Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place and on Public Transport) (England) (Amendment) (No. 2) Regulations 2020 Debate
Full Debate: Read Full DebateLord Russell of Liverpool
Main Page: Lord Russell of Liverpool (Crossbench - Excepted Hereditary)Department Debates - View all Lord Russell of Liverpool's debates with the Department of Health and Social Care
(4 years, 1 month ago)
Lords ChamberMy Lords, we are all aware of the rising rate of infection, particularly after this morning’s candid briefings, and the risks this poses. Therefore, noble Lords will understand the importance of taking the necessary steps to keep members of the public safe, while continuing to keep the economy running, the schools open and heading off the need for a second lockdown.
We know that some of the rules put in place have become increasingly complex and difficult to enforce. That is why the Prime Minister has set out today how we will further simplify and standardise local rules by introducing a three-tier system of local Covid alert levels in England. This is not the subject of the debate today, nor does it change the legal requirement to wear a face covering, but it should reassure noble Lords that we continue to work with local leaders to tackle outbreaks with more targeted restrictions that are simple and constructive.
The regulations being debated today introduce the requirement that members of the public should wear a face covering in taxis and private hire vehicles. In addition, they should also be worn when inside a premises that provides hospitality—such as a bar, pub or restaurant—except when eating or drinking, for which they must be seated. This means that people must wear a face covering when entering, leaving and moving around inside these premises. Additionally, staff working in certain retail and hospitality settings should wear a face covering if they are in areas that are open to members of the public and are therefore likely to come into contact with members of the public.
I will now set out why this is a necessary measure, and how we have seen public behaviour change since the introduction of the first set of face covering regulations. A review of recent clinical research published in the Lancet in August suggested that face covering usage
“in community settings with reduced physical distancing might be justified.”
But despite this, the paper concluded that for Covid-19 this evidence is of
“low or very low certainty”
due to the nature of the data collection.
Studies published in the journal Nature have shown different degrees of support for face coverings. In an article at the end of September, the publication concluded that the effectiveness of cloth face coverings is not as well established as that for PPE in a clinical setting. This article recognised that face coverings are intended to protect the public from exhaled virus-containing particles, but points out that
“few studies have examined particle emission by mask-wearers into the surrounding air.”
In a news feature a fortnight later, Nature quoted studies suggesting that face coverings might have the capacity to save lives, but the article outlined the difficulty of establishing definitive proof. The BMJ pointed out on 7 September:
“There are large gaps in our knowledge and without clear evidence on the use of cloth masks in the community we may be wearing false reassurance.”
PHE conducted a rapid review in June of 28 studies into face coverings for community usage. At the time it concluded:
“There is weak evidence”
in these studies
“that mask wearing in the community may contribute to reducing the spread of COVID-19”.
There is, however, stronger evidence that the
“beneficial effects of wearing masks may be increased when combined with other non-pharmaceutical interventions, such as hand washing and social distancing.”
SAGE has advised that using cloth masks as a precautionary measure could be at least partially effective in enclosed spaces where social distancing is not always possible.
This is the scientific context for these measures. The Government have mandated the use of face coverings in places where social distancing is difficult and where there is closely shared space. We are not increasing high levels of acceptance that face coverings are gaining among the public. We need to be clear that face coverings are not a panacea; they are not a substitute for the key measures. Face coverings alone will not stop the chain of virus transmission, but to do so we must continue to maintain good hygiene, including when putting on and taking off face coverings, and follow social distancing guidelines and safe self-isolation advice.
As the WHO pointed out this summer, due to the limited evidence of the efficacy of homemade masks,
“their use should always be accompanied by frequent hand hygiene and physical distancing.”
With this in mind, noble Lords may have seen the recommendations published by the BMA this weekend about extending the use of face coverings in more settings, including outdoors.
We know that people are responding positively to these regulations, as it is reflected in data published by the ONS. On 11 May the Government advised the public to wear face coverings in enclosed spaces, and on 5 June ONS data suggested that only 32% of people reported that they had worn a face covering outside of the house. Fast forward to now, and ONS figures published on 9 October show that 98% of people had reported wearing a face covering when they leave the house. YouGov polls from the start of October provide further support for these findings. Data collected for the DHSC on health behaviours also show that since new regulations came into force on 24 September, 84% had worn a face covering in a restaurant, café or pub on some occasion, a rise of 22%.
This instrument is already benefiting members of the public and workers alike. I am enormously grateful to noble Lords for their continued engagement on this challenging process in the scrutiny of these regulations. We will, of course, reflect on this in the debate to come. I beg to move.
Just for the benefit of noble Lords, let me say that the noble Baroness, Lady Thornton, will not be speaking next; she will be winding up for the Opposition. The noble Lord, Lord Campbell-Savours, will be relieved that he is not winding up for the Opposition, and I call him next.
My Lords, it must be hard work for the Minister to have to come here, make speeches and deal with noble Lords all the time. Trying to do this particular one twice must be a nightmare—fortunately, he was rescued from that.
As far as public consent is concerned, masks are one of the few successes of the Government’s policies and strategies on Covid-19. There is a high degree of compliance with mask-wearing, which is to the credit of people in this country.
When we started again in September, I was very concerned—I was frightened—at the prospect of going on the Underground, remembering what it was like in July, so I brought my bicycle down to London and had a wonderful fortnight cycling in, during the day. My daughter told me that if I brought my bicycle to London, it would be stolen, so I took precautions against that. It was not stolen, but somebody had a go at it and tried to smash it up and I had to take it home to be repaired. I took courage into my hands and went on the Underground. I have to say that, at the moment, the Underground is a safe environment. I have been coming down on the west coast main line, as I did this morning, and I worry how long those trains will run for when it is only me in a whole carriage. At least the public transport I use is safe, and almost all the people I see on it are wearing masks and behaving sensibly. That is good.
The problems seem to be in supermarkets and similar retail premises. People go on social media and get all het up about people not wearing masks in those places. The answer of the operators of retail premises is that they cannot force people to wear masks. But what they can do, and sometimes do do, is refuse to serve people. If the rule was that you could not be served in such places unless you were wearing a mask, it would be much easier to enforce. They would simply say, “I am sorry, I am not serving you.” It is not difficult to sort that out, so the Government ought to think about that and do it.
I am not someone who will march along the street behind the Great Barrington banner; I think that they are going overboard in what they are saying, though some parts are quite sensible and ought to be taken on board. Generally, there are too many people, on all sides, who are proclaimed as experts and believe that they are right about every aspect. Whether they are professor this, doctor that, or even professor-doctor something else, everybody in this debate, and everybody going on television, ought to have a great deal more modesty about what they are putting forward. The truth is that we do not know a huge amount about the virus and the illnesses that it causes, and we will not know everything for a long time, if ever. Therefore, instead of saying that this is necessary or this is essential, it would help if people had greater modesty and relied on evidence when we can get it.
The problem is that, increasingly, what is put forward as evidence, including the statistical stuff, varies according to where you go. A great deal of the evidence that we need is simply not there. I look at the PHE surveillance report every week. It is a mass of exciting graphs, many of which are put up on our television screens by various organisations. But the crucial evidence that is not known, which I think the Minister referred to in his speech, is how much of the primary transmission of this virus—the real source of it—comes from different elements out in the community.
We are told that it is almost all community transmission now—that while transmission within the health service has not been eliminated, it has been substantially reduced. We are told that care homes are being dealt with, so the two huge problem areas from before have been dealt with. But do we really know how much is coming from shopping, from hospitality, from sporting events and, if I dare say it, from schools—an area that we are not allowed to talk about—and so on? Also, how much of it is essentially among families? I think that family transmission is secondary and, as the Minister suggested, the virus is being brought into homes and then spread in that way. I do not think we know, and that is because the testing and tracing being done does not look backwards; it looks forwards. Environmental health officers can do the job of finding out where the virus is coming from in the first place. There is a huge amount of evidence about this that the Government really need to look at seriously.
Since the noble Lord, Lord Bowness, has withdrawn from the debate, I now call the noble Earl, Lord Clancarty.