 That concludes topical questions. The next item of business is a statement by Nicola Sturgeon on a Covid-19 update. The First Minister will take questions at the end of her statement, and so there should be no interventions or interruptions. I call on Nicola Sturgeon. Presiding Officer, in giving an update on the latest Covid situation, I'll provide an assessment of the current course of the pandemic. In light of that, I'll confirm that no immediate changes are being proposed to the mitigations that remain in place. I'll also report on the progress of the vaccination programme and provide a brief update on international travel. Lastly, I'll give a summary of the mitigations that are being deployed to minimise the risks of transmission at or around COP26. First, though, the most recent statistics, 2,262 positive cases were reported yesterday. 11.5 per cent of all tests conducted. 917 people are currently in hospital with Covid, 15 more than yesterday. 59 people are receiving intensive care to more than yesterday. Sadly, a further 20 deaths have been reported over the past 24 hours. That takes the total number of deaths registered under this daily definition to 9,072. Once again, I want to send my condolences to everyone who has lost a loved one. More positively, the vaccination programme continues to make good progress and I'll provide more details on the booster programme later. However, at this stage, I will confirm that 4,309,932 people have received a first dose, 3,897,133 have had both doses. In total, 87 per cent of the over-18 population is now fully vaccinated with two doses. That includes 96 per cent of the over-40, 76 per cent of 30 to 39-year-olds and 67 per cent of 18 to 29-year-olds. In addition, 75 per cent of 16 is 17-year-olds and 53 per cent of 12 to 15-year-olds have had a first dose. Of course, for most people in these age groups, only a single dose is recommended at this stage. This weekly update coincides with the latest three-week review point for the remaining regulations, so I can confirm, as I indicated a moment ago, that at our meeting today the cabinet agreed to make no change to the current regulations that are in place. That reflects our assessment that, although the situation has greatly improved since August, it remains fragile as we head into the winter period. In my statement before the recess, I reported that case numbers had fallen by more than 20 per cent in the preceding week and by more than 60 per cent in the preceding five weeks. The fact that cases had declined so steeply without the need for tougher restrictions was extremely welcome. It showed that increased compliance with mitigations together with increased immunity through vaccination previous infections or, in some cases, both had been capable of stemming even the delta variant. However, over the past three weeks, while cases remain much lower than the previous peak, the decline has levelled off. In recent days, we have been reporting a very slight increase in cases. To illustrate that further, three weeks ago, there was, on average, just under 2,500 new cases being reported each day. Now, the average is just over 2,500 cases a day. It is important to see this in a wider context. Having had the highest rate for a period, Scotland currently has the lowest Covid case rate of the four UK nations. The increase in cases is, at this stage, relatively small, around 2 per cent. We are certainly not experiencing a surge in new cases of anything like the magnitude of late August. However, as we know from experience, there is never any room for complacency with this virus. We cannot ignore the fact that case numbers have started to creep up again. Of course, even before this recent increase, they were at a level higher than we would have wanted. One consequence of the continued high number of cases is that the NHS remains under significant pressure. Although case numbers are lower than in early September, we are seeing a slightly different age distribution with increases in the older rather than the younger populations. That, in part, helps to explain why the steep reduction in case numbers has not been mirrored by an equally steep decline in hospital admissions. Covid-related hospital occupancy, which is the number of patients in hospital with Covid at any given time, is lower than it was three weeks ago, at 917 today compared to 998 three weeks ago, but it has increased slightly again in the past week. Hospital admissions also remain high. There are more than 600 people with Covid still being admitted each week just now, and admissions to ICU have also increased. What all of that means is that NHS staff are dealing with significant numbers of Covid patients alongside other patient care, while also preparing for wider winter pressures and dealing with the backlog of care built up in earlier stages of the pandemic. In fact, the entire health and care system is currently under considerable pressure, as all members are aware—arguably, more pressure now than at any previous stage of the pandemic. Across the country, hospitals are at or close to capacity, and the social care system is also under pressure. Those pressures are, of course, likely to intensify during the winter period. We know that, with people meeting indoors more often during winter, there are more opportunities for a virus to circulate, and that could lead to a further rise in cases. We are also approaching the winter flu season, which could also add to the pressure on the NHS. We are therefore working closely with health boards as they deal with those pressures. Of course, the health secretary has already confirmed a package of winter support. In addition, I can confirm today that a further £482 million is being allocated to the NHS and to integration authorities. That includes more than £120 million to support, test and protect, and more than £130 million also to support further the vaccination programme. The balance of funding will cover additional Covid-related costs such as staffing and equipment. The pressures on the NHS are a reminder that Covid is still a threat to our individual health and also to the capacity of our health and care services. That is why continued high compliance with existing mitigations and protections is so vitally important. At this moment of fragility, I am asking all of us across the country to make a renewed individual and collective effort to stick to the basic protections that are still in place and help to drive cases down again. Please wear face coverings when required, ventilate indoor spaces wherever possible, wash hands and surfaces, use LFD tests regularly and book a PCR test if one of those LFD tests shows up positive, or if you have symptoms of Covid or if you are identified as a close contact of someone who is positive. Please also continue to give contact details when visiting pubs and restaurants, for example, and show your Covid certificate if visiting a venue where that is required. The Covid certification scheme has been operational now for more than three weeks and is now enforceable by law, and I am grateful to the businesses who have worked hard to comply with the scheme. Last but not least, we continue to ask people to work from home whenever that is possible, and that continues to be an important way of reducing transmission. The Scottish Government will continue to work with business to support an appropriate phase return to office working, but it is important to stress that, at this stage, we are still encouraging people to work from home as much as possible. I am grateful to employers who continue to do everything possible to provide safe environments for both their workers and their customers. Presiding Officer, in summary, this is a moment again for all of us to step up our compliance with these basic protections. We do know from experience that if we do so and when we do so, we can stem transmission, and it is important that we do so now. The judgment of the Cabinet today, informed of course and as always by clinical advice, is that it is not necessary at this stage to reintroduce any tighter restrictions. However, as has always been the case, we will keep that under review. In particular, we will consider on an on-going basis whether any of the existing mitigations need to be strengthened in any way. Of course, the most important tool that we have against Covid is vaccination. The NHS is currently delivering the biggest-ever winter vaccination programme. Over the course of this winter, more than 4 million flu vaccines and more than 3 million Covid vaccines will be administered. Almost 1.5 million of those have been delivered already. The Covid booster programme commenced within a week of the JCVI advice on prioritisation, being received, and so far more than half a million people have had a booster jack. Those over 70 and those on the highest risk list are being prioritised first, and those groups, together with older people in care homes and front-line health and care workers, will all be offered the booster vaccination between now and early November. Other groups, including all adults over the age of 50, will get booster appointments through November, December and, in some cases, into early January. The portal that will allow those in younger age groups to book appointments online will open in November. I remind members that the main constraint on the speed of vaccination is the JCVI advice that six months must have elapsed between a second dose and a booster dose. In short, we are making good progress, but every effort is being made and will continue to be made within the limits of that JCVI advice to accelerate the pace of the programme. For example, particularly as the programme moves down the age groups, we will be considering additional clinics, particularly at evenings and weekends, and we will continue to support health boards to identify, recruit and train additional staff as required. We are also enabling boards to make use of healthcare students and primary care staff, including GPs, GP practice staff, dentists and pharmacists, where that is appropriate to help meet demand. It is also important to note that, for convenience and to avoid older and more vulnerable people in particular, requiring two separate appointments, Covid booster and flu vaccinations are being co-administered wherever that is possible. That might mean that some people will receive their flu vaccine slightly later this year than might normally be the case. However, please be assured that the timing of flu vaccines is entirely clinically appropriate. I mentioned earlier that 53 per cent of 12 to 15-year-olds have now received their first jaggan. I sincerely thank all those young people who have come forward for vaccination. I can confirm that everyone in that age group has now had an appointment scheduled and should have received a letter telling them about their appointment. I would again encourage all 12 to 15-year-olds not already vaccinated and their parents and carers to read the online information about vaccination so that they can take an informed decision about getting the jaggan. If you have not come forward yet, please do so as soon as possible. As I noted earlier, the scale of the winter vaccination programme currently under way is unprecedented. Therefore, I want to take the opportunity today to say how grateful I am, how grateful all of us in the Government—and I am sure across the chamber—are to all those across our pressurised health and care service who are contributing to the success of the vaccination programme. Again, I would urge everyone to get vaccinated for flu, for Covid or for both, if you are eligible, as soon as you are called to do so. Getting vaccinated remains the single most important thing that we can all do to protect ourselves, particularly over the course of this winter, and of course to protect each other. The good progress in vaccinating young people is relevant to the next issue that I want to briefly refer to, which is our on-going work to ensure that schools remain as safe in this context as possible. We confirmed last week that the current school mitigations, including the wearing of face coverings, would remain in place for a further period. That is in light of the slight increase that we have seen, and I have reported on today, in transmission of the virus. However, we also gave a commitment to monitor key information, including, of course, case rates, on a weekly basis, and lift those mitigation measures in schools as soon as it is considered prudent to do so. We also know that ventilation is one of the most important ways to reduce the risk of airborne Covid transmission and that carbon dioxide monitors can help schools assess and improve their ventilation. That is why we committed to provide local authorities with an additional £10 million of funding to ensure that schools and childcare settings have access to carbon dioxide monitoring. I can confirm that the education secretary will be writing to the education committee of Parliament later this week with a full update on the progress that local authorities have made in completing CO2 assessments of schools and other education facilities. There are two other issues that I want to touch on before concluding today. The first relates to rules on international travel. Fully vaccinated travellers returning from non-readless countries are currently required to take a PCR test on day 2 of their arrival back to or into Scotland. The UK Government announced recently that travellers arriving into England will be able to take a lateral flow test with photo verification instead of a PCR test. For practical reasons, the Scottish Government will align with this change. That means that from 4am on Sunday 31 October, people travelling to Scotland can also provide a lateral flow test rather than a PCR test on day 2 of their arrival. Travellers will be able to book lateral flow tests from the list of providers on the Gov.uk site in advance of arrival into Scotland from around 5pm on Friday. Those tests cost between £20 and £30, which is less than a PCR test, so I am sure that this change will be welcomed by travellers and by the travel industry. However, it is important to stress that if a lateral flow test is positive, a PCR test must then be booked to confirm the result. The final update that I want to give today relates to the upcoming COP26 summit in Glasgow, which of course gets under way this coming weekend. Indeed, some delegates are already here for pre-sessional events. The summit, of course, is one of the most important gatherings of this century so far. It is perhaps the world's last chance to avert future climate catastrophe. The Scottish Government will do everything that we can working with the UK Government to help to make it a success. The hosting of COP would always have been a significant challenge given the scale of the event for the UK and Scottish Governments and for Glasgow City Council. However, the fact that it is happening amidst a global pandemic obviously makes it even more challenging, and it is inevitably the case that an event of this scale poses a risk of increased Covid transmission. However, I want to assure Parliament and the public that the Scottish Government has been working closely with the United Nations and the UK Government to mitigate those risks as far as possible. Steps have been taken to ensure, as far as possible, that delegates have been fully vaccinated before arrival. Everyone arriving in Glasgow from outside the common travel area will also need to show a negative test result before they arrive in the UK, and anyone from the seven countries still on the travel red list will be required to stay in managed quarantine for 10 days. In addition, everyone entering the core venues for COP, the blue zone, will be required to take a lateral flow Covid test every day, where face coverings and follow 1m physical distancing and hand hygiene guidance. The event space also has strict hygiene protocols in place. Of course, all those attending, whether they are attending as official delegates or activists, will be required to follow the same basic Covid precautions as the rest of the population, such as wearing face masks in indoor public places and in public transport. As we know, all of those steps will help to reduce the risk of Covid transmission, and I hope they help to make COP a safe event, as well as, we all hope, a successful event. I said earlier that our position, although improved from over the summer, is still fragile. Vaccination is still allowing us to live with far, far fewer restrictions and mitigations than was possible at earlier stages of the pandemic. Of course, case numbers are lower than they were in August and early September, but they are still high and may now be rising again. First, as I have already mentioned today, please get vaccinated if you are eligible and have not yet done so. That includes going for a booster-jag when you are invited to do so. It is never too late to get vaccinated, so if you have not done so previously, it is still possible to come forward and get your jags. Second, please test regularly with lateral flow devices. I remind people that they can be ordered through NHS Inform or collected from local test sites or pharmacies. If they test positive or are identified as a close contact or have symptoms, please self-isolate and book a PCR test. Thirdly, please comply with the mitigations that are still in place. We face coverings in indoor public places, wash hands and surfaces thoroughly. Meet outdoors if you can. That is increasingly difficult as we get deeper into winter, but outdoor environments are safer. When meeting indoors, open windows, anything at all that improves ventilation will help. All those precautions make a difference. We have seen that at previous stages of the pandemic. They will protect you and the people around you, and they will help ease the burden on our national health service. Please stick with it, and my thanks once again to everyone who is doing all that. The First Minister will now take questions on the issues that were raised in her statement. I intend to allow around 40 minutes for questions after which we will move to the next item of business. I ask members to please press their button if they wish to ask a question, and I call on Douglas Ross. Figures released today confirm that we have the worst accident and emergency waiting times ever. Every week, just when we think that they can't possibly get worse, they do. It's not only in A&E. Every part of Scotland's front-line health services are stretched to breaking point. Crucially, every one of those numbers represents a patient waiting far too long, sometimes in great pain. Our NHS staff are doing outstanding work, and they are very best, but they need more support from this Government. We welcome the announcement of extra NHS funds, but the problem is that this Government has repeatedly failed to properly plan ahead and heed the warning signs. The Government has dithered and delayed instead of acting, and nowhere has that been more apparent than in the roll-out of the vaccine booster jack. As the First Minister said, the vaccine is our biggest weapon against the virus. Back in January, when the Covid vaccine was first rolled out, there was real urgency to deliver it. Where is that urgency now? In her statement, the First Minister said that the main constraint of rolling out the vaccine is the JCVI advice to wait six months between the second jack and the booster jack. But today we learned that there are 100,000 people who got their second jack six months ago and should be getting their booster but are still waiting. Has the First Minister identified specifically what is holding up those people getting their booster jack? Also today we heard that, despite calling for Armed Forces assistance a week ago, NHS Grampian is still waiting. It is unclear if the Scottish Government has made that request to the Ministry of Defence. Will the First Minister update Parliament on that request and this issue? I know that she is getting—it would be useful for the Parliament to get that update today. Finally, we have all heard from constituents, including some very vulnerable people, who have been sent considerable distances to get their flu jab and Covid booster. Do we have enough vaccination clinics right now to make sure that everyone across Scotland can get their injections locally? First, on the pressure that our national health service is operating under, including our accident and emergency services, it is pressure that is unprecedented. Not just here in Scotland but across the UK and indeed health services are facing this pressure across much of the world because of the circumstances of the global pandemic that we have been living through. This Government continues through resources and through support in a range of other ways to support the health service as much as we possibly can and that will continue. The pressure on our health services is undeniable and that pressure is felt first and foremost by those working on the front line. My gratitude to them is well known and I will repeat it again today. That support means that this does not, in any way, take away from the reality of the pressure but to give some context. Accident and emergency services, for example, in Scotland are performing to a higher standard than in the other four nations of the UK. We want to get it higher but it is important that we understand that context. Through the measures that the health secretary has outlined, through the further support that I have outlined today, we will continue day and daily to ensure that the health service has the support that it needs. Of course, we can all help the NHS right now by doing all the things that we know keep down our pressure on Covid. The fewer people in our population who have Covid, the fewer people who will need hospital treatment for Covid and therefore the more we will all be helping the national health service. The vaccination programme in Scotland is going exceptionally well and I want to just share some of that in more detail briefly with the chamber. We have, as a percentage of our total population, the highest percentage of people vaccinated, for example, with a first dose of all the countries of the UK, 78.8 per cent of the total population. The next is Wales, with 76.4 per cent. Similarly, in terms of the second dose, 71.2 per cent of the total population in Scotland. The next is Wales, again, with 70.6 per cent. We are top of that table. We are also significantly ahead when it comes to the vaccination of 12 to 15-year-olds. On the roll-out of booster jacks, which is the single most important thing that we are focused on right now, our vaccination rates are broadly in line with the rest of the UK. As I said, we are doing everything that we can to accelerate that within the confines of the JCVI advice. I heard the WHO special envoy on Covid on the radio this morning recognising the logistical issues that all countries have to grapple with in delivering a vaccination programme of this scale, but everything is being done to make sure that that happens at pace. Lastly, on vaccines, we have had to balance local delivery with large-scale delivery, which leads to some people having to travel longer distances for the older and more vulnerable members of our population. We have tried to do that as locally as possible, and that will continue. We will continue to assess on an on-going basis the number and location of vaccination clinics to make sure that balance is right. Finally, on the issue of the request for military support by Grampian, that will be submitted when that request has been refined to an appropriate degree. It is important that health boards do not request things that they do not need and make sure that those requests are properly framed, and that work is on-going. When the first wave of the pandemic hit thousands of our older people and the most vulnerable were put in danger, particularly in our care homes, the First Minister assured the chamber that lessons would be learned. I know what the First Minister says about NHS pressures, and I accept that Covid is a part of that. However, let us not deny the fact that there were huge pressures in our NHS pre-Covid, and our NHS staff were crying out that they were overworked, undervalued and under-resourced even before the pandemic hit. We are facing those pressures even before the winter has begun. We have also seen thousands of older and vulnerable people whose protection is reducing from the pandemic, because protection from Covid decreases over time, and the scientific advice is clear. The booster vaccine should be delivered after six months of the second dose. The Government is claiming that the booster programme is on track, but today we learned that up to 104,000 people who are at higher risk in Covid-19 are still waiting for a booster, having already waited longer than six months. We are hearing about long queues outside vaccination centres in all weathers, with people being asked to travel many miles for their booster. Some examples. In Alexandria, 79-year-old Janet Finlay waited over two hours before being turned away due to her vaccines being recorded incorrectly. Mrs Christine Howick, 81-year-old, had an appointment at 4pm and had to wait for two hours. Mr MacDonald, 79-year-old and disabled, had to wait almost an hour and a half. That is simply not good enough. Those are not figures on a spreadsheet. Those are people, people's mothers, people's fathers and people's grandparents. The First Minister suggested that evening weekend clinics might open in the future, but does she not agree that we need more capacity right now? She has set out that the Government's timeline for when boosters will be delivered, but can she tell the 104,000 people who have already waited far too long when they expect to get their boosters? I am a bit puzzled and confused by what she said about NHS Grampian and the use of refined and whether it actually needs it or not. The simple fact is that NHS Grampian has asked the Scottish Government for additional support and military assistance and, over a week later, the MOD has not received that request. We need urgent action for those NHS boards, so we can deliver quality NHS care for people. First Minister, nobody denies the pressure on our NHS pre-Covid. That is why the Scottish Government had already introduced and was progressing well with, for example, a waiting times improvement plan. Equally, not least anybody who wants to have credibility on those issues can deny that that pressure has been significantly exacerbated by a global pandemic. On the issue of care homes, we are prioritising vaccination now, as we did at the start of the vaccination programme for those elderly people in care homes. We were criticised at the start of the vaccination programme for doing so, because it made it look as if we were slower in our progress overall, but that was the right decision then and it is the right decision now. We could not start vaccinating with booster jags until the JCVI gave their final advice, by which time many people had already passed the six-month mark. We are making sure that that pace is as fast as it can be and looking at always to speed that up, but the six-month rule is there. We are taking a slightly different interpretation of six months actually to the health service in England, where we are defining it as 24 weeks rather than 26 weeks to allow us to do it that bit quicker. We will continue to speed that up as much as possible. We look on an on-going basis. I had a session with the health secretary and officials yesterday to look at what more we can do now and what more we need to do as we go into the lower age groups to make this as quick as possible. All Governments across the UK are grappling with this and following not identical approaches, but broadly the same approaches. Overall, our vaccination programme has gone well. I have already cited the figures that show how well it is going, but we are focusing on this on a daily basis. We also want to make sure that we support health boards to avoid queues or delays when people turn up for vaccination. It will always be a difficult balance to strike between local access and mass access, a difficult balance to strike between appointments and drop-in. That is something that is reviewed again by those who are administering the programme on a daily basis. The vaccination programme is a success, but the next phase of it remains absolutely critical to getting through the winter nothing that the Government is doing right now is more important than that. Finally, Presiding Officer, because I can see you looking at me, with that gaze, it is often the MOD—rightly and understandably—that asks for those requests to be refined. It is important that we make use of military assistance, where that is appropriate, but that we do not ask the military to do things that health boards should be doing themselves. That is why that process is so important. On 20 September, the Government announced that all adults over the age of 50 will be able to book a booster through the portal in October. Yes, in October, arrived in the Government quietly slid the opening of the portal to mid-November, such a delay will cause anxiety to those who may be coming hard up against the six-month recommendation. The First Minister has today caused on the public to step up compliance with basic protection, but the Government has a duty to step up their efforts to get the basics right as well. Why do they keep missing their own timetables? Why are elderly people without transport being sent to vaccine hubs many miles away, some of whom have vaccine centres on their own doorstep? And why are people still being turned away from appointments due to inaccurate record keeping? First Minister. We do those things in a way that we judge to be the quickest and most effective. I remember just a few weeks ago being questioned, rightly, about why we weren't using schools for the 12 to 15-year-old as the first option in terms of vaccination of that age group, and we explained then why. As it turns out, that has allowed us to vaccinate 12 to 15-year-olds more quickly. On the specific questions here, we judged that for the over-70s, rather than opening a portal so that they could book online, it was quicker to letter those people and then allow the portal to come in later for the over-50s. If you take, I am in the over-50 population. I cannot get my booster jag right now because there has not been a six-month period yet since my second dose. The fact that I have to wait until November to book my appointment makes no practical difference to me right now, so we are seeking to do it in the most effective and the most efficient way. I understand the difficulties that trying to get that balance between local access and mass access will strike for people, which is why, for the older and frailer age groups, we are using a different approach to the younger age groups. A system of this scale will always have tensions and difficulties within it. I accept that, and we work to try to resolve those as much as possible. However, overall, the vaccination programme is an outstanding success, and that is because of the efforts of the many people who are delivering it across the country. Fiona Hyslop is followed by Oliver Mundell. The First Minister may be aware that Westlothian-based vaccine producer, Valneva, published successful phase 3 trial information recently and is proceeding to seek MRHA and AMA approval. As the UN has indicated that the pandemic may last some time requiring additional Covid vaccines globally, should the Valneva vaccine receive final MRHA AMA approval, can the First Minister commit the Scottish Government to constructively support the company in its export activity and work with the UK to reassess its decision on future ordering policy should future rounds of vaccination and boosters be needed and to support this Scottish-based manufacturing outlet to provide sustainability of vaccines at home, as well as support global efforts to protect against the pandemic, and what contact, if any, has the Scottish Government had with the company and the UK Government since the phase 3 trial news? I will continue to have appropriate contact with both the company and the UK Government. I know that the health secretary has had a discussion with Fiona Hyslop as well. At present, the UK vaccine task force is procuring vaccines on behalf of all four nations, and vaccine supply is secure for the programme that is currently under way. Obviously, we await further scientific and clinical advice on future programmes. However, I welcome the positive phase 3 results that Valneva has reported and congratulate the company on those. Scottish Enterprise will continue to support the company as they develop their growth plans in light of the successful clinical trials, and the Scottish Government will continue to keep all options open as we progress into further phases of the vaccination programme. On 8 October, draft guidance was circulated by the Scottish Government to stakeholders on future plans for the wearing of face coverings in schools. It said that learners in secondary schools will no longer be required to wear face coverings in class, although they will still be required in communal areas. However, when the finalised guidance was published just over a week later, the text had disappeared. Can the First Minister help parents, pupils and teachers to understand what led the Scottish Government to overturn the contents of its own draft guidance? Does the First Minister accept that the indefinite use of face masks in classrooms is not proportionate? Will she set out what the specific conditions that would be required before the Scottish Government would implement its own draft guidance on 8 November? I think that most parents and young people, although I absolutely recognise that many of them do not like a situation where face coverings have to be worn in classrooms, nevertheless understand the reasons. It is not the case, and it is a mischaracterisation of the position to say that the wearing of face coverings is indefinite. We do not want that to be in place for longer than is necessary, but, while it is necessary, it is an important protection. I said in my statement that we are now monitoring the case numbers and other relevant information on a weekly basis. In terms of why the position changed at the start of October, informed by the education advisory subgroup that the draft guidance was put together in the way that the member has cited. Of course, back then, cases were declining. Since then, as I have set out fully today, cases have been plateauing and now have started to increase slightly again. It is in light of that that we considered this further with the full input of the chief medical officer and it was considered an appropriate and precautionary measure to keep those mitigations in place right now. However, we will consider the situation on an on-going weekly basis and, as soon as it is considered prudent to do so, those mitigations will be removed. I think that everybody would agree that one of the first mitigations when it is safe to do this that we would want to see removed is the requirement for young people to wear face coverings in classrooms. Scotland's vaccination certification scheme remains an important tool in helping to control the spread of Covid-19. What assurances can the Scottish Government provide to civil liberty and human rights groups who remain understandably cautious of such public health measures? The Covid certification scheme is, in our view, a necessary proportion and a limited measure that is targeted towards activities that are at a higher risk. It is, and I think that this is the important point, to remember an alternative to the potential closure of higher risk venues. All of our decisions are taken and reviewed on the latest data and clinical evidence. The review process includes consideration of impact assessments such as equality impact assessments and children's rights and wellbeing impact assessments. That should be an important assurance to civil liberties and human rights groups. We will not keep this scheme or any other Covid mitigation measure in place any longer than is necessary. Right now, it is an important protection and one that, for the foreseeable future, will continue to be an important mitigation. John Mason Vaccination appointments for Covid boosters may be rolling out in the rest of the country, but, weeks on, in mainland Argyll and Bute, there are no booster clinics at all. GPs have been giving flu vaccinations, but NHS Highland has fallen well behind in their delivery of the Covid booster. Many of my constituents, and certainly all of those over 80 years of age, have waited more than the JCVI recommended six months for their booster, so their protection from Covid is waning. It is critical that they receive their boosters without any further delay. Why is there this delay in NHS Highland? When will vaccination clinics be opened locally? When will the elderly and vulnerable in Argyll and Bute receive their Covid booster? It is important that the programme continues at pace and the pace accelerates wherever possible across the whole country. I have already gone into some detail about that. I am happy to look at the particular figures for NHS Highland and mainland Argyll and Bute, in particular to see if there is a particular problem there, and to come back to Jackie Baillie in due course. It is important to recognise that, at the point of the JCVI advice, some people, particularly in the older group, had already been waiting six months. We couldn't do it before we had the advice, so there has always been a catch-up requirement in the programme. That is why it is important that we get that done as quickly as possible. All efforts are being focused on that, but I will come back on the particular geographic point as soon as possible. John Mason, to be followed by Sandesh Gilhane. I think that, at the start of the vaccination programme, there was awareness from the experts and the medics about mixing vaccines for a particular person. Can the First Minister say anything about whether vaccines can be mixed now? First Minister. All our decisions on the vaccination programme are guided by the JCVI advice. After reviewing the data on different combinations of vaccines, the JCVI has advised that, regardless of which product was used in the primary course of someone's vaccination, those who are eligible for a booster should be offered a dose of the Pfizer vaccine or a half dose of the Moderna vaccine, as those are well tolerated as a third dose and will provide strong booster protection. Where the Pfizer or Moderna vaccines can't be offered, for example, due to contraindication, booster vaccination with AstraZeneca might be considered for those who received AstraZeneca in the primary course. To be followed by Annabelle Ewing. Thank you. A critical factor in our Covid recovery is NHS workforce planning, with the First Minister's own strategy looking to recruit from overseas. Across Britain, 65,000 Indian physicians currently work in the UK, and that makes up the second-largest NHS cohort after those doctors trained in the UK. Given the on-going pressures to resource our NHS here in Scotland, why are you not working with the British Association of Physicians of Indian Origin or BAPIO, which is a recognised professional development and placement organisation that is already working with and trusts in England and Wales, to bring in and train doctors over two years through to their Royal College of Physicians membership exams, whilst providing vital services for the NHS? Will you commit to meeting and exploring the possibility of recruiting doctors by a BAPIO? Absolutely. I will ask the health secretary to look into this as a matter of urgency. I'm happy and keen that we work with anybody to try to attract people to come and work in our national health service. I want to take the opportunity to express my gratitude to those who come to Scotland to work in our health service, whether they come from India or any other country. They do a hugely valuable service to all of us. I know that we are working with the royal colleges and others to try to promote and increase international recruitment right now. There is no reason that I am aware of why we wouldn't do that with any organisation seeking to help us to recruit people from India, so I'm happy, as I say, to ask the health secretary to look into that as a matter of urgency. Annabelle Ewing, to be followed by Gillian Mackay. Given the daily confusing picture that was presided over by both television and radio, which simply failed to take into account that Covid protections are very much still in place in Scotland, unlike south of the border, can the First Minister confirm that mask wearing will still be required in Scotland for the foreseeable future, given the important role that it plays in fighting the pandemic? Yes, I do envisage that the requirement to wear face coverings in certain indoor public places will remain in place for the foreseeable future. Of course, I should also say that we are required to assess that on an on-going basis to make sure that that continues to be proportionate and appropriate, but given the level of cases right now, given that we are going into the winter period, it is highly likely that that will continue to be a requirement for some time longer. It is, of course, one of the simplest things. It is not, of course, without inconvenience, but it is one of the simplest things that we can all do to protect other people. Everybody who wears a face covering helps to protect somebody else, and that, I think, is an important part of the solidarity that we all need to continue to display. I encourage everybody. I know that it is difficult and that we all have lapses at times in this, but all of us should now make sure that we are remembering to wear our face coverings when we are required to do so. Can I extend my party's condolences to everyone who has lost a loved one? I have previously expressed concerns about the changes to travel restrictions and the impact that this will have on our ability to prevent variants from entering the country. The First Minister said in her statement that travellers who receive a positive lateral flow test will have to book a PCR test. Can the First Minister outline how that will be enforced and how that will affect our ability to monitor for new variants entering the country? As I said before, we are aligning on the international travel rules because of the practical considerations of having different rules in place in different parts of the UK, and the potential for that to do damage to our travel industry without delivering any additional public health benefit. We have not always been in agreement with all those changes, but we continue to discuss those things carefully with the UK Government on an ongoing basis. In terms of the situation with post-arrival testing, people will still require to be tested and the same arrangements are around that. They will simply be able to do an LFD test in the first instance, as opposed to a PCR test. If that LFD test is positive, they will then book a PCR test in the normal way, so the requirement for testing is not being removed. It is simply the type of test in the first instance that is being changed, but all the other arrangements around the testing after people's arrival remains as it was previously. Jackie Dunbart, to be followed by Liz Smith. To ask the First Minister, with regard to the Covid vaccination certification scheme, can she confirm if local authorities should be ensuring that businesses across Scotland are indeed scanning the QR codes on the individual apps or if just a visual check is acceptable? The NHS Scotland Covid check app is available for businesses to download, and it is free to download. This is a verifier app that businesses can use to verify vaccine certificates, and I know that many businesses are using that. However, we have also made clear that visual checks are also acceptable. We continue to engage with sectors that are affected and we will encourage more use of the app as the scheme continues to develop. Liz Smith, to be followed by Stephanie Callaghan. First Minister, you say on page 5 of your statement that it is for practical reasons that the Scottish Government has decided to make the change from a day 2 PCR test to a lateral fro test, yet in previous statements you have said that it is for medical reasons. If it is for practical reasons, is it not the case that that change could have been made at the same time that it was made for England and Wales and would have saved a lot of people a lot of problems? I do not think that Liz Smith, with the greatest of respect, is right when she says that I have changed the basis on which the Scottish Government is making those decisions. In terms of the change of testing, I have made clear that, if it had been down to us, we may not have made all of those changes. The reason that we have decided to align is because, for practical reasons, if we have different arrangements in place here, the risk is that people then simply choose to travel to Scotland via England. They then do not do what we would be requiring, so our travel industry takes a hit, but we do not have the public health benefit. That is the practical reasons. I think that I set out when I announced the changes previously that I have set out here today. Even so, when a change is made, it is right that we take the appropriate time to consider in all of the circumstances whether that is the right thing to do to align for those practical reasons or whether there are any other arguments that would lead us in the opposite direction. That is what we have done. We have reached the decision that I have set out today. I think that it is a decision that will be welcomed, but none of those decisions are easy, and none of them should be taken lightly or without proper consideration. First Minister, I am looking for clarity around booster vaccinations in the NHS Scotland Covid status app. As residents of the Kingston and Bells hill constituency have been in touch with me with concerns around reports that boosters will not be recorded in the NHS app and that international travel could be restricted 12 months after the second vaccination as a result. Can you provide reassurance in that matter? Given the current state of the booster vaccination programmes, not just here in the UK but around the world, boosters are not currently required for international travel or domestic use, so they are not currently included in the Covid certification process, either the app or the non-app routes. However, we are anticipating that that may change in the future as boosters are used more widely internationally. Of course, there will be further discussions across four nations of the UK and the EU on this requirement, and we will keep Parliament appropriately updated. Bob Doris, to be followed by Pam Duncan-Glancy. Thank you, Presiding Officer. Could the First Minister provide any further update on measures that has been taken to encourage continued uptake of the vaccine and boosters, especially among young people, including the increase in the use of drop-in surgery, something that I will make in my constituents? It made Helen Springburn very welcome. The first thing to say is that the uptake rates for Covid vaccines are exceptionally high across all age groups. I want to thank people who have come forward in such huge numbers to get their vaccination. We continue to gather information on uptake and any reasons for hesitancy and work with health boards and other groups to try to get anyone who has not already come forward to take up their vaccine to consider doing so. It is important to recognise that, if you have not done so already, you have not lost the opportunity and you can still come forward. Part of that consideration is thinking about the locations for vaccination. As we have gone through the bulk of the initial phase of the programme, the considerations around appointments versus drop-in clinics change because there are smaller numbers of people yet to come forward for vaccination. As we go further into the booster programme, those considerations will change again. That is quite a dynamic programme to deliver, and it is important that we continue to learn from experience, consider the different stages that we are at in the programme and make sure that the overall arrangements are appropriate, taking account of all of that. Thank you. Throughout the pandemic, we have heard about the pressure rightly on the NHS, but the pressure on care services is also pushing that service and those who work in it to breaking point. Recently, that has led to some councils such as Glasgow City Council stopping essential services and leaving more pressure on unpaid carers. Unfortunately, the Covid recovery strategy does not include specific actions to tackle the impact on unpaid carers, leaving them feeling voiceless. I have written to the health secretary, the minister for mental wellbeing and social care and now the deputy first minister, asking them to meet with carers and hear directly about the impact. I would like to ask the First Minister today to set out how the Government plans to support carers at this time, whether she will commit today that she or one of our ministers will meet them as soon as possible, and will she consider publishing a specific carers recovery strategy? On that latter suggestion, we will certainly take that away and consider whether that would be helpful. I would make a couple of points briefly. First, increasingly in the way modern healthcare is delivered, we cannot distinguish between them, but we cannot separate the NHS and social care because the two are so closely integrated. Equally, we have to recognise very strongly the role of unpaid carers in the delivery of social care, and that is something that we always do. There is a range of ways in which we have been supporting unpaid carers. One of them, for example, is the increased financial support through the carers allowance supplement. There will be an additional payment of that coming up over the course of this winter. However, I understand that the pressure on unpaid carers is under. That has been an incredibly difficult set of circumstances for them, so we will always consider what more we can do, and we will certainly give consideration to the suggestion of a standalone strategy. To ask the First Minister whether the Scottish Government is considering reintroducing shielding restrictions for people who are considered high-risk over the coming winter months? We know how harmful shielding can be and has been to the physical and mental health of those who had to do it, so we do not want nor do we expect to advise a return to shielding in future. Most adults in Scotland and over 94 per cent of adults on the highest risk list have received at least two doses of the vaccine, and many of them will be getting their booster vaccination as well. We know that vaccine gives a significant degree of protection, so we do not want to go back to shielding. However, it is important that everybody who is in the highest risk list understands the protections that they can take to make themselves safer, but that all of us recognise that, following all the mitigations that we are being asked to follow, we are contributing to making the whole environment safer for those at the highest clinical risk as well. First Minister, like Jackie Baillie, I have constituents over 80 who have yet to be offered an appointment for a booster jag. They have gone beyond the six months, so they are very anxious. I understand from the statement that they should be offered at the latest by early November. Is that correct? Those in the over-70 age group are being vaccinated. Many of them have been vaccinated with boosters already. Those who have not will be between now and early November. In total, over half a million people have had the booster vaccine, and those over-70 are being prioritised. Some of those over the age of 60, between 60 and 69, have also started to receive letters as well. In all the discussion about booster vaccinations that we have had today, which is a really important discussion, I want to make it very clear that, while there will no doubt continue to be questions and people will push us to go faster rightly so, there is probably no single thing and no bigger responsibility on the shoulders of Government right now than to get the booster programme delivered as quickly as possible, because it is the biggest protection that we will have over the winter months. I assure everybody across the chamber that the greatest possible priority is being given to this. Statistics released today on the number of courses of dental treatments show that, in 2020 to 2021, almost 360,000 less treatments were carried out on children compared to the previous year, with a decrease of over 3 million treatments carried out on adults in 2021 compared to 2019-20. That comes after warnings from dentists last week that the combination of high demand and the withdrawal of Scottish Government support will devastate the sector. Can I ask the First Minister, given this dire situation facing dentistry, what her Government is going to do to ensure that dentists are supported and that people can access to the vital treatment that they need? Obviously, the figures that the member has quoted today, which of course are a concern, are a reflection of the limitations on dental services during the course of the pandemic. It is really important that, as with other treatments, there is a catch-up as quickly as possible. We will continue to support dentists as we did pre-pandemic and as we will continue to do as we come out of this pandemic. Indeed, the health secretary's winter package of support, which he set out to Parliament before the recess, had funding within it for dentists, including for dental services for children. Again, we understand the importance of that, and that will be reflected in the actions that we take in the weeks and months to come. Recently, the education secretary told this chamber that she believed that the lateral flow testing rates in schools were too low and that she would like to see higher figures. Since then, the rates have reduced again. Indeed, for S1 to S3 pupils, it is now down to 7.3 per cent. For S4 to 6, 3.1 per cent, prior to the October week holiday. Does the First Minister believe that those rates are too low? If so, what will the First Minister and her Government do to increase them? I want to see people take advantage of lateral flow testing. I want to see people across the population do that. Certainly, young people and those who work in schools, for them, that is particularly important. Testing, although we strongly recommend it, is voluntary. All of us, led by the Government, have a role to play here and encouraging people to remember to regularly test with LFD devices. It is naturally the case that when the transmission is rising, people are perhaps more vigilant and will do it more often. When cases start to fall again, perhaps that falls away. We are, as I have said, going into a period where cases appear to be rising again, so it is an important moment for all of us to remind people of the role that regular testing can play in trying to identify cases of the virus and then be able to break the chains of transmission. Regarding the co-administration of vaccines and booster programme, does the First Minister agree with me that it is safe to have both flu vaccine and Covid booster at the same vaccine appointment, as many other vaccines are co-administered this way? That co-administration will help to expedite the winter flu and third-dose Covid programme, and I remind members that I am part of the G&G's vaccination team. Of course, it is entirely safe to have the Covid booster and the flu vaccine co-administered. It would not be happening if that was not the clear clinical advice, and that is allowing us to make sure that both of those vaccination programmes happen as quickly as possible. I know that some people—I have certainly had contacts to this effect—have been slightly concerned that their flu vaccine is maybe a couple of weeks later this year than it would have been in previous years because of that attempt to co-administer and not call people back twice that is under way right now. Again, as I did in my statement, I want to reassure people that, given the timeframe of winter flu, the clear advice is that the timing of flu vaccinations is clinically appropriate. I would advise people as soon as they are invited to come forward, and if they are offered flu and Covid in the one appointment, please make sure that they take that. On the same subject, I would seek a point of clarification from the First Minister on behalf of a constituent. I note that, in her statement, she talked again about Covid booster and flu vaccination jags being co-administered, but will the First Minister confirm to the chamber that, for those who, for good reasons, want to take their flu jags separately from their Covid booster that arrangements are in place for them to be dealt with separately? We want everybody to get vaccinated with both Covid vaccine and flu vaccines, so I am not a clinician if there is a good clinical reason or a good reason why somebody cannot do that. Of course, we will want to facilitate that being done separately, but I would also want to take the opportunity and I hope that Stephen Kerr will assist with it in saying to people, as Emma Harper has just highlighted, that it is clinically safe to have the vaccinations together and our strong advice is for people to do that. That is the quickest way of getting people and getting everybody who is eligible vaccinated. I hope that the message goes out loud and clearly, but I also hear the message if there are good reasons why that cannot happen. We have to facilitate the vaccines happening in other ways. That concludes the First Minister's statement, Covid-19 update. There will be a brief suspension before the next item.