Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) (No. 6) Regulations 2021

Debate between Lord Scriven and Lord Bilimoria

Wednesday 15th December 2021 Lords Chamber

[Lord Bilimoria (CB)]

My 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.

[Lord Scriven (LD)]

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.