Coronavirus

Commons Urgent Question

The following Answer to an Urgent Question was given on Tuesday 15 September in the House of Commons.

“Coronavirus exists only to spread, and yesterday the World Health Organization once again announced a record number of cases globally. France and Spain have both reported daily figures of over 10,000 positive cases and increasing hospitalisations. Here in the UK, we saw around 2,600 new cases yesterday, and last week medical advisers advised that R is above 1. The epidemic is growing.

There are signs that the number of cases in care homes and the number of hospitalisations is starting to rise again, so last week we acted quickly, putting in place new measures—the rule of six, which came into force yesterday. We do not do this lightly, but the cost of doing nothing is much greater.

Testing also has a vital part to play. Everyone in this House knows that we are doing more testing per head of population than almost any other major nation, and I can tell the House that we have now carried out over 20 million tests for coronavirus in this country. As we expand capacity further, we are working round the clock to make sure that everyone who needs a test can get a test. The vast majority of people who use our testing service get a test that is close to home, and the average distance travelled to a test site is now just 5.8 miles—down from 6.4 miles last week; but the whole House knows that there are operational challenges, and we are working hard to fix them.

We have seen a sharp rise in people coming forward for a test, including those who are not eligible. Throughout this pandemic, we have prioritised testing according to need. Over the summer when demand was low, we were able to meet all requirements for testing, whether priorities or not, but as demand has risen we are having to prioritise once again. I do not shirk from decisions about prioritisation. They are not always comfortable, but they are important. The top priority is, and always has been, acute clinical care. The next priority is social care, where we are now sending over 100,000 tests a day, because we have all seen the risks this virus poses in care homes. We will set out in full an updated prioritisation, and I do not rule out further steps to ensure our tests are used according to those priorities. It is a choice that we must make.

Finally, to defeat this virus in the long term needs effective vaccines and treatments. I am delighted to say that over the weekend the trial of the Oxford vaccine restarted, and I can tell the House that we will now be trialling a promising new antibody treatment on coronavirus patients in the UK. The challenges are serious. We must work to overcome them, optimistic in the face even of these huge challenges, and to keep this deadly virus under control.”

My Lords, the Prime Minister claimed again today that the UK does more Covid tests than anywhere else in Europe. This is not true. Denmark does almost twice as many per 1,000 people, and the UK figure includes antibody tests, which others do not do, and is based on when tests are sent out and not on results. So it is more hyperbole.

I hope today we can look at facts. There is now a backlog of 185,000 swabs and tests are being dispatched abroad. Can the Minister advise the House how many tests have been sent abroad, to which countries, the processing time and the void rates? If the Minister does not have that information at his fingertips today, can he please to write to me and put the answer in the Library?

Secondly, Coronavirus infection rates among middle-aged people have reached the same level now as rates among those in their 20s two weeks ago, and Professor Neil Ferguson has warned us that infections are back where they were in late February. So what discussions have the Government had with the Joint Biosecurity Centre and the CMO about raising the alert level from three to four?

I am grateful for the noble Baroness’s questions. In terms of European rates, Britain is way ahead of many of its fellow countries in Europe. On Friday last week, we did 240,312 tests. It is a massive number and, I believe, the highest we have done on any day. This is a huge achievement and I pay testimony to those in the NHS and in test and trace who have contributed to that figure.

In terms of tests being sent abroad, our testing environment and economy are part of an international system. Reagents, swabs, consumables and machines are regularly exchanged between countries and I pay tribute to the enterprise and energy of the NHS and the test and trace scheme for using whatever schemes they can find in order to process the tests accurately, efficiently and promptly. I will be glad to send the noble Baroness details of the rates which she asked for.

In terms of the increase in prevalence among the middle-aged—yes, we are deeply concerned about this. As I have said at the Dispatch Box before, as night follows day, rates progress from the young to the middle-aged and, I fear, to the elderly. We are keeping a close eye on this progress.

My Lords, we know that the Minister is an avid listener of Radio 4’s “More or Less.” In today’s episode, Professor Alastair Grant of the University of East Anglia pointed out that 70% of coronavirus test results were completed within 48 hours at the start of August. Looking at official figures and analyses, he pointed out that by Monday, it was just 11.8%. The Minister may dispute the exact figures, but the trend clearly is down, which is worrying when we need an effective trace and isolate system to trace and isolate people as fast as possible. Can he tell the House and the country by what date all results of coronavirus testing will be turned around within a maximum of 24 hours?

My Lords, I am indeed an avid listener of “More or Less,” although I have not heard the episode to which the noble Lord referred. Can I just explain that not all tests need to be done within 24 hours? There are tests that are done for surveillance, to support clinical trials and to help our investigation into vaccines and therapeutics. Those kinds of tests have a much longer turnaround time, and that is entirely appropriate and will be built into the numbers to which “More or Less” referred. Some 89.6% of in-person test results were received the next day after tests were taken; those are the ones that need fast turnaround times and the ones that will be delivered promptly.

I want to talk about care homes and hospital in-patients, many of whom have been marooned for literally months. One of the problems is the testing regime. Could I ask the Minister, first, to give priority to relatives of people in care, so that they can be tested and go in and see their loved ones? Secondly, there is clearly a problem with a lot of the staff, because they are moved around a lot. Can the Minister undertake that his department will consult UNISON, the main trade union for those staff, and see what it can do to open things up so that people in care homes and hospitals are able to be visited again?

My Lords, I note my noble friend’s comments. However, I flatly deny that the social care system and social care homes have been in any way marooned. We have made a profound commitment, particularly in the testing environment, to supporting social care. One hundred thousand tests a day out of our capacity of between 200,000 and 250,000 are ring-fenced for social care and delivered to social care every day. Many of the challenges that we have for walk-in and drive-through testing centres are exactly because we are so committed to the ring-fenced testing for social care. That is a commitment that we are proud of and remain committed to.

I want to clarify with my noble friend that it is not an appropriate use of government test and trace capacity for relatives to use test and trace as a convenient method to find out whether they have the disease before they go to see relatives. That is not an appropriate use and not in the guidance.

As for UNISON, we are very much engaged with the union and are supporting staff in every way we can. However, I very much take on board my noble friend’s notes, and we will maintain that correspondence.

My Lords, can the Minister clarify one or two issues? Does the rule of six mean that it will no longer be possible to have any public marking of Remembrance Sunday outdoors this year? Will he also clarify whether this effectively means that all public protests and demonstrations are now illegal?

I thank the right reverend Prelate for his question. I thank greatly those local authorities and charities that are putting in place Remembrance Day service arrangements that will abide by the new rule of six. Some of those guidelines are being written now, and I will be glad to share the guidelines with the right reverend Prelate when they are published. One thing I note is that virtual attendance at these services and the use of virtual remembrance books will be an aspect of Remembrance Day this year.

My Lords, Professor William Hanage of the TH Chan School of Public Health at Harvard University has said of the lack of mass testing that:

“By the time you become aware of the problem it is likely to already be much larger. You are not going to detect outbreaks if you don’t look for them.”

He also said that you need

“very good diagnostic tests as well as tests that may be less sensitive but can be used more frequently.”

I am totally with the Government in their aim for mass testing, but would the Minister agree with Professor Alan McNally of the University of Birmingham that the £500 million already announced

“could have funded around 33 million standard swab PCR tests that could have been run in well-equipped university labs”?

Why is that not happening? On rapid saliva tests, the Abbott Laboratories’ BinaxNOW $5, 20-minute test has been FDA approved, with 10 million tests produced this month and 50 million to be produced next month. Why are we not getting on with it? We need to do this really urgently. Does the Minister agree?

I completely support the noble Lord’s commitment to mass testing. We are looking at ways in which to use less sensitive machines to provide the kind of prophylactic testing to which he alludes. I thank very much indeed all universities for their contribution to our testing programme.

My Lords, in the course of the pandemic, a significant number of contracts with private companies have been signed without tender and a number of these have been in areas such as PPE and test and trace. Most appear to have failed to deliver essential services and equipment—