Scotland but within the common travel area, you can phone the status helpline that I mentioned a moment ago, 08081968565. On-going collaboration is taking place between Scottish Government and NHS Digital to establish appropriate data sharing agreements within the common travel area. We are working to make sure that we rectify that situation as soon as possible. Those who live in Scotland but have been vaccinated outside of Scotland or England should obtain proof of their vaccination from the country that they are vaccinated in. Graham Simpson, to be followed by Stephanie Callaghan. First Minister, earlier today I was able to download my record of vaccination certificate. Within a minute I managed to create a copy where I was able to change every single detail on that certificate. That is not a particularly robust system, is it? It actually is because the one thing that you could not change and the thing that matters is the QR code. You cannot change the QR code. I do not pretend to be a technical expert on all of that, but we set that out quite clearly last week. I would not advise the member to seek to travel on the forged document that he has just admitted to having because the QR code and his ID documents will probably find him out. Stephanie Callaghan, to be followed by Evelyn Tweed. Colleagues, can we please hear the member? With new Covid cases in Lanarkshire still the highest in Europe and with proportionally higher levels of A&E attendance in hospital admissions in Lanarkshire than other Scottish NHS areas, what additional support the Scottish Government can provide NHS Lanarkshire to respond to the immediate and worrying situation locally? Obviously, we continue to work with local partners. The area that Evelyn Tweed represents is hard hit and we continue to work with the health board there, with the local authority and more broadly to make sure that the situation with Covid cases is being addressed appropriately, but broader recovery is also being taken account of the Stirling and Clotmanusure deal has been impacted by Covid, but there is work on going with regional partners to ensure that the deal is delivered and that work will continue. I am happy to ask the relevant minister to write to Evelyn Tweed with a full update. I don't think that the First Minister heard the appropriate question because of all the noise. I call Evelyn Tweed for your question, Ms Tweed. As our minds turn to economic recovery, it is important that we act ambitiously to unlock Scotland's potential. Can the First Minister advise what steps the Scottish Government is undertaking to ensure that the delivery of the Stirling and Clotmanusure city region deal is accelerated as a result of the pandemic? I apologise to Stephanie Callaghan and take full responsibility for getting her mixed up with Evelyn Tweed and the questions mixed up. It is my responsibility, I am not making excuses, but there is constant noise that is making it sometimes difficult for me to hear. It is my responsibility and I apologise to Stephanie Callaghan. On Evelyn Tweed's answer that I gave a moment ago on the work that is on-going around the deal in particular, I will make sure that update gets to her. My apologies again to both members for that confusion, which was confusion on my part. The First Minister says that the work of Test and Protect is vital and hugely appreciated. Yet, two months since I first raised with her concerns of Test and Protect staff, failing stress and overwhelmed, whistleblowers now describe the situation as staff being burnt out. Test and Protect is stressed to breaking point with reports of contact tracing that has been told only to make two calls before closing a case in order to get through the volume of calls, and staff have also reported not failing lessons to when scripts change. The First Minister also referred in previous answers to the overall number of cases being closed. However, the figures for the week ending 29 August show that only 60.5 per cent of completed contact tracing was completed within 72 hours. That is 13,330 taking over the 72 hours from the time cases were recorded on the system, not tested. I would ask her to just clarify the position on that point and indeed answer what she is doing to fix Test and Protect and support her hard-working staff. We continue to take steps to support staff and we will continue to do so. The staff in Test and Protect are working under extreme pressure. They have my gratitude, but it is more important that they have our on-going support through recruiting more staff and making sure that they have the resources that they need. The point about provisional versus finalised figures is an important one, and I think that it is really important that we all understand that. I have been making the point today that it is important to wait for the finalised figures. In the ones that the member has quoted, which are the ones assessing the performance within the WHO target, what usually happens there is that the provisional figure is higher than the finalised figure. Last week's provisional figure, which was over 80 per cent, has now, in the finalised figure, come to the level that the member has cited today. However, the provisional figure today—no, it is not. I will come back to the second point of the minute. The provisional figure today is higher than the provisional figure last week, so we will see the finalised figure next week, but it suggests an improvement in performance. The other figure, the one that Jackie Baillie cited last week in Douglas Ross's is the figure for the overall number of cases being closed. What we find in that figure is that the provisional data is much lower than the finalised data. The 43 per cent last week became 82 per cent today. I know that that is complex, but it is reflective of a system that, when you report at a snapshot date, there are many cases that are still in process. It takes a few days after that for the figure to be finalised. I encourage all members to look in detail—those who have not done so already—at those figures to understand the difference between provisional and final. It will then stop any of us using provisional figures in a way that is misleading and in a way that I am sure inadvertently does underplay and understate the performance of those working so hard in test and protect. Confirm that Covid vaccine certificates will be available for people who have had their first or both vaccines from those outside the common travel areas, such as Canada or Australia. As I said a moment ago, if you are a Scottish citizen and you have received one or more of your vaccinations outside Scotland but within the common travel area, you should contact the helpline and that is taken account of. We are continuing to work with NHS Digital to establish data sharing arrangements within the common travel area and broader than that internationally. Those arrangements will be in place as soon as possible. However, if you live in Scotland but you have been vaccinated outside of Scotland or outside of England, where there is already that data sharing agreement, you should obtain proof of your vaccination from the country that you were vaccinated in. That concludes the First Minister's statement on Covid-19 updates. There will be a short suspension before we move on to the next point of order, Julian Mackay. Presiding Officer, there is a strong point to be made from that last session of noise within the chamber over the last couple of weeks in particular. The noise level has prohibited me from participating fully as a member with a disability. I would be really appreciative if you could write to business managers in particular to set out how we can continue to make the chamber a place where everybody can participate despite their disabilities. Thank you. I thank Ms Mackay for that point of order. I have several times asked members for quiet since taking up this rule when others are speaking. While we do not want a sterile holy silent chamber, nor do we want it to become the norm that when members are making a contribution, others cannot hear the member properly, they cannot hear interventions and, generally, it makes their full participation in business very challenging indeed. I would refer members once again to the code of conduct that urges that members treat one another at all times with courtesy and respect. It is indeed a debating chamber, but it needs not to be a chamber where others are constantly speaking when members are doing their best to represent their constituents.