Covid-19 Update Debate
Full Debate: Read Full DebateLord Kamall
Main Page: Lord Kamall (Conservative - Life peer)Department Debates - View all Lord Kamall's debates with the Department of Health and Social Care
(2 years, 10 months ago)
Lords ChamberMy Lords, with the leave of the House, I shall now repeat a Statement made in another place by my honourable friend the Parliamentary Under-Secretary of State for Health and Social Care. The Statement is as follows:
“With permission, Mr Speaker, I would like to make a Statement on coronavirus. Even through the warm summer days, we drew up our autumn and winter plan. We used the time to plan and prepare, because we know that Covid-19 thrives in colder weather. With winter now around the corner, Covid-19 is re-emerging, as expected. It is clear that this pandemic is far from over: new cases of the virus are high; the pressure on our hospitals is steadily growing; and, sadly, we are seeing over 100 deaths a day. We must therefore be prompt and proportionate in how we enact the plan. We will not be implementing our plan B of contingency measures at this point, but we will stay vigilant and ready for all eventualities, even while pursuing plan A to its full extent.
Vaccines are our first line of defence. Eighty-six per cent of everyone in the UK over 12 has received at least one dose, and 79% of people have had at least two. Two steps naturally follow from this. The first is to plug any gaps in the wall by doing all we can to get vaccines into the unvaccinated. There are 4.7 million people over the age of 18 in England who have not accepted the vaccine, so we are working hard to encourage those who can take it to do so. It is never too late to come forward. We are also working with parents and schools to ensure that this life-saving protection is extended to over-12s.
Our vaccines continue to save countless lives, but early evidence shows that their protection can wane over time, especially in older and more vulnerable people. Our second step has therefore been to reinforce our wall of defence still further. That means third doses, not only for the immunosuppressed but booster shots for all those in phase 1 of our vaccination programme. We have given more than 4 million third doses and boosters in England so far. It is good, but it is not good enough. I want all those eligible to come forward. Over 85% of people have done it twice; there is no good reason not to do it again.
Those who are over 50 or in another priority group, and who had their second jab over six months ago, will be eligible for a booster. The NHS will send an invite once an individual is eligible. But if the invitation has not arrived despite a person becoming eligible, they should contact the national booking service. Boosters can be booked online or by calling 119, because there is zero room for complacency when it comes to this deadly disease and we all have our part to play.
Vaccines are not our only line of defence. Antivirals can stop a mild disease from becoming more serious. Our antivirals taskforce has been looking for the most promising new drugs, to speed up their development and manufacture. Yesterday, we signed a landmark deal for hundreds of thousands of doses of two new antivirals from Pfizer and Merck Sharp & Dohme. Should the MHRA approve their use, we will work with the NHS to make sure that they quickly get to those who need them.
There are, of course, further lines of defence: those that form plan B of our autumn and winter plan. We have always sought to maintain measures that are proportionate to the stage of the pandemic that we are in. We detailed plan B so that people and businesses would know what to expect. This includes face coverings in certain settings, encouragement to work at home where possible, and Covid certification. None of us wishes to implement these measures, but they are clearly preferable to having to close businesses or enforcing further lockdowns.
I recognise vaccine certification is of particular interest to my colleagues in this House. As we set out in our plan, we would seek to provide a vote in Parliament ahead of any regulations coming into force. However, at this time, we remain on Plan A and we will continue to monitor the situation carefully. We are identifying new variants all the time, including a new version of the Delta variant known as AY.4.2, which seems to be growing in prevalence.
Equally, we are monitoring the situation in our hospitals. I want to thank everyone in the NHS and social care for everything they are doing to keep us safe. Today, I can confirm to the House that we are making £162.5 million of additional funding available for social care through a workforce retention and recruitment fund to help local authorities work with providers to boost staffing and support existing care workers through the winter.
In closing, I want to underline just how many things remain within the control of each and every one of us. When we are offered vaccines for Covid-19, we can take up that offer. When we are offered a flu jab, we can take that too. When we have symptoms of Covid-19, we must isolate and get tested. Even if we are well, we can wear face coverings, meet outdoors, let the air in when we are indoors, regularly wash our hands and make rapid tests part of our weekly routine. Let me be clear: rapid tests are a vital tool. A quarter of the positive cases we are identifying at the moment come from lateral flow tests. They also help to give people peace of mind when they visit vulnerable people, such as grandparents.
Even before Covid, winter has always been a tough time for people across our country, for the NHS and for social care. We have another tough winter ahead. But we have a plan. We are prepared and, if things have to change, measures will be prompt and proportionate. We all have a part to play in protecting each other and the people we love.”
I commend this Statement to the House.
My Lords, it is the turn of the Front Bench.
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.
My Lords, I declare my interest as chair of Genomics England. Does the Minister agree that, as well as testing, sequencing is critical to tracing the pandemic as cases rise? In addition to delta, we are now observing the delta subtype, AY42, and we need to be constantly on our guard for vaccine escape. Can he say what steps are being taken to ensure that our so far really very good pathogen sequencing programme will be as responsive as it needs to be to the winter surge?
I thank my noble friend for that question. The UK is world leading in genomics, and it is something that we can all be proud of. COVID-19 Genomics UK has now sequenced 1 million genomes, and the UK is working with global partners to fill global sequencing capability gaps. This includes building the new variant assessment platform, which will offer UK expertise to assess and detect new Covid variants emerging globally.
My Lords, I apologise for having stood up too early a moment or two ago; I am still very much learning my trade in this House, but I follow the dictum of Martin Luther, that if you must sin, sin boldly.
I am grateful for the Statement, and assure the Minister that the faith communities, which did a lot last year to get health messages to some of the harder-to-reach groups in our society, stand ready to do the same again this winter, but I wonder whether the Government have made a rod for their own back in having plan A versus plan B. It seems a very polar way to deal with things when, actually, we need a more graduated method. Perhaps I might encourage the Government not to be the prisoner of their own rhetoric and for the Minister to share with his colleagues in another place that perhaps we could have steps between a plan A and a plan B: we need gradual, incremental stages as the virus levels rise. I encourage him to try that.
I thank the right reverend Prelate for his advice, and for pointing out the very important role that faith communities paid played helping many people get through the lockdowns. They play an important role in this country; many people often assume that it is down to the state, but faith communities play a really important role and complement many of the things we do.
In answer to the right reverend Prelate’s specific question, it should not be seen as plan A or plan B; it is sequential. The Government would prefer that plan A works and that we vaccinate more and make sure that we reach those who have not yet been vaccinated. But if the figures, and the various factors we are looking at—scientific, but also socio-economic—suggest that we have to go to plan B, then we will. At the moment, we are hoping that plan A will work, but we are reliant on the advice that we get from the various scientific advisers that I outlined, but also the other stakeholders, to ensure that we test plan A. Hopefully, it will work, but if it does not, we will move to Plan B.
My Lords, I have recently returned from Germany, where medical masks are worn indoors in settings such as shops, restaurants, theatres, conferences, churches and, of course, on public transport. To enter, you have to show a Covid green vaccination pass—the QR code is checked—or, alternatively, a same-day antigen test performed and certified in a pharmacy. It is easy, it is acceptable, it is working and people feel safe. The death rate is much lower. Will plan B provide the same security and reassurance to British citizens as I experienced in Germany by mandating face masks and green passes, and will this happen soon enough to prevent more deaths? We started the pandemic with a first lockdown that was too late; plan B may be too late.
I thank the noble Baroness for sharing her experiences from Germany. We are relying very much on a range of scientific advisers to tell us whether we need to move to plan B but at the moment, because we are not where we were last winter and because we have broken the link between cases, hospitalisation and deaths, we would prefer to try plan A. If we have to move to plan B, we will—on the advice of our range of scientific advisers—but there are also some concerns, as the House can imagine. I think it was Professor Mark Pennington of King’s College London who said, when assessing Covid-19 and the response to it, that you have to look at it as a complex system. When one thing happens, there might be a reaction elsewhere but also unintended consequences.
One concern we have heard about mandating face masks at the moment is: who enforces that? Do we suddenly have more police enforcing it and become a police state? Transport workers are also concerned about having to approach certain people and ask them to put their mask on in the proper place, for fear of abuse, so we have to get the balance right. We will try to stick to plan A, given that we have broken that link between cases, hospitalisations and deaths, and encourage more people to get vaccinated while reaching out to those hard-to-reach groups. But if the numbers and the various indicators are there and the scientific advice tells us to move to plan B, we will do so.
My Lords, I too thank the Minister for repeating the Statement. It is such a pleasure to follow the noble Baroness, Lady Blackwood, to whom I had the pleasure of referring by name a week ago today in my maiden speech. SAGE is so crucial to the advice given to the Government. So far as I understand it, in the first half of this year SAGE met on at least a dozen occasions. Yet since July it appears to have met only three times. Is it true that SAGE has not met since 9 September and, if so, why? On 9 September, SAGE’s official advice was that the epidemic was
“entering a period of uncertainty”
because of waning immunity and “changes in contact patterns”—which meant people going back to work and children going back to school. SAGE then
“reiterated the importance of acting early to slow a growing epidemic.”
When SAGE advises the Government, as it did on 9 September, that
“Late action is likely to require harder measures”,
does the Minister agree?
I thank the noble Viscount for his question and welcome him to the House. The Government are taking a range of advice, including from SAGE, but also from the Chief Scientific Adviser, the Chief Medical Officer, the UK Health Security Agency and the NHS. We have to balance a number of different views. We want many scientific experts to contribute directly to ministerial discussions and believe that we have benefited from that wide range. I know that SAGE has met regularly; I do not have the latest date for when it did so but I can forward that information to him.