Covid-19: Obesity
Lord Lilley Excerpts(3 years ago)
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Lord Bethell (Con)
My Lords, the Government take the advertising of unhealthy foods seriously, which is why we have commissioned this consultation. It has not finished yet so it is not possible for me to pronounce on its findings, but I assure the noble Baroness that we are looking at this issue extremely carefully indeed.
Lord Lilley (Con)
Does my noble friend agree that the determination of the opposition parties and much of the media to pin the blame for the high level of deaths in this country from Covid on the Government has obscured the fact that the major reason why we suffer from a high mortality rate, compared with other countries, is that we are fatter than other countries? Nearly two-thirds of adults in this country are overweight, and the number of obese people in this country is six times the proportion of obese people in Japan. Can we give those facts to people? They can then make their own decision on whether to take this risk or not.
Lord Bethell (Con)
I thank my noble friend for his question. It is for others in the post-mortem process to pronounce on the exact cause of deaths during Covid, but it is an unavoidable fact that, of the 2.5 million Covid deaths reported by the end of February, 2.2 million were in countries where more than half of the population is classified as overweight; that includes Britain. This is a stark fact that, as my noble friend rightly points out, is sinking in among the British public. We want to use this fact as an inflection point—it is an opportunity —to give people the inspiration they need to take the necessary steps towards healthy and fit living.
Covid-19: Restrictions
Lord Lilley Excerpts(3 years, 3 months ago)
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Lord Bethell (Con)
The noble Baroness quite rightly pays tribute to the work of the NHS. An enormous amount has been done on the marginal expansion of ICUs. My local hospital, University College Hospital, has increased the number of beds from 19 to 52 by expanding the scope of the wards and the oxygen supply. We have put a huge amount of work into A&E units, often building out the front of the units to create more space. Those marginal differences are being extremely effective, and that is our first line of defence. The Nightingale hospitals are there as back-up and, if they are needed, we will bring them into play.
Lord Lilley (Con)
My Lords, perhaps I may break with convention and the advice I was given when I first entered Parliament and ask a question to which I do not already know the answer. Every week, the Government submit figures to EuroMOMO for deaths from all causes. During the spring, the figures showed a huge level of excess deaths over the normal, but currently, and in recent weeks right up to the end of last year, they show almost no excess over the normal level of deaths in this country. That conflicts with all the evidence we are seeing from hospitals and elsewhere. Can my noble friend reconcile the figures and the facts?
Lord Bethell (Con)
The CMO has given some guidance on this matter. He has made the observation that deaths from other flus are down, partly because of the social-distancing that is part of the lockdown. He has also pointed out the very sad, but I am afraid inevitable, possibility that the large amount of infection that has grown up in the last few weeks will in time lead to further deaths. This is an uncomfortable piece of speculation but, as sure as night follows day, I am afraid that infections and hospitalisations will lead to further deaths. We are running at nearly 1,000 a day at the moment and that number is set to increase.
Health Protection (Coronavirus, Restrictions) (All Tiers) (England) Regulations 2020
Lord Lilley Excerpts(3 years, 5 months ago)
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Lord Lilley (Con)
My Lords, it is a pleasure to follow my noble friends Lord Howard of Rising and Lady Neville-Rolfe, whose regret Motion I am minded to support.
The Prime Minister has an unenviable task—that of balancing not just health and economic impacts, but conflicting evidence and views, the majority of which, I suspect, are opposed, within Cabinet and among his advisers, to his own instincts. He has been criticised for not imposing those well-known libertarian views on the majority in Cabinet. Prime Ministers are not, however, dictators. I remember Mrs Thatcher, after spelling out her support for a proposal, asking her Cabinet Ministers for their views, all of whom dissented, turning to Nigel Lawson and saying, “Am I alone in supporting this policy?”. To which he replied: “Yes, Prime Minister, but you are not without influence”. I am glad that some of the Prime Minister’s influence has been brought to bear, otherwise these regulations would be even worse.
But there are reasons we should be sceptical about these latest proposals. First, the Government claim to be “following the science”, but there is no such thing as “the science”—there are scientists, who have opinions, and there is the scientific method. That was explained by the great scientist Richard Feynman, who said: “You make predictions on the basis of your theory or model, you compare them with the facts; it doesn’t matter how beautiful your model is, or it doesn’t matter how smart you are, if the model doesn’t agree with the facts, it’s wrong”.
We know that the original assumption that coronavirus would behave like flu was wrong. We know that the Imperial model predictions of half a million deaths here and 85,000 deaths in Sweden were wrong. We know that Sir Patrick Vallance’s prediction of 50,000 cases by the end of October was wrong. We know that on the chart used to frighten us into lockdown on 5 November, every single forecast of deaths over the coming months—not just that of 4,000 a day—has proved wrong. We know that half the graphs used during that extraordinary press conference ahead of the second lockdown turned out to be mistaken or used outdated forecasts, which had subsequently been revised down—which was wrong. We know that the chart leaked to Laura Kuenssberg, showing hospital capacity being overwhelmed, was never issued and has proved wrong. It is reasonable to be sceptical about the projections of what will happen if we do not adopt the measures before us today.
Of course, we all make mistakes, but the second reason for being sceptical is that these mistakes have not been random errors. There have not been some too low, some too high, some too alarmist, some too complacent. All of them have been in the same direction: exaggerating the risks and dangers. I am sure that has not been deliberate, but when errors all point in one direction, it is a sure and certain sign of groupthink. Groupthink is a mindset which can grip any of us, especially if we are convinced that we are in the right and others are in the wrong. Those in the grip of groupthink tend to accept without questioning too closely any evidence which supports their beliefs and discount anything which casts doubt on them, and they tend to ignore the costs of their actions and exaggerate the benefits.
That brings me to the third reason for scepticism, which is that these proposals were not based on any systematic, quantitative analysis of their impact—positive or negative—nor of their costs and benefits. It is not just that the document the Government rushed out yesterday is, to put it mildly, less than convincing; it is because the Government did not even have such an analysis themselves when they reached their decision.
There is an underlying problem which lies behind the Government’s explanations. They seem to believe that R is a constant, and that consequently infections will double every X days—after X days there will be twice as many, after 2X days there will be four times as many, after 3X days there will be eight times as many, and so on. They seem to believe that infections, deaths and the numbers of people in hospital will slow down or decline only as a result of government restrictions, hence the official claim that national and regional peaks occurred after the new measures were introduced. It is simply not true: the peak occurred before these measures were introduced, and there are only two possible reasons for that. One is that R declines as the virus spreads, because the natural spreaders get it and cease to spread it thereafter, and because there is more natural immunity in the population than anything like herd immunity was expected to be. The second reason is that people began voluntarily to restrict their social interactions before they were compelled to.
Whichever of these reasons—and I expect both are the case—they are reasons for not relying on the Government’s projections, not relying on the restrictions being introduced in these measures and asking the Government to think again, which is why I am minded to support the amendment to the Motion in the name of the noble Baroness, Lady Neville-Rolfe.
Covid-19: Transparency and Accuracy of Statistics
Lord Lilley Excerpts(3 years, 5 months ago)
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Lord Lilley
To ask Her Majesty’s Government, further to the statement by the Office for Statistics Regulation on the transparency of data related to COVID-19, published on 5 November, and reports that charts on projected daily deaths from COVID-19 have been reissued, what assessment they have made of such reports; and what steps they are taking to review (1) the transparency and accuracy of statistics relating to COVID-19, and (2) the decisions that are based on such statistics.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, the Office for Statistics Regulation is 100% right: the best use of data and statistics is critical in this unprecedented time. All slides and data from press conferences are published on GOV.UK, normally at the time of the press conference. The Government are committed to transparency to build public trust throughout the pandemic; that is why we publish data, the modelling used and any revisions as part of this process.
Lord Lilley (Con)
I thank my noble friend. Does he realise that this rebuke from the statistics regulator is unprecedented, as is the unparalleled series of errors, dubious charts, outdated data and failed projections? It would be bad enough if those errors were random, but they all point in the same direction: alarmism justifying a lockdown. It is invariably a symptom of groupthink when sincere people—I have been there myself—become so wedded to a prediction or policy that they uncritically accept evidence that supports it and ignore facts that challenge it. Will he heed the warning of the great Professor Feynman: when you convert even the finest scientists into policy advocates, you risk ending up with what he called cargo cult science? Should we not leave advocacy to politicians and ask scientists for balanced advice?
Lord Bethell (Con)
My Lords, we are grateful to the Office for Statistics Regulation for its challenge; its points were perfectly reasonable and we take them on board completely. However, I reject the characterisation made by my noble friend and his suggestion that the modelling is either political or erroneous in some way. I remind him that, in January, the modelling showed that the epidemic in China was considerably larger than anything reported at the time. In February and March, we used data from the “Diamond Princess” and elsewhere to show how the threat of Covid was much larger than had previously been understood. In March, we showed that the epidemic in the UK was doubling every three to four days, allowing us to make the difficult decision to lock down. Throughout the spring, the modelling demonstrated that half the UK had not been infected, as previously thought.
In mid-September, the modelling showed that we were at the start of a second wave, despite those who said that there was no evidence of it. It also showed that the uptick in cases involving younger people would spread to older adults and, as a result, into healthcare. Most recently, the six-week projections of SPI-M that were produced throughout October, based on contemporary trends, have been remarkably accurate at assessing the trajectory of hospital admissions and deaths.
Health Protection (Coronavirus) (Restrictions) (England) (No. 4) Regulations 2020
Lord Lilley Excerpts(3 years, 6 months ago)
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Lord Lilley (Con)
My Lords, these measures involve grave restrictions on the economy and our liberties. They may be necessary, but we should take them only on the basis of sound law and solid data. Unfortunately, they are based on dubious law and dodgy data. So, I have tabled a Motion that
“this House regrets that the Regulations have been laid under the Public Health (Control of Disease) Act 1984, which does not give specific powers to Her Majesty’s Government to impose restrictions on uninfected persons, and not the Civil Contingencies Act 2004, which does.”
I am not a lawyer, but I know a man who is: Lord Sumption. He has spelled out that the Public Health (Control of Disease) Act 1984 empowers Governments only to confine infected persons, not to confine the population as a whole, the vast majority of whom are not infected, and still less to close down large swathes of the economy. None the less, the Government could lawfully do all they seek to do in these and other regulations if they invoke the Civil Contingencies Act 2004. In that case, however, they would be subject to much closer parliamentary scrutiny than has been the case. In my own ministerial experience, parliamentary scrutiny invariably led to better decision-making, if only because officials had to work to satisfy all conceivable criticisms, not just those that their Minister could envisage.
The noble Lord, Lord Anderson, contacted me to say that he, too, considers it regrettable from the point of view of parliamentary scrutiny and arguably unlawful that the Public Health Act 1984 was selected in preference to the Civil Contingencies Act, though he took the view that the courts might find a plausible legal argument for upholding regulations made on this basis. Will the Minister either provide a convincing rebuttal of Lord Sumption’s critique, or use the Civil Contingencies Act in future?
I may not be a lawyer, but I did take the Institute of Statisticians’ exams half a century ago and I have been allergic ever since to statistical jiggery-pokery. Noble Lords may recall the gang in Oxford Street which I used to watch fleecing gullible passers by using the three-card trick. They were eventually exposed when a covertly taken film, played back in slow motion, revealed how the trick was done. Ed Conway of Sky News has performed a similar public service by showing, slowly and methodically, how official sleight of hand has misused the figures to justify this lockdown by creating a scarier illusion than they warrant. I urge every noble Lord to google: “Ed Conway: Why doesn’t the Government give us all the information” to see how this trick has been performed.
In brief, we were told at the weekend that the Government’s case for the lockdown rests on the fact that the virus is now spreading even faster than the Government’s reasonable worst-case scenario. Most of us assumed that that referred to the scary projection by Sir Patrick Vallance in mid-September showing reported cases doubling every seven days, to reach 49,000 a day by the end of last month. Far from spreading faster, reported cases are growing less than half as fast—just 20,000 per day. Sir Jeremy Farrar, of SAGE, rushed to Patrick Vallance’s rescue, claiming that his projection has been met, citing the Office for National Statistics’ figures that new infections are running at about 50,000 a day. However, to compare new infections with reported cases is comparing oranges with pumpkins. New infections include non-symptomatic cases and are typically two and a half times as numerous as reported cases, which Patrick Vallance was using.
The Government then claimed that Vallance’s projection was not the realistic worst case. It was certainly never realistic, and it has proved far worse than reality, but the Government refused their actual realistic worst case. Fortunately, the Spectator got hold of an official realistic worst-case scenario for projected deaths. It assumed that the second wave would not begin until mid-November, apparently unaware that students return, the weather gets colder and evenings darker, well before then. Stark data apart, the curve of deaths that have actually happened during the real second wave has followed closely the curve of the projected one. It does not overshoot the scenario for which the NHS has been planning. In short, instead of evidence-based policy, we have seen policy-based evidence.
I am not claiming that a second wave is not serious; it is. I am not suggesting that no action is required; it may be. But using a weak legal base and playing fast and loose with the statistics can only undermine trust in what is proposed in these regulations.
Lord Lilley
At end insert “but that this House regrets that the Regulations have been laid under the Public Health (Control of Disease) Act 1984, which does not give specific powers to Her Majesty’s Government to impose restrictions on uninfected persons, and not the Civil Contingencies Act 2004, which does.”
Health Protection (Coronavirus, Local COVID-19 Alert Level) (High) (England) Regulations 2020
Lord Lilley Excerpts(3 years, 6 months ago)
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Lord Lilley (Con)
My Lords, I congratulate the Prime Minister on resisting the pressure for a renewed lockdown. Fewer than 1% of those dying from Covid have been of working age with no comorbidities, so our main aim is to protect the elderly and the frail.
There are two possible strategies. One is to help the elderly and frail avoid succumbing to the infection and the second is to limit the spread of the infection, primarily among those of working age who are unlikely to succumb themselves, but who may infect the elderly and frail. These strategies are not mutually exclusive. Unfortunately, in the regulations we are debating, the Government have put the bulk of their effort into the second strategy. But focusing on the economically and socially active all too often reduces economic activity, destroying livelihoods. I urge Ministers to try to avoid measures that disproportionately harm economic activity, with little likely effect on the rate of infection. The most obvious example of this is the 10 o’clock rule.
At the same time, the Government should put more emphasis on enabling the elderly and frail to avoid infection. In Germany, elderly people in multigenerational households are enabled to live separately in otherwise unused hotel space. Why not also give much more prominent advice to everyone, especially the elderly, to take vitamin C and zinc supplements and to lose weight, all of which will help them be less vulnerable to not only Covid but other ailments?
Testing should be the best the best way to help to protect the elderly and to minimise the adverse impacts of these regulations on the economy. On 14 September, I tabled a Question for Written Answer to try to clarify the Government’s position on this. I referred to the claim by the Secretary of State for Transport that testing could not be used to minimise quarantine for travellers because
“even using highly accurate tests, the capture rate of those carrying Covid-19 may actually be as low as 7%.”—[Official Report, 9/9/20; col. 775.]
What scientific evidence is there for this capture rate? What period after infection did it refer to, and if tests were not identifying infectious visitors to this country, why are we relying on the same tests for the staff and visitors to old people’s homes?
The Question was due to be answered on 28 September, but officials are clearly struggling to find one. I would be grateful if the Minister could either give the answer himself or tell me when I will receive an answer. Whatever it is, it may well have a bearing on the sort of regulations and strategy that we should be following.
Covid-19: Mental Health
Lord Lilley Excerpts(3 years, 10 months ago)
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Lord Bethell [V]
The noble Baroness, Lady Brinton, is entirely right to raise the issue of attendance. One of the greatest concerns during the epidemic is the declining attendance at mental health services, at primary care level and in hospitals. We are working hard on that. Last week, we launched the first aid kit for psychological first-aiders. Public Health England has launched this important resource, and it is indicative of the kinds of measures we are putting in place to address the inequalities of which the noble Baroness speaks.
Lord Lilley (Con) [V]
My Lords, although it is strange to describe people who are, not surprisingly, worried about the current situation as suffering mental health problems, we should be concerned that so many young people are worried and stressed at present. Will my noble friend reassure any young people who have exaggerated fears of Covid-19 that they are more likely to be killed by lightning? I expect that many more young people have justified worries about the threat to their education and future job prospects. Will he abandon the physical distancing rule in schools and colleges, where it is unnecessary, and cut it to one metre elsewhere to enable the economy to recover?
Lord Bethell [V]
My noble friend is entirely right that the fears described as mental health issues are about not only Covid itself but the economic and social consequences. The impact on mental health of the financial crisis 10 years ago was profound, and largely driven by fears of economic hardship. That is paramount. Reducing the distancing is not currently government policy, but we have that under review and news is expected.