Covid-19 Update

Lord Scriven Excerpts

Thursday 8th July 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I cannot promise to have a simple algorithm to make the calculation that the noble Lord refers to. I will ask the system if such a thing exists, but I have never come across such a thing. The challenge he alludes to is entirely right: the vaccine pressure on the virus will create the circumstances in which variants are possible. That is why we are investing heavily in sequencing, not only here in the UK where everyone positive is now sequenced thoroughly and studied, but also offering that around the world through NVAP—the new variant assessment platform—to try to understand what is going on in markets around the world. To date, we think that we have tracked down all the current routes that the virus is taking, and we are satisfied that they are met by the vaccine, but we keep our eyes peeled.

[Lord Scriven (LD)]

My Lords, evidence shows that those in close contact with a positive case need to be traced with 48 hours to break the chain of transmission. Regardless, if close contacts have to self-isolate or self-test, how does stopping a mandatory requirement to register, either digitally or manually, on entering a venue such as a pub or restaurant help with the effective tracing of close contacts if no record exists of people in venues where positive cases are identified?

[Lord Bethell (Con)]

My Lords, the registration of people going into events is an onerous responsibility for the hospitality industry and we have to make a proportionate assessment of what kinds of burden we are putting on the economy and society. With more than 60% of the population now having been double vaccinated for over two weeks and with the vaccination programme going along at 500,000 a day, it is the moment to start backing off on some of these obligations. That means dismantling some of the infrastructure of test and trace, which we seek to do in a proportionate and logical fashion.

Covid-19 Update

Lord Scriven Excerpts

Tuesday 6th July 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I pay tribute to the NHS, but the rise in infections among mainly very young people will not necessarily lead immediately to a large increase in the demands on the NHS. An extraordinary aspect of this disease is that it targets the elderly and those with comorbidities and leaves the young largely alone. The proportion of people who have the disease in the months to come will mainly be the unvaccinated. Those are mainly the young and our modelling, which is supported by the NHS, suggests that our resources in healthcare can support that kind of situation.

[Lord Scriven (LD)]

My Lords, the Health Secretary this morning said that there could be 100,000 cases per day by mid-summer as a result of lifting the restrictions in the Statement. Professor Neil Ferguson’s analysis today, based on the delta variant and the age group affected, shows that would equate to about 100 deaths per day. That will mean an extra 15,000 deaths by the end of the year. Is the Minister aware of and comfortable with that projection of extra deaths, when he says from the Dispatch Box that the policy he now advocates leads to a low level of deaths?

[Lord Bethell (Con)]

I am not comfortable with any deaths. The suggestion that we are going into any of this with a sanguine, devil-may-care attitude is quite wrong. We approach the matter with extreme caution. But many people are dying because they have missed their cancer appointments. There will be people who die of flu this winter; there will be many people who die of all manner of diseases. We cannot focus only on Covid—we cannot make it the sole priority of our healthcare system and our entire economy. At some point we need to move on.

We will remain extremely cautious; we have all sorts of back-up resources in place that we can pivot to should there be an escalation of Covid hospitalisations and deaths. I do not need to list from the Dispatch Box any of the things we are all worried about. This is the right decision right now; it is proportionate, and it gives us the space to address the many other health issues we have as a nation.

Coronavirus Act 2020 (Early Expiry) Regulations 2021

Lord Scriven Excerpts

Monday 5th July 2021 Grand Committee

[Lord Scriven (LD)]

My Lords, after the sacrifices and deaths of the past 16 months, the Government must not throw away the hard-earned actions of the British public. Ideology over epidemiology will not beat the virus. As we move into the endemic phase, as worldwide vaccination rates are low, new variants will emerge, as will resistance to vaccines, and the shadow of long Covid is hanging over many people. That means that some mitigation and proportionate measures will still be needed. This is not about just personal responsibility. It has to be tied in with social responsibility. This virus is not about “I”, it is about “we” as a society, and therefore there has to be government action as well as personal responsibility.

Therefore, it is not honest to—the Government are not being honest with the British people when they—talk about “irreversible” change or “freedom day”. Rather, we will need to have “mitigation day”, and unforeseen issues will arise. For some time, the country will have to balance personal freedoms with social measures; this is the context in which we should address these SIs and the next phase of the lifting of restrictions.

Regulation 2(2) sets out an extension to the retention of DNA and fingerprints until September 2021. Can the Minister tell us how many DNA samples and fingerprints will be retained? How many individuals, and cases, will that affect? What evidence is there that these need to be retained until September 2021?

I note that there is still no date on the front of this statutory instrument. When do the Government intend for it to come into force? I assume that there will have to be at least one amendment, since under paragraph 15.3 of the Explanatory Memorandum the former Secretary of State’s signature is on the SI. As I have said, we need to ensure as we go forward that epidemiology, not ideology, is at the forefront. I suggest three areas to the Government and the Minister where forward thinking rather than emergency legislation will be needed.

The first is on face coverings. I take the example of Israel, which is ahead of us on vaccinations and stopped the use of face coverings—but, within five days, face coverings had to be reintroduced. What epidemiological evidence do the Government have that, in not using face coverings, this country will somehow be different from Israel and people here will be safer? What epidemiological evidence is there for that?

The Government have allocated £37 billion to test and trace. Localised tracing will be vital as vaccine leakage potentially arises with new variants. To do that, you need to know where people are, where they have been and who they have been with or near. What evidence is there that stopping people pinging in to pubs, bars, et cetera, will improve the test and trace system in this country? What evidence is there for that? Again, ideology will not win against the virus. Good scientific evidence will help us to be safer. Why is this issue potentially being brought forward by the Government?

These Benches have talked for a long time about support for isolation—again, a mitigation issue. What evidence has arisen from the pilots that have been done on isolation and isolation support? Do the Minister and the Government now accept that isolation payments will probably have to be increased, both to encourage people to come forward and get tested, particularly locally, and to self-isolate for the whole period of their isolation?

Long Covid will be with us for a long time, so vaccination is not just about saving people from death, as vital as that is. It is also about ensuring that many young people do not face the spectre of long Covid and disability, and all that will do to their lives for quite a long period of time. Can the Minister tell us about the latest evidence on long Covid, in particular as regards “freedom day”?

All these issues matter in the endemic phase. Given the other issues that are around, the Government cannot continue to say that we are safe because of the vaccine. It is important for the Government to mitigate, and to put in place proportionate restrictions. I hope that the Minister and Government will listen to this rather than be driven by ideology.

Hospital Waiting Lists

Lord Scriven Excerpts

Tuesday 29th June 2021 Lords Chamber

[Lord Bethell (Con)]

I agree with the noble Baroness that diagnostics is one area where this country needs to make further investment. In the 2020 spending review, we ring-fenced £325 million of capital spending to support NHS diagnostics; the funding will be spent on new equipment, digitising NHS imaging and the pathology networks. New capacity is also coming through the new community diagnostic hubs and pathology and imaging networks. This work is critical, and we are working hard to make sure that it is effective.

[Lord Scriven (LD)]

My Lords, data from four major studies shows that disadvantaged groups have faced the greatest disruption to medical care during the pandemic. How are the Government ensuring that these health inequalities are dealt with in reducing the NHS backlog, and what targets have been set to deal with this issue?

[Lord Bethell (Con)]

I completely agree with the noble Lord that the pandemic has illustrated the severe health inequalities that exist across the country as well as the need to address them. The resilience of our health system depends on addressing those who can create the biggest demands on it. There is both a preventive agenda and an agenda for getting through to the communities, to communicate effectively that they can find the treatment they need in their local authority. The Help Us Help You advertising campaign is particularly targeted at the disadvantaged to encourage them to come forward for diagnosis and treatment.

Covid-19 Update

Lord Scriven Excerpts

Tuesday 29th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, hospitalisations have doubled but the vast majority of them are among people who have not been double-vaccinated for plus two weeks. It is very striking, when you look at the list of who is in hospital, how many simply have not been vaccinated. That is why our focus is on seeing through the vaccination programme, particularly getting all those at-risk groups—those over 50—double-vaccinated as soon as possible.

I cannot rule out anything, but I am more optimistic today than I have ever been, and that optimism is grounded on a very careful study of the facts, having sat through the joint biosecurity presentations day in, day out, for months on end. While I cannot be 1000% confident of everything, since this virus has a lot that it can throw at us, I really am hopeful for the future.

[Lord Scriven (LD)]

My Lords, to minimise the need for another national lockdown, effective local test, trace and isolate systems will need to be in place. Therefore, can the Minister explain why, in the test and trace budget, centralised corporate services, which has no front-line test and trace activity, has £931 million more allocated than the localised front-line test, trace and contain allocation? If he does not have those figures to hand, can he please write to me, although not from his personal email address?

[Lord Bethell (Con)]

My Lords, I suspect that I have corresponded with the noble Lord from my personal email address; I am deeply hurt that he does not want to receive any of my emails again, but not entirely surprised. The waiting at test and trace has moved dramatically, as I think the noble Lord knows, from the central supply of testing and tracing services to a much more local model, and that does not always manifest itself in the corporate accounts of the organisation. It manifests itself in both the management and the delivery, and I pay huge tribute to those who are involved in the local implementation. As I said earlier, the way in which the delta virus infection rates, which were skyrocketing at one point, have been turned around in places such as Hounslow, Blackburn with Darwen and other areas of the north-west is phenomenally impressive and is a tribute to the impact of test and trace.

Covid-19: Care Homes

Lord Scriven Excerpts

Thursday 17th June 2021 Lords Chamber

Asked by

[Lord Scriven]

To ask Her Majesty’s Government (1) on what date, and (2) in which policy document, testing for COVID-19 was offered as a matter of policy to those leaving hospitals and going to care homes.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

My Lords, the Covid-19 hospital discharge service requirements were published on 19 March 2020. They stipulated that patients’ Covid-19 test results, negative or positive, should be included in their discharge documents. On 15 April, we built on this with the adult social care action plan, including a policy of testing all patients prior to discharge to a care home. I remind noble Lords that the WHO acknowledged the threat of asymptomatic transmission on 9 July 2020.

[Lord Scriven (LD)]

My Lords, last week the Secretary of State said that a policy of testing patients going to care homes was brought in

“as soon as we had those tests available”.

That was in mid-April 2020, and more than 500,000 tests were carried out to mid-April 2020. Only 25,000 would have been required to test all patients being discharged to care homes. Can the Minister explain these figures and the contradiction in the Secretary of State’s statement that they highlight?

[Lord Bethell (Con)]

My Lords, I do not quite understand the noble Lord’s figures. As of 14 March 2020, the seven-day rolling average showed that there were 51,741 discharges a day from hospital, of which 1,123 were from hospitals specifically to care homes. That was at a moment when our testing capacity was 3,000 a day. A month later, on 15 April, the rolling average was 22,000, of which 548 were discharges from hospitals specifically to care homes. By that date, the testing capacity was 38,766.

Health Protection (Coronavirus, Restrictions) (Steps and Other Provisions) (England) (Amendment) (No. 2) Regulations 2021

Lord Scriven Excerpts

Wednesday 16th June 2021 Lords Chamber

[Lord Scriven (LD)]

My Lords, here we are again, discussing emergency regulations because of incompetence and lack of speed by government. It is appalling that the Government did not take the correct decision to put India on the red travel list in early April, at the same time as Bangladesh. Yesterday, the Minister said that I should stand in his shoes about that decision. I note that, time after time, both the noble Lord and the Secretary of State gave the reason for Bangladesh but not India going on the red list as the positivity rate.

The data that I am about to read were on the Minister’s desk when the decision was made. In the two weeks leading up to Bangladesh going on the list, its positivity rate—based on the Government’s own test and trace data—was 3.7%. India’s positivity rate was 5.1%. You do not have to be a genius to work out that India’s positivity rate was higher than Bangladesh’s. Can the Minister explain why, when India had a higher positivity rate than Bangladesh, based on the Government’s own test and trace data, Bangladesh was put on the red list and India was not.

That catastrophic mistake by government meant that, rather than just under 40 seeded cases of the delta variant being in the UK on 2 April, it went up to nearly 1,000 seeded cases by the time that India was put on the red list. Public health research shows that, if India had been put on the red list at the same time as Bangladesh, it would have given four to seven weeks’ grace before we started hitting the surge levels of the delta variant that we are seeing now. That would have meant that everybody over 40 could have received a second dose—in four weeks—or everyone over 30—in seven weeks—and all adults would have had a single dose of the vaccine. The Government were driven by a date: a date for the Prime Minister to visit India to look for a trade deal. A consequence of Ministers not following the data is that trade in this country is now suppressed for four weeks. This is a disgraceful abdication of following the data and keeping our country safe. The country deserves far better than this. It is clear that the Minister and the Government made the wrong call.

We will have to live with the virus as it becomes endemic, and take measures to support this. One area where change is required is self-isolation. Evidence is overwhelming that the biggest impediment to people self-isolating, or even taking a test, is practical support and financial security for the whole period of isolation. We do not need pilots to re-prove this; action from the Government is required now. A self-isolation system that gives individuals both the practical and financial support to isolate for the full period will be essential to minimise future local lockdowns. Despite repeated requests from these Benches to pay people their full wages, the Government will still not do so. They need to address this now and not continue to ignore the data.

Covid-19 Update

Lord Scriven Excerpts

Tuesday 15th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am not sure whether I accept the characterisation presented by the noble Lord. We have worked incredibly hard to bring in a managed quarantine system that is a novel, new introduction into the UK. We have done extremely well in fighting off many of the variants that have come to our shores, including the Manaus variant, the South African variant and others. We have strong links with Pakistan, India and Bangladesh, which means there is a lot of traffic between our countries. I am not sure whether it would ever have been possible to prevent this variant making landfall in the UK at some point. But we have done an enormous amount in the UK to delay and prevent the arrival of these variants, and for that I am enormously grateful to those involved.

[Lord Scriven (LD)]

My Lords, following the data is the Government’s mantra. Using the Government’s own test and trace data, for the two weeks prior to Bangladesh going on the red list it had a positivity rate of 3.7%; India’s was 5.1%. Of all variants entering the UK, including the delta variant, more than 50% of cases came from India and fewer than 5% from Bangladesh. So if the Government were following the data on 2 April, why was Bangladesh put on the red list and not India?

[Lord Bethell (Con)]

The noble Lord is enjoying the benefit of hindsight very much indeed; we can all use the retrospectoscope. The data he refers to was not available to us at the time. We did not know that the variant now known as India 2 was a variant of concern. We did not know that it was going to be the most transmissible one. There were three variants in India; we did not know at that point which of them would present the most problems. It is extremely easy to sit here, look back and say that one person should have done this and another should have done that. I ask the noble Lord to try to sit in the seat of those who made the decisions at the time.

Covid-19: Proof of Vaccination

Lord Scriven Excerpts

Monday 14th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, we have engaged considerably with the sector on exactly these kinds of matters. GPs and pharmacies are briefed to help those with difficulties get this material. We are also conscious that some with autism may struggle to take a test and find the process of swabbing intimidating, so we are looking into workarounds for that.

[Lord Scriven (LD)]

My Lords, regardless of whether you hold a paper or digital record, personal health and data will be held on a central database. Can the Minister therefore inform us which government departments and private sector organisations will have access to the data on the central database?

[Lord Bethell (Con)]

My Lords, vaccine data is held in the vaccine database and in the patient’s record. We abide by the principle that the data is owned by the patient.

Health Protection (Coronavirus, Restrictions) (Steps and Other Provisions) (England) (Amendment) Regulations 2021

Lord Scriven Excerpts

Monday 7th June 2021 Grand Committee

[Lord Scriven (LD)]

My Lords, if ever we wanted an example of the farce that parliamentary democracy has become, these regulations should be an example that is studied for years. The Government had known for months that the date of 21 June was coming, yet still they decided to use emergency legislation to get their own way. Then they laid these regulations on the day they were to become law—in fact, at 11 am. Then they had to redraft them because parts of them were wrong.

This is a pattern of behaviour by the Government, using whatever means they decide to push through emergency legislation on Covid and using the signature of a Minister’s pen as a substitute for detailed parliamentary scrutiny and amendment. Emergency legislation was required on some issues, but not on this issue. The House and the other place need to stop nodding through this kind of emergency legislation as a matter of course.

An example of the potential unintended consequences of these regulations is the expiry on 20 June of the Health Protection (Coronavirus, Restrictions) (Local Authority Enforcement Powers and Amendment) (England) Regulations 2020. I declare my interest as a vice-president of the Local Government Association. These are the regulations that give local authorities the power to enforce Covid restrictions and give fixed penalty notices for breaches. As we move to a situation in which local lockdowns will become more important if we see clusters of cases around new variants, what powers will exist to ensure that local authorities can make sure local restrictions will be adhered to? Or will we have the perverse situation of more knee-jerk emergency legislation every time we see a local outbreak so that local authorities can fulfil their duties? Will the Minister please clarify this issue?

The reason all this matters is that Covid-19 will be with us for years to come. It is moving into the endemic stage. Emergency legislation is not acceptable, or indeed desirable, for managing an endemic. The Government now need to bring forward legislation about how we live with Covid as an endemic and stop relying on such regulations. The endemic means we move away from binary extremes and have legislation that is much more subtle and nuanced about how we deal with the complex issues for freedoms, health and the economy and that finds a new balance in this Covid world—a way of trying to keep as much open as we can while keeping the virus circulation and harm as low as possible. We have done it before with other diseases.

Very sensitive issues will have to be addressed as to what level of death the country accepts, as we do with flu, before more serious public health restrictions are enacted. Issues of ventilation and how it affects building standards and building control are important if we are to see large parts of the economy remain open every time we have a new variant or local surges.

What are the new ways of working for education, to keep access to knowledge and learning open and ensure that young people have access to their education? Again, the endemic stage will require changes that will have legal implications about when, where and how education takes place. At what stage is government thinking on this? When will proposals be brought forward for the legal implications for health, the economy and our freedoms of living in the endemic stage of Covid?

It also has big implications for the effect of self-isolation, which is an issue that has yet again to be raised because of the total lack of support, both financial and practical, for many who cannot afford to isolate for the whole period. I note that the Minister agrees that the present system is not acceptable, and that is why local authorities are piloting, but we need a national system of people being paid their salary, as in other countries, so that they can afford to remain isolated for the total period. What percentage of people asked to self-isolate carry out the full period of isolation required? How do the Government measure that? If the Government will not bring forward full financial support, such as paying people their wages, when all the evidence now shows that it is a barrier to people self-isolating for the full period, why not?

After 16 months of the country living with Covid, it is time for the Government to stop treating it as purely a public health emergency. They must bring forward detailed plans and legislation that deal with the ongoing implications of Covid as an endemic. The longer the Government refuse to do this and continue to bring forward only emergency legislation, the more the country will suffer and not be equipped to live with the long-term effects of Covid.