Covid-19 Update

Baroness Chisholm of Owlpen Excerpts

Thursday 21st October 2021 Lords Chamber

[The Lord Bishop of Manchester]

My Lords—

[Baroness Chisholm of Owlpen (Con)]

My Lords, it is the turn of the Front Bench.

[Lord Kamall (Con)]

My Lords, I thank the noble Lord and noble Baroness for their questions, and I will try to clarify some of the issues. I also thank the noble Lord for his acknowledgement of my newness to the job and for giving me some bandwidth on it, if that is fair enough.

Let me be quite clear on the questions that were asked in terms of threshold. There is no pre-set threshold for considering plan B; we consider a range of evidence and data—as we have done throughout the pandemic—to avoid the risk of placing unsustainable pressure on the NHS. For example, while the number of Covid-19 patients in hospital is an important factor, the interaction with other indicators, such as the rate of increase in hospitalisations and the ratio of cases to hospitalisations, will also be vital. We will need to make a judgment on whether plan B is necessary based on the interaction of all those indicators, and informed by advice from the Government’s scientific and clinical experts—I will come to that question later. As I have said, we have an effective vaccine and much-improved treatments, so we are not where we were last winter.

The Government’s objective is to avoid a rise in Covid-19 hospitalisations that would put unsustainable pressure on the NHS. The Government will monitor all the relevant data on a regular basis to ensure that we can act if there is a substantial likelihood of this happening. The Government monitor a wide range of Covid-19 health data which, to give a taste, includes cases, immunity, the ratio of cases to hospitalisations, the proportion of admissions due to infections, the rate of growth in cases and hospital admissions in the over-65s, vaccine efficacy and the global distribution and characteristics of variants of concern.

In assessing the risk to the NHS, the key metrics include hospital occupancy for Covid-19 and non-Covid-19 patients, intensive care unit capacity, admissions in vaccinated individuals and the rate of growth of admissions. The Government also track the economic and societal impacts of the virus to ensure that any response takes into account these wider effects. We also monitor a range of metrics on other NHS pressures, including winter respiratory hospitalisation rates, influenza, urgent and emergency care pressures, elective activity and ambulance response times.

A number of noble Lords asked, “So what is the plan for autumn and winter?” The Government’s plan includes building our defences through pharmaceutical interventions, including vaccines, antivirals and disease-modifying therapeutics; identifying and isolating positive cases to limit transmission—test, trace and isolate; supporting the NHS and social care, including managing pressures and recovering services; advising people on how to protect themselves and others through clear guidance and communications; and pursuing an international approach, helping to vaccinate the world and managing risks at the border.

Of course, we have had to prepare contingency measures for if the various indicators and the range of scientific advice that we receive suggests that we have to move to plan B. The measures include: mandatory vaccine-only Covid status certification in certain riskier settings; legally mandating face coverings in various settings, such as public transport and shops; and communicating clearly and urgently to the public if the risk level increases. The Government may also consider asking people to work from home again, if necessary, but, once again, a final decision on this would be made at the time, dependent on the latest data and recognising the extra disruption this causes to individuals and businesses. The message is clear: we prefer not to go to plan B. We prefer to rely on informed choice, but we might have to go to plan B, if cases rise.

I was asked questions on some statistics. Some 49.5 million people had been given a first dose by the end of 19 October, and almost 45.5 million people had been given a second dose. More than 4 million boosters and third doses have been administered so far, including to one in three health and care workers who are eligible. But there is more to do: 5.5 million people have been invited for their booster so far, and another 1.9 million people will be invited this week, as they have become eligible over the last few days and weeks.

Looking at NHS pressures, we are working with NHS England, which is leading work with NHS providers, regions and stakeholders to ensure that robust operational plans are in place for the winter, including plans to meet potential increases in demand for emergency care driven by seasonal flu and Covid-19. To further protect the NHS this winter, we are also carrying out the largest ever seasonal flu vaccination, alongside Covid-19 booster vaccines for priority groups. The NHS will also receive an extra £5.4 billion over the next six months to support its response to Covid-19.

The noble Baroness asked about boosters in care homes. We are committed to ensuring that those who are most vulnerable receive their booster jab as soon as possible after they become eligible. That of course means that care homes are a priority. Vaccination teams have already visited over 40% of all care homes in England, and we expect thousands more to have either received a visit or have a date for a visit scheduled in the coming weeks. The latest figure I have, from a few days ago, is that 40% of care homes—in addition to the 40% where boosters have been received—have booked a visit. That leaves a 20% gap, which we are continuing to look at and work on. Some, for reasons of local outbreaks, cannot yet receive a visit, but we are very clear that 80% are on plan and we are looking at how to narrow that 20% gap.

The noble Lord referred to the NHS booking system. I was not aware of the problem, so I thank him for bringing it to my attention. I will investigate and get back to noble Lords, but I am afraid I do not have the answer at my fingertips. I am sure the noble Lord will appreciate that.

The noble Lord also asked about NHS capacity. The NHS can respond to local surges in demand in several ways, including through expanding surge capacity in existing NHS hospitals, mutual aid between hospitals, and making use of independent sector capacity and accelerated discharge schemes.

I apologise to noble Lords that I am over time. All I will say to finish off, in answer to the question about our scientific advice, is that we have confidence in SAGE. I was also asked who we listen to. Our approach has always been informed by scientific and medical advice, using the latest data. We take advice from the Chief Scientific Adviser, the Chief Medical Officer, the UK Health Security Agency, the NHS and others, which remains valuable. As always, scientific experts have contributed directly to ministerial discussions.