Covid-19 Update Debate
Full Debate: Read Full DebateLord Bethell
Main Page: Lord Bethell (Conservative - Excepted Hereditary)Department Debates - View all Lord Bethell's debates with the Department of Health and Social Care
(3 years, 3 months ago)
Lords ChamberMy Lords, I too thank the Minister for coming before the House to deal with this Statement, and also for his work ethic in dealing with Covid-19 over the last 14 months.
From these Benches, we have always said that we will support whatever is proportionate and follows evidence to keep people safe. The more that you delve into the Government’s reason for not including India on the red list at the same time as Pakistan and Bangladesh, the more it feels like a big ball of candyfloss that initially seems tempting but disintegrates on touch. Yesterday, both the Minister and the Secretary of State said that India was not put on the red list at the same time as Pakistan and Bangladesh because of the positivity rate.
Looking at the figures for the two weeks before Bangladesh and Pakistan were put on the red list, the positivity rate for India was 5.1%. For Pakistan, it was slightly higher at 6.2%, yet for Bangladesh it was lower, at 3.7%. The same data—the Government’s test and trace data—shows that in the same two-week period, 50% of all new variants entering the UK, including those of concern, were from India: the largest country by far. Therefore, variants of concern and positivity rates show India to be on a par with, or ahead of, Bangladesh and Pakistan. So what data were the Government actually using, if it was not their own test and trace data? Can the Minister place on the record that data and the raw data which made him, and the Secretary of State, say that India’s positivity rate was three times higher?
Another area of concern is people entering the UK being huddled together at the border with people entering from red-list countries. One needs only to look at the significant Twitter feeds from yesterday of people arriving from green or amber countries, who were spending up to four hours in queues to get over the UK border and having to stand next to and mingle with people entering from red-list countries. Heathrow and Manchester Airports were responding that, despite asking the Government for more border staff to deal with the issue, none had been forthcoming.
This was planned. We knew that international travel was allowed and the Government knew that the traffic-light system was being introduced, so why have the Government not carried out the wishes of the airport operators to ensure that more border staff and more guidance are available to segregate those entering from red-list countries? This is a clear public health crisis at our border, and the Government have not, to date, solved it. So, as a matter of urgency, when will this public health breach right at our borders be solved?
Finally, as variants of concern continue to enter the country and replicate at speed, “isolate, isolate, isolate” becomes vital. Yesterday, the Secretary of State in another place indicated to Munira Wilson MP that the Government were worried that isolation might not be as robust as required, and that some pilots were taking place. Can the Minister outline where they are, what the parameters of the pilots are and when the results will be made public? Also, overwhelming evidence now shows that people on lower salaries must be paid their full wages and given support to ensure that they can comply with full isolation requirements. Will the Government now look at this as a matter of urgency?
My Lords, I am enormously grateful for the very detailed and thorough questions from the noble Baroness and the noble Lord, and I am also appreciative of and touched by their kind comments.
The noble Baroness asked about the Indian variant and the uptake of the vaccines. I reassure her that we are doing absolutely everything that we can to ensure that there is a thorough uptake of the vaccine among all communities. She spoke touchingly about the feeling of blame associated with those in hospital who people hear have not taken the vaccine. I hear her comments, but there is no attribution of blame meant in this. It is a simple statement of fact that if you do not take the vaccine that is offered to you, or if you do not take two doses, and you then expose yourself to the virus, that is putting yourself in substantial danger, and it is a clinical observation that many of those who have ended up in hospital with severe disease are those who have not had the vaccine, even though they may have been offered it.
The noble Baroness asked about accessibility. She is entirely right that there are some people to whom we as a healthcare system have not made ourselves accessible enough. During this pandemic we have moved on from using the phrase “hard to reach” and we now think of it in terms of people who find us “hard to access”. She makes a perfectly reasonable observation in that respect, but I reassure her that we have absolutely bent over backwards to do everything we can to put the vaccine in front of all groups in the country, particularly those in areas such as Bolton, which we recognise have in the past been places where we have not got our message across.
I personally am hugely touched by the videos I have seen of people now queueing to have the vaccine. I applaud all community leaders and those who work with communities in Bolton, who have clearly mobilised a huge amount of public sentiment behind the vaccine programme. We are seeing a transformation in the penetration rates among some very important communities.
There is more that we can do. I am open to any suggestions from noble Lords on how we can do better, but I would like to reassure noble Lords that we have strained every sinew in trying to achieve vaccine equity across all groups in the country. That is true not only in Bolton but in Bedford, and I am disturbed to hear that people in Bedford feel they may have somehow been overlooked. I do not believe that is the view of the Vicky Head in Bedford, the DPH, and we have worked extremely closely with her. I assure the noble Baroness that cluster 2, linked to 12 cases in Bedford, was targeted immediately. An MTU went to the community on 8 May, and two community sites were opened up on 10 May. We have absolutely prioritised Bedford, as we have Sefton, Leicester, Nottingham and London—all areas where clusters have broken out. There is absolutely no question of prioritising one area over another. On the availability of the Pfizer vaccine in Bedford, that is news to me. I will be glad to look into that and to write to the noble Baroness accordingly.
On children, as noble Lords will be aware, this is an area in which some of the vaccine companies are making considerable progress in their clinical trials. None is categoric yet. It is too early to have agreed policy in this area, but the noble Baroness makes a very good point. Opening up the Covid vaccine, as we have with the flu vaccine, means that not only are children with some kind of vulnerability, particularly to long Covid, put into a safe place but that the transmissibility of that important age group can be reduced.
I am afraid we cannot know for certain the long-term effect of the vaccine until time has passed, but the CMO’s view is that the indications on the body’s immune system are extremely strong. At this moment it seems the vaccine is working, and our confidence is at a reasonably high point, but we remain vigilant. VoCs could emerge that either reduce the effectiveness of the vaccine or, for instance, effect some kind of decline in protection from the vaccine. That is why we have put in place contingent plans for boosters in the autumn. Those boosters might be of the existing suite of vaccines that are proving extremely effective. We are also looking for VoC vaccines that may be used to supplement the range of immune responses so that they cover any new mutations or variants that may emerge.
I cannot immediately recognise from the Bench the data the noble Lord, Lord Scriven, gave on the India VoCs. I wonder whether it was data that emerged after we made the decisions, because a lot of the sequencing data is retrospective; it takes between a week and 10 days to emerge from the Sanger Institute. That is one of the difficulties in making these decisions, which sometimes seem so clear-cut in retrospect. When you have the data available to you on the day, the decisions are not necessarily quite so apparent.
I do not really recognise the criticisms the noble Lord makes of the red list system. The red list system we have in the UK is an incredibly important shield and is proving extremely effective. Segregation is unbelievably difficult during travel. It is very difficult to segregate amber list and red list passengers on a plane, train or ferry. Within an airport it is very difficult to segregate people, because of the physical proximity. That is why travelling is dangerous, why we tell people not to travel and why, when people do travel, we tell them to isolate. Travelling is dangerous, and that is not news to us or to the people who get on those planes in the first place. The ultimate sanction here is that, particularly as we go into the summer, we tell people: travelling is not for this year. Please stay in this country.
On the isolation pilots the noble Lord referred to, we are running a large amount of work on pilots for isolation generally. If he would like to write to me about the particular pilots he was referring to, I will be glad to give him an update. I am afraid I am not quite clear at this stage which ones he is referring to.
My Lords, we now come to the 30 minutes allocated for Back-Bench questions. We do not have that many Back-Bench questioners, but it is still quite good discipline if people keep their questions and answers as brief and relevant as possible.
My Lords, I thank my noble friend the Minister for his repeat of the Statement. It is indeed welcome news for people and the economy that we are able to move to step 3 in our road map. However, as the Health Secretary said,
“we must be humble in the face of this virus.”—[Official Report, Commons, 17/5/21; col. 424.]
While the UK has had the highest vaccination enthusiasm in the world, does the Minister agree that it is deeply worrying that many people eligible for a vaccine, particularly among vulnerable age groups, have still not had one? This was seen in Bolton, where the majority of the 19 patients admitted to hospital with the new Indian variant, especially people from ethnic-minority communities, have not had a vaccine. What further support can the Government give to promote the better uptake of vaccines among ethnic minorities?
My Lords, my noble friend refers to humility and he is right: we have all had to develop a stronger sense of humility in the face of this awful virus and this dreadful pandemic. It has taught us that, despite all our 21st-century healthcare systems, we are all vulnerable to its awful effects. His words are absolutely spot on. I repeat the statistic that 69.4% of adults across the UK have had the vaccine, because the overall story of the vaccine rollout has been one of incredible participation by the British public. Not only have I never been involved in anything quite so successful in my life but there are very few national projects anywhere in the world that have been as successful. I really applaud all communities in every part of Britain for the way in which they have stepped up to the vaccine. My noble friend is right that there are some communities in which those levels are not as high as they should be. That has led to higher transmission among younger people, and in a few cases that has led to severe disease among older people who, frankly, should have taken their vaccine. I urge everyone to step up to their opportunity.
As the Minister, who has worked tirelessly during Covid, knows only too well, an outbreak anywhere can become an outbreak everywhere. Can he tell us how the UK plans to increase vaccine distribution globally through COVAX to control the pandemic and decrease the risk of further variants arising in countries with high rates of infection, particularly as the risk of vaccine-resistant variants will remain high for at least a decade?
My Lords, the Tedros principle of us being safe only when we are all safe remains the most profound insight. The noble Baroness is entirely right: we must do more to try to help those in the developing world. The frustrating truth is that the world simply does not have enough capacity for the manufacture of these very complex and tricky substances. We are straining every sinew to try to deliver the 9 billion vaccines we need to deliver worldwide vaccination, but the rate of manufacturing is not as high as any of us would like. I take my hat off in particular to AstraZeneca, which has provided licences for the vaccine worldwide on a no-profit basis, but I also pay tribute to the other vaccine companies, which, despite what one might read in the press, are trying all they can to set up manufacturing sites all around the world. Progress is being made.
My Lords, I too salute AstraZeneca for its noble efforts. However, I would like to take the Minister back to the SAGE meeting of 13 May, when the Government were warned:
“In the areas where numbers of infections are increasing rapidly … an even faster increase can be expected if measures are relaxed”.
The Government went ahead with relaxing the measures yesterday. I know that Mr Dominic Cummings can perhaps not be regarded as the most reliable of commentators, but was he not right to say that fast, hard and effective action is the best policy for the economy, as opposed to always delaying taking decisive action? When it comes to the next stage, can we be reassured that the decision will not be taken until the evidence in June is fully assessed and evaluated?
My Lords, I am a big supporter of the “fast and hard” principle. In our response in Bolton, Bedford, London and elsewhere, we have demonstrated that principle in our handling of the Indian variant. I point out that the use of testing and social distancing measures in schools has been enormously effective. One of the remarkable aspects of the infection rate so far is that transmission levels among school-aged children have not increased in the way that SAGE and others, including myself, once feared. We should take a “glass half-full” moment to applaud that fact. I reassure the noble Lord that we will absolutely make these decisions on the data. Space has been put in between the steps for exactly that reason, and we are not going to rush it.
My Lords, could the Minister outline the Government’s plans for test and trace as lockdown is lifted, particularly in areas such as Bolton and Bedford where surge testing is currently being deployed? With former centrally based Public Health England staff being disbanded and senior civil servants returning to their own posts, what financial resources are being passed to the local resilience teams, run by local directors of public health, to operate test and trace, which will be so critical to controlling the spread of the virus alongside the vaccine rollout?
My Lords, the outbreak in Bolton, Bedford, London and elsewhere has demonstrated, if that were needed, the paramount importance of keeping resources for test and trace at a critical level, and that is what we have done. Since the national infection rate is lower, there is a much greater emphasis on the kind of surge activity and outbreak management that the noble Baroness describes. Sequencing has proved to be an essential part of that process, and we have brought sequencing from the back of the laboratory to the front line of test and trace operation. Every single positive case is now treated as though it were a VOC, with the same amount of tracing and sequencing that a VOC would have had a few weeks ago. We have the full operation on standby. Should another wave of infections arrive, as it may well do with the relaxing of social distancing, we have the systems in place to be able to deal with it.
My Lords, I declare my interest as Deputy Colonel Commandant of the Brigade of Gurkhas. The Indian variant is spreading not just across the United Kingdom but across the north Indian plains and into Nepal, a country ill-equipped to deal with such a pandemic. Given the speed of response and support offered to India, I simply ask my noble friend whether the Government will respond positively to Nepal’s request for 2 million doses of vaccine.
I am grateful for the briefing on Nepal I had earlier from my noble friend. The scenes that we have seen in north-west India are heart-breaking. Nepal is such a good example of the kind of country that the global community needs to surround and support with vaccine technology that, frankly, is for G7-style countries to help to provide to developing countries. I take my noble friend’s point completely on board. I do not have immediately to hand the statistics about what Britain is doing for Nepal on the vaccine front, but I will be glad to write to him with any data that I can put together.
My Lords, I declare my interests as set out in the register. With the move to stage 3 of the road map, university students can now return to campus. Most of them are too young to have received vaccines so students around the country will form a significant cohort of young people undertaking regular and frequent testing as a matter of course. What consideration has been given to the benefits of sustaining PCR testing and sequencing at scale in universities as a way of rapidly identifying and understanding new variants? Will the Government consider providing funding to support that in future?
My Lords, I pay tribute to the vice-chancellors and to the universities and colleges of Britain for the way in which they have embraced campus testing. It has been a salutary lesson in what can be done, and it has helped to keep infection rates down on campuses where there has been a small number of returning students to date. That is done mainly through LFD testing. Positive tests then have a complementary PCR test, and the PCR test is automatically sequenced if it is positive. The combination of LFD, PCR and sequencing is the right one for keeping infection rates down, but we tweak the formula as and when best advice comes in.
My Lords, the pandemic has hit the low-paid and the poor the hardest. The Government need to commit to a road map to a better post-Covid society so I invite them to make two pledges. First, at the very least, they need to reduce the NHS waiting lists in England from the present 4.95 million to 2.5 million, which was the case in 2010. Will the Minister pledge to do exactly that by the end of this Parliament or even sooner? If not, why not? Secondly, the poorest 10% of households pay 47.6% of their income in direct and indirect taxes, compared with 33.5% for the richest 10% of households. This condemns millions of people to poor food, housing and health, which is a key reason for deaths during this pandemic. Will the Government pledge to eliminate that injustice by the end of this Parliament?
My Lords, I recognise some of the noble Lord’s insights. It is undoubtedly true that the low-paid and the poor have been hardest hit by Covid, both by the infection rates themselves and by the lockdown. That is a frustrating truth that is completely recognised and acknowledged by the Government. It is also true that the low-paid and the poor have health inequalities that have themselves made people more vulnerable to sickness, both from Covid and from the non-Covid diseases that have been exacerbated by limited access to some parts of the NHS. We are absolutely committed to reducing NHS waiting lists—that is an incredibly important part of the “build back better” mantra—but we need to do more to bring a degree of levelling up to all parts of society in order to address the symptoms that the noble Lord rightly describes.
My Lords, I welcome the remarkable progress of the uptake of the vaccine in all communities, and I thank the Minister for coming to us with this Statement. However, I am sure he will understand that serious questions remain about the Government’s decision not to red-list being a direct cause of this dangerous Indian variant—I am sure that at some point the Government will have to answer fully to Parliament—and that it is not true, even as a clinical assessment, despite the media repeatedly and consistently suggesting this, that the uptake of vaccinations is the responsibility of certain communities. The Minister will appreciate the likely and even inevitable consequences of rising Islamophobia and hate crimes, as has been reported by Tell MAMA. What are the Government going to do to monitor and support local communities to ensure that they do not face such consequences? Also, echoing the noble Baroness, Lady Tyler, what plans and resources are in place to monitor and support compliance as we enter the next phase of the road map?
My Lords, I have to be honest with the noble Baroness: I am not sure it is helpful to try to connect healthcare policy decisions with a commentary on hate crime. The people who have not stepped up to the vaccine come from a very wide variety of communities; it is not one single community that has been singled out. We are talking about everyone from migrant workers in the apple yards of Herefordshire, to hard-working off-book sweat-shop labourers in east Leicestershire. In between there are people from many different communities who have not taken advantage of the vaccine opportunity. We are working really closely at NHS level to reassure community leaders and individuals concerned that the vaccine is safe and will provide protection. That is the right conversation to have.
The bus industry has cleaned up its buses and introduced lots of ventilation, and people are wearing masks. Is there any hope that the amount of social distancing on buses will be reduced in the near future, because there is a lot of unused capacity?
My Lords, I pay tribute to the bus industry. Many noble Lords will remember those terrible stories at the beginning of the pandemic about bus drivers having an extremely high incidence of severe disease and even death. But the noble Lord should have hope as there is a really good reason why the buses will one day be full, and that is the vaccine. The vaccine gives us all hope that the kind of life we once had can be revisited, although we have to take some time to ensure that the vaccines are working as well as they should. We have to ensure that booster shots, if needed, are delivered. We have to ensure that the vaccine cuts through to all communities and that hygiene—the social distancing, handwashing and other personal hygiene disciplines which are going to be a long-term commitment by the entire nation—is truly imbedded in everyone’s habits.
My Lords, I thank my noble friend for the Statement repeat and congratulate him on the work he has been doing over the last many months. Does he agree that the public health messaging, which has been very good in all communities, should continue because we are going to get many other forms of variant? As the noble Baroness, Lady Finlay, says, this is going to be an ongoing issue, probably for a number of years, and continuous messaging will be key. Will he also tell me, given the recent new variant, what conversations he is having with counterparts from the countries concerned to see how that variant is reacting, what is happening there and whether it is reproducing rapidly or slowly, so that better informed decisions can be made in our own country?
My Lords, I am extremely grateful to my noble friend for her insight. She is entirely right; this awful pandemic does have a silver lining, which is that it can be an inflection point for a complete transformation in our public health messaging. The work we are doing on communicating the threat of the variants is one example of that. The next front line will be the flu jab rollout in the autumn, where take-up rates have been okay but not great. I hope that, when the flu jab campaign begins this autumn, a completely different generation and spread of people will step up to that opportunity. We are working extremely hard to use the public mood and sentiment behind preventive medicine to full effect to ensure that the flu jab works, that therefore a much smaller proportion of the population will transmit flu, and that deaths and severe disease from flu will be reduced. That can be the legacy of this awful pandemic.
My Lords, I welcome the vigilant focus described in this Statement that has been adopted by the Government, and that the response is being co-ordinated through the UK Health Security Agency. Could the Minister explain how England is working with the other three countries in the UK to ensure that a proactive approach is taken to the new virus variant, that the uptake of vaccines increases, that the monitoring of transmission continues, and to enable early intervention should the number of cases increase? In particular, what data are the Government collecting on the number of people in quarantine hotels testing positive for coronavirus and how many people have absconded from quarantine? Would the Government consider adopting a process similar to the electronic tagging undertaken in South Korea, to more accurately monitor the movement of people in and out of the country at its borders?
I am enormously grateful to the noble Baroness for that creative and thoughtful question. The good news is that the number of absconding residents from managed quarantine is minimal; it can be counted on one hand and many of them have been retrieved. The bad news is that the positivity rate in managed quarantine is far too high. I do not have the precise number in front of me and do not want to guess at it, but it is clearly true that far too many people are getting on planes when they are infected and far too many people are catching the disease on their travels. When we think of how to manage any vaccine-evading and highly transmissible variants, we have to look to the red list for secure protection for this country. She asked another question I cannot remember, but I will be glad to write to her about it.
I was genuinely excited to be able to attend a Saracens rugby match last night, and I notice from my noble friend’s Twitter feed that he too was out last night enjoying a thoroughly well-deserved visit to Sadler’s Wells. My sincere thanks go to all those who have made this step to normality possible, particularly my noble friend. However, like others, I have concerns about the entry arrangements at airports. While I fully understand the difficulties of segregation and that international travel should be strongly discouraged, does he agree that more should be done to prevent passengers arriving from red, amber and green countries mixing—particularly at airport border entry points with those from red countries, where, as he has just said, there is obviously a high degree of infection?
My Lords, I enjoyed the contemporary dance at Sadler’s Wells, which really lifted my heart, but I rather wish I had been at Saracens for that thumping victory and to see my favourite team doing so well after a difficult year. I very clearly hear the concerns of noble Lords about social mixing of amber and red route passengers at airports, and one reads about it in the papers. I reassure noble Lords that the amount of segregation in place in the airports is the focus of both Border Force and the Home Office. We are absolutely doing our best. We are looking at red list terminals, but the practicalities of that when there is a relatively low level of flights are very challenging indeed. I reiterate my point that if you are travelling you are putting yourself at risk, and there is no way we can pretend otherwise. If you are travelling, you should isolate yourself for a substantial amount of time when you touch down in the UK. This question of mingling in airports is, to some extent, a red herring.
My Lords, it is clear that the B16172 variant of SARS-CoV-2 is now established in the community, but that only highlights the need to keep out further variants of concern that will inevitably arise around the world as the coronavirus runs rampant. Following the question of the noble Baroness, Lady Watkins of Tavistock, can the Minister reassure me about the security arrangements in quarantine facilities given the number of cases of transmission in New Zealand and Australia, who have long practised quarantine? How often are staff being tested? Are they being paid in ways that mean they do not have to take other jobs, particularly jobs where they may have contact with large numbers of people? Are ventilation systems being checked regularly?
My Lords, the noble Baroness is entirely right to cite the examples of Australia and New Zealand and the challenges they have had with staff manning managed quarantine facilities. I am extremely grateful to officials from both Australia and New Zealand for the very thorough briefings we had when we set up our managed quarantine facilities. We totally took on board their profound insight on that area and that was the number one thing they told us to get right. We focused on it, we have invested in it, and that has worked well to date.
My Lords, all questions have been asked and answered.