Covid-19: R Rate and Lockdown Measures

Lord Bethell Excerpts

Tuesday 9th June 2020 Lords Chamber

[Baroness Thornton (Lab) [V]]

First, will the Minister say what weight the Government attach to the science presented in the figures that the Centre for the Mathematical Modelling of Infectious Diseases at the London School of Hygiene & Tropical Medicine published, which state that R is above one in the south-west and north-west of England? Secondly, the regularly estimated national R rate appears to be a key driver of policy; accurate measurement of R depends on a world-class testing regime, not yet in place; the likelihood is that some geographical areas may have an R close to or above one; and effective local control measures rely on knowing the local R rate. Given all that, when will the system for more accurate measurements of R agreed with the relevant local authorities be available by localities, so that this information can be used to inform and adapt the emerging local planning led by directors of public health?

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con) [V]]

The London School of Hygiene & Tropical Medicine’s report is one model of more than a dozen that contribute to the SPI-M committee, which looks at modelling. We value it, but it is not the only model. Regarding the statistical analysis of R, I pay tribute to the Office for National Statistics, which has put in place a massive testing programme to look at prevalence across the country. Hundreds of thousands of tests are done. This is by far the gold standard in terms of understanding prevalence and it feeds in accurate, up-to-date information for the accurate assessment—not modelling—of R0. It is on that work that we depend.

[Baroness Brinton (LD) [V]]

On 3 June, my noble friend Lord Scriven asked the Minister which body had legal powers to implement a local lockdown. The Minister replied:

“The arrangements for local lockdowns are not fully in place. In fact, the policy around them is in development and a full decision has not been made”.—[Official Report, 3/6/20; col. 1428.]


Five days on, local authorities and directors of public health are reporting publicly that their hands are tied without the postcode data they need or the specific powers for lockdown. When will this vital decision be made so that flare-ups of Covid can be stopped?

[Lord Bethell [V]]

The work is being undertaken at the moment. Rather than focusing on local lockdowns, we are focusing on local action plans with a wide variety of measures, perhaps including behavioural changes as well as clinical and diagnostic interventions. It is only by working across the piece that local actors, such as local authorities, directors of public health and local infection directors, can implement the right array of measures. That holistic approach is the one we are pursuing.

[Lord Crisp (CB) [V]]

My Lords, many academics are warning of the likelihood of a second wave of the virus, and there is some evidence that it is already happening in other countries. I appreciate that the Government seek to avoid that, but what is their assessment of the likelihood of a second wave, what lessons have they learned from their first experience of lockdown, and what planning are they doing for a second wave nationally and regionally?

[Lord Bethell [V]]

The fear of a second wave is profound. We have seen what happened in Singapore and we remain vigilant. However, enormous progress is being made against the epidemic, as the noble Lord will have seen from recent figures. We have put in huge infrastructure to protect ourselves in the winter, which is the moment of greatest anxiety. That includes Europe’s biggest testing programme, stockpiling medicines, upgrading NHS capacity, the recruitment of returning staff to the NHS and—as I mentioned to the noble Baroness, Lady Brinton—the implementation of a local action plan regime which will give teeth to our measures on a local basis.

[Lord Robathan (Con) [V]]

As my noble friend has admitted, the scientific advice and modelling have been confused, often contradictory and changing as nobody knows a lot about this virus or its progress. Many believe that the virus arrived here as early as November and has swept through the population, often without symptoms. The figures for deaths may be too low or too high because nobody really knows. We have mortgaged this country’s future and our children’s future on uncertain science. The Health Secretary has now described the virus as

“in retreat across the land”.

Will the Government lift all lockdowns now, or as soon as possible, as has happened in New Zealand? Let us all hope the entire lockdown was not a catastrophic error.

[Lord Bethell [V]]

I share my noble friend’s frustration that this disease has proved a horrid and at times confusing foe, but I testify to the strength of the scientific advice we have been given. We do not expect scientists to agree. We believe that a degree of conflict is the right approach to trying to find the right answer. The role of the CMO and the Government’s chief scientist is to distil the advice of a great many sources into the best possible advice. We expect there to be a dialectic, with some form of conflict. I do not believe that we have made profound mistakes on the science. In fact, I believe that the scientists have been wise and thoughtful in the advice and recommendations that they have given us.

[Baroness Pitkeathley (Lab) [V]]

The Minister will know from research published yesterday by Carers UK—I declare an interest as a vice-president—that more than 4 million extra people have taken on caring roles at home for family and friends during the pandemic. Following the question asked by the noble Lord, Lord Crisp, I ask: in the event of a second wave, how will the Government ensure that these carers are provided with adequate PPE and access to services?

[Lord Bethell [V]]

I share the noble Baroness’s tribute to the nation’s carers. This week is Carers Week, and it is quite right that the House pays tribute to the contribution of all those who have looked after loved ones and neighbours in the manner she described so well. Support for carers has been at the front of our minds, but she rightly reminds us that we could do more in a second wave, and we are looking hard at ways of developing that support in the months to come.

[Lord Mann (Non-Afl)]

What discussions have Ministers had with their German counterparts about the success of the German test and trace system?

[Lord Bethell [V]]

I have conversations with the German Government, medical authorities and diagnostic industry on a very regular basis. I have a fortnightly call with my counterpart in the German health system. It is true that Germany had a more developed and more local testing facility than the British at the beginning of the epidemic, but since then we have built up our capacity dramatically and we regularly do more tests than our German counterparts at the moment. The testing regime being developed is already delivering fantastic results that match those of many countries.

[Lord Bilimoria (CB)]

My Lords, given that the R rate is now below one across the UK, will the Minister acknowledge that the risk of infection from reducing social distancing from two metres to one metre goes from 1.3% to 2.6% and that the WHO is recommending one metre as safe? Denmark, France, Singapore, China, Hong Kong and Lithuania have moved to one metre. A pub or restaurant can barely open with a social distancing rule of two metres, being able to operate at only 30%; with one metre, they could operate at over 70%. At one metre, you can have four times as many people in a space as at two metres. It is the difference between being in business and going out of business for the hospitality industry, which employs 3.5 million people, let alone for theatres, cinemas and the university sector. Now that the Government are saying that masks are to be worn on public transport, and given the PPE measures within the sector, does the Minister not agree that we need to get the economy back and working as soon as possible, safely?

[Lord Bethell [V]]

I completely agree with the noble Lord that we need to get the economy back, and I very much agree with his last word—safely. The CMO’s advice is very clear that social distancing of two metres makes a very big difference compared with one metre. When the time comes to move from two metres to one metre, we will very clear about that moment, and I, for one, will celebrate the reopening of restaurants and pubs, which are a source of great joy and happiness for the nation.

[The Deputy Speaker (Lord Duncan of Springbank) (Con)]

My Lords, the time allowed for questions has now elapsed.