Coronavirus (COVID-19) - vaccines and testing programmes: Health Secretary's statement - 23 December 2020

Presiding officer, I welcome this opportunity to update Parliament on both  our extended testing programme and our NHS Scotland COVID-19 vaccination programme.

The discovery of a new more transmittable COVID-19 variant is a bitter blow.

But we have many more tools now to fight this virus than we had in March and vaccination and testing are critical to suppressing the virus and preventing the harms it causes.

Presiding Officer, following the announcement last month to expand testing across a number of areas significant progress has been made.

Two of our three new NHS regional lab hubs went live on a phased basis last week with the West and the North hub are now receiving samples. The East regional hub will be operational by the end of  January.

Processing the weekly tests of 42% of care home staff has now moved to our NHS labs as planned and we will complete that transition again by the end of January.

Testing of all admissions to hospital is underway and should be completed by the end of the month and twice weekly testing has been introduced on a phased basis for all patient-facing staff in NHS Scotland hospitals, Covid-19 Assessment Centres, the Scottish Ambulance Service (SAS) and all COVID-19 vaccinators and on track to be fully implemented by the end of next year.

All Care Homes now have the equipment for Lateral Flow Testing and a rolling programme of training is underway to provide testing for care home visitors with Lateral Flow Testing to support professional visitors to care homes from the beginning of January.

All students at Scottish universities and colleges who are going home for the winter break were offered testing, during a 2 week testing window from 30 November.

Over 26,000 students were tested with 106 positive cases found - a very low positivity rate overall of 0.2%. Testing will be offered on a similar basis to support the staggered start of the university term in January.

In January our pathfinder testing programmes will begin, with the aim of developing a sustainable programme of asymptomatic testing among school staff, working closely with a number of local authorities and volunteer schools to develop detailed plans.

The first model will involve in-school testing using Lateral Flow Devices. The second model involves at-home PCR testing using the satellite testing channel that has previously been used in the care home sector.

We expect these pilots to help inform the development of a scalable, sustainable approach to asymptomatic testing of school staff at the earliest opportunity.

And we have completed our community testing pilots. Between 26 November and 9 December we targeted testing resources at eight communities in Scotland with stubbornly high prevalence levels of the virus as part of a Community Testing pilot. This involved the deployment of six mobile testing units, over 4,000 home test kits and the establishment of the Asymptomatic Test Site using Lateral Flow Devices in Johnstone.

Over the course of the pilot, 22,133 tests were completed and 850 positive cases identified - an overall positivity rate of 3.8%.

We will expand this strategic and targeted use of testing through a Community Testing programme in January. Delivered in partnership with local authorities we hope to have their proposals in early January for those communities where this approach will have the greatest impact.

With local authorities we intend to build on this intense targeted period of testing to wraparound a full public health package – including continued offer of support for those asked to isolate, the use of the Self-Isolation Support Grant, Local Self-Isolation Assistance Service and National Assistance Helpline and ensuring that compliance with NPIs in vulnerable settings including schools, care homes and employment settings are being followed and offering support where we need to.

Finally, I’m pleased that following work with Royal Mail all 82 mainland postcode areas now have access to home test kits and we have met our commitment of 22 local test sites by the end of this year and from January will have access to an additional 14 MTUs.

Turning now to our vaccination programme - our NHS Scotland vaccination programme began on 8 December. In the period to 20^th December, 56,676 people received their first dose.

This includes care home residents and staff, and patient-facing NHS staff. Depending on supply delivery, we will complete the second dose vaccinations to residents in care homes for older people and their carers, and those frontline health and care staff during January.

I have previously outlined the challenges in delivering the Pfizer vaccine - such as stability in transportation, storage requirements, and pack sizes. These issues have limited our capacity to take the vaccine everywhere it is needed.

Scottish Government health officials, our Boards, and the MHRA have worked to mitigate these issues and help streamline our process of deploying the vaccines.

Thanks to their efforts we are now able to safely reduce pack size which has allowed the care home programme to begin and the transport challenges of getting the vaccine to all of our islands to be resolved.

We anticipate receiving a total of 172,575 doses of the Pfizer vaccine by the end of this week, 50% of which we will retain so we can be sure to give those vaccinated the second dose after the 21 days required.

A key area that would help streamline the process further is predictability of delivery. But this is not in our gift. Safety is a paramount concern and there is rigorous process of safety checks between the vaccine leaving the factory in Belgium and arriving in the UK and then arriving in Scotland.

These checks mean while we know when the vaccine leaves the factory, we cannot be certain of the date we will receive it. This is a challenge for our forward planning but it is one we share across all the 4 nations of the UK and we are working together to resolve this with the regulator and the distributor. And I expect at my normal weekly meeting of the 4 nation health ministers tomorrow that will be another item that we will continue to discuss.

The JCVI’s recommendation for the delivery of a COVID-19 vaccine is that prioritisation should first be given those with the greatest clinical need.

Taken together vaccinating that JCVI list will help reduce around 99% of preventable mortality from COVID-19. This is clearly a compelling rationale and it is right that we follow this advice.

Those who are clinically extremely vulnerable are high on the JCVI prioritisation list, alongside those aged 70 and over. I understand the concern around those who are terminally ill who want, if at all possible to receive the vaccine earlier.

Both Matt Hancock and I have written to the JCVI asking them for further consideration and clarity on this one group for all the reasons that I know members will understand.

Right now we have access to just one vaccine. In the near future we hope that it will be two.

The new Astra Zeneca vaccine – should it get MHRA approval - does not need to be stored at ultra-low temperatures, and is easier to transport.

That means that we will be able to deploy it in far wider settings than has been the case for Pfizer. Dependent on JCVI advice, we will likely use it to prioritise vaccination of the over 80s who are not care home residents, and for this group to largely be vaccinated in GP settings.

Should the Astra Zeneca vaccine be approved before the end of this calendar year then we anticipate that we will be able to commence vaccination from primary care locations from Monday 11 January.

Vaccine supplies permitting, we aim to have vaccinated all those on the JCVI prioritisation list in the spring. Once we have completed this group, and again dependent on vaccination supplies, we will commence vaccination of the rest of the population.

The dedicated officials and NHS staff who have taken forward the vaccine programme have done remarkable work at pace and I am grateful to them for it.

We said on December 3 that dependent on supply we would begin on 8 December and we did. We said that we would begin vaccination of care homes on 14th December and again we did. All of that is down to their hard work.

And, when we have more vaccines and greater number of doses available to us these public servants stand ready to deliver once more.  Members will receive today initial Board maps of primary care and other vaccination centres in their area to meet this scale up alongside the use of mobile units where needed. 

We are also looking at the use of larger centres in heavily populated areas such as Glasgow, Edinburgh, Dundee, Aberdeen, and Lanarkshire, to supplement these local and mobile solutions for those in remote and rural areas, and those with particular requirements.

Alongside this, we are building a national scheduling tool which will support wider cohorts of the population to schedule their appointments, and is on track for delivery by the end of January.

While limitations with vaccine supply have meant a lower initial workforce requirement for the early weeks of the programme, we have nevertheless been keen to ensure that we continue to ramp up capacity.

We currently have 1,729 registered vaccinators and 4,000 attended national training events on the delivery of the Pfizer vaccine.

To deliver on our intention of concluding vaccination of those on that priority list in the spring where our workforce modelling shows a requirement for around 1,400 vaccinators and 600 support staff we remain confident in our workforce supply.

We are also exploring all offers of assistance from individuals and across organisations, for which we are very grateful.

I know the wait for many to get the vaccine will be an anxious one. I hope they can be assured that we will contact you as soon as we have the vaccine supply and as soon as we reach your eligible group.  It is also essential that once you have been contacted you attend for your first vaccination and that you return for your second dose.

Presiding officer, a vaccination programme of this scale is unprecedented and is a significant logistical challenge, requiring a major nationwide effort. So far we have secured the enthusiastic support of many partners across our public sector but it is a challenge we continue to take with optimism and determination to succeed for Scotland.