Public Health

Lord Mackinlay of Richborough Excerpts

Tuesday 30th November 2021 Commons Chamber

[Sir Graham Brady]

My right hon. Friend is absolutely right. It is a very serious concern that we might be entering a world where we lurch from one set of restrictions to another, where no business and no individual can get used to the idea of the freedoms they are able to exercise or what restrictions might be in force at the time.

What really concerns me—I think we all know and recognise this—is that we are dealing no longer with a pandemic, but with an endemic virus that will be with us for many, many years and probably forever in some form. Further variants will emerge. They might do so every couple of months or every year. We tend to have a new flu strain on an annual basis and some are much worse than others. But surely, we need to get back to an assumption that people will make decisions for themselves and have control over their own lives. We cannot move, as we appear to have done, to an environment in which the Government simply assume they can instruct us whenever there is the first small evidence from anywhere in the world of a new strain that might behave in a different way, and new and potentially swingeing public health measures are put in place. I ask Ministers to consider the implications of that and for looking at other diseases. Will we start to treat other diseases and viruses in the same way, assuming the best thing to do is to compel people and instruct them on what actions they need to take?

[Craig Mackinlay (South Thanet) (Con)]

My hon. Friend is starting to explore the issue of what happens when there is a variant. What we see from the Government thus far is a load of new measures and, possibly, the pharmaceutical companies saying, “We can make a new vaccine for that within about 90 days”. We would then have many months to get it in everyone’s arm. Having done that and gone back to a sense of freedom, another variant would emerge and we would be on that track all over again. Has he considered the madness of that type of policy?

[Sir Graham Brady]

We should all be afraid of the madness of that kind of policy. The difficulty is that 18 months ago, when some of us started raising these concerns, it was possible for some people to suggest that we were being fanciful. We have now lived it for 18 months and we can see this reaching ahead. We think back to when the Coronavirus Act 2020 was renewed again, taking us through to spring next year, and the assurances we were given that that would be the last time. I thought we would not need this kind of legislation again, but we see the Government’s immediate assumption that they should reach for new controls, new compulsion and new rules to inflict on the British people. We need to move away from that and back to a world where we trust people, engage with the public and recognise that the Government are there to serve the people, not the other way around.

--- Later in debate ---

[Dr Whitford]

I was not claiming that it was, because genomic testing takes a couple of weeks generally and it is therefore too late for someone to isolate. What I am saying is that with this variant, as in alpha but not in delta, the missing S gene means that on that initial test—which takes six hours or until the next day, or whatever it is—we already get a heads-up that we are dealing with an omicron case. We can go on to do the genomic analysis, but we can say to the patient, “We think you have this variant. You need to isolate thoroughly and for longer.”

[Craig Mackinlay]

I thank the hon. Lady for bringing her medical knowledge to the House. It is very interesting, particularly on the S gene. I do not know what magic goes on in a lateral flow test. We put the drips in at one end and then one band, hopefully, appears and not two. Could a lateral flow test be adapted to be specific for this type of variant?

[Dr Whitford]

I think we would be talking about redesigning the test for a whole new antigen. I mentioned just one advantage that we get from PCR testing, which basically looks at genes—I will not talk about the whole long name and what PCR stands for—and the benefit is that we get a heads-up. I do not think it is feasible on any reasonable timescale to change lateral flow tests, so we are lucky that this one has S-gene dropout and that we will get an early warning.

One issue with focusing only on a day-two PCR and then, if someone is negative, they are released—unlike what is being discussed for domestic isolation—is that the incubation period of covid, generally, is much longer than two days. It has generally been reported as an average of five days and it can extend for longer. If someone who may have had contact arrives in the UK, gets a negative PCR result on day two and then goes about their business, there is a real danger that that is a false reassurance. That is why the Scottish and Welsh Governments have asked for a Cobra meeting to debate the evidence on a four-nation basis and to discuss having at least an eight-day isolation period for travellers, with a negative day-eight test required before people can be released.

The Prime Minister should listen on that, because one issue that we had in Scotland when we tried to maintain stricter and broader hotel quarantine was that the majority of long-haul passengers arrive through hubs such as Heathrow. The devolved nations have no ability to have an impact on that and we should be working with the Republic of Ireland to make the whole common travel area safer from the point of view of how we move about inside it.

--- Later in debate ---

[Craig Mackinlay (South Thanet) (Con)]

I understand the dilemma that the Government face and are in. There are two main questions that we need to ask and to which we all—including the Government as much as anyone—want to know the answer: first, what is the state of the omicron variant’s resistance to our vaccine programme? Secondly, if someone becomes infected, is their illness weaker or worse than it would have been with the delta variant that we have got used to? In some ways, it does not matter what happens with the vaccine if the omicron variant does not cause bad illness. Frankly, if it does not cause bad illness, I do not care about this thing at all. My hon. Friend the Member for Bexhill and Battle (Huw Merriman) just made an interesting point: if, as we all hope, the omicron variant is weaker than the delta variant in terms of illness and effect, we are going backwards a long way today, because we will all have to lock down when we get the text, email or phone call to tell us we have been close to somebody with the new variant. That makes little sense at all.

Let me address the proposals before us in some sort of order. Like my hon. Friend the Member for Winchester (Steve Brine), I do not have too many concerns about the face-mask regulations: they are an extension of rules that we have pretty much got used to and there is very little difference from what I have been doing on public transport, where I have been wearing masks religiously. I am still a little bemused as to how a fairly flimsy mask with a filter size that is far greater than a coronavirus particle can somehow be the salvation, but so be it. I am not terribly concerned about that.

We are, though, left with a gross absurdity that will perhaps face everyone in the House over the next few weeks. When someone goes to the off-licence on the way to a party later, it might take them only 45 seconds to get their tiple of choice but they will have to wear a mask on pain of a fine. They can then make their way to a house party, with 100 people or perhaps more—perhaps an infinite number of people—where it will be enclosed, warm, cosy and friendly and they can take that same face mask off. Really? It is an infantile proposal and we are in danger of falling down the same absurdities as we fell down before, with the madness of the couple who could walk across a golf course but dare not play on it. This is the absurdity that I have voted against previously and will vote against again.

Let me move on to the self-isolation requirements. I am afraid that the proposals mean we are going to fall into a new pingdemic. There is nothing in the regulations, in anything the Minister has said or in anything else I have heard to date to say that the testing regime will be backed up with proper genome sequencing at the right rate, so we can get back to a situation in which people can be told, “No, your contact was not omicron. You’re fine.” My hon. Friend the Member for Winchester picked up on a very dangerous phrase in the regulations, and that is “suspected of”. I do not know what that means. I know what “confirmed as” means—to be confirmed through a proper genome-sequence test—but what about “suspected of”? When people get that phone call, text, email or ping from the NHS—if they have been daft enough to have the app on their phone—are they now going to hear, just because the words “suspected of” have been added, “Thou shalt be held indoors for 10 days”? This is where we end up with mission creep and the chilling effect that my hon. Friend the Member for Winchester mentioned.

I am going to be somewhat concerned about going to that Christmas party or that pub, because I have friends and family coming round for Christmas day. This legislation is going to have a dangerous pingdemic effect, either through a proper pingdemic or just through the effect of fear. I asked the hon. Member for Central Ayrshire (Dr Whitford), who spoke for the SNP and is knowledgeable on these matters, whether we might be able to get a new lateral flow test that is specific to omicron, but I think the answer is possibly no. We are in a confused state and I am concerned that the regulations will shatter businesses that are getting ready for Christmas. With the support of Opposition parties, sadly the regulations are likely to go through.

I am somewhat confused, as are many other Members, that we are not considering the regulations on travel today. It seems somewhat bizarre. There is a new requirement for a PCR test within two days. I am afraid we have seen far too much of what I call wild-west behaviour out there when people try to obtain a test. We have a well-established, well-working, accurate and fast PCR network that has stood up throughout the whole country. For instance, I can go on the NHS website and organise a PCR test tonight, probably within a mile or two of where I live, and I would probably get a result back tomorrow. The system works very well and that is to the Government’s credit. We went down a stage, for good reason, and said that lateral flow tests for people who travel in are fine. We are now back to the confusion—do lateral flow tests work or do they not work? If they work, surely that will do; if they do not work—if they are not reliable—why on earth have we spent billions of pounds over the past few months and why are everybody’s draws and cupboards full of these things, which are handed out like candy in the streets? It is something of a nonsense.

We have not yet discussed the regulations on the travel restrictions, so perhaps we have a chance of changing them for the good. We are introducing new requirements so it is only fair that we offer the ability to meet those requirements within the NHS PCR testing system, either for free or at a minimal cost. That way, we will not have these situations involving what I have described as wild-west companies that have not served us well.

Sadly, we are allowing ourselves to go back into a rabbit hole, and I am concerned that we will never get out. Last year, before we had the big vaccine roll-out, there were reasonable reasons, although I did not support them, for the levels of restrictions: we were waiting for the cavalry of the vaccinations and wanted to protect the NHS from being overloaded. We did that, it all worked and we got back to a semblance of normality. But we have a new variant, so we introduce new measures, then await a new vaccine formulation, then wait another few months to get that into people’s arms, and then we might be able to go back to normality—but then we will find another new variant and do it all over again. This has to stop. We have to live with this ever-changing virus. Enough is enough: it is done.

[Several hon. Members rose—]