 That concludes topical questions. The next item of business is a statement by Nicola Sturgeon on Covid-19 update. The First Minister will take questions at the end of her statement, and so there should be no interruptions or interventions. I call on Nicola Sturgeon. First Minister. Thanks, Presiding Officer. I'll give an update today on the general Covid situation, but I'll also share the most up-to-date information that we have on the Omicron variant, both its transmission here in Scotland and the world's developing understanding of it. I'll set out the steps that we must take to slow its spread and to stem transmission of the virus more generally. First, today's statistics. 3,060 positive cases were reported yesterday, and 9.2 per cent of all tests carried out. 576 people are currently in hospital with Covid, which is 15 fewer than yesterday, and 38 people are in intensive care, which is five fewer than yesterday. Sadly, a further 12 deaths have been reported over the past 24 hours, and that takes the total number of deaths registered under the daily definition of deaths to 9,661. I want once again to send my condolences to everyone who has lost a loved one. I'm pleased to report, however, that the vaccination programme continues apace. 4,355,063 people have now had a first dose, 3,962,203 have had two doses and 1,922,604 have had a booster or a third dose of vaccine. On 1st, 2nd, 3rd and booster doses, Scotland is still the most vaccinated part of the UK. Indeed, at this stage, on booster doses, we are comfortably ahead of the other UK nations, with around 40 per cent of the over 12 population having had a booster drag to date. I want to again record my thanks to everyone involved in organising and delivering the vaccine programme. Today's weekly update coincides with the latest three-week review point for all of the remaining Covid regulations. I can therefore confirm that at our meeting this morning. The Cabinet agreed to keep all of the current protections in place with no immediate changes. Given the very significant risks posed by Omicron and the continuing high, and indeed once again rising number of cases in Scotland overall, our judgment is that it would be inappropriate to lift any of the protections currently in place at this time. On the contrary, we agreed that it is vital at this stage to strengthen compliance with all of those existing protections. We also agreed that, in light of the rapidly developing Omicron situation, it was important to keep the need for any additional protections under daily review at this stage. The importance of doing that will be clear from the latest data, particularly the data that I will share shortly on Omicron. First, let me quickly summarise the overall situation. After two weeks of falling case numbers, the last seven days have seen a rise in the overall number of cases. Last week, I reported that the number of new cases being recorded each day had fallen by 14 per cent over the preceding seven days. However, in this past week, cases have increased by 11 per cent and we are currently recording just over 2,800 new cases a day on average. Encouragingly, though, cases in the over 60 age groups have continued to fall in the past week by a further 8 per cent. There is little doubt, if any doubt, that this reflects the effectiveness of booster vaccines. However, in all age cohorts, under 60 cases are rising again. In total, cases among under 60s increased by 13 per cent in the past week. Since people under 60 currently account for more than 90 per cent of all cases, that has inevitably driven an increase in the total number of cases recorded. More positively, the number of people in hospital with Covid has fallen further in the past week from 706 to 576, and so has the number in intensive care from 54 to 38. That is, of course, welcome news, but we shouldn't in any way be complacent about that. Firstly, because we know that there is always a time lag between rising cases and rising admissions to hospital, and secondly, because the NHS continues to be under very severe pressure from direct Covid pressure, but also from the backlog of work that was created during the pandemic, on top of all that, the NHS may soon face additional pressures, for example from flu, as we had further into winter. There has always been the potential for Covid cases to rise during December, as may now be happening as a result of more people mixing indoors more often. In any circumstances, we would be concerned about the current high level of cases and the impact that this might have on the NHS. However, the emergence of the Omicron variant is now an additional and indeed a very significant cause for concern. Public Health Scotland's weekly Covid report will from tomorrow provide more detail on confirmed and probable Omicron cases in Scotland. It will include data not just on confirmed cases but also on the number of PCR tests showing what is called the Sgine dropout. That is not conclusive evidence that a case is of the Omicron variant, but it is highly indicative of it. The report will also contain data on the age, sex and health board area of Omicron cases. In weeks to come, and as soon as the quality of data allows, those reports will provide detail on the vaccination status of and hospital admissions and deaths associated with Omicron cases. For now, though, let me summarise what we currently know about the presence and spread of the new variant in Scotland. I can confirm that as of 5pm yesterday. There were 99 confirmed cases here. This is an increase of 28 since yesterday. To give a sense of the speed of increase, albeit at this stage from a low level, the figure that I reported this time last week was nine. We have seen more than a 10-fold increase in the space of a single week. I still low at around 4 per cent, but nevertheless steadily rising proportion of cases also now show the Sgine dropout that, as I said a moment ago, is highly indicative of the Omicron variant. Our estimate at this stage is that the doubling time for Omicron cases may be as short as two to three days, and that the R number associated with the new variant may be well over two. I can also report that there are now confirmed cases in nine of our 14 health board areas, suggesting that community transmission is becoming more widespread and possibly more sustained across the country. Now, our health protection teams are working hard through contact tracing, testing and isolation to slow the spread of Omicron cases. That work will obviously continue, and I want to thank them for their excellent efforts. However, given the nature of transmission, I would expect to see a continued and potentially rapid rise in cases in the days ahead and for Omicron to account for a rising share of overall cases. All that explains, I hope, the requirement for Government to review the situation on a daily, rather than a weekly basis at this stage. Let me turn now briefly to the developing global understanding of this new variant. The first point to make is that there is still a great deal that we do not yet know. However, data on cases worldwide, including here at home, gives a reasonable degree of certainty at this stage that Omicron is more transmissible than the Delta variant, and perhaps significantly so. Early, though, again, unconfirmed data also suggests that Omicron is more capable of reinfecting people who have had the virus previously. In other words, it has some ability to evade natural immunity. Of course, there is also a concern that it may evade, to some extent, the immunity conferred by vaccination. Let me stress again, though, at this point, that even if that latter point proves to be the case, getting vaccinated will still be vitally important. Vaccines being slightly less effective is not the same nowhere near it, in fact, as vaccines being ineffective. Being vaccinated will still give us much more protection against Omicron, especially from severe illness, than we will have if we are not vaccinated. Further data and analysis is needed to confirm all the hypotheses about the transmissibility, immunity, evasion and severity of Omicron. We will learn more about its characteristics and implications in the days and weeks ahead, and that developing understanding will inform and shape our response. However, we can assume already that the emergence of Omicron is a significant challenge for all of us. A variant that is more transmissible than Delta, and which has even a limited ability to evade natural or vaccine immunity, has the potential to put very intense additional pressure on the national health service. A key point that we must understand is this, and I want to underline this point, the sheer weight of numbers of people who could be infected as a result of increased transmissibility and some immune evasion, will create this pressure even if the disease, the new variant, causes in individuals is no more severe than Delta. There is no doubt, unfortunately, that this is another serious moment in the course of the pandemic, and I will talk shortly about what that means for all of us. First, let me outline the principles that will guide any decisions that the Government may have to take in the days and weeks ahead. It is worth noting that the period ahead, as we learn more about the new variant, may involve very difficult judgments for Governments everywhere. Indeed, many Governments around the world are already taking decisions that we all hoped were behind all of us for good. For the Scottish Government, our first principle will be to seek to do what is necessary to keep the country as safe as possible, even if that is sometimes at the expense of being popular. Second, we will strive to get the right balance between acting proportionately and acting preventatively. We know from experience, sometimes bitter experience, that, with an infectious virus, acting quickly can be vital. If we wait too long for data to confirm that we have a problem, it might already be too late to prevent the problem. In fact, acting preventatively is often the best way of ensuring that action can remain limited and proportionate. However, after two years of restrictions with the accumulation of social and economic harms that previous restrictions have caused, we also know that it is ever more important to minimise further restrictions as far as is possible. While recognising that it is never a perfect science, we will seek to get that balance right. Let me turn to the action that we have taken so far and what we are asking everyone to do now. First, in line with the other UK nations, we have tightened travel rules. In the past week, Nigeria has been added to the travel red list. That means that anyone arriving in the UK from Nigeria or the 10 countries already on that list must enter managed quarantine for 10 days. In addition, since this morning, anyone aged 12 or over who is travelling to the UK from outside of the common travel area will be required to take a Covid test shortly before they leave for the UK. That is in addition to the requirement to take a test on day 2 after arrival in the UK and to self-isolate pending the result. My advice to anyone planning travel between Scotland and countries outside the common travel area is to check on the Scottish Government website for detailed guidance and to also check the requirements of the country that you are travelling to, because the requirements there may well be different to those in force here. At this stage, travel restrictions have an important part to play in responding to the new variant. However, given that we already have some community transmission in Scotland, what we do domestically is also important. That is why Cabinet decided this morning to keep in force all the existing protections. However, we also agreed that it is vital not just to maintain but to strengthen compliance with those protections. It is time for all of us to go back to basics and ensure that we are taking all the steps that are required to minimise the risk of getting or spreading the virus. Indeed, it is through heightened compliance with current protections that we will give ourselves the best possible chance of avoiding the need for any additional protections. I am asking everyone to make an extra effort to do so from now through the festive period and into January. Obviously, that means wearing face coverings in indoor public places, ventilating rooms by opening windows whenever possible, and ensuring good hand and surface hygiene. However, there are two important protections that I want to emphasise particularly strongly today. First, working from home. We already advised people to work from home wherever practical. Today I am asking employers to ensure that this is happening. To be blunt, if you had staff working from home at the start of the pandemic, please now enable them to do so again. We are asking you to do this from now until the middle of January when we will review this advice again. I know how difficult this is, but I cannot stress enough how much difference we think that could make in helping stem transmission and avoiding the need for even more onerous measures. Second, testing and isolation. Test and protect is deploying enhanced contact tracing for all cases with the SgN drop-out that is indicative of Omicron. For those cases, household contacts of close contacts rather than just the close contacts themselves are being asked to test and isolate. If you are asked to do this, please comply. More generally, for non-Omicron cases, if you have symptoms of Covid, please get a PCR test and self-isolate until you get the result. If your result is negative, you can end isolation at that point. If you are double vaccinated, if positive, you must isolate for the full 10 days. Crucially, please remember that you can have this virus even if you have no symptoms. Testing regularly and repeatedly with lateral flow devices is essential. We are asking everyone to do a lateral flow test before mixing with people from other households and on every occasion that you intend to do so. That means before going to a pub, to a restaurant, visiting someone else's house or even going shopping. Let me be clear, Presiding Officer. I am not excluding myself from this. I am currently doing a test every morning before coming to work. I will do a test on any occasion. I mix with others over the festive period and I will ask anyone visiting my home over Christmas to do likewise. I am asking every member of this Parliament to lead by example and to do that too. LFD kits are easy to get through NHS Inform or from local pharmacies or test centres, and they are very easy to use. Please, please do this. It will significantly help us to break the chains of transmission. If we do all of those things—difficult though I appreciate that—even with a more transmissible variant, I really hope that we can avoid the need for any further measures. However, I cannot guarantee this. I do not think that any responsible person in my position could ever guarantee this at this stage. Given the situation that we face, it is important to remain open to any proportionate measures, for example the extension of Covid certification that might help us to reduce the risks should the situation deteriorate. The Government will carefully analyse the data in the days ahead. I hope that that does not require us to take any decisions ahead of my next scheduled statement a week today, but if it does, I will obviously return to Parliament. I want to end by reiterating the vital importance of vaccination. We are currently the most vaccinated part of the UK. We have more quickly than other nations implemented the JCVI advice to reduce the gap between second doses and boosters, but we are not complacent. We are identifying and training additional vaccinators. So far, we have added the equivalent of more than 300 additional full-time staff to the vaccination workforce. We are also working to further increase vaccination capacity. A number of health boards—Fife and Tayside, for example—are now using drop-in centres to make vaccination even easier. We are in the process of increasing the use of mobile vaccination units provided by the Scottish Ambulance Service. In addition to those efforts, which are intended to improve the supply and availability of vaccination, we are also working to increase demand by encouraging even more people to take up the offer of vaccination. In the past week, texts or email messages have been sent to those aged between 40 and 60, encouraging them to book their booster jag. For those now able to get a booster jag, that is anyone over 40 who had the second jag 12 or more weeks ago, please arrange an appointment as quickly as possible. You can book through NHS Inform or by calling the vaccination helpline. If you are 16 or 17, you can and should also book your second dose in the same way. Last week, we also sent blue envelope letters to all 50 to 59-year-olds who have not yet been vaccinated at all. A similar letter has been issued over the course of this week to everyone between 40 and 49 who have not yet been vaccinated. Take-up of the vaccine has been exceptional, but there are still a significant number of people in those age groups who have not been vaccinated. To anyone in that position, let me be clear about this. It is not too late to get vaccinated, in fact it is now more important than ever to get your first jag and start to get that essential protection. Omicron is a really concerning development and the most unwelcome of developments at this stage in the pandemic, but this is the more positive aspect. The actions that have helped us against other variants will also help against Omicron. That means that we all know what we need to do in the days and weeks ahead and so my request to everyone is to follow those steps. Please go back to basics and make sure that we are all doing everything that we are being asked to. That is the best way that we have of making Christmas and the new year as safe as possible and of maximising our ability to navigate this next unwelcome but unavoidable challenge without any additional protections being necessary. It will also help us to protect the NHS and those who are working so hard in the NHS and social care to keep us all safe. Please get vaccinated. Secondly, do test regularly on any occasion before socialising or mixing with people from other households. Finally, make sure that you comply with all the existing protections, where you face coverings on public transport, in shops and when moving about in hospitality. Keep windows open—not easy, I know, in the weather that we are currently experiencing, but try to keep windows open if you are meeting people indoors and follow all of the hygiene advice. If you were working from home at the start of the pandemic, please do so again for the next few weeks. None of this is what any of us want two years into this ordeal. I know that, but it is the best way of slowing the spread of the virus in general and Omicron in particular. By doing that, we give ourselves the best possible chance of enjoying a Christmas that is more normal but also safe and of avoiding a new year hangover of spiralling cases. I really hope that this will be for one last time in this pandemic. Let's all pull together, do what is necessary and get each other and the country through this winter into what we all hope will be a much brighter spring. 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 to the next item of business. I would be grateful if members who wish to ask a question were to press their request to speak buttons now, and I call Douglas Ross. As we wait for more information on the latest Covid variant, there are actions that people can take right now to protect themselves and their families. I want to encourage everyone who can go out and get it to get the vaccine and if they have symptoms to get a Covid test. There are actions that the Government can take right now to tackle the huge challenges facing Scotland's national health service. Today's monthly accident and emergency statistics are the worst on record. Fewer people are being seen on time than in any month since the SNP came to power. We have repeatedly warned that Hamza Yousaf's flimsy winter NHS plan was inadequate. The First Minister previously accepted that there was a crisis in Scotland's NHS, so does she now accept that her Government has failed to do enough to prevent this crisis escalating when hundreds of patients every week are left waiting more than half a day to be seen in our hospitals. Turning to the Covid situation, a school in Paisley has been forced to close because of a number of absences. It is a situation that, although it may be necessary in extreme circumstances, nobody wants to see happening. In the early stages of the pandemic, there was consensus across the political parties in the chamber that children's education must come first, and closing schools should only ever be at last resort. Will the First Minister confirm that that remains her Government's position, and can she also say that no plans for school closures on a national basis have been discussed by her cabinet? Finally, doctors, including my party's health spokesperson, are warning that new guidance, issued by the Government to GPs, will reduce the number of people being seen face-to-face. The guidance means that every patient seeking an in-person meeting will now be asked an extra nine questions by a member of staff before they receive an appointment. Dr Andrew Buist, chairman of the BMA Scotland's GP committee, has said, and I quote, we see 1 million patients each month face-to-face in our GP surgeries. I do not think that we can maintain that if we are having to do this new process, so can the First Minister tell us how many fewer people are going to be seen face-to-face because of her Government's new policy? I will come back to the clinical guidance around GP access later on. Let me run through the other points on accident and emergency, like probably every other country in the world right now. The pressure of this pandemic is creating real challenges in unscheduled care in our national health service and, of course, in scheduled and planned care as well. We are no different to other countries in that respect. In fact, though notwithstanding that, although our accident and emergency performance is nowhere near where we want it to be, our accident and emergency units are still performing better than counterparts in other UK nations, but we will continue to support our A&E departments and our national health service generally to cope with the current pressure and then to recover to normal as we come out of this pandemic. In order to do that, it is really important not just that we contain first of all and then hopefully drive down Covid cases, but to take measures to keep the national health service as safe as possible from the ingress of Covid cases into it. I will come to the issue of GP clinical guidance right now. That is clinical guidance, not a Government policy, and it is about screening patients to ensure that, if they are accessing GP practices physically, in the process of doing that, we are minimising the risk of Covid getting into those practices and creating perhaps outbreaks. GP's have expressed some concerns about that. We will listen to that to see whether that can be done more flexibly. However, it is inescapable in the midst of this pandemic, in the midst of dealing with a variant that may be significantly more transmissible than anything before, that we need protective measures like that. It is not surprising to me to hear Douglas Ross oppose anything that we have in place, because he has opposed pretty much everything that we have done up until now to keep the country safe from Covid, but we will continue to take appropriate, proportionate, protective measures to keep our NHS safe and to keep the country safe. Secondly—or thirdly, rather—on schools—and this is my final point, it is absolutely the case that protecting the education of children remains a top priority. We are not discussing the closure on a national basis of schools. Everything that can be done to avoid that will be done by this Government, and that is a really important principle that will drive everything that we do. However, that means doing some other things that, again, Douglas Ross has opposed time and again. Firstly, it means making sure that there are sensible mitigations in schools, like face coverings, which nobody likes, but are essential. Douglas Ross has repeatedly opposed the use of face coverings in schools. Secondly, we do what is necessary in the wider community to keep control of Covid. Again, most of the things that we have done to try to achieve that have been opposed by the Conservatives. We need to continue to take sensible actions, proportionate actions, but we are again in a really serious juncture of the pandemic, and it demands serious Government, serious decisions, and it certainly does not demand opportunistic opposition. I send my condolences to all those who have lost a loved one, and I want to put on record my thanks to all those in the front line, in particular all our vaccinators, who continue to help to protect and save lives. In the last few days, I have been contacted by a number of people who, having booked an appointment, turned up at the vaccination centre on time, stood on the queue, but as it reached the closing time, they were turned away. Can we ensure that all those who queue on time will get their vaccination? For lots of Scots, the brief respite that comes from the winter break will be a chance where they find the time to go and get their booster vaccination, so I ask the First Minister what the plans are for over the Christmas period and whether there will be more drop-in centres. The First Minister is right to say that the NHS continues to face huge pressures. Stats published today show 5,700 nursing and midwifery vacancies, over 400 consultant vacancies, and the worst A&E waiting times on record. When we are supposed to be catching up, there are 43 per cent fewer planned operations compared to pre-pandemic levels, but perhaps more shocking of all is the news that almost 2,000 children have been waiting over a year for specialist mental health services. Many issues in the NHS predate the pandemic, but NHS catch-up must be part of our national emergency response. Can the First Minister give a commitment that she will come every week, just like alongside her Covid statements, and bring detailed updates on the steps that are being taken to address the emergency issues in our NHS so that we can have that catch-up programme that Scotland needs? My ministers report regularly to Parliament on the whole range of NHS pressures and actions that are being taken to address and resolve those pressures, and that will continue. In fact, I would strongly suspect, over the winter period, that that will, if anything, only intensify. On the specific points raised on vaccination, last week I explained the issue that we had last week that led to a relatively small number of people being turned away, because we were in the process of changing the protocols and the guidance from saying that there had to be a 24-week gap between second doses and boosters, to a 12-week gap. As we now know, we had that problem for a short period, because we were doing that more quickly than other Governments. In England, for example, it may be the 13th of December before that advice is operationalised. In addition to that, for example, in parts of Glasgow on Friday, there were some people because of the busyness of vaccine centres turned away at closing time. Again, action has been taken to ensure that there is the capacity in terms of vaccinators in clinics to make sure that that is dealt with. I have always said that, with a programme of the scale and complexity of this one, there will be problems at times, and we work to resolve those problems as quickly as we can. Again, I would ask everybody to acknowledge, not for the sake of the Government, for those working so hard to deliver this programme, that we are the most vaccinated part of the UK. Today, I suspect that, when the figures are published, we will see that we have gone over 40 per cent of the over-12 population having received a booster vaccination that is considerably ahead of any of the other UK nations. That is to the credit of those who are organising the programme, resolving the problems when they arise and to those who are administering vaccines in the centres in every part of the country. On the point about the festive season, part of the work that we are doing right now is to ensure that what would often happen over the festive season is that activity drops, and that we avoid that as far as possible over the Christmas and New Year break, and that the run rate of vaccinations per week maintains at the level that we are right now, so that we can keep that flow through to the end of January when we want to have completed the booster programme. Every effort has been made to ensure that all that is taken full account of. Finally, on staffing in the health service, recruitment in our health service and social care, similar to recruitment across our economy right now, is a significant challenge, partly because of the pressure that has come from ending freedom of movement. That affects the national health service, and we must be blunt about the reasons for that. However, notwithstanding that, the figures that are published today show that we have a higher number of people working in the national health service than ever before. Since this Government took office, I think that almost 30,000 more people are working in our national health service. Perhaps the ninth consecutive year of an increasing NHS workforce. That is what this Government has delivered. It is what we are focused on delivering more of. We are looking to accelerate recruitment, and the health secretary, when I came into the chamber, was just talking about some of that work that is under way. We continue to focus on those challenges as we go through this winter and remind people that all of us have a part to play to help to relieve the pressure on the NHS. I thank the First Minister for advance sight of her statement. This morning, we suffered the evidence of the pressure that exists in the NHS. Nursing and midwifery vacancies are up 19 per cent since the summer, with well over 5,000 posts empty. Mental health waiting lists as long as you are armed. In the region of 265,000 operations have now been lost to Covid, and that matters to people such as my constituent, who has been off work since April in agony, now on reduced pay, but told that their operation won't be for another year. The backlog is only getting longer, and operations remain well below pre-Covid levels, so what can the First Minister tell my constituent? What I would tell Beatrice Wishart's constituents, and indeed anyone across the country, is that the Government is investing in the additional staffing, the additional capacity, to ensure that we are reducing and recovering the backlog created by Covid as quickly as possible, and that work is continuing to intensify. However, the second thing I would say to everybody, to all of us, is that the more we reduce the pressure that Covid is putting on the health service, the more we reduce the ability of Covid to delay and pause other treatments, the less of a growing backlog that we will create. It comes back to my central point today. We are again at a really critical juncture in this. I wish we weren't facing this again in the shape of the new variant, but it is a moment where all of us have a part to play to reduce that pressure, to reduce the number of cases overall, and that will help to reduce the pressure on the NHS and allow the NHS to do more to recover that backlog as quickly as possible. We know that vaccines are the best line of defence against Covid, especially as we face the new variant. Can the First Minister therefore provide an update on the progress being made with extending the booster programme for under-40s? We have said that our aim and target are very clear. We have a lot of confidence in delivering that, given the progress of the booster programme so far, as we want to complete the booster programme. That includes for under-40s for those over 18 by the end of January. That is what we are working to do. That involves all the things that I spoke about in my statement, increasing the vaccination workforce. We have already increased it and we will seek to go further, increasing the capacity for vaccinations, but also making sure that we are doing what is necessary to generate the demand, making sure that those who are eligible, when they are eligible, come forward and get vaccinated. All of that is really important work. Of course, all the MSPs can help us with that by getting those messages out in their own constituencies. Murdo Fraser, to be followed by Kenneth Gibson. The First Minister highlighted the importance of the vaccination programme, and I am sure that we would all pay tribute to the NHS staff and the community volunteers who are working so hard to deliver that. However, we are still seeing too many unacceptable delays. I was contacted by constituents who advised me that, at the pitlockery vaccination centre on Saturday morning, there was a three-hour delay for those turning up to be vaccinated, and many of those who turned up were having to queue outside in inclement weather. We have the vaccines, but we do not have enough vaccinators. What more can be done, for example, to call upon recently retired medical staff, or perhaps medical or nursing students with adequate training, who could come in and fill up those gaps? I am not sure whether Murdo Fraser paid attention to the statement that I made. I said that we have already, through recent recruitment efforts, added the equivalent of 300 additional vaccinators, and that is through a range of different approaches, some of which are the ones that Murdo Fraser has already talked about. That is work that is already on-going. I accept that, because we are seeking to encourage people to make appointments, some people will come forward for vaccination without an appointment, so there is always a balance every single day in every vaccination centre to strike between supply and demand. There will be some days where more people are coming forward than anticipated, which, in some ways, is a good thing, where that is putting pressure on the supply and is leading to regrettable delays in people being vaccinated, or in some cases, albeit a small number of people being turned away. We are working hard, and health boards are working hard to avoid that, but in the overall scale of the programme, those are relatively small issues, and issues, unfortunately, that sometimes are unavoidable. The overall programme is going exceptionally well. I keep making the point, because I think that it is really important to give the credit to the teams across the country. We are not marginally now significantly ahead of England, Wales and Northern Ireland in terms of the delivery of boosters. That does not mean that we cannot let up. We have to keep pushing ahead with that, but that suggests to me that the programme is going well, that we are doing the right things, we just have to do more of them and we have to make sure that we stay on it, and that is exactly what we intend to do. Kenneth Gibson, to be followed by Pam Duncan-Glancy. Thank you, Presiding Officer. First Minister, a huge and disproportionate number of people being treated in intensive care units with Covid chose not to get vaccinated. This is a significant non-going adverse effect on the NHS, including its capacity to treat patients with other illnesses. We are the most vaccinated part of the UK, but despite the exhortation of ministers over the last year, the importance of everyone being vaccinated, a stubborn minority refuse. What further steps will the Scottish Government take to increase the number of people being vaccinated to protect the NHS and wider society? I have already set out today some of the steps that we are taking to generate additional demand to get to people—the blue envelope letters that I spoke about to particular age cohorts—to get to people who have not yet been vaccinated to encourage them that, even at this stage, it is not too late and they should do so. We will continue to use methods like that to encourage people to come forward. Of course, everybody by the end of January will have been offered—everybody over 18—by the end of January will have been offered the booster vaccine. I would say pretty bluntly to people that if you are eligible and able to be vaccinated right now and you are choosing not to be vaccinated, then you are being deeply irresponsible. I would say that you are being selfish. You are putting your own life much more at risk. You are putting the life of everybody that you come into contact with at risk. That was true before the emergence of Omicron. It may be even more true now, so please, for your own sake, get vaccinated. However, if you are not going to do it for your own sake, then do it for the sake of others that you are coming into contact with. For goodness sake, do not put their lives on the line. Last week, the First Minister announced a significant change in guidance, meaning that anyone who is contacted by test and trace in relation to the Omicron variant must self-isolate regardless of vaccination status. Can the First Minister give reassurance today that self-isolation support grant guidance will be updated to include those who have been vaccinated and have been advised that they have been a close contact of someone with Omicron? Yes, I can. If there is still work to do to make that clear, we will make sure that that is done by anybody eligible who has been asked to isolate for a longer period if they are a close contact or a household contact if a close contact of an Omicron case is eligible for the self-isolation support grant if they are otherwise eligible and we will make sure that guidance is properly updated to make people aware of that. Siobhan Brown to be followed by Gillian Mackay Thank you, Presiding Officer. Can the First Minister give an indication on how the new variant Omicron is being identified and tested for, and what measures do health boards have in place to identify the new variant? The Omicron variant has a mutation that leads to what people have heard me refer to previously, the SgN drop-out. Although the SgN drop-out in a PCR sample is not conclusive of Omicron, it is highly indicative of it. Previously, that used to be what indicated presence of the alpha variant, but the alpha variant has more or less disappeared from circulation in Scotland. Now, if a PCR test has the SgN drop-out, then that is indicative of Omicron and that gives an early indication of the presence of that variant. All PCR samples from test sites in Scotland are processed by the Glasgow Lighthouse Lab, and it can detect the SgN drop-out. Health protection teams are right now treating all such cases as if they were Omicron confirmed in their public health response, and that will then influence the approach to contact tracing and isolation. From the PCR SgN drop-out, many cases that have that go through whole genomic sequencing, which then confirms absolutely the presence or otherwise of the Omicron variant. The presence or rather the absence of the SgN in those tests is a really important way of quickly identifying that a case might be Omicron and then making sure that the public health response is appropriate on the basis of that. As the First Minister outlined in her statement, continued homeworking will be a vital tool in our efforts to suppress the virus. I am sure that we have all read comments online from workers concerned at the expectation to be back in the office. What support will be offered to employees who were working from home earlier in the pandemic but who are now feeling under pressure and are being required to come into work by their employers? I am making very clear today what the Government is asking of employers. Do not get me wrong, I understand how difficult this is for employers. I also understand that there will increasingly be much different to the start of the pandemic being mixed views among workers about the desirability of homeworking versus office work. I appreciate many people who have been working at home for long periods who actually want to get back to the office. However, we know that maximising homeworking and therefore reducing some of the contacts that go around office working can help stem transmission. At this point, that is really important. To support workers to work from home, we are sending a very clear message to employers today to make sure that that is being facilitated wherever possible. To make this easier for people to understand the message, if your staff were working from home at the start of the pandemic, please, for the next few weeks—we are saying at the moment until mid-January, when we can review this again having come through this next very difficult period—please enable staff to work from home at this stage. It can, I believe—we have seen this before—make a significant difference and, hopefully, help us to avoid the need for any more owner's restrictions. John Mason, to be followed by Jamie Halcro Johnston. Concerning vaccine certification, I have been asked by constituents how and when their booster jag will appear in the certification. I wonder if the First Minister could say anything about that. Booster information will appear in the international section of the Covid status app from 9 December, so later this week Thursday, along with negative test status from PCR tests and recovery certificates for those who have previously tested positive for Covid. Those have been developed in line with the standards set by the European Union and are for use for travel purposes only. At this stage, non-app users will be able to access their booster information on paper or PDF from the week beginning 13 December, so from next week. We will give further information in due course about the incorporation of booster vaccinations for domestic purposes. Jamie Halcro Johnston, to be followed by Marie McNair. What assurances can the First Minister give to Scotland's small businesses that her Government's upcoming budget will help to insulate them from any loss of business caused by the unmacron variant? Right now, in Scotland, small businesses in certain sectors have 100 per cent rate relief that they would not have if they were situated south of the border under the Conservative Government, so we can take from the actions in place just now that this is a key priority for the Government. I know that it is a particular priority for the finance secretary, who of course will set out the budget to Parliament later this week. Marie McNair, to be followed by Katie Clark. The First Minister will be aware of the strain that NHS dentists have been under during the pandemic. I have been contacted by local dental practice and patients who are concerned over NHS dental provision. In light of the new variant, the full resumption of services will of course have to be done cautiously. Can the First Minister outline what funding has been made available to support practice recovery and remobilise our dental services in a way that is safe? Obviously dentists provide essential services and we are doing everything we can to support NHS dentistry. We have already provided £50 million of financial support payments throughout the pandemic and additional funding for PPE to help dental services in these circumstances. From February next year, we will bring in new and increased fees for dentists for a range of treatments that will support them in their efforts to clear the backlog in routine care that built up during the pandemic. Those plans build on more recent announcements for funding for new dental drills and for ventilation improvements, which are about helping NHS dental teams to see patients safely in dental settings. Seafarers returning to Scotland from work overseas are still required to quarantine in hotels at a cost of £2,285, with some employers refusing to meet the cost. That is not consistent with other sectors such as offshore or the rules in the rest of the UK. Has the First Minister had the opportunity to look at the issue and would she be willing to meet with the relevant trade unions to discuss how rules can be made consistent? The Government will certainly be happy to talk to trade unions about any concerns that it has here. I know that we have understandably had concerns raised about seafarers in the past. We have looked at those concerns. Clearly, there is a need here to have protective measures in place, but we do not want to have measures in place that are any more onerous than necessary. I know that those are matters that we look at on a regular basis. I will write to the member or ask the health secretary to write to the member with an update on particular considerations around managed quarantine for seafarers and, yes, be happy to discuss any remaining concerns with trade unions. Joe FitzPatrick to be followed by Pam Gossel. The First Minister will be aware of calls from the People's Vaccine Alliance for Action to Tackle Vaccine Inequality and to ensure that life-saving vaccinations can be made across the globe. Given that this is a global pandemic requiring a global response, will the First Minister join me in urging Boris Johnson to take action, including backing proposals to waive intellectual property rules to ensure equitable access to Covid-19 vaccines to protect the health of all people all around the world? I support the calls of the People's Vaccine Alliance. I certainly call on the Prime Minister to take whatever action he can to ensure that we get vaccines equitably to the population of the world as quickly as possible, but I also take very seriously the responsibility on the shoulders of my Government to make sure that we are doing everything possible. Covid is a global crisis, so it is very understandable that often we focus on the implications for ourselves in our own country, but it is an unprecedented global crisis. Earlier in the pandemic, the Government allocated funding for our own international development budget to provide Covid support for partner countries Malawi, Rwanda, Zambia and Pakistan. The UK also participates in covax, which is an important way to help other nations to access vaccines, but it is fundamentally the case as Omicron is reminding us that until everybody across the world is safe, none of us are truly safe, so we are very keen to explore further routes that support equitable access to vaccines. I will write to the Prime Minister on that to encourage him to take whatever action is necessary but also to offer the full co-operation of the Scottish Government in doing so. Can the First Minister tell us when lateral floor devices will be more available for pick-up from more accessible places, such as shopping centres, supermarkets, sports grounds and even petrol stations? As I said last week, local authorities are planning, and I am sure that some of them are doing it already, to make lateral floor devices accessible in shopping centres, garages and garden centres, anywhere that they think is appropriate and where it may be convenient for people. However, I appeal to all members, including Pam Gosw, not to give the suggestion to the population right now that lateral floor devices are not easily accessible, because they really really are. You can order them online, you order them one day, they will arrive through your letterbox the next day, you can go to a local pharmacy and pick up LFD tests, you can get them from local test centres. We should be uniting to tell people that it is really easy to get LFD tests and uniting to ask people to use them before mixing with other people. They are also really easy to use. I repeat my request to members across the chamber to lead by example and to say publicly that they are testing themselves every day and certainly before socialising with others over this festive period. Please let us get the message across. They are easy to get, they are easy to use and using them regularly and repeatedly will really help us to break the chains of transmission. No one wants to see further restrictions and I welcome the cautious approach that has been taken. Can the First Minister provide any further information as to the steps that have been taken to continue to maximise public awareness of the vital measures that remain in place? We will continue to take all opportunities from statements here, media statements asking members across the chamber to communicate those messages and their constituencies to get all those messages across. In addition to that, our public awareness campaign will intensify over the winter period. The current campaign, Living Safely for us all, will run until 12 December. That reinforces the importance of key safety behaviours and then a new Living Safely this winter campaign will launch on 13 September and that will run throughout the festive period and that will focus on the behaviours. We are asking people to adopt over this period to help protect each other and that will include testing before travelling, socialising, visiting busy places, visiting other people in their houses, taking a PCR test if showing symptoms, getting vaccinated and of course wearing face coverings and following all the necessary hygiene advice. Martin Whitfield to be followed by Christine Graham I'm grateful, Presiding Officer. Test and trace has all been but abandoned in our schools. Pupil testing is all but nonexistent. For the week ending the 28th of November, just 2.6 per cent of pupils, 12 to 17-year-olds, were tested. Siblings are not being required to isolate where one has Covid. Public health no longer liaise where there is an outbreak and the fire doors and the windows are open in our classrooms as temperatures are dropping. However, the Scottish Government clinical director this morning talked about the risk of school closures. When will we see a return to the support that our teachers, staff, pupils and their parents need to keep our schools open safely? Well, to get to suspect, that's a gross mischaracterisation of the position. Over the period from much earlier this year to now, we have gradually eased up some of the measures in place to avoid the need for mass isolation of classes and for the closure of schools, which many members across the chamber raised concerns about because of the undeniable impact that that had on children's education. That is not the same as saying test, test and protect. It's not test and trace. It's test and protect, of course. It has disappeared from our schools. That is not the case. There has been continued targeted approaches to contact tracing and isolation in our schools. Given the new variant, of course, there is now enhanced contact tracing and isolation requirements, which will, as we are already seeing, unfortunately be likely to have an impact on classes and schools in different parts of the country. That proportionate targeted approach is scaling back when we can to reduce impact on education but scaling up again when necessary, as is the case now, is the one that we will continue to take. On testing, we can't force children or staff to test, but we strongly encourage, as we are doing the entire population right now, to test using LFDs regularly and repeatedly. Again, I would ask all members to help us to get that message across through their own communication in their constituencies. Christine Grahame, to be followed by Finlay Carson. Thank you, Presiding Officer. Further to the First Minister's answer to Pam Gaudzell, I can suggest that there are two big advantages in distributing through supermarkets and garden centres. It is so easy to pop something into your shopping trolley. It is almost casually done. Secondly, it will increase education, the importance of flow before you go. I said last week that we are going to, through local authorities, be making them available in shopping centres and garden centres. I am not arguing against that for a moment, but I will repeat what I said to Pam Gaudzell. In arguing or saying, and I agree entirely with that, we should extend the access to LFDs. Please let us not inadvertently send a message to the public that they are not easily accessible because they are. Let's say to people, get them now, don't wait for them becoming available in garden centres or shopping centres, they will do over the course of the festive period, but go into NHS inform now, get the test, use the test. It is possibly, next to vaccination, the most important thing that we can do to try to stem this transmission. Given the potential risk of further spreading the new variant, can the First Minister set out what contingency plans are in place to provide additional support to care homes to allow our elderly loved ones to safely see our friends and family over the Christmas period? We will keep the protections in place around care homes under very, very close review. What I would say now is that the most important protection for people in care homes is the vaccination programme, and that is why we have all, through the vaccination programme, prioritised care homes in the roll-out of the programme. However, to anyone, staff or visitor who is accessing a care home right now, it is even more important than it is for anyone else and it is vitally important for everybody to make sure that you are vaccinated and to make sure that you test yourself before you go. That makes sure that we minimise the risk of the virus getting into care homes, and that has always been important, but it is particularly important in the face of the Omicron variant. With around a third of Scotland's Omicron cases currently being reported in Lanarkshire, can the First Minister advise any additional interventions in place across Lanarkshire to mitigate against more rapid community transmission? The local health protection teams in Lanarkshire have been working hard through enhanced contact tracing, isolation and targeted testing to try to limit transmission. The same approaches will be used in other health board areas where we are seeing cases. I said earlier on that we now have cases in some health board areas. That may only be a single case at this stage, but we have confirmed cases in nine out of 14 health board areas. We are seeing transmission of the variant in pretty much all parts of the country, and it is important to be mindful of that. This is certainly the case with Lanarkshire, and it is something that we all have to be mindful of. The Government has to be mindful of as we consider the data and any implications of that in the days ahead. Many of the cases right now we know are associated with large events, so I know that, within the scientific community, there is a concern that the variant has a particular super-spreading risk associated with it. Again, if you are attending events, make sure that you test before you go. Even though it is not the law to physically distance anymore, just be mindful of the distance between people and other households. If we take sensible precautions right now, then we have a chance of stemming this and avoiding the more onerous precautions that might otherwise become necessary. First Minister, you said a moment ago that the importance of taking lateral photos, and we all agree with that. However, for those who have disabilities, it is becoming increasingly difficult to do that. At the cross-party group on disability today at lunchtime, a person who is visually impaired cannot see the result. Thus, he cannot go out, and his wife is also visually impaired. I am those who have upper limb disability cannot do the test. We cannot go to a pharmacy because they will not allow us to do it there. What advice do you give to those with disabilities who have been wanting to use the test but have nowhere to do it safely? That is a very fair and legitimate point. We need to consider a range of different ways because there will not be one particular measure. It is so serious a point that I want to ask the health secretary to consider that more to see if there are ways in which, as well as spreading the accessibility of LFDs, we can look at providing ways in which those tests for people with particular disabilities can be taken and processed. If Jeremy Balfour is willing to wait, we will look at that quickly over the next couple of days and come back to him with more detail afterwards. The First Minister will be aware that there are different arrangements in place in the island health board areas for booking booster and third vaccinations. In her statement last week and again this week, I do not think that she has necessarily drawn a distinction between the arrangements nationally and the arrangements for island health boards. I wonder if she could put on the record that distinction that those in the islands will wait for a letter about their vaccination rather than booking it through the portal, as those in mainland Scotland will do. No, again that is a very fair point. Perhaps two or three weeks ago I did draw that distinction. Liam McArthur is right to point out that I have not necessarily drawn it clearly enough in recent weeks. The island health boards are not using the online portal, so people living in islands should wait for the letter with the appointment for their booster vaccination. Not all parts of Highland are using the portal, but not all parts of Highland health board are using the portal. Again, there will be some people there who will get a letter, so it is a clear and important distinction to draw. If you live in the western isles on Orkney or Shetland, you do not book your booster online. Your health board will contact you with an appointment. Thank you. That concludes the First Minister's statement. Covid-19 update. There will be a very brief suspension.