The following Statement was made on Tuesday 1 September in the House of Commons.
“With your permission, and indeed your encouragement, Mr Speaker, I would like to make a Statement on coronavirus. The latest figures demonstrate how much progress we are making in our fight against this invisible killer. There are currently 60 patients in mechanical ventilator beds with coronavirus—that is down from 3,300 at the peak—and the latest daily number for recorded deaths is two. However, although those figures are lower than before, we must remain vigilant. I said in July that a second wave was rolling across Europe and, sadly, we are now seeing an exponential rise in the number of cases in France and Spain—hospitalisations are rising there too. We must do everything in our power to protect against a second wave here in the UK, so I would like to update the House on the work we are doing to that end.
To support the return of education, and to get our economy moving again, it is critical that we all play our part. The first line of defence is, and has always been, social distancing and personal hygiene. We will soon be launching a new campaign reminding people of how they can help to stop the spread of coronavirus: ‘Hands, face, space and get a test if you have symptoms.’ Everyone has a part to play in following the social distancing rules and doing the basics. After all, this is a virus that thrives on social contact. I would like to thank the British public for everything they have done so far, but we must continue and we must maintain our resolve.
The second line of defence is testing and contact tracing. We have now processed over 16 million tests in this country, and we are investing in new testing technologies, including a rapid test for coronavirus and other winter viruses that will help to provide on-the-spot results in under 90 minutes, helping us to break chains of transmission quickly. These tests do not require a trained health professional to operate them, so they can be rolled out in more non-clinical settings. We now have one of the most comprehensive systems of testing in the world, and we want to go much, much further.
Next, we come to contact tracing. NHS Test and Trace is consistently reaching tens of thousands of people who need to isolate each week. As I mentioned in answer to a question earlier, the latest week’s data shows that 84.3% of contacts were reached and asked to self-isolate, where contact details were provided. Since its launch, we have reached over 300,000 people, who may have been unwittingly carrying the virus. Today, we also launch our new system of pay to isolate. We want to support people on low incomes in areas with a high incidence of Covid-19 who need to self-isolate and are unable to work from home. Under the scheme, people who test positive for the virus will receive £130 for the 10-day period they have to stay at home. Other contacts, including, for instance, members of their household, who have to self-isolate for 14 days, will be entitled to a payment of £182. We have rolled out the scheme in Blackburn with Darwen, Pendle and Oldham, and we will look to expand it as we see how it operates on the ground.
The third line of defence is targeted local intervention. Over the summer, we have worked hard to integrate our national system with the local response, and the local action that we are taking is working. In Leicester, as the honourable Member for Leicester South (Jonathan Ashworth) knows well, as a local MP, in Luton and in parts of northern England, we have been able to release local interventions, because the case rate has come down. We also now publish significantly more local information, and I put in place a system for building local consensus with all elected officials, including colleagues across this House, wherever possible. Our goal is that local action should be as targeted as possible. This combination of social distancing, Test and Trace and local action is a system in which we all have a responsibility to act, and this gives us the tools to control the virus while protecting education, the economy and the things we hold dear.
Meanwhile, work on a vaccine continues to progress. The best-case scenario remains a vaccine this year. While no vaccine technology is certain, since the House last met, vaccine trials have gone well. The Oxford vaccine continues to be the world leader, and we have now contracted with six different vaccine providers so that whichever comes off, we can get access in this country. While we give vaccine development all our support, we will insist on safety and efficacy.
I can update the House on changes to legislation that I propose to bring forward in the coming weeks to ensure that a vaccine approved by the Medicines and Healthcare products Regulatory Agency can be deployed here, whether or not it has a European licence. The MHRA standards are equal to the highest in the world. Furthermore, on the development of the vaccine, which proceeds at pace, I will shortly ask the House to approve a broader range of qualified clinical personnel who can deploy the vaccine in order of clinical priority, as I mentioned in Questions. As well as the potential vaccine, we also have a flu vaccination programme—the biggest flu vaccination programme in history—to roll out this year.
Finally, Mr Speaker, in preparation for this winter, we are expanding A&E capacity. We have allocated billions more funding to the NHS. We have retained the Nightingale hospitals to ensure that the NHS is fully prepared, and we published last month updated guidance on the protection of social care. As well as this, last month, figures showed a record number of nurses in the NHS—over 13,000 more than last year—and record numbers of both doctors and nurses going into training. We are doing all we can to prevent a second peak to prepare the NHS for winter and to restore as much of life and the things we love as possible. As schools go back, we must all remain vigilant and throughout the crisis we all have a role to play.
This is a war against an invisible enemy in which we are all on the same side. As we learn more and more about this unprecedented virus, so we constantly seek to improve our response to protect the health of the nation and the things we hold dear. I commend this Statement to the House.”
My Lords, I thank the Minister for the Statement and the Covid update that the House will discuss today. We are, of course, all on the same side in fighting this virus. I hope the Minister will understand that when we raise issues it is to urge the Government to improve their response to fighting the virus which, as he said earlier today, remains lethal and leaves many with serious, debilitating sickness. Everything must be done to drive down and eliminate infections and suppress the virus completely.
Given the news today about testing availability and the aspirations of the Secretary of State in that regard, I start by asking the Minister about the current state of testing and tracing. From the news this morning, it would seem that coronavirus testing was being prioritised in high-risk areas, leading to shortages in others. This has led to some people with symptoms being asked to drive significant distances for a swab. The Government say that areas with fewer Covid-19 cases have had their testing capacity reduced to cope with outbreaks elsewhere. Is this within the 300,000 tests which the Secretary of State has mentioned as being his aspiration? As the Minister will be aware, public health experts warn that this could miss the start of new spikes, so I would be very grateful if he could clarify the exact position on the rollout of mass testing.
Saliva testing is being used in Hong Kong, as we know. Would the Minister be able to ensure a quick turnaround of these tests? Has he seen the study from Yale which suggests that saliva testing could be as sensitive as nose and throat swabs? What is his attitude towards pool testing, which surely could increase capacity in areas of low prevalence? Does the Minister have a plan to introduce pool testing? Will we now allow GPs to carry out testing or, at the very least, arrange tests for their patients directly? They currently have to ask patients to log on to the national system, which may be causing huge delays.
My Lords, yesterday it was raining when I left the house, so I decided to catch a bus. I donned my mask and got on. There were signs to say that only 30 passengers would be allowed, but I was disappointed that not only was that number exceeded, but masks were not universally worn. Some came off when the individual wanted to use their phone or talk to a friend, and there appeared to be no awareness of the reason for wearing one. I was glad to get off. It raised as many questions as it answered.
I appreciate that there is positive movement in some parts of the country. In my own part of the world, the far south-west, despite many visitors from elsewhere—the locals were anxious that they would bring the virus with them—they mainly kept to themselves and only left their footprints in the sand behind. Areas have been locked down in north-west England, Yorkshire and Greater Manchester, as there have been many cases identified. Will the Minister outline how these cases were identified?
Social distancing is difficult when you are young. We all might remember when we felt immortal; many young people catch the virus, are barely unwell but are spreaders among their generation. They then take it home and pass it on to their older family members. Mass testing would avoid this.
What is the Government’s policy on testing key workers? Do they have to book their own tests, or are some professions automatically tested or encouraged to book a test? I was contacted by text quite out of the blue by my local authority to take a test, which I dutifully did. No reason was given; perhaps it was a contact trace. I therefore looked at where the local testing stations were located and no station was nearer than 50 miles, so I ordered a postal test. Easy, excellent directions came with the test and the result came back quickly, so I had a completely different experience from that of the person who wrote to the noble Baroness, Lady Thornton. Could the Minister outline where test and trace is being used and what system is in operation? I know that it is going well in Northern Ireland. Have the Government considered using this in England?
My Lords, I thank both the noble Baronesses for extremely perceptive and thoughtful contributions and I will try to get through as much data as I possibly can.
I completely and utterly agree with the noble Baroness, Lady Thornton: we are all on the same side. As I said earlier, I pay tribute to the huge efforts across the nation of national and local politicians and officials working collaboratively. There are the occasional lightning points that hit the headlines, but that completely disguises the overall picture up and down the country of a huge amount of collaboration that is going on to great effect. I will talk later about the impact of the local restrictions, lockdowns and infection-control efforts that are making a big impact on this disease.
The noble Baroness, Lady Thornton, is absolutely right to raise the question of capacity for testing because the testing that we have got is proving to be incredibly effective. It is being put to work extremely hard. The marketing that we have done to the population took a massive reboot recently and is proving much more effective. The take-up of testing is up 63% since June. The amount of surveillance that we do now has been hugely upgraded in order to give local authorities and local actors the data that they have cried out for. We provide that data for them in as much quantity as we possibly can.
The regular testing in hospitals and social care, which has been the subject of a huge amount of comment here in this Chamber, is up enormously. Testing is allocated to outbreak management in areas such as some of the cities that have been mentioned here earlier and has had huge effect. Our ambition is to have 500,000 tests by the end of October. Earlier today, the Secretary of State made announcements in detail of how we are going to achieve that. I would particularly like to mention the Lighthouse Lab in Charnwood, which is exactly the kind of modern, impressive, industrialised outfit that is going to help us achieve a huge amount of capacity over the next few months.
My Lords, why do we not have testing at airports yet? Leading figures in the aviation industry are expressing frustration and it is having a detrimental impact on the industry. Other countries have managed to introduce testing at airports; why are we lagging behind?
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A testing problem came to my notice in an email I received from an English family on holiday in Northern Ireland. They went there to have a break and did everything they could to ensure their safe passage—they did not stop for toilet breaks, they packed lunches, they booked the shortest ferry crossing, and they were heading to a house that had not been occupied for a week. However, something went wrong, and the father became ill. He said: “Getting a test should be easy, right? Well, wrong. When we first tried to get a test, the booking system was completely down. It was not working online or by telephone. When it eventually resumed, I was offered a test appointment 460 miles, and a ferry journey, away in Scotland. I was worried about having potentially to drive 20 or 30 minutes with a raging fever, so we ordered the home tests. The kits took 48 hours to arrive. Remarkably, there seems to be no test-kit storage site in Northern Ireland itself, so they have to come from the mainland, even though one of the companies that manufactures tests—Randox—is based in Northern Ireland.”
This person had the usual problems that lots of people have when doing a self-administered test and returning the results. They were in an isolated place, so they chose to use the specially designated postal box, which meant his wife driving 25 minutes. That box was inside a building. It did not seem to cross anybody’s mind that potentially infectious people should not be entering a building full of people. When the wife talked to someone about their concerns, they said that they were not allowed to handle parcels and she should put the results in another post box. It took six days from the husband developing the fever and seeking a test to getting the result. When it came, it was not absolutely conclusive. We know that these tests can sometimes be only 70% accurate. This person is still very ill and still in Northern Ireland. He is an academic who, as it happens, is also a scientist. He is very disappointed with the 111 service, which he called to ask for another test. He was told that he could not have one, that he probably did not have Covid, and that he should go back to work. It seems to me that this system is not working terribly well. What is the Minister’s view of this sorry tale, which raises all sorts of issues about testing and tracing, at least in Northern Ireland?
I move on to the cancer plan and whether a task force will be in operation. The number of new cancer patients presenting is down by one-quarter this year, the number of appointments for specialist cancer treatment is now also falling, and the amount of money available for clinical trials has fallen through the floor. This means that people will die. What are the Government’s plans to move this forward?
We know that a vaccine is our best hope to stop this pandemic. It will save hundreds of millions of lives. We on this side of the House have offered to work with the Minister on a cross-party basis to promote uptake and challenge the poison of anti-vax myths. That offer remains in place. We would work constructively with the Government on any proposals that they bring to the House to deal with those myths.
On Public Health England, the Minister is aware that we on this side of the House think that embarking on a distracting restructuring of Public Health England in the middle of a pandemic is very risky. Conservative MPs seem to like to blame Public Health England and this will sap morale even further. The UK has suffered the highest per capita death rate of any major world economy. To get through this winter safely, our NHS and public health services need resources, staff, protective equipment, fair-pay security and the support of this Government. I hope they will be able to deliver that.
Finally, the Minister said a few minutes ago that the folic acid issue would not be dealt with until after the pandemic. He needs to write to the House about exactly what that means and what the timeline is.
The Government pay-to-isolate scheme also seems a good idea for those who cannot afford to miss work. Will the Minister tell the House what the take-up is and where the department might use it in future?
When do the Government expect to roll out a vaccine? I would like to know how many volunteers are taking part in the programme and how that number compares with the development of any other new vaccine that would be working to the usual timetable. I would expect Public Health England to organise vaccinations when it is ready. Now that Public Health England’s future is uncertain and it is being disbanded, how will this happen? What clinical personnel would the Government consider capable to deliver the vaccine? Presumably, as local pharmacies deliver flu vaccines, they would be capable of delivering coronavirus ones as well. Would this be something paid for by the patient, as with flu, or paid for by the Government? Has the department had conversations with the pharmacy profession about doing this work?
May I ask the Minister a question about numbers? In the Statement, it was mentioned that 84.3% of contacts were reached and asked to self-isolate. Do we have any certainty that they did so? Are local authorities or call centres checking on this?
My final point is about nurse numbers. I am delighted that they are higher, although we will still be far off full complement. Will the Minister comment on care-worker numbers? In the new year, some EU-origin workers might not be able to afford to stay under the new system. The Home Secretary suggested that we could use British care workers. Is the Minister confident that they will exist in sufficient numbers?
The noble Baroness, Lady Thornton, was absolutely on the money when she mentioned saliva tests. Saliva tests are an incredibly exciting opportunity because they are much more usable. For any of those in the Chamber who may have had a swab test, they would know that it was okay, but you do not necessarily want to have a load of them. Saliva tests are much more accessible. The Yale study she mentioned was incredibly impactful when it was published earlier this year and it surprised everyone with conclusive evidence that saliva tests would be just as accurate as a nasal or swab test. That has opened up a huge amount of interest in this area. That is one of the ideas for which we put £500 million into the innovative tests kitty. There is a huge project in Southampton, and hopefully another one in Salford, which will be using saliva testing. I pay tribute to the Southampton authorities, the hospital, and OptiGene and its LAMP test, which uses saliva, and we are really hopeful about that.
The noble Baroness, Lady Thornton, mentioned pool tests. I suspect that she meant multiplex testing, which is the combination of testing in the same well. That is, again, another technology that has the opportunity to massively increase our capacity for testing. It is exactly these kinds of innovations that we have spent the spring and summer pushing really hard on in order to get our capacity up to do the kind of mass testing that has been mentioned by several noble Lords in the discussion.
We have worked really hard in order to get access to GPs for registering patients for testing. This is a not inconsiderable technical challenge. I remind everyone that it is not that difficult for a GP to register a patient on the normal coronavirus testing page. It takes about 45 to 50 seconds. We have worked hard in order to ensure that all testing results go into the GP records and to upgrade the booking system to give GPs that special access.
In terms of the testimony of the noble Baroness, Lady Thornton, it is very difficult for me to comment on an individual’s experience. I do not in any way question any of that testimony. What can I say that is constructive? I share completely the frustration of the experience of the person involved. In particular, there are millions of people who want to know whether the symptoms they have are Covid or not. The ONS data suggest that a lot of people who think that they might have Covid do not actually have it. It is extremely frustrating for them not to be able to clarify that. That is one of the reasons why we are pushing so hard in order to get our capacity up. The long-distance question of when you book a test and get sent to Inverness to have your test is an odd thing to happen, but we are trying to make as many tests possible to as many people as possible. It is up to the individual to decide whether they want to travel a long distance.
The noble Baroness, Lady Jolly, mentioned home testing, which has proved hugely effective. We recently celebrated 1 million home tests. On the whole, that experience has been extremely positive for the vast majority of people, and we have worked hard with our contractors to get the turnaround time down to 20 hours, although there is more that we could do. Not everyone is able to drive to a test site; test sites are not available in many city centres. That is why home testing is important and why we continue to prioritise it.
The noble Baroness, Lady Jolly, is entirely right about cancer. It is a huge problem that, over the last six months, cancer screenings and referrals, and the attendance for cancer procedures, have not kept up with the needs of patients. We are working incredibly hard. I pay tribute to colleagues in the NHS, Sir Simon Stevens and others who are working hard to open up facilities, to use marketing to get people back into hospitals and to create community-based facilities, so that people do not have to travel to hospitals for some of their diagnostic and procedural treatments. Those efforts are making a massive difference. Referrals in June were up by 90%, and 92% of the referrals in June were seen within two weeks. We are working through the backlog more quickly than the current numbers seem to suggest.
The noble Baroness, Lady Thornton, raised important questions about PHE. PHE is incredibly important to both the science and organisation of our response to this public health challenge. We do not blame anyone at PHE for anything—quite the opposite. The Prime Minister, the Secretary of State and others have paid tribute to the expertise and effectiveness of PHE—the staff, the scientists and the organisation—but there are immense operational benefits in getting PHE, test and trace and the Joint Biosecurity Centre to work more closely together. I see that in my own life in the department, in the collaborative working we can do. You can decide to wait to do these things, maybe until after the epidemic, but it is right that we have used the summer months to mend the roof and to take the tough decision to pull through this organisational change now, in preparation for the second wave. No criticism is implied. We want to see these three important organisations working closer together, under joint leadership. I pay tribute to all who have collaborated in this change.
The noble Baroness, Lady Jolly, asked about mass testing. It presents an enormous opportunity, but our capacity needs to meet its needs. As Innovation Minister, I have been blown away by the rate of progress and innovation of our partners in the NHS, business and the big medical organisations on the scale, price, speed and accuracy of tests. It has been phenomenal, and we are beginning to see a route towards mass testing opportunities that we would not have been able to dream of in February or March, when we began this odyssey.
We are conscious of testing of a diagnostic or preventive fashion to break the chain of transmission. That needs to be swift, accurate, prompt and specified on individuals who either are at risk or present symptoms. But, as alluded to by the noble Baronesses, Lady Jolly and Lady Thornton, there is also an opportunity to use testing to provide reassurance that someone is not carrying the infection and perhaps is not infectious to others. This would give them the confidence to return to the workplace and to areas where social distancing is challenging, or to see people who are at risk. We are looking at avenues to develop that kind of testing in every way possible.
We are hugely encouraged by progress made on a vaccine, not only by our own teams in Oxford and Imperial, but by vaccine teams around the world. But let me be frank with the Chamber: vaccines for coronaviruses are notoriously difficult. Vaccines for anything to do with the respiratory system are also very complex, difficult to deliver and unreliable in their long-term impact. The macro challenge is enormous but, given its size, the progress made by some of the vaccine teams is phenomenal. We are giving them all the resources they need to continue making that progress.
The delivery of a vaccine, when it arrives, will be a massive national challenge and the noble Baroness, Lady Jolly, is entirely right to raise it as something worthy of scrutiny. We will need all the resources that our National Health Service, private partners and the whole nation can provide. A huge number of personnel will be required to deliver one or two doses to a large proportion of the population. Certainly, pharmacies and the pharmaceutical profession will play a pivotal and important role in that. We are deeply engaged in consultations with all parties that have a role in delivering vaccines, and we are putting plans together to do that.
We are making great progress with track and trace. I mention the outbreak in Herefordshire because it does not exist. There is no outbreak in Herefordshire: when we spotted a contagion among migrant workers on a farm in Herefordshire, we used track and trace to break the chain of transmission and close down that mini-outbreak. As a result, it did not expand widely into the community and there is no communal outbreak in Herefordshire. In the last week, 81.4% of people transferred to the contact system were reached, 80% of contacts on whom we had information were reached and 452,679 people have been newly tested under pillars 1 and 2. These are incredibly impressive numbers. Track and trace comes in for much scrutiny and attack, but I reassure noble Lords that it is an incredibly important system that provides an important tier in our fight against the epidemic, and has proved effective already.