 Good morning, and welcome to the sixth meeting of the Covid-19 recovery committee in 2021. We are joined this morning by Alex Cole-Hamilton, who is not a member of the committee, but is attending due to an interest in the proceedings. I welcome Alex to the meeting and invite you to declare any interests relevant to the committee. Thank you, convener. I have no relevant interests. Murdo Fraser and Alex Rowley are running slightly late and will be joining us shortly. The first agenda item this morning is a decision to take item 4 on the consideration of evidence heard in private. Our members of the committee agreed. Thank you. We agreed to take agenda item number 4 in private. Moving on to agenda item number 2, this morning we are taking evidence from a panel of stakeholders on vaccination certification. I would like to welcome to the meeting Professor Christopher Dye, FRS, Professor of Epidemiology, University of Oxford, Professor Stephen Riker, Bishop Wardlaw, Professor of Social Psychology, University of St Andrews, and Professor John Drury, Professor of Social Psychology, University of Sussex. I thought it might be helpful to start by giving a brief recap on the vaccination certification scheme. The Scottish Government announced its intention to introduce a vaccination certification scheme on 1 September. The Scottish Government's intention is for the scheme to be in place by tomorrow. The committee intends to listen to the views and to feed them back to the Scottish ministers directly in our regular evidence sessions with them. Any issues that you raise today will also inform our scrutiny of any relevant legislation that is brought forward to give effect to the scheme. As such, your input is very valuable to this committee and we are pleased to hear from you to receive your written evidence. I wonder if I could please start by asking the witnesses what are your key priorities that you think should be embedded within the proposed scheme to make this work. Can I start with Professor Dye? Good morning everybody. I hope you can hear me and possibly see me as well. I am attending this session because of the work that we did at the Royal Society some months ago now. The purpose of that was to lay out what we felt ourselves and through consultation were the main criteria for using vaccination passports and I circulated in advance of this meeting the report that we produced. We came up with 12 quite criteria in detail, but they really fall into three main categories. First is, are vaccines technically good enough, that is, are they protective enough, do they do medically, clinically what we want them to do to warrant certification? I think that it is clear that the answer to that question is yes. That was the first area. The second was, is it possible, practically, through means of software and hardware, to set up a system that would, for example, guard people's privacy in a way that has concerned many? There are many debates around this and perhaps we will have some of them in this session, but broadly my answer to that question would be yes, it is possible to do that. The third area is perhaps still the most contentious of all and that is the issue of whether Covid passes or Covid vaccination certificates can be set up in a way that is fair. A certification scheme is intrinsically discriminatory and exclusive, that is the very nature of it, but can we set up a system that is broadly regarded as being fair? In other words, a system that really does what we wanted to do. It does the job of giving peace of mind to individuals who are attending collective events, let's say there, going to restaurants or bars, nightclubs, sports events, whatever it may be. It gives peace of mind to those who are organising those events and to community overall. We laid out the criteria. We weren't expressing an opinion about whether they should be used or should not be used. Our goal was to lay out the criteria under those, broadly those three headings, but there are 12 points in detail, as you can see in our report. However, my view of the situation now, some months on, is that Covid certification is a feasible and helpful process by and large, although we haven't ironed out all of the difficulties, but by and large it's a feasible and successful approach, an approach that adds force to our central approach to controlling Covid nowadays, which is through vaccination, so it reinforces vaccination. In that regard, I read with interest the report that was circulated to us yesterday evening, the evidence paper. I must say that, with one or two comments and queries, I broadly agree with its recommendations. I think that it's a very good report, and I agree with its basic recommendations, which is that vaccine certification is a useful device, a useful approach to support the vaccination programme in Scotland. A couple of queries. One is why, in Scotland, the system has decided to focus on vaccine certification only, whereas most of the other schemes that I've encountered—I'm speaking to you from France, where I live mostly, especially during pandemics—why the Scottish scheme focus only on vaccines and not the other two instruments that have been used, such as negative testing or a prior confirmed episode of coronavirus, Covid-19. That's one question, and I don't quite know what the answer to that is, although I can perhaps guess. The other thing that's missing perhaps in the report is, to my eyes anyway, a discussion about approaches to care homes, clinical settings and hospital settings, which I didn't see mentioned. Those are two smaller points. Broadly, that's my overview of where we now stand on certification. What he feels are the key priorities that should be embedded with the proposed scheme. My sense of the vaccine certification scheme and vaccines to cuts more broadly is that they are very much a double-edged sword, and how they work is very much a function of social trust. In areas of so high social trust where people believe that the vaccine certification schemes are there for them and to help them and our public health intervention, by and large, what it does is it takes, if you like, the vaccine indifferent. Those people who are not anti-vaccine but haven't got round to it, it gives them a good reason to get vaccinated. Therefore, when you introduce such schemes, what you see is quite often a surge of people getting vaccinated. That's certainly true in France. However, in countries and in communities where there is low social trust, they can have a very different impact because they lead to a sense of compulsion, that the vaccine is mandatory in effect. When you try to impose things on people, number one, you get psychological reactants. People reassert their autonomy, and secondly, it undermines their relationship with authority. Indeed, we have data to show that, in high trust individuals and communities, you find that the prospect of vaccine passports increases the intention to get vaccinated, whereas for those who have low trust in communities such as the black community, where you have low trust, it can actually not only have no effect, it can actually increase opposition. I think that the evidence paper that we were given slightly understates the problems. It says that perhaps it won't have much of an effect among those who have low trust. Actually, it can lead to greater opposition. That's one problem, and the issue of social trust is a major problem. The second issue is that what does it do to other behaviours? Early on in the pandemic, when vaccines were first introduced, there was some data to suggest that those who were vaccinated were given an illusion of immunity and vulnerability and increased their risky behaviours. What you get, on the one hand, from vaccination, you lose on the other by an increase in risky behaviours. Very much the issue of how you message is really important. That has a number of practical implications. For me, first of all, the broader context in which you introduce vaccine passports is critical. I think that they only work where you are doing other things to increase social trust, especially around vaccines. I think that it's really important not to see vaccine passports as your sole strategy to increase vaccination. They have to be seen in the context of increasing the ease of getting vaccination, making it easier, making sure that vaccine stations are in schools, colleges, universities, workplaces and communities, and secondly, that you engage with people, that you listen to their concerns, that you take those concerns seriously and answer those concerns. There are other things that you must do to increase trust. One, for instance, is to have a very clear set of end criteria, because otherwise you feed into those narratives that say that this is about controlling us. This is the thin end of the wedge of ID cards, so you need a very clear set of criteria of when this will be taken away. This is not going to continue. This is temporary. I also think that it would help to have, if you like, a conscientious objection clause, that there is a procedure by which people don't have to get this if they don't want to. I think that not many people are likely to take advantage of that, so I don't think that it will be a major problem in terms of numbers, but at least it would show that this is not imposed upon you. You don't have to do it. I think that those issues of how you introduce such a scheme are critical. The other point is messaging. I think that messaging is absolutely critical. It's really important to say to people that you are not invulnerable, that vaccines make you safer, but they don't make you safe. As I say, if behaviours change, then you undermine the advantage of the vaccine. The final point that I would make is this. I also felt that it was a very impressive document, the evidence document, but I did think, as I've already indicated, that it understates the risks. It understates the importance of messaging, but it also understates the alternative. One of the points that it makes—I think that this is a really important point, it's not made prominently, but it's a really important point—is vaccines are crucial for making us safer, but they're not enough on their own. We also need other measures like improved ventilation, improved hygiene. Indeed, the research on even large events in indoor spaces shows that if they are properly ventilated and if there is proper hygiene, actually levels of transmission are very low. It does seem to me that vaccine passports, as I say, are a very double-edged sword. They create problems, they alienate people from authority. I think that there needs to be much more emphasis on making venues safe, making them necessarily safe and having clear criteria for the opening of those venues. I don't think that the alternatives are between vaccine passports and closure. I think that they should be between vaccine passports and safe venues or, indeed, perhaps vaccine passports and safe venues. I don't think that there's enough emphasis on that in the document or, indeed, in the discussion more generally. Thank you, Professor Rackham. Can I ask the same question to Professor Drury, please? I think that I'm here because I conducted the only systematic review that's yet been carried out of possible behavioural consequences and social impacts of vaccine passports and other forms of Covid certification. My priorities are in terms of psychology, behaviour and social impacts. I would say that they divide into three areas. The first, which has already been mentioned, is in terms of possible social exclusions. As has been mentioned by definition, vaccine passports exclude some, but the question is who do they exclude? The criteria, of course, is vaccination. You only have to look at the vaccination data. Consistently, there is a pattern. The groups behind others in terms of getting vaccinated tend to be those who are more deprived and those who are black, and they will be the ones who are disproportionately excluded by such a scheme. That would have to be a consideration, either recognising that or trying to mitigate in some way for that. The second priority that I'm concerned with is in terms of take-up and backfire effects. One of the arguments for vaccine passports is that they might encourage people, incentivise people to get vaccinated. There is mixed evidence for that. Anecdotally, for those countries that have implemented those schemes, there is some evidence that there has been surges in take-up. You have to take into account that those are very different cultures. Denmark is a good example where they have been successful. They have very high levels of public engagement with testing and vaccination, but they also have very high levels of trust—much high levels of trust—in their authorities than we have in this country. There is some evidence that a scheme, like the one proposed, would lead to an increase in take-up. I note in the report that there was some evidence that the prospect of the scheme led to a surge in vaccination take-up in Scotland, but there are also possible backfire effects. When we did our systematic review last year, we started to think about that. We started to notice the circumstantial evidence. Most of the studies were carried out before vaccine passports were introduced, so they were survey-type studies and experiments that were hypothetical, but there was a suggestion—a hypothesis, if you like—that that could happen. Since the review was published, there have been two studies that I know of that have shown that kind of effect. I think that one of them is cited in the report. I am not sure about the other one, but we have much more firm evidence that this can happen by a backfire effect. Some groups harden instead of becoming motivated to get vaccinated. They harden in their anti-vaccine view because they construe and understand the scheme as a form of control. It tends to be the same groups or people in the same groups that are not getting vaccinated, so those two issues—social exclusion and backfire effects—interact. There is a related point to this, which is that it might be beneficial for our response to Covid to introduce such a scheme and make many more venues and activities possible, but, if the backfire effect does occur to any degree, the concern that I have is with the long-term relations that those groups have with the authority. Part of my research background is in public behaviour in emergencies and in how the public interpret and respond to different interventions by the professional emergency services and the authorities. Where there is a poor relationship, that relationship can be damaged by interventions and the consequences of that can be long-term. What I am saying here is that there might be consequences for future engagement with the authorities. For example, one of the studies in our review found that, if you made vaccination mandatory, people were less likely to be motivated to take a subsequent vaccine. Therefore, there are knock-on effects. The third priority, the third concern that I have, is probably less important than the other two, but there is evidence that vaccination and vaccination passports can provide a false reassurance. One of the mechanisms that they would be achieving in this case would be the dichotomisation of risk. Instead of a continuation of risk, it is a sophisticated understanding of vaccination. It reduces your risk and does not eliminate it. With vaccination passports, you have suddenly got a dichotomy of those who are able to engage in certain activities and those who are not, creating and supporting the impression that there is a fully safe venue and other venues that are unsafe. We know that there is a notion of risk compensation whereby people change their risk-related behaviours, their precautionary behaviours, after some vaccination. That is a third possibility. Thank you very much. Before we move on to members, we have been joined also this morning by Graham Simpson, MSP, who is not a member of the committee, but is attending due to an interest in our proceedings. I welcome Graham to the meeting and invite you to declare any interests. Thank you very much, convener. I have no relevant interests to declare. Thank you, convener. Good morning, and my apologies for my late arrival due to train being cancelled this morning. Can I maybe start by picking up the comments that were made by Professor Drury about the issue of backfire effects, which I think is very interesting, because it seems counterintuitive that if you introduce vaccine passports, you would expect that to encourage take-up, but your argument is that there is some evidence that it might have the opposite effect with some groups. I think that that is worth exploring a little bit further, both with yourself and the other panellists. I wonder if I could ask two questions around that that might help to form the discussion. First, would it assist with those groups that you are talking about if the vaccine passport scheme had an end date? Would that make any difference? Secondly, as an alternative to vaccine passports exclusively, would it make a difference if, as has happened in some other countries, there was an alternative to using testing at venues so that people could either be double vaccinated or produce a negative test? Maybe Professor Drury could start with yourself. Yes, as I mentioned, there are a couple of studies that show these backfire effects now, and it is associated with existing levels of trust in those groups. It is to do with the meaning of the scheme. I guess that, to some extent, we can manage that meaning, but sometimes those meanings escape our control. If it is the authorities who are trying to reconstruct the meaning of the scheme and present it as something democratic but the authorities are the ones who are not trusted, then there are some limitations there. Certainly, the question of end date is important because, by setting an end date, you are working against that possible narrative that these things are about control. I understand that some of the schemes that are already existing do not set end dates, and I think that that is problematic. In order to increase trust, you would want to have an end date. Testing is one of the alternatives. In my submission, I mentioned that. I know that there are practical problems why testing might not be included. If it is self-testing, you have got the issue of self-report and people being honest. If it is testing for getting into venues, you cannot test everybody getting in. On the one hand, people's engagement with testing is subject to the same demographic variability as vaccination. If you look at the evidence for the mass testing programmes, for example, in Liverpool last year, you find that, again, it is deprived groups, ethnic minorities who are not coming forward. On the other hand, testing is far less controversial than vaccination. It does not have the same connotations for those who are mistrustful of authority. You can imagine a one-off testing scheme being more acceptable to people. I agree with Professor Dye that I am slightly surprised that it was not included, because it is perhaps a more acceptable alternative to purely reliance on the vaccination passports. Professor Dye, can I ask you the same question? Thank you very much. The first thing that I would like to say before answering the question directly is that we have already heard in the conversation this morning about the pros and cons of certification, and what we are ultimately dealing with is the balance of those pros and cons. There are adverse effects that have been documented, and Stephen Rice and John Drury have outlined many of those. The important question is whether they are dominant in any situation, such as to outweigh the advantages of using certification. And whether they are important, how can we directly compensate for them? That is something that Stephen Rice has said, and I completely agree with that. On the two parts of your question, an end date, around the UK—where I am not at the moment, I am in France—there has been a slogan, data not dates. There is some merit to that, and how that translates here is that my preference would be not so much for an end date, which might have to be rescinded, but rather for an end criterion. Once we have reached those criteria, we would then remove it. That would give assurance that this is not a permanent method of control, but the intention is to release it, but I think that that would be a better criterion for doing so. On the alternatives to vaccine certification, I think that John Drury has covered that very nicely, but it was my surprise, too, when I read through the documents for this meeting, that the Scottish intent is to use only vaccination and not the other two backup methods that are used most widely in Covid passes around Europe, namely, a negative test of some kind or previous evidence of an episode of Covid implying that one is—the subject would be immune in some regard. The advantage of a tripartite system like that is that it provides a backup for those who really do not want to be vaccinated or who cannot be vaccinated for medical reasons and therefore factors into that third aspect of fairness that I spoke about in my introduction. A reason for excluding those other two options might be in Scotland—I do not know what the reason is, but I can think of a couple of possibilities. One of them is that it increases the incentives for getting vaccinated, which is ultimately what we would like from a public health perspective, but there may also be some cost aspects to that as well, particularly where Government is providing a free testing service, a rapid antigen test or a PCR test, which is a cost to Government, which they may not wish to bear. That might also be another factor, but, as I say, I do not know the reasons for that. Across Europe in general, the tripartite system has been broadly agreed, and that is what has been adopted by the EU. The Scottish system, a consequence of that incidentally, is that it would not therefore be interchangeable with a European Covid pass, and with regard to travel and movement, that would be a considerable disadvantage. Professor Dye, I have the same question to Professor Riker. To understand the backfire effects, it is important to place what is going on in a broader context of what are the influences on people's behaviour. It is not just that people are being subject to information from Government telling them to get vaccinated. Of course, there are other voices. There are anti-vaxxer voices, which are telling them not to get vaccinated, telling them that vaccines are a problem, that vaccines are a form of control. Very much is part of that broad populist politics, which says that the system is trying to control you. People are positioned between these different voices. The question is, what does one do to make sure that the voice of the Government, the pro-vaccine voice, gets traction and the anti-vaxxer voice does not get traction? Of course, one wants to avoid doing anything that will give traction to those anti-vaxxer voices. We have to look at those things in that context and be aware of the fact that there are those voices out there. One of the problems is precisely that what vaccine passports do is that they give traction potentially to the argument that vaccines are about control and particularly amongst groups who historically have concerns along those lines. The reason why you get more vaccine hesitancy amongst the black population is not because they are stupid, it is not because they are backward in any way, they have historical experience of that being a reality. If there was a report to the House of Commons and House of Lords, I think a couple of years ago, which showed that something like 70 or 80 per cent of the black population felt that the health systems did not take their interests into account. So there are these historical beliefs and the danger is that if you feed into those, then something like a vaccine passport is more easily interpreted as about control and therefore leads to more resistance. You have to ask yourself how do we undermine that sense of this is about control? What are all the levers we have in order to do that? Certainly, end criteria. I absolutely agree. Data not dates was also a slogan in the UK, sometimes observed in the breach, especially in England, but nonetheless it is a key slogan. It has to be about criteria, I think dates, where we have seen how they come back fire. As I say, there are other things that you can do as well. First of all, I would argue that we need to again look at the broader context of building trust. Building trust is so essential in so many ways in this pandemic with engaging with communities, with not treating people who have doubts and questions about vaccines as if they are fools, as if they are ignorant, as if they are selfish, but taking them seriously. In a sense, that is absolutely central to any scheme, must be that it is done in a context of building trust more generally. If you just have vaccine passports and use them as an alternative to the community engagement, that will increase the backfire effect. As I say, a conscientious objection process would also be helpful. It would not be something that people could do just by ticking a box. It has to be a process that, if it is a matter of convenience, it is easier to get vaccinated than to opt out, but it would show that you can opt out if you do actually want to opt out. Building trust undermining the narrative that this is about control in the way that you message, in the way in which you have alternatives, in the way that you introduce the scheme is absolutely critical. The final thing that I would say about testing, and here I agree with the others, is that, in one sense, it is very simple. People, especially if they are self-testing, people will not test positive if they cannot afford to. We saw right at the beginning with the schemes on mass testing in Liverpool. There was far much less take-up among poorer sections of the community, because they could not afford to find that they were positive because they could not afford to self-isolate. The evidence from the events research programme was very clear about this around the euros, and they found that the euros led to a large spike in infections. One reason is with self-testing. Why would you go to the length of making sure that you test well if that makes it more likely that you test positive, which means that you cannot go and see the game? The problem with testing is that self-testing is not very reliable if the effects of a positive is to stop you doing the thing that you want to. It is rather practically inconvenient to be tested by others. There are difficulties, but I still accept the argument that those different options again are part and parcel of undermining the narrative that this is about control. So, if you are going to introduce these things, I would include all the various possibilities, even if it is less about a matter of practicality than a matter of messaging very clearly, that vaccines are for you and for your health, they are not imposed upon you and about controlling you. I have noticed that the messaging coming out of NHS Fife in the last few weeks has been very much. If you have any questions, if you are uncertain at all, we have people to discuss so picking up on on that point. Professor Ritchard, I think that I picked that up. Is there any evidence or have you come across any evidence of where these schemes have been introduced in Israel, across Europe and some states in America, where there is actually concrete evidence that shows that it has led to an uptake in vaccines? The UK seems to have good uptake, and the Government in Scotland seems to highlight particularly young people and seem to be aiming at young people. Is there other best practice out there that we can build on in terms of trying to encourage those who have not taken the vaccine to take it? Professor Ritchard, what is that? I think that those are very good questions and they are very challenging questions indeed. Early on, one of the first examples of a vaccine passport scheme was the Green Pass scheme in Israel. It has lots of publicity and lots of positive publicity, but some of the literature coming out of Israel suggested that, in terms of the take-up, it was not simply to do with the Green Pass. Indeed, the Green Pass was often not being scrutinised, not as effective as it might have been, but there were very impressive community engagement schemes in Israel. Israel, in many ways, pioneered the philosophy of not getting people to come to you and go to them. For instance, there were vaccination stations outside the bars in Dizengof in the middle of Tel Aviv for young people to go to and people would be given something to eat and something to drink, not alcoholic, but they have given something to drink to make it attractive to do that. In many ways, the uptake in Israel was as much to do with those forms of engagement. Secondly, it was one of the first things that the WHO said. If you go back to January, the WHO said that community engagement must be at the centre of any vaccine roll-out. Historically, there is plenty of evidence. We wrote a piece in the Lancet looking amongst the black community showing how community engagement schemes were effective. As you say, there are many such schemes. There is a large amount of very good work. If you go to the website of the Royal College of General Practice, you will find hundreds and thousands of such schemes up and down the country. I think that it would be better if that was the focus of the national campaign and it was nationally co-ordinated, but I do indeed think that it has been very effective up and down the country. I echo what the WHO said right at the start, right in January, that community engagement must be at the centre of any vaccine roll-out programme. Thanks very much. Perhaps I will speak from the French experience, because France is where I live and operate in neighbouring Switzerland, which is quite similar to that. We know that the French experience is that a number of people, particularly a vocal minority, expressed reservations about vaccination and have continued to do so, but we also know that that is not the majority sentiment in the population. When President Macron announced in July that vaccine certification, or rather the pass sanitaire, as it is called in France, which is the three-part Covid pass, was going to be mandatory for access to many venues, a million people signed up within a few weeks to get vaccinated. Most of those people were people that Professor Reiser referred to earlier on as not anti-vaxxers but just those people who didn't feel the need to get a vaccination and then they did feel the need to get a vaccination. A large number of people did sign up and that has been very effective in boosting vaccination coverage in France. In France, the system has worked and, in my perception, it has worked pretty well. There are very few complaints about the Covid pass and how it is used in France. It has very quickly become a routine fact of everyday life, along with mask wearing, where it is obligatory. People just do it. They do it every day and they do not complain about it. In France, it has been a success. That leads me on to the other remark that you made, Mr Rowley, in your introduction, which was about good uptake of vaccines. The question is what is good enough in terms of vaccine uptake. One thing that we have discovered in the last months of the pandemic with the emergence of new variants is that we are going to need very high coverages of vaccine in order to keep Covid at very low levels. The initial assessment of perhaps 70 per cent coverage would lead us to cross the herd immunity threshold is now generally viewed as being too low and we are going to need higher vaccination rates. Vaccination rates are good but we need the vaccination rates in short to be as high as possible and Covid certification is going to be a way to help that. Just one final remark, if I may, about your very first point about what kind of support, and it goes on from what Stephen Reichan was saying as well, about the need to support those people who might be excluded for one reason or another. I think that it is not good enough in this regard for this to be passive support. In other words, putting out an announcement saying, please contact us if you have problems, because the people who have problems are not the people who are going to contact you. I think that what is needed is a much more proactive approach to those people who feel that they are excluded and to work out the reasons why they are excluded and ways of compensating for that. Thank you. Just to add a few points to what has been said, in the Israeli situation, it is regarded as an example of success. As Stephen Reichan said, there is a confound there with the community engagement programme, which included things such as working with trusted leaders. Trust was important. In my initial remarks, I mentioned Denmark and, again, a success story. They have, as far as I understand, abolished their passport scheme because they have had so much success, but, as I said, very high levels of trust in that country, and very good levels of engagement already with the vaccination scheme and with testing in that country before they introduced the passport scheme. In Italy, I read and reported that vaccinations increased by 15 per cent after they introduced their scheme and made it compulsory and similar reports in the Netherlands. Although I have to say that a lot of this is anecdotal and I have not seen any peer-reviewed evidence from those countries. One last comment about this, because Professor Dye's point about attitudes in France is really interesting, because we are all aware that, at the beginning of their scheme and before the scheme came in, the very visible opposition. I will acknowledge—this came through in our systematic review that we carried out last year—that there are various dimensions of variability for attitudes to vaccine passports. We have already talked about population demographic variability, so different groups have different attitudes to vaccine passports. There is lots of evidence that the purpose to which the vaccine passport is put to is another variable. Public support for vaccine passport schemes tend to be much stronger for international travel, much weaker for activities such as going to work, and then there are other activities that lie in the middle, including leisure activities. However, the other dimension along which attitudes vary is time. One thing that was quite clear when we looked at the many attitudes surveys that have been carried out on vaccine passports last year and this year is that attitudes change and they become more positive, they become more negative. One of the factors that makes them more positive is implementation and roll-out. It tends to be associated with greater public acceptance, although that is still not to say that there is not going to be a rump of people. The question of whether it is worth it boils down to knowing how big that rump of people are who are still oppositional and the consequences of that opposition for later public health engagement and interventions. Can I ask Professor Dye first of all? I think that you mentioned people who couldn't be vaccinated. We have been given a suggestion that that would be less than one in a thousand. Can you comment if that is about right or what? I cannot give you a precise figure, but it is a very small minority from a medical perspective. I would echo what the others have said in this regard. Just because they are in a small minority, they should not be ignored. However, in terms of balance, it is a very small number of people. Professor Riker, you mentioned, I think, conscientious objection. I am interested in how that might work, because can somebody just say, I object to passports and therefore I am not getting one? Presumably they would still be excluded from going to a big football match or a nightclub or that kind of thing, or would you say that they should be counted as exempt, just like somebody who is medically exempt? Let me go back to the logic for that. In terms of the impact of vaccine passports, I think that we have to distinguish between the short-term effect. The short-term effect is genuinely positive because it leads to those who I call the vaccine indifferent to think, well, I might as well get a vaccine because it is more of a hassle not to get a vaccine. Those are people who just have not got round to it. That is why you see the surge. The danger is that, in the longer term, while you win over the vaccine indifferent, you consolidate the opposition of those who are already doubtful. That is important not only in terms of social exclusion, because those, as John Drury pointed out, tend to be rather marginalised groups in our society. It also, in a sense, has a biological implication, because when you talk about herd immunity, one of the problems is that we talk about herd immunity as if the population is homogenous. If 90 per cent of people are vaccinated, that is evenly spread. If it is unevenly spread and it has some communities in which there is much lower levels of vaccination, that means that you have pockets in our society where the vaccination can still spread, where new variants can still come about, and therefore poses a major problem. Even if there are only some communities in which there is lower levels of vaccination, it is still very much a problem. That relates to conscientious objection. If the great advantage is in terms of the vaccine indifferent, then you will not undermine the vaccine indifferent taking up the vaccine if you have conscientious objection, as long as the procedures are such that it is easier to get vaccinated than non-vaccinated. However, at the same time, for those who are doubtful, for those who think that it is control, it says to them that there is a way out if you want it. It could have an advantage that you still win over the ones that you can win over, but you do not alienate the ones that you do not want to alienate. In order to achieve that, I would say that if you choose to go through the process and be a conscientious objector, then yes, you can still go to venues and so on. In other words, it is a device in order to undermine the narrative of control and so to have the benefits of the vaccine passport system as a whole without the problems. I do not know whether others might follow on that. Another point is that France has been mentioned a few times as a comparison. They seem to have a much wider scheme in the sense of much more services you would need to have a certificate for. Does that make a difference? Can we be more relaxed because we are saying that it is only for a very small number of high-risk and luxury items? Is the advantage in France in having it wider is that it has become more widely accepted? Maybe Professor Dye, because he is there. The reason why the French scheme is more comprehensive is, as I recall, because it was introduced at a time when a new resurgence of Covid was beginning during the summer. The Government decided that it really wanted to use all means at its disposal to control that new resurgence. It decided, in effect, to take a few risks, in other words, to be more comprehensive about the way in which the vaccination programme was done, backed by the Covid pass system. Subsequently, for that and for other reasons, case incidents have now come down to relatively low levels. That reminds me of what has been absent from the conversation so far. We have talked about balancing risks, but whether and how certification is used depends on the epidemiological circumstances of each country. Of course, there is no need for any more certification process, and that was the point that Israel almost reached earlier this year. The situation is that we have to translate the comparators that we are talking about—France, Denmark, Switzerland and other countries—into the Scottish epidemiological situation at the moment, which is less favourable. As I see the data, cases are now coming down, but Covid is still at pretty high levels in the UK. Because it is at high levels, there are stronger arguments for reinforcing the vaccination programme in strengthening methods to improve coverage of which certification is one part. I also comment on conscientious objection. The difficulty that I see with that—I offer that just for discussion—is that whether or not you are permitted to object depends upon the circumstances under which you are operating. To take an uncontroversial example in medicine, for example, doctors who are doing surgery have to be vaccinated against hepatitis. You cannot be a conscientious objector if you are in medical service to not having that vaccine, because that simply is too high a risk for everybody concerned. The same will be true under Covid certification. There are circumstances in which people can simply opt out if they want to be objectors, they do not have to go to nightclubs, for example. However, in medical settings, clinical settings, care homes and so forth, the community at large might take a different view of that. I think that that is a difficulty with the idea of conscientious objection. Thanks for that. That leads me into my final question, which I will be aiming at, Professor Drury, if I can start with. Although the Government or the Parliament is only intending that for nightclubs, big crowds and so on, presumably employers or other venues could use the system as part of their entry requirements. Is that a good thing or a bad thing? Are there other risks with that? The first point that I would make about that is that one of the groups that we have not talked about are those who work at those venues. I guess that one of the arguments in favour of vaccine passports is that it could make front-line workers safer, like people who work behind bars, because they are exposed a lot. However, it is interesting to bring up the question of employment. I mentioned at the beginning that if you compare public attitudes on vaccine passports across the different activities that they allow or disallow, the activity that is most supported in terms of vaccine passports is international travel, and the one that is supported least is your ability to go to work. In Israel, they include going to your workplace in the scheme. There is some evidence there that that led to conflicts, as some people tried to get into their workplaces and were unable to broaden that a little and address the question of the scope. We have touched upon that in the last response, and I think that it is quite interesting the scope of the proposals in Scotland compared to other places. On the one hand, as Professor Dye said, the activities and the types of venues that are included are the ones where people have a relatively high choice. Maybe you could say that the possible exclusions for certain groups would be less severe, because they are not necessarily everyday activities, such as going to the pub or going to the shops. On the other hand, I was quite interested to see that, as well as night clubs, which are indoors, outdoor events are included. That is slightly paradoxical, perhaps, because, as we are all aware now, outdoor events are fresh air and are much less likely to be infected. We talked briefly about the events research programme earlier, and it is useful to consider the evidence from that and other evidence that has been brought to bear on the question of people's attitudes towards vaccine passports for live events and people's engagement with vaccine passports and similar live events. There was a survey carried out by an agency in the live events industry earlier this year, and they produced a very high figure of support for people going to live events, with very high levels of support, but they framed the question as all biometric testing. That was picking up not only vaccine passports, but testing for immunity, as well as the broad range of tests. There is broad support for that. If you look at the events research programme, there is considerable variability and outcome, which is consistent with Stephen Reicher's point that it seems that you can operate outdoor live events and minimise risk of infection without a vaccine passport scheme, but with other things instead, because they picked up relatively low levels of infection at Wimbledon and relatively high levels of infection at other events, such as the Euros, and two of the key variables that seem to matter are, one, how the event was managed, but two, the behaviour of participants and the culture, the levels of intimacy, the levels of physical proximity, whether people were shouting, and both of those things—this is the key point—can be modified. That is the logic and rationale of a scheme that certifies venues and events as an alternative or a complement to a vaccine passport scheme. Thank you for coming in to give evidence. I am trying to establish where the evidence base is for not just the introduction of the vaccine passport but the way in which the Scottish Government introduced it. One of the things that concerns me is that we seem to be comparing Scotland with what is happening in other countries and trying to pull lessons from other countries, but, of course, there is a huge variation in vaccine uptake across all those countries, so there is a variation in the need to encourage the uptake of vaccines. My first question is the way in which we are comparing the Scottish vaccine passport scheme with other schemes in other countries is really an accurate measurement of the way in which we should be adopting vaccine passports in Scotland. Comparison with other countries is both the best of worlds and the worst of worlds. It is the best of worlds in that we can learn much from what happened elsewhere, but it is the worst of worlds if the comparisons are made mechanically and they ignore the key parameters that differentiate between countries. The key parameters, it seems to me, are both biological and medical, so incidence rates, as Professor Dye has pointed out, that is a major factor. The need for schemes is there only if you have high rates in the community. At a social level, I would come back to this absolutely critical role of trust. Social trust is a key parameter. Those things are understood in very different ways and have very different implications in different countries. Professor Drury made the point that Denmark, where they have worked well, is a high trust country. The Scandinavian countries have the highest trust, both in government and in people in each other, of any nations in the world. There are surveys, there are world trust surveys done every year and you find that systematically. The comparison must take those two factors into account and it shows us that whatever we do around this pandemic, the central issue for me as a psychologist, as a social scientist, is about the building of trust. You can give all the information to people you like, but if they do not trust the source, they will not listen to us. Again, going back to the fact that what we are involved in is a battle between ourselves and the anti-vaxxers over information, we will win that battle to the extent that there is more trust in us than in them. Anything which atrophies or undermines trust is corrosive not only in terms of vaccination but in terms of any measure that we need in order to deal with a pandemic. Going back to the question itself, let us take international comparison very seriously, but only in the context where we are aware of the key parameters that differentiate between countries. As a social scientist, that key parameter for me is trust. I wonder whether the other two panellists would like to add anything to that before I move on. Professor Dyer. I agree with what Stephen Reiser has said, in that international comparisons are important to make, but they are limited. The difficulty is that we do not know how much of what goes on in France, Denmark or Switzerland or any other country applies directly to Scotland. In other words, the decision that is being made now with regard to certification is going to be measured, made in the presence of uncertainty. That is a key point. We are never going to have all of the information that is needed. Therefore, the question is what decision should be made given a certain amount of evidence but plenty of uncertainty. Is it the political decision to err on the side of caution and strengthen the vaccination programme by using certification? Or is it the decision to err on the side of less caution, more risk, if you like, and not introduce? It seems that the decision has already been made, as we heard at the beginning of the committee, that the intent is to introduce the scheme tomorrow. I guess that decision has already been made, but what follows on from that uncertainty is the need to follow up with data collection and information to understand how successful the introduction has been, both with regard to the practicalities of what is acceptable and not acceptable, and we spent a lot of time on that, but also on the epidemiological impact. It is an important need for continuing collection of data and information to see how well the scheme is working. I move on to my next point. The introduction of the vaccine passport scheme that the Scottish Government has said that the main driver for that is trying to encourage those who have not been vaccinated yet to take up the vaccine. As we heard in evidence last week, I notice Professor Riker's evidence that one of the key issues is around those groups who are reluctant to get the vaccine. Ethnicity is one of the big drivers, especially around our Polish and African communities and those in areas of deprivation. I wonder whether the idea that you need to be vaccinated to get into nightclubs or football appears to me unlikely to be participants in those particular activities. I wonder whether you consider that the way in which the vaccine passport is being introduced will help those groups to do what the Scottish Government wants them to do, which is to get vaccinated. I will ask Professor Drury, since you have not spoken to me yet. Can I first make a broader point about evidence? It does bear on this question, but it frames everything that we say, because how can we be confident in the arguments that we are making? International comparison is one set of evidence. We have four different types of evidence for the backfire effects, vaccination, take-up and so on. International comparison is one. We have survey evidence and self-report evidence. We have experiments and surveys that might be based on self-report and rather artificial, but they provide relatively consistent patterns of the types that we have been talking about. Then we have the vaccination rates and the demographic differences that I talked about. These are all that we have. We do not have randomized controlled trials, which is the gold standard, but we still need to make decisions, and we are making decisions. On the specifics, I do not have any evidence on the groups that you mentioned, so I cannot really talk about those two. I guess that what we need to do is understand the existing attitudes of those groups to answer that question. Professor Iker? My dad came from Poland during the war to join the Polish Air Force in the UK. You should have seen my dad when there was football on. The Poles are quite interested in football, and the black community is interested in football as well. In terms of data, we have some unpublished data—a study that I did with one of my master's students—and that showed reasonably clearly that, for black participants, the introduction of vaccine certification for large events such as concerts and going to the football led, first of all, to a greater sense that vaccination is about control, being done to us rather than being done for us, and led to lower intentions to get vaccinated. I absolutely accept all the provisos that John Drury has just pointed to. This is experimental data, self-report and so on, but I would also echo what he said in terms of it being consistent. As I say, the point is here that you have, especially among the black community, a community in which there is traction for a narrative that says that we are not well treated by authority and that we are controlled by authority. Therefore, anything that feeds into that is more likely to be read in those terms and leads to more resistance. It is also consistent with the evidence. For instance, if you look at evidence on vaccine hesitancy, overall, there is very little vaccine hesitancy in the UK. Only 4 per cent of people are vaccine hesitant, but then you look at the smaller communities. If you look among the unemployed, it is 14 per cent. If you look among the Muslim community, it is 14 per cent. If you look among the black community, it is 21 per cent. Again, you see these much higher levels. For me, that is not only a social problem—it is a social problem, it is a major social problem, but potentially it is also, if you like, an epidemiological problem because it means that you have potential reservoirs of infection in this country and you will never get herd immunity while those reservoirs exist. Professor Dyer, would you like to add anything to that? I would like to add a comment about the purpose of certification. You mentioned that the main purpose is to increase incentives for vaccination, and it says that in the evidence report as well. In fact, I think that it is equally to protect health and stop transmission because it controls—I use that word advisedly and hopefully carefully—it is aware of controlling the transmission of infection at the events that we are talking about, the mass gatherings that we are talking about. It is about incentivising vaccination, but it is also about protecting personal and public health. Given that, as has been highlighted here, the specific pockets of our population that are less likely to be vaccinated, what should we be doing to encourage that uptake in vaccination? I will go back to Professor Dyer, if I could. I think that this is a difficult one to answer very specifically, but I think that all I can do is reinforce all of the things that have already been said. I think that it starts with not being dismissive—perhaps I am stating the obvious here—but it starts with not dismissing people who do not want to be vaccinated as fools and stronger language has been used under many circumstances. My knowledge of the behavioural literature is somewhat limited here, but the studies that I know of, which have investigated the reasons why people do not wish to be vaccinated, discover that, of course, it is not one single reason, but there are four, five or six different groups of reasons in different communities. We have to start with that understanding of why people do not want to be vaccinated. We may say that it is irrational, but, from its perspective, it could be fully rational and very recent. Unless we understand those reasons by working with those communities, we will not be able to persuade them. That goes to the point about messaging as well. It is not just messaging per se, it is messaging that is effective communication with the people who are on the receiving end of those messages. Therefore, in short, we have to understand why people do not want to be vaccinated. When we do that, we will be in a better place to increase vaccination rates. Thank you, Professor Iker. I mean, there is a very long answer to that and a very short answer. The short answer is community engagement. It is going to people. It is listening to people. It is respecting people. It is allowing them to have doubts and to go away and come back to you. It is very much about treating those who are vaccine hesitant as not them, but treating them as perfectly reasonable people who have real doubts. Another thing that is really important is to distinguish between different populations. The first thing is that, if you look at the number of people who are not vaccinated, it is far higher than the number of people who are vaccine hesitant. Most people who are not vaccinated are the vaccine indifferent. They have not got round to it. They are the ones who can capture more easily. The difficult ones are those who are vaccine hesitant. They have questions, but they are fundamentally different from anti-vaxxers. Anti-vaxxers do not have questions. They think that they have the answers. They know that the vaccine is wrong. The danger is, if you treat the vaccine hesitant as if they are like anti-vaxxers, if you lump them all together, the danger is that they will become lumped all together. If you want people to see you as on their side and to trust them, you have got to treat them likewise. You have got to respect them if you want them to respect you. That is the first thing engagement. The second thing that I would say, and again, it is a very simple philosophy, do not wait for them to come to you. Go to them, making it so much easier to get vaccinated, setting up vaccination centres in communities, giving people time off and paid time off to get vaccinated, using community champions and so on. All those things, it seems to me, I would put those at the start of my debate about how to increase vaccination rates. I would not have it as an add-on after vaccine certification. The final point I would make, and here I absolutely agree with what John Drury has said. In many ways, I think that it is the most important thing that has been said today, that if we are concentrating on certification, certification for individuals creates all the problems that we have been talking about. Once you have certification for individuals, you then have got to have forms of scrutiny and surveillance to make sure that they have got vaccine passports and so on and so forth. You introduce all the problems of what happens when you have to stop people and ask them to show passports, all the problems of alienation that we have talked about. We ought to be laying, it seems to me, equal, if not greater emphasis on certification for venues, because if the venues are well ventilated, if they have high hygiene, then they are relatively safe. Not only is there evidence about large events outdoors, there was a recent large study in nature showing that even indoor large events are relatively safe if they are well ventilated, if there is high hygiene. If you have certification for venues that they have to meet particular standards before they can welcome individuals, it seems to me that you have many of the advantages without many of the disadvantages. I am not saying that it is neither or that you can have both, but I would say yes. If you can talk about certification, do it in the context in which you have put much, much, much more work into community engagement and into certifying venues. In that context, where you show that you are acting to protect people, again, you are likely to get far more trust and far more traction for the narratives that the vaccine passports are about protecting people, rather than taking away their freedom. Professor Judy, just to give you the opportunity to add anything to that if you want. Yes, just briefly, as Christopher Dye said, usually incentivisation is not the main rationale for schemes like that. I know that it has been mentioned by many policy makers, but it is not usually from a public health perspective, it is usually about making spaces more safe. Just to echo what Stephen Reicher says, hesitancy is only one reason why people are not getting vaccinated. If you look at successful public health campaigns around the world, they have all been based on community engagement among some inspiring campaigns in relation to AIDS and Ebola in some countries. On top of community engagement and building trust, there is the practical side of facilitation, which means that people are sometimes reluctant to come forward and get vaccinated because they expect to be sick for two days. So, give them paid time off work. They are sometimes reluctant to get vaccinated because the vaccination centre is out of town, so bring the vaccination programme to them. That is what they did in Israel and what they have done in some local authorities. The final point is about the different groups. If you look at the attitudes and views of different groups who are not coming forward to be vaccinated, you find particular concerns. One of which, I was at a seminar yesterday where some new evidence was being presented on this, and it is often amongst young women with concerns around pregnancy. That is a specific concern that needs to be addressed in a community engagement programme. I am just conscious of time. We have got 15 minutes before one of our witnesses has to leave. Thank you, convener, and welcome to the panel. First of all, I would like to know, are we talking to Stephen Riker or Richard? That is the first thing, because we keep hearing different names. I have listened carefully to a lot of the stuff that has been said. I have read the papers, and I have to say that it is a hugely confusing and conflicting conversation. However, I have drawn some conclusions. First of all, we know that the virus is endemic. I will quickly run to those conclusions. The virus is endemic in the population. We know that it kills people. The targeted scheme is working because we are getting an uptick in the numbers of people who are going and getting vaccinated at the moment. We know that the vaccine reduces infection by up to 50 per cent, as we have heard in a previous session. The virulence of this delta variant is much higher than we have heard in a previous session. The post-vaccine and passport requires a strong messaging to continue with handwashing and masks because of the false reassurance that you have spoken about. Largely, the Scottish Government is trusted on what it has done so far. This scheme has a sunset clause on it, and I know that there is a debate between time and data. Events and venues do not transmit the virus to me. People do. By and large, the nightclub industry in particular has worked incredibly hard to make themselves as safe as they possibly can, so I take the point that you are making about venues and events, but I would argue that it is the people who transfer the virus, not those events. I have a couple of questions. Conscience objectors have a choice. You are right, they can absolutely make the choice that they do not want to take the vaccine. This is a targeted scheme, so they do not have to go to the events that they are going to be excluded from by not having the vaccine. If we follow what you said, Mr Riker, by allowing the access for conscious objectors to go in, aren't we then taking away the rights of the people who are in the event or in the place? Are we not discriminating against the business owners who are saying that if you come in here, you can put other people at risk and therefore cause us a problem? I will go on to a question that I have asked on numerous occasions now. Care home workers in my constituency have been sacked by a care home owner because the staff will not take a double vaccine and they have balanced the rights of the residents as being more important than the rights of the workers. We have discussed that at length, I think that is something that we really need to delve into. That comes back to the question who's rights are more important to conscious objectors or to the people who are on the other side who want to see a population that is vaccinated. I will leave this openly as a discursive thing. What about if that backfire effect is reversed? Events cannot trade, businesses cannot open. If we have people who simply refuse to get vaccinated and continue to spread the virus unvaccinated and then put pressure on our NHS, who then block beds for allowing people to get into all the other things, all the stuff that we know is already happening. How does the rest of the community react to a demographic who simply refuses to get the vaccine, either through hesitancy or because they do not believe it? How does that affect the majority of the community who are saying that all you are doing is stopping everybody else from getting on with their life? I know that that is probably controversial, but I would like to discuss it. Professor Ryker, you go first. Lots of questions there. Christopher Dye has it perfectly right. It's Rysha. Actually, it's not Rysha, it's a guttural Polish pronunciation that I can't do, so my father always said Rysha. I'm not going to answer every single question even if we had three days to do it, but I want to make two broad points. First of all, in many ways, my arguments are pragmatic. They are about what will get people to be vaccinated. I absolutely agree with you that, of course, we want more people to be vaccinated, but vaccinations don't save lives. It's been estimated that they save over 100,000 lives. What's more—and here I equally think that this is a really important message—is that if people aren't vaccinated and indeed if people act in risky ways by not wearing masks, by not socially distancing, what they do is create an exclusive society. They mean that people who are vulnerable don't feel confident and don't feel able to go out in society. As we reopen our society, we reopen it to some, but we imprison others more. In terms of the messaging, one of the things that worked about the messaging early on in the pandemic was that it focused upon, if you like, the communal rather than the individual. It was about we rather than about I. Many people went along with restrictions that were quite onerous and quite difficult for the community. Lots of evidence, a number of studies showing that the key factor in adherence was about wanting the community to come out of things well, not about personal risk but about communal risk. I think that message—you talked about messaging—is about getting over that messaging and building norms in particular groups and particular communities that we're behaving this way so that we as a community can reopen, that even vulnerable people can go out, can go to the cinema, can go to night clubs and so on. I think that's an absolutely central point. I think that communal framing is absolutely central. I think that we've forgotten it a little bit and I think that the messaging needs to concentrate very much on that. That's one general point. In terms of the various issues about the impact of vaccine certification, I suppose my arguments are that if you have these interventions and you moderate the scheme in such a way that people don't feel it's a form of control, then they're more likely to go along with it and get vaccinated in such a way that it does become safer for everyone, that the vulnerable can go out, that the venues can stay open. The final thing that I would say is that I absolutely agree with you that most places are very good and have put huge efforts into making their venues safe, but then why not make that formal? Why not show it? If people know that venues are safe, just like when you go into a restaurant, you see hygiene certificates that make you know that you're not going to be infected by bugs from the cooking, that the venue is safe, then it will give people more confidence to go out. It will give them more confidence to use the economy and be good not only for public health but for the economy, because more people will be using the economy. It's a matter not only of making us safe but making us know that spaces are safe so that we can use those spaces. I think that a certification scheme for venues would actually be good all-round, be good for public health, it would be also good for those employers and owners who put huge efforts into making their venues safe. Professor Dye? Just a few Swiss remarks to follow on from that. First, as I think you said, Mr Fairlie, safe people are not an alternative to safe venues. We should be doing both because both together is going to have the best effect. On your other point about care homes and whose rights are important, I think that that raises a question of general importance to me, which is that the science that lies behind that, which is partly why we're here, can only take us so far. From the perspective of epidemiology, we can speak about risks to individuals and groups of people in different settings such as care homes. However, when it comes to the assessment of rights and values, that is a subjective judgment and a subjective judgment that needs to be made by all those who are involved, so not just by one group of people such as those people who run care homes but by the community of people, all of whom are involved in what care homes do. We hear a lot about in the UK, especially following the science, but the science only takes us so far in this regard. When it comes to the assessment of value, that is a community-based decision, and it may be a different decision made in different sets of circumstances. Professor Drudy? I might have my own views on rights, but the points that I have been making are not based on rights, they are based on public health outcomes. I think that the case of the care home workers is a case in point. The difficulty that they have in recruitment is a real practical problem, so the argument that might be made against mandatory vaccination for those workers is not for me about their rights, it is about what happens in terms of having a viable care home. The point about the rights of others is similar to the point made about those shielding, and in fact it was made in the UK context, the England context, around July 19th when many people who were shielding felt that, while everybody else now had the right not to wear a mask and not to distance, they were being systematically disadvantaged and losing their freedom, losing their rights. However, that was an argument for not in favour of this measure of vaccine passports, that was an argument in favour of other public health measures, distancing masks and hygiene and so on. It is quite important to remind ourselves that most public health experts say that we still need, we will still need these measures, we will still need other public health measures and that vaccination cannot do all the work. The last point is about the kind of divider rule point that you made. Divider rule division is a real worry and I think that it is a real worry for me as something possibly coming out of vaccine passports, of people feeling excluded and different groups feeling resentful towards others. My understanding is that those venues that are being affected are already open, so unless I have misunderstood what the proposal is, it is not to reopen venues, it is to license or to get venues that are already open to use this scheme. It is not a proposal that venues would not be open to use, so I am not sure that that is a basis for this resentment. Thank you very much, convener. Good morning to the panel. I just have one question, I hope that it will be pretty straightforward. Section 5.1 of the Government evidence paper produced last night states that the scheme aims first and foremost to reduce the risk of transmission. In fact, driving vaccine uptake is ancillary to that. It is the fourth bullet point after that first one. It sort of triumphs with a theme that the Government is trying to strike in its case, and that is that the Covid ID cards of vaccine certification are, in and of itself, a tool of infection control. When I asked the First Minister to respond to the fact that there were 5,000 cases occurring at an event that required vaccine passports, she stated that without those passports transmission would have been worse. She presented that as indisputable fact. Can I ask, starting with Professor Steven Ricehead, because you are leaving, if that fact would have been worse, were we not to have vaccine certification at that event? It is very difficult to deal with those counterfactuals, so the simple answer to that is I don't know, but I can point to the issues that are important. In terms of the balance of risks, when you come to the issue that we have been discussing at great length of vaccine take-up, you have an advantage with the indifferent, but you have a disadvantage with those who lack trust. There is that balance to be made. When it comes to the issue of transmission, on the one hand, it is indisputable that those who are vaccinated are less likely to be infected and less likely to transmit. We do not know exactly how much. That is indisputable. What we do not know is about whether people's potential sense of invulnerability leads to more risky behaviours. As I say, there is some evidence that, when people were first vaccinated, they began to act in more risky ways. There was evidence from Israel that that was happening, and there was evidence in the UK that, over the 1980s, people were going out and socialising more, which is a rather nice image. Nonetheless, it led to the potential of more transmission, because the simple fact is that the more contacts we have, the more transmission there will be. We cannot say absolutely what vaccine passports will do upon behaviour, because, in large part, that is also a matter of communication. That is why the issue of communication and messaging is so important. I think that John Drury's point is an absolutely essential one. We misunderstand the pandemic, and it is not helpful to see things in binary terms. Either the vaccine works or it does not work. Either the vaccine breaks the linked hospitalisation or it does not. It does not make us safe, but it makes us stay firm. It is really important to message in ways that, if you get vaccinated, then behave more riskily. Let us say that the vaccine biologically makes you half as likely to get infected, but you then go out and you see twice as many people. In the end, you have lost the vaccine advantage. Behaviour is critical, and the messaging is absolutely critical. Where the First Minister is indisputably right is that at a biological level, the vaccine makes you safer. We have got to make sure, and the way that it is introduced has got to make sure, that we send the messages that make sure that that is not undermined by behaviours that are more risky. I broadly agree with all of that. It is never possible to say with regard to one particular instance or one particular event what would otherwise have happened, but it is clear where the balance of probabilities lies. I think that it is clear that vaccine certification is a way of increasing the safety of events like that. In other words, there would probably be less transmission under circumstances of vaccine certification. On risk compensation, I take the point that that could happen in society at large, but one would have to imagine how risk compensation among people who have vaccinated doing riskier things, for example taking place in a particular nightclub or a bar or whatever it might be. It seems to me that that might not be so important under those circumstances, because people do what they do in nightclubs. By and large, I think that the First Minister is right in terms of the balance of probabilities, but it is impossible to speak about what might have happened at any particular single event. Before I bring in Professor Drury, can I just ask you Professor Drury, considering that you have spoken to behavioural science in this quite extensively? Given the quite significant coverage that the vaccine already enjoys across the United Kingdom, is there a tipping point at which an event like the Boardmaster's event in Cornwall that we are discussing where there were 5,000 infections, is that the benefits of people evidencing their vaccinated status versus the risks of them dispensing with some of the precautions and indulging in riskier behaviour because of that means that it is more of a liability than an asset to ask for Covid certification? I think you are on mute Professor Drury. You are okay now, I think we can hear you. So, on the specific question of the venue, I am not an epidemiologist, so I cannot comment on that. I do understand that all the published studies on the reduction in transmissibility provided by the vaccine are pre-Delta, and we are talking about Delta, so there is even more uncertainty. On the balance of risks, again, it is not easy to give an answer to that because it relates to what Stephen Reicher said about the consequences and how many and how much risk behaviour follows from people's understanding of what it means to be vaccinated, so I cannot really give an answer to that. Thank you very much. I thank the witnesses for their evidence and giving us their time this morning. If witnesses would like to raise any further evidence with the committee, they can do so in writing and the clerks will be happy to liaise with you about how to do that. I will now suspend the meeting to allow a change over of witnesses. Members are advised that there is time to have a short comfort break during the suspension, and we will resume at 10.15. Thank you. Thank you. We will now move to agenda item number three, which is a ministerial statement on Covid-19. I welcome John Swinney, Deputy First Minister and Cabinet Secretary for Covid Recovery, Dr Gregor Smith, chief medical officer, and Elizabeth Sadler, Deputy Director of Covid-Ready Society from the Scottish Government. Thank you for your attendance this morning. Deputy First Minister, would you like to make any remarks before we move on to questions? Thank you, convener. I could make some opening remarks. I am grateful to the committee for the opportunity to appear once again. On Tuesday, the First Minister set out a number of updates in relation to Covid on the rules on international travel and on promoting better ventilation, including the immediate step to make up to £25 million of additional funding available to support business to enhance ventilation. The focus of what the First Minister said on Tuesday was on the Covid certification scheme, and the Scottish Government takes the position at the implementation of a mandatory domestic certification scheme as proportionate and appropriate at this point in the pandemic. Recent data has been a stark reminder of the challenges that we continue to face as a nation. Getting vaccinated remains the single most important thing any of us can do to help cases to remain under control. We have seen considerable efforts from businesses and individuals to step up compliance to mitigation measures that remain in place that remain crucial to how we emerge from the pandemic. In line with our strategic intent to suppress the virus to a level consistent with alleviating its harms while we recover and build for a better future, the Covid-19 vaccination certification scheme will allow us to meet the following aims—to reduce the risks of transmission, to reduce the risks of serious illness and death and, in so doing, alleviate pressure on the healthcare system, to allow higher risk settings to continue to operate as an alternative to closure or more restrictive measures and to increase vaccine uptake. Last week, we set out details on how a domestic certification scheme will operate, and on Tuesday we published detailed guidance on how we expect this to be implemented in the small range of sectors in scope. We have listened to a range of stakeholders and very much appreciate the challenges that the implementation of the scheme presents. That is why we are ensuring that the enforcement measures will not take effect until 18 October. To be absolutely clear, the expectation is that businesses adopt the scheme from 1 October, so we will be monitoring this closely to ensure that those requirements are being met. The interim period will allow businesses to familiarise themselves with the guidance, develop measures to enforce Covid certification and to test these in collaboration with local authority representatives and, indeed, with ministers from the Scottish Government. The Scottish Government's view is that certification can play a useful role in helping to keep case numbers low as we move into winter. We have come a long way in recent months, our economy is open and we are seeing a relative return to normality. Partnership has been catered, and I ask businesses and individuals to continue with this endeavour in the coming weeks to ensure that we are all doing all that we can collectively to recover from the ill effects of the pandemic. This afternoon, the health protection coronavirus requirement Scotland Act 2 regulations will be laid and will come into force from 5 o'clock tomorrow morning. I understand that, in line with the usual procedure that I agreed with my officials for made affirmative Covid SSIs, my officials shared draft regulations with committee clerks yesterday. The regulations amended by the regulations require Scottish ministers to review requirements at least once every 21 days, and the regulations require Scottish ministers to revoke any requirement as soon as it is no longer necessary. Thank you, Deputy First Minister. Can I ask the first question? I wonder if you could comment on the indicators that the Scottish Government intends to use to monitor the implementation of the vaccination certification scheme. What we intend to do is to monitor the pattern of the pandemic, as we have done on a consistent basis, up until now. The key indicators that we look at are in relation to the daily cases, the age breakdown within those, the levels of hospitalisation, the demand on intensive care units and to apply that to the wider modelling of the pandemic to determine what is the effect that all those measures are having within the handling of the pandemic and the scale of the challenge that we face. That enables the Government to formulate a view about what measures remain proportionate, because that is the key test that the Government must continue to fulfil to ensure that there is legal foundation to the approach, but fundamentally to enable us to make a judgment about the course of the pandemic and the measures that we require to take to take the necessary intervention. What are the key indicators that you will be looking for to determine whether the scheme is working as intended? I also wondered how the businesses, organisations and the public will be able to provide feedback on the implementation of the scheme and will you publish that information as part of the three-week review process? I am certainly very happy to consider what material we can helpfully publish to demonstrate the response and the reaction to the measures. We publish a huge amount of data on a regular basis, but if the committee wishes to specify and stipulate areas where it believes the publication of data would be of assistance, I would be very happy to consider what would be able to be published in that context. The committee has received correspondence from a member of the public who was a volunteer participant in the stage 3 Novovax trial in Aberdeen that took place in December last year. He claims that the NHS England has registered all 13,000 volunteers, but no participants have been registered in Scotland. First, do you recognise those figures? Secondly, what contact has the Scottish Government had with the vaccine trial participants to hear their concerns and to address them? I will invite Dr Smith, the chief medical officer, to comment on that. Firstly, I would be very happy to consider the letter that has come from the member of the public and to try to address the issues that have been raised. It is important that individual cases are looked at properly. The second point that I would like to make is that we have written to those who have been involved in vaccine trials to provide them with the assurance that they will be exempt from the Covid certification arrangements. However, if there is a particular issue that has arisen as part of that process that we have not taken account of, I would be very happy to do so, but perhaps Dr Smith would like to give more detail. The first thing that I would like to say is a big thank you to everyone who has participated in these trials. They have been enormously important in giving us the knowledge and the confidence to be able to move forward with an incredibly successful vaccine programme that we have done. We are eternally grateful to everyone who has participated in those. There are some specific trials that are still on-going. Within those trials, there are trial protocols that mean that people are blinded and perhaps do not know whether they have had a particular type of vaccine or if they have had a placebo. What we have committed to and done to this stage is that for those people who are participating in trials in Scotland, the principal investigators of those trials have written to each of the participants with a particular letter that they can use in the same circumstances as certification is currently employed. If you like a letter of comfort that shows that those people are involved in trials and should be treated as though they are vaccinated, where it becomes just a little bit more challenging and where there are international discussions is how those certification pieces are recognised on an international basis received by other countries. It is not unique to the UK just now. Every country is currently working through some of the challenges that are in that area, but we continue to liaise with our colleagues in the UK Government on how we might achieve a solution to that. Thank you, convener. Good morning, cabinet secretary. I have a large number of questions that I would like to ask, but if your time constraints only allow me to ask a fraction of them, we will see how we get on. This is based on the draft regulations that we got yesterday afternoon and the evidence paper. I will start by asking about the issue of allowing negative PCR tests as an alternative to proof-of-double vaccination. You say that, at paragraph 5.1 of your evidence paper, Scotland will be the only European country that will adopt a vaccine-only certification scheme with no option to provide a negative PCR or antigen test result or proof-of-recovery from a previous Covid-19 infection in a predetermined time period. We also heard in evidence this morning from experts, including Professor Dury, who talked about the backfire effects of requiring vaccine certification and how that might depress vaccine take-up among those who are already vaccine-hesitant. Given that every other European country allows testing as an alternative, why was that not considered by the Scottish Government? It has been considered by the Scottish Government and we came to the judgment that the core purpose of the scheme was to encourage the improvements in take-up of the vaccine. Therefore, we felt that on balance, and I accept that on almost all of the questions that we wrestle with in relation to Covid, we are wrestling with questions on balance because there is never a crystal clear position to be adopted. The benefits of concentrating the scheme on a purpose of increasing vaccine take-up rates would be potentially undermined by an alternative route of testing evidence being demonstrated. That is the judgment that we arrived at on that question because we did not want to undermine the vaccine take-up approaches. We have of course said that we will continue to consider the issue of whether a testing approach can be added to the arrangements that were put in place. We have not rolled out for all time, but we have taken a view that, as we introduce the scheme with the express purpose of boosting vaccination rates, we should not adopt the approach that Mr Fraser has put to me. We also heard this morning in evidence from Professor Dye and others that the backfire effects that he referred to might be minimised if there were, in the provisions for vaccine certification, some form of criteria set down whereby they would be time limited. If people could see an end point, that would remove the potential distrust among vaccine hesitant groups. Is that something that the Scottish Government has looked at? I suppose that there are two aspects to that. I accept the point that time-limited restrictions and constraints are beneficial because everybody wants to feel as if we are not in this forever. There is an end point to that, so I completely accept that point, which is why, on a number of the arrangements, a statutory level about Covid restrictions, we have end points when regulations will naturally fall as a consequence. The second point is that there is a three-weekly review of whether that carries on, and that three-weekly review will have to be tested against the judgment of whether it remains a proportionate intervention. The Government, every three weeks, will have to demonstrably show why that remains a proportionate measure to be in place. I hope that that would address some of the legitimate points that the committee has heard this morning. I think that the public needs to hear a message that this has only been done for a certain set of circumstances and for a certain purpose, and that will not last forever. I hope that that helps to address some of those points. In the court of session yesterday, James Muir was appearing for the Scottish Government. According to a report by the BBC's Philip Zym—an excellent court reporter—he told the court that there was ample time for the Government's evidence paper to be considered by all parties before the vaccine passport scheme is enforced on 18 October, rather than when the regulations come into force tomorrow. I do not understand what that comment is supposed to mean, because the regulations coming into force tomorrow have been made. Was he intending to mean that the Scottish Government might review that before 18 October, or withdraw those regulations? What did he mean? I think that Mr Muir means what he says, which is my experience of Mr Muir on all of these occasions, which is that the regulations coming into force tomorrow morning at five o'clock, but they will not be enforced until 18 October. Mr Muir was simply trying to make a helpful point to the court, which was that the evidence paper is available and can be considered by any interested party. I know that there has been quite a lot of discussion around the publication of an evidence paper. I think that it is important to remember that, on a very regular basis, the Government publishes a report on the state of the pandemic. No studied observer of that report could come to any conclusion other than the fact that we face an on-going, very challenging and acute situation in relation to the handling of the pandemic. My contention would be that, on a very regular basis, the state of the pandemic report is issued weekly. On a weekly basis, we are publicly expressing what we think to be the scale of the challenge that we face. Therefore, we are providing the evidence base for why we need to take action. We have taken other actions. We maintain a position that face coverings have to be worn in indoor settings, in public places, in public transport, in shops and all the rest of it. We encourage physical distancing and a whole variety of interventions based on the evidence that we have marshaled and communicated publicly. I would like to ask a minute, but I am afraid that we do not have time. I quickly want to ask a question on the vaccine passports before moving on. The evidence that we received this morning and an interesting expert panel by and large said that they thought that the paper that was published yesterday was fairly good. However, they said that, by putting a date on when this could perhaps finish coming back fire, what they suggested was an end criteria, where they set out a criteria. Is that something that the Government would be interested in looking at? I would contend, Mr Rowley, that that is exactly what the Government has done by fulfil, by recognising—and I have confirmed that again to the committee this morning—that the Government can only sustain those regulations if there is a proportionate justification for doing so. That is essentially the answer to the question that the witnesses were expressing to the committee this morning and the point that Mr Rowley fairly puts to me in his question. We cannot say that those regulations will be in place until a given date, because the state of the pandemic could improve to an extent where I did not have the justification for so doing. I cannot say to Mr Rowley that they will be here until X, because every three weeks that would be me prejudging the three-weekly review that we have to undertake. The likelihood is that we expect cases to be high, that hospitalisation to remain high, and that is putting great pressure on the system, which is why we need to take steps to suppress the prevalence of the virus, and the best way to do that is to increase uptake in vaccination. I hope that that helps to address the point. I took for what they said that there would be a criteria where you would set out hospital admissions due to Covid being down to zero or down to whatever. It is a criteria so that you have something to work towards rather than a specific date, and it probably makes more sense to take that approach. I do not want to sound as if I am disagreeing with Mr Rowley, because I think that that is the approach that we are taking, but we express it slightly differently in the legal test of proportionality, because if we find ourselves in a situation where there is not a sustainable legal case to be made for the proportionality of those regulations, the Government will have to deal with that. I want to move on to what I think is a much more pressing issue in terms of the public. The more I speak to people working within our NHS, our health and community services, the more concerned I become that our ability to cope this winter is immense, the pressure on staff, the pressure on these services is immense. I raised on Tuesday with the First Minister the issue of home care and community care services. It seems to me that, for what I can see, the waiting times are growing and growing and growing. For people living in the community who need home care support, the numbers of people who are assessed as needing care and on waiting times, the waiting times are going up and the numbers are going up. That will have a very clear impact on accident and emergency, as many of those people find that the only route forward. More widely, community care services support older people in the community, those services are all under pressure. The question that I asked the First Minister, and I think that she would like to ask herself, because I met the NHS 5 last week and they were keen to stress to me that this is not just a 5th problem, that this is right across the country, but what was not clear to me was where the solutions lie and therefore do we need a task force that can start to look at the level and extent of the problems that exist within community care and actually start to look at what we are going to do to address that, the here and now, given that if we do not address it, the problems are going to become even significantly greater as we get into the winter. Are we in massive pressure on our hospitals? There is a lot in that question, convener. Frankly, Mr Rowley summarises the dangers and the challenges very acutely. As of the 28th, that was yesterday, there were 1,581 delayed discharge patients in our hospitals in Scotland. If we go back to the period of the pandemic, and I know that this is a very controversial issue, but sustained efforts were taken to ensure that patients who did not require to be in hospital in the spring of 2020 were discharged to other settings. If my memory serves me right, Dr Smith might help me out here, I think that it came down to about 700 at its lowest. Forgive me, I do not have that number immediately in front of me, but my recollection was that delayed discharge came down from about 1,581 where it was yesterday to about 700, which created space in our hospitals to deal with the upsurge in Covid patients. Our hospitals are congested just now, and I accept that. Within that congestion, there are 1,581 delayed discharge patients. A proportion of those could go to home settings if the appropriate level of care packages were available for them. I am satisfied with the view that the problem about the availability of care home packages is not the availability of money to provide for those care home packages, it is the availability of personnel to deliver the care home packages. That is about the shortage of people that we have in our country that are able to be employed just now. We have lost people from the workforce because of Brexit that have returned to other countries. As a consequence of that, we have fewer people available for unemployment, which is sitting at 4 per cent, and furlough ends today. We will see the effect of that in relation to unemployment, but the estimations are that we do not expect a significant impact on unemployment as a consequence of the ending of furlough. What that means is that we have to do one or two of two things. First, we have to try to maximise the number of people that we can activate to enter the labour market to try to deliver the type of care services that Mr Rowley talks about. Secondly, we have to come to a different position of free movement of individuals, because the abolition of free movement has been a disaster for the labour market in Scotland. It was predicted and it is a disaster. Those issues are not new issues. Lord Macdonald, when he was First Minister in the early part of this century, rightly highlighted the dangers of Scotland's population falling below 5 million, and the population profile essentially weighing more towards the older population and the economically inactive. Free movement in 2004 addressed those issues for the labour market in Scotland and it has just been taken away and it is now creating real difficulty. The point that Mr Rowley highlighted is a significant threat to our ability to manage our way through the winter, because we simply cannot get people out of hospital and into their homes because the care packages cannot be supported because there are not enough people to do so. Lastly, I am forgiving me for giving such a long answer, but it is a big question that Mr Rowley has raised with me. Mr Rowley raises the question of, is a task force necessary? We are straying into portfolio territory for a couple of my colleagues, Mr Ysaf and Ms Robison, but I am certainly open to finding that those issues are being focused on in our dialogue with local government and with health boards on a daily basis. If there is another means or channel to assure Mr Rowley that those issues are being addressed, I have no criticism of the engagement of different public bodies in the process, but if we need to think about another mechanism and device to try to do that such as a task force, I am very open to that question. I will make a brief point. The issue for me is not just about bed blocking and people being able to get home care packages to get out of hospital. It is the number of older people that are living in the community that are being assessed as needing support to live in the community and being put on waiting lists, and those waiting lists are growing and growing. I visited yesterday at the Kinross day centre, where I do a brilliant job supported financially by Perth and Kinross Council, and I do a brilliant job of supporting older people in the community, bringing them in for lunch, getting lunch to them, etc. If that level of support in the community is not available, those older people will end up at the door of their accident emergency. That is the key point I am making. It is much wider than just bed blocking. It is the whole of social care and community care, and my view is buckling at the seams, and we need to focus on that. That would be my only point. I think that the points that I made were designed to address exactly the situation that Mr Rowley faces. That is not just about a compartmentalised A and E problem, if we express it that way. That is a whole system challenge, because there are not enough people—to the legitimate cases that Mr Rowley raises about people who could be much better supported if they were able to get to a day centre with a wee bit of care in their home and all that. Their entire quality of life would be better as a consequence than perhaps being in a setting that is not appropriate or suitable for them. The reason why that is not able to be delivered is because we are severely constrained in the availability of people to deliver such services. I assure the committee that the Government is preoccupied by trying to address that. My initial concerns about the passport scheme when they were first announced have been by and large allayed. I am now comfortable with where we are. Even more so with the fact that the panellists this morning all gave a good account of the evidence paper that was released yesterday. However, what they did come up this morning and still concern me is that the passport hesitancy from certain demographics is the messaging and how we get to them. My tension now is not turning to having the passport. I am comfortable with having the passport. However, my concern now is that there is a demographic in our community who are not engaging with the process and by them not engaging they put themselves at risk and they put greater society at risk. My question to the Government is what are you going to do or what are you doing about your messaging and getting into these communities where people are genuinely concerned and I take the point that they made this morning is that we cannot treat people as though they are some other because they have a problem with getting a vaccine. How are we getting to those people to make them trust the system in the first place? I think that it is important to look at this in two different ways. There is the Covid certification scheme, which has one of its purposes to increase take-up of the vaccine. However, it is not the only tool in the box. My second point is that we have to have very tailored communication and dialogue with particular sectors of our society where there is a challenge in relation to the vaccine take-up. That is about trying to make sure that, for example, respected figures or voices within a particular community make the case for vaccination. There are many people in specific communities who have been encouraged to do that and are doing that. It is also about making sure that vaccine availability is practical and conceivable for communities. If vaccine availability is for somebody who is living in poverty, if the vaccine availability is an expensive public transport journey away to get it, it is unlikely that they are going to get it. We have to take the vaccination to those individuals. There is a lot of work being done in making sure that vaccine buses and all sorts of other approaches enable vaccination programmes to be taken right into communities to enable that to be the case. I would not want the committee to take the view that the Government only views the vaccination certification scheme as a means of encouraging take-up. There are a variety of other interventions that are about messaging, practical measures and wider targeting of communications to enable that to be the case. The point was made at the previous session by one of the experts that, at one point, we had thought that 70 per cent of vaccination would be enough to give like-herd community for the whole society. Is there now a figure—I think that that is now realised to be too low—a target figure that we are going at A for the whole population, but B also for minorities, as Mr Fairlie has been saying, who have not got it yet? I think that I might be very chief medical officer to respond to that question. The concept of population immunity is whereby you and I, getting a vaccination, protect someone else as well, because the likelihood of us being able to then pass on infection diminishes as a consequence of that. There were some early calculations based on the early virus type that we saw that suggested 70 to 75 per cent may be enough if you add that into natural exposure in the country to begin to develop that population immunity. Unfortunate truth is that, with the arrival of Delta, that was blown out of the water. The original virus, the original wild type, which came from Wuhan, probably had an R number of somewhere in the region of four, two and a half to four, whereas Delta is estimated to have an R number, a raw R number of probably closer to six. That makes the achievement of that population immunity in that context much more difficult, because it is so much more transmissible. The virus is probably showing some signs of escape properties that allow it to go beyond the vaccination protection as well, although that is marginal. Where we are now is that achieving that population level immunity is very difficult to even estimate just now, because we do not have the full estimate of what the unadulterated raw R numbers are for the Delta virus. However, we could say with confidence that it is likely to be very much higher than with our original virus or even Alpha, and it is more likely to be certainly above 85% and 90% if it is achievable at all on a whole population basis. That is helpful. If we did not have the vaccine certificates, what would we need to do? For example, if nightclubs were not to have certificates, would we just close all the nightclubs at midnight? If 10,000 was the limit, would we just put a limit on all crowds of 10,000? Obviously, we have had to demonstrate reluctantly over the course of the last 18 months the type of restrictions that have been put in place on the liberties and the activities of our fellow citizens. I think that the range of interventions that are available are quite clearly understood by members of the public. It does undoubtedly come down to restrictions of sectors and opening hours and all the other measures with which colleagues will be familiar. What we are trying to do is to take an approach that enables sectors to remain open. When we look at the case numbers that we have and the hospitalisation levels that we have, we are a very serious threat. I have rehearsed with Mr Rowley this morning the challenges in our healthcare system because of the levels of hospitalisation that we still have, as of yesterday, over 1,000 people in hospital with Covid. We cannot just wish that away. That is the hard reality that is causing the challenges in the healthcare system. Levels of cases, although thankfully lower today than they were a couple of weeks ago, are much, much higher than was the case at different stages during the pandemic. When we had communities locked down, if Mr Mason represents the city of Glasgow, it had a rate per 100,000. I think that we were locking down Glasgow at 300 per 100,000, and its case rate per 100,000 will be in excess of that today. Obviously, because the vaccine provides us with a certain amount of protection, but it cannot provide us with total protection, which is why we have to have tempering effects that then try to moderate the effect of the virus. The Covid certification scheme, one of its motivations, is to keep sectors open that, in any other circumstances, would be likely to have to close because of the prevalence of the virus. This morning, we heard that one of the key successes for vaccine passports is community engagement. We heard from the Deputy First Minister three weeks ago that there was no public or business consultation prior to declaring the intention of implementing the vaccine passport, because he did not want that to become public knowledge that he was considering. Can I ask how the Scottish Government gathered the evidence on passport vaccine potential effectiveness? We have gathered that by looking at international experience. We have seen examples in other jurisdictions where the application of a Covid certification scheme has significantly increased vaccine take-up, so the evidence for that has been demonstrated in other jurisdictions. One of the very strong examples of that being in France, but there are others where that has been the case. We have always looked at the experience that emerged from the studies undertaken by Public Health England when the United Kingdom Government was exploring some of the questions around the access to events process that was undertaken in the course of this year. Earlier this year, Public Health England undertook that work for the United Kingdom Government. Obviously, we have looked at some of the research material there. A lot of that is charted in the evidence paper that was published yesterday. One of the things that we heard this morning was that, for example, in France, they did not just have a vaccine passport, they also took evidence of previous infection as well. What they suggested this morning was the comparison with other schemes in other countries. We have to be careful how we utilise that data, because it is going to be specific to the country. Even in your evidence paper, it said that the impact in Israel is unclear. One of the things that we have heard in evidence in this committee is that, as was alluded to by Jim Fairlie, one of the main barriers to uptake of the vaccine, which is what the vaccine passport is for, is within the ethnic minority, especially around Polish and African communities and in areas of deprivation. Where the evidence suggests that the introduction of a vaccine passport will have a positive impact on those communities, because those communities are the ones that are the hardest to reach at the moment with that particular issue? I think that quite a lot of this I covered in my response to Mr Fairlie, because I see that as the Covid certification as one part of a two-part strategy. I cannot give Mr Whittle a tangible number of members of the Polish community or the Black and minority ethnic community that will have vaccination as a consequence of Covid certification. What I am confident about is that, if we make sure that that scheme, plus measures to reach those communities in a direct, focused, targeted way, with messaging from within the community, with practical availability of access to vaccine services available, we can get to a point whereby we are increasing vaccination levels in those communities and in other communities, particularly to ensure that among younger people and those who are using higher risk settings, that we are ensuring that the take-up is maximised to the greatest extent possible. I think that the point here that I am trying to make, Mr Swinney, is that the Government used the percentage of the population that is vaccinated, but when you drill down into those figures, you find that predominantly the indigenous population of Scotland is highly vaccinated. In fact, it is more vaccinated than the people who perhaps would have expected at the start, but there are pockets within our communities that are not highly vaccinated. When we are implementing a vaccine passport, my problem is that I am not convinced that we have the evidence that suggests that using vaccine passports at night club to football matches will actually impact those that require it the most. I agree with you that community engagement is really important, but vaccine passports will not impact that to the level that you would want. I fear that we are not going to have a meeting of minds on that particular question. If I look at vaccine uptake, let me make a sweeping generalisation that people below the age of 39 are more likely to be in night clubs than people of my vintage. I am afraid to break that solemn news to Mr Whittle. He will not be bumping into me in a night club. However, the levels of vaccination below the age of 39 are comparatively lower than those above that age group. Part of the approach about Covid certification is to try to say to people that it is a further incentive to get vaccinated to make sure that you can enable yourself to participate in those activities. Obviously, a large number of people of different ages go to some of the other settings, such as football matches, where I accept that it is a much broader age demographic. However, if we approach that, I encourage colleagues to think of it in that way as one part of a two-part strategy, who we accept. I do not dispute Mr Whittle's point about making sure that we have targeted focused interventions for people living in deprivation, for people in the black and minority ethnic community, for people from other social groups that are low-take-up, and that we concentrate our efforts on doing that. I pay tribute to the vaccinators for what they are doing to try to do all that. We will get to the point that Mr Mason puts to us that we have vaccination levels at such a height that they are providing us with protection within the population, or as much protection as we can have. To be fair, cabinet secretary, you probably will not find over 70s from the African community in nightclubs either, but their vaccination rate is 20 per cent lower than the average. The meeting of minds here is the fact that I do not believe that the evidence that you suggested you had three weeks ago is that you are backfilling that evidence now to establish the need for a vaccine passport, so that is probably the point that I am making. On that point, if Mr Whittle was to look back, at the state of the pandemic, evidence papers published on a weekly basis over the course of the past six, 10, 12 or 20 weeks, he would see the same evidence-based emerging of the challenges that we face. The question that flows from that is what do we do in a changing pandemic to address those circumstances and, ideally, avoid the type of scenarios that Mr Mason put to me that there might have to be wider restrictions applied on the way in which particular sectors are operating? I would love to take this to be a wider band for us, but I think that we are running out of time. Thank you, Graham Simpson. Thank you very much, convener. What level of vaccination rates do we need to get to in order for you to drop the scheme? That is a difficult question for me to answer, because we have to weigh up a range of factors in the discussion of the proportionality of the scheme. As Mr Simpson will be familiar with, we have tended not to have one particular indicator that judged performance at any given time. There is a basket of information that we have to look at. I have cited principally that we have to look at cases, levels of hospitalisation and levels of vaccination. I think that those three factors provide us with a reasonable assessment of where we are and how we are performing. It is within the condition of those three indicators that we have to make a judgment principally about the proportionality of any intervention that we make. It is not just about Covid certification. When the schools returned in August, we said that we would regrettably require pupils in the secondary sector to wear face coverings for a period that we thought of six weeks because of the prevalence of the cases, particularly among younger school age populations. We had to say that regrettably that is going to have to extend for another period, but we judged that to be a proportionate act based on the segmentation of information around case numbers. You cannot say what level of vaccinations you wish to get to. Will you be in a position at any point to give the public your thinking on the number of cases and the vaccination rates, the whole suite of things that you just mentioned, so that we know what we are aiming for? The best thing that I can say is that we know what we are aiming for and we are aiming to suppress the virus to a position whereby we can get on with normal life. If we get good levels of compliance on the baseline measures that we have in place, I think that my sense is that there has been a significant upsurge in recent weeks of compliance with baseline measures, which I think is helping to suppress levels. I thank members of the public for that. We can come to a judgment about the proportionality. When can we do that? On a weekly basis, the First Minister is updating Parliament. Cabinet looks at the issues on a weekly basis. We are taking stock every single week about whether there is an on-going justification for those measures. Cabinet on Tuesday, we took the view that there was an on-going justification, but there was no justification for going any further beyond the Covid certification scheme. We are looking at that on a weekly basis, plus we have the formal three-week reviews that are reported to Parliament. The problem with all that, and I am not asking you to respond to this, is that the rest of us have nothing to judge you against because you will not say what it is that you are aiming at. I want to ask about something else. This is a real concern of mine. It is about privacy. If my daughter goes to a nightclub tomorrow, I would be astonished if that ever happened, but if she does, she has to show a QR code, up pops her name, her date of birth and anyone could then find out where she lives. I think that that is an awful breach of privacy and potentially puts people in at some risk. I would want to assure Mr Simpson that I might help if I was to provide Mr Simpson with the opportunity in the committee. I should offer the committee if the committee wished to have a more detailed briefing with the officials and the teams that have developed the app. I would be very happy to arrange that if that would help to reassure members about some of the issues and the practicalities at another stage. I am very happy to be able to— I am not a member of the committee, but the point that I am making is that it is the information that is given to a complete stranger, be it a nightclub or a football match, at this point name and date of birth, at a later point just your name, but even just your name. Why should anyone, why should a complete stranger know your name, they have seen your face and then be able to look you up? For certain circumstances that will happen in other environments. If I go to an airport and I have to show my passport, I am shown it to a complete stranger and they will know my name, not know my date of birth, my passport name. Sorry, if I could just come in as well with nightclubs, you do need to show identification of your driver's licence when you go into nightclubs, so that usually the stewards would see that as you go into nightclubs. I am delighted that the convener's knowledge of nightclubs has come to my assistance, but I think that there is a very serious point that Mr Simpson raises. If it would help—I will reflect on this as to whether there is perhaps a way that members of Parliament can be briefed about the approach to try to reassure Mr Simpson about the issues that he raises. I totally understand the sensitivity that he has on this question. It is a data protection issue. I would not for a moment trivialise the significance of the issues that are raised. Do I have time for one more? I was just reading through the draft regulations. Correct me if I have misread this, but it looks to me like cinemas are exempt, but theatres are not. Theatres are live entertainment, so they are technically within scope. However, the scope also has to take account of the capacity limits. It would only be a theatre that was over 10,000 people, so in practice they are not within scope. It has to be a big theatre, so if it is a small theatre, it would be exempt. It is only indoor settings of 500 or more people who are mainly standing, so that would not include indoor settings over 10,000 people. It would only take out every theatre in Scotland. All theatres in Scotland? Unless there is a theatre that is over 10,000 capacity. That is useful. Good morning to the panel. Deputy First Minister, I wrote a phraser and brought our attention to the most striking admission in the Government's paper that was published last night. Scotland, when it introduces vaccine certification, will be the only country in Europe to bring that in isolation without the requirement for testing. I wrote down part of your answer that the Government did not want to undermine vaccine uptake. Is there empirical evidence that you have from other European countries that have brought that in tandem with testing requirements to suggest that their vaccine uptake has been inhibited by that combination of measures? I do not have any information on that point, but I would point out to Mr Cole-Hamilton two things. First, there are other jurisdictions that are bringing in a Covid certification scheme on vaccination only. The Government has made a choice that is about the focus of the scheme and the focus of the scheme is primarily to drive the increase in vaccination rates. I am grateful for the reply. That seems slightly at odds with the messaging in the Government's own evidence paper that was published last night in section 5.1 on the basis for introduction. The very first clause of that is about reduction of transmission. The increase in vaccine uptake is ancillary. That is the fourth bullet point. I recognise that— On that point, I think that if we increase uptake of the vaccination, we increase the degree of protection within the population, which therefore has the effect on suppressing the circulation of the virus. I suspect that we are about to get into whether the chicken is following the egg or the other way around. I am more than happy to concede that point. I think that Mr Cole-Hamilton and I know what we are debating here. Of course. I am happy to concede that point. My anxiety is that, as we have heard from eminent academics this morning, that it potentially drives down uptake in those hesitant groups, or rather the vaccine-skeptic groups. If they are feeding and feel brow-beaten, they might not take it up. I want to move on. That has been a point that I wanted to reflect on from the evidence that the committee heard this morning. I think that there is another important element that the witnesses this morning were adding to this, which was around the question of whether that has been done within an environment of a trusted society. I think that the evidence generally suggests that there is a high level of trust within Scotland on the way in which Covid-related issues have been handled. It is important that we acknowledge that backdrop is there to enable a scheme of this type to be applied in the fashion that I have suggested to the committee. I have one final area, convener. That is about proportionality. We heard from the Scottish Human Rights Commission last week that there is very much an anxiety that this scheme will row back our application of human rights and those ones that we have a statutory right to. Judith Robertson, the convener, was very clear that it is acceptable for states to do that in times of pressing need, and obviously coronavirus is a pressing need, but if the scheme that is being introduced or the rollback of those rights can demonstrably impact on pushing down against that need, she also talked about proportionality and you talked about proportionality. The question that I would like to ask is the evidence of proportionality. Meeting that test set just by the Scottish Human Rights Commission requires that the Government evidence that it has considered alternatives to that scheme. Are you satisfied that you have considered the use of testing as an alternative to vaccine certification to an extent that the Scottish Human Rights Commission would be satisfied with? I obviously cannot speak for the Scottish Human Rights Commission, but I absolutely accept the tests that the Scottish Human Rights Commission would place upon us. Those matters to the Government, Mr Cole-Hamilton, will be familiar with the Government's position on the significance of human rights in all of the activities that we take forward. He knows the legislation that the Government has taken through Parliament, for example, on the incorporation of the United Nations Convention on the Rights of the Child, so that is an illustration of the Government's commitment to a human rights-based approach. Indeed, the Covid recovery strategy that the Government is working on focuses very much on a human rights-based approach in relation to recovery and it will be material to the public inquiry that takes place on Covid issues. I do not in any way dispute the importance and significance of the human rights questions. Where I absolutely agree with Judith Robertson is that those questions are fundamentally hinge on the question of proportionality. The Government has got to be able to satisfy itself of the question of proportionality of any of the measures that it takes forward. We also, as Mr Cole-Hamilton will well know, have to satisfy ourselves that we could withstand legal challenge on any of those questions, and it is a question that the Government considers very carefully on all occasions. In answer to the question about alternatives, the Government looks at a range of possible approaches that we might take, and Mr Mason invited me to speculate on some of those as alternative measures on the restriction side. There are, of course, other arguments in relation to testing approaches, which I would contend that the Government is using to the maximum of our ability to ensure that those devices are being used. However, we judge that a Covid certification scheme is a proportionate measure in addition to the range of other interventions that we are taking forward to suppress the virus, to increase uptake of the vaccine and to protect the public. I think that we might just have one more brief question, if we could, please. I will try to be brief, convener. I have got some specific questions around the terms of the regulations, so I will ask one and see how we get on. There is a new power of entry contained in regulation 16A in the draft instrument that we saw yesterday afternoon, which gives power to entry a property without warrant, where permission to enter is refused to ensure that an offence is not being committed in terms of the regulations. That is a power that can be exercised by a police officer or by a local authority officer. How does the Scottish Government foresee those regulations being enforced? For example, do you see a role for the police in doing this? No, I do not. I think that the approach that will be taken—this is a habitual approach that is taken in all the settings—and I am very happy to put on the parliamentary record that this will be the approach that will be taken. It is an approach that I have discussed with local authorities and a very helpful discussion with local authorities on the question the other day. We will be taking an approach that is about engaging, explaining and encouraging before we get to enforcing. The Four E's approach, with which many institutions will be familiar in relation to the work of local authority regulators, will be very much the approach that is taken. We want to work with businesses to make sure that they understand the obligations and to support them in putting in place the practical measures that they can take forward. That will be the cultural approach that is taken. Local authorities are very keen to make sure that that approach, which is a very commonplace Scottish local authority approach, is maintained as we take this forward. One other question about the draft regulations. There is a provision in the new regulation 7E, which sets out the list of exempt events. 7E subparagraph C exempts any event designated by the Scottish ministers as a flagship event according to criteria and in a list published by Scottish ministers. That is a very wide power being given to Scottish ministers there. Obviously, we have no definition at this stage of what a flagship event is. Can you explain a bit more about what is envisaged there and what would fall under that list? It is trying to provide the appropriate opportunity for us to designate individual events that might be of a particular noteworthy nature. For example, our Majesty the Queen is coming to Parliament on Saturday and I would describe that as a flagship event. There is no necessity for us to consider those issues because the numbers of people involved will not be appropriate, but I can envisage flagship events that we might all wish to have the appropriate opportunity and recognition to take forward. I will be right. The committee may recall that during the summer there were a number of events that were allowed to progress outwith the scope of the regulations in place at the time. That included things like the Edinburgh international festival, some of the larger golf events, where there was an exempt where, on the basis of public health advice, those events were considered to be so significant in terms of their impact on Scotland as an international place where people want to do business that they were allowed to progress. That is essentially—there are no events in that programme extant at the moment, but that is just to enable if there were to be any events such as that that they could be exempted from certification, if required, but we do not have any at the moment in planning. I can go back to Graham Simpson's point and ask the Deputy First Minister with the agreement of the committee. I think that it could be helpful if we had a briefing, not only for the committee, for all MSPs on the new app, if that would be possible. I will take that issue away, convener, but I think that there is a fair point to be addressed there, so let me take that away and put that into motion. That concludes our consideration of this agenda item. I thank the Deputy First Minister and his officials for their evidence today. The committee's next meeting will be on 7 October and will take evidence from the Cabinet Secretary for Health and Social Care on the vaccination programme and pandemic preparedness. That concludes the public part of our meeting for this morning, and I suspend the meeting to allow the witnesses to leave.