Covid-19 Update

Baroness Morris of Bolton Excerpts

Monday 30th November 2020 Lords Chamber

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

My Lords, I thank the noble Baronesses for their thoughtful and searching questions on an important day’s traffic of announcements from the Government. I would like to try to tackle them as comprehensively as I can, but I assure both noble Baronesses that I will write to them on any points I fail to address in these comments.

The noble Baroness, Lady Thornton, started by saying that she felt the endless cycle of lockdowns had not been working. It is undoubtedly true that we all regret the return to a national lockdown earlier this month, but it is not true they do not work. New infections are down by a third, and that is an enormous achievement by the British public, whose discipline and obedience to the restrictions has yielded a massive dividend.

The noble Baroness said that test and trace was not working. It is undoubtedly true that when prevalence levels are so high, when there are more than half a million infections in the country and when new infections are running at five digits, it is extremely challenging for any national testing and tracing system to keep up with that sort of capacity. I beg the noble Baroness to give some ground and acknowledge the achievement of the huge scaling of the number of tests, the vast number of people who have been asked to isolate, thereby breaking the chain of transmission, and the hard work of those who work on the tracing side of the business, which has dramatically increased its performance and will continue to meet target numbers.

The noble Baroness also talked about care homes being stranded. I remind her that we have come a huge distance. I could reel off a dozen achievements in the care homes strategy, but two stand out. First is the regular testing of staff, which has now become a systematic programme that has massively protected those in care homes. There has also been the recent introduction of testing for visitors, which brings welcome relief for those needing to support and visit those in care homes, a much-valued service that needed a huge amount of work to put into place.

The noble Baroness talked about the role of the public. I have alluded to my respect for and thanks to the public. I will be crystal clear: the challenge that we face as a country is not public apathy but the virus itself. There is an absolutely vicious aspect of the virus, which is its high contagiousness. In a room with a few people together, it is quite unlike most contagious diseases in its infectiousness. When we talk about the challenge of social distancing and the need for lockdowns, it is not one another whom we blame: it is the virus itself. I encourage all those who feel frustrated to remember who the enemy is.

The noble Baroness asked whether the tiering allocations would be done in consultation with local authorities. The brief answer to that question is no. We tried that, but it did not prove a successful experiment. The acrimony and large amount of delays created long-standing problems for the implementation of the policy. Therefore, we will be implementing the tiering on a fortnightly basis from the centre. It is a big yes, however, on the approach to community testing and infection control. We absolutely want to work in partnership with local authorities and local DPHs, which have all the powers that they need to decide whom they seek to target and what incentives they would like to provide for those who need to be attracted to testing. I also say yes—absolutely—to transparency, both in terms of the publication of the numbers and our approach to our collaborations. I put on record our massive thanks to local authorities, particularly those that have been working with us over the last fortnight on our community testing programme, the publication of which earlier today is a really important framework of the local-national partnership of which I have spoken at this Dispatch Box many times. It really brings alive that commitment.

The noble Baroness, Lady Jolly, was entirely right that there was an influenza plan, but it envisaged a completely different type of virus. The lessons from the influenza plan, though relevant for the kind of flu envisaged, were not applicable for the coronavirus. A good example of that is the PPE. Had we followed the possibility of preparing a massive stock of PPE for the kind of flu envisaged in the influenza plan, we would have had the wrong kind of PPE. There was nothing that we could have done about that.

The other big learning was on mortality rates. The mortality rates for Covid-19 and the long-standing effects that it has on people are completely unlike those of the kind of flu that we were envisaging earlier. It has been a grave learning curve to have to change our plans to deal with Covid.



In relation to other learnings or things that we have moved on since then, I reiterate a theme that I have mentioned before: our commitment to national and local test and trace. Quite understandably, the noble Baroness challenges me on that point, but I gently remind her that, in February, local authorities did not have any tests; nobody had any tests. We were doing 2,000 tests a day. Therefore, it is all very well saying that we should have left test and trace to local authorities, but there simply were not the resources there to do that. It took a massive national programme and huge national effort to get us up to half a million tests a day, which is something that the local authorities, even in collaboration, could not possibly have done.

The local authorities also did not have scalable tracing capacity. The PHE capacity was designed for ultra-low prevalence rates—for when you are chasing a few dozen carriers of a disease who, perhaps, have recently arrived from overseas. It was not designed for 20,000 infections a day, which is the kind of infection rate we have been looking at recently. It was only by building the data systems, protocols and guidelines, and having tens of thousands of employees, that we have been able to put that tracing capacity in place.

We also did not have the organisational or analytical capacity to do the kind of surveillance that is done through ONS and REACT or the kind of data management that the JBC has done. Now that we have those components in place—the physical, data and diagnostic frameworks—we are in a position to work as a team, both nationally and locally. The noble Baroness is entirely right that that local insight, intelligence, empathy and leadership are absolutely critical for our success, and I encourage her and all those in the Chamber to read our community testing programme, which was published earlier today and which encapsulates the spirit of the local-national partnership of which the noble Baroness has spoken previously in the Chamber.

The noble Baroness challenges me on communications, and I will not deny that it has been one of the great challenges of the pandemic to try to explain, in a fast-changing and confusing climate, the government imperative and recommendations to the public. One of the key things that we have learned is that, sometimes, the desire to share the delicious complexity of the epidemiology stands in the way of simple communication. Sometimes, trying to find the exemptions that are fair to everyone and cater to every single consultative recommendation stands in the way of simplicity, straightforwardness and tractability.

We have learned that, sometimes, it is more important to be simple, clear and straightforward than to try to accommodate every nuance and exception. This is why we have pursued rules like the rule of six, have gone for a simple and easily understood regional tiering process and applied the 10 pm curfew, although we have updated that to an 11 pm curfew, with a drinking-up time of 10 pm. That kind of consistent messaging is what the public, quite reasonably, respond to, which is why we have moved to it.

In response to the noble Baroness’s question about under-12s, I say that there are both the communication and epidemiological reasons that children are vectors of disease. This is an uncomfortable truth because they very infrequently show any symptoms and it is incredibly inconvenient—I say this as someone with four children, three of whom are under 12. However, it would be epidemiologically irresponsible to try to make an exception in that way, and I certainly will be spending quite a lot of Christmas with my family.

In relation to hardship, the noble Baroness makes the point extremely well, and we are totally sympathetic to her point. It is undoubtedly true that the least advantaged will be the hardest hit by this epidemic. It is true because their jobs are hit hardest, particularly those in casual labour, because the virus often hits those who have the most cramped accommodation or low-quality health and because many of those who live on the borderline of life will be the ones nudged into poverty.

The Government have worked hard, with the furlough scheme in particular, to ensure that a financial safety net is put into place, but I have no doubt that there will be a moment when the economic hardship created by the pandemic will be acute, and I have no doubt that the mental health implications of that for the population will be extremely hard. The Government are extremely aware of that and we are trying our hardest to minimise the impact. One reason why we are hitting the virus hard with these tiers is to ensure that we can get the economy back as quickly as we can, mostly to the advantage of those who are hit the hardest.

The noble Baroness asked me about entry and exit points to the tiers, and I have no easy solution for her. There are very clear considerations which we will be looking at when we consider which regions go into which tier: case detection rates, particularly of those over 60; the rate at which cases are falling; the positivity rate; and pressure on the NHS. But this is an incredibly complex matrix of interdependencies. It is not simple to plop it into the kind of easy algorithm that can churn out an answer at the push of a button; nor is it easy to have one simple metric where we can say, “You’ve hit this and therefore you move this way,” or “You’ve failed and you move that way.” If it were so easy we would publish it. The best advice we can get is that we have to consider all those factors when making those decisions. We will do it in a spirit of transparency, but we will have to make tough decisions. I reassure noble Lords that it will happen every two weeks, as the Prime Minister explained, and we will seek to be as fair and thorough as we possibly can.

[The Deputy Speaker (Baroness Morris of Bolton) (Con)]

My Lords, we now come to the 30 minutes allocated for Back-Bench questions. I ask that questions and answers be brief so that I can call the maximum number of speakers. I now call the noble Lord, Lord Caine.

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[Lord Bethell (Con)]

My Lords, I am enormously grateful to the noble Lord for his very generous comments. I commend him for his advocacy both in the instance of Covid and for his lifelong commitment to standing up for the homeless. He is right that the homeless are undoubtedly super-vulnerable to a pandemic such as Covid and that there is a finance problem for the charities which look after those who live on the streets. He is right that those who have trouble paying their rent and face eviction are in a particularly difficult position. That is why we have put in place a mortgage relief scheme, continue to support the furlough scheme and keep in mind the plight of those who struggle to pay their household bills.

[The Deputy Speaker (Baroness Morris of Bolton) (Con)]

The noble Lord, Lord Liddle, has scratched, so I now call the noble Lord, Lord Dobbs.

[Lord Dobbs (Con) [V]]

My Lords, I would like to indulge in a little flight of fantasy by bringing two different elements together. The first is the Oxford vaccine, which appears to be much cheaper and easier to distribute than the other vaccines currently on offer. The second is the pressure on our foreign aid budget. Will my noble friend have a word with his Foreign Office colleagues and see whether it is possible to bring the two together, using the aid programme to distribute the Oxford vaccine as soon as any surplus supply becomes available? Distributing it to our aid recipients to help them with their own battles against Covid will show that Britain is a proud world leader in supplying practical humanitarian support.

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[Lord Bethell (Con)]

My noble friend makes a very interesting point. Our priority right now is to vaccinate the British public. He is right that there are many vaccines available and Britain has made a massive investment in vaccines. We are also supporters of the international distribution of vaccines and the fair access of the developing world and those around the world to vaccines. That is why we support COVAX, Gavi and CEPI. He is right that there is an opportunity somewhere, and we are entertaining ways of supporting such a vision.

[The Deputy Speaker (Baroness Morris of Bolton) (Con)]

I call the noble Lord, Lord Dubs.

[Baroness Penn (Con)]

I think the noble Lord needs to unmute.

[Lord Bethell (Con)]

The noble Lord hits the nail on the head. We have already brought into place a test-to-release programme for foreign visitors and we are looking at ways in which such a principle could be applied elsewhere.

[The Deputy Speaker (Baroness Morris of Bolton) (Con)]

The noble Baroness, Lady Noakes, has withdrawn. We are not sure whether we have the noble Lord, Lord Rooker. We do not. I now call the noble Lord, Lord Forsyth of Drumlean.

[Lord Forsyth of Drumlean (Con) [V]]

My Lords, could my noble friend comment on reports in today’s press that four hospitals only, in the whole of England, are busier than last winter? Could he explain how on Saturday Michael Gove warned that, unless the latest regulations were implemented, every hospital in England risked being overwhelmed by Covid-19 cases? Before our debate tomorrow, could he publish the modelling on which this assertion was based?

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[Lord Bethell (Con)]

I completely endorse the noble Baroness’s points. I know well the very good work that both Birmingham and the entire West Midlands are doing. Recruitment of champions and liaison with faith leaders are exactly the kinds of interventions that local authority leadership can provide. It is absolutely at the heart of our local and national approach. We are providing the kind of support that local authorities need to pursue these plans, which includes military personnel, testing facilities, data and analysis, and financial support, where necessary.

[The Deputy Speaker (Baroness Morris of Bolton) (Con)]

The noble Lord, Lord Balfe, has withdrawn, so I now call the noble Lord, Lord Moynihan.

[Lord Moynihan (Con)]

My Lords, I congratulate my noble friend the Minister on the importance that he attaches to the safe return of fans to designated sports events, the reopening of many gyms and sporting activities across England, and the financial package announced last week for key sports in need of urgent financial assistance. Does he agree that we now need to help all clubs, particularly grass-roots clubs, to fulfil the critical role of ensuring that the population is as active and healthy as possible, to provide a strong counter to the Covid virus? Delivering and funding that objective must remain a key priority for the Government.