Health Protection (Coronavirus, Local COVID-19 Alert Level) (Very High) (England) Regulations 2020
(Limited Text - Ministerial Extracts only)
Read Full debate16:16 - Division conducted remotely on Baroness Thornton’s amendment to the Motion - Ayes: 256 / Noes: 250 - Baroness Thornton’s amendment to the Motion agreed.
Lord Bethell
That the Regulations laid before the House on 12 October be approved.
Instrument not yet reported by the Joint Committee on Statutory Instruments
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, these regulations, which were made on 12 October and came into force today are necessary owing to the continued rise in the national transmission rates of coronavirus in England. They form a critical part of the government response to the ongoing threat to public health posed by the coronavirus epidemic.
The new local alert level approach, announced by the Prime Minister on Monday, will rationalise the important programme of local interventions that have been applied across the country. It will enable a coherent set of interventions across England, making it easier to communicate to the public which restrictions apply in their area. This will increase the likelihood of compliance and the effectiveness of social distancing measures.
Today we are debating three sets of regulations: very high, high and medium. The regulations in this debate set out the restrictions that will apply when the local alert level category is set at very high. These will apply when the local alert level category high measures cannot contain the virus or where there has been a dramatic rise in the transmission rates. There is no automatic trigger for an area to move into higher restrictions. Government, working with local authorities and directors of public health, will consider several factors, including the number of cases in the area, the rate of transmission, the effectiveness of current interventions, hospitalisations, the national picture and an assessment of the capacity of local health services.
Regarding restrictions on gatherings, in areas subject to local alert level very high restrictions, social contact will be reduced to break potential chains of transmission. For that reason, meetings in indoor venues and private gardens is limited to a single household. Meetings in outdoor venues are limited to a single household unless exemptions apply. The intention is to dramatically reduce social contact while balancing the social and well-being benefits of meeting family or friends. We recognise the risk of isolation, and have taken targeted policy interventions to mitigate this. For instance, a single-adult household and one other household of any size may link together to form a support bubble. A gathering that is made up of people from the same bubble is not subject to the six-person outdoor limit or the one-household gathering limit that applies indoors and in private outdoor settings.
The Government recognise that both weddings and funerals are significant life events. As such, the following higher limits apply to balance the need for people to recognise these significant events, while minimising the spread of the virus: weddings and civil partnerships are subject to a 15-person limit; funerals are subject to a 30-person limit; and wakes are limited to 15 people.
The restrictions placed on business seek to balance reducing social contact and enabling businesses to continue operating to minimise disruption to the economy. We know that hospitality poses a high transmission risk. PHE data shows that, between 3 August and 27 September, 148 known outbreaks occurred in restaurants and food outlets. PHE’s weekly surveillance report also highlighted that, from 21 to 27 September, 13% of those who tested positive for Covid-19 reported eating out in the time before symptom onset, when there is a high risk of asymptomatic transmission. The Scientific Advisory Group for Emergencies has also highlighted that alcohol consumption may increase risk of non-compliance with social distancing and that hospitality settings are associated with increased risk of transmission.
At alert level very high, businesses and venues must follow the restrictions imposed at local alert level medium and high. This requires the closure of all hospitality and leisure venues from 10 pm to 6 am. In keeping with the restrictions on businesses and venues at alert level medium and high, hospitality settings in alert level very high must only use table service for the consumption of food on their premises. This is to reduce the potential for social mixing of customers from different households.
The regulations require the closure of services that pose a higher transmission risk and cannot currently be opened safely. These include nightclubs, dance halls, discos, sexual entertainment venues and hostess bars. The Government are conscious of the impact that this will have on these sectors and we continue to work with representatives from these industries to develop options to facilitate a safe way for them to reopen.
We know that alcohol consumption results in reduced compliance with social distancing rules. These regulations mandate that hospitality venues can only serve alcohol for consumption on the premises alongside a main course meal. Those venues that do not serve main meals must close.
Key to our approach is financial support. Businesses that are required to close will be eligible for support from the Local Restrictions Support Grant. Eligible businesses will receive a grant for each two-week period they are required to close, payable after the first two-week closure period.
In addition, the Job Support Scheme will provide a safety net for businesses across the UK required to close temporarily. The Government will support eligible businesses by paying two-thirds of each employee’s salary up to a maximum of £2,100 a month.
Given the likely impact of the new measures introduced in very high alert level areas, it is important that local areas shape the restrictions introduced and that the restrictions reflect the local, economic, social and public health situation. The Government will work with the respective local authorities to achieve this.
The regulations create offences punishable by fines and provide for fixed penalty notices. I pay tribute to the vast majority of the general public who are doing the right thing and diligently following the rules, but it is vital that the police have appropriate powers to deal with those who do not.
I appreciate that these changes have caused real disruption to people’s lives. However, the evidence continues to indicate that the infection rate is rising across the country. It remains vital that the Government take decisive action to limit further spread. For that reason, I beg to move.
Amendment to the Motion
Lord Bethell (Con)
My Lords, I am enormously grateful to noble Lords for an incredibly thoughtful debate about measures that were laid only recently and have come into force today.
I start by addressing the two big, chunky issues that were raised by noble Lords. The first is the connection between Test and Trace and local efforts on the ground. I want to take a moment to reassure noble Lords about our commitment to a really strong connection between the national efforts of our test, trace and isolate programme and the work that goes on on the ground. Test and Trace and Public Health England work incredibly closely with the Association of Directors of Public Health, the Society of Local Authority Chief Executives and Senior Managers, the Local Government Association and UK chief environmental health officers as part of this programme. Those conversations happen daily on an institutional and personal basis.
The challenge was put to me that the contact tracing does not include public health experts. That is not quite right. There are 1,000 tier 1 contact tracers working within the core contact tracing service and in health protection teams and field services right across the country. More recruitment is under way. In fact, we have more than doubled the size of local health protection teams since the pandemic began, precisely because of our commitment to the partnership between the national and local efforts.
It was suggested that we should do more to work with local clinicians. We do an enormous amount of work with local clinicians. Thousands of NHS clinicians have signed up as contact people. They are in touch with those who have tested positive and talk them through the process to find out where they have been and who they have been in contact with. They do an incredible job every day and are the expert bedrock of the contact tracing process.
We absolutely depend on and mobilise local know-how, which we do through data sharing. Local public health officials can use the data provided by NHS Test and Trace to follow up cases that the national service has been unable to reach. Together, we can increase the numbers who are reached. More than 90 local authority partnerships across the country have gone live with locally assisted contact tracing, and more are coming on every week. The results are enormous. In England, we have reached more than 650,000 people and advised them to self-isolate. Everyone who tests positive is contacted by Test and Trace.
On the testing service, we are doing 310,000 swabs a day—22 million tests in all. There are five Lighthouse labs, 96 NHS labs and a total of 500—I repeat, 500—local testing sites. As a result of the tracing numbers, last week, 51,000 people tested positive, 34,000 of whom went into the contact system—and we should bear in mind that many would have been in the care service and therefore do not need to be transferred. Of those, 25,000 were reached and it was suggested to 21,000 that they isolate. Without that system, the epidemic that we have today would be worse than it is, and we owe enormous thanks to those involved.
A number of noble Lords asked about the app. There have been some 16.9 million downloads. That is 29% of the over-16 population, and the costs up to 31 July were £13.8 million. We are completely live to the challenge that some people have phones that do not work with the app, but I reassure noble Lords that it works with Apple iOS 13.5, Marshmallow 6.0 and the Huawei OS 8 or anything above.
My noble friend Lord Robathan challenged me about the evidence base for the curfew at 10 pm. My noble friend Lady Noakes quite rightly cited the SAGE notes that make the clear point that I made here yesterday when discussing masks: it is very difficult to put together the precise clinical trials and detailed modelling for individual measures that are brought to bear on the epidemic. But my noble friend Lady Noakes misrepresented SAGE when she implied that there was no evidence for the restrictions overall. The huge growth in the epidemic in recent weeks demonstrates the urgent need for these restrictions. The impact of the epidemic is not just on those who have Covid; it is also on those who find that the hospital beds they need are filled and on those who are put off going to hospital and therefore incur either delays or an impact on their current illness. There is also an impact on those who suffer as a result of any kind of avoidance of medical practice. The impact of Covid is not just on those who get it; it is on all those who seek medical attention. That is why, with the disease growing exponentially, we have to lean into it extremely heavily.
The noble Lord, Lord Birt, asked about the mass media campaign. I reassure him that we have invested massively and applied the best behavioural science to convey the restrictions as clearly as we can, and that that is backed up with quite severe sanctions, fines and police action.
The noble Baroness, Lady Watkins, raised, quite rightly, the challenge of getting visitors to social care settings, many of whom perform really important care duties for those in social care. We are completely live to the challenge of getting a regime of testing for those very important visitors. There are challenges in identifying exactly which visitors should qualify for such a scheme. We are building up our testing capacity to have enough tests available to them, and I shall be glad to update the noble Baroness when we have made progress.
My noble friend Lord Moynihan mentioned gyms. I completely endorse his commitment to fitness regimes, whether inside or on a beach. But it is true that local authorities in Liverpool suggested that closing the gyms would be a helpful way of restricting the epidemic.
We have been asked about balance. The Government’s strategy is one of balance. It is to contain the virus in any way we can while protecting the NHS, our economy and our schools. We are working extremely hard on the vaccine, on therapeutic drugs and on mass testing, which we believe will provide a route out of this horrible disease.