Covid-19

Chris Bryant Excerpts

Thursday 22nd October 2020 Commons Chamber

[The Secretary of State for Health and Social Care (Matt Hancock)]

I beg to move,

That this house has considered covid-19.

The House meets today to debate the coronavirus pandemic once more. The peril of the pandemic has no short-term quick fix, but calls for ingenuity, commitment and resolve from us all. We have responded with one of the greatest collective efforts that this nation has seen in peacetime, but the fight is not over: the virus continues to spread, and cases, hospitalisations and, tragically, deaths are all rising. Yesterday we learned that Liverpool University Hospitals NHS Foundation Trust is now treating more patients than it was at the peak in April, and across the UK the number of deaths has doubled in under a fortnight. And yet, just as the situation we face is grave, so the hope of a solution is growing. With every day, my confidence in the ingenuity of science to bring resolution grows. But until that moment, we must have resolve. We are focused on finding a long-term solution, and we reject political point scoring. I call on the House to work together in the interests of our whole nation—and, indeed, the whole world.

[Chris Bryant (Rhondda) (Lab)]

I just wonder whether one problem we have at the moment is that we do not have enough capacity in the whole of the NHS to take on covid in a long-term way, as the Secretary of State suggests, and still be able to do all the things that we really need to do. How can we ramp up that capacity so that we are still treating people for cancer, for brain injury and for all the other things that we all care about?

[Matt Hancock]

The hon. Gentleman is absolutely right. He represents a seat in Wales, and this is a challenge for the NHS in all four nations of the United Kingdom. I was going to come on to this, but one thing that we have learned in the first phase is how we can do better in keeping the other services running that the NHS must and should provide, for instance for brain injuries, for cancer treatment and for heart patients. There are also those things that are not life-threatening, but that harm people’s lives—a painful hip or a cataract that needs treatment. In the first wave, as we knew so much less about this virus, many of those treatments were stopped altogether.

In the second wave, we have two things at our advantage. The first is that this is a much more regional second wave, which puts more pressure on areas such as Liverpool and Lancashire than elsewhere in the country, but that does mean that elsewhere the elective and the urgent operations can continue. The second difference is that we know much more about the virus and how it spreads, so we have separated the NHS into green sites and blues sites. Green sites are for where we have a high degree of confidence that there is no covid, using testing and asking people to isolate before going in for an operation, so that people can have more confidence. The central message across all parts of the UK is that the NHS remains open. Finally on this point, the best way we can keep the sorts of treatments that we all want to see going is to keep the virus under control.

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[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

We face a difficult winter. Many areas of England are under heightened restrictions, including Elmbridge, part of which forms part of my constituency. We face the national challenge of a new disease, with a population that is largely unexposed to it and has built no immunity to it through either prior infection or other means, such as vaccination. It spreads easily and quickly, and can make people in high-risk groups, particularly the elderly, seriously ill. It can spiral out of control and overwhelm our health service.

I supported the first lockdown and I support the current restrictions. As an NHS doctor, I say with all my body and soul that we cannot let the NHS be overwhelmed. But lockdowns and restrictions are deeply harmful in themselves. The long-term effects will be profound—a higher burden of disease from poverty, with associated costs in lives; loss of livelihoods; misery and damage from isolation, and reduction in liberties. We need a way out.

My constituents are feeling it—especially those who are now in tier 2 restrictions in Elmbridge—and I pay tribute to them for their resolve. They rightly ask me, “What’s the way out? How does this end? How do we escape the cycle of lockdown?” The current strategy is to suppress until there is a vaccine, but what if there is never a vaccine? As people start to tire of lockdown, increasing coercion and punitive measures are being put in place. On my commute from Runnymede and Weybridge, I travel to Waterloo station, and I have seen the signs there change—from a £100 fine for not wearing a face mask, to £3,000, to £6,000—in the course of a few months. It is inevitable that greater coercion will be needed. When does that stop?

Coercion is illusory. It works briefly, but after a while it fails, unless we take people with us and they own the decision. Of course, in a public health response to an infectious disease, we cannot have a free-for-all, but at the same time, in my constituency, I see people at low risk from covid who ignore the guidance because it will not directly affect them and all they see is harm from restrictions. I see people at high risk ignoring guidance because life is short and they want to see their grandkids. I see people terrified of covid hiding away from the world. Day in, day out, people make decisions about their health risks, such as to smoke or not to smoke—indeed, given that 76,000 people die every year from smoking, probably more people have already died this year from smoking than from covid. People decide whether to put salt on their chips, or not to eat chips. We all make compromises and trade-offs, but rather than the state deciding those trade-offs, we must find a way to let people decide their own.

[Chris Bryant]

Is not the problem that whether I choose to have salt on my chips is a matter for my health, but when I take risks with covid, I take them not just for myself but for everybody else with whom I interact, and for the whole of society?

[Dr Spencer]

I thank the hon. Gentleman for his intervention, and I will come to precisely that point in due course.

I supported the first lockdown, and I support the current restrictions, but we need a way out that works, irrespective of the invention of a vaccine. We need a way out that supports people to take their own decisions and respects free choice but, as the hon. Gentleman said, we must also protect society from an infectious disease. Such a system needs to be sustained for a long time, and those measures will need to be in place for a long time.

It is easy to criticise, but it is more difficult to put forward other options. We therefore need a debate about what a plan B could look like. We started with a national lockdown, but that was too blunt. We rightly moved to targeted measures, which are better, but still not great. The geographical area is too large, and people do not live their lives by local authority boundaries. The next logical step is to shrink the geography further—to the household or individual—and to have a system that allows people to make decisions for themselves regarding their own risks and the people they come across socially or at work.

We must use our testing capabilities in a targeted, risk-based manner, so that those at high risk, should they choose to, can shield and have support to do that. Those at low risk would be able to live their lives more freely, should they choose to do so. At the same time, we must ensure that things do not spiral out of control, with broader measures and restrictions available in reserve if needed. We must invest in our NHS surge capacity, and carry out research into vaccines and treatments.

The challenge, of course, is how we support those at medium risk, or those who live or work with high-risk individuals, and we need to have that debate. Lockdowns are not a cure for covid. They only regulate the pressure on the health service and, important as that is, in time they can, and will, be worse than the disease itself. We need to have that difficult debate and there is no easy solution. While I suggest that we wait for the phase 3 trials of vaccines, which come out imminently, we must start putting flesh on the bones of a plan B, based on individual choice, and consider a pilot in the UK. To get through this pandemic, whatever we do will be difficult. Difficult decisions have to be made, and more difficult decisions remain to be made.

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[Chris Bryant (Rhondda) (Lab)]

I want to talk about a dangerous bit of fake science that is doing the rounds—the so-called Great Barrington declaration which calls for focused protection for the vulnerable and ending all lockdowns and restrictions so that everyone else should immediately be allowed to resume life as normal. It sounds wonderful, doesn’t it? Idyllic. Some 6,300 people have signed the declaration. That sounds impressive, but that is a tiny, tiny proportion of all the medical professionals in the world, the vast majority of whom dismiss that approach out of hand.

Many of the signatories to the declaration are not world-leading epidemiologists and virologists. Many of them are homeopaths and self-certified therapists. They include the famous Dr Johnny Bananas, the Rev. Booker Clownn, Dr Person Fakename and Mr Matt Hancock, although not the one of this parish. I remember what fake science did over the MMR vaccine when lots of journalists paid court to one man, Dr Andrew Wakefield, simply because he had the title Doctor in front of his name. That caused immeasurable harm to a very important vaccine programme.

Some of the people who signed the declaration told us earlier this year that the virus would just melt away by the summer and others guaranteed that there would not be a second wave. Yet some people still support them. None of the declaration’s assertions is supported by evidence. They do not even pretend to be. There are no references to peer-reviewed research; they are simply assertions.

It is completely wrong to call people who believe all this stuff “nutcases”. I did earlier this week and I wish that I had not used that word the other day. I have worked long enough in acquired brain injury and as a personal counsellor to others to know that that is wrong. I apologise. But this really is a fringe opinion shared by conspiracy theorists, funded by hard-right economic libertarian extremists in the United States of America and advocated entirely by fake scientists. Ignorance is one thing. Deliberate ignorance really is stupidity.

At the heart of the declaration is the belief that we need to acquire herd immunity by letting everybody get infected. The facts—and there are no alternative facts here—are that there is no evidence that contracting covid-19 grants long-term immunity to future infection. We already know that one can catch it twice and it is not yet a year old. Other coronaviruses only grant temporary immunity. Fact.

[Bob Stewart]

To support the hon. Gentleman’s case, may I point out that if we could achieve herd immunity, we would not contract diseases like measles? We still get them, so herd immunity is impossible to achieve.

[Chris Bryant]

In this case, the point is that we will not achieve herd immunity just by trying to let everyone get the disease. That is an immoral proposition. We have all heard the line that this virus is not that dangerous and is less dangerous than flu. I am sure that we have all had emails about it. The facts—and again there are no alternative facts here—are that covid is more easily transmitted than flu and has more complications for more people. Between January and August 2020, there were 48,168 deaths due to covid-19—not associated with it—compared with 13,619 deaths due to pneumonia and 394 deaths due to influenza. The number of deaths due to covid up to 31 August this year was higher than those due to influenza and pneumonia in every single year since 1959, including years when we did not have a vaccine for flu.

The other theme of the great declaration is supposed to be focused protection. Again, that sounds great—“let’s protect the most vulnerable”—but we cannot just shut the elderly and vulnerable away and throw away the key. They do not live in hermetically sealed units, funnily enough. They rely on nurses, carers, home helps and family members. All those people would presumably have to be locked away. Is somebody going to suggest that the most vulnerable communities—in fact, the BAME community—are en masse all going to be locked away, as well as the overweight, no doubt, and all the men? Of course, that is a complete and utter nonsense. By one estimate, we would be incarcerating a quarter of the whole UK population.

There is a cruelty at the heart of this proposal: it is basically survival of the fittest. Yes, it does make me angry when people propose it. It makes me angry for those who have lost loved ones this year, who seem to be ignored. It makes me angry for the NHS staff who have slogged their way through the misery on our behalf and need us all to realise that there is a much better creed than survival of the fittest, and it is that we are all in this together.

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[Ms Dorries]

I do apologise, Madam Deputy Speaker, it is because I have not been here very often lately.

The hon. Gentleman made one of the best speeches I have heard him make in this House, probably because he agreed with every word I have been saying—indeed, I almost ripped up this speech. I applaud him for some of the comments he made.

[Chris Bryant]

I will have to resign now!

[Ms Dorries]

Possibly; the hon. Gentleman is in a very difficult position now. I say well done to him for taking apart the Great Barrington declaration. I will now not go into it, as he did an excellent job.

Turning to herd immunity, without a vaccine how do we attain herd immunity? With no knowledge of immunity from coronavirus, how do we obtain herd immunity? I will share with the House that I was diagnosed with coronavirus on 7 March, I had a severe dose and my antibodies had disappeared 12 weeks later. I am no longer immune to coronavirus. That is not just my story; it is the story of many, many people. Many people who were donating their plasma post-coronavirus for convalescent therapy were told quite quickly, “We no longer need your plasma because you do not have any antibodies left.” Work is going on into immunity, and we have not reached a conclusive position yet, but I can speak from my own experience and from the experiences that we are hearing about, and if people do not have long-term antibodies and we have no vaccine, there is no such thing as herd immunity. I say that again because it is the truth.

On the comments about the measures we are putting in place, how restrictive they are and social distancing, all I can say—and this relates to the number of deaths in hospitals—is that back in March no one was wearing face coverings and no social distancing was being complied with by the public, and the rate of infection was doubling every three to four days. Now, it is doubling every seven to 14 days, because the public are wearing masks, they are hand washing and they are socially distancing, and that means that when someone contracts coronavirus, they contract a smaller viral load, which is enabling doctors to treat those patients once they reach an intensive care unit. In ICUs, people are now living, not dying, but we still need the ICUs and we still need the ICU beds in which to treat those people in order that they can live. The fundamental purpose of every measure we take is to protect the NHS and to keep those beds in ICUs, so that they are there to treat people and to keep people alive.

I described this to someone today who argued with me that face masks and coverings are unnecessary. If people are in the space of someone with no facemask—I will use a scale of one to 100—they will breathe in 100 droplets and a full viral load, but when someone has a mask on it is much less. This is not a scientific experiment; it is my own analogy, but the figure is probably 10. The hon. Member for Tooting (Dr Allin-Khan) knows this much better than I do, and can confirm or deny it. Therefore, with a mask, people’s viral load is lower and it is far easier to treat them once they arrive in hospital at A&E and are transferred to an ICU, and there is a huge chance of success. That is what we are seeing in action now in our hospitals. If we all abandon our face coverings, stop social distancing and stop hand washing, we will be back to where we were in March, when the virus was doubling every three to four days.

My hon. Friend the Member for Christchurch (Sir Christopher Chope) mentioned Sweden, but an article in The BMJ—a research study—concluded that Sweden and the US are the only two countries that are failing to reduce their numbers of deaths. In fact, it is far more accurate to compare Sweden with its Nordic neighbours. Sweden has 586 deaths per 1 million people, while its neighbour Norway has 279, so I am not quite sure why Sweden would be cited as a country of success.[Official Report, 24 November 2020, Vol. 684, c. 8MC.]