(2 years, 1 month ago)
Lords ChamberMy noble friend raises a very important question. We are waiting for advice from the JCVI, coming later this week, on the autumn programme. There have been various reports, but we are waiting for confirmation of whether it will be the existing cohort of 75 and over, 70 and over, or whether it will be given to wider groups. That is being considered and will be announced later this week.
My Lords, the Minister mentioned £2 billion being spent in a month on Covid tests, which includes PCR tests as well. What proportion of that £2 billion was spent on lateral flow tests? If necessary, looking down the road to this winter, are the Government prepared with vaccines, free lateral flow tests for businesses and citizens, and the antiviral programme? Are we ready just in case?
We continue to monitor the situation. The Secretary of State and I have regular meetings with the UKHSA, which tells us about the various issues of concern. Noble Lords will know about the outbreak of monkeypox in certain communities and the discovery of the polio vaccine in sewage, though not leading to cases. Clearly, we constantly talk about Covid cases. We are monitoring numbers, and the UKHSA looks at the ONS numbers as well. We are planning for the autumn, but we also have plans should the number of infections start leading to hospitalisations and possibly deaths.
(2 years, 8 months ago)
Lords ChamberMy Lords, with plan B, while we have measures to keep the economy open, we have messages that have ended up closing much of it. There is fear and there are confusing messages, including the advice to work from home—just look at trains, buses and restaurants, which have seen a collapse in demand. We have to consider how necessary all this is, with a major South African study of 78,000 omicron cases showing that symptoms are significantly less severe than with the delta variant and that the vaccines still afford protection. There are many fewer hospitalisations and admissions to ICUs.
As president of the CBI, in July we produced a document called Living with the Virus. We are now updating it to Living with the Variants, in which we say that, if we follow these steps, there should be no necessity for a plan B or a plan C. First, there should be forward guidance to support businesses and organisations to adapt. We should prioritise mass testing over mass isolation or working from home. We should utilise all Covid-secure tools available to build employee and customer confidence. We must maximise our world-leading vaccine programme, of which we are all so proud—hats off to Kate Bingham and what she did. We should also use our antiviral programme as much as possible. We should prioritise border control so that we keep our country and economy open and, if there are restrictions, government support must move in lock-step with them.
If we follow these steps, there should be no need for a plan B or plan C. I am very proud that I was one of the first people in this country to call in August last year for lateral flow tests to be widely available. I am so glad that the Government eventually listened; they are very effective, as the noble Baroness, Lady Walmsley, said. Will the Minister confirm that the supply of lateral flow tests will be there and that they will be freely available—at the moment they are not even available—to businesses and the public until at least March next year, if not longer, as necessary?
Will he also confirm that the Government will put effort and urgency into the approval of antivirals? The best example I have is the Pfizer antiviral—tablets given for five days—which has shown in trials that it reduces hospitalisations and deaths by 89%. Can the MHRA approve drugs such as that as soon as possible? Can they be widely available, so that every GP has them and anyone, if they test positive and has symptoms, can take these tablets, which will lead to an 89% reduction in hospitalisations and deaths? That in itself could be “game over” for this wretched virus.
Can he also confirm that we will do everything possible to make sure that schools, colleges and universities are never shut again? Use daily lateral flow tests; do not have a bubble system or a million children isolating. It is completely unnecessary. The Oxford trial that took place between April and June last year proved that using lateral flow tests is the way forward, so that staff and students do not miss a single day of school. Can the Minister please assure us of that? Our children and parents have suffered so much. We should not let our children suffer any more.
My Lords, first of all, you will have heard me coughing—but I have done PCR and lateral flow tests and it is a chest infection. But I have found that coughing quite a bit is a way to get a seat on a train at the moment.
I have not prepared a speech, because I wanted to listen to the debate and see what happened. The most powerful speech so far has been that of the noble Lord, Lord Fowler. Let us be clear: political philosophy is not a tool that you use to deal with a health crisis. You have to listen to public health advice and the people who collectively advise the Government on that public health advice. There will of course be outliers—that is the nature of science—but SAGE is the body which brings scientists together to have those discussions and come to the best collective view on what is in the best interests of keeping people safe. This is not a political discussion about freedom or trying to say that you are the purest freedom fighter of all. I have to say to the noble Lord, Lord Robathan, that political jibes about other parties’ philosophies are not what is required to bring about a safe and stable approach to keeping this country safe.
The clear issue in this is about test, trace and isolate. Those are the three pillars of public health policy, which will not end infection but will mitigate transmission by taking out as many chains of transmission as possible while people are infectious. The concept is as simple as that, but it is difficult in practice—and that is what government policy should be about.
This virus has shown itself to be complex. It mutates, which means that, at times, emergency legislation will be required—and because of this variant, emergency legislation is required. The Minister will know that I have been sceptical about some of the statutory instruments and whether they are an abuse of parliamentary procedure—I think some of them have been. However, these regulations are required in an emergency. We are talking about 2 million people potentially being affected by the end of next week, and it only takes a small proportion of those to be hospitalised to cause great damage to the NHS. The backlogs and the pressures on cancer treatment are because the health service cannot cope—not just with coronavirus but with the effects of the everyday procedures it needs to carry out.
I declare an interest: I am a non-executive director of Chesterfield Royal Hospital NHS Foundation Trust. It would be interesting to know whether those who have talked about the pressures on the health service have actually been to talk to the staff who are dealing with this, who are psychologically, as well as physically, drained. They are drained from the wave of difficulty that they have had to deal with, not just with coronavirus but the pressures of having to deal with people with ongoing problems and acute procedures. This wave is coming and it will mean that, yet again, more people will end up in intensive care and more people will die.
What can we do to try to minimise that? We test, we trace and we isolate. I have heard arguments that this is about the economy or public health, but it is not that binary; they affect each other. If you have 5 million to 6 million people infected, it affects the economy and it affects the NHS’s ability to cope with this. We have to go back to what the experts are saying and to these regulations: test, trace and isolate.
There are a couple of issues that I want to raise with the Minister, because I am a bit perplexed. I have no view that he is deliberately trying not to introduce test, trace and isolate procedures, but some of the things are contradictory and do not lead up to that approach.
The issue of self-isolation is about taking out chains of transmission, so that people are not circulating when they are most infected. But on the reduction of self-isolation and the use of lateral flow tests, paragraph 7.6 of the Explanatory Memorandum states:
“Close contacts of positive cases will be advised (but not required by the regulations as amended) to take daily tests for up to 7 days”.
That means that people are not required to test and to isolate, and there will be no tracing. What is the effect of that? I ask the Minister why it is not mandatory to test and upload those results, so test, trace and isolate can kick in. It seems to be a fundamental flaw in these regulations that people who have been in contact with somebody with Covid, and in particular with this most virulent strain, are told not to isolate and also not to test. If the key to public health is to test, trace and isolate, and we are taking out isolation and testing, how do we trace, particularly as we are told that the R rate could potentially be 3—so every person who is infected could infect another three people? This is a fundamental flaw, so will the Government look at this as a matter of urgency? It is vital.
I continue on some of the issues raised by my noble friend Lady Walmsley about the effectiveness of Covid certification. This is a chocolate teapot approach; it is not going to work. The reason for that has been laid out. If I have not had the booster, I may still have my certification and will be able to show it—but it could have been 10 or 11 months since I was vaccinated if this continues until March. That will mean I am 40% protected going into a large venue where I may actually infect people. The way to do this is a lateral flow test at the point of entry. That would not be 100% effective—nothing is in this type of pandemic—but it would be a damn sight more effective than relying on certification that is out of date, does not require a third dose and actually means that you are putting more people at risk of getting and spreading this than you would be if there was a lateral flow test on entry. Again, I urge the Government to look at this.
Finally, on the wearing of face coverings, lots of studies can be quoted but most come down to this fact: the argument is not about whether they are effective, apart from certain outliers that have not been peer-reviewed, but the extent to which they actually reduce transmission. In this case, where we are talking about numbers doubling every two days and up to 1 million or 2 million people being infected a week, it is important to do everything possible to minimise transmission, as part of a systematic approach. That is why face coverings are important.
Just as important as wearing them is who will enforce the wearing of them. It is unfair to leave it solely to private enterprise to deal with, so what is the enforcement regime? My noble friend Lady Walmsley referred to our noble friend Lady Pinnock and, similarly, I came down on an East Midlands train on Monday. I had to ask six people to put on their face coverings. One was quite verbally violent towards me. I was not doing it to be difficult; I was trying to protect people in that carriage. The evidence is that we wear masks not to protect ourselves but to try to stop the spread of a disease that could kill somebody—and I do not know who it will kill. Who is going to enforce? So I will not be voting for the amendment tabled by the noble Lord, Lord Robathan, on face coverings.
I might vote for the noble Lord’s amendment on certification simply because, for me, it is not a political issue but a practical one about whether certificates will work, because I think lateral flow tests will. Generally, I want this debate not to be about who is the purest of all in upholding a political philosophy. I want it to be about listening to SAGE and the collective view of scientists, and about doing everything possible to follow the public health view of test, trace and isolate, and trying to keep as many people as safe as possible and reducing the risk of death and serious illness to people in this country.
(2 years, 8 months ago)
Lords ChamberI thank the noble Baroness for making noble Lords aware of that particular comparison website—let me put it that way. We try carefully not to recommend particular private providers or comparison websites, but this market is developing, and there are lots of comparison websites out there looking at this market. As we start to have more testing and do more diagnoses at home, this market will develop.
My Lords, I was one of the first people in the country to call for lateral flow tests, going back to August last year, and I am delighted that the Government now provide these free to businesses and the public. Can the Minister assure us that these tests will continue to be made available free as we continue to fight this pandemic? Secondly, as president of the CBI, let me say that the aviation sector is suffering hugely. Is there a need for pre-departure PCR tests when we could use lateral flow tests?
Let me assure the noble Lord that there will be sufficient tests; and if you are contacted by test and trace, you will either be asked to take a lateral flow test or be sent a PCR test. But when it comes to international travel, we feel it is only right that the traveller or the company bears the cost. At the moment, travel companies are offering and recommending specific PCR tests.
(3 years, 1 month 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, 5 months ago)
Lords ChamberMy Lords, Covid-19 was an unpredictable and unprecedented crisis—a health crisis, an economic crisis, a supply shock, a demand shock—reverberating across the globe. It came out of the blue. How you deal with, respond to and adapt to crises is what matters. The Covid-19 crisis has brought huge emotional tragedy, with sad deaths and a social and economic toll. It has forced us to reckon with the things that mattered most to us as a society and instilled a deep-rooted desire to build back better, looking ahead.
Also, the crisis has seen the best of what business can do in the service of the nation. I declare my interest as president of the CBI. Our UK economy has so many strengths. We have just 1% of the world’s population but six of the world’s 30 best universities, 12% of Nobel Prizes, and 16% of the highest-rated research papers. We are recognised globally as a magnet for international students, start-ups, and entrepreneurs and inward investment. The World Bank consistently rates us as one of the best places in the world to do business Now we need to harness that expertise and ambition as we build back from the crisis, creating jobs, opportunities and shared prosperity across the UK. This year, 2021, is a golden opportunity for the UK to redefine its position in the world.
Right now, businesses are focused on Covid and keeping employees, customers and communities safe. We need to look ahead to the next quarter, the next year, the next decade. At the CBI, we have worked closely with the Government and are grateful for the huge rescue packages, including the furlough scheme, which have saved millions of jobs and businesses. The Budget was a seminal moment and, overall, it succeeded strongly in protecting the economy now and helping to kick-start recovery. The Chancellor has spent more than £400 billion. He has also set out a longer-term economic vision and a further boost to investment. We at the CBI will soon come out with our economic vision for Britain over the next decade to 2030.
To improve business confidence, companies would welcome greater clarity about the evidence base for why the working from home message is not evolving with restrictions, alongside guidance about what companies can and cannot instruct their employees to do in certain situations. The potential availability of home testing is increasingly seen as a crucial enabler for employers. We welcome long-term clarity about workplace testing because businesses see the vital role that testing can play in combating Covid-19 and reopening the economy. Through workplace testing, many have noted the benefits of being able to detect asymptomatic cases that would otherwise have gone unnoticed.
The CBI has also submitted evidence to the Global Travel Taskforce, calling for
“A risk-based roadmap for re-opening … A platform for UK leadership in reopening global traffic, supporting, amongst others, the country’s world-leading aerospace, international high-speed rail and maritime sectors.”
Full credit needs to go to Kate Bingham, who headed the Vaccine Taskforce. She was appointed on 18 May last year. Less than seven months later, on 8 December—V-day—we saw the first inoculation. An amazing three and a half months later, almost 30 million people have been inoculated. Full credit also to Nadhim Zahawi, our Vaccinations Minister. I predicted that we would be able to do 1 million vaccines a day; we did more than 800,000 and, if the supplies are there, we should be able to.
However, we should note what one leading vaccine manufacturer said:
“Our vaccine contains 280 different components that are manufactured in 86 different sites across 19 different countries.”
Any disruption to this supply chain would affect supply. The Oxford/AstraZeneca vaccine was developed with AstraZeneca headquartered in Cambridge in partnership with the Serum Institute of India, with 1 billion doses contracted. Wow—it is phenomenal. We have 400 million doses, three approved vaccines and two more coming down the line. The Prime Minister has already said that we will share our surplus vaccines with the rest of the world. Vaccines, mass testing, a travel protocol and a reopening road map will help tourism and business travel and the hospitality sector, which suffered so much. Can the Minister confirm that, if the numbers of sad deaths and hospital admissions go down to zero before the dates, including 21 June, the economy can reopen sooner, safely?
Finally, what about therapeutics? We are not talking about them enough. Can the Minister tell us about them? They could be a game-changer. Dexamethasone was one. There is Regeneron in the States. Nature published an article on EIDD-2801. There is Ivermectin, a cheap, off-patent, anti-parasitic drug; Oxford University has already started trials. Israel has invented an inhaler that it claims cures Covid-19 in just five days.
One year on and three lockdowns later, the pandemic has seen uncertainty, ambiguity, tragedy, bravery, resilience and adaptability at speed, with government, universities, businesses and citizens all collaborating and working together in a caring, compassionate and empathetic way, which makes me so proud of our great country.
I call the noble Baroness, Lady Noakes.
(3 years, 5 months ago)
Lords ChamberMy Lords, we are talking about self-isolation and test and trace. It is less than three months since 8 December, when the first inoculation took place, and we have vaccinated 20 million people. Hats off to Nadhim Zahawi and everyone involved, for this is remarkable.
Throughout the past week, companies throughout the UK have continued broadly to welcome the Government’s roadmap out of lockdown—I speak as president of the CBI. Businesses back the step-by-step, data-driven approach to reopening, with the hope of ending the damaging “stop-start” of restrictions. We also welcome the return of schools in a few days’ time on 8 March. The Government’s decision to extend the workplace testing scheme until the end of June was excellent news, alongside the roadmap’s reviews into reopening high-risk sectors such as large events and international travel. It is this workplace testing which will identify asymptomatic individuals and cause them to isolate. Business sees the vital role of this in reopening the economy. Firms conducting workplace testing—both privately and through the government scheme—have noted the benefit of being able to detect asymptomatic cases that would otherwise have gone unnoticed. However, confusion remains about what resource from businesses is required to sustain workplace testing, and how it will interact with community surge testing and NHS Test and Trace, particularly as the economy reopens. Could the Minister tell us more?
Firms undertaking testing privately are highlighting how disparate the testing market is. CBI members are saying that the cost of a single test ranges between £5 and £20, and that is unsustainable. To build confidence and encourage the implementation of workplace testing across all workplaces, businesses require clear guidance on how it interacts with other policies such as Covid-secure guidelines and vaccinations. Does the Minister agree that data, and not dates, should drive the reopening of the economy? If vaccinations increase from half a million per day to 1 million per day—as we have the capacity to do if the supply comes on line this month, as I think it will—that will mean more than 20 million per month, and we will be able to vaccinate the population well ahead of the government forecast. Every day earlier the economy can reopen is every day that livelihoods will be affected, in industries such as hospitality, aviation and tourism. Does the Minister agree that we would need to review those dates if, in the optimistic scenario, we were well ahead of the game and infections, cases and the sad deaths dropped to zero before 21 June?
(3 years, 6 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, 7 months ago)
Lords ChamberMy Lords, it is absolutely essential that we put the health of our citizens first. The economic impact of the new restrictions is significant. We have to ensure that firms have the cash flow to make it through and that they have a clear line of sight that the support will continue, including the furlough scheme possibly being extended until June. I can say as president of the CBI that British business stands ready to play its full part in the vaccine rollout, increasing massive rapid testing and acting flexibly to support employees, particularly with regard to their mental health.
The vaccines Minister, Nadhim Zahawi, said that 99% of deaths could be stopped by vaccinating the top nine priority groups laid down by the JCVI. The Government have said that there is no shortage of glass vials, for example, and AstraZeneca and Pfizer have said that they can supply vaccines fast enough. The Government have set the target of 13.9 million people to be vaccinated by 15 February, yet the Tony Blair Institute for Global Change recently issued a report saying that the UK could have access to 3 million doses a week by the end of January, 4 million a week by the end of February and 5 million a week by the end of March, so it must have the ability to distribute those. It should be all hands on deck: hospitals, healthcare facilities, car parks, warehouses, offices, everything, including the Armed Forces, which were brilliant with the Nightingale hospitals, and, as I said earlier, businesses—we are all standing by to help.
I want to ask the Minister about airport testing. Nine months after business and the aviation industry were crying out for testing on arrival and before boarding planes, the Prime Minister has finally admitted this week that measures will be brought in. Tests need to be taken 72 hours before departure, as is done in many other countries. Heathrow’s chief executive, John Holland-Kaye, has said that there should be a common international standard. For the first time, Paris has overtaken Heathrow. Let us act on this quickly now.
(3 years, 7 months ago)
Lords ChamberMy Lords, I congratulate the Government. The Minister just announced the MHRA’s clearance of the Oxford University AstraZeneca vaccine. I congratulate Kate Bingham and the Vaccine Taskforce on this phenomenal example of collaboration between business, universities and the Government, and of international collaboration between Sweden and Britain. India has a contract for 1 billion doses to the Serum Institute of India—the largest vaccine manufacturer in the world. Could the Minister assure us that there will be all hands on deck for vaccinators, including retired doctors and nurses, wherever we can get volunteers, and that we will use all possible premises, including workplaces, as long as they are in a safe supervisory environment?
There was an excellent article in the FT the day before yesterday on rapid Covid tests, titled:
“Rapid Covid tests are being used more widely: can they be trusted?”
Yet here we have the example of Britain and France using rapid Covid tests to unblock the 48-hour blockage of movement. Enabling the use of these tests has saved so much. Can the Minister confirm that permission was granted on Tuesday for the public to use these tests on their own? Will the lateral flow tests now be available to the public? Professor Sir John Bell, Regius Professor at Oxford University, said:
“Testing asymptomatic people is an enormous priority … If there’s no testing, they don’t get caught. Every successful positive you get is a win.”
Surely that gives validation to this, yet we have others who say that we will miss half the cases. Professor Tim Peto of the University of Oxford said:
“They’re not perfect, but that doesn’t stop them being a game changer for helping detect cases of infectious disease”.
Would the Minister agree? There is also the very clear example of Slovakia. That test was employed throughout the country and lead to a 60% to 70% reduction in the rate of infection across Slovakia.
There is no perfect test. “Everything is a compromise”, according to Jo Martin at Queen Mary University. The best will otherwise be the enemy of the good.
Baroness Royall of Blaisdon. No? I call the next speaker, the noble Lord, Lord Greaves.
(3 years, 8 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.