Covid-19 Update

Baroness Brinton Excerpts

Monday 16th March 2020 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, I am very grateful to the Minister for repeating the Statement made by the Secretary of State in another place today. Our thoughts are of course with those affected by coronavirus and the families of the 35 people who have died in the UK and the British citizens who have died overseas.

We understand that the Government’s commitment to ensure the UK’s response to the Covid-19 pandemic is driven by evidence and science, but the Minister must have realised that the public are confused and concerned about the advice that has been given, especially when Governments around the world appear to be receiving and giving their citizens different advice. Surely the answer to this lies with the Government publishing the scientific advice and modelling behind their coronavirus action plan, which would enable experts to analyse, peer review and stress test it.

The Covid-19 pandemic is a global problem that requires Governments to work together. Can the Minister confirm that the UK has access to the evidence and data collected by other affected countries? Does he agree that a global response would give more public confidence? I am not suggesting that the UK is not doing the right thing from our point of view, but it is very important that the public understand why we are doing the things we are doing.

We welcome the update that the Government have already increased the number of tests to 5,000 a day and hope to double this to 10,000. Experts have advised that the most effective way to prevent infections and save lives is breaking the chain of transmission. To do that, you have to test and isolate. The head of the World Health Organization has implored Governments to “test, test, test” and check every suspected case, warning that Governments cannot fight the pandemic blindfolded. Therefore, we are concerned by the Government’s decision that only patients who require hospital admission will be tested for coronavirus. This will mean that only a subset of cases, the most severe, will be identified and we will not know how widespread the infection really is. If our approach is to be science-led, surely data is the key.

The Minister will be aware that NHS workers have also expressed concern about this policy, given that it could lead to staff who do not have coronavirus needlessly self-isolating for seven or 14 days, which would put a further strain on NHS staffing. It could also lead to asymptomatic staff with coronavirus treating frail and vulnerable patients, putting them at further risk. Indeed, there is a petition calling for the prioritisation of testing for NHS staff which currently has over 15,000 signatures. Does the Minister agree that mass testing will allow for valuable insights into the behaviour of this virus? Once testing capacity is increased, will the Government reinstate testing for those suspected of having the virus, prioritising NHS workers, including the cleaners, porters and other essential staff who are needed to keep a hospital running and who play a vital role in infection control? If the Government want to keep key workers at work, they have to make testing available to them. That applies to not only nurses and doctors but teachers and head teachers. It is a nonsense not to do so. Will the Government make tests available to key workers?

Public anxiety has been heightened by Britain seeming to take weaker measures than other countries, confusion over things such as herd immunity and anonymous speculative briefing to the media from government sources. It is unimpressive for the Secretary of State to publish a newspaper article updating us on Covid-19 behind a paywall. It does not smack of a firm communication strategy led by the need for clarity, honesty and reassurance. The Government must provide clear and transparent communication to the public about the steps they are taking to mitigate the impact of this outbreak. This is especially important as the coronavirus curve enters a steeper trajectory, with advice changing rapidly. Just today, the advice has changed for those displaying symptoms to stay at home for 14 days rather that seven. Can the Minister advise us on why the length of time has increased?

We certainly welcome the decision to introduce daily briefings to keep the public informed about what action is being taken to fight the spread of this virus, when certain protocols will be implemented and, perhaps most importantly, why. Will the Government commit to providing clearer guidance for people, including specifying the conditions that may indicate that someone is more susceptible to the effects of Covid-19? The phrase “underlying health conditions” is far too vague and misleading to be helpful, and may cause unnecessary panic and confusion. The NHS website is providing information but I am concerned about how those who are digitally excluded will access it, especially now that they are being advised to socially distance themselves. Will the Government launch a dedicated coronavirus telephone advice line for people? This would be an important source of up-to-date information for many people and would help to alleviate pressure on the 111 service.

Many low and middle-income families will be severely hit by a reduction in income if workplaces shut and they have to take time off sick or need money to respond to the crisis. This morning, Virgin Atlantic asked staff to take eight weeks of unpaid leave over the next three months to help the airline to cope during the pandemic, but that means that those staff will not be eligible for sick pay.

The Prime Minister has now advised everyone to stop non-essential contact with other people by working from home where possible and avoiding pubs, clubs and theatres. Experts have warned that this could push 14 million people who live in poverty into hunger and homelessness, which is why we on these Benches call on the Government to bring forward a package of emergency financial security measures to give people the security and confidence that they need to follow public health advice as part of our collective national endeavour.

The Government have confirmed that the NHS has insufficient ventilators to cope with the number of people who may be admitted to hospital. We certainly welcome the announcement that car makers and defence contractors will be asked to switch production to make medical equipment a national priority. Can the Minister confirm whether it is true that the European Union has passed a regulation so that medical equipment can be exported outside the EU only with special regulatory authority? If true, that would cut us off from a huge number of ventilator manufacturers. What action are the Government taking to increase the number of medical staff who will be trained to deal with respiratory care?

[Baroness Brinton (LD)]

I too thank the Secretary of State and the Minister for the Statement. I also thank the Prime Minister, the Chief Medical Officer and the Chief Scientific Adviser for the press conference earlier, which laid out the new advice that we will have to take into account. I will come to this at the end of my comments, but I note in particular the advice to people over 70 and with underlying health conditions; I have been asking in your Lordships’ House for specific advice for about six weeks now—at last, it is here. A couple of points of clarification would be useful but it is extremely helpful.

I also thank all NHS and social care staff, public health officials in our local communities and other public servants who are all now working above and beyond even the emergency duty. We on these Benches recognise them across the country in everything they do. Our thoughts are with those who are currently ill and the families of those who have died.

I will not repeat much of what the noble Baroness, Lady Thornton, said, but I want to make the point that the past week has seen a big sea change in attitude among not just the public but many experts who may not be epidemiologists but certainly have an understanding of modelling. It is important to keep them onside by making sure that the modelling is published; I echo the concerns that that has not happened yet, although I note that Chris Whitty said that it would become available in due course.

I share the horror at the Daily Telegraph article being behind a paywall. Notably, some of the largest American newspapers are making every single article on coronavirus free so that the public can access it; I wonder whether we could encourage our newspapers to do the same.

On testing, which seems to be the big issue of the day, I had an email from a friend who has been in a hospital in London with a severe case of coronavirus. That person is recovering now, but it was noticeable that there was an astonishing lack of knowledge on the part of paramedics, NHS 111 and others that breathing difficulties were a symptom. It was assumed that she was having a panic attack, although she had never had one in her life before. It was clear that A&E was completely overwhelmed. There was not enough protective equipment, and the doctor who saw her said that when doctors themselves became sick at their hospitals they were told to self-isolate for seven days but were not being tested, so they did not know whether they were immune or infectious.

The doctor concerned was desperate, and said that testing seemed to be happening only in care homes and in hospital outbreaks. The whole system had been overwhelmed. According to the Health Service Journal, the Department of Health and Social Care has said that the regime is set up to provide testing, but at the moment it is unclear how it will be applied. More and more of the people we are asking to go on to the front line are feeling very exposed.

Moving on to some workforce issues, various airline companies have announced that they are in real trouble; I think everybody understands why. And they are not alone. From these Benches, I express real concern about the Prime Minister’s announcement today, in which he encouraged people not to go to clubs, cinemas, restaurants and theatres. That is likely to mean that many of those businesses will not be able to claim on their insurance, as they could if this was an instruction, as opposed to a guide. Can the Minister tell us why the Prime Minister used that framing? It will cause serious problems for many small businesses.

As for other money issues, it is reported that there is a very large drop in donations to food banks. What will the Government do to ensure that the many thousands of people who rely on food banks will continue to get the support they need, when most people are no longer dropping two or three items into the boxes as they leave the supermarket?

There was some debate recently, involving the House of Commons Library, about sanctions for those attending jobcentres. According to the Library report, Will Quince MP had said that there would be discretion, and that people would not be sanctioned as long as they let the jobcentre know before the appointment. There are two problems there. First, if someone is sick they may not be able to call in and spend the hours it takes on the phone to do that. Secondly, if staff at the DWP are ill, there may not be enough people available to take those messages. Surely during this crisis—the Prime Minister has made it plain how severe it is—sanctions should be stopped for everybody.

Finally, on the advice to the over-70s, I am grateful that Chris Whitty said this afternoon that anybody, adult or child, with an underlying condition, including anybody who had had to have a flu jab, should consider taking action, especially if they have respiratory problems. Can the Minister confirm that and make it clear? I understand that the message about flu jabs has just come down from the website, so I am concerned that there will be confusion. There is no doubt about people who are immunosuppressed, but will he please reassure people who use inhalers—that is certainly one of the categories on the Department of Health and Social Care website—that they will be included?

[Lord Bethell]

My Lords, I thank the noble Baronesses, Lady Thornton and Lady Brinton, for their testing but important questions. Let me go through them systematically. As there were quite a few, I will do it at pace.

I can reassure the Chamber that the CMO has committed to publishing advice. It is extremely complicated, because the models used by SAGE are the result of many different collaborators submitting papers to a central committee, so publishing something simple and robust that can be used by third parties is not as easy as it might initially seem. But that commitment has been made, and we support the commitment to transparency.

In answer to the question from the noble Baroness, Lady Thornton, about other countries’ data, I reassure the Chamber that there is an extremely strong spirit of collaboration between the countries of the world in fighting this virus. The Prime Minister had a G7 call over the weekend, in which there was a very strong commitment by those countries. That will begin a cascade of inclusion to other countries around the world in order to launch a real commitment to combating the virus. That spirit of collaboration is a powerful and encouraging dimension of an otherwise very difficult situation.

Both the noble Baronesses asked about tests: this is a really important question. The tests that we have are, rightly, being concentrated—as the noble Baroness, Lady Brinton, alluded to—on ICU units and care homes. The reason is that it is likely that those who show the most symptoms are also the most infectious. Therefore, the people who are most likely to catch the virus are those who are nearest those who have the strongest symptoms. Those include our healthcare workers, who not only deserve to be protected but need to be, in order to keep our health and social care system working. That is, therefore, where the tests are being focused.

It is also worth saying that, until the end of this week or next week, we are at the very tail end of the winter flu cycle when, if you have a cough or a cold, it could be any number of viruses. However, that is likely to change and, as we go forward, if you do have a cough and a temperature, it will be most likely that you have coronavirus and so the relevance of testing diminishes. None the less, we are working extremely hard to increase the number of tests available and the way in which we test will move to bedside instead of central testing. We hope to be able to develop an at-home test. I believe that there is news of that on the horizon.

The noble Baronesses, Lady Thornton and Lady Brinton, both asked about the media. I reassure the House that the article in the Telegraph was not behind a paywall; it was freely available from 11.20 pm last night. I can confirm that, if any noble Lord has any concerns about it. The Prime Minister has made a commitment to daily updates, in the company of his medical advisers. The public have clearly found that approach reassuring, and it will continue during this important phase of the virus.

The noble Baroness, Lady Thornton, asked about those with underlying health conditions and whether the definitions were clear. The noble Baroness, Lady Brinton, asked about flu jabs and whether those on the flu jab list would be contacted. I reassure both noble Baronesses that those on the flu jab list will be contacted by their GPs within the next few days. Advice will be given and, where necessary, health and care packages put in place for them. Those with underlying health conditions will be contacted by local GPs in order to clarify exactly what kind of risks individuals face.

Both noble Baronesses rightly brought up the question of the economy. This is an area of massive concern, not only to the Government but to everyone whose job and livelihood are threatened by a slowdown in the economy. Without doubt, the recommendation to close clubs, pubs, theatres and all manner of social gatherings will have a profound effect on the economy. The Chancellor has already committed billions of pounds to an economic fund to try to support those industries. Further work is being put into place to ensure that businesses can see this epidemic through.

Those who are homeless or in the gig economy will be the particular focus of measures. We are working extremely hard to change the system of statutory sick pay to include those who would not necessarily be captured by the usual arrangements. That work is still in progress, but we look forward to providing an update when the coronavirus emergency Bill is brought to Parliament on Thursday.

The noble Baronesses, Lady Thornton and Lady Brinton, asked about ventilators. These are clearly the key pieces of equipment that we need to combat the most profound effects of the virus. We have 5,000 in our stock and are working extremely hard to increase that number dramatically. Industry has responded extremely positively. We have been overwhelmed by the response from all parts of industry, from big, established companies to innovators, academics and those with good ideas for how to increase the number of ventilators. We were already in the market many weeks ago and have done a lot to shore up our supplies.

It is entirely right that any number of ventilators will not be any good if you do not have the staff to man them, so we are going about retraining existing clinical staff in how to use them. To give an example, on Saturday I sat next to a surgeon who has found that his operating theatre has been turned into a respiratory support unit. He and his anaesthetist are learning how to work the respirator.

The NHS undoubtedly faces a period of enormous pressure. There is no amount of special pleading that I can do from this Dispatch Box to hide the fact that front-line clinicians and support staff will be under huge pressure. They will take profound personal risks and they are being asked to deliver an important national duty. As I am sure that everyone in the Chamber does, I pay tribute to the work that they have already done and to the work in prospect on the horizon.

Lastly, the noble Baroness, Lady Brinton, asked about food banks. I reassure her that we have a full understanding of the challenge faced by charities—the collapse of not only food donations but financial donations. That is why special provision has been given to DCMS to provide funds for charities, which will play an incredibly important part in many aspects of this national effort, particularly in providing the kind of support to social care needed for those who face an extremely difficult time of loneliness and exclusion as they take the correct decision to socially distance themselves from this virus.