- 2:23 pm
- I beg to move,That this house has considered covid-19.The House meets today to debate the coronavirus pandemic once more. The peril of the pandemic has no short-term quick fix, but calls for ingenuity, commitment and resolve from us all. We have responded with one of the greatest collective efforts that this nation has seen in peacetime, but the fight is not over: the virus continues to spread, and cases, hospitalisations and, tragically, deaths are all rising. Yesterday we learned that Liverpool University Hospitals NHS Foundation Trust is now treating more patients than it was at the peak in April, and across the UK the number of deaths has doubled in under a fortnight. And yet, just as the situation we face is grave, so the hope of a solution is growing. With every day, my confidence in the ingenuity of science to bring resolution grows. But until that moment, we must have resolve. We are focused on finding a long-term solution, and we reject political point scoring. I call on the House to work together in the interests of our whole nation—and, indeed, the whole world.
- I just wonder whether one problem we have at the moment is that we do not have enough capacity in the whole of the NHS to take on covid in a long-term way, as the Secretary of State suggests, and still be able to do all the things that we really need to do. How can we ramp up that capacity so that we are still treating people for cancer, for brain injury and for all the other things that we all care about?
- The hon. Gentleman is absolutely right. He represents a seat in Wales, and this is a challenge for the NHS in all four nations of the United Kingdom. I was going to come on to this, but one thing that we have learned in the first phase is how we can do better in keeping the other services running that the NHS must and should provide, for instance for brain injuries, for cancer treatment and for heart patients. There are also those things that are not life-threatening, but that harm people’s lives—a painful hip or a cataract that needs treatment. In the first wave, as we knew so much less about this virus, many of those treatments were stopped altogether.In the second wave, we have two advantages. The first is that this is a much more regional wave, which puts more pressure on areas such as Liverpool and Lancashire than elsewhere in the country, but that does mean that elsewhere the elective and the urgent operations can continue. The second difference is that we know much more about the virus and how it spreads, so we have separated the NHS into green sites and blue sites. Green sites are for where we have a high degree of confidence that there is no covid, using testing and asking people to isolate before going in for an operation, so that people can have more confidence. The central message across all parts of the UK is that the NHS remains open. Finally on this point, the best way we can keep the sorts of treatments that we all want to see going is to keep the virus under control.
- The Secretary of State has answered my question in part with his reference to the importance of green and red. One of the big problems in the first wave is that people were frightened, even if they feared that they had cancer or some other condition, to go into the hospitals, and we have to reassure them that they can go there and they can be safe.
- The right hon. Gentleman is absolutely right. We have an advertising campaign, “Help us to help you”, to make the simple point to people that, if they are asked to go to hospital by a clinician, then it is safer to go to hospital than not to do so. In fact, we call them green sites and blue sites. Green means free from covid—we are as confident as we can be that they are. It is blue, not red, which means that we still want people to come to hospital, even if they have to come to A&E, because there is only likely to be, at worst, as much covid as there is in the general population, unless, of course, a person is in a covid ward treating only covid patients. The NHS has learned a huge amount both about the microbiology of the disease and about how to run health services in a world when covid is at large.
- Of course this is a dangerous disease and of course cases are rising, including in my own area, so it is with some humility that I have a look at the daily excess all-cause deaths in all ages in England, which show that there has been no significant excess all-cause mortality observed in week 40 overall. Is it not the case that the good news in this second wave is that the disease is not progressing as it did in the first?
- I want to keep it that way. It is true that the all-cause mortality rates are at around the typical levels for this time of year, and that is partly because non-covid deaths are actually lower at the moment than in most years, and because, thus far, we have worked to keep this virus under control. We know from the basic mathematics of compounding growth and the exponential nature of the growth of any virus that the number of deaths will increase if the number of cases increase, exponentially, hence the need for the actions that we in this House have voted for.
- Many of my constituents were frightened to go to hospital because they thought that they might get infected with covid. With that in mind—I am quite sure my right hon. Friend has thought of this—would it not be an idea to separate hospitals so that we have a covid centre of excellence, say using the Nightingale hospitals, where everyone goes, and then the normal hospitals that deal with everything else? Forgive me for raising this point, because I am quite sure that the Secretary of State has a very good answer.
- It is a brilliant idea—so brilliant that the NHS has spent the summer working on that concept. We cannot do it as perfectly as my hon. Friend suggests, and the reason is the practicalities of the treatment of covid—for instance, if someone has covid and something else, they need a normal intensive care unit. But the Nightingale hospitals are there—in fact today, sadly, the Nightingale hospital in Manchester is reopening. In all the rest of the hospitals, we are making sure that different parts are deemed either blue or green—essentially covid-free or at risk of covid. Some of the different buildings are covid-free or non-covid, or, in some cases, whole hospitals are covid green sites and people cannot go to them unless they have tested negative. That means we can have a high degree of confidence because, for instance, if we are treating cancer patients, we want to ensure that there is not any covid in there.We need these long-term solutions and, like other liberal democracies around the world, we are wrestling with this question—as we have wrestled with it in the last few minutes—of how to keep people safe from the virus while protecting other important things in life: our liberties, our livelihoods and the things that we love. That is what leads us to the strategy of suppressing the virus and supporting the economy, education and the NHS. The NHS needs to be supported to do all the other things that it needs to do until a vaccine is available.I reject the false choice that says we must pick a side and choose between a healthy economy and a healthy nation, because the two are intrinsically linked. If, God forbid, we were to let the virus unleash its full force, the damage to not just the NHS and the hundreds of thousands of lives, but our livelihoods would be catastrophic. We can only get our economy and our society going gangbusters again if we drive this virus down, so that people have the confidence that they need to live their lives to the full—and drive it down we must.
- When my right hon. Friend came to the Health and Social Care Committee a few weeks ago, he talked about long covid and the fact that clinics were being set up to deal with it. Will he give the House an update on where that has got to?
- These clinics are being set up—the London clinic is now open—but we need to see them right across the country. The NHS now has a programme of rolling out clinics to be able to support people and, of course to communicate with GPs. That is important because primary care is often where people arrive with long covid, because there appears to be no correlation between the seriousness of someone’s initial illness and how long they can have these debilitating consequences. In some cases, people have no symptoms of the coronavirus initially, but then find that they have months and months of fatigue, a brain fog and muscle pain, and they do not know where it came from until they are diagnosed with long covid. It is a very serious complication.
- To enable us to get a picture, could the Secretary of State tell us what percentage of people up to 25 suffer from the condition?
- Yes. We have two points of evidence; one is the evidence from King’s College London that shows that approximately one in 20 people with coronavirus is likely to have long-term symptoms, but the other evidence implies that in adults under 50, the proportion is more like one in 10. There seems to be some correlation that implies that it is more of a problem among younger people, but the understanding of long covid is still in its early stages and an awful lot more research is needed.
- I am sorry to press the point, but it is a question of roughly what percentage is affected not of those who contract the disease, but of the overall cohort.
- It is very difficult to know. We estimate that approximately 8% of the population have had covid and that one in 20 people who has had it has symptoms for longer than eight weeks. Of course, the fewer people get covid, the fewer people get long covid, which reinforces the overall strategy of suppressing the virus until we get a vaccine. Let me turn to how we do that.We cannot reiterate enough the importance of the basics: social distancing and “hands, face, space”. The next area is following rules on local action, which are at the core of how we and an increasing number of other countries around the world are tackling the crisis at the moment. Through our local covid alert levels, we have been able to take a balanced approach; I would like to update the House today on some further changes that we are making.Unfortunately, we are seeing rising rates of infection in Stoke-on-Trent, in Coventry and in Slough. In all those areas, there are more than 100 positive cases per 100,000 people, cases are doubling approximately every fortnight and we are seeing a concerning increase in cases among the over-60s. We have agreed, in partnership with local leaders, to move those areas to the high local alert level, which will come into force at one minute past midnight on Saturday.The central change is that people will not be able to meet other households socially indoors. This applies in any setting—at home, in a restaurant or in any other venue. The rule of six still applies in any outdoor setting, and although people may continue to travel to open venues, they should reduce the number of journeys where possible. I thank local leaders in the areas for the work they have done and for their co-operation. I can assure the people of Stoke-on-Trent, of Coventry and of Slough that we will support them all the way through, including with the business support that the Chancellor announced earlier today for all areas with a high local alert level.
- I thank the Secretary of State for the ongoing dialogue with me as a Warrington MP and with my colleagues in Warrington. I was particularly concerned this morning after having seen Public Health England data about the rapid rise in the infection rate among the over-60s in Warrington. Could he say a little more about that information?