Covid-19: One Year Report
Lord Farmer Excerpts(4 years, 3 months ago)
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Lord Farmer (Con) [V]
My Lords, the Coronavirus Act one-year report, published earlier this week, states:
“Since the start of the pandemic, we have dramatically improved our understanding of the virus: the physiological impact it causes, how it transmits, and most importantly, the measures we can take to reduce infection.”
What it tellingly neglects to say is that we have also, dramatically and painfully, improved our understanding of the mental and physical health impacts of those measures—tellingly, because our draconian restrictions have produced a new social order that has infection reduction as the one overriding priority, regardless of how low infections are.
A public health-determined yardstick of risk is firmly in the ascendant and seems likely to remain so for the foreseeable future. Polling showing public support for restrictions cannot be the sole occupant of the driving seat in this House. We are here to scrutinise the likely effects of legislation. We know enough about the effects of lockdowns to give us pause before we renew the regulations being debated.
For the sake of time, I will focus on brain and mind. The monotony of lockdown depletes our memories and makes us sluggish, and screen overload cramps our ability to concentrate. Isolation causes brains to shrink. Lonely people’s brain volumes reduce in the region affecting decision-making and social behaviour. Prolonged isolation affects regions associated with learning, memory and the processing of emotion. Basically, the processing capacity of a brain not constantly challenged through social interaction begins to decline. Loneliness releases stress hormones affecting neuro- transmitters such as dopamine, serotonin and adrenaline, which profoundly influence brain function and mood. It also sharply increases the rate of Alzheimer’s disease among the elderly.
Finally, uncertainty drowns creativity—the elixir of progress and the main natural resource for our island race. We were told that the road map would bring certainty, but instead its rate-determining steps inherently mean constantly changing goalposts. For example, if risk assessment is fundamentally changed by new variants of concern, does that mean, as some fear, that our borders will remain indefinitely closed?
Fear is an important factor, which the Government and their spokespeople in the scientific community seem to have no interest in dissipating, possibly because they see it as a vital tool of social control to force people to abide by our particularly extreme restrictions. Their effect has been to penalise the many, due to fear of the misbehaviour of the few. Holidays always seem one more unattainable metric away.
Many parallels have been drawn with the Second World War and the need to keep morale high over that long campaign. I am not a historian of that period, but I seem to recall that the population were regularly inspired to keep going. The diet of public pronouncements we have been living on cannot be so described. Deaths—key to another of the four criteria—are now even lower than in non-Covid times, but this is hardly mentioned. Fear can now be retired and inspiration can take its place.
Finally, if SAGE meeting attendance is determined by the Chief Scientific Adviser and the Chief Medical Officer, surely the likely emphasis will be the low level of risk acceptable to public health, leaving little oxygen for mental health and other considerations, such as the need to boost morale, resuscitate the economy and get those who have been laid off working again. My question for the Minister is: at what daily rate of infections, hospitalisations and deaths will we unlock?
At the risk of sounding dramatic, many are concluding that a world run according to a level of risk acceptable to public health is one that might be hardly worth living in. It is absolutely clear that, when the day of reckoning comes as to their handling of the pandemic, the Government will be held to account not just for how well they held down infections but for how they balanced this against these other harms that have emerged over this torrid year.
Women’s Health Strategy
Lord Farmer Excerpts(4 years, 4 months ago)
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The Deputy Speaker (Lord Duncan of Springbank) (Con)
My Lords, we now come to the 20 minutes allocated for Back-Bench questions. There are 13 questioners and only 20 minutes, so pith is the order of the day.
Lord Farmer (Con)
My Lords, I have constantly argued against the lack of emphasis on prevention in the Domestic Abuse Bill and have been assured that the domestic abuse strategy and guidance will fill that gap. Domestic abuse disproportionately affects women’s mental and physical ill health, so will the new women’s health strategy prioritise its primary prevention, rather than, as usual, simply addressing its terrible harms?
Lord Bethell (Con)
I pay tribute to my noble friend for his campaigning on this important cause. It is not the specific focus of the health strategy but it will play a part in it, and I encourage my noble friend to submit the characteristically detailed evidence, for which he is so well known, to this important evidence-gathering process.
Covid-19 Vaccines Deployment
Lord Farmer Excerpts(4 years, 5 months ago)
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Lord Bethell (Con)
My Lords, I do hear the noble Baroness and I would be happy to look into this matter further. However, my understanding is that the vaccination rates among care home staff are much higher than she describes. It is not unusual for care home staff to have their health provided for by the local NHS, and for them to be required to travel to receive that support. That is quite normal for anyone getting a vaccine, even if they work in social care. It is entirely in our interests to make sure that social care staff are vaccinated, so there is no way that there is any kind of policy or deliberate effort to avoid vaccinating care home staff. However, I will be glad to look into this further and, if I may, I will copy the noble Baroness into the correspondence that will clearly result from this debate.
Lord Farmer (Con) [V]
My Lords, having vaccinated the vulnerable tiers, at what level do we revert to normal, bearing in mind, first, that the remaining population is highly unlikely to require hospitalisation or to die from Covid; and, secondly, the mental health stresses which are starting to unravel our social fabric? On that note, do any members of SAGE have recognised expertise in mental health, so that their advice is weighted to this consideration as well as to others?
Lord Bethell (Con)
My Lords, the honest truth is that I cannot lay out a timetable for my noble friend. That will happen in the week of 22 February and the Prime Minister has made that clear. He is entirely right that the vaccine dramatically reduces hospitalisation and death. Target groups 1 to 4 account for nearly 90% of the deaths, so this is a dramatically improved situation. However, it does not remove the threat of Covid altogether. At the moment we have an infection rate of around 2% in the country. Were we to open up tomorrow, that infection rate might lead to a much higher rate: 10% or 20%. If we ran at a rate of 20% we would have a very large number of young people who would end up in hospital one way or the other, and who might experience long-standing damage from the Covid disease. We would also increase the rate of mutations in our own country and we would have a great displacement of that effect on the rest of the NHS system.
So this is not a binary game in which we have suddenly hit the moment where we can lift everything. We have to tread cautiously on that. However, I agree with my noble friend that the mental health impact of the lockdown is intense. I reassure him that two members of the SAGE subgroup SPI-B are members of the British Psychological Society. SPI-B presents the independent expert behavioural science to advise the top SAGE—the Scientific Advisory Group for Emergencies—and it brings to the debate a very clear insight on mental health and brings to our awareness the impact of lockdown, which, as my noble friend quite rightly points out, is immense.
Covid-19: Vaccinations
Lord Farmer Excerpts(4 years, 6 months ago)
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Lord Bethell (Con)
My Lords, I would put the truism slightly differently: the vaccine makes you pretty safe, but it does not mean you are not dangerous to other people. I think we all have to get used to that. Regarding the South African variant and the other variants popping up in Brazil and elsewhere, this is a manifestly different disease that is growing up around the world. It has a huge implication for international travel. We are working with the WHO and other groups to try to understand this, but it is certainly of grave concern to the country.
Lord Farmer (Con)
My Lords, I join many others in applauding the Minister and the Government on their vaccination energy and foresight, and for being leaders in the world, frankly. Given the Minister’s zeal and energy, he informed the House on 30 November that the SIREN and Oxford healthcare workers studies would report on the level of sterilising immunity provided by natural infection before the end of 2020. Have they concluded that antibody protection can be relied upon for at least six months after infection, or longer, and what are the implications for herd immunity?
Lord Bethell (Con)
My Lords, the SIREN study is an important study on antibody protection. My understanding is that it is due to be published very soon indeed, and when it is, I will be glad to share the insight with my noble friend.
Covid-19: Variant
Lord Farmer Excerpts(4 years, 6 months ago)
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Lord Bethell (Con)
The noble Baroness is entirely right that the EpiData showed that the figures shot up in December; that is exactly why we looked extremely carefully at the genomic data from Kent and other places. As she knows, genomic data takes time to process—the tests can take a week to turn around. Looking at all the variants and matching EpiData figures with genomic data is an enormously complicated mathematical task. We moved as swiftly as possible and far faster than in many other countries.
Lord Farmer (Con)
My Lords, at the Downing Street press conference of 5 January, we were told that people had protection from the new variant if they had already been infected. What is the Government’s estimate of the number of people in the UK who now have antibodies after contracting the virus and are therefore likely to be immune? What is their approach to the large population of such people, estimated by Professor Neil Ferguson to be at 25% to 30% in London, and their need for vaccination?
Lord Bethell (Con)
My Lords, PHE weekly seroprevalence data suggests that antibody prevalence among blood donors aged 16-plus in England is 6.9%, which is consistent with other data that we have. The MHRA has considered this and has decided that vaccinating is just as important for those who have had Covid-19 as it is for those who have not.
Covid-19 Update
Lord Farmer Excerpts(4 years, 7 months ago)
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Lord Bethell (Con)
My Lords, I am not sure that I accept the premise of the question. The scepticism that the noble Baroness describes has not stopped millions of people stepping forward to have tests. Our experience is that those who have direct experience of test and trace—whether they are people who use the app, people who turn up for testing, people who go to hospital and have tests through the NHS or people who are traced—speak of the good service and experience that they have. It is undoubtedly true that test and trace takes a hammering in the press, and its reputation has been hard hit by sceptics who talk down its performance, but, generally speaking, those who actually experience it speak highly of the service.
Lord Farmer (Con)
My Lords, just 10 days ago, Professor David Eyre of the University of Oxford reported that, for most people, being infected with Covid-19 protects against reinfection for at least six months. He said:
“This is really good news, because we can be confident that, at least in the short term, most people who get COVID-19 won’t get it again.”
Washington State University research found that just one case out of the multiple millions worldwide suggested that waning antibody levels or a poorly developed immune system to Covid could put people at risk of reinfection. I am aware that studies need to be replicated, but this good news seems to be a very well-kept secret, ignored on the official government web page on the relevance of antibody tests. What would give the Government confidence that potent antibodies linger beyond at least six months in the majority of cases and how small would the tiny minority of proven cases of reinfection have to be in order for them to say that this risk is a price worth paying for society to begin to get back on its feet?
Lord Bethell (Con)
My Lords, the Government—and I personally—are extremely interested in this area. Early findings of a study by the Coronavirus Immunology Consortium and Public Health England, which have not been peer reviewed yet, suggest that a strong cellular immune response is likely to be present in the majority of adults six months after infection. At present, there is not enough evidence to rule out people who have positive T cell responses or antibodies to Covid-19 from potentially still playing a role in transmitting the virus to others. However, further research on the level of sterilising immunity provided by natural infection should be available from the SIREN study and the Oxford healthcare workers study before the end of the year. I look forward to the results of those studies very much.
Covid-19 Update
Lord Farmer Excerpts(4 years, 9 months ago)
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Lord Farmer (Con)
My Lords, in the other place yesterday, the Secretary of State was very definite that the virus is transmitted from surfaces. However, this has been recently disproved, for example by Professor Gandhi of the University of California and the microbiologist Emanuel Goldman, who state that while the virus may persist on surfaces, the traces involved are not viably infectious. Will their important new research now be instilled into our response to Covid, so that we can start to move on to “project hope”?
Lord Bethell (Con)
My Lords, I am extremely grateful for my noble friend’s recommendation. It is a source of huge frustration, and amazement to me on some level, that the precise nature of transmission in all cases is not crystal clear. I am not sure that I would completely agree with my noble friend that it has been thoroughly disproved that the disease can never be transmitted from surfaces. In fact, there are others who think that this may actually be a very important vector of transmission. We certainly do not understand the full nature of the way in which aerosol transmission behaves, and it is likely that it is a mixture of them both. That is why we urge the country to comply with the Hands, Face, Space protocols.
Covid-19: Local Restrictions
Lord Farmer Excerpts(4 years, 10 months ago)
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Lord Bethell (Con)
My Lords, I have before me a large list of eight or nine public portals where exactly that information can be received. I will lodge links to those portals in the Library and on my Twitter -feed.
Lord Farmer (Con) [V]
My Lords, there is a marked polarisation in the country, particularly evident in attitudes towards and poor rates of return to work. Many would agree that this is not about where people can work most effectively but about unnecessary fear, given what the science says about transmission. What are the Government doing to reduce the level of polarisation in the country?
Lord Bethell (Con)
My Lords, we are working extremely hard to create confidence in the Test and Trace system and in the effectiveness of our two-tier system of hands, face and space combined with Test and Trace. We are appealing to the country to take necessary precautions but within those precautions to go about everyday life.
Dental Care
Lord Farmer Excerpts(5 years, 1 month ago)
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Lord Farmer
To ask Her Majesty’s Government when they plan to permit the resumption of routine dental care.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, the NHS and the Chief Dental Officer have worked hard to reopen the dental sector, with the aim of restarting routine dental care as soon as we safely can. In the meantime, over 500 urgent dental treatment centres have been set up in each NHS region, to provide urgent face-to-face care for patients.
Lord Farmer (Con)
I thank the Minister for his reply. Untreated and moderate dental problems can become severe and potentially life-affecting. Infected teeth were a major cause of death in the 19th century. I note the 500 urgent dental care hubs already set up in England following strict guidelines, but can my noble friend say why the regulator cannot simply modify the existing guidelines used in the hubs to make them transferable to local dental practices?
Lord Bethell
The noble Lord is entirely right that poor dental care is extremely damaging to individual health. The current situation is one that we massively regret, but the safety of patients and dental professionals is paramount. The aerosols generated by dental drilling and other dental practices leave the threat of germs in the air in a dental practice for hours to come, which could be caught by staff or future patients. It is for that reason that we have focused the infection protocols in 500 special units that have the right kit, the right training and the right arrangements.
Covid-19: Social Care Services
Lord Farmer Excerpts(5 years, 2 months ago)
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Lord Farmer (Con)
My Lords, I, too, congratulate the noble Baroness, Lady Wheeler, on initiating this important and well-timed debate. I will speak today about children’s social care and how supporting those on the edge of it can prevent this crisis from being the tipping point when they become looked after by the state. First, however, we should acknowledge the families who are flourishing now that they are no longer in the time famine of normal life, even though money and space are tight. Many children are enjoying being with their fathers, for example.
On those in social care, the Government are consulting on reforms to the use of unregulated care homes which include banning this provision for under-16s and introducing national quality standards. In these strange times, young people currently in such accommodation are out of the sight of social workers and others, who have high case loads. I have heard that these professionals are seeing only the highest-need families face to face. Some have adapted well and are catching up with young people directly, for example through WhatsApp, but such flexibility might be patchy. Can the Minister inform me whether a national assessment has been made of the welfare of those in unregulated accommodation during this crisis?
More broadly, the Government have committed to reviewing the care system. For the system to be sustainable going forwards, this review requires what I call the prevention pipeline. It should establish how we can best prevent, first, children from coming into care in the first place and, secondly, the care system from being a runway into educational underachievement, unemployment, criminality and prison, early parenthood, addiction and poor physical and mental health.
Early family support is essential to prevent children from tipping across care thresholds. Many local authorities have set up family hubs where families with children of any age can access help. I have set up the Family Hubs Network, which has held several virtual round tables with providers, who report that hubs have come into their own in this pandemic. They are offering food, maternity appointments, a rich programme of online family support and more. I understand that the DfE is leading on family hubs, but can the Minister inform me whether and how it is supporting their spread?
The Deputy Speaker
I call the noble Baroness, Lady Blower. She is not here. We will move on to the noble Lord, Lord Addington.