(3 years, 4 months ago)
Lords ChamberI do not accept that at all. The noble Lord does this debate no favours by using that kind of language. The argument I make is extremely reasonable. It is supported by the Chief Medical Officer and the other scientific advisers we have in government. I would like to ask the noble Lord to reflect on the manner of that question.
My Lords, I was contacted by NHS Test and Trace and asked to self-isolate earlier this week. I am double jabbed, I have no symptoms, I have had Covid, I have been testing myself every day with lateral flow devices and I am negative every day. The CBI, of which I am president, is finding that many companies and businesses are complaining of losing employees. The NHS itself is complaining of losing staff because of self-isolation. Surely, we have to move as quickly as possible to a test and release system so that people can get on with work. Will the Minister confirm that lateral flow devices will continue to be made available free to businesses and citizens? If not, it will be penny wise and pound foolish.
My Lords, I am sympathetic to the noble Lord’s frustrations, but he is illustrating the delicacy of the inflection point we are currently at. Only 60% of people are in his fortunate position of having had two jabs for over two weeks. That is a huge reservoir of tens of millions of people who are unvaccinated. There is also a very large number of people—3.5 million in total—on the shielding list who have some kind of vulnerability. The noble Lord could be carrying the disease even though he has been double vaccinated. Of course I aspire to the destination the noble Lord described, but we cannot rush it. We are taking it in a proportionate and logical fashion, and we are absolutely keeping our eye on the kinds of down side risks the noble Baroness, Lady Thornton, described.
(3 years, 9 months ago)
Lords ChamberMy noble friend is entirely right. We can only be safe here in the UK if we understand what variants of concern are developing elsewhere in the world, if the countries where those variants are emerging are testing and are identifying those variants, and if measures are put in place to tackle them. That is why we have put together an international platform where we will accept samples of new variants from anywhere in the world and use Britain’s substantial genomic testing capacity to help countries process them. We are sending machines from the UK and providing expertise for all those who need to supplement their genomic testing using the considerable resources of Public Health England, the Sanger Institute and our genomic testing capabilities.
My Lords, I congratulate the Vaccines Minister Nadhim Zahawi on the excellent rollout of the vaccines. However, the CBI, of which I am president, had a recent survey that showed that only 13% of firms are testing their workforce, due to lack of expertise, unclear guidance and funding and operational regularity. However, firms have welcomed the workplace testing portal and the lowering of the employee threshold to 50. Can the Minister confirm what the medium and long-term strategy for workplace testing is and also the interaction of mass testing and mass vaccinations?
My Lords, of course, employees should be working from home wherever possible, and that is why our focus has not been on this area to date. I emphasise that on Monday the community testing part of Test and Trace issued a call to all those employers of more than 50 employees where it will provide free testing kits for those interested in using workplace testing. This is going to be an essential part of our fight against Covid in the future, and we look forward to working closely with the CBI and other employer groups to make sure that the rollout happens efficiently.
(3 years, 11 months ago)
Lords ChamberI am grateful to my noble friend for his kind comments, and endorse his tribute to all those who have worked hard on the front line of healthcare during this pandemic, at times putting themselves at risk, and all of them under great stress. We owe them enormous gratitude. The JCVI has made a clear priority list and advised that the first priorities for any vaccination programme should be the prevention of mortality and protection of healthcare staff and systems. Therefore the vaccine is being rolled out to the priority groups, including care home residents and staff, people over 80, and healthcare workers. They are the ones who will be at the top of the list, and that seems to me proportionate, fair and right. As we work through the later prioritisations, others in the population will have access to the vaccine.
My Lords, many congratulations to the Minister, the Government, Kate Bingham and the Vaccine Taskforce on V-day, yesterday. Does the Minister agree that this has been possible only because of the collaboration, in just six months, between the private sector, the Government, the NHS, universities, including Oxford, and the pharmaceutical sector, including AstraZeneca? In due course, could business help to roll out the vaccines, through inoculations taking place in offices, factories and business premises, thus causing less disruption? The CBI, of which I am president, stands by, ready to help.
I am enormously grateful to the noble Lord for his clear and heartfelt offer of help, and I completely endorse his comments. The collaboration between the NHS, the Government and business has been at the heart of our entire response to the pandemic. This collaboration has been termed the “triple helix”—a phrase that I like very much indeed. It is going to be at the heart of our building back of the healthcare system in the years ahead. On the noble Lord’s kind offer, I remind him that when someone takes any medical treatment, including a vaccine, they have to have the space to take stock and recover from the excitement of the vaccine, and they have to be supervised in that space by someone with some kind of clinical experience. So, while his offer is kind, it is likely that vaccine distribution will be in locations where we can put clinical supervision.
(3 years, 11 months ago)
Lords ChamberMy noble friend is entirely right about the hospitality sector. It is a sector that we care about greatly and we recognise how hard hit it has been. None the less, we have to be considerate of the fact that the best epidemiological studies suggest that this is an environment where infection hits hard, so we are trying to hit the right balance between the two. As for local areas and trying to be more precise and focused in our tiering, that sounds like a sensible suggestion. However, we experimented with it quite thoroughly during the summer, and I remember standing here at this Dispatch Box week after week running through tweaks to various local tiers, only to find that the virus very quickly leaped from one area to another. It is a frustrating fact that the virus spreads from city to surrounding rural area and from one town to the next with alarming speed. It is also true, as discussed in response to the earlier question, that for communications it is important to keep things simple. For those reasons, we are not envisaging a change to the tiering structure at the moment.
My Lords, is the Minister aware that just a few minutes ago, before the Statement, a press report questioning the accuracy of lateral flow antigen tests said that 140,000 tests were carried out in the Liverpool City Region, and yet the Statement says that more than 300,000 people were tested in Liverpool and, with the mass testing, cases have fallen by three-quarters and Liverpool has now gone down from tier 3 to tier 2? Why can we not get the communication right so that people can have confidence in mass testing so that it can be rolled out nationally, and show the evidence that it actually works?
I am extremely grateful for the opportunity to remind the noble Lord that earlier today we published a fulsome programme of community testing. I would be very glad to send him a copy of it, because it lays out exactly the plan he has just described; I am hopeful that he will celebrate its publication. He is entirely right that infection rates have come down in Liverpool—not just because of mass testing but it has made a contribution—and I pay tribute to the mayor and people of Liverpool for their approach in recent months.
(3 years, 12 months ago)
Lords ChamberMy Lords, the Question of the noble Baroness, Lady Campbell, shows very clearly that flexibility will be needed, and I think the Government are hearing that. Now that we have three vaccines, including the Oxford-AstraZeneca vaccine, how soon does the Minister think we will be able to roll out vaccinations at a target of 1 million a day? Will he confirm that target? Will that be from January onwards? In the meantime, the need for rapid mass antigen lateral flow testing is all the greater.
My Lords, the noble Lord tempts me to commit to schedules that I am simply not in a position to commit to, I am afraid to say. The performance of the various vaccines is extremely complex: each one of them needs a different delivery plan. In collaboration with the NHS, we are putting in place an extremely energetic and thoughtful deployment programme. Those in charge have been instructed to have that ready to start from 1 December, but I will not hide it from the House that it may well be after the new year that the very large numbers begin. I reassure the House that we are super-focused on this deployment plan, and, as soon as the vaccines become available, we will be trying to get them to the public as soon as we can.
(4 years ago)
Lords ChamberMy Lords, the noble Lord is entirely right on two things, and wrong on another. He is entirely right that isolation is absolutely key—without isolation, there is no point in testing or tracing. It is true that not everyone who is asked to isolate does isolate, but we have a programme in place to try to encourage, inform and inspire people to isolate. He is entirely right that lateral flow tests offer huge advantages, in terms of the speed at which they can be used, their cost and their flexibility. But we have bought tens of millions, maybe even hundreds of millions, of these tests in recent weeks. We are deploying them in mass testing, and we have completely followed the advice and inspiration of the noble Lord in this matter in a massive way.
My Lords, Sir John Bell, the Regius Professor of Medicine at Oxford University, has said that these inexpensive, easy-to-use lateral flow antigen tests, when used systematically, could reduce transmission by 90%. Could the Minister confirm that the trials are already showing that these tests are picking up 75% of positive cases and 95% in the most infectious individuals? If that is the case, when can we have these millions of tests that Ministers have spoken about deployed, not only in the NHS, care homes, schools and universities but at airports, factories, offices, workplaces, theatres and even sports grounds, so that we can get our economy back firing on all cylinders very soon?
(4 years ago)
Lords ChamberMy noble friend makes a very reasonable point. The marketplace for vaccines is extremely competitive. The British Government have been emphatic in our commitment to CEPI, Gavi and the other vaccine organisations. The COVAX advance market commitment aims to produce 1 billion doses for high-risk populations in 92 developing countries in 2021. We support that initiative enormously and work with other partners to ensure the fair and equitable distribution of vaccines around the world.
[Inaudible]—about the Pfizer BioNTech vaccine and full credit to the vaccine taskforce. Given that other vaccines, such as the Oxford AstraZeneca one, will, I hope, be available soon, what will the Government do to ensure the rapid rollout of the inoculations of these vaccines? Can business help in any way? As president of the CBI, we stand by to help in any way we can. Secondly, I offer my congratulations on the rapid mass-testing pilot starting in Liverpool. Can the Minister confirm that these pilots will now be rolled out to another 67 regions, and how soon will that happen?
I am grateful for the noble Lord’s remarks. Business can play an important role. Distribution of the vaccine will employ a large workforce and the supply chain is incredibly important. There will be a dimension for business to provide thought leadership and behavioural leadership to encourage and make space for employees and to be advocates for the principle of vaccination in every way. In terms of mass testing, we have sent lateral flow devices to 67 directors of public health and we will be learning from the Liverpool experiment to see whether we can apply citywide mass testing of the kind he describes to other cities in the future.
(4 years ago)
Lords ChamberMy Lords, we are extremely grateful to the Resuscitation Council for its work on this important tool. It gives an opportunity for patients to express their preference and for clinical judgment to be used at moments of acute intervention. It is being used in some places but, as the noble Lord rightly points out, its use is variable. I would be glad to take this back to the department to see what can be done to encourage its use more thoroughly.
My Lords, I am the chancellor of the University of Birmingham, and the professors at the university hospital there said that there was no way that any triage tool was used. If anything, better intensive care treatment was given during the crisis, so I am glad that the Minister very categorically said that. The Sunday Times article was trying to insinuate that people were not getting the intensive care that they needed. Can he reassure the House that in the second wave, the Nightingale hospitals that were built at such brilliant speed will be used if needed and are ready for use?
My Lords, I completely agree with those at the University of Birmingham who confirmed that triage tools were not used. They were not necessary, and everyone had absolutely the best care that could have possibly been given to them. The Nightingale hospitals are on standby where necessary; they will be deployed if needed, but it is my hope that they will not come into play.
(4 years, 1 month ago)
Lords ChamberMy Lords, I cannot help but observe the palpable irony of being told, on the one hand, to engage, form alliances and double up on stakeholder engagement and, on the other, being told to hurry up and get a move on. An effective response means a combination of both national and local systems. A huge amount of work needs to be done to build the consensus, support and technical arrangements for that response. We are putting a huge amount of work into that process and look forward to making announcements on it. Until then, I reassure the noble Baroness that officials and politicians are working night and day to make that response as effective as possible.
My Lords, does the Minister agree that, with almost 30% of the country under lockdown and more lockdowns to come, the key solution is mass testing? Does he also agree that we could have the equivalent of the ventilator challenge to manufacture the portable LAMP machines, which could greatly enhance testing capability, and have the Abbott Laboratories Binax-type, $5, 15-minute test available widely? Why are we not hearing more about this being implemented urgently?
I reassure the noble Lord that we are making progress. He is entirely right: the ventilator challenge is an inspiration, and I note that we have hit our target of 30,000 ventilators. I note that we have 300,000 tests a day at the current run rate; we have re-registered 50,000 new clinicians to return to support the NHS; we have had 16 million downloads of the NHS app; we have recruited 14,200 nurses as part of our recent recruitment; we have processed over 24 million tests in laboratories as of 8 October 2020; and the Vaccine Taskforce has secured access to six different vaccine candidates across four different vaccine prototypes. These are enormous achievements and we will continue to pursue our response with energy and vigour.
(4 years, 2 months ago)
Lords ChamberI thank the right reverend Prelate for his question. I thank greatly those local authorities and charities that are putting in place Remembrance Day service arrangements that will abide by the new rule of six. Some of those guidelines are being written now, and I will be glad to share the guidelines with the right reverend Prelate when they are published. One thing I note is that virtual attendance at these services and the use of virtual remembrance books will be an aspect of Remembrance Day this year.
My Lords, Professor William Hanage of the TH Chan School of Public Health at Harvard University has said of the lack of mass testing that:
“By the time you become aware of the problem it is likely to already be much larger. You are not going to detect outbreaks if you don’t look for them.”
He also said that you need
“very good diagnostic tests as well as tests that may be less sensitive but can be used more frequently.”
I am totally with the Government in their aim for mass testing, but would the Minister agree with Professor Alan McNally of the University of Birmingham that the £500 million already announced
“could have funded around 33 million standard swab PCR tests that could have been run in well-equipped university labs”?
Why is that not happening? On rapid saliva tests, the Abbott Laboratories’ BinaxNOW $5, 20-minute test has been FDA approved, with 10 million tests produced this month and 50 million to be produced next month. Why are we not getting on with it? We need to do this really urgently. Does the Minister agree?
I completely support the noble Lord’s commitment to mass testing. We are looking at ways in which to use less sensitive machines to provide the kind of prophylactic testing to which he alludes. I thank very much indeed all universities for their contribution to our testing programme.
(4 years, 2 months ago)
Lords ChamberThe noble Baroness raises a very difficult subject. A huge amount of work has gone on in this country and others to define the most effective possible list of symptoms. The honest truth is that this disease manifests itself in different people in a great many different ways, and we have done a huge amount to try to understand the list of symptoms to be described in a way that will capture the greatest number of people in the clearest way possible. We keep that under review, but the work that has gone into it could not have been more thorough.
My Lords, a programme of nationwide mass testing is exactly the ambition we will need to build confidence in the public and businesses before a vaccine becomes available. Professor Devi Sridhar of Edinburgh University says that the only safe way is mass testing. I agree with the Minister: look at where we were in March, with 2,000 tests a day, and now we have the capacity for well over 300,000 tests. Given that, why can we not get on with instant mass testing? The Abbott BinaxNOW test laboratory in America is producing antigen tests—10 million this month and 50 million next month—that give results within 20 minutes, and they are already FDA-approved. Why can we not do that at such speed? Can we get this into the market quickly? Likewise, Germany started testing at airports in June, and France did so in August. Why can we not start testing at airports quickly? Jobs, the economy and lives are at stake.
My Lords, we could not be moving more quickly to engage with the producers of tests in order to sign up the resources we need to put in mass testing. That cannot be switched on overnight, but we could not be moving more quickly. On airport testing, the CMO has been crystal clear: he is deeply concerned about day-zero testing and about any but the most thorough airport testing measures. We were caught out on this at the beginning of the epidemic and we remain extremely cautious.
(4 years, 2 months ago)
Lords ChamberMy Lords, any new regulations will be in place from Monday and will capture events such as the one the noble Lord describes.
My Lords, I was delighted to hear the Secretary of State, Matt Hancock, announce the Government’s investment of £0.5 billion for testing innovation. Is the Minister aware of Abbott Laboratories’ new $5 antigen test, released just two weeks ago in the United States? On a card, within 15 minutes it can give results anywhere—at a school, a university, in the workplace or at the airport. Ten million are being produced this month in America, and 50 million next month. How soon will we have access to those sorts of tests, which will be a true game-changer in being able to have mass testing around the country?
My Lords, I am aware of the Abbott test. I spoke to Chris Scoggins from Abbott yesterday, and I pay tribute to innovators in this country, in America, and around the world for the dramatic increase in the speed, accuracy and scale of these tests. We hope that they will make a big difference.
(4 years, 4 months ago)
Lords ChamberI think my noble friend and I need to have a chat about statistics, because the statistics I have differ from his. Mine suggest that 28% of the public are either obese or overweight, and it does defy common sense that 72% the public are obese or overweight. Maybe he and I can have a chat about that offline: I would be glad to clear it up. However, my noble friend makes a really important point that I and the Government completely endorse: the Covid epidemic has been a wake-up call for the country—in that, he is right. There is an urgent need to address the obesity epidemic and the Government are looking at ways to do so. The Prime Minister is personally vested in it and my noble friend’s points are extremely well made and supported on these Benches.
My Lords, it is very good to see the Statement saying that new cases are at their lowest since the lockdown began. Will the Minister confirm that 30,000 excess deaths have taken place in care homes, and that almost 20,000—almost 50%—of all the sad deaths have been in care homes? Are care home staff, the 1.6 million people who work in the care sector, as well as the 1 million patients in care homes and at home, being tested every week? Just today, we heard that the accident and emergency department at a London hospital has closed because of infection among the staff. Are all staff at NHS hospitals around the whole country being tested regularly, every single week? Looking ahead, will there be a large-scale flu vaccination campaign as an extra precaution leading up to this winter?
The noble Lord is entirely right to emphasise the importance of flu vaccination. We are very focused on getting the right amount of flu vaccination stocks and encouraging take-up once the WHO has nominated the right vaccination and we have stocks of it in this country.
(4 years, 5 months ago)
Lords ChamberMy noble friend makes a tough but serious set of points. It is undoubtedly true that this country has been hit hard by Covid because of the prevalence of obesity, and it is a truth long explained by Public Health England that there is a direct correlation between calorie intake and weight—there is no getting away from that. The Government are looking at how to address this issue, public health remains a massive priority for us and, when the time is right, we will look at ways of using marketing to communicate the message on this.
My Lords, it is very good news that the trials of dexamethasone have gone successfully and that other trials are progressing well; I hope that the vaccine trials will also yield success. However, can the Minister confirm reports that more than a third of care home patients have not yet been tested? When will all care home patients and staff be tested fully and regularly? Secondly, with the good news coming from the Prime Minister—we hope—of the economy opening up from 4 July, will widespread testing be available for businesses on top of the two-metre social distancing being reduced to one metre?
My Lords, the progress on testing in social care is dramatic. The rollout of testing to all care homes is complete, and tests have been offered to all those who are symptomatic. The focus is very much on staff who travel between more than one home, and asymptomatic testing. As for the economy, all those who show symptoms can have a test, but we are talking to business about how businesses can also contribute to their own testing regimes, and we look forward to developing those plans.
(4 years, 5 months ago)
Lords ChamberI 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.
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?
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.
(4 years, 6 months ago)
Lords ChamberMy noble friend raises one of the key features of our social care system. It is provided by 12,000 different care home providers—or 16,000, depending on how you measure it—many of whom have very different business models. This creates a rich and diverse tapestry of provision, but it is also extremely difficult to engage with from a central campaign provision. That is one of the challenges that we have faced when rolling out support such as PPE and testing. We do not believe that the business models are inappropriate, but undoubtedly we have challenges when we are trying to reach all the care homes with an equal and central format.
My Lords, the Statement says that 27% of coronavirus deaths in England have taken place in care homes, whereas in Europe the average is around half—but does the Minister agree that in Hong Kong, Singapore and South Korea there were zero deaths in care homes, and in Germany, a country with a population of 90 million people, 3,000 deaths? Also, can he confirm that no patients were ever sent from a care home to a hospital and then back from a hospital to a care home without being tested? Can he reassure us, as the Statement says, that the testing of all care home residents and staff, with and without symptoms, is now taking place? That is 2.5 million people. When will it be done by, and will it be done on a regular basis? Some care homes are saying that it will be necessary to test many times a week.
The statistics which the noble Lord refers to are correct. It is probably more appropriate to compare the British care home statistics with those in Europe rather than Asia, which had previous experience and different models. With regard to care home testing, not everyone needs to be tested every day. Not every care home has an outbreak, and we must focus our resources on those that do. Regular testing may be necessary for them, but it is not correct that, for example, 2.5 million people need to be tested every week. That is not the advice from the scientists or the CMO. We want to focus our tests where Covid-19 has been found, and we must use our testing resources to expunge the disease from those locations.
(4 years, 6 months ago)
Lords ChamberMy Lords, the Minister said that isolation is essential for those who have symptoms. It was only yesterday that the Government finally included the loss of the senses of smell and taste as a symptom. I fell ill with coronavirus on 15 March and lost my senses of taste and smell. At the time, it was not an official symptom. I could not even get tested then—indeed, not even doctors and nurses could—yet the WHO has been saying since the middle of March that we should “Test, test, test”. Eventually we have come around to doing it now and we are ramping it up. As the noble Baroness, Lady Thornton, pointed out, the WHO said eight weeks ago that the loss of taste and smell should be considered a symptom. How many hundreds of thousands of people have now been infected and have infected others because this was not an official symptom? The WHO has also said that social distancing should be one metre, but we say two metres. Why are we not listening to the WHO, or only eventually listening to it? Why are there these inconsistencies?
I am very sorry that the noble Lord had coronavirus, and it is good to see him on such fine form and in characteristically enthusiastic shape. The bottom line is that lots of people do not lose their sense of smell or taste, and the addition of this symptom was delayed because we did not want to put off those who had not lost their sense of smell and taste from declaring their symptoms. The WHO is right about many things but not about everything.
(4 years, 6 months ago)
Lords ChamberThe Government have gone about the Covid crisis with a great amount of transparency; a very large number of figures are published every single day. I am afraid that some of the questions my noble friend asks are beyond the reach of measurement in our statistical accountability at the moment, but I completely take on board and celebrate her call for transparency. We are working as hard as we can to get as many numbers out to the public as possible.
My Lords, tracking, tracing and isolating can be effective only if there is adequate testing. It was reassuring to hear the Prime Minister say today that the target was to be 200,000 tests a day by the end of this month. Earlier, he referred to 250,000 tests a day. Can the Minister confirm that millions of tests a week will be available, not just to patients and staff in hospitals and care homes but to the whole British public? In particular, they should be available to workers so that they can get tested and have the confidence to go to work, while consumers can have the confidence to go to restaurants and hotels, bars and venues. Can he also confirm whether pin-prick antibody tests will be available in the millions later this month to the whole British public so that people such as me, who have had Covid-19, can get tested? This would show that we have the immunity to go out to work and participate in the economy without infecting people or getting infected ourselves.
“Track, test and isolate” does not necessarily depend on doing millions of tests. South Korea, which has an extremely effective regime, does only 20,000 tests a day. That is because its whole society has worked hard to get the prevalence of the infection as low as possible. I celebrate the fact that the British public have committed to the lockdown, but I cannot disguise from the House the fact that the lockdown needs to continue to get the prevalence rate lower.