Coronavirus Act 2020 Debate
Full Debate: Read Full DebateLord Robathan
Main Page: Lord Robathan (Conservative - Life peer)Department Debates - View all Lord Robathan's debates with the Department of Health and Social Care
(3 years, 1 month ago)
Grand CommitteeMy Lords, I certainly do not oppose these measures since I believe them to be going the right way. I am pleased with that.
I want to concentrate on face masks. The noble Lord, Lord Scriven, mentioned them quite a lot because he believes that everybody wearing them would save lives; they were mentioned in the Minister’s final words as well. They have become a bit of a totem for both sides of the argument on coronavirus restrictions. They divide society, actually. On the one hand—I find myself on this side—I do not believe them to be effective so I do not wear one. It is an act of individuality, if you like; you might even call it an act of rebellion against being told what to do. On the other side of the argument, where the noble Lord, Lord Scriven, is, believers in further restrictions believe that wearing a mask shows virtue and solidarity and provides reassurance to others. That is a perfectly reasonable position, I suppose.
Whatever the opinion polls say, I reckon that about 40% of people on the Tube do not wear a mask now—not 13%, as the noble Lord suggested. That 40% has given up, basically. Children are not required to wear them, of course, but they obviously cannot pass on the virus; I will come back to that later.
In the Chamber of the House of Commons, there is a great political divide between the Government on the one hand, wearing hardly any face masks, and the Opposition on the other, where practically everyone wears one. Last month, I went to a packed memorial service in the Brompton Oratory. It is a huge church—perhaps not the biggest Catholic church in London, but huge. One person was wearing a face mask. None of the clergy was. However, last week, I went to David Amess’s memorial service, where probably about 20 masks were being worn in the congregation. All the bishops and clergy, as they processed behind the unmasked choir, were wearing them. We almost have a Reformation divide now, with Catholics versus Anglicans.
My question for the Minister is simple. Are masks effective? We have, I fear, had some mixed messaging from the Government over the past 18 months. Either masks work or they do not. I am certainly not an expert; I do not pretend that they will or will not do good because, unlike the noble Lord, Lord Scriven, I do not know whether they work.
However, full surgical masks worn in operations presumably work. All the doctors and nurses wear them and have done so for some time—but they are proper surgical masks. Flimsy paper masks are being worn by several people in this Committee, and by the general public. I do not know whether those masks do any good, but I suspect that they do not. What I do know is that Jenny Harries, who is now the chief executive of the UK Health Security Agency and was the Deputy CMO previously, said in March last year that it was “not a good idea” for the general public to wear them. She also said that they “trap the virus” and cause people to start breathing it in.
I have a series of quotes, if the Committee will bear with me, that show the confusion in this matter. I am not saying that I am right. Professor Jonathan Van-Tam, who noble Lords will know, said on April 4 last year that the wearing of face masks by those who are not sick was not recommended by the British Government. He said that there was
“no evidence that the general wearing of face masks by the public who are well affects the spread of the disease in our society.”
That is his view—or it was in April last year. I do not know. Sir Patrick Vallance, who, again, we have got to know well over the past 18 months and is the Chief Scientific Adviser to the Government, told MPs last May:
“The situation with masks … is that the data and the evidence are not straightforward”.
In this House, the then Minister, the noble Lord, Lord Bethell, said on 21 April last year that
“the British Government have been sceptical about the efficacy of face masks. We do not want to be in a position of misleading or providing false reassurance for the public when there is not sufficient scientific evidence for the relevance of face masks.”—[Official Report, 21/4/20; col. 22.]
The following month, on 19 May, he said:
“There is an instinctive human belief that face masks make a difference, but the scientific proof that they do so is not crystal clear.”—[Official Report, 19/5/20; col. 1096.]
Then on 11 June he quoted the World Health Organization and said that
“‘the widespread use of masks by healthy people … is not yet supported by high quality or direct scientific evidence’”.—[Official Report, 11/6/20; col. 1908.]
On 22 June, 11 days later, he said that the mandatory of wearing of face masks was not recommended by the Government.
Now I genuinely do not know, but the situation is certainly confusing; I think everybody can agree on that. I am willing to accept that I am a bit confused. At the Labour Party conference, everybody wore face masks in the hall—we saw them all on television—but they did not wear them at the karaoke parties or receptions. The Liberal Democrat conference was of course virtual, so that was fine. However, they would not have had to wear them because it would not have been very crowded.
So what is the evidence now? Can the Government publish the evidence that made them change their position of last year, with the quotes I have given, to encouraging people to wear face masks? Perhaps there are studies. If they are conclusive, I will wear a mask. That is a promise—but I warn the noble Lord, Lord Scriven, who has just spoken, that one should not rely and base one’s policies on opinion polls.
All the calls that we hear for a return to restrictions should, again, be based on evidence. Are things getting worse? The vaccines certainly seem to work. Indeed, I had a message today to get my booster jab. Deaths are actually right down on what they were a year ago. Can the Minister tell us the percentage of deaths from the virus among those who are over 85? I understand that the average age of death is 85, which is actually higher than average life expectancy.
The Office for National Statistics shows that about half of all new infections are among school-age children—in other words, the unvaccinated young—with few lasting ill-effects. Is that true? Perhaps the Minister can enlighten us on that. Is it the case that there are now studies predicting that cases are likely to fall sharply in the winter? That was in a study from the London School of Hygiene & Tropical Medicine, which was covered in the press yesterday. Is that the case?
We have now heard one or two doctors panicking about flu and calling for the wearing of face masks because there will be flu around. Wear face masks for ever. Every year, on average—it varies dramatically—about 11,000 people die from flu. That is about the same number who are dying every week. So will the Minister reassure me that the Government will not be panicked into reintroducing any dramatic restrictions, or plan B, without basing the decision on very serious evidence?
The noble Baroness, Lady Wheatcroft, is not with us, so I call the noble Baroness, Lady Foster.
My Lords, whether we approve of these restrictions or not, and despite the relaxations of last summer, we should be honest with ourselves and admit that, as the noble Lord, Lord Hunt, said, this remains one of the most illiberal pieces of legislation the House has had to consider since the days of Oliver Cromwell. Actually, Oliver Cromwell abolished this House, so that might not be true.
That it will extend into 2022, two years after the rules first came into force, is alarming. It surely reminds us that the Government made a mistake when they declared an emergency under health legislation rather than the Civil Contingencies Act. Under that Act, we would be able to revisit these regulations much more frequently—monthly rather than six-monthly. When he winds up, will my noble friend express the strongest possible commitment—and hopefully promise—that this is the last time we will extend these regulations?
I am the first to admit that we are not out of the woods. Infections, hospitalisations and deaths remain higher than we would like, although far lower than even the most optimistic of SPI-M-O’s models published in early September—yet another failure of modelling, I am afraid. Already, the recent mini-wave, which is mainly happening among children, seems to have peaked. I urge the Government to resist the increasingly noisy calls for another mandatory lockdown, vaccine passports and mandatory mask-wearing. We can get through this winter with faster vaccinations, especially boosters, and sensible voluntary measures. Remember that, thanks to vaccines, the overall mortality rate for people who get Covid-19 is now down to about 0.1%, as low as flu.
Of all the measures taken, by far the most effective has been vaccination. Lockdowns have undoubtedly also helped but at a brutally painful cost. All other interventions have, as far as I can read from the evidence, proved either surprisingly ineffective, such as handwashing, or ambiguous at best, such as face masks. I want to focus on face masks and the argument for making them mandatory.
I am completely open-minded as to whether face masks help; they might or they might not. I have been willing to wear them. I favour them on precautionary grounds and if anybody can present me with a decent study on their effectiveness, I will read it and shout it from the rooftops. However, in preparing for today’s debate, I read a lot of scientific papers and I came up empty. The papers that purport to vindicate masks tend to be flimsy or flawed: they ignore the effect of other measures; they confuse correlation with causation; they compare apples with oranges; they rely on modelling rather than data.
For example, a meta-analysis commissioned by the WHO claimed that masks could lead to a reduction in the risk of infection, but the studies considered mainly N95 respirators in a hospital setting and not cloth masks in a community setting. Another study in the PNAS claimed that the correlation between declining infections and mask mandates was due to causation, ignoring similar declines elsewhere, and 40 scientists recommended that the study be withdrawn. Early in the pandemic, the advocacy group, #Masks4All, argued that Czechia had fewer infections thanks to the early use of masks. In reality, the pandemic simply had not reached eastern Europe by that stage. A few months later, Czechia had one of the highest infection rates in the world despite an early and strong mask mandate. A study in the US and another in Bangladesh were eventually withdrawn; a German study claiming to vindicate masks actually found no net change overall; a Canadian study claimed that countries with mandated masks had fewer deaths, but it compared very different countries and only the first few weeks of the pandemic. A review by Oxford University claimed that face masks are effective, but it looked at healthcare settings and not community settings—and so on and so on.
Meanwhile, the studies that are well designed and carefully executed have all reached the opposite conclusion: that they cannot find evidence that masks help. An April 2020 review by the University of Illinois, a May 2020 article in the New England Journal of Medicine, a May 2020 US CDC meta-study on pandemic influenza, a July 2020 review by the Oxford Centre for Evidence-Based Medicine, an October 2020 randomised control trial with close to 8,000 participants, a November 2020 Danish randomised control trial with 6,000 participants, a November 2020 gold standard Cochrane review—sorry about this; I am nearly at the end—
A February 2021 review by the European CDC, a July 2021 experimental study published by the American Institute of Physics and an August 2021 study published by the International Research Journal of Public Health all failed to find causation. It might be there; they are not saying it is impossible, but they have not found it. If somebody can produce a study showing a strong and significant effect of masks on transmission then I will change my mind, but it has to be a decent bit of work.
Talking of experts, Gary Lineker said of mask wearing on Twitter that
“the evidence is clear that it reduces your chances of catching Covid”.
Well, which studies is he referring to? He did not cite a particular study.
Yet surely it is common sense that covering your face must help. To some extent, I am convinced myself that it probably does. It certainly stops large droplets. However, one thing that we have learned in this pandemic is that decades of advice about how such a virus is spread has turned out to be wrong. We now know that the way that this kind of virus spreads is generally not through droplets, which masks stop, but through much smaller aerosols, which are essentially evaporated droplets. They go straight through or out the side of most masks. Catching aerosols with masks is like catching midges with a tennis net.
Masks can give false reassurance. Like my noble friend Lord Robathan, I went to a memorial service yesterday, albeit a different one. There were hundreds of people in the church. The organisers suggested taking a lateral flow test before coming, which was a good idea, and I did. They also said that mask wearing was a condition of coming and I did that too. So did anybody else. But did that give me and the others there just slightly too much reassurance? Risk compensation behaviour is a real phenomenon: motorcyclists drive faster with helmets on. Do people take slightly more social risks when wearing masks? I fear it is possible that they do, so it is not necessarily the right policy.
Masks signal that you care and that you are being careful. That is worth something, I admit, but is it enough to justify making them compulsory? I do not think it is. Again, I say this not because I want masks to be ineffective—I would much rather they were useful; I do not find them particularly enjoyable to wear, but I do not particularly mind wearing them—but I try to think with my head and not my gut. It is data that should guide us, not feelings.
I have one final point. I declare an interest in that I am about to publish a book about the origin of Covid—I might have mentioned it before. The fact we still do not know and that we most certainly cannot rule out that it was a lab accident, as my noble friend Lady Foster said, at the Wuhan Institute of Virology means that another such pandemic is possible and could happen any day. That fact alone will have encouraged rogue states and terrorist organisations to investigate the possibility of deliberately causing a pandemic. The UK Government have shown surprisingly little interest in this issue so far, leaving it to the American Government, the Chinese Government and the WHO, but as one of the leaders in scientific research in the world the UK Government should give it their attention. I ask my noble friend to put it in his no doubt very thick in-tray.