 The next item of business is a statement by John Swinney on Covid-19 update. The Deputy First Minister will take questions at the end of his statement, and so there should be no interventions or interruptions. I call on John Swinney, Deputy First Minister. Presiding Officer, I will be providing the update to Parliament today on the latest Covid-19 situation on behalf of the First Minister. Given the update, I will provide an assessment of the current course of the pandemic and our on-going consideration of how to respond, an update on the pressures on the national health service looking ahead to the winter, a report on the progress that we are making to deliver the vaccination programme, an update on changes to international travel rules and an update on management of the risk of transmission at or around COP26. First, I will report on the most recent statistics. 2,233 positive cases were reported yesterday, and 12 per cent of all tests conducted were positive. 753 people are currently in hospital with Covid, 23 fewer than yesterday. 57 people are receiving intensive care, four more than yesterday. Sadly, a further 20 deaths have been reported over the past 24 hours. That takes the total number of deaths registered under this definition to 9,313. I would like to send my condolences to everyone who has lost a loved one during the pandemic. More positively, the vaccination programme continues to make good progress. I can confirm that 4,324,440 people have received a first dose, 3,918,528 have had both doses and 1,17,359 have received a booster vaccination or third primary vaccination. The vaccination programme is continuing at considerable pace. I am pleased to say that the United Kingdom Government's Covid data dashboard confirms that our booster programme continues to be the best-performing roll-out in the United Kingdom. Today is also a major milestone in that programme as we have reached 1 million Covid boosters and third doses, totaling 2 million doses of both Covid and flu vaccines. That is an amazing achievement, and I want to thank everyone who is involved in their extraordinary efforts. That further demonstrates that the booster programme is performing exceptionally well. In total, 88 per cent of the over-18 population is now fully vaccinated with two doses. That includes 99 per cent of over-50s, 88 per cent of those aged 40 to 49, 77 per cent of 30 to 39-year-olds and 68 per cent of 18 to 29-year-olds. In addition, 76 per cent of 16 and 17-year-olds and 55 per cent of 12 to 15-year-olds have had a first dose. For most people in these age groups, only a single dose is recommended at this stage. After the most recent peak in new cases at around the start of September, the spread of the virus has not reduced to anything like the low levels that we had seen following the lockdowns. At slightly over 2,500, the number of new cases each day is holding at a concerningly high level. The situation is precarious and unpredictable. If the previous pattern, characterised by waves of infection, is repeated, there is a risk that the spread of the virus could very quickly increase again during the coming weeks, perhaps over the Christmas period. We are starting from the current high level of infection in the community and the intense pressure that the NHS is already under as a result. Some scenarios for what may happen next are very concerning. We need to avoid the most dangerous of those scenarios. There are some specific reasons to suspect that case numbers may increase in the weeks ahead. With the onset of colder winter weather, increased time spent indoors means that there will be more opportunities for Covid to circulate. The top 26 has seen people from all over the world meeting in Glasgow, and that presents a known infection risk. Many of us will wish to spend time visiting loved ones over the festive period. However, we are not yet able to predict with confidence what will happen next. We certainly want to avoid the sort of strict lockdowns that we have seen before. Most of us were vaccinated. We do not want to repeat the sort of disruption to our daily lives, businesses and the economy that had been required at earlier stages in the pandemic. However, we need to take appropriate measures to keep the pandemic under control. It is because we want to avoid more difficult restrictions that we cannot rule out strengthening the baseline protective measures currently in place as the best way to head off any prospect of future lockdowns. Indeed, all Governments in the United Kingdom have said much the same—not least, for example, the United Kingdom Government's plan B. We have been considering, for example, whether we may need to extend the Covid certification scheme to bring more settings into scope, such as indoor hospitality and leisure settings. Among other possible interventions, we are exploring how we can help to improve ventilation, what we could do to increase home working and whether changes are needed to extend the use of face coverings. I would stress, though, that we have not yet taken any decisions about strengthening the existing baseline measures, and we will be discussing options with business sectors in the course of this week. As you would expect, the Scottish Government has been exploring all options for how it will respond to the evolving situation. We have been reviewing our strategic framework, which defines the Scottish Government's overall approach to responding to the pandemic. The next three-weekly review of the existing baseline measures will take place a week today. The First Minister, my Cabinet colleagues and I are, of course, watching the situation closely and stand ready to respond at the right time when the data indicates that it is necessary and proportionate. The challenges that we face and the continuing spread of the virus mean that now is certainly not the time to relax our approach. We all need to redouble our efforts to adhere to the protective measures in place and to follow the guidance. For that reason, I want to take this opportunity to reiterate the appeal that the First Minister, my Cabinet colleagues and others have been making to members of the public, to businesses, to transport providers and to organisations throughout Scotland. Please do get vaccinated, including booster jabs and flu vaccinations for those that are eligible. Please wear face coverings when required. Ventally, indoor spaces where possible. Wash hands and surfaces regularly. Use lateral flow device tests regularly. Book a PCR test if one of the lateral flow tests shows up as positive or if you have symptoms of Covid or if you are identified as a close contact of someone who is positive. Please continue to give contact details when visiting pubs and restaurants. Covid certificates should be shown if visiting a venue where this is required and, critically, please continue to work from home wherever possible. The Government knows that none of this is easy, but it is vital that those efforts continue. The entire health and care system remains under considerable pressure. For many months, our health and social care services have been dealing with levels of demand that are usually only experienced in winter. Across the country, hospitals are at or close to capacity. The social care system is also under pressure and reporting an increase in the number of people that require care packages. Indeed, the continued high number of cases of Covid-19 means that the pressure on our national health service is greater than at any time in its 73-year history. As of today, Covid-related hospital occupancy, the number of patients in hospital with Covid at any given time is 753 compared to 932 a week ago. Hospital admissions also remain high, although have decreased slightly. There were 585 people with Covid being admitted to hospital in the latest week compared to 687 in the first week in October. Admissions to ICU have also decreased slightly over the past month. NHS staff are dealing with significant numbers of Covid patients alongside other patient care. They are also preparing for and responding to wider winter pressures and dealing with the backlog of care built up in the earlier stages of the pandemic. As I have set out, there is a real risk that the pressure on the national health service could intensify further during the weeks and months ahead, including as we enter the winter flu season. The Scottish Government is working closely with health boards as they deal with those pressures. The Cabinet Secretary for Health and Social Care set out last week the measures that we are taking to support the NHS in preparing for and responding to the pressures now and the challenges that lie ahead. As we know, vaccination has proven to be one of our most effective public health interventions against this pandemic. The first phase of the programme delivered more than 8 million Covid vaccinations in 10 months. With Covid boosters, flu vaccines and jabs for new groups, we now need to deliver roughly the same number of vaccines again—7.5 million—by early next year. The vaccination programme is continuing at considerable pace. We have now administered in total more than 1 million boosters and third doses. We are nonetheless continuing to explore how we might increase capacity further, for example by establishing additional clinics, particularly at evenings and weekends. We are confident that the programme remains on track. We are now sending letters to those aged 60 to 69 and those with underlying health conditions, inviting them to appointments at local community clinics, which will run throughout November. We will then, from mid-November, launch the online self-booking portal for adults aged 50 and over, those aged over 16 who are unpaid carers and household contacts of immunosuppressed individuals with the aim of offering vaccines to everyone over 50 by early next year. That has been a huge job for the national health service. I would like once again to offer my thanks to the national health service staff for working tirelessly to keep us safe. I also take this opportunity to reiterate our thanks to the armed forces for agreeing to support our vaccination effort by complementing our existing workforce. We have asked the people of Scotland to help us to deliver the vaccination programme by coming to appointments where possible and rescheduling where necessary. By being vaccinated and having a booster vaccination, we can protect each other and help the national health service through what will be another exceptionally busy winter period. Turning now to the question of international travel, colleagues will be aware that the United Kingdom Government announced a change to international travel rules for England, recognising a wider range of vaccines. The Scottish Government will also make this change to regulations for arrivals here. With effect from Monday 22 November, we will recognise vaccines on the World Health Organization emergency use list, as well as those approved in the United Kingdom by the MHRA. Those individual vaccines are Sinofarm and Sinovac, manufactured in China, and Covaxin, manufactured in India. Travellers who have been vaccinated with these products will be eligible for quarantine-free travel if they have a certificate of vaccination status from a country that is listed in our regulations but meets the data and security standards that are required at the United Kingdom border. There are now more than 130 countries in which we recognise vaccine certificates, although China is not yet on that list. There is a process of engagement led by the Foreign Office to work with international partners so that we bring more countries in scope as soon as possible, where we are satisfied that it is safe and secure to do so. Further announcements on this matter will be made on a four-nations basis. In addition, we will also simplify rules for children under 18 years of age. All children will now follow the rules for eligible vaccinated travellers, whether they are yet fully vaccinated. That means a test on day 2 after arrival, but no isolation and no test before departure or on day 8. The final update that I want to give today relates to the COP26 summit in Glasgow. The summit is one of the most important gatherings of the century so far. The Scottish Government has been doing everything that we can to help to make it a success. The Scottish Government has been working very closely with the United Kingdom Government and partners in Scotland, including Glasgow City Council, Transport Scotland, NHS Scotland and Police Scotland, to ensure that the summit is delivered safely. Covid-19 has presented significant challenges to staging this unique event. The scale and worldwide draw of COP26 poses risk of spread of Covid-19 both within delegates and to or from the local population of Scotland and the United Kingdom. A comprehensive and exceptional package of mitigation measures has been in place to ensure that the event is delivered safely, helping to protect the welfare of everyone involved and the wider community. In addition to vaccination, measures include a robust testing regime, contact tracing, hygiene measures and ventilation. Of course, while public health measures can mitigate the spread of Covid-19 to an extent, there remains a risk that Covid-26 could increase the spread of the virus. That is why Covid-19 continues to be closely monitored by all relevant agencies and why the Scottish Government is closely involved in operational decisions during the event. As of 5 November, the cumulative test positivity results for blue zone pass holders, based on lateral flow tests, were around 0.1 per cent. However, we are only just past the midpoint of the conference and we continue to monitor the situation carefully. We will provide a further update following the conclusion of COP unless there is a need to do so at an earlier opportunity. The successful roll-out of the vaccination programme has been enabling us to live with far fewer restrictions and mitigations in place than were necessary a few short months ago. Case numbers remain high and, looking ahead to the winter months, there is a real risk that they may increase again. Hundreds of people each week are still being admitted to hospital with Covid and our national health service is under intense pressure. Covid remains a threat. We all need to play our part in keeping the virus under control. For that reason, I make no apologies for repeating again the three things that we can all do to help to protect each other. Firstly, please get vaccinated if eligible and have not yet done so. That includes going for a booster jab. It is never too late to get vaccinated and it remains the single most important thing that any of us can do to protect ourselves and the people around us. Secondly, please take regular LFD tests. Those can be ordered through the NHS informed website or collected from a local test site or pharmacy. If individual tests are positive or identified as a close contact or have symptoms of the virus, they should self-isolate and book a PCR test. Thirdly, please comply with the mitigations still in place. Work from home when possible, where face coverings in indoor public places such as shops, public transport and when moving about in hospitality settings, wash hands and surfaces thoroughly, meet outdoors if you can. I know that that will be increasingly difficult as we get deeper into winter but outdoor environments are safer. When meeting indoors, please open windows anything to improve ventilation will help and try where possible to keep a safe distance from people in other households. Those precautions make a crucial difference. They will protect individuals and the people around us all and help to ease the burden on the national health service. I express once again the thanks of the Scottish Government to everyone in Scotland for what they are doing to help to protect each other and I encourage people to continue to take the steps that are necessary to ensure that we all remain safe. The Deputy First Minister will now take questions on the issues raised in his statement. I intend to allow around 40 minutes for questions, after which we will move on to the next item of business. I would be grateful if members who wish to ask a question were to press their request to speak buttons now and I call Douglas Ross. Thank you very much. It is very welcome that we have reached a new milestone in terms of the Covid booster jag and I would encourage everyone who is able to do so to take that up as soon as possible. The vaccine has been immensely successful and it should be our main weapon against the virus. Considering reintroducing restrictions at this stage in the pandemic when we have a vaccine that 4.3 million Scots have received is the wrong approach. Today John Swinney says that the Government is considering the need to extend the Covid vaccine passport scheme to more premises. The same John Swinney, who just last week said that there was no evidence that Covid passports had reduced the spread of the virus. If he does not know if it is working, why is he looking to expand it? How can the Government take those plans forward when they know that the damage that the scheme is already doing to Scottish businesses and the impact that it is having on people's jobs? He says that he is considering to expand the scope of the scheme to include further indoor hospitality and leisure settings. Exactly which venues will be impacted by this change because the statement as it currently is only brings more uncertainty and certainty for businesses at an extremely difficult time. They need to know if they are on the cusp of being hit with added costs and extra hassle. Finally, the Deputy First Minister says that the Government is considering extending the use of face masks. Does that mean keeping them in classrooms throughout winter, knowing the disruption that they cause in our schools? When the Government's own advisory subgroup in education said over a month ago that the time was right to end their use? I thank Mr Ross for his welcome of the progress on the booster vaccination programme, because I think that it is important that today we acknowledge the very significant landmark that has been achieved by the staff both in the national health service and the armed forces who have been delivered and the volunteers who have delivered such an exceptional and at pace programme given the volume of vaccination between the flu and the booster programme that it is an enormous physical undertaking. I very much appreciate Mr Ross's comments in that respect. In relation to the vaccine certification programme, the Government throughout the whole handling of the pandemic has been open with the public, open about what we feel necessary to consider. What I would say to Mr Ross and I recounted this to the Covid Recovery Committee last Thursday, we are at a pivotal moment in the pandemic. We are about to approach winter. We have cases that are sitting at what I think would have to be described at an uncomfortably and consistently high level of on average around about two and a half thousand cases per day. That is much, much higher than when we came out of the lockdown restrictions before and we are still seeing admissions to hospital in excess of 500 in the last seven days. We face significant threats and dangers, so the Government has to be open with the public about the fact that we may have to take other decisions. I stress the word that we may have to take other decisions should the situation be more challenging. Mr Ross will know that the Government has to satisfy itself that any measures that it takes are proportionate, that they can be justified as proportionate in law as to the restrictions that they may place against individuals or against businesses. The Government is satisfied that what we have done so far to date has been the case and any further judgment would have to pass that test as well. Lastly, on the question of vaccine certification, the point that I made last week to the committee was that I cannot establish a direct connection between one individual measure and the levels of the virus. We have never been able to do that and we are very candid about that. What the Government has to be satisfied about is that we have adequate protections in place to safeguard the public alongside the rise in the number of vaccinations that have taken place and the levels of hospitalisation and the levels of cases. That is the framework that we consider and we will take decisions accordingly. Lastly, on the question of face coverings, the Government has judged on the input of the chief medical officer that it was appropriate to maintain face coverings in schools for some pupils and for some staff. Obviously, that is a judgment that will be subject to review and the Government will consider those issues when we undertake the three-weekly review and report to Parliament accordingly. I begin by expressing my condolences to all those who have lost a loved one to the virus and to pay tribute to all those who are especially in the health service who are on the front line of battling the pandemic. It will be of significant concern to all those running hospitality businesses what the Deputy First Minister stated in terms of the prospect of rolling out the vaccine passport to yet more context, especially given the broad and nonspecific nature of his statement. Can he take this opportunity to clarify the following things? First of all, what process and timeline will the Government be adhering to in terms of examining the roll-out of the passports? Will they publish further evidence regarding transmissions specifically within those settings? Will they also confirm whether a negative test will be taken in lieu of a vaccine passport? Finally, in terms of the specifics around enforcement—there is a particular point raised with me by the hospitality industry just last week—we were pointing out that, while nightclubs have doorstaff and have a natural point to check those things, cafes do not tend to have doorstaff and therefore the practicalities of checking passports in those contexts are hugely more challenging. I also just ask about the booster programme. We share the welcome in the landmark that we have reached with that, but the progress of that continues to be variable. In my own area, people are waiting two to three hours to receive their boosters. Accessibility in relation to the location of those sites is still problematic. The promise of combined flu and booster jams at the same time simply is not a reality. Indeed, we see very variable roll-out rates across health board areas, so what steps will the Government take to step in and support health boards who are struggling to roll out the booster vaccines for whatever reason there may be? In response to the points that Mr Johnson has raised, the Government's stress and the remarks that I have made to Parliament today are about the Government being open with the public about what we are considering. Mr Johnson will know that there is a three-week review that we will undertake next week, and those issues will be part of the consideration. At this stage, I cannot say to Parliament whether the discussions will be concluded by then, because fundamentally the judgment as to whether or not the Covid certification scheme needs to extend any further has to be driven by the evidence of the pandemic. What is the prevalence of the level of the virus in the community? What is the level of pressure on the national health service? What is the level of vaccination that is under way? The Government has to make a proportionate judgment about those questions. He asked me specifically about the question about whether a negative LFD test would be a possible alternative to that, and I confirm that the Government is considering that very question as part of those deliberations. In relation to the question of enforcement by proprietors and operators of any hospitality venues, there is a requirement for contact tracing data to be retained by many of those venues, and we encourage people to participate in that. Obviously, there are opportunities for such exchanges between operators of venues to be able to undertake that discussion to satisfy themselves at that point. Lastly, in relation to the booster programme, I have heard and aware of points that have been raised about the accessibility of certain venues for individuals and the waiting times that have been involved. The health secretary has been discussing those issues with individual health boards. Obviously, there is a huge volume of activity being undertaken, as a consequence there may well at times be congestion at individual facilities if that is the case. However, I give Mr Johnson the assurance that the health secretary and officials are in active dialogue on an on-going basis with health boards to offer support where it is necessary to do so and to enable health boards to be able to deliver the joint vaccination programmes between the flu and the booster jags to make sure that the inconvenience to members of the public is kept to an absolute minimum as they participate in this important programme. Alex Cole-Hamilton Thank you very much, Presiding Officer. Taken in the context of remarks from the Royal College of Nurses to a parliamentary committee this morning about workforce pressures, the crisis affecting our NHS is really scary. We have already seen that the waiting times crisis has proved fatal. However, the last thing that this Government should do is rush towards and embrace solutions that are ineffective. The Deputy First Minister has answered questions to Douglas Ross and Daniel Johnson, citing evidence and that he will follow the evidence, but research published by the Lancet last week has shown that, although vaccines are excellent at preventing harm, they are ineffective at preventing transmission. Liberal Democrats warn that when vaccine certification came in, it would be the steady creep into other aspects of our lives. This statement is the start of that creep. The Deputy First Minister has dangled the threat to the festive period as possible justification for their future roll-out. However, clinicians are showing him evidence that there is no evidence base for their use. Will he rule them out today, as he will not save Christmas? I do not see how Mr Cole-Hamilton can possibly expect me to give a positive response to his question with what I have put on the record in my parliamentary statement. Mr Cole-Hamilton's question has a fundamental contradiction at the heart of it. Mr Cole-Hamilton marshalled the dangers that face the national health service over the course of the next few months. I could not have said it better myself. It was an accurate reflection of the challenges that are faced. We have then got to make sure that we have sufficient protection in place to ensure that we reduce any impact on the national health service. What we know is that people who are double vaccinated have less worse symptoms than if people are not vaccinated. As a consequence, that naturally answers Mr Cole-Hamilton's question. If people are double vaccinated, therefore having a Covid certificate as a consequence, they are likely to be exposed to less danger and we will be able to sustain more aspects of our social and economic activity. It all follows. The only problem is that Mr Cole-Hamilton is missing a fundamental step of logic in the question that he puts to me. Deputy First Minister, can I have a moment, please? We have an on-going dialogue across the chamber and I am trying to understand what is being said, so I would be grateful if colleagues could be quiet when the Deputy First Minister is responding. My simple point to Mr Cole-Hamilton is that there are a number of steps that we can take to try to avert the enormous pressure that he foresees in the national health service in the winter, which I agree with. The Government is trying to take the necessary and proportionate steps to make sure that we can do that. John Mason, to be followed by Rachel Hamilton. Thank you very much. I very much welcome the indication in the statement that COP is not having so far at least a negative effect on Covid. Last night, I certainly attended an event where we had to show our certificate, we had to wear masks and it all went perfectly well. Has the Deputy First Minister any further advice to give to those attending COP? The one appeal that I would make is that for people to apply and to follow the guidance and the restrictions that we have in place, I do not think that they are in any way an obstacle to individuals successfully participating in COP. The type of routine measures that Mr Mason talked about that he experienced last night are the types of measures that we would like to see in place across the board. That minimises the risk of transmission and maximises the chances of protecting the public. That is exactly what we have focused on in the preparation for COP, which is being maintained. We are working hard with Glasgow City Council, the United Kingdom Government and NHS Greater Glasgow and Clyde to ensure that we are managing any implications that arise. Rachel Hamilton, to be followed by Christine Grahame. The NHS and social care sector are under unimaginable pressure, and I would like to thank them for what they do. In 2014, the then health secretary, Shona Robison, said that she would urgently prioritise and eradicate bed blocking in hospitals. Six years on, hospital beds are filled with 1,615 medically fit people with no place to go. Deputy First Minister, put yourself in their shoes or the shoes of their families and tell us please what this Government will do in terms of the specific measures in place to resolve the indignity of bed blocking for thousands of vulnerable and elderly people across Scotland? I acknowledge that this is a serious issue, and that is why the Government has put in place measures in dialogue with our partners in local government to make sure that individuals can be safely released from hospital settings and into appropriate settings, whether that is in their own home or in some other form of care facility. One of the points that are at the heart of the issue is about the availability of staff in the social care sector. The issue has been the subject of extensive dialogue with our local authority partners and with third sector providers. One of the issues that we face, I am afraid, is as a consequence of Brexit and the loss of free movement of citizens. Rachel Hamilton may fein exasperation, and Mr Kerr may shout out at me, and Ms Webber may shake her head. However, the reality is that evidence is staring the Conservatives in the face that we are suffering because we have lost the access to population that was providing a vital support to our social care sector. One of the measures that we are doing is improving the remuneration for social care workers. That was part of what the health secretary announced some weeks ago. We are working with our local authority partners to make sure that we have the maximum amount of arrangements in place to support the transition of individuals from hospitals to the community. We are supporting local authorities with the resources to enable them to do that. However, one of the consistent points of feedback from local authorities is the difficulties in recruiting staff to enable them to deliver those services. We will support them in those efforts, but we have to have an honest understanding of what the problems have happened to me. Christine Grahame, to be followed by Paul O'Kane. Thank you, Presiding Officer. The Deputy First Minister on boosters, and I appreciate those exceptions, but several elderly constituents, some in the catchment of NHS, Lothian, some in NHS Borders, were unable to get through the helpline. Those who did were told the earliest date for their booster would be late December, and even a one-coupling penny crook in their 80s were told by the helpline January 1, 2022. Can that be right when younger age groups are being offered boosters and even booking online? I am concerned by that information from Christine Grahame, because, certainly for people in the over-70s groupings, the vaccination programme should be completed for them well before December, or well before the end of the year in December. If Christine Grahame would like to share specific information with the health secretary about those issues, we will explore that. Certainly, the booster programme should be delivered at an earlier stage to that age group. We are beginning, as I said in my statement, to issue letters to those in the 60 to 69 age groups, so the older categories should be satisfactorily resolved by then. If Christine Grahame would like to write to the health secretary, that would be appreciated. Paul O'Kane, to be followed by Willie Coffey. Thank you, Presiding Officer. Can I associate myself with thanks to all our vaccination staff as we acknowledge the vaccination milestone? The Deputy First Minister referred in his statement to concerns about winter flu and the pressures of the flu season. A roll-out of the flu vaccine must be faster if we are to ensure that vulnerable Scots are not left unprotected this winter. In common with colleagues across the chamber, I have heard issues about people who have respiratory issues not being called for their flu vaccine, people in the same household, being unable to travel together when they provide one another transport and, indeed, nursery staff in my region were told that they will not be vaccinated for flu in school, along with the teaching staff, as they work in a separate area of the school campus. Indeed, they were told to make their own arrangements. Given the urgency with flu season approaching, can he tell me what percentage of people who are eligible will have received a flu jab by Christmas and will he provide a firm date by which he expects the most vulnerable to be protected from flu before the onset of midwinter? Deputy First Minister, I recognise the importance of the points that Mr Rocain raises, but I think that he would also, I am sure, appreciate that, in a programme of the scale and complexity taking account of all the circumstances and scenarios that he put to me, which I think are reasonable points, is difficult in a programme of that complexity and magnitude. That is why the online portal system that we are putting in place for younger age groups is designed to give people a bit of flexibility to be able to address some of the practical circumstances that he said. Mr Rocain asked me for some data. The flu vaccine programme has so far administered over 1.4 million doses to date, so it is making very good progress. Since the start of the flu vaccination programme, taking flu and the third dose and booster programme together, we have surpassed 2.5 million doses on those programmes in a relatively short space in time. I hope that it gives Parliament some confidence, because if we have 7.5 million doses to do by the spring, 2.5 million, since about the start of September, is a pretty substantial effort to get to where we have got to. I assure him that we are trying to be as flexible as possible, but critical importance is ensuring that we cover the volume of vaccinations that are required. I think that Parliament should be encouraged by the progress that has been made to date. Willie Coffey to be followed by Donald Cameron. Thank you. I ask the Deputy First Minister if he is aware that many young adults who were recently turned 18 and are now eligible for their double vaccination are losing out financially because they have purchased expensive tickets for concerts and other events, but cannot now use them because of the timing of their vaccinations and the requirement for certification. Is this something that the Government might look at if we can persuade events management organisers to agree refunds for those young people who, as we know, have already borne the brunt of many of the restrictions during the pandemic? I think that some of the scenario that Mr Coffey puts to me can be addressed by the fact that we did invite young people who were 17 to come forward for vaccination before their 18th birthdays, and that would have preceded the introduction of the certification scheme. I am very happy to explore in further detail some of the issues that Mr Coffey raises and to identify if there are practical steps that we can take to try to address the situation. Nobody wants to see anybody disadvantaged, but we are trying to maximise the protection that is in place for the wider population by ensuring that individuals are double vaccinated. If Mr Coffey wishes to write to me in further details about the scenario, I will happily consider that. Donald Cameron, to be followed by Stephanie Callaghan. As Douglas Ross has already said, last month, the Scottish Government was advised by its own expert education advisory group, chaired by Professor Linda Bald, that the rules on face coverings in schools should be relaxed due to their impact on the wellbeing of young people. Why was that advice rejected, and will ministers now consider removing the blanket requirement for pupils and teachers to wear face coverings, given that that is plainly a disproportionate and damaging measure? The issue that Mr Cameron raises with me is one that the Government has considered very carefully, because the advice that was given to ministers came at a moment when the situation around the pandemic was deteriorating. We took further medical advice from the chief medical officer, which suggested that ministers concluded that it was better to operate on a more cautious approach, given the fact that the wider course of the pandemic was deteriorating. Part of the argument that I have tried to maintain throughout this whole discussion with Parliament has been that we must take a balanced set of judgments looking at the overall course of the pandemic. Much though we may not like particular components of the steps that we have got to take place, we have got to take a range of measures that avoid us doing other more dramatic interventions to try to stem the circulation of the virus. I explain to Mr Cameron that the Government is looking at that evidence in the round, making a judgment if we believe that there are opportunities for us to relax those restrictions. We will take those opportunities, but we must also be mindful of the likely course of the pandemic, given what I have put on the record today about the onset of winter, the possible impact of COP, the fact that people will be able to spend less time out of doors than indoors. There is a complex picture that has to be wrestled with, because nobody wants to find themselves in a situation where our national health service is overwhelmed at any stage in the future. That is the situation that we have been consistently trying to avoid. What I have marshaled in front of Parliament today and what I have shared with members on a regular basis is the volume of pressure that the national health service is experiencing, and nobody wants to see the national health service overwhelmed. Stephanie Callaghan, to be followed by Gillian Mackay. Thank you. My question is around ensuring fair access to events and travel. Deputy First Minister, can you confirm what arrangements are in place for people who cannot currently take Covid vaccines due to a confirmed or suspected allergic reaction to obtain a medical exemption letter from the vaccine certification scheme? Obviously, vaccination is demonstrably of benefit to the overwhelming majority of the population based on the evidence that has been gathered, but there will be individual cases where the vaccination does not operate compatibly with some individuals. Local vaccination centres can help to answer questions about the vaccine and to advise what arrangements can be put in place to enable safe vaccination. In the rare cases that I am talking about where an individual cannot be vaccinated, an individual will be identified as either able to safely receive the vaccine but decides not to do so or as clinically unable to safely receive the vaccine, in which cases they will receive a secure paper exemption certificate by post, which will provide them with the ability to access venues on the clear understanding that there is an appropriate justification for them not to be double vaccinated. Gillian Mackay, to be followed by Claire Adamson. Thank you, Presiding Officer. I am concerned about vaccination of people who may have changed priority groups since the vaccination roll-out started. For example, if someone was classed as clinically extremely vulnerable or at risk but is now no longer considered to be so, they will have received their initial doses earlier than others but may not qualify for a booster due to their change in status. The same can be said of others such as those who were unpaid carers but whose circumstances may have changed due to the death of those who they were caring for. Can the Deputy First Minister advise those who may have changed category of when they should get their vaccine booster? It is difficult for me to give a specific answer to the general proposition, the general but legitimate proposition that Gillian Mackay puts to me. The best advice that I can give is for individuals should they find themselves in that circumstance is to contact the helpline to secure advice or to secure alternative clinical advice, which will enable us to make a judgment about what is the best course of action individual by individual. Even on the scenarios that Gillian Mackay put to me, it could be that those circumstances might have accelerated someone's access to the programme or, in fact, might have delayed their access. An individual assessment of those circumstances through engagement with the helpline would be the best way forward and potentially the pursuit of other clinical advice. Can I thank the Deputy First Minister for his statement and his ambition that we return to social and economic equity as quickly and safely as possible? Last week, following the Chancellor's budget statement, OBR officials said that, being predicted, that real household disposable incomes will not reach pre-pandemic levels until the end of 2023. Was the Deputy First Minister agree that the Chancellor needs to U-turn on his spending of plans, including the cut to universal credit uplift, as those plans will leave millions of people wash off across the UK? At the heart of the Government's Covid recovery strategy is the determination to ensure that we do all that we can to eradicate child poverty, to address the inequalities that existed pre-pandemic, which have been exacerbated by the pandemic. The point that Clare Adamson put to me is an important point about how we deliver recovery from Covid for the population. I made clear to Parliament in my statement on 5 October that the tackling of inequality that has worsened under Covid would be at the centre of the Government's Covid recovery strategy, and the suggestions that Clare Adamson has made of the Chancellor maintaining the uplift to universal credit would assist us in our efforts to reduce child poverty and to support families that are experiencing the difficulties that come with living on low incomes. I, too, like others, would like to put on record my thanks and congratulations to all those involved in the vaccine programme, including the booster vaccine, in terms of the milestones that we have reached to date. I wrote to the health secretary in September highlighting several concerns around the current crisis in our NHS and ambulance services. This week, I received a reply from the chief operating officer of NHS Scotland, in which he explained that additional assistance, including but not limited to, over 100 millilitre personnel, around 100 second-year paramedic students, the Scottish Fire and Rescue Service and the British Red Cross and private transport companies, has been brought in to support the hard-working health service staff. To any reasonable onlooker, that is indeed a crisis, yet the letter and the Government still say that the NHS is not overwhelmed. Presiding Officer, Deputy First Minister, I'm really worried about the NHS, I'm really worried about the staff who are working in it and I'm really worried about my constituents and people across Scotland who need it to be delivering. I have countless stories of people having their surgery cancelled and unacceptable delays in waiting for ambulances. The current situation is letting those people who rely on the service down and working within it who have gone above and beyond throughout the pandemic. If that is not a situation where the NHS is overwhelmed and in crisis, what would the Deputy First Minister say it is and when can people expect to have a functioning health service again? The detail that Pam Duncan-Glancy puts on the record in a sense reinforces the fundamental argument that I have been making with Parliament this afternoon, that the national health service is under extraordinary pressure. I don't think that it is overwhelmed, but it is under extraordinary pressure. The fine balance that the Government is trying to strike is about enabling as much of our economy and our society to function without interruption, without restriction at this moment, although not allowing so much of that to happen that the national health service does in fact become overwhelmed. Pam Duncan-Glancy is absolutely right. If the national health service becomes overwhelmed, that helps nobody. When I am under pressure to relax the restrictions that we have in place, and I have been under pressure this afternoon to relax some of the restrictions that we have in place, I simply say to members of Parliament that there is a fine balance to be struck because the points that Pam Duncan-Glancy puts to me are completely legitimate worries about the prospects of the national health service, so we have to take certain precautions and apply certain restrictions to make sure that we avoid the scenario that she paints to Parliament today. Stuart McMillan, to be followed by Jim Fairlie. Thank you very much. With Covid still severely affecting our NHS, can the Deputy First Minister outline what additional funding is going to NHS Greater Glasgow and Clyde to help ease pressures over the winter months, as my constituents and myself are keen to see the full rein statement of the GP out of our service in my constituency, which will afford local people the local service instead of having to travel to Paisley or Glasgow? The National Health Service Greater Glasgow and Clyde has already received an additional funding of more than £130 million so far this year to support Covid-related costs, and it will continue to receive all the necessary support throughout this pandemic. There will also be further support for NHS Greater Glasgow and Clyde coming from the £300 million fund for winter funding pressures that were announced by the health and social care secretary some weeks ago, and that will obviously be the subject of discussion with the health board in question and for deployment in due course. Jim Fairlie, to be followed by Jeremy Balfour. Thank you, Presiding Officer. Given the genuine concern that has been shown by Mr Ross and Mr Johnson in their questions today, I am sure that they will be welcoming of my question. Major employers in my constituency such as Persia, South England and Russia, Simon, Howie Butcher's, Glen Eagle's hotel and Creeff Hydro have all been in contact to express their concern at the major shortages of staff that they are all suffering from. I have written to the Home Secretary to demand that she take immediate and urgent action to alleviate this problem. However, what more can the Scottish Government do to help these businesses under the current devolved settlement and should this Parliament not be ascertaining the powers to be able to manage our own immigration policy? Deputy First Minister. Many of the issues that Mr Fairlie raises are connected to the points that I discussed with Rachael Hamilton a moment ago. We are facing acute challenges in the availability of skills in a number of different sectors. It is not just health and social care, it is in hospitality, it is in transportation, it is in distribution, it is in some aspects of the rural economy that Mr Fairlie is familiar with and the hospitality sector. The Scottish Government is taking measures to ensure that we support individuals who have perhaps lost employment in one sector to gain access to employment in other sectors, and that is through the retraining offer that we have in place. We have measures such as the young persons guarantee, which are designed to make sure that young people have access to employment, training or to a college place when they require so. We also have measures such as the national transition training fund, which are designed to support individuals to make that transition from one sector to another. Lastly, we are also working with partners to try to ensure that those who are economically inactive are given every support possible to enable them to access the labour market where they may be able to make a contribution to the skills requirements that we have in the economy at this time. Jeremy Balfour, to be followed by Emma Roddick. Presiding Officer, me and my family last Tuesday went to see Beauty and the Beast with thousands of other people at the playhouse. Unfortunately, in a few weeks' time, parents, or for maybe 100, will not be able to go and watch their children perform in a Christmas show. Will the Government urgently bring forward guidance to allow nurseries and primary schools to have in-person concerts? Or what is the difference between that and going to thousands of people going to a playhouse? That relates back to the point that I have just discussed with Pam Duncan-Glancy about the measures that we often have to take that we would rather not take but have to take to try to protect the wider bulk of the population. The point that Mr Balfour raises with me involves a vast number of individuals entering into school premises when we have worked very hard to keep the environment as focused as possible on the delivery of learning. That is the right thing for schools to do to make sure that young people are able to have uninterrupted access to their learning. The issues that Mr Balfour raises are the subject of local dialogue and discussion. I am sure that they will continue to be and the Government will make sure that those issues are properly aired in the education recovery group to address the concerns that have been raised today. Emma Roddick, to be followed by Jamie Halcro Johnston. What is the Deputy First Minister doing to encourage transport providers to reinforce measures aimed at reducing the spread of Covid-19, particularly where services originate in other countries that may have different guidance? A lot of effort has been put in by officials and also reinforced by ministers to discuss with individual transport providers the importance of the regulations in Scotland being properly applied within all transport settings. That has been the subject of a great deal of dialogue with transport providers. It is involved direct discussion with ministers. Having been on some of the public transport in Scotland in recent weeks, I have heard announcements that have been made. I happened to walk through Queen Street Station in Glasgow on Sunday and there was very high adherence to wearing face coverings in Queen Street Station on Sunday. I think that Emma Roddick's point is absolutely valid and essential that such an approach is taken. I assure her that ministers and officials are doing all that they can to make sure that that message is heard by transport providers. Jamie Halcro Johnston, to be followed by Liam McArthur. I have been speaking in the last few days with a nurse whose workload is now focused away from their normal duties and solely on providing flu vaccinations and Covid boosters. That is obviously extremely important work, as we have heard today. It takes members of staff away from other vital areas of our NHS and risks putting additional pressure on our already under-pressure nursing staff. How many existing NHS staff have been diverted to providing vaccinations and boosterjags as their primary role? Given that Scotland already has a shortage of 3,400 nurses, can he also advise what efforts have been made to recruit vaccinators from other sources outside of existing NHS staff? At the start of question time today, Mr Ross gave a very warm welcome to the steps that have been taken to deliver the vaccination programme, and I thought that his comments were absolutely appropriate and valid. Mr Halcro Johnston invites me now to... Mr Halcro Johnston essentially is complaining about the fact. He is complaining about that because to enable us to deliver the great performance that Mr Ross has complimented, we have to use some national health service staff to enable that to be the case. I do not know what discussion is going on between Mr Graham and Mr Ross, but it is something to do with the thing which... I am trying to be helpful here. Mr Ross has welcomed the vaccine programme roll-out. How do we manage that? We manage that by making sure that it is the priority to give the maximum protection to the population. We give the maximum protection to the population, and Mr Halcro Johnston comes along and moans about it. That just says it all about the Conservatives. Employment in the national health service is at a record level. We have never had more nurses working in the national health service than we have today. Deputy First Minister, I wish to ensure that each and every member in the chamber can hear what is being said. That is absolutely impossible given the current on-going interruptions, so I would appreciate it if members could please ensure that everyone can hear what is being said. Thank you. NHS staffing in Scotland is at a record high level and is increased by over 25,000 under this Government. We have got most staff working in the national health service. According to Mr Ross, we have a successful and effective vaccination programme. I would hope that that might give Mr Halcro Johnston some reassurance that the Scottish Government is doing everything it can to roll out the vaccination programme as quickly and as significantly as we possibly can do. Of course, the evidence demonstrates that that is the case. I call Liam McArthur to be followed by Stephen Kerr. Thank you, Presiding Officer. The Deputy First Minister, confirmed that Scotland now recognises vaccine certificates from 130 countries, but I am still being contacted by constituents. We have had one vaccine in Scotland but received another in either England or Wales and remain unable to get valid certificates. Can the Deputy First Minister therefore update Parliament on when those on-going issues will be resolved and, in the meantime, will he undertake to ensure that any such cases raised with the Government will be dealt with so that individuals are not being left going from pillar to post? I am aware that many of those cases are being resolved. In a programme that involves around about 10 million vaccinations, there are undoubtedly, I think, we all accept, going to be challenges of absolute accuracy in all circumstances. I can assure Mr McArthur that those issues are being resolved, where there is a need to take further steps. If members wish to contact ministers, we will do all that we can to resolve them as quickly as possible to ensure that individuals are not in any way disadvantaged by a lack of access to the Covid certificate. Thank you, Presiding Officer. Last week, the United Kingdom became the first country in the world to licence an antiviral in the form of a pill, which clinical trials have found cuts the risk of hospitalisation or death by 50 per cent. That is a game changer for the most vulnerable people. Have the Scottish ministers acted to secure a supply of the new treatment? When will vulnerable Scottish patients get the benefit of it? How will the use of this new treatment be prioritised? Obviously, those issues are part of the discussions on a four-nations basis, as have all aspects of the vaccination programme that we have undertaken. They will also be the subject of clinical advice and clinical interventions. The health secretary will be happy to update Parliament on the steps that are taken in relation to the matter as a consequence of the discussions that are taking place on a four-nations basis. That concludes Ministerial Statement Covid-19 update by a very brief suspension.