Covid-19: Personal Protective Equipment

Lord Patel Excerpts
Thursday 23rd April 2020

(4 years, 7 months ago)

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Lord Bethell Portrait Lord Bethell
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I reassure my noble friend that we have been in daily and constant contact with the Turkish Government, who have behaved with good faith and in a supportive fashion throughout all our dealings. We are thankful to them for their involvement.

Lord Patel Portrait Lord Patel (CB)
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Does the Minister agree that we have not done well when it comes to the delivery and availability of PPE? As yet, nobody has said sorry to anybody for that. Does he think that somebody should? If I may repeat and slightly rephrase the question asked by the noble Baroness, Lady Smith, at the door of which Cabinet Minister does the buck stop?

Lord Bethell Portrait Lord Bethell
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I am not sure that I agree with the analysis of the noble Lord. No one could have anticipated the huge demand for PPE not just in the NHS and care homes but in other workplaces. This is a global phenomenon. The chase for PPE is difficult in all countries around the world. Britain is not alone in struggling with this. I do not think now is the time for apologies; now is the time for delivering PPE, and that is what this Government are focused on doing.

Covid-19

Lord Patel Excerpts
Thursday 23rd April 2020

(4 years, 7 months ago)

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Lord Bethell Portrait Lord Bethell
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The noble Lord raises an issue that I remember was raised during discussions on the emergency Coronavirus Bill. It is my understanding that a generous and open-hearted view is taken on the treatment of those with irregular status in the UK. Now is clearly not the time to try to put in prison those who have irregular status. The precise arrangements escape me, but I would be glad to write to the noble Lord with a precise description.

Lord Patel Portrait Lord Patel (CB)
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My Lords, the Minister mentioned in his Statement the introduction of app-based tracing of contacts, which others have already mentioned. At the same time, I assume that the Government will introduce serology testing and expand the current molecular testing. When will the Government publish the protocol for implementation of this, and how will the public be informed?

Lord Bethell Portrait Lord Bethell
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The noble Lord, Lord Patel, will be interested to read the details of our ONS serology tests that have begun earlier this week, which will be published in mid-May. These are surveillance tests and will provide us with the information that we need to understand how the epidemic is developing. At the right time we will also bring in mass serology testing. However, as the noble Lord will be aware, when prevalence rates are around 3%, 4% or 5%, as they seem likely to be, serology tests for managing the epidemic are not relevant yet.

Covid-19: Removal of Restrictions

Lord Patel Excerpts
Tuesday 21st April 2020

(4 years, 7 months ago)

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Lord Fowler Portrait The Lord Speaker (Lord Fowler)
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Lord Mackay of Clashfern. No? Okay, we will go on. Lord Patel.

Lord Patel Portrait Lord Patel (CB)
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Noble Lords cannot see me, but I hope they can hear me. One of the five conditions the Government have set themselves before any changes will be made to the current lockdown is that they will have to be confident that there will not be a second wave of infection. What scientific evidence will the Government need in support of this decision, and what role will population-based serology testing play in this decision?

Lord Bethell Portrait Lord Bethell
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The noble Lord, Lord Patel, asks an incredibly perceptive question. The ultimate decisions will be made by the CMO, who, as noble Lords know, has enormous experience in this exact area. Serology tests play an extremely important role in this by giving an indication of the number of antibodies there are, whether people have a degree of immunity and therefore a sense of how far the virus has spread through the community. However, we are aware of reports that there are recurrences of the virus in people who have emerged and recovered. That creates a great sense of concern around our serology tests.

Coronavirus

Lord Patel Excerpts
Monday 9th March 2020

(4 years, 8 months ago)

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Lord Bethell Portrait Lord Bethell
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The noble Lord asks an important question about the critical element of the research phase of our plan, and we have announced £46 million of additional funding for this area. Britain’s scientists are providing a leading contribution to the international effort. That effort is being conducted in an extremely transparent, open source fashion, with important details on genomic material being shared widely and openly. My understanding is that it is being done in a spirit of public collaboration.

Lord Patel Portrait Lord Patel (CB)
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My Lords, does the Minister agree that what we have learned so far from the outbreaks in other countries, and even the small number of deaths in this country, is that the vulnerable groups are people aged over 65—more men than women—and those with underlying conditions? What is the Government’s strategy to protect the elderly and reduce their risk of getting this disease?

Lord Bethell Portrait Lord Bethell
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The noble Lord is entirely right. The CMO’s effort is now to identify those groups who require the greatest priority of assistance. We are not sure, and the CMO has not declared, at exactly what age that should start. He is considering publication of the exact details of the priorities in future. It seems that it is not necessarily gender-specific but that the state of your immune system is the key driver. In some areas, of course, men have very bad habits when it comes to things such as drinking and smoking. The CMO has made it clear that if you want to do one thing to avoid getting the virus, it is giving up smoking.

Wuhan Coronavirus

Lord Patel Excerpts
Tuesday 11th February 2020

(4 years, 9 months ago)

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Baroness Blackwood of North Oxford Portrait Baroness Blackwood of North Oxford
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As ever, my noble friend is astute on this issue. Contact tracing has been hugely effective, particularly for the 1,466 passengers and 95 staff who arrived in the UK on direct flights from Wuhan between 10 and 24 January. All those have now passed through the incubation period and none of them was a confirmed case. Of the remaining cases that we have found, a number are linked to contact tracing. We should be very proud of the effectiveness of our system.

On the question of antivirals, work and research is ongoing in regard to a particular HIV retroviral which has been used in this measure. That is being considered. There are three projects which aim to advance the vaccine candidates into clinical testing as quickly as possible. We are also looking at some correspondence from both diagnostic kit manufacturers and potential end users, and we are considering whether we can also improve the diagnostic kit.

Lord Patel Portrait Lord Patel (CB)
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My Lords, it is always a pleasure to correct the former Secretary of State for Health. This virus is RNA in its genetic makeup. H1N1—the previous pandemic that we were worried about when we stockpiled the antivirals—had a DNA genetic make-up. Some antivirals work better with DNA than RNA, although the Minister was correct to say that there are several antivirals currently being tested to see whether they will work against the coronavirus. As far as a vaccine is concerned, it takes a long time to develop a vaccine; when you develop one, it takes even longer to see whether it is effective.

Last time we discussed this, I said that the Government were taking a proportionate action to contain the virus in the United Kingdom. I believe that to be so even today. However, we might be on the knife edge of a pandemic. If a pandemic is declared, the whole attitude to how we contain this changes. It becomes much more draconian, to stop the movement of people, isolate the index cases and identify the contacts. Currently, asking the Members of this House to wear masks would only make the public panic and ask why we are protecting ourselves when they are not being protected. It can be a good measure, but we have to wait to see how things develop. I would like to hear reassurance from the Minister that there are plans in place, so that if this becomes pandemic, the Government will take the draconian action that is required.

We are fortunate that, apart from the Chief Medical Officer Chris Whitty, who is a first-rate epidemiologist, we have Professor Piot, who discovered the Ebola virus, and Jeremy Farrar, chief executive of the Wellcome Trust. They have better knowledge on containing pandemics than anyone else in the world; I hope the Government will use their expertise.

Baroness Blackwood of North Oxford Portrait Baroness Blackwood of North Oxford
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The noble Lord has demonstrated, far more eloquently than me, why we have more expertise in public health, and in particular in infectious diseases, than many other nations; we of course share our expertise through the WHO with Professor Piot, Professor Jeremy Farrar and our own Chief Medical Officer Chris Whitty. We operate using the best scientific evidence and advice from SAGE, which is currently advising the risk level of moderate. We keep that under constant review and are not complacent in any way. Through the preparations that we are putting through the NHS and all other parts of the system, we will be prepared for whatever situations might emerge should there be more sustained transmission in the UK. We will take the measures necessary to protect public health. The steps that we have taken so far have been proportionate and appropriate; they also demonstrate that the Government will act as necessary to make sure that we protect public health.

Coronavirus

Lord Patel Excerpts
Monday 3rd February 2020

(4 years, 9 months ago)

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Baroness Blackwood of North Oxford Portrait Baroness Blackwood of North Oxford
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The noble Baroness has rightly raised this issue with me before. She is quite right that flu can and should be managed much more effectively in the community and by individuals. I think we have had an effective flu campaign this year. The flu vaccine has been offered to 25 million people. We have also extended the flu programme this year to children in year 6 to improve herd immunity and drive up its impact. We are seeing the number of those with flu declining, so we are starting to see some improvement. However, I completely recognise the noble Baroness’s point about public health lessons and improving public education on the management of infectious conditions, which we live with every winter, not just when we have an infectious situation such as this. I thank the noble Baroness for an important question.

Lord Patel Portrait Lord Patel (CB)
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My Lords, in my view the measures the Government have taken are balanced so as not to cause a panic and unnecessary alarm. The important thing, though, is that the Government remain on top of developments. If the virus mutates and spreads rapidly from human to human, it will require much more draconian measures to be taken.

It has been reported that the virus transmits from human to human and to people who have not been in China, although the numbers are small. An index or measure of human-to-human transfer is known as R0. It currently stands at about 1 to 2. If it increases, that means the virus is spreading faster. Sequencing of all the known cases so far suggests that the virus has not mutated. It remains 99.98% the same sequence, including in the two patients known in the United Kingdom. I hope the Government have a strategy in place to keep on top of developments and that they will take the steps required to stop the spread.

Baroness Blackwood of North Oxford Portrait Baroness Blackwood of North Oxford
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I thank the noble Lord. He is right that there is a global effort to keep on top of the sequencing of the virus to track any evolution of it. As he said, the indications are that the virus has not evolved in the past month, which is encouraging. The rate of transmission is as reported. That means that the infection control measures in place, which are based on clinical evidence and the data, are proportionate and appropriate. Combined with the public health advice that has come out and the contributions each of us can make as individuals to manage the spread of infection, we believe that this is the responsible and appropriate route. However, as the noble Lord said, we will keep the developing situation under a close eye so that we can respond quickly and nimbly as the situation goes forward.

Health: Sepsis

Lord Patel Excerpts
Wednesday 22nd January 2020

(4 years, 10 months ago)

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Baroness Blackwood of North Oxford Portrait Baroness Blackwood of North Oxford
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I thank my noble friend for this Question and I pay tribute to his work on it, and the work of the UK Sepsis Trust. I am aware of the calls for a national sepsis registry for patients. It is important that we understand the data; we are confident that it provides an accurate indication. We think that UK data is as good as it can be at the moment but that there is a clear need for better data on sepsis. The problem with the registry as proposed is that it would use retrospective data collection. We want to go beyond this with the UK’s five-year national action plan for AMR, which includes a commitment to develop the real-time patient-level data of individual patients for infection, treatment and resistance history. Work is already under way by NHS England and NHS Improvement. I hope that is the kind of answer my noble friend was looking for.

Lord Patel Portrait Lord Patel (CB)
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My Lords, as a country our record for the number of deaths due to sepsis is pretty abysmal, as stated already. Most of that is due to late diagnosis of sepsis. One-third of patients die and for every hour that a diagnosis is delayed, the death rate rises by 8%. Last year, on a visit to a biotechnical company in Northern Ireland, the Secretary of State commended the development of a quick diagnostic test, which will give a result within two hours so as to start appropriate antibiotics. Will the Government make a commitment that when this molecular test is available, which is likely to be soon, it will be immediately available to the whole of the NHS?

Baroness Blackwood of North Oxford Portrait Baroness Blackwood of North Oxford
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The noble Lord, as always, speaks with great expertise in this area. I emphasise the work that has been ongoing to improve the picture on sepsis. Since 2015, screening for sepsis in emergency departments has improved from 52% to 89% and timely treatment for sepsis from 49% to 76%, but the noble Lord is absolutely right that we need to improve the outcomes. Early and accurate diagnosis is at the heart of this. I shall keep an eye on innovations in diagnostics. The noble Lord knows that innovation in this area is right at the heart of what I do, and I think that his proposal is very sensible.

Wuhan Novel Coronavirus: Threat to UK Citizens

Lord Patel Excerpts
Wednesday 22nd January 2020

(4 years, 10 months ago)

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Asked by
Lord Patel Portrait Lord Patel
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To ask Her Majesty’s Government what is their strategy for protecting UK citizens from the threat posed by the spread of Wuhan novel coronavirus (WN-CoV).

Baroness Blackwood of North Oxford Portrait The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Blackwood of North Oxford) (Con)
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My Lords, we are monitoring closely the development of this virus. Advice from Public Health England and the Chief Medical Officer is that the risk to the UK is currently low. The UK is well prepared for the emergence of novel viruses. As part of our preparedness, we have introduced enhanced monitoring of direct flights from Wuhan to the UK and updated our travel advice for Wuhan. We continue to update health workers on how to identify, treat and contain any possible cases.

Lord Patel Portrait Lord Patel (CB)
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My Lords, I thank the noble Baroness for her reply and commend the Government for publishing tomorrow initial measures for controlling the spread of this virus, if it comes to the United Kingdom. This is a newly identified virus, which probably originated in animals, particularly in the seafood markets in Wuhan. None the less, it is 80% genetically identical to the SARS virus, which killed a significant number of people. We now understand that, although the Chinese have sequenced the genome of the virus, it has mutated and can now spread directly from human to human, which raises the likelihood that it will spread more widely. The initial illness can vary and is sometimes very mild, hence the case in the United States where the diagnosis was not made on arrival at the airport in Seattle by the authorities, even though they had procedures in place. Will the Government keep a watch out and update the advice depending on how the virus develops? Secondly, will there be procedures for quarantine and follow-up contact if a case is identified, particularly if the virus mutates and becomes highly virulent?

Baroness Blackwood of North Oxford Portrait Baroness Blackwood of North Oxford
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I thank the noble Lord for his important and timely Question. I am happy to update the House that, from today, enhanced monitoring is in place for all direct flights from Wuhan to the UK. Public health officials will meet every direct flight from Wuhan to the UK and will be on hand to provide information about symptoms. Mandarin and Cantonese speakers will be on hand and leaflets will be available in several languages. We will also roll out enhanced monitoring of all flights arriving in the UK from China. Leaflets and information will be available across all UK airports, advising travellers from China on what to do if they feel unwell. The enhanced monitoring of direct flights will obviously be kept under continuous review and expanded if necessary. The risk to the public is low and the NHS is well prepared but, to answer the noble Lord, any patients assessed for this new disease would be isolated under standard procedures if necessary. There are a number of infectious disease units around the country that would be able to respond appropriately.