Health Protection (Coronavirus, Restrictions) (Self-Isolation etc.) (Revocation) (England) Regulations 2022
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Lord Kamall
That the Grand Committee do consider the Health Protection (Coronavirus, Restrictions) (Self-Isolation etc.) (Revocation) (England) Regulations 2022.
Relevant document: 31st Report from the Secondary Legislation Scrutiny Committee
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
My Lords, over the course of this pandemic, we have had to put in place curbs on our liberties. Many of those curbs would at one time have seemed intolerable, but they were part of our national effort to slow the spread of the virus. We have now reached the position that we have been waiting for ever since this national effort began: a time when we can roll back some of the rules that have governed our lives over the past two years.
We are able to take this step because of the incredible progress that we have made; I thank noble Lords for alluding to that in the previous debate. When this virus first arrived, we knew very little about it. People were dying. There was no vaccine. We had to make tough decisions to protect our loved ones, our healthcare staff and the British people while we built up the defences to make us safe.
Since then, our vaccination programme has put more than 140 million doses in arms. That has included a booster programme where we were the first major European nation to boost half our population. It has resulted in more than 70% of adults in England receiving the booster, including 93% of those aged 70 and over. Vaccines have given us greater protection and slowed down the advance of the virus. They have allowed us cautiously to open up the country and attempt some return to normal life. The scientific protection that we have built up, together with our greater understanding of the virus, has shifted the odds.
We must be quite clear that our fight against the virus is not over, but we are now able to take a different approach, moving away from legal curbs towards an approach based on personal responsibility and public health guidance, where we trust people to make the right decision for themselves, for their loved ones and for those around them. I hope that noble Lords will bear with me while I talk through each measure in turn.
First, the legal requirements around self-isolation are being revoked. This includes the duty to self-isolate if you test positive, the duty to provide NHS Test and Trace with details of contacts, the duty to notify an employer that you are self-isolating and the legal duty on employers not knowingly to allow someone who is self-isolating to attend work.
Rather than relying on legal restrictions, we are encouraging people to act responsibly and to follow the guidance that has been set out. If you experience any of the main symptoms of Covid-19, you should take a test. These symptoms are a new continuous cough, a high temperature and a loss of or change in your normal sense of taste or smell. People who test positive should still stay at home and avoid contact with others for at least five full days. They may choose to follow this advice until they have received two negative test results on consecutive days.
Household contacts are also advised to work from home if they can and to avoid contact with individuals who are at greater risk from Covid-19. They should also limit close contact with other people outside their household and wear a well-fitting face covering in enclosed spaces. Following this advice for 10 days after the case’s symptoms started, or the day their test was taken if they did not have symptoms, can help to protect others. Specific guidance for staff, in particular those in vulnerable settings, such as adult social care, healthcare and prisons, is being kept under review and regularly updated.
The other regulations being revoked today are the Health Protection (Coronavirus, Restrictions) (England) (No. 3) Regulations 2020. These gave local authorities powers to issue directions to close, prohibit and restrict premises, events or outdoor places. They also gave the Secretary of State powers to require a local authority to issue a direction for closure. These regulations were vital for a local response to the crisis, allowing us to act with speed in response to local outbreaks, but these powers have not been used since July last year and we are now seeing fewer outbreaks, meaning that they are no longer proportionate or necessary. With these regulations revoked, outbreaks will be managed by local authorities through local planning and pre-existing public health powers, as they would be with other infectious diseases.
Although we are able to take these steps, we must remember that this pandemic is not over. There are simple actions we can all take to limit the spread of Covid-19 to protect those around us: get vaccinated, ventilate shared spaces, wear a face covering in crowded or enclosed spaces, get tested if you have Covid-19 symptoms and stay at home if you are positive. It is important that those who test positive for Covid-19 follow the public health advice to stay at home and avoid contact with others for at least five days.
We are taking additional steps to protect the most vulnerable with targeted vaccines and treatments, including offering spring boosters as we announced and the protection offered by antivirals, of which we have a greater supply per head than any other country in Europe.
In our surveillance to build up our resilience to manage and respond to new variants, we will continue to rely on the world-leading ONS survey, allowing us to track the virus in granular detail. We will make sure that we still have the ability to ramp up testing should we need to and will help countries across the world to develop their own capability for surveillance. These defences will be our first port of call in the future, rather than relying on legal restrictions, while we maintain our vigilance.
The regulations we are debating today restore some freedoms to our nation, but we have to make sure we maintain our vigilance and continue to rely on a scientific evidence approach to keep us safe. I commend these regulations to the Committee.
Baroness McIntosh of Pickering (Con)
My Lords, I thank my noble friend, both for his Answer to my Question earlier, which I would like to pursue in more depth here, and for moving the regulations today. I also pay tribute to the work that he, the ministerial team and the department have done. They have worked exceptionally hard in challenging circumstances. I declare my interest as an adviser to the board of the Dispensing Doctors’ Association.
I understand, as my noble friend said in response to my Question earlier, that the department and the Government are reaching a balance in living with Covid. The context of these regulations must be set against that background. My concern is that we are still relying on the vaccination programme. I pause and say how welcome the vaccination and booster programme has been. I particularly welcome the fourth jab being rolled out to the most vulnerable. It seems slightly patchy: we heard earlier that some in London have a date for their vaccination, but hearsay and anecdotal evidence are that people are being told that they will have a vaccination but have no date yet.
My main concern is simply this. The Secretary of State has said publicly, and my noble friend has repeated it in the House and in Committee today, that the Government hope to respond and keep the development of the pandemic under review. I welcome that but my concern is very simple: that we are removing all the tools to enable the Government to do so.
Baroness Thornton (Lab)
The noble Baroness, Lady Brinton, has raised very many relevant questions, as did the noble Baroness, Lady McIntosh. Those questions come from the anxiety that people are feeling about what the future of living with Covid means, with what looks like not having all the instruments to identify it or the recommendations about what to do if you have it. There is also the support that people may or may not be able to get from their workplace; and the support that may or may not be available to local authorities, for example, which are going to pick up some responsibility for this.
Almost exactly two years ago, my noble and learned friend Lord Falconer and I faced the Minister and his Whip, two Liberal Democrat colleagues, a couple of people who were chairing the sessions and a skeleton staff as we put on to the statute book the restrictions we are lifting today. Everybody else had already gone into lockdown; we put the legislation on to the statute book about three days after the rest of the country had gone into lockdown. It was a bizarre experience and actually felt quite risky. I am sure the noble Lord, Lord Newby, will not mind me saying that he went home and told us the day after that he had got Covid. My noble and learned friend Lord Falconer and I were absolutely convinced that we were going to get it, because we had been sat very close together, but neither of us did at that point.
In a way, I am very pleased to see that we are rescinding these restrictions now, but the Minister needs to put some answers to what has already been put to him on the record. The first thing I want to ask about is the support for local government. If local government and public health authorities are to be picking up how to identify what to do about the pandemic if things get worse, I would like to know whether support is available to them to do that.
The second thing I want to raise is to do with monitoring and research. I excuse the Minister for not answering my question in the Chamber earlier, because it is quite hard to answer such questions in detail in the 30 seconds that might be available, but I will repeat the fact that the ZOE Covid study app is no longer going to receive its funding. The app was launched in March 2020, having been developed by King’s College London and the technology company ZOE to help discover new symptoms of Covid. It reported on the effects of vaccines and has provided up-to-date predictions about the spread of the pandemic. It has 4.7 million users, of which I declare myself as one, and 850,000 people contribute daily to its recording of more than 480 million health reports. The app was part of one of the largest studies of its kind in the world and has led to 40 peer-reviewed scientific papers, based on its findings.
Many noble Lords will have heard of Professor Spector. He has been doing weekly YouTube broadcasts that I have watched from time to time as part of my information gathering to do my job from these Benches more effectively. He has developed the study further to look at things such as heart disease, cancer and dementia. It is extremely disappointing and very short-sighted that the UK Health Security Agency is going to withdraw its funding for this programme. It has been an important tool in protecting the UK and could protect the UK from the next pandemic.
I want to hear from the Minister what he and the Government are going to do to replace the kind of surveillance that the ZOE app has provided to this country in a very cost-effective way. The Minister’s earlier answer to me in the Chamber said this and that, but he did not specify. We need to know why the Government have allowed this to happen and what they are going to do to replace this effective surveillance and reporting.
Thirdly, I would like the Minister’s view on the BA.2 variant. His honourable friend said that it is of no significance but that is not what the chief executive of the UKHSA said. She acknowledged it and said that we do not yet know whether it is significant. How do the Government propose to monitor this?
Finally, I want to talk about the problem of inequality that the Government’s withdrawal of free testing brings. I think it will mean us having two tiers of Covid in this country. Those of us who can afford to will continue to test because we believe that it is important to protect other people, particularly the vulnerable, when we go out and about. I do not want to come into the House of Lords without having a test in the morning because I would hate to bring an infection into the workplace, because of the young people and pregnant colleagues who are here. That would be irresponsible. But there will be those who cannot afford to buy tests; what do they do? Our part-time staff here, for example, might not be able to afford to test. The Minister needs to address the problem of the inequalities that the Government’s policy will bring about for those who may get Covid but cannot afford to test.
Lord Kamall (Con)
I thank all noble Lords for their questions today. I will try to answer as many as possible but, if I do not answer some, I hope that noble Lords will allow me to write to them in more detail.
I start with some of the questions from my noble friend Lady McIntosh. We have taken this step because of the success of the vaccination programme but the guidance states that, if you have Covid, you should stay at home and avoid contact with other people. On 21 February, we will continue to make tests available for a small number of at-risk groups. We are considering which groups will be eligible for tests after provision for the general public ends. We have also sent out 1.3 million PCR tests to clinically extremely vulnerable individuals. This will allow them to take an immediate PCR test, should they develop symptoms, and give priority to them to be prescribed antivirals.
UKHSA will continue to maintain what it calls critical surveillance capabilities. That includes the Covid-19 infection population-level survey, genomic sequencing and additional data. These will continue to be augmented by the SARS-CoV-2 immunity and reinfection evaluation, SIREN, along with the continuation of the VIVALDI studies. As for the assertion of the noble Baroness, Lady Brinton, that the VIVALDI studies are coming to an end, I do not have that information—I am, in fact, informed that they are continuing. So, the UK Health Security Agency still has a number of tools available, including surveillance. Positive cases should stay at home, as we said, and avoid contact with other people for at least five full days. They should continue to follow this advice until they have received two negative test results on consecutive days.
A number of noble Lords expressed concerns about the communication of this guidance. If they will allow me, I will go back to the department and ask more questions about the comms strategy to make sure that the public are clearly informed. As for the cost of LFTs, the Government are looking at how to make them freely available in particular settings, such as health settings, and for social care staff.
We are also looking very hard, as noble Lords have rightly said, at potential inequalities. These are issues that my right honourable friend the Secretary of State and I believe very strongly in—we have actually asked questions on this issue. How do we make sure that we do not end up with a two-tier system? How do we target this more effectively? Are there proxies, for example, to allow people to be given free tests? We are also looking at engaging with retailers to develop a strong private market for tests and make sure, I hope, that they are affordable. At the same time, we are in discussions with employers, et cetera. Some have said they will make testing available for their staff and we are looking at a number of different programmes. We are very aware of the inequalities issue and the Secretary of State and I have been asking questions about that.
On the number of cases, as indicated by the ONS infections survey and reported case rates, they have started rising after a period of sustained falls throughout February. Evidence indicates that the link between Covid-19 infections and progression to severe disease is substantially weaker than in earlier phases of the pandemic but, as I said, we are continuing to keep an eye on all the variants of concern with the tools that I explained.
People who are severely immunosuppressed are eligible, as many noble Lords will know, for a third dose of the Covid vaccine as part of their primary course and a booster fourth dose. I am also very aware that the noble Baroness, Lady Brinton, asked me about a potential fifth dose and I promise to write to her. The NHS is now offering new antibody and antiviral treatments to people with Covid-19 who are at the highest risk of becoming ill.
I was asked about local authorities. Local authorities will now be required to manage outbreaks through their local planning and pre-existing public health powers, such as those under the public health Act of 1984, as they would with any other infectious disease. The Department of Health and Social Care is also conducting work looking at the health powers framework for the future. We see that local authorities still have an important role in supporting businesses and public spaces to be Covid-safe—for example, by improving knowledge of infection prevention and control, ensuring that spaces are well ventilated and explaining the relevant best practice guidance.
A number of noble Lords wondered whether movement from mandating to guidance is sufficient. When I was travelling in today, for example, I noticed that some transport companies are still asking their passengers to wear masks in crowded places. Noble Lords made fair points about the communication of this guidance. As I said, I will find out from the comms team what we are proposing to do. The Government will retain the capability to stand up a national trace response if it is needed. Local health teams will also continue to use contact tracing and provide context-specific advice where they assess this to be necessary as part of their role in managing local outbreaks of Covid-19, as they do with other infectious diseases.
A number of noble Lords asked about the number of people who have yet to be vaccinated. Was that the previous debate? I am sorry; they kind of flow into one another at the moment. However, we are spending £22.5 million on a community vaccine champions scheme, following a £23 million investment in the initial scheme. We will continue to encourage people to get vaccinated.
Baroness McIntosh of Pickering (Con)
I am most grateful to my noble friend for repeating the responsibilities of the local authorities. Were they allocated special funds to do this or are they just relying on their existing public health budgets? In other words, are they not getting any new money for this role?
Lord Kamall (Con)
I am afraid I do not have a detailed answer, and I do not want to give an inaccurate one. I think I know the answer but I just want to double-check it. I will write to all noble Lords, as more than one Member raised that issue.
We see the importance of continuing to be vigilant, and of surveillance. We continue to monitor the virus and want to make sure that we have informed decisions and that everything is data-led. A number of noble Lords mentioned the ZOE app. Again, I will have to go back to the department to find out more information, if noble Lords will allow me.
In closing the debate, I thank noble Lords for their contributions. I apologise for the questions I have not answered; I will check Hansard and write to noble Lords. We should also thank the scientists, the health and social care workers, the volunteers, the life sciences industry, the postal, courier and transport workers and everyone who has helped us to get to this point. They have helped us to get through what has been a very difficult period in our lives.
We believe that the regulations before the Committee mark an essential step on our journey to living with Covid, away from legal restrictions and towards guidance and personal responsibility. Once again, I am grateful to noble Lords for raising their concerns, some of which I will have to go back to the department and check on, especially concerning the guidance and its communication. I have taken that point on board.
Throughout the pandemic we have sought to strike the right balance between the safety of the public and keeping the country open. We saw restrictions as a vital weapon in the armoury, but now we have the defences of the vaccination programme and the antivirals, along with a better scientific understanding of the virus, and can take a different approach. However, I repeat: we will keep monitoring the data, drawing on the latest scientific advice, and protecting the country through the defences we have built.
It is important that we follow public health advice should we display Covid-19 symptoms or receive a positive test result. We can all help each other in limiting the spread of the virus by getting vaccinated, ventilating shared spaces, wearing a face covering in crowded or enclosed spaces, getting tested if we have Covid-19 symptoms and staying at home if positive. Lifting these restrictions does not mean that we are ignoring the virus; it means managing the virus through the best possible guidance, as we do for other infectious diseases. I urge noble Lords to agree to these historic measures and commend the regulations to the Committee.