Covid-19 Update

Baroness Brinton Excerpts

Thursday 4th February 2021 Lords Chamber

[Baroness Thornton (Lab)]

I thank the Minister for this debate on the Statement made in the Commons on Tuesday. I start by joining the Minister and everyone across Parliament and government in sadness at the death and in celebration of the life of Captain Sir Tom Moore. I also join everyone in celebrating the fact that 10 million people, 15% of the population, have now been vaccinated with a first dose. That is a fantastic achievement and I am so grateful to the NHS and all those who have contributed to this amazing national effort. Another Statement about vaccines is being taken in the Commons today, so I think we can see that this is a fast-moving world that requires Parliament to be quick on its feet to make an input and provide both scrutiny and support.

However, we are all aware of some people who are refusing the vaccine, including care workers. Can the Minister advise the House how many people in the priority vaccine groups have refused the vaccine? If he does not yet have these figures to hand, can he say when the figures, broken down by area, age, gender and ethnicity, will be available? This data seems to be crucial to understanding and tackling vaccine hesitancy moving forward. I am sure that the Minister will be aware of the research carried out by Professor Tim Spector and his team at King’s College London into why people are refusing or doubtful about the vaccine. Only yesterday there was a webinar about this. What was quite clear from that is that communication and example setting are important, and I hope that the Minister can share some of the thinking that may be going on about how to tackle this.

I turn now to the vaccination of the most vulnerable. I thank the Minister for his letter today in response to my question last week about how the bedridden and the homebound, and their carers, are being vaccinated. I would appreciate it if we could have some numbers showing how many people are in this vulnerable cohort. Only yesterday on the news we saw the example of an elderly man living alone who is recovering from cancer. He is isolated and his family are very anxious indeed that he has not yet been vaccinated.

According to recently released figures, Covid-19 deaths in care homes in the week ending 22 January represented 46% of all deaths in homes. That was the highest proportion of deaths since the beginning of the pandemic, surpassing even the previous high of 39.2% set last May. During that week, 1,817 care home deaths involved Covid-19, taking the total to more than 25,000. Gavin Terry, head of policy at the Alzheimer’s Society, said that, given the worsening figures

“staff vaccinations must be urgently prioritised along with rapid rollout of second jabs.”

The Government are being optimistic in saying that vaccines have been offered in care homes—but that is not the same as them having been taken up. Time is rolling on for older people who have not been able to see and touch their loved ones for almost a year. We all admit that this is cruel. In many ways, it underlines the dreadful inequalities that Covid has revealed in our society and its care of the most vulnerable.

If the current rate continues, the UK will be on track to have offered a dose to everyone in the top four priority groups by mid-February and to complete the remaining five priority groups in early April, when the need for the second dose begins.

The Minister will be aware of concerns as to whether medical and administrative staff can continue at the current pace for many months at a time, when many are already working seven days a week. What steps are the Government taking to relieve the pressure on staff and ensure that the pace of vaccination remains sustainable in the weeks and months ahead?

The new research from Oxford shows that the AstraZeneca vaccine is 76% effective after one dose and can reduce transmission by 67% over 12 weeks. This is fantastic news. Will the JCVI review this evidence and consider using the AZ vaccine to help prevent spread of the disease—not just serious illness and death—once everyone in the priority groups has received two doses? This would allow public health directors to speed up the vaccine rollout in more deprived communities, including among black and ethnic minority groups, and in hotspots where the disease is threatening to run out of control.

We all agree that children’s health must always be a priority. On current plans, how many teachers will be vaccinated as part of bands 5-9? How many teachers and support staff will have to wait until the period between Easter and summer to be vaccinated? Last September, it was reported that 25,000 teachers had been off sick with Covid-related illness, further disrupting children’s learning. How can the Government ensure that we do not see the same disruption again from March, when it is hoped that the schools will return? I hope that the JCVI will prioritise this as part of its review because, once schools have reopened, we need them to remain that way.

Finally, high infection rates, death rates and the identification of the South African variant in the community and the E484K mutation in the infectious Kent variant are deeply worrying. Although the noble Baroness, Lady Harding, claims that this was

“something that none of us were able to predict”,

the Minister must know that scientists have long warned of new variants as the pandemic unfolds and that the likelihood of mutations increases when there are high rates of transmission. It is more urgent than ever that this hole in our defences is fixed.

Increased testing is always welcome but will ultimately be insufficient unless test and trace is made to work for everyone. This week, the noble Baroness, Lady Harding, advised that at least 20% of people—she reckons approximately 20,000 a day—who should be self-isolating are not abiding by the rules. These figures demonstrate the need for both decent sick pay to break the chain of transmission and for test and trace to work properly.

[Baroness Brinton (LD) [V]]

My Lords, we also express our condolences to the family of Captain Sir Tom Moore. He was an inspiration and an example to so many.

The health Statement reminds us that this is HIV testing week. HIV Prevention England rightly says that the message about early HIV testing must be well publicised. I pay tribute to our Lord Speaker for his key role as Health Secretary in the 1980s in managing urgent and uncompromising messages to the public about HIV and AIDS. This Government could learn much from those campaigns about communicating clear messages.

From these Benches, we also echo the excellent news that 10 million people in the first four priority groups have been vaccinated so far. Last week, I asked the Minister whether the vaccine dashboard could break down vaccine take-up below national level. I note that this Statement says that this is happening at local health and local authority level. However, there is still no breakdown between health and social care staff. On Tuesday, the United Kingdom Homecare Association reported that only 32% of its staff had been vaccinated so far. It said that invitation to vaccinate care staff was a local lottery, with some areas having excellent arrangements, but others not. Live-in carers face even harder access to vaccines, as they are often completely left off local vaccination lists.

Further, we know that some care staff have concerns about taking the vaccine, so dialogue is vital. Recently, there was an excellent radio interview with a GP from the north-east who explained how they had talked to staff who were worried about vaccinations at the care home where they worked. Those staff were reassured and were vaccinated. Too many social care staff are just referred to large vaccination hubs with no opportunity to discuss it with a known and trusted GP. Will the Minister ensure that GP surgeries can still have vaccine doses for everyone in groups 1-4, including social care staff, so that the barriers to vaccination are tackled and removed? Please can we see the NHS and care staff separated out on the vaccine dashboard?

This Statement also raises the emerging problems with the South African variant, with further restrictions in some postcodes. These, as well as the new changes to the UK variant discovered in Bristol and Liverpool, remind us that Covid-19 is still challenging us at every turn. I say well done to the local directors of public health and leaders of councils, working with their local NHS, on their excellent speed of response and the clarity of their local messages to people in the relevant postcodes.

I have a couple of questions for the Minister. First, Ministers have said that the new South African variant problems were discussed and planned for last Thursday. So why was there not an announcement before the weekend, ensuring that affected residents could protect themselves and their neighbours as soon as the risk was apparent? Secondly, the Statement says that everyone in these areas must have a PCR test—good. However, a letter sent from the NHS to hospital staff said that no staff were to go to work until they had had the results of a PCR test. Given that hospitals already have a large number of staff off sick or self-isolating, what help are they getting to deal with further staff absences?

The Minister will remember that I have urged the Government to include unpaid carers in the priority list in order to protect those they care for. The announcement of their inclusion in priority group 6 is welcome. However, they are not in the summary lists in the vaccines delivery plan. Will the Minister commit to clear up any confusion by explicitly including unpaid carers in government communications and by publishing specific guidance on making sure that they are vaccinated as part of group 6?

Finally, we look forward to hearing the Prime Minister speak on 22 February about the route map out of this third lockdown. Progress on vaccination is vital, but test, trace and isolate is also essential if we are to avoid a fourth national lockdown. We on these Benches believe that people who are self-isolating should be paid their wages and have access to a proper care package, as in Germany and Taiwan. We have been asking for this for 11 months. The failure of people to comply with self-isolation rules demonstrates that the current system is not working. Will the Government urgently review the arrangements for isolation and encouragement to comply?

Yesterday, Chris Whitty and the Prime Minister were clear that this third lockdown cannot be lifted until it is safe to do so. Yet already MPs and some Peers are pressuring the PM to open schools immediately. Strong, clear messaging is needed every day—as strong as on the AIDS campaign by the noble Lord, Lord Fowler, 30 years ago. We know from polling data that the vast majority of people want to do the right thing. The Government’s role is to tell us what and why and to provide support for those who need help to do it.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

My Lords, I am enormously grateful to both the noble Baronesses for their thoughtful and provocative questions. I join the noble Baroness, Lady Thornton, in paying tribute to Captain Sir Tom Moore. His story touched on something we have talked about in this Chamber this year: the way in which someone, in their 99th year, can make a tremendous impact on the whole country, bringing us together and raising money for NHS staff. It was an amazing achievement so late in life. It demonstrates that every year of every life, however late in that life it is, is valuable. That is why this Government are extremely proud of the measures that we have put in place to protect the lives of, and avoid severe harm to, the elderly and infirm.

I also share in the noble Baroness’s tribute to NHS staff and the vaccination rollout. She is entirely right; there is huge mental and social attrition across the NHS at the moment. The hard work that goes on, particularly in intensive care, is having a tough impact on those who work there. We hear of the need for some form of respite for NHS staff, loud and clear, but I have to be candid: when we are done dealing with the hospitalisations for Covid, there will be a massive wall of work to manage the huge backlog and restart business as usual. We are looking at the human investment needed. I pay tribute to my colleague Helen Whately, the Minister who covers the NHS workforce. She speaks to the NHS and social care workforce daily. We are looking extremely carefully at the investment that will be needed to support healthcare staff in the difficult year ahead.

The noble Baroness, Lady Thornton, asked about those who refuse the vaccine. I am afraid that those statistics do not exist, because people do not identify themselves as vaccine refusers. However, the overall picture is extremely positive at the moment. Those in categories 1 to 4 are stepping forward for the vaccine in tremendous numbers, and we are extremely encouraged by that. I take on board the insight of Tim Spector and others who have spoken thoughtfully about the barriers. I pay tribute to civic and particularly religious groups, which have often put vaccination sites in their temples, synagogues, churches and other religious settings. That is exactly the kind of trusted civic engagement that has led to vaccine deployment reaching deeply into communities that might otherwise have been worried or suspicious.

The challenge that we will face will be when we turn our attention to the younger. To answer the other question from the noble Baroness, Lady Thornton, we will be rolling out the vaccine to all age groups. The very good news from AstraZeneca about the vaccine being an extremely effective agent against transmissibility is exactly what we need to know, because it gives a green light to using the vaccine to avoid not just severe illness, hospitalisation and death, but transmissibility. We have to get the message across to those whose lives are not necessarily saved by the vaccine—it saves someone else’s life—that taking it is important and something they should feel trusting about and obligated to do. That will be the second phase of the vaccine rollout, and we are thinking carefully about how to do it as effectively as possible.

The noble Baroness, Lady Thornton, alluded to staff vaccination. She is entirely right about the very high number of Covid deaths in homes at the moment, and I reassure her that vaccines have been offered to every person in every home. There is an email address, which I would be happy to share with all noble Lords, for anyone who thinks that they have not been offered the vaccine. There is an absolute backstop for anyone who thinks that they have been overlooked or have missed out. We are doing our level best with an effective deployment and rollout programme to ensure that all social care homes, whatever their status, and all staff in them are protected by the vaccine.

I will say a word about schools and teachers. I completely support the views of the noble Baroness, Lady Thornton, and many other Peers who have spoken thoughtfully and emotionally about the importance of getting schools back. The Government and I agree that this is our priority. I spoke to the Schools Minister, Nick Gibb, about this yesterday. I pay tribute to the work of the Department for Education in rolling out testing in schools. Either today or very soon, we will have had the millionth test in schools, which is a great tribute to the work that schools, teachers and the DfE have done on asymptomatic testing in schools. It is an important way to cut the chain of transmission and to protect all those in schools, from both the disease and being agents of transmission to those who are more vulnerable. I support all the measures on social distancing, PPE and testing that we can put in place to keep schools open.

When it comes to vaccinating teachers, I emphasise that saving lives and avoiding severe harm is the priority for the vaccination programme. While we are sympathetic to teachers and will definitely have them on the prioritisation list, the protection from harm and death is our current priority.

We take the news on mutations from South Africa, Brazil, California, Kent and Bristol, and all the other manifestations of mutations, extremely seriously. The noble Baroness, Lady Harding, spoke about not expecting a mutation, but of course it was not the virus mutating that was not expected—that is commonplace. The CMO spoke about that impactfully and early, in February and March; he utterly predicted that mutations would lead to a second wave. But the virus had not mutated much last year. In fact, it was a phenomenally rigid and consistent virus for a long time. What was not easy to predict was that a highly transmissible disease would emerge that completely outperforms its previous classic manifestation. We saw that only when the infection rates started to climb extremely quickly. We changed our tack accordingly, and we continue to change our tack.

As I have said from the Dispatch Box previously, we are in a different game now. Previously, the focus was on keeping a lid on infection rates and getting the prevalence levels low. That remains an important feature of our battle against Covid. On the other hand, we have to protect the vaccine. We are aware of the potential for a mutation to emerge that escapes the vaccine. That has been seen in other diseases and could be seen in this disease. That is why we have mobilised Operation Eagle to track down the South African variants that have landed in the UK, where we do not have a clear chain of transmission. That is why we are going door to door, offering PCR testing to all those—around 10,000 people—in each of the relevant postcodes, to put a lid on any community transmission. That is why we have deployed a special team, tracing variants of concern, which is tracking down the origins of each infection to stamp out and suppress variants of concern, where they emerge.

This is exactly the kind of capability that we need to put in place should a highly transmissible vaccine-escaping variant manifest itself. I pay tribute to those in test and trace who have put together this capability extremely quickly and are implementing it so thoroughly.

Both the noble Baronesses, Lady Thornton and Lady Brinton, alluded to the important issue of isolating. I hear those points loud and clear. We support those who are isolating, and make a £500 payment to those on benefits, who need it. Charities and local authorities support those who isolate. But I hear the point made about additional measures, and we are looking at further ways to support those who are required to isolate, either because they are infected themselves or because they are the contact of someone who is infected.

The noble Baroness, Lady Brinton, spoke thoughtfully and movingly about the role of the Lord Speaker in fighting HIV and AIDS, and I join her in paying tribute to the Lord Speaker, whose 83rd birthday was earlier this week. The messaging in that campaign was poignant, it cut through and we all remember it very well.

I also pay tribute to those in the communications team who have, during the last year, put through some incredibly impactful campaigning around the Covid messages. There has been massive societal behavioural change because of the clarity and the impact of the campaigns that we have done. Those campaigns have got better and better, and the most recent “look into my eyes” campaign, as it is now called, is one of the most impactful. When we look back on this campaign, we will think very highly of the marketing and communication skills of those in the Department of Health, the Cabinet Office and other departments, who have worked so hard in this area.

The noble Baroness, Lady Brinton, alluded to the vaccination of social care staff. She is absolutely right to allude to lists. One of the current difficulties is that we do not have proper lists of all those who work in various roles in social care, either as domiciliary staff or in unpaid roles. My colleagues are looking at this, and we are moving quickly to address it. I know that the noble Baroness feels very strongly about the vaccine dashboard; I have taken it back to the department and spoken to the vaccine team about it and I will raise the matter with them again. Regarding the unpaid carers and the delivery plan, I will take that to the department again. I will be happy to write to the noble Baroness.