Health Protection (Coronavirus, Restrictions) (Self-Isolation and Linked Households) (England) Regulations 2020
(Limited Text - Ministerial Extracts only)
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Lord Bethell
That the Regulations laid before the House on 11 December 2020 be approved.
Relevant document: 40th Report from the Secondary Legislation Scrutiny Committee. 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, today we have more than a million people in Britain infected with Covid. A third are asymptomatic, and most are highly infectious. That is just too many. That is why on Monday the Prime Minister announced a new national lockdown. The measures are tough but necessarily so. They reflect not only the current case rate but the extent of the pressures faced by our health and care system.
We have over 30,000 people with Covid in hospital beds, with over 2,500 people on mechanical ventilation, and based on the infection rates of the last month and the inevitable clinical chain reaction those numbers are set to rise. Yesterday, sadly, the UK reported a further 1,041 people who had died after testing positive in the 28 days previous and, with yesterday recording our highest daily increase since mass testing began, unfortunately it is inevitable that more deaths are on their way. That is why the Government took swift and decisive action this week, introducing a national lockdown and closing schools. We take this action with deep regret—for society and for the economy—but it is necessary to respond to the grave situation that we face.
The SIs we are debating today cover the tiering system introduced following the November national lockdown. Those regulations have been amended five times to extend the geographical reach and to fine-tune the terms, and we are also debating this week’s national lockdown. Overall, these SIs tell the story of our containment of the original strain of the virus, with a tiering system that eventually proved to work. They also cover the subsequent identification of and reaction to a more transmissible strain of the virus that was far more aggressive than anything that had been seen anywhere in the world before.
The New and Emerging Respiratory Virus Threats Advisory Group spelled it out clearly: the new variant demonstrates a 70% increase in transmissibility. This means that successful measures that were previously in place such as tier 3 are no longer enough to reduce the transmission of cases. The new variant makes up around 60% of cases in some parts of England, and that is rising. Since the beginning of December, cases reported per day in the UK have steadily increased, with on average 15,000 reported in the week of the 6 December, 34,000 in the week of 20 December, and a shocking 57,000 in the week to 3 January. This will inevitably lead to more hospital admissions and increased pressure on secondary care over the coming weeks. This is why a national intervention, introduced swiftly, is so necessary, and why the tier 4 measures have been strengthened by the closure of schools.
We are also taking on additional measures to support industry given the further national restrictions. We have announced additional support to the most affected businesses worth £4.6 billion across the UK. This support will help businesses get through this difficult period until spring. We will take further decisions about our economic response to coronavirus and how best to support the economy, businesses and jobs at the Budget on 3 March.
We have aimed to balance the economic impact of greater restrictions on business with measures to protect public health. Implementing a national lockdown with the vaccine rollout will allow the nation to return to some sense of normality and for the economy to bounce back. We have mitigated the short-term impact through financial support schemes to reflect these changes, and will carry on supporting the British public through these tough times.
However, we are not back to the bleak days in March: hope is on the horizon. The rollout of the Pfizer and AstraZeneca vaccines is making excellent progress. We have now vaccinated over 1.1 million people in England and over 1.3 million across the UK. The rollout in care homes started on 16 December, meaning that our most vulnerable as well as vital care staff can be protected.
While the vaccines project is an international collaboration, we should take a moment to recognise the contribution of the British life sciences sector and to reflect that an easy-to-administer, affordable and mass-produced vaccine offers Britain a way out of this disease and will make a huge impact on the global response.
The end is in sight but, until that time, we must all take responsibility for reducing the transmission of the virus, protecting the NHS and saving lives by complying with these restrictions. I know that these measures require a huge sacrifice. They are designed to minimise our social contact, coming at the cost of seeing our friends and family, participating in the hobbies we love and preventing us taking those holidays we desperately look forward to, and the economic cost is high. But this is a price worth paying to help our key workers, who have dedicated themselves for the benefit of others. We owe it to them and to protect the economy from a collapse in confidence and from rolling lockdowns.
The other SI that we are debating today relates to the self-isolation periods for households and is another example of how we have applied what we have learned. We are doing everything we can to identify and isolate the infectious. Between 25 December and 31 December, 346,901 people across the UK tested positive and were told to isolate, and a further 493,573 people were identified as recent close contacts, of which 92.3% were reached and told to self-isolate. This is a massive national effort.
On 14 December, we amended these regulations to make changes to the self-isolation period for households, non-household contacts and international arrivals, reducing it from 14 days to 10. This is based on evidence showing that the likelihood of being infectious as a contact after 10 days is low. To bring our policy in line with other nations in the UK, the 10-day self-isolation countdown begins on the day after exposure, onset of symptoms, or a positive test result.
Before I finish, I will address the question of parliamentary scrutiny. I want to be clear that no one in the Government makes use of these emergency procedures lightly, nor do they do so without the conviction that they are absolutely essential. Unfortunately, as I have set out and as we have seen across recent weeks, urgent action has been required. I know that some of your Lordships may be disappointed that the amendments were made before there was a debate. However, I emphatically reassure them that we remain committed to parliamentary scrutiny. I commend these regulations to the House.
Lord Bethell (Con)
My Lords, we are debating today the 59th regulation in a restriction round—quite a colossal number. They are unfortunate and regrettable, but they are necessary. This Government are committed to making them the best they can be, and I am extremely grateful to noble Lords for their recommendations and suggestions on the restrictions. Let me trot at pace through a few of the recommendations from noble Lords.
Noble Lords are entirely right that money to isolate is an incredibly important element of the effectiveness of isolation. I reassure noble Lords that we are in active dialogue with 314 local authorities to figure out how to make the isolation payments more effective and mobilise charities’ and local authorities’ support for those who need it.
A number of noble Lords brought up travel restrictions. I completely agree with the noble Lords, Lord Winston and Lord Reid, that international travel has been a source of infection for this country in the first and second waves, and continues to be. The prospect of a South African variant that is even more transmissible than the Kent variant puts a spotlight on that threat of infection. That is why we are working on processing new measures, which will be introduced shortly, for pre-flight testing for travellers to Britain, and we look forward to those being announced shortly.
In the meantime, I have to break it to the noble Baroness, Lady Jolly, that test-to-release, which she mentioned, was introduced on 15 December. I get a weekly update on it, and I can reassure her that the evidence to date suggests that the isolation of travellers on test-to-release is much more effective using the testing mechanism than it was on the isolation mechanism. We will probe those figures very carefully, but I am optimistic that that scheme has worked well.
My noble friend Lord Lancaster mentioned the tiering system. It is a grim prospect, but I warn noble Lords that we are unlikely to spring out of this national lockdown straight into the sunny uplands, and a new tiering system will likely be necessary. The right honourable Secretary of State for the Home Office spoke this morning on the radio about the kinds of penalties that she has instructed the police to apply. I reassure the noble Lord, Lord Berkeley, that our approach to the lockdown is effective and implementing all the regulations necessary.
To my noble friend Lady Altmann and to the noble Lord, Lord Foulkes, and others who asked about test and trace, may I just be crystal clear? I sometimes find I am repeating myself on this matter. In the last week of the year, test and trace identified 450,000 people who had Covid and isolated another 350,000 of their contacts. That is an absolutely incredible achievement. No other country has a scheme like it, and it has become repetitive and inaccurate to suggest that it is not making any impact.
The noble Baroness, Lady Thornton, and others asked where community testing might be going. Of course, during a lockdown, the community testing component is not necessary, but I reassure the noble Lord, Lord McNally, and others that we are very committed to it. We are in dialogue with councils at all levels about how they might use community testing, and with schools about once the lockdown is lifted.
A number of noble Lords looked beyond this lockdown to the future. The noble Baronesses, Lady Finlay and Lady Bennett, asked about ventilation and workspaces. That is exactly where our heads are at the moment; we are trying to understand and think through the implications of this pandemic. The reality is that there will be no quick transition. We shall have to think about workplace hygiene. My noble friend Lady Wheatcroft asked how workspaces will have to be reimagined. I very much welcome the suggestions, evidence and recommendations of noble Lords in this area; it is something that both BEIS and DHSC are looking at very closely, and I look forward to updating the House on that.
A number of noble Lords’ questions and comments were about the vaccines, not the regulations. Since that is the hot subject, let me address it directly. I reassure noble Lords that, whatever they may read in the papers about problems and blockages, the rollout of the vaccines is being done at pace. It includes the Army; volunteers are being mobilised, GPs and pharmacies are being recruited and we will hit the numbers that the Prime Minister has committed to. The noble Baroness, Lady Masham, rightly thanked factory workers and others involved in the process of manufacturing and logistical support in supplying these vaccines. It is an incredible process to put together 30 million or 40 million vaccines before the spring at pace in highly delicate, secure and hygienic environments, and to get them to the front line in a way that is temperature-controlled and fulfils the commitment to the MHRA.
Patient safety must be our priority. That is why it is done in a thoughtful fashion. While we are very grateful to BrewDog and others for innovative ideas for how to roll out the vaccine—through the middle of the night and what have you—we must get it right. You cannot jab someone’s arm and inject them with a potent vaccine without being absolutely sure that it is the right person in the right place, the right vaccine and in the right conditions. Getting all those stars aligned requires an enormous logistical process, and we are absolutely determined to get it right. We also must have availability of vaccine. I thank Pfizer and AstraZeneca for the enormous lengths that they have gone to to provide millions of doses of vaccines, but it takes time to deliver. At the moment, it is not the NHS that is the limiting factor but the provision of the vaccines.
To achieve that provision, we will deliver through hospitals, GPs, pharmacies and mass centres. Today, we have 107 hospital sites online, and there will be a further 100 by the end of the week; there are 595 GP-led sites, and there will be a further 180 by the end of the week. The mass centres will be open shortly, and they will have a huge impact on the rollout.
Obviously, the big vaccination centres have hugely more impact than small pharmacies and rural doctors, but that is not to say that those are not being prioritised as well. However, I ask for noble Lords’ consideration: the practical matter of getting a vaccine that has to be temperature controlled and comes in large packs of sometimes up to 1,000 doses to small rural pharmacies, community pharmacies and GP practices in the far-flung parts of Britain is an enormous logistical exercise—we have to balance scale and volume with breadth and the niche interest. I think we are getting it right; we have not forgotten anyone, but there will need to be a little bit of time before we can reach everyone.
A number of noble Lords have talked about cancelled trips to the GPs; I completely recognise and acknowledge those stories. It is true that, sometimes, we have to line people up for appointments, and the delivery of the vaccines, which is an extremely delicate task, has not always proved to be as reliable as we might have hoped. We are seeking to iron that out, and I ask for the forgiveness and forbearance of any pensioners or patients who have had to wait for their vaccine. I reassure noble Lords that, if there are cancelled appointments, it is only because we are trying to make maximum use of the stock of vaccines that we have at the moment.
On the volunteer scheme, I completely and utterly agree with all noble Lords who are frustrated and irritated by the large amount of bureaucracy that this has involved. As the noble Baroness, Lady Watkins, rightly pointed out, we have stamped on some of it, but there is more to do, and I think that there is a lesson to be learned about how the NHS and British Government treat volunteers, and we are making a lot of progress on that already.
To my noble friend Lady Neville-Rolfe and others who asked whether we are using the Army, I say yes we are using the Army.
On dentists, I reassure my noble friend Lord Balfe that all those with direct patient care are prioritised for the vaccine, whether they are dentists or dentists’ assistants.
I do not recognise so well the stories of the noble Baroness, Lady Brinton, about logistical problems, with car parks and freezing GP surgeries. I am on a vibrant WhatsApp group with MPs, and I am deluged with hundreds and hundreds of positive stories of quick, polite and accessible service. I would be very grateful if the noble Baroness would write to me with her anecdote; I would be glad to follow it up.
On therapeutics, I am grateful to my noble friend Lord Moynihan for his quite accurate remarks on the importance not of vaccines but of the therapeutics that can assist in recovery. We are grateful to RECOVERY and REMAP, the two big clinical trial schemes that have proved to be a massive global success—and, without giving the game away, I am hopeful for more good news from that direction shortly.
I remind my noble friend Lord Cormack that, although he may get his vaccine soon, immunity does not necessarily mean sterility. While he himself may take the vaccine and, therefore, be protected from the impact of Covid, he may be the carrier of the virus. To those, like myself and my noble friend Lady Penn, who are not candidates for the priority list for the vaccine, we would be extremely wary of anyone who has had the vaccine but is still a carrier of the virus. That is a really important policy point that we will have to wrestle with in months ahead.
I reassure the noble Lord, Lord Truscott, that the Oxford vaccine is extremely good, and just as good as all the others.
Lastly, on the NHS, I completely agree with all those noble Lords who pointed out that the second, or potentially the third, time round is tougher for the NHS: there are mental health issues and capacity issues, and there is the sheer miserableness of being back on the front line again. I live opposite University College London Hospital; the sound of the ambulances arriving through the night wakes me all the time. It used to be once or twice a night, but it has been a dozen times a night for the last month, which is a sombre reminder for me, personally, of the front-line experience of those who work in the NHS. I profoundly thank all those who are spending a tough winter looking after those with Covid and other conditions. We are working hard to get volunteers to support the front line, but I acknowledge that that has been slower than perhaps expected. Some £15 million has been allocated for mental health support for those in the NHS, but more can and should be done, and we are consistently working on it.
By way of winding up, I say that these restrictions are extremely regrettable. The noble Baroness, Lady Fox, demonstrates her anger and frustration; I do not really agree with much of what she says, but the emotional frustration she shares is well expressed, I think. However, I cannot hide from the Chamber that the new variants that have developed in Kent, South Africa and elsewhere present a tough challenge for all of us. We have learned an enormous amount about how to contain the virus and we have a huge amount of hope from the vaccine, but we have a long way to go.