Covid-19
Debate between Lord Bethell and Viscount Waverley(3 years, 2 months ago)
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Lord Bethell (Con)
I am very grateful for the questions and I will take them one at a time. I am enormously grateful for the advice of SAGE; the work it does is invaluable. However, it is not regarded as the key medical adviser to the Government—that is the role of the CMO, who advises the Government on medical matters.
On the circumstances for moving to plan B, that is a reasonable question. We do not have a specific formula or algorithm, because it is extremely uncertain how things will play out. Undoubtedly, pressure on the NHS is one of the biggest drivers of that decision, and if we were to see a spike in hospitalisations, severe disease and deaths, and beds being used up and capacity being drawn down to an extreme level, that would be one of the key drivers. But we have to also look at variants of concern, other diseases and the state of the NHS in the fightback, as well as at the flu epidemic that may or may not come. Therefore, I cannot give an easy and simple answer to that question—there is not a “four tests” type of answer to it—but we are looking at it extremely carefully.
On the criticism on speed, I remind the noble Baroness that, at the beginning of this year, the Government laid out a very clear steps process, whereby we left the last round of regulations. That was extremely well considered; there were at least five weeks between each step, and it was done in a proportionate and empirically based manner, and I think noble Lords would recognise that it was a thoughtful and reasonable way of doing things. To characterise the Government’s approach this year as being behind the curve is not reasonable. As I said, we are trying to accept the risks that we have in front of us, and Covid is only one of them: there are other pressures on the NHS, including the huge catch-up that we need to do, and the possibility of flu and other epidemics on the horizon. We cannot just focus entirely on this.
Viscount Waverley (CB)
My Lords, quite rightly the Minister is in popular demand this evening. This is nothing against Boots the Chemists, which by the by does an excellent job, but with not shy of 2,000 eligible candidates on the parliamentary estate, could not the testing facilities on the estate be designated as official testing areas for flying purposes and for any other reason that tests are required? Furthermore, notwithstanding the announcement to which the Minister referred, which may or may not address this point, why, oh why, do we need day 2 testing, having had a valid test 48 hours prior to arrival in the UK from, for example, the continent?
If the Minister is minded, given that I do not think that another noble Lord is going to ask a question, could he possibly also say a word about the issue of mixing and matching booster vaccination types? Can the flu jab, to which the Minister referred, be taken at booster stage?
Lord Bethell (Con)
Like the noble Viscount, I pay tribute not just to Boots—an excellent chemist—but all the other pharmacies, which have contributed so much in this epidemic in looking after the communities that they serve, not only in trying to provide essential services during lockdown but in their contribution to the vaccine rollout programme. It really has been a demonstration of the enormous amount of value in big and small chains and community pharmacists across the board.
As for the testing provisions here on the estate, those are of course LFD asymptomatic testing provisions, and for flying purposes you need a PCR test, so I am not quite sure whether it would necessarily read across directly.
Viscount Waverley (CB)
My Lords, just from first-hand experience— Sorry, I apologise for intervening.
Lord Bethell (Con)
It is an interesting and creative idea, and certainly one that would be worth looking at.
On day 2 testing, I recognise that it is inconvenient to do the follow-up testing if you are travelling but, for the protection of this country, it is an important part of our border public health measures.
The pre-flight testing regime is helpful; it catches some disease, but in no way could it be thought of as a reliable barrier to infection into the country. I am afraid that there is simply, as I am sure noble Lords know, too much variance in the quality of that testing regime, to put it politely. Our estimate is that it catches between 10% and 20% of disease, but we know from our own testing in this country that it certainly does not catch all of it. In fact, most people will not travel if they are blazingly ill, so almost all travel infection is asymptomatic. That is why we look to day 2 testing, because it has the benefit of catching those people who might either have asymptomatic disease or are incubating the disease and would not be caught even by a PCR test.
The day 2 test is an effective way of catching those with the disease; it is an essential part of our surveillance. We would not know how much disease was coming into the country, what VOCs were coming into the country or which countries had disease, because so few have sophisticated testing, let alone genomic sequencing. It is literally the only way we know what is coming into this country and where the threats are from around the world. That is why it has played such an important part in our testing regime to date. The Secretary of State for Transport will be making announcements tomorrow and I look forward to his update on that.
On mixing and matching, one of a great many surprising medical outcomes from this disease is the idea that you might have one vaccine one day and another one three months later. When that was first posited to me, and when I first made that suggestion in this House, it was greeted with surprise and with some concern, but actually they somehow provoke different parts of the immune system, they somehow complement each other and there is strong and growing evidence that this is a very effective and complementary way of administering programmes. They work for different types of people in different ways, and different mixes and matches complement each other in a strange Rubik’s cube of complicated arithmetic. I would have to leave it to JVT, the deputy CMO, to explain it in more detail if noble Lords would like more information on that.
Covid-19
Debate between Lord Bethell and Viscount Waverley(3 years, 4 months ago)
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Lord Bethell (Con)
I thank the noble Lord for that very touching personal testimony about his neighbour who passed away. It is an important account of many who have put themselves at risk. The PHE report on high mortality groups includes bus drivers, taxi drivers and many who perform an important public service that puts them in front of the general public and therefore at risk from this virus. We absolutely support the wearing of masks. Published guidance will continue to recommend that wearing a face covering will reduce the risk not only to yourself but to others, particularly in enclosed and crowded spaces. The noble Lord asked about whether mandation should be in place and for whom, and I do not wish to duck his point The mandation of masks on public transport is best left to those who run it, which is why we have moved away from legal rules to an approach that enables personal judgments and the intervention of businesses and local leaders.
Viscount Waverley (CB)
My Lords, much uncertainty and changing dynamics surround travel—Malta and the EU have already been mentioned. To flip that around, can the Minister kindly explain the rationale as to why government advice has belaboured ad nauseam travelling from the UK, yet my wife is able to travel to the UK from Portugal?
Lord Bethell (Con)
My Lords, our intention is that, later in the summer, those who are fully vaccinated will not have to quarantine when arriving in England from an amber list country. This will benefit the noble Lord’s wife, and I hope she will take advantage of it. When it comes to travel, caution is still the principle because travel exposes us to proximity to people in very confined areas. It also raises the possibility that variants of concern will come back with travellers returning from abroad. We have worked so hard and done so much to keep those VOCs out of the UK that it is not just right to give up these efforts now. Those arrangements are under review and will change if the risk assessment changes.
Covid-19
Debate between Lord Bethell and Viscount Waverley(3 years, 9 months ago)
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Lord Bethell (Con)
I do not agree with my noble friend on this in any way—fraud is fraud. If you put people in danger, you deserve to serve the consequences. It will be up to either the magistrate or the Crown Court to determine the sentence. The sentence is laid out in law, not by me or any new measure. Those who put the entire nation at risk by bringing variants of concern into the country should be aware that the courts may take an extremely dim view of their actions.
Viscount Waverley (CB)
My Lords, I am going to pass the baton to the next speaker as the points I wished to raise have already been addressed. However, I commend the noble Lord, Lord Bethell, whose performance as a torchbearer at the Dispatch Box is exemplary by anybody’s standards. I have recently been jabbed myself, and the whole vaccination process from start to finish is commendable for being conducted with efficiency and courteousness, making one proud to be a Brit. We will be on to a winner if we replicate that in global Britain.
Lord Bethell (Con)
I am extremely grateful for the noble Viscount’s kind remarks. They are rightly directed at those responsible for the deployment of the vaccine. The NHS itself has been a central player in all that, as have our academic colleagues, particularly at Oxford University but also Imperial, as well as others who have contributed. I will take his remarks back to the Department of Health and Social Care. It has been a very tough year, and I am extremely grateful for his remarks.
Covid-19: Variant
Debate between Lord Bethell and Viscount Waverley(3 years, 10 months ago)
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Lord Bethell (Con)
My noble friend asks a very challenging question. The honest truth is that we have to look at the systems whereby that data is exchanged. CMOs around the world have extremely regular contact with each other, and a lot of the data is exchanged through the formal links of the scientific community. But I think that there is a case for more structured intergovernmental exchange of data about the new variants, because this will be the major challenge of the year ahead.
Viscount Waverley (CB)
The Minister mentioned a number of countries. Is there sufficient exchange between all of them or could more be done in that regard? Is there anything that the public could usefully know about the new variant’s transmission traits—whether it is airborne, for example?
Lord Bethell (Con)
The exchange of information between the scientific community has worked extremely well during this pandemic and epidemic, and I pay tribute to it for the open-hearted and transparent way in which it has exchanged data across political, cultural and national boundaries. In terms of transmission, the noble Viscount alludes to something that is very difficult to pin down. It is not clear what proportion of the disease is transmitted through the air and what proportion by touch and manual transmissibility. That is a very frustrating conundrum. The CMO guides us to believe that there is more transmissibility through the air than by touch, but it is absolutely essential that people keep their distance and wash their hands.
Covid-19 Update
Debate between Lord Bethell and Viscount Waverley(3 years, 11 months ago)
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Lord Bethell (Con) [V]
The noble Baroness is entirely right. The vaccine is a great success story for the union and for the United Kingdom. We have had a four-nation approach and the distribution of the vaccine shows the union at its best. She is right to say that the work done at Porton Down is on behalf of all the nations of the United Kingdom and that the communication to the WHO was on behalf of the whole country. That communication demonstrates that our approach to the vaccine is to put transparency first and that we have moved extremely quickly to share this insight with our colleagues overseas.
Viscount Waverley (CB) [V]
My Lords, I am reliably informed that only two of the 14 passengers in a carriage on the 5.48 am Southeastern train from Gravesend to the London terminus this morning were wearing masks, so clearly the message is not getting through. Adding to the words that the Minister offered to the remarks of the noble Lord, Lord Winston, on the challenges that have appeared this morning of the long- awaited test release scheme, I ask: why not resolve this in part by passengers obtaining a test evidencing a negative result within 72 hours of travel into the UK? Further, if they have received a vaccination abroad or a negative test result abroad, will official confirmation from an appropriate authority from abroad be acceptable to the United Kingdom?
Lord Bethell (Con) [V]
If I have heard the question correctly, that is exactly how the test release scheme works. Travellers are invited to sign the appropriate forms and after some days they can be released from isolation early by taking tests. That scheme has been signed off by the Chief Medical Officer and data from the test is transmitted to Public Health England. We currently have a UK-only testing regime and we do not take tests from overseas, but we are keeping the scheme under review.
Coronavirus Vaccine
Debate between Lord Bethell and Viscount Waverley(3 years, 11 months ago)
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Lord Bethell (Con)
My Lords, as few will be surprised to know, the rollout of the flu vaccine has been hugely successful this year; the take-up has been massive. I am not aware, from the stats that I have seen, of any slowdown in the take-up of the flu vaccine, but the point my noble friend Lady McIntosh makes is understandable—I am happy to check it out. I also encourage anyone who is thinking about deferring the flu vaccine until they get the Covid vaccine to think again because it is a massive priority to get vaccinated for both.
The noble Baroness and I have talked before about dispensing doctors, whose role is very important. There is a challenge with the distribution of the Pfizer vaccine because of cold storage and the large number of shots in each vial. I am not sure whether that means that rural dispensing doctors can play the important role that they might do at this stage of the distribution, but I reassure the noble Baroness that they will play a role in the national distribution as it pans out over the next few months.
Viscount Waverley (CB) [V]
My Lords, I note that many unknowns exist in differing vaccine effectiveness cycles. Are the Government planning to combine the careful management of linking certified testing to identity data, particularly given that the technologies and solutions are available? As regards the urgent rollout of vaccines globally, I propose that a commandeering exercise of wide-bodied aircraft, laid-up due to Covid, be considered to lessen the global logistical nightmare.
Lord Bethell (Con)
My Lords, in relation to the logistical nightmare, one of the nice things about vaccines is that they do not take up much space: they are relatively compact, so I am not sure that wide-bodied aircraft will be needed, but I thank the noble Viscount for the wise suggestion. In relation to certification, he raises an interesting prospect that we have not fully bottomed out yet. As I said in response to earlier questions, we do not know whether vaccination will reduce transmissibility. Our hope and expectation are that it will, but until that is proven, any thoughts of certification will be premature.
Covid-19 Update
Debate between Lord Bethell and Viscount Waverley(4 years ago)
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Lord Bethell (Con)
The role of Kate Bingham, the head of the Vaccine Taskforce, has been to acquire vaccines—and that is what she has done. She has served the nation brilliantly by acquiring six of the vaccines on four of the platforms. We should be extremely grateful for the work that she has done. It was not remunerated, and it was extremely effective. To knock those who have contributed voluntarily to our fight against Covid is not appropriate at this stage.
Viscount Waverley (CB) [V]
My Lords, notwithstanding the Minister’s positive and sensitive remarks this evening, can it be confirmed that, despite SAGE advice and planning, a national mass Covid testing programme has been ruled out by No. 10 this week? If that is the case, who mandated the decision and what was the rationale for doing so?
Covid-19: Local Restrictions
Debate between Lord Bethell and Viscount Waverley(4 years, 1 month ago)
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The Deputy Speaker (Lord Alderdice) (LD)
The noble Lord, Lord Mann, has withdrawn, so I call the next speaker, the noble Viscount, Lord Waverley.
Viscount Waverley (CB) [V]
My Lords, the issue is indeed about collaboration with local government. However, the Government’s decision to introduce the Coronavirus Act marred the use of secondary legislation in respect of the Civil Contingencies Act, suggesting that the Executive believe that existing legislation is not robust enough to counter the threat of pandemics. Given that we live in such a world, what plans do HMG have to review the robustness of all existing legislation? If they do, can they confirm that it will not infringe on parliamentary sovereignty?
Lord Bethell (Con)
My Lords, I note and take very seriously the noble Viscount’s comments on the state of our legislative response to the epidemic. There will no doubt be a time for reflection, learning the lessons of the epidemic and reviewing the legislative processes that we have available. This is not the time; the challenge of Covid is still very much a clear and present danger, but we will take on board his recommendation to reflect and improve on the structures we already have.
Covid-19 Update
Debate between Lord Bethell and Viscount Waverley(4 years, 1 month ago)
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Lord Bethell (Con)
My Lords, I recognise that this epidemic has hit women hard—it really has—particularly in high-density areas such as Leicester where women and girls do not have access to the kind of exercise and space that they need in order to lead fulfilled lives. We have given substantial funds to the authorities in all cities, including Leicester. I greatly encourage those authorities, including the ones in Leicester, to think about how they can help women and girls to access the space and exercise that they need to fulfil their lives during this difficult period.
Viscount Waverley (CB) [V]
[Inaudible] the presence of the noble Lord, Lord Hunt, perhaps I may refer the Minister to his response to me when he presented a Covid update on 14 September, and indeed as he has confirmed today. On what calculation does he anticipate that
“we are looking at making up to half of our PPE requirements in the UK.”—[Official Report, 14/9/20; col. 1007.]?
Why do the Government have their sights on only 50%, and what plans do they have to increase national production? Is it suggested that this is the sum total of our manufacturing prowess?
Lord Bethell (Con)
Absolutely not, my Lords. I pay tribute to British manufacturers, which have come an enormous distance—everyone from high-end manufacturers such as Burberry to those which once made recycled bin bags and have now turned their factories over to producing aprons and other important PPE articles. I pay tribute to my noble friend Lord Deighton, who has done an enormous amount to generate interest among British manufacturers of all kinds in order to support British PPE production. However, we have to have a balance to this. Some specialist goods, such as gloves, are best made elsewhere, but having the capacity and expertise to make 50% of our PPE means that we now have a route to making it all if necessary.
Covid-19 Update
Debate between Lord Bethell and Viscount Waverley(4 years, 2 months ago)
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Lord Bethell (Con)
My Lords, I pay tribute to amateur sports clubs, which have jumped through enormous hoops to keep operating and to provide important leisure and fitness to the country during an incredibly difficult period. They have been extremely disciplined and entrepreneurial in the way they have applied hygienic protocols. On Sunday I went to three amateur sports clubs, taking one of my children to each. The warning the noble Lord, Lord Addington, gives about the financial future of these clubs is extremely well made. The Department for Digital, Culture, Media and Sport is looking at ways in which it can provide both the financial and infrastructure support for those clubs and will work hard to ensure that they survive.
Viscount Waverley (CB) [V]
My Lords, the Minister has touched on critical countrywide issues but, as regards those who have crossed the channel, does automatic Covid testing take place for migrants detained by the UK border agency on the Kent coast, for example?
Lord Bethell (Con)
My Lords, all those resident in local authority hostels or accommodation will be tested regularly to prevent the transmission of this disease.
Covid-19 Update
Debate between Lord Bethell and Viscount Waverley(4 years, 2 months ago)
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Viscount Waverley (CB) [V]
My Lords, it is clear that face masks are a critical component of slowing the virus. Following on from the observations of the noble Lord, Lord Rooker, and other noble Lords, how self-sufficient is the UK expected to become in the supply of PPE, and are there targets for the supply of face masks in particular?
Lord Bethell (Con)
My Lords, we have taken huge steps in the domestic production of PPE. In some matters, where the production is relatively straightforward, such as aprons, we have taken huge steps forward and the vast majority of our production is done at home. For some products, such as gloves, that are more complex because of their shape, we are having to work harder. The progress of my noble friend Lord Deighton’s Make strategy for PPE has been profound, and we are looking at making up to half of our PPE requirements in the UK.
Covid-19 Update
Debate between Lord Bethell and Viscount Waverley(4 years, 4 months ago)
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Lord Bethell
My Lords, we have an energetic fake news and rebuttal team at the Department for Health—which I regard as an enormous shame. It is a waste of our time and indicates how dangerous speculation and false information of this nature can be. I have noticed in today’s social media a large amount of extremely irresponsible recycling of fake news by those who, frankly, should have known better. I urge all influencers, whether from the worlds of media, politics, health or other parts of society, to think carefully before recycling fake news and speculation on outbreaks in a way that wastes the time of public health officials and creates anxiety among the public.
Viscount Waverley (CB) [V]
My Lords, moving beyond the unfortunate Leicester situation, is it the case that Covid is mutating at such speed that it will diminish the effectiveness of a vaccine, and does it therefore follow that emphasis would best be placed on a cure?
Lord Bethell
The noble Lord stretches my scientific expertise to the limit, but my understanding from the CMO is that a distinctive feature of this virus is its surprising lack of mutation. It has proved to be an extremely sturdy and consistent virus. While many viruses get less deadly but more infectious, this one has remained pretty much the same. Cures for coronaviruses, particularly those that hit the lungs, are extremely rare and difficult to track down. I am advised that a vaccine is the quickest and most effective route, and I am extremely pleased that, in Imperial and Oxford, Britain has two of the leading vaccine candidates.
Covid-19: Response
Debate between Lord Bethell and Viscount Waverley(4 years, 5 months ago)
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Lord Bethell
I completely understand the noble Lord’s frustration, but I remind him that in Covid time, two weeks is ages. We have been moving so quickly to cover the ground that we have had to stand up very big programmes within a fortnight. He speaks with frustration that there seems hardly enough time to get things organised, but that is the pace at which we have had to move. The prevalence rate is down and the infection rate is down—that is not say we are complacent, but now is the moment when we are bedding in our operations.
The noble Lord is entirely right that our focus and our investment of time is in stitching together the local response, which is, as many noble Peers have said in these discussions, an essential part of our response. As I said earlier, the work of the Serco call centres, of the directors of public health, of Tom Riordan, of local authorities—all these need to be stitched together. It is extremely complex, but that is what the team of my noble friend Lady Harding is doing at the moment.
Viscount Waverley (CB)
Following a previous response by the Minister that touched on politics, will he clarify an issue that is exercising the country at large? Is the response by government to corona led by science or by taking note of science? If the latter, what are examples of choices by government that differ from that of scientific advice?
Lord Bethell
The noble Viscount asks an incredibly broad question, upon which many a treatise could be written. I can best answer by giving my personal experience, which is of being in meetings where the scientists absolutely lead our thinking, where their clinical judgment takes precedence over any lay opinion and where we have been advised by unbelievably impressive and experienced clinicians, epidemiologists and scientists from different groups. My experience is that those voices have been the ones that prevailed in almost every debate. However, not everything can be answered by scientists and there are political decisions to be made. Ultimately, major decisions such as on lockdown, on the strategy for test and trace and on how to run a vaccine strategy are informed by scientists, but politicians have to make big calls. That is the same in every single major national project. I think we have got the balance right. We have tried to put the science, quite rightly, at the heart of the decision-making, and sometimes we have been led into quite politically awkward situations by the good judgment of our scientists. I pay tribute to them and their judgment. My personal experience is that we have listened to and been led by them wherever necessary.
Coronavirus (COVID-19)
Debate between Lord Bethell and Viscount Waverley
Lord Bethell
I reassure the noble Baroness and the House that we are clearly in the midst of a global pandemic, and nothing will stand in the way of the Government’s best efforts to work with our international partners, in Europe, through the WHO and abroad, to find a proper solution to this challenge.
Viscount Waverley (CB)
My Lords, there is a consensus on the necessity of handwashing. Will the Government ensure that sufficient quantities of gel are readily available around the country? There are reports that, nationwide, stocks are just not there to supply people who wish to get hold of that product to follow government advice.
Lord Bethell
The noble Viscount is right; I have also read the reports of sanitiser shortages. I wish I was in a position to reassure the House that we could somehow guarantee that there was enough sanitiser in the country for the next six years. I am not sure whether that is either reasonable or possible. However, I can tell noble Lords that the CMO’s guidance is clear: washing your hands with soap and preferably hot water is much better than using sanitisers.