We now move to the statement by the Minister for health, and I call on the Minister for health to make the statement—Vaughan Gething.

Thank you, Llywydd. I'm just trying to move my screen back.

I had the same problem. In fact, I lost my iPad off the sofa in doing so, so perfectly understandable.

I am now back with you. Thank you, Llywydd. I'm grateful to you for the opportunity to provide this update statement on the position in respect of coronavirus here in Wales, and, indeed, the positive news story today, with the approval of the Oxford-AstraZeneca vaccine. But I do want to begin by going through some more of the detail of the current position and, I'm afraid, the likelihood that we will see things worsen still before they start to improve.

Members will recall that, just prior to the Christmas break, the Welsh Government had to make the difficult but necessary decision to move Wales into alert level 4. This affected non-essential retail at its busiest time of the year. It also reduced the amount of time that families were allowed to gather over the festive period to a single day of overnight stay.

We took this decision as levels of virus transmission continued to grow exponentially. Today, we have seen some levelling off in the all-Wales figures, which are still very high. Sadly, we have seen the predicted and continued growth in north Wales case numbers. As Members will be aware, this is potentially influenced by a new, more infectious strain of the virus. The new variant had been identified as a factor or a possible factor in the rapid growth in the numbers of cases in the south of England. Our own exponential growth in cases was and still is a real threat to our NHS Wales services and colleagues across social care in terms of our ability to respond.

Health boards across Wales are under increasing pressure as more and more patients are admitted with COVID-19. The current number of beds occupied in hospitals across NHS Wales is still higher now than at the peak in the initial wave in April 2020. Whilst there are physical beds available, staff absence and the nature of the hospital environment, which makes it difficult to safely distance COVID-19 and non-COVID-19 patients, means that usable capacity is limited and varies on a daily basis. I published a written statement on 23 December, giving stark detail on the extent of NHS system pressures here in Wales.

The coming weeks will be an extraordinary challenge for our health and social care services. We would not normally expect to face a winter with more than 2,600 beds out of use for normal winter pressures because of a new condition that we still cannot cure. We would not normally face a winter with the level of staff shortages in health and social care that we do face right across Wales. And yet still there are well-placed loud and angry voices who deny the problem, who claim that the cure cannot be worse than the virus.

Let me remind you that this is a virus to which more than 3,000 of our people have already lost their lives. More will do so. Many will recover, but it will not be easy or quick for every person that does. There is no harm-free route through this crisis, and I do not accept that the cure is worse than the virus. Each and every choice that we take to keep Wales safe comes at a very real cost to protect our NHS and to save lives.

NHS organisations will continue to work collectively to provide mutual support to one another, but the available bed capacity is reducing. We continue to see this translate into critical care pressure in all of our health boards. As a result, health boards have had to reduce or stop a range of non-COVID services in order to cope. These are difficult decisions that are never taken lightly.

Critical care is perhaps under the greatest pressure and has seen COVID-related critical care increase to 126. That is an increase of 24 per cent since 21 December, even. This rate of growth is inevitably linked to the higher community prevalence of recent weeks and is a significant concern within our overall hospital capacity, and this is likely to increase over the next two weeks.

This is the highest number of COVID-19 critical care patients we have seen in the second wave, although still lower than the peak of the first wave. However, including non-COVID patients, yesterday there were a total of 210 critical care patients in beds across Wales. This is well in excess of our normal capacity of 152 patients, or, to put it another way, critical care is operating at nearly 140 per cent of normal capacity. In parts of Wales, staffing pressures, including sickness, are reducing our options to expand further.

And I have to say, Llywydd, it is despairing and dishonest to claim that there is lots of unused critical care capacity. I have to reiterate to Members and the public that using critical care surge capacity comes at a real cost. Staff have to be transferred from other activity that cannot go ahead. Delaying or cancelling non-COVID care stores up harm that our NHS will have to return to and, sadly, harm that our NHS may not have the opportunity to resolve.

Our critical care staff have not had a break and the awful truth is that patient flow out of critical care is not all good news. Some people do recover. However, mortality rates are making a major contribution to freeing up beds. Current mortality rates for COVID patients in critical care, the figures from the Intensive Care National Audit and Research Centre, show that in Wales nearly 40 per cent of people admitted since 1 September have passed away. That is not critical care failing—it is the reality of the number of infections that we have seen and are continuing to see.

As was explained when the UK variant of coronavirus was announced, it is not uncommon for viruses to undergo mutations. Routine genomic surveillance has recently identified a new variant in South Africa as well. As at 19 December, that new variant had been found in around 200 samples in South Africa. This new variant is not the same as the UK variant, but does have some similarities. Our scientists are studying the possible impacts on transmissibility, severity of illness and whether there are implications for the effectiveness of vaccines.

It is important to emphasise that the same prevention measures will be effective against the new UK variant and the South African variant—limiting mixing, social distancing, hand hygiene, use of face coverings and ventilation. Quarantine of those who have come into contact with the South African variant will also be vital to stop this variant becoming established across Wales and the UK.

The most recent SAGE estimate of the reproduction number for Wales is predicted to be between 1.0 and 1.3, with growth of around 1 per cent to 4 per cent per day. A doubling time of 19.1 days is estimated by Public Health Wales, using data for the period 5 December to 18 December. Data from the most recent Office for National Statistics infection survey for Wales show that approximately one person in 60 has COVID. This figure is the highest value to date from the ONS survey.

Our latest Public Health Wales data by local authority show that the all-Wales rate is now at 433 per 100,000. As I set out earlier, rates within that are rising across the north and falling elsewhere, but still at a very high rate, with a very high test positivity percentage. 

But there is hope. Since the beginning of December, we have been delivering the Pfizer-BioNTech vaccine to health and social care staff as well as care home residents and staff and people aged over the age of 80. In the first two weeks, over 22,000 people were vaccinated in Wales, with management information indicating this number is well over 30,000 now. The next official figures will be released tomorrow. I have no reason to believe that Wales will be significantly behind any other UK nation on distribution when those official figures are published tomorrow. I expect that we are keeping pace with every other UK nation.

Today, the Oxford-AstraZeneca vaccine has been given the go-ahead by the Medicines and Healthcare products Regulatory Agency, and its roll-out across Wales and the rest of the UK will start next week, from Monday. It will arrive in small quantities initially, with more of our population-based allocation arriving each week.

Unlike the Pfizer-BioNTech vaccine, the Oxford-AstraZeneca vaccine is stored at normal vaccine fridge temperatures. This means it will have fewer storage and transportation issues, making it much easier to use in community settings, such as care homes and primary care. Again, two doses will be needed, albeit the interval can now be moved to 12 weeks between each dose.

This is excellent news for our response to the pandemic and our NHS plans are in place to ensure Wales has the capacity, systems and staff to increase vaccination activity. It is important to be realistic. Whilst plans are in place, the effects of the vaccines may not be seen nationally for many months.

The advice on keeping Wales safe remains the same for everyone, and it is important that everyone realises that they, we, all have a part to play in influencing the level of virus in our communities: to keep contact with other people to a minimum, to keep a 2m distance from others, to wash our hands regularly, wear a face covering where required, and avoid touching surfaces others have touched, wherever possible, and, of course, as I said earlier, good ventilation. The Welsh Government and our NHS cannot do this alone. We all still have a part to play in keeping Wales safe. However we can now do so with a greater sense of optimism for 2021. There really is light at the end of this long, dark tunnel. Thank you, Llywydd.

Minister, thank you for your statement this afternoon. I have some questions to ask in relation to vaccines, hospital pressures, the supply of testing in education, and the new variant. I'll leave my comments on the restrictions that were imposed before Christmas to when we have our debate in the Senedd on our return after the Christmas recess.

On vaccination, Minister, why is Wales lagging behind the rest of the United Kingdom when it comes to its vaccination programme? I appreciate the gap isn't large, but every one missing a vaccination is someone missing the safety of that vaccination against the virus. Why have so many over-80s not been called up for vaccination here in Wales, and why has there not been a more comprehensive roll-out in care homes across Wales? At the current forecasted rate, the UK as a whole needs to be hitting 2 million vaccinations a week, which in Welsh terms will be approximately 100,000 vaccinations undertaken. When will Wales reach that target in your forward planning, Minister, because I'm sure you've done some modelling that indicates with the supply of vaccines now coming online we should be looking at these numbers to make sure we can get as many people vaccinated as possible? And do you support the evidence that's been put forward by the Joint Committee on Vaccination and Immunisation that to speed up the roll-out programme the vaccination programme should aim for a one-shot vaccine as opposed to a two-shot vaccine, to get as many people vaccinated as possible? Can you confirm that GP contracts are in place for primary settings to undertake the vaccination programme, as the evidence we've received recently from the Cwm Taf health board indicated that there were some problems within that contract? Can you also confirm that the vaccination teams that are required are in place and that they have their quota of staff to fulfil the objectives that will be set before them as the vaccine programme unfolds across Wales? And also, do you support or not the call today from the chairman of the Welsh general practitioners committee for health workers to receive the vaccine before the elderly, given what we understand about the new potency of the new variant of COVID across Wales?

Could I also put on the record my thanks and that of the Welsh Conservatives to all the staff within our hospitals and NHS settings and care homes over the Christmas period, which have been under huge pressure? Could you enlarge more on the information you provided within your statement around the capacity for critical care beds in Wales? In the evidence you gave to the health committee, you indicated there was the possibility of a surge capacity up to 280 critical care beds to be made available in Wales. Your statement alludes to 210 critical care beds being used at the moment. Absence rates due to sickness have been reported across the whole of the Welsh NHS. Are you in a position to update us what the absence rate is this week, given that the high levels before Christmas were indicating unsustainable pressure on the Welsh NHS across Wales? The army moved in to support the Welsh ambulance service at the request of the service due to absences of staff. Is this an open-ended deployment or a time-limited deployment, and with the numbers that have been available, do they meet the shortfall in staffing numbers to have a safe and reliable ambulance service to respond to the calls placed on them? Could you also respond to the press reports recently about the wish list that staff had compiled for goods that they require from Amazon to undertake their work, such as calculators and soap and washing utensils for patients? We focus, as politicians, on PPE and the availability of PPE, but basic utensils for washing and cleaning patients, and ultimately the facilities that staff require, such as calculators to work out medical applications, surely should be a basic necessity that should be provided within the NHS.

On the education portfolio, which I appreciate isn't your area, but ultimately the testing that will go into schools will come from your area of responsibility, can you confirm that there is enough capacity within the testing regime envisaged for education settings in the new year, and that this will not be used as a reason for education settings not starting back in the new year after the Christmas holidays?

Finally, Minister, could I ask, after the briefing we had before Christmas with the chief scientific officer, that the map that was indicated, which was available to show the new variant COVID infections across Wales, is made available so that we can understand how its spread has affected services and the spread of the virus across Wales? You allude in your statement to the spread in north Wales in particular. I think this map, which was said is available and you would look into making it available to Members, should be made available as a matter of urgency. Can you, finally, confirm that all labs are now testing for the new variant COVID virus, because in the briefing that was held before Christmas you indicated, as the chief scientific officer indicated, that this testing was only undertaken in a limited number of labs at the moment? Thank you, Presiding Officer.

Thank you. I'll try to rush through as many of the 12 separate questions as I can, Presiding Officer. To start off with, Wales is not lagging behind other UK countries when it comes to the vaccination programme, and you'll see that when the official figures are published tomorrow. It's important that we compare like with like and don't get carried away by misleading press reports. 

On over-80s in care homes, we are already vaccinating people over the age of 80 and in care homes. I do note with some regret that the utterly misleading and misrepresentative tweet from the leader of your party has never been corrected. On that, care home residents have never been left behind. 

On JCVI advice, that remains in place. Their advice and the advice that we've received from the regulator about the use of the vaccine and its approval is that a gap of up to 12 weeks can be taken. All four chief medical officers across the United Kingdom have confirmed that a 12-week gap is appropriate, so people will still be getting their second shot but in 12 weeks' time. That actually means that we can cover more people with the immunity benefit that the first shot provides at a more rapid pace, because we won't need to hold back a second shot, in terms of the conditions that the regulators have placed on approval of not just the Oxford vaccine but the already approved Pfizer-BioNTech one. 

Primary care contracts are in place for vaccination. That will, most obviously, cover community pharmacy and general practice. We've had very constructive conversations in planning for this with primary care contractors, and I'm very grateful to them.

Vaccine teams are expanding. That includes a very positive and continuing partnership with the military, which, as I've said on a number of occasions, has been very can-do throughout this. We have a good working relationship with military planners and we'll be taking up the offer of some military support to actually help with the vaccination roll-out as well.

Front-line health and social care workers are already in the current priority groups. We have about 360,000-odd people who are in the current two priority groups who are already receiving the vaccine. It's quite a large number to work through. They already include our front-line health workers, so they are already part of what we're doing and we are following the JCVI advice. We're not going to be interfering with that to suddenly deprioritise vulnerable members of the public. Providing the vaccine in large numbers rapidly will actually help us to reduce mortality within some of our most vulnerable citizens, and we'll certainly be doing that, as well as protecting our front-line staff.

On critical care capacity, as I said in my statement, which I know you had a copy of in advance, the capacity does vary from day to day because it is so reliant on staff. Staff are the limiting factor, with absence rates of over 10 per cent not being uncommon across our services—more so, I'm afraid, within the ambulance service. So, that is the biggest limiting factor that we have, and it's why I do find some genuine despair with some people hawking themselves around as statistics experts claiming that there is lots of free capacity available within our health service. There simply is not. Every choice we make to surge into more critical care capacity means other NHS activity is not going ahead, and we are very much limited by staff availability. That is also a real and significant factor for challenges facing colleagues in the social care sector.

On WAST and the army, I agreed and approved the approach for the army to assist, and that will be reviewed as opposed to having a hard stop within that. As I say, I'm very grateful for the way that the army and their other colleagues within the armed forces have been very much can-do in supporting the efforts not just of the ambulance service but more generally as well.

On press reports about a wish list, these were not required items. Basic items are provided by the health service. There is no failure in the basic provision of items that our staff rely upon. I think we actually should be very proud of what our NHS has done to equip our staff at very, very difficult times throughout this pandemic, and I hope that Members are not carried away with a silly-season story that actually, on examination by the health board, wasn't shown to be a plea for people to provide their own basic items that they should need.

On education's return, we still expect to return as planned, with a phased return to schools, together with the serial testing that we will be introducing. There will be further conversations between local government, the education Minister and relevant trade unions in the area to provide confidence for people who'll want to return to work, but also the confidence for parents and learners. And it's in all of our interests that children do return to school, because we recognise the real harm that could be done if children aren't in school. Home isn't always a safe place for every child, but we also know that there's a—[Inaudible.]—in terms of the mental health and well-being of children and young people. We also know this can have a real effect on their ability to get good qualifications at the end of this year as well. And, in the conversations I had yesterday with our scientific advisers and the chief medical officer, there is nothing available to us in the evidence that suggests that schools should not open even with the new variant in wider circulation, because the same control measures, if undertaken properly, should be effective.

Now, on the point about publishing the seeding map of the new variant, I expect that to be published in a future technical advisory group report. It will be published as soon as possible. I think it would be helpful, as I indicated to spokespeople when providing the briefing, that the information on this, I think, would help people to understand what's happening with the spread of the new variant across the country.

But going to your final question, there are only four labs in the UK, as I understand, who can test for the dropout—the change in the genetic sequence that allows us to understand if the new variant is likely to be present. Three of those are lighthouse labs that receive tests from Wales; the other is a lighthouse lab in Scotland. And that means that we are now sending more of our samples to get a more representative understanding of where the new variant has spread, to those three labs that we have access to, to then understand more clearly the extent to which the new variant is prevalent or whether it's becoming dominant, because, in England, they now believe that it is the dominant part of COVID. So, no longer a new variant, but what normal COVID is going to be, and that, in itself, has real concerns and real problems for all of us across the health and care sector right across the UK. Thank you, Llywydd.

I'm pleased that we have this additional opportunity to have an update from Government, and an opportunity to ask some questions. May I start by sincerely thanking all of those health and care workers who have been working so very hard under such immense pressure over the Christmas period? The number of cases has been frighteningly high in large parts of Wales, and whilst there are some positive signs that things are starting to move in the right direction in some areas, we are still facing a situation where the number of patients in many of our hospitals is unsustainably high, and those areas where case numbers have been low have also seen an increase, reminding us that no part of Wales is immune. We are reminded again today of the importance of doing those basic things—washing hands, social distancing and so on—and I'm pleased to hear the Minister mention ventilation and the importance of good ventilation wherever possible. 

There is hope now. There are vaccines available. A second has been approved today, and that, more than anything else, is the light at the end of this very long and dark tunnel. But people need to see clearly that everything is being done in the most effective way possible to move us towards that light. May I endorse the words of public health officials over the recent days who have condemned those who have abused staff who are part of the vaccination process? It is quite unacceptable. Yes, there is frustration, but nobody should target those who are there to help us. However, we do need far more assurance from the Welsh Government in terms of that process of vaccination. 

We're told by Welsh Government that we are getting our share in Wales. If so, we can concentrate on what's happening in the distribution of the vaccines within Wales. Seeing statistics suggesting we're way behind the curve on roll-out is very worrying, and seeing statistics painting a picture of Wales lagging behind, with around half the doses administered in Wales per head of the population compared with Northern Ireland, that's troubling to people, despite supposedly following the same vaccination programme.

Now, in a statement earlier this morning, the health Minister confirmed that Wales would get its share of the newly approved Oxford-AstraZeneca vaccine. There's also there a reminder that people shouldn't phone their doctor and should wait to be told when to go for their vaccination. I know from my own postbag and from looking at what's happening in other parts of Wales that there are concerns about how quickly the vulnerable are being reached, in particular those over the age of 80 but living at home. Many people are seeing reports, perhaps, of over 80s being treated or being given the vaccine in other parts of the UK, perhaps hearing directly from friends and family living in other parts of the UK.

To avoid frustration, to avoid that building frustration, people need to have confidence in the process that is being followed. If there's a lack of trust in the system, there's a lack of faith that their turn will come, so we need to be given much clearer assurances from Government, through clear communications, easily digested and regularly published data and so on, that Wales is, indeed, getting its share. I'm pleased to hear that we will be receiving some data tomorrow. I'm looking forward to that, but that can't come a moment too soon.

We need assurances that the vaccines are being distributed effectively, that all parts of Wales are getting their vaccinations in a timely way—and it's not just differences between health boards. We know in the north, for example, that the first batch went to the east, then the centre, and the west is way behind. People need confidence that wherever they are in Wales they will be given the protection that they want. We need assurances that the most vulnerable are getting it in a timely manner and that also an extension to the priority list will be built in when the roll-out reaches that point. For example, one of those that I'm hearing most often is the call for vaccination or prioritising those working in schools.

We're clearly in a worrying place still, but the more assurances that Government can give us, be that on testing or on measures being taken or on the data on the new strain on the virus, that is what's going to give people confidence that we are headed at least in the right direction.

Thank you for the comments and questions. It was very helpful, I think, to start the comments with not only thanking staff but recognising how unacceptable it is for our staff to be attacked and criticised, whether on social media or otherwise, for the job that they do, and being honest with the public about the scale of the challenges we face. But the scale of the challenge we face reiterates why we're in level 4. It's because of the significance of the virus circulating and because of the extraordinary pressures that our health and social care system are soaking up and coping with that we're in level 4.

And just to consider this: there are more than 2,600 people being treated for COVID in a hospital bed here in Wales—more than in the April peak. There are more than 1,600 confirmed people with COVID in our hospital beds. There are still hundreds of people—I think over 700 people—recovering from COVID in our hospital beds. They still need the care and treatment that only an NHS bed can provide. And there are more than 200 people in critical care. These are not trifling matters. This shows the serious harm that is already being done, and if we were not in the midst of level 4 restrictions, we can, I'm afraid, be confident that even more people would be going into hospitals in the next two to three weeks, and there would be a very real risk that our NHS would indeed be overwhelmed. That's why the level 4 measures are in place, and that's why all of us have a responsibility to reiterate the 'stay at home' message for our constituents in any and every part of the country, however they vote, or if they choose not to vote, if that's their choice. This is about all of us being in this together. 

On vaccination, I'm happy to confirm again that we are getting our share. I know the question is regularly raised and I keep on giving the same answer: we are getting our population share of each of the vaccines. Actually, on the Oxford vaccine, a significant part of it is manufactured in north Wales. So, the supply chains for this are shorter and more secure from our point of view. But the really good news comes back to the Member's questions about access, and accelerating the programme for our most vulnerable citizens. Because the Oxford vaccine is easier to store and to transport, it will allow greater acceleration and practical access, so we won't need to move people to larger vaccination centres. General practice and community pharmacy will be able to undertake a greater share of this work. I'm really pleased they've been in such a 'can do' place in terms of not just agreeing the contracts around this, but actually then wanting to positively get on and vaccinate their patients and people that they know within a greater number and range of places around the country. But it will also mean that those people who are housebound, whether in a residential care setting or otherwise, will be much easier to reach with the new vaccine. 

On the vaccine, the official figures are out tomorrow, and I don't think they'll show that Wales is lagging behind at all. It's somewhat frustrating that whenever a story is run that Wales is somehow behind the curve, it appears to have legs and accelerate faster than any time we're actually ahead of where other countries are, and this is yet one more of those examples. We're currently vaccinating around about 2,000 people a day. I do expect that after a week or so of having the Oxford vaccine available, when we'll have been able to test out our systems, we'll start to accelerate and vaccinate many more people, as indeed will the other UK countries.

I should, though, point out to the Member that if he were looking at the news in Northern Ireland, Scotland or England, then he'd find people there who are in care homes or over the age of 80 raising concerns that they haven't yet been contacted or reached by the NHS as well. The idea that Wales is uniquely not reaching vulnerable people simply isn't true. We have many, many vulnerable people to reach. In the first two priority categories that we're currently vaccinating, there are over 360,000 Welsh citizens, so it will take time to vaccinate all of those people. We're not behind where other countries are. We're making progress, and, as I say, you can speak to over-80s in England, in Scotland or in Northern Ireland who won't have received their contact yet, because it wouldn't be at all reasonable to expect that you would have covered all of that part of the population to date.

We will, though, be sticking to the prioritisation approach set out in the advice of the Joint Committee on Vaccination and Immunisation. I know this is difficult, because there are different groups making a case for them to be advanced up, over and above that prioritisation list. But, that priority list is there to indicate where the greatest benefit can be given, and by that I mean where the greatest number of lives can be saved. It's a good thing that people working in our schools should be aware that they're not a high-risk profession when it comes to COVID. Their occupation does not place them at greater risk than other professions, whereas, actually, our staff who work on the front line in health and care are very much placed at a greater risk.

We're undertaking a pilot with the South Wales Police force that all other police forces are supporting, because they recognise that the physical contact they will have with members of the public, including in enforcing some of the COVID laws that we have had to introduce to keep people safe, means that they are at a different level of risk. That serial testing is part of helping them to understand where they get. The priority that we have from the JCVI is about how we keep people alive and how we avoid the levels of excess deaths that we would otherwise see. I don't think any responsible professional group would want to argue that they should leapfrog a group of our most vulnerable citizens who could otherwise come to harm and, potentially, lose their lives. So, we'll follow the objective advice we're given.

I know they're looking at the various cases that different groups have been making. If the advice changes on the relative level of impact and the benefit to be given, then, as I've said on many occasions in the past, if the evidence and the advice changes, Ministers have to be prepared to make different choices. We'll continue to do so, but at this point in time there's no reason to depart from the current priority list. We will use the vaccine to keep our country safe. We'll use the vaccine to save lives.

We've had a great many questions asked by the two party spokespeople, so now it will be a minute each for each of the next Members to be called. Hopefully, I'll get through as many of you as possible, though it may not be possible in terms of time to get to all of you. Alun Davies.

Thank you very much, Presiding Officer, and thank you for the statement, Minister. These have been the most difficult of days, as you've suggested, and I think all of us want to join you in thanking all of the key workers who've given up their Christmases to support people in our communities over the last few weeks.

I'm also grateful to you for the foresight of some of your decisions. We've seen the UK Government running to follow the Governments in Wales, Scotland and Northern Ireland over the last few weeks. The far-sighted decisions that you've taken, although exceptionally difficult, have helped to ensure that the NHS and our people are kept as safe as possible in these difficult days.

There are two issues I wanted to ask you about. First of all, about the enforcement, I continue to get a number of people who are scared to visit supermarkets, particularly in my constituency, who do not believe that supermarkets are delivering the regulations in the way that they need to be. I'd be grateful if you could look again at some of the issues around enforcement.

The second issue is around the vaccine. You've just answered a question from Rhun ap Iorwerth about the roll-out and access in every community. This is important in places in the Valleys, such as Blaenau Gwent, where you don't have high levels of car ownership amongst particular groups of the population and where it's important that the vaccine is delivered as locally as possible and in each part of our communities. I'd be grateful if you could ensure that that happens as we roll out this new vaccine. Thank you.

I thank the Member for his questions and comments. I completely agree that we are very fortunate that, whilst it was an unusual Christmas, most of us were able to enjoy Christmas at home and safe, and whilst we were doing that, there were people in our health service and other emergency services, and across social care, who were going out to do their job to keep us safe, many of those knowingly putting themselves in harm's way to do so.

On enforcement, I recognise the frustration of the Member and the concern of his constituents, and many others, who are concerned that essential retail still need to have control measures in place for the safety of their customers and, indeed, their staff. The enforcement conversation is one that does not stop. There'll be a meeting between Ministers, the police and local government next week again to look at where we are on enforcement. I hope that we'll be able to provide some figures and information to Members on where we are in terms of enforcement activity. I've seen a draft report of the enforcement activity taken in the run-up to Christmas that showed that, at that point, most enforcement focused on hospitality venues when it came to improvement notices or closure notices.

I know there are other Members, too, who have contacted me directly about their concerns over localised incidents at supermarkets. There doesn't appear to be a consistent view across one chain or another, but there are local incidents of real concern, and we do want to see those followed up, as I say, for the safety of staff and the public. We'll also be talking to the police as well. I think we're a long way past taking an education approach to these matters. We're nearly 10 months deep into this crisis, and if people don't understand the need to do the right thing now, then I have to say that I don't take the rather more hand-off approach. I actually think that people who are travelling in their cars to go and visit beauty spots know damn well they're doing the wrong thing and know they are outside the law, and I believe the law should be enforced in those circumstances.

On vaccine delivery, I'm very happy to confirm this will be of particular benefit to those areas where people don't have ready access to their own transport. So, the work we're doing with local healthcare providers, GPs and pharmacies in particular will mean there's much readier and easier access for communities to get this vaccine, to get the coverage and the protection that it provides. I hope the Member will see that for himself in his own community over the coming weeks ahead.

Thank you for your update, Minister. I too wish to thank those who work tirelessly, especially over the Christmas period. We have known about the new variant of SARS-CoV-2 for the past several months. During the intervening period, what assessment has been made of the severity of disease caused by the mutated virus? Is the ‎infection fatality rate any lower or, God forbid, higher? Reports from the new and emerging respiratory virus threats advisory group seem to report that the new variant can be spread more readily by children. What assessments have you made of the role schools have played in the increase of COVID-19 across Wales? The move into alert level 4 restrictions was driven, mainly, by falling numbers of beds available in our NHS. Minister, how does the bed situation compare with previous years? And finally, Minister, the sooner we get our population vaccinated, the better chance we have of weathering the economic storm caused by the response to the virus. So, can you provide an update on the roll-out of the AstraZeneca vaccine in Wales? What steps are you taking to increase the pace of mass vaccinations? When will Wales receive the first doses, and how many doses will we be receiving? Diolch yn fawr.

I thank the Member for the questions. On the final question, I think I've covered several times the Oxford vaccine roll-out. We expect to receive the first vaccines for delivery on 4 January, as with every other UK nation. The first few days will be about making sure that our delivery systems are secure. I've also had indicated that it may be sensible to have the first few of those delivered within an environment where there is access to further medical assistance. You'll recall that, at the start of the Pfizer roll-out, there were a couple of limited anaphylactic reactions. We want to make sure that we understand what the population response is. We do then expect to have much greater pace over the next week or two with the roll-out of the vaccine. And as I said in response to Alun Davies, that should mean that vulnerable people in a range of communities will have much more ready access to the vaccine and the protection that it provides, and that in itself is good news.

On the new variant, we know there are new variants all the time, as it were, because the virus is constantly mutating. There are many of those, but it makes no difference. The reason why we're now talking about a new variant is that it has made a difference in the way that the virus behaves, specifically how the virus is transmitted. It isn't that there's any evidence that the harm is greater; it's actually that the virus transmits much more rapidly, and that may well explain the significant exponential growth we saw through south Wales and the rapid growth we are now seeing through north Wales, where, in Wrexham, case numbers are over 500, in Flintshire over 300, in Denbighshire well over 200, and in Conwy just under 130—a significant growth from where we were just a week or so ago. And that does show, I believe, that it's partly the impact of the new variant, and that shows the threat and the risk that we have. But there's no evidence that it is more harmful.

On beds and availability, I refer the Member to the fairly detailed written statement that I provided on 23 December and the comments that I made within my statement and in answers to Rhun ap Iorwerth as well. You would not normally start a winter period where 2,600 of your normal beds are taken out of use because they are being used to treat a new condition for which there is still no known cure. That in itself is a huge issue. We normally say that we expand the NHS capacity to get to beds by the size of a large district general hospital. Well, this year, we've got several district general hospitals-worth of people being treated exclusively with COVID, and we've got critical care capacity operating at nearly 140 per cent. This really is a winter like no other, and that's why all of us need to play our part individually but also in the platform that we have as elected representatives to encourage people across our country to do the right thing and to help all of us to save lives.

Thank you, Minister, and I very much welcome the action that you took before Christmas to take us into alert level 4, and I also wanted to pay my heartfelt thanks to our NHS and social care staff, who are dealing with an unprecedented public health emergency. You referred in your earlier comments to the importance of keeping children and young people in school, which I entirely concur with, but, as you'll be aware, the evidence about a new variant emerging has caused a lot of anxiety, both for families and for school staff. Can you say a bit more about how the technical advice cell paper you've commissioned on the transmissibility of the new virus will look specifically at the role children play in transmission so that we can try and reassure everyone that the return to school will be safe?

Can I also ask about shielding? I was pleased to see the advice issued just before Christmas on shielding, but that advice did relate, obviously, solely to people who are shielded and not their families. I think it would be useful to have some further advice for families, particularly in view of the concerns about the higher levels of infectivity of this new variant, and can I ask if you'll discuss that with the chief medical officer, with a view to issuing further guidance for family members and carers of those who are shielded? Thank you.

Thank you. On your final question, I have to say I'll happily take that and have a further discussion with the chief medical officer's department about shielding and families and advice that we should give to people about how to best protect themselves and their loved ones. I recognise there are genuine concerns that people have.

On the move to level 4 before Christmas, I do believe that we've been vindicated in the move that we took. I think it was absolutely the right thing to do. I've yet to see the measures that are being taken in England, and I completely expect that there will be more communities moving into higher levels of restriction because of the reality of the spread of the virus, and the reality that, without additional action being taken, parts of our healthcare system could otherwise face being overwhelmed. We can't expect our staff to run through brick walls on our behalf for another three months. We all need to be part of doing the right thing. That includes the Government, but it includes the public as well.

On the new variant and the school return, I have commissioned some further work from the technical advice group to understand not just the impact on transmission and children, but to understand what it means for how safe the school environment is, because whilst teenagers in particular are able to not just get the virus but pass it on to others, actually, they themselves are very unlikely to suffer harm. Conversely, though, I know that there are concerns for people who work in schools, but, actually, we don't have any real evidence of there being any kind of significant level of pupil-to-staff-member transmission, and that, I think, does show how successful our schools have been, and it's a real positive for them, about having a COVID-secure learning environment. What we do see, though, is some staff-to-staff transmission, and that's about people following the requirements in their own workplace to keep themselves and colleagues safe, and it's also about making sure that the mixing outside school doesn't take place as well, and that's why the stay-at-home period is so important for us as well.

What's different about the last week before Christmas, where we moved all high schools to distanced learning, is that non-essential retail was open for a period of time in that week. It's also the case that we didn't have a stay-at-home requirement, for people to only leave home for essential purposes. So, we're operating in a very different context moving into the new year, with the phased return that's been agreed, compared to that last week in December. But I do think that the research that I've commissioned from TAG, which I'd like to publish as soon as possible, will help to give more confidence not just to staff, because I am concerned that staff have confidence to return to school, but confidence to parents and learners as well that they will be able to receive some face-to-face teaching and learning, because we know that's vitally important not just for a general sense of well-being and mental health, but actually to get good qualifications at the end of this year as well, and I would not want to see that compromised, if at all possible. As ever, if the evidence changes, we'll need to consider what they means for us and the decisions we make. I want to assure the Member that I do have regular conversations not just with our chief medical officer and scientific advisers, but also regular conversations with the education Minister as well, to make sure that we understand how our plans are moving, including of course the plans for serial testing for secondary school aged children going back to school from January next year.

Minister, people in north Wales are concerned that they're not getting their fair share of the vaccine at the moment. You'll be aware that the Public Health Wales figures that were published for the number of vaccinations that were distributed up to 20 December seem to demonstrate that people in north Wales are less likely, frankly, to get access to the vaccine than people elsewhere in the country. So, for example, in Powys it seems that people are four times as likely to have been vaccinated up to that 20 December date. In Cardiff and the Vale, your own area, people are more than two and a half times more likely than people in north Wales to receive the vaccination. Obviously, it's very important that all parts of Wales get their fair share of the vaccination, going forward, so that people can have the confidence that the roll-out is being dealt with appropriately at a national level by the Welsh Government. What assurances can you give to people in north Wales that they will get the vaccine on a fair basis with other parts of the country, and can you tell us what the timescale for the roll-out will be given now that we have access to the AstraZeneca and Oxford vaccine, further to its approval today?

I'm happy to confirm that every part of Wales will continue to receive its fair share, so I would expect that, when we ultimately see all the figures smoothed out, the Betsi delivery will be in accordance with its population—I think it's about 23 per cent or 24 per cent of the population. So, it will get its fair share. It's not being held back. It's actually about its ability to test all of its systems and then go ahead and accelerate delivery. And I certainly think that, with the roll-out of the Oxford-AstraZeneca vaccine, you will, as I said to Alun Davies and the constituency he represents, see communities across north Wales have even easier and readier access to the vaccine because we won't be asking people to move themselves to mass vaccination centres, but we'll actually be able to more readily and easily transfer and transport the vaccine around. Now, the way that you and many of us, including me—. I've had the pleasure of being jabbed with a flu vaccine in front of a camera for, I think, eight years running now. In many ways, we'll be able to store and transport this vaccine in the same way as you would a flu vaccine, where it's fridge storage, and that will make a really big difference, and that should see a significant acceleration.

I should just say, as you mentioned Powys, that I think Powys have been remarkably can-do in their approach not just for citizens in Powys, but, where they've had gaps in their ability, to reduce wastage they have offered some vacant slots to either north Wales, depending on the part of the county of Powys where they're delivering, or indeed some south Wales health board areas where they're delivering there as well. So, it does show that our NHS is acting not just to work together and across organisational boundaries, but a real commitment to reduce wastage as well, because the vaccine is a precious resource and we want to make sure it's used effectively and quickly, but of course that also means not having unnecessary waste. But I think that you'll again reassert a sense of pride in north Wales health services as we go through the coming weeks and months, and as more and more of us see our communities being protected by the roll-out of the Oxford-AstraZeneca vaccine and the much easier access we'll all see to that. 

You've just confirmed that you have commissioned some new scientific work on the transmission of the new variant of the virus among children. Before receiving the result of that work, how can you be confident that the education Minister's plans to get everyone back to school by 18 January is wise and sustainable in terms of preventing the spread of this new variant? Aren't the signals currently suggesting that we should reconsider that policy and maintain on-site learning for smaller groups only beyond 18 January? If it's inevitable that schools will have to be closed for the majority of pupils, then, please, inform schools in good time. If closure is inevitable in order to prevent transmission, then we need to provide adequate warning so that teachers can prepare to teach as best as they can and for families to make their own arrangements too. 

I think it's a fair question. What I've done is I've asked our technical advisory group to look again at the current evidence, not just on the new variant, but the evidence of COVID and education, and my understanding has been that teachers are not high-risk professionals. Other education staff are not high-risk professions, and that's good news. And it's credit to those teachers, and other leaders who organise those work places for their staff, that we don't see large amounts of coronavirus spreading through our schools, and we don't see evidence of pupil/learner transmission to staff members, and that's a good thing. It shows that people are respecting social distancing where it's possible.

Now, that then means that we need to understand this, because the same control measures are the ones that will be effective—that's good ventilation, as I have mentioned in my statement, and your colleague, Rhun ap Iorwerth, is keen on as well; it's also social distancing; it's also about having consistent cohorts of people—for the new variant, as for others. But the stringency will be even more important because the new variant is more transmissible, and that is the main change in the operation of the new variant. Now, we're of course looking to see if there is any other change within it, but that was the very clear advice that I had when I spoke to scientific advisers and the chief medical officer just yesterday. And the chief medical officer was clear with me that there was no reason, no evidence at that point in time, to change our approach to prioritising education and the balance of harms that we always have to run through. Because, as I'm sure the Member understands, there is real harm done to children and young people if we end up closing schools unnecessarily, and that harm is something we should not walk into lightly. We would need to have evidence that it is not safe to return to school, because actually the current evidence is that, with the conditions that we are planning for, we should be able to return to school safely. And there's extra reassurance for learners and staff and concerned parents, because we'll have serial testing in our secondary schools as well. That will mean that people don't need to isolate unnecessarily. It also means we should identify more asymptomatic cases as well. So, I actually think that is additional reassurance, compared to where schools were operating at the start of December, for example, when we were seeing a rapid growth in coronavirus across large parts of Wales. 

But, of course, I'll continue to talk with the education Minister, as I indicated in response to Lynne Neagle. And I know that she will continue to have dialogue with trade unions and, indeed, the Welsh Local Government Association, because all of us, surely, want to see children's education and learning protected, not just the value of it as to the straight education provided, but the wider learning and protection that a school environment provides. So, I am very keen that we maintain that. It's a stated priority of this Government, and it would take something extraordinary for us to say that we did not want schools to go ahead with the already agreed plans that are in place between the education Minister, the WLGA and, indeed, our trade unions. 

Can I firstly welcome today's news of the Oxford vaccine announcement? And I appreciate the Minister has said quite a lot about that this afternoon, and I thank him for the assurances he gave in a previous answer that north Wales is getting, and will continue to get, its fair share of the vaccine, both the Oxford and the Pfizer vaccine before that, and we'll start to see that when more data is released.

Secondly, Minister, I have been contacted by residents concerned about shielding, particularly those pregnant. If people who are pregnant can't work from home due to their nature of employment— for example, working in a supermarket—once a risk assessment has been carried out by the workplace and the individual still remains extremely anxious about attending work, do you agree with me, Minister, that the employer should then look to furlough that member of staff?

I think it's an interesting question that the Member raises when it comes to staff being furloughed. The starting point is, should an employee be shielding—and we've given clear advice that if you're on the previous shielded list—then our advice is if you can't work from home securely, then our advice is not to go to work, and there's written confirmation of that advice going out to people. For people who are pregnant, just being pregnant isn't a reason for people to undertake that form of shielding advice; it would specifically apply, though, to pregnant women who also have, in particular, heart conditions as well, whether congenital or acquired. In that instance, they would fall within the ambit of the announcement that was made on 22 December, and our advice would be they should not attend work outside home. It is still then a matter of people having a conversation with their employers, and we would expect employers to be sensitive and understanding, even if a pregnant woman is not within the shielded category, to responsibly have that conversation with them and to understand the additional stress and strain that may provide for the woman and her child. So, in those circumstances, it may be that an option is to be furloughed. But that's a conversation that the pregnant woman should have with her employer, and obviously, I'd encourage anyone in that position to make sure they have joined a trade union within the workplace to be supported in having that conversation.

I thank the Minister, and apologies to those Members I wasn't able to call this afternoon because of time constraints. May I take this opportunity to wish you all a very happy new year, and a better new year to you all? And as others have done this afternoon, may I thank everyone who is working here in Wales to keep us all safe and healthy over the Christmas period and into the new year? Good afternoon to you all, and that brings today's proceedings to a close.

The meeting ended at 13:17.