Living with Covid-19

Lord Newby Excerpts

Tuesday 22nd February 2022 Lords Chamber

[Baroness Smith of Basildon (Lab)]

My Lords, the Prime Minister was clearly very upbeat throughout his Statement yesterday, announcing an end to all legal Covid restrictions in England and setting out part of the Government’s living with Covid plan. The pace and the efficiency of the vaccine programme, the justification for the changes, has been extraordinary. I again commend and thank the scientists, staff and volunteers of the National Health Service, and indeed some Ministers, for their collective efforts.

As many in your Lordships’ House have said before, Covid and our necessary response to it has taken an enormous toll on the nation’s physical and mental health, on society as a whole and on every aspect of our economy—we are all desperately keen to get back to how things were. Yet even the Prime Minister admits that Covid is not going to suddenly disappear, which means that this next stage—with a now hopefully much reduced virus—has to be well thought out, manageable and resilient over time.

I would like to probe the background to the decision with the noble Baroness and clarify some of the points about how we move forward. First, as the noble Baroness is aware, the BMA and other bodies do not believe that the decision is evidence led. Can she offer any reassurance to your Lordships’ House and state whether the decision is in line with the recommendations of SAGE, as well as those of the Chief Medical Officer and Chief Scientific Adviser?

On these Benches, we are optimistic that we could well be moving on from the very worst of this pandemic. Vaccinations, testing and self-isolation have been highly effective in reducing infections and transmission and thereby reducing the likelihood of new variants. But the SAGE advice is that something worse than omicron will be an ever-present threat. So, with all the restrictions being removed, there is real concern that ending the legal requirements to isolate and stopping free tests on 1 April feel quite arbitrary. So, can the noble Baroness say anything further about the evidence base for the timing of those two points following restrictions being removed, and commit to placing supporting information in the Library? Also, will there be an impact assessment on the consequences of lifting restrictions all at once, alongside the testing and self-isolation, and what mitigations are being considered?

On self-isolation, the Prime Minister draws a comparison with flu in terms of staying at home. Yet we know Covid is much more highly transmissible. If I have understood this correctly, the advice is to make a personal decision on whether or not to self-isolate. But without a legal requirement, what assessment has been made of high-risk workplaces such as care homes and the National Health Service? The noble Baroness will understand that most people want to do the right thing. But some are going to struggle with, on the one hand, guidance telling them to self-isolate if positive, and, on the other hand, pressures—either financial or from an employer—forcing them to work.

Can the noble Baroness also provide further details on the cost of purchasing tests? With rapidly increasing household bills, paying for testing, particularly where an employer might require it, will be an additional pressure for many. The Prime Minister has said that free tests will be available to the oldest age groups and the most vulnerable. What about those working with them? In the Statement, Mr Johnson merely offered that the Government were working with retailers to supply tests, so can the noble Baroness shed any further light on this, including on whether the reports of £3 for each individual test are accurate and whether the price will be fixed?

Also, will there be a greater effort to support UK manufacturers rather than relying on imports? Most of the tests I have had have come from China. Also, what is the Government’s response to concerns about the sale of the UK’s flagship Vaccine Manufacturing and Innovation Centre in Oxford, at a time when vaccines are so important?

The Prime Minister reflected on the eye-watering amount of money spent on test and trace. He said it was more than the entire budget of the Home Office. Given the criticisms of that service, is the noble Baroness satisfied that the budget was well managed and value for money, or will an independent assessment be made of this?

In terms of going forward, despite the success to date of vaccines, only two-thirds of those eligible for a third jab have had one. The advice is that two jabs are not enough to provide maximum protection. With all the regulations being scrapped, how will the Government ensure that everyone eligible for a booster actually gets one? With the evidence that immunity and protection are reduced quite significantly over time, we welcome the rollout of a further booster for those who are over 75. Can the noble Baroness say how long this will be for? Will it be ongoing at least for the foreseeable future, perhaps as people reach their 75th birthday?

In the Statement, the Prime Minister committed to monitoring future outbreaks. That seems sensible. But what was missing from the Statement was what the Government would do if they identified such an outbreak—or even if the emergence of a new variant was identified. Without testing and self-isolation for those infected, I am not clear what the Government’s plan is. So, can she provide any further information on that and the purpose of the monitoring, or write to me if it is not yet available?

It is absolutely critical that the right measures are in place to support people to make the right, proportionate choices going forward. We know now that, moving forward, we have to live with the virus. But that is not the same as ignoring it, and I am really not sure that the Government have the sequencing of events or the messaging right. Following this announcement, it seems that the message that the Covid-weary public can take away is that Covid is no longer a threat, because it is not essential to know whether you have it or not, as there is no testing, and it is not essential to self-isolate if you have. That is going to lead many to conclude—wrongly, as even the Prime Minister has admitted—that the pandemic is now over. So, can the noble Baroness today give us some reassurance of what the Government’s plans are in the face of any further outbreaks or new variants and what the Government are going to do to encourage the public and signal the importance of everyone getting their booster? Also, reassurance on the issue of government monitoring of any new variants or outbreaks would be really helpful, because we need to understand why the Government are doing that and what the plan is if they identify any.

[Lord Newby (LD)]

My Lords, I begin where the Prime Minister concludes his Statement:

“We do not need laws”,


he says,

“to compel people to be considerate of others. We can rely on that sense of responsibility towards one another”.—[Official Report, Commons, 21/2/22; col. 45.]

If this were the case, many laws would not be on the statute book and, indeed, many aspects of the regulations that we have had in place over the last two years would not have been necessary. For this Prime Minister to claim that we can rely on the sense of responsibility towards one another shows a remarkable lack of self-awareness. He did not behave responsibly even when there were laws in place, so to remove all legal restraints at one fell swoop seems to me, at best, an extremely risky option. Doing so makes sense only if we are confident that the costs involved are manageable.

It is obviously a great relief that numbers are falling and that serious illness is on the wane, but the death only last week of one of my colleagues, having been in ICU with Covid, is a timely warning to us all that this disease is far from done. While everybody agrees that we have to learn to live with Covid, that is not the same as getting rid of every precautionary measure. We need to ensure that cases continue to diminish, the vulnerable are protected and pressure on the NHS is bearable.

The Prime Minister repeatedly said yesterday that taking personal responsibility requires people to test themselves and to self-isolate if they think they have the disease, but, for those on limited income, including the millions who are not eligible for sick pay, the cancellation of self-isolation support payments will make that an impossible choice. If faced with heating or eating, or paying for a coronavirus test, it is pretty obvious which will be the lowest priority. So, we have real concerns about getting rid of free testing, especially for those who are either vulnerable or have family members who are vulnerable.

The latest testing figures show that, every week, nearly 4 million people are taking regular Covid tests—on average, two a week. This includes people who take tests to protect their elderly relatives and friends, as well as vulnerable workers in people-facing industries such as hospitality who are concerned about their health. If people have to pay for this, we estimate that it could amount to an annual testing cost to an individual of up to £500. Does the Minister agree that this is simply unfeasible for many people and is also, in effect, a tax on caring? While the Prime Minister said that half a million people who are the most severely immunocompromised will get free tests, their carers and families will not.

There is also a more important principle at stake here. The Government have consistently said that the NHS is safe in our hands because it is free at the point of need. However, Covid-19 is a notifiable, highly infectious disease under the Public Health (Control of Disease) Act 1984 and the Health Protection (Notification) Regulations 2010, which say that medical practitioners must test potential cases under the NHS so that infections can be managed and monitored. Currently, all notifiable disease tests are free of charge but, from 1 April, that will no longer be the case. So, how can the Government claim that the NHS will continue to be free at the point of need? In this case, it clearly will not.

The Statement refers to SAGE’s concern about the future path of the pandemic, which underlines the importance of the survey work carried out by the ONS and Imperial College. Can the Leader confirm that these surveillance operations at ONS and Imperial will continue on a substantial scale, and can she say how quickly full, free testing and tracing can be restarted in the not unlikely event of another variant emerging?

While vaccination remains a vital tool in learning to live with Covid, some people’s immune systems wane quickly after their booster jabs. The Statement says that these people will have access to antivirals and other treatments, but the antivirals must be administered within 48 hours of symptoms starting. Can the Government confirm that such people will get access to rapid testing, to be able to start these vital treatments within the first 48 hours?

Finally, the Statement mentions the UK’s G7 plan for future pandemics. How do the Government respond to comments from the WHO that countries such as the UK are dismantling the precautions needed to ensure a safe reduction in Covid? We will learn to live with Covid, but the Government have a lot more work to do to ensure that we do it with minimal risk.

[The Lord Privy Seal (Baroness Evans of Bowes Park) (Con)]

My Lords, I thank the noble Baroness and the noble Lord for their comments. On behalf of the whole House, I send condolences to colleagues on the Liberal Democrat Benches on the loss of one of their dear colleagues, and to Lord Chidgey’s family. He is in our thoughts.

The noble Baroness and the noble Lord asked about SAGE advice. We have continued to take and publish the best advice and analysis from scientific groups such as SAGE and its subgroups, which has been used in decisions taken by Ministers, alongside economic and social considerations. The latest SAGE advice was referenced within the strategy that was published on 10 February. We will continue to publish SAGE advice as and when we have it.

The noble Lord rightly pointed out that the proportion of infections from the current omicron variant resulting in hospitalisations is significantly lower than in previous waves, with less than one per 100 infections, compared with over four per 100 infections during the alpha peak. Although there is a delay, we are also seeing a welcome fall in deaths, which we expect to continue.

The noble Lord and the noble Baroness both referred to the changes in the self-isolation regime and the legal requirement finishing on 24 February. We will be replacing that with guidance in the short term, still advising people with Covid to stay at home and avoid contact with others. From 1 April, we will be issuing new guidance setting out the ongoing steps that people with Covid should take to minimise contact with other people. There will be specific guidance for staff in particularly vulnerable services, such as adult social care, healthcare, and prisons and places of detention. Health and social care workers will continue to be asked to stay at home following the lifting of the legal requirements to self-isolate. We will review over the coming weeks the long-term approach to managing Covid in health and social care settings and will publish adult social care guidance, again by 1 April.

The noble Lord and the noble Baroness asked about testing. Free symptomatic testing will remain available to those at highest risk of Covid and to social care staff. Again, details will follow ahead of 31 March. We will also set out in due course further details on which high-risk groups and settings will be eligible for continued free testing. The noble Lord and the noble Baroness also asked about the costs of tests. We will be working with retailers to establish and develop a private market for lateral flow tests. There have been private markets operating in the US and many European countries for some time now. Retailers will be setting the price, but we will be ensuring that the private testing market is properly regulated, including monitoring prices charged, and we will continue to work with UK companies in developing lateral flow tests, which the noble Baroness referred to.

The noble Baroness asked about the value of test and trace and its cost. Of course, we are all aware that we began the pandemic with no diagnostics industry and yet have conducted the most tests in Europe. We have conducted more than 460 million tests, and over 36.3 million positive cases and their contacts have been reached who could have spread the virus. We have built a testing network from scratch that can process millions of tests per day—more than any other European country—and over two billion lateral flow tests have been distributed across the UK since the start of the pandemic. That is a pretty impressive record.

The noble Baroness mentioned, rightly, that we have accepted JCVI advice for a new spring booster, to be offered to those over 75, older care home residents and those over 12 who are immunosuppressed. Those doses will be given six months after their most recent booster dose. We have also procured five million patient courses of antivirals, more than anywhere else in Europe, which is a significant supply and will provide a crucial layer of protection going forward. We are rolling out neutralising monoclonal antibodies and antiviral treatments for patients at highest risk. Up to 1.3 million patients could benefit if they are clinically eligible, and we have a plan to personally communicate with these relevant patients so that they can take advantage of the treatments that we have invested in.

Both the noble Lord and the noble Baroness talked, quite rightly, about future surveillance and what we would be doing about it. UKHSA will continue to sequence infections and monitor a range of data, including infections, hospital admissions, patients in hospital and deaths with Covid. It will maintain critical surveillance capacity, including the Covid infection survey, genomic sequencing and additional data, and this will be augmented by continuing the SIREN and Vivaldi studies.

As the noble Lord and noble Baroness pointed out, we will have to keep a very close eye on the emergence of new variants, so we will retain the core capabilities and infrastructure required to scale up a proportionate response in the event of a resurgence or a new variant. Obviously, this will involve the continued use of pharmaceuticals as the first line of defence, along with continuing to develop capacity to respond in the health system. We will retain laboratory networks and diagnostic capabilities so that PCR testing can be stood back up in the event of a resurgence, and we will retain the ability to stand up the national trace response if it is needed. Local health teams will continue to use contact tracing and provide context-specific advice, where they assess that to be necessary, as part of their role in managing local outbreaks, as they do with other infectious diseases. We will also maintain the ability to increase asymptomatic testing in the NHS and care homes.

UKHSA continues to have good stocks of lateral flow tests and will manage them to enable the Government to establish an adequate stockpile that could be rapidly deployed in future outbreaks. We will also continue to run public health campaigns such as we have seen in the past to encourage people to think about their behaviour and to ensure the continuation of the good work that we have done to understand how to deal with Covid.

Finally, the noble Lord asked about the global scene. He is probably aware that in March we are hosting the Global Pandemic Preparedness Summit for the Coalition for Epidemic Preparedness Innovations, and we are working with international partners on future pandemic preparedness, including through a new pandemic treaty, an effective early warning system—or global pandemic radar—and a mission to make safe and effective diagnostics, therapeutics and vaccines available within the first 100 days of a future pandemic threat being identified; this is, of course, a global problem.