Animal Diseases: Future Pandemics
Debate between Lord Bethell and Baroness Blackwood of North Oxford(3 years, 4 months ago)
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Lord Bethell (Con) [V]
My Lords, there is a very large number of initiatives. I emphasise our international efforts to reverse the underlying causes of spillover infections from animals to humans, including biodiversity loss and the risk from the illegal wildlife trade. Using the UK’s G7 presidency, we have committed to doing more by establishing the International Zoonoses Community of Experts, by creating the centre for pandemic preparedness and conducting a one health intelligence scoping study to ensure that the systems work better together to identify future threats.
Baroness Blackwood of North Oxford (Con)
My Lords, in 2016 a woman in rural Thailand spotted a cow frothing at the mouth. She snapped a few photos, reported it on the “one health” disease detection app and local authorities stepped in. They limited the spread of foot and mouth to just three cows, averting millions in potential losses. This app is now expanding across Asia and Africa, supported by Dame Sally Davies’s Trinity Challenge. This demonstrates that ever more global health data by itself is just not enough; it is deriving actionable insights from that data that matters, and that needs dedicated analytics tech at scale. What steps is the Minister taking to find and scale the “one health” surveillance tech that we need to prevent future pathogenic risk?
Lord Bethell (Con) [V]
My Lords, my noble friend puts it extremely well. It is exactly that kind of intervention at the front line that can nip infections in the bud, but it is only through international collaboration that we can really tackle the threat of zoonotic infection. The concept of zoonotic tech is not one that I had previously come across, but I will take it away from this debate and have a good look at what more we could do to support it.
Health: Dementia
Debate between Lord Bethell and Baroness Blackwood of North Oxford(3 years, 4 months ago)
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Lord Bethell (Con)
My Lords, I take seriously the testimony of the noble Baroness. I am not aware of the specific concerns that she describes, nor am I completely up to speed on the precise arrangements of the training, but I would be glad to correspond with her on this matter.
Baroness Blackwood of North Oxford (Con)
My Lords, while virtual assessments were vital during the pandemic, without further diagnostics many led to a diagnosis of unspecified dementia. An accurate diagnosis of dementia subtype is critical to good management, especially in complex cases. Given the backlog, there will understandably be a temptation to deprioritise those who have a preliminary diagnosis from a virtual assessment, but this would be a false economy. How can the Minister ensure that those with a provisional diagnosis will be invited back for a comprehensive assessment after the pandemic has finished, and for imaging and other diagnostics where necessary?
Lord Bethell (Con)
Few people are as enthusiastic as I am about the benefits of digital medicine and virtual consultations, but I completely acknowledge my noble friend’s point: this is one area where we absolutely must have face-to-face assessment. The diagnostic tests and assessments she describes play a critical role, and those whose conditional assessment was done virtually must be cascaded into a face-to-face assessment, as she says. That is why we have put the funds in place to ensure that this backlog is caught up with.
Covid-19: Wuhan Institute of Virology
Debate between Lord Bethell and Baroness Blackwood of North Oxford(3 years, 4 months ago)
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Lord Bethell (Con)
I entirely agree with the noble Baroness. It is extremely frustrating that we do not know the steps of evolution that this virus went through. It has come to us completely out of the blue. That leaves us in a vulnerable state when we are preparing for the next pandemic. It is absolutely essential, as any epidemiologist will say, that one knows and understands where the virus came from—whether that is the water pump handle for an outbreak of cholera or a virus from China.
Baroness Blackwood of North Oxford (Con)
My Lords, the situation could not emphasise more clearly the need for genuine global participation in transparency in surveillance and pathogen sequencing to respond to future pandemics and epidemics. I was pleased to see the progress at the G7 on this but, if the global anti-pandemic action plan is to have any teeth, we will need to ensure that countries such as China contribute trustworthy data to global surveillance in the future. What steps does the Minister envisage to ensure that this happens?
Lord Bethell (Con)
I completely agree with my noble friend. The international health regulations need to be amended in that respect. It was one of the aspects of the pandemic preparedness treaty that was brought to Carbis Bay for the G7 earlier this year. We are working extremely hard, through our G7 chairmanship, to ensure that this relatively obscure but absolutely critical international treaty has the teeth it needs to do the work on genomic sequencing and pathogen identification that needs to be done.
Covid-19 Update
Debate between Lord Bethell and Baroness Blackwood of North Oxford(4 years, 2 months ago)
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Lord Bethell (Con)
The noble Lord is right to be concerned about false positive results. However, our experience, our piloting and the emerging technologies suggest that that will be the case in a relatively small proportion of the tests and is entirely manageable within a mass population testing system. With regard to the idea that we can somehow identify vulnerable groups and target them pre-emptively, I wish that that were true, but this disease constantly confounds expectations and turns up in places where we least expect it. If we could tell people that they were going to get the disease, we would not have this problem in the first place.
Baroness Blackwood of North Oxford (Con) [V]
I thank the Minister for his answer, but those who were formerly shielding, those whom we had identified as being most at risk, will be watching the rise in cases and some of this debate with anxiety. There were a number of problems with the rollout of the shielding programme the first time round, and we have new evidence about who is most at risk from Covid. Has there been a reassessment of the criteria for those who might need to shield this winter? If so, what is the Minister doing to ensure that this is communicated early and much more clearly to both those who will not need to shield this winter and those who might need to, so that we can reduce anxiety among those groups and protect the most vulnerable?
Lord Bethell (Con)
I completely recognise the problem identified by my noble friend. I reassure her that the expert sub-group NERVTAG is developing a predictive risk model to enable a more sophisticated approach to clinical risk and to identify more clearly those who need to shield. The model incorporates known relevant risk factors, such as age, sex, BMI and ethnicity. We are working at pace and will continue to engage patients, those on the shielding list, healthcare professionals and the voluntary sector as we embed this important insight into what we do.
Folic Acid
Debate between Lord Bethell and Baroness Blackwood of North Oxford(4 years, 2 months ago)
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Lord Bethell (Con)
My Lords, I am not aware of any conclusive scientific evidence that contradicts the benefits of folic acid. As I said, the demographic data would seem to suggest that experiences in other countries have been benign. Longitudinal studies take a very long time to emerge and, therefore, we are not expecting a massive change in that data. However, back at the department, I will ask if any science has emerged and I will write to the noble Baroness if I can put my hands on anything.
Baroness Blackwood of North Oxford (Con) [V]
I of course join other noble Lords in pressing the Minister to implement mandatory fortification as soon as possible—it really is time—but if he needs additional motivation, can I point to the potential wider benefits in addition to vital prevention of NTDs: reducing anaemia caused by folic deficiency in older adults, for example? Given the inequalities associated with these deficiencies, is the Minister confident that such wider benefits have been fully considered? If not, will he commission the relevant research as a matter of urgency?
Lord Bethell (Con)
The noble Baroness is entirely right to explain and expand on the wider benefits, but the benefits in respect of NTDs are extremely persuasive in themselves and the consultation focuses on them. I understand that it is an analysis of those benefits that will form the basis of our decision-making.
Smoking
Debate between Lord Bethell and Baroness Blackwood of North Oxford(4 years, 4 months ago)
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Lord Bethell [V]
I completely agree with the noble Baroness that there is a massive health dimension to the levelling-up agenda. Health inequalities affect families the hardest and the Government are highly focused on them. However, it is not our style to introduce emergency legislation, because we believe that prevention is better than cure and that people have rights and choices to make for themselves.
Baroness Blackwood of North Oxford (Con) [V]
My Lords, I welcome the publication of the draft guidance on pavement licences in time for the debate this afternoon. However, I note that, while local authorities are to consider public health when setting local conditions, Section 5.2 fails to reference the smoking reduction targets set out in the tobacco control plan or the ambition for a smoke-free England by 2030. These would be a helpful addition, so will the Minister consider including them as the guidance is finalised?
Lord Bethell [V]
It is not my role to comment on the drafting of legislation in the manner that my noble friend describes. However, I resolutely repeat the Government’s commitment to a smoke-free 2030 and the tobacco control plan, both of which are absolutely essential to our tobacco policies.
Covid-19: Mental Health
Debate between Lord Bethell and Baroness Blackwood of North Oxford(4 years, 4 months ago)
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Lord Bethell
The right reverend Prelate is entirely right to be focused on the support offered to both NHS and social care staff. There is considerable potential trauma in this area, and those who have been on the front line are under more pressure than one could possibly imagine. We have put in place schemes specifically targeted at both NHS and social care staff, and I reassure the right reverend Prelate that there is parity between the two sectors.
Baroness Blackwood of North Oxford (Con) [V]
My Lords, the first UK study of neurological and psychological complications of Covid-19 was published last week. It found that 31% of patients developed an altered mental state arising from both neurological and psychiatric diagnoses. This is a relatively small cohort study, but the breadth and prevalence of the complications uncovered mean that larger studies are crucial to truly understand the scale of the challenge. With recovery, we have proven our capability to run outstanding trials at pace, so can the Minister please outline his plans for research into the acute and longer-term mental health effects of Covid?
Lord Bethell
The noble Baroness is entirely right to emphasise the importance of longitudinal studies. The UK household longitudinal study data, which analyses the GHQ-12 scores, has been upgraded. We will continue to invest in that, and Public Health England has been tasked with monitoring the development of mental health issues across the country.
Personal Protective Equipment
Debate between Lord Bethell and Baroness Blackwood of North Oxford(4 years, 4 months ago)
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Lord Bethell [V]
My Lords, we have had regular engagement with the devolved Administrations and have discussed how we manage cross-border services. The balancing of stockpiles of PPE around the nation is something that we are very much focused on. We have moved from the supply of PPE to a few NHS trusts to nearly 55,000 individual users of PPE. This is a massive undertaking that has hugely expanded the scope of our PPE supply.
Baroness Blackwood of North Oxford (Con) [V]
My Lords, I was pleased to hear the Minister’s ambitions for a 90-day stockpile. NHS Providers has now stated that most trusts are receiving the right PPE when they need it, but it highlights the need to move from a crisis day-to-day supply to secure access to 14 days’ worth of all PPE. Obviously this is important for planning, restarting elective care safely and especially for patients being asked to isolate for surgery. When will a 14-day supply of PPE at trust level be achieved?
Lord Bethell [V]
My noble friend is entirely right that having adequate stocks on hand is important, but having line of sight is also important. Individual trusts are able to make their own decisions on whether they wish to have stockpiles on the premises or a flow of supplies from their suppliers. At present we are working on supporting the trusts in their decisions on this matter.
Covid-19: Track and Trace System
Debate between Lord Bethell and Baroness Blackwood of North Oxford(4 years, 5 months ago)
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Lord Bethell [V]
My Lords, the epidemiological maths is as the noble Baroness describes, but our focus on symptomatic cases does not mean that the system does not work. Taking out more than a quarter of infected cases is a massively important and impactful event. Asymptomatic testing has started in healthcare and social care workers. It is making a big difference in both those forums, where prevalence is higher than the community prevalence, and we will be learning lessons from those schemes.
Baroness Blackwood of North Oxford (Con) [V]
My Lords, a key priority of “track and trace” is to monitor the emergence of localised hotspots and intervene before wider community transmission can occur. Local authorities and public health officials have expressed concerns that they do not have the powers to deliver swift local interventions and that a top-down approach might be too slow. Can the Minister say what process is in place to prevent community transmission when “track and trace” finds evidence of such localised hotspots?
Lord Bethell [V]
My noble friend is entirely right that local action is central to an effective response to Covid-19. We are working extremely hard through the JCVI to take the intelligence from our testing programme to identify hotspots when they occur and to move resources to those areas to support local directors of public health and local infection officials with the resources they need, whether in terms of testing or surge control of the disease.
Contact Tracing: Personal Privacy
Debate between Lord Bethell and Baroness Blackwood of North Oxford(4 years, 5 months ago)
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Lord Bethell [V]
My Lords, the evidence before me suggests that the British public have an enormous amount of support for the app. Recent research by Johnson and Lubbock partners for ITV showed that 59% of British adults report that they would download the app. We remain committed to reassuring all British people that the app is safe. I take completely on board the noble Baroness’s recommendations to engage with community and faith leaders who may have particular misgivings; it would be worth engaging with them on a particular basis.
Baroness Blackwood of North Oxford (Con) [V]
My Lords, I understand that a second version of the tracing app is now undergoing testing and that, following the outcome of this trial, the plan is to issue the new version to Isle of Wight residents as an update. Is this the case? If so, what are the differences in the information gathered between the first and second versions? Will Isle of Wight residents have to consent to any update or does their original consent include all future updates?
Lord Bethell [V]
My Lords, we are currently assessing the value of a specific Isle of Wight update and whether it would be worth while before we move on to issuing the full app. When we have finished that assessment, I would be glad to answer the questions asked by my noble friend.
Covid-19: Cancelled Medical Operations
Debate between Lord Bethell and Baroness Blackwood of North Oxford(4 years, 5 months ago)
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Lord Bethell [V]
My Lords, the impact on the over-75s is, as has been described, profound. We have worked hard to try to protect those who are shielding. The reopening of GPs’ surgeries is a priority but, at the moment, we are not encouraging those who are over 75 to make the journey to surgeries that are a potential source of infection. Therefore, we will not be taking the steps the right reverend Prelate described.
Baroness Blackwood of North Oxford (Con) [V]
My Lords, as the waiting lists caused by Covid create huge pressures, harder-to-treat patients must not be left behind. Last month, Eurordis released a survey which included UK rare disease patients and found that nine out of 10 had experienced disruptions in care, while more than half who needed surgery had had it cancelled or postponed. Many rare disease patients are in the shielding group and many have degenerative conditions. Can the Minister set out the plans to improve access to care and communications about care for rare disease patients, and can he please undertake to meet with patient groups about this?
Lord Bethell [V]
The work of my noble friend Lady Blackwood on rare diseases is well known and acknowledged in the House. Those with rare diseases are in exactly in the kind of vulnerable groups that are being hard hit by Covid. They are given particular access to local support systems and they should have access to home testing services if they feel vulnerable to the effects of Covid. Further, I am happy to undertake a commitment to meet with the relevant stakeholder groups to discuss how we could be working harder to support them.
Covid-19: Care Homes
Debate between Lord Bethell and Baroness Blackwood of North Oxford(4 years, 6 months ago)
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Baroness Blackwood of North Oxford (Con)
My Lords, I congratulate the Government on publishing the data behind their assessment of the Roche and Abbott ELISA tests. The transparency is welcome, but given the latest evidence on how asymptomatic cases affect transmission and how challenging infection control has been in care homes, can the Minister say whether care workers and care home residents will now be prioritised for antibody as well as PCR tests to give them the best data to improve infection control?
Lord Bethell
My noble friend Lady Blackwood is quite right that the Roche and Abbott antibody tests are a great step forward. It shows how diagnostic technology is progressing very quickly. We are determined to use all the benefits of modern technology in the fight against Covid. Our announcements on antibody testing in the NHS, in the care service and for key workers will be announced shortly. When it is, I assure her that NHS and social care workers will be on an equal footing.
Covid-19: Contact-tracing App
Debate between Lord Bethell and Baroness Blackwood of North Oxford(4 years, 6 months ago)
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Lord Bethell
My Lords, I am in touch with both the South Korean and Taiwanese Governments, and we are greatly inspired by the throughly professional way in which they have gone about epidemic management. I commend both those countries and their efforts. However, the epidemic arrived in Britain in an incredibly fulsome way. The Chief Medical Officer has been very clear that if that had happened in either of those countries, their responses would have been similar to that of Britain. I defend the Government’s response to the epidemic.
Baroness Blackwood of North Oxford (Con)
My Lords, one of the core principles of data protection is to gather the minimum amount of data. I understand that one reason given by the NCSC for asking for partial postcodes on registration for the app is to assist with regional healthcare planning and to monitor potential Covid flare-ups. Can the Minister explain why data from Covid tests and NHS 111, for example, would not be sufficient to keep the transmission rate down in a post-lockdown test, track and trace strategy?
Lord Bethell
My noble friend Lady Blackwood is entirely right. The testing and the surveillance done by testing give us powerful insight into the demographic reach of the virus and information on a very broad basis on the regional reach, but we are looking for a much more granular level of detail from the very powerful, multimillion level of detail that the app can provide. The value of those surveillance details has led us to design the app in the way we have.
Covid-19: Personal Protective Equipment
Debate between Lord Bethell and Baroness Blackwood of North Oxford(4 years, 7 months ago)
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Lord Bethell
The noble Baroness asks a perfectly reasonable question. I am afraid that I do not know the individual amount off the top of my head. I can tell her that, to date, we have delivered 135 million masks, 148 million aprons, 1.3 million gowns and 485 million gloves—more than 900 million items in total. The amount that we are providing increases every day. I will not hide from the noble Baroness or the House that this is a fast-moving situation. It is my impression that the demand for PPE will soon extend to other workplace situations and increase. It would be wrong to give the impression that this is a fixed amount that we should try to hit with short-term targets.
Baroness Blackwood of North Oxford (Con)
Following on from my noble friend Lord Blencathra, it is vital that we explore all options to increase the sustainability of UK stocks. I understand that UVC is often used for surface sterilisation; early research suggests that it can also be used for gowns and masks, using UV sources, which are found in lots of biosafety cabinets in academic, commercial and hospital labs. If the reuse committee mentioned by the Minister has not started looking at this, can he please ask them to consider whether this is a viable option to extend the lifespan of PPE?
Lord Bethell
The noble Baroness is right to champion this point. The Cleveland Clinic is known to us. I will ensure that it is played into the task force that is working on both the regulations and practicalities of reuse.
Covid-19: Critical Care Capacity
Debate between Lord Bethell and Baroness Blackwood of North Oxford(4 years, 8 months ago)
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Lord Bethell
My Lords, I welcome the testimony of the noble Baroness and cannot help but be moved by the situation she describes. This virus has moved incredibly quickly. Hospitals are doing amazing work to adapt to the conditions that dealing with the virus requires, and everyone is learning how to do it on the job.
Baroness Blackwood of North Oxford (Con)
My Lords, I welcome the reassurance that we have been given by the Minister that testing is being scaled up, especially for health workers, but surely a serological or immunity test will be the real game-changer, because it will allow us to track those who have already had the virus, even unawares, and who are safe to return to work and help the most vulnerable. It is also essential that PPE is available, especially on the front line, to ensure infection control. Can my noble friend update us on whether availability of that is improving and on the training available to ensure that it is used most effectively?
Lord Bethell
My noble friend Lady Blackwood is right that there are two types of test. The first is an antigen test to ensure that those in hospital, as workers or patients, do not currently carry the virus, and the second is a serological or antibody test that will confirm that a person has the antibodies and can therefore return to work, either on the front line or elsewhere. Both those tests exist, but mass production is restrained. We are working extremely hard with manufacturers around the world, and with British firms, massively to escalate our capacity.
Covid-19: Vaccine
Debate between Lord Bethell and Baroness Blackwood of North Oxford(4 years, 8 months ago)
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Lord Bethell
The noble Lord, Lord McNicol, is entirely right to focus on the importance of vaccines. The Government are extremely concerned that the entire public have a clear line to having confidence that they can rid themselves of the threat of the virus so that we can all get back to work and normal life. That will not be possible until we have a vaccine. If I may digress for a moment, one consideration is that, for a vaccine to work, it will have to be taken by billions; for that, it must be as safe as houses. I contrast that with the vaccine for Ebola, where the death rate was at nearly 80% and a just-about-good-enough approach could be taken. However, the coronavirus has a relatively low mortality rate and the introduction of an added risk factor into the population is something we can avoid. For those reasons, the development of a vaccine is considered to be at least a year or 18 months off. However, the noble Lord is entirely right that planning for the production of the vaccine, when it is fully developed, is front of mind for the Government.
Baroness Blackwood of North Oxford (Con)
My Lords, ever since John Snow discovered the link between the famous London water pump and the cholera outbreak in 1854, UK scientists and innovators have led global efforts to tackle infectious diseases. We should be very proud of that. However, many UK biotechs and healthtechs which are leading the race to fight Covid-19 are loss-leading and will struggle to raise risk capital in the current climate to maintain operations. One very simple intervention the Treasury could make would be to pay R&D tax credits in advance. This would be matched very well to each individual company and could be based simply on their most recent claims. Will the Minister look into this as a matter of urgency?
Lord Bethell
My noble friend has an important and exciting idea, and I am grateful to her for communicating it to me in advance of today’s Question. I have already taken the idea to Treasury colleagues. I have not had a formal response, but the idea supports a pressing and important need in the essential life sciences sector and seems to have strong merit. I hope it will go far.
Coronavirus (COVID-19)
Debate between Lord Bethell and Baroness Blackwood of North Oxford
Lord Bethell
The noble Baroness asks a very important question. I do not know the precise answer but will be glad to reply to her later.
Baroness Blackwood of North Oxford (Con)
My Lords, I commend the Minister for his excellent and balanced answers and for the clarity provided by the action plan today. It is clearly right that we remain in the containment phase. Listening to the debate today and outside, there are a lot of questions around which social distancing measures might be introduced in the delay and mitigation phases, when they might be implemented and what the social and economic costs might be. Could the Minister explain what work is ongoing to understand the effectiveness of specific distancing measures and on whose advice there might be recommendations for them to be implemented?
Lord Bethell
In all these matters, the Chief Medical Officer guides the Government’s decision-making. We are looking at the modelling done by SAGE—the Scientific Advisory Group for Emergencies—which guides our decision-making. It has sophisticated computer analysis, which all this information is being plugged into, and that helps inform the decisions that we make about the guidance on isolating and social distancing. It is not possible to lay out today exactly what guidance we will issue or what decisions we will make in the weeks or months to come, but when those decisions are made they will be broadcast with energy through public communications.