My Lords, 14 weeks ago, I raised in the House the issue of masks. The Government’s response was to reject my case. I have repeatedly raised the issue. Meanwhile, nearly 60 countries worldwide have adopted mandatory mask wearing. During that period, we have registered the second-highest incidence worldwide of death and new cases. Indeed, today there are more cases in the UK, with a population of 67 million, than in the whole of Europe, with a population of 460 million. We are struggling in the UK against an avalanche of reported new cases—between 4,000 and 7,000 a day—and we have moved into second place worldwide for deaths per 1,000 of the population.
I am not arguing that our shocking record is down to PPE shortages, though I do argue that mask policy has been a major contributory factor. The Government’s whole approach to this pandemic has been riddled with miscalculation, misjudgment and mistake. Their errors in the case of the elderly, on PPE, on testing and in the dispersal of the elderly from hospitals to care homes—all unparalleled in medical history—have undoubtedly cost thousands of lives. Those responsible will never be forgiven—never.
Obsession with the herd, the abandonment of test and trace, reliance on Public Health England’s advice on testing and an early failure to take the big decisions have all contributed to this disaster. The sight last week, televised worldwide, of MPs lined up over a kilometre to vote in our Parliament has made us an international laughing stock. That is the background to this affair: the worst example of government incompetence in my political lifetime.
Last week, the policy on masks was finally rescinded. It would be churlish of me, despite what I have said, not to welcome this decision, limited as it is. I understand that, for many in government, the change would have been professionally embarrassing. One would hope that comments in the Lancet of 27 May, where it is stated that there is increasing evidence of aerosol spread of Covid-19, meaning that people further than two metres away are all at risk, help to strengthen their resolve. If that is so, why are the Government still so wedded to hesitant change at a time when the country is desperate for real action and resolve? The truth is that they should never have allowed procurement and supply to compromise their professional judgment. The policy change does not go far enough.
I think the debate is no longer about face masks. We accept that there may be shaky evidence that they are needed, but what we need to debate is when they should be worn and what sort of face mask? The overall European opinion is that they need to be worn in enclosed spaces and where people are together for a minimum of 10 minutes, because that is where the danger lies. I hope that we will look into this and not talk just about face masks. There are different types, with different levels of effectiveness. I would like the Minister to comment on what is going to be done to get them distributed. This morning, at King’s Cross station there were no face masks; at St Pancras, they were being given away free; and in Cambridge station, there were none. What do HMG have in the way of plans to distribute face masks and to look at the quality control of the types of masks that are going to be used?
My Lords, many people now wearing masks may feel that they are protecting themselves. The WHO makes it clear that any role non-medical masks have is to protect others. It advises Governments to adopt a comprehensive strategy to suppress transmission. Only where physical distancing is difficult should Governments encourage the public to use non-medical fabric masks.
In the UK, people have been asked not to buy medical masks so that they do not deprive the NHS and care sector. Will the Government therefore stop companies from advertising these masks, for example in newspapers? The care sector still reports not being able to get adequate PPE, especially via Clipper. When will there be sufficient? Are the Government building reserves of PPE for a second wave of the infection? These issues must be addressed if the risk of coronavirus is genuinely to be reduced.
4:14 pm
Lord Skidelsky (CB) [V]
My Lords, I welcome the Government’s decision to make mask wearing compulsory on public transport from 15 June, but I believe that this needs to be accompanied by two further measures. First, mask wearing should be encouraged by distributing free masks to all households. Japan and Turkey have done just that. Secondly, the recommended measurement for social distancing should be cut. We are now almost alone in asking for two metres. One metre is the distance recommended by the WHO; Austria, Germany and Holland advise 1.5 metres; and Hong Kong, Singapore, France, Italy and China advise one metre. Our Government have made no effort to test the trade-off between social distancing and wearing masks. The noble Lord, Lord Bethell, admitted on 1 June in his reply to a Written Question that I asked:
“No assessment has been made of the change to a face covering’s health benefit when social contact is at two, one and zero metres.”
Common sense suggests that wearing a mask reduces the distance you should keep from someone else. Giving people the confidence to interact normally is the key to reopening schools and to economic recovery.
My Lords, I am pleased to be here supporting the increased use of face masks in public—so ably argued by my noble friend. In his argument, which he made with conviction and authority, he used evidence, information and knowledge to make his case. I want to highlight two of his arguments.
First, he gave us an indication of the bodies that support the increased use of face masks—the BMA, the World Health Organization, the Royal Society, the Lancet, and so on. Then—this is critical—as further evidence, he cited 80 research sources worldwide that found that wearing a face mask increased the success rate in the battle against Covid-19.
My Lords, can my noble friend the Minister say what work is being done with health experts to ensure that face coverings on sale are in good supply, of sufficient quality to stop the virus spreading, and affordable? I looked online yesterday for sales of face masks and saw that some well-trusted high-street retailers now have non-surgical masks in stock—but they are not cheap, especially for those on lower incomes and for those who need to use masks on public transport every working day, perhaps for many months ahead.
Finally, I watched online as Members of the House of Commons voted yesterday and noticed that some wore masks. Has advice to parliamentarians been changed to permit or indeed encourage the wearing of masks while on the Parliamentary Estate?
My Lords, this debate, as well as the one introduced last week by the noble Baroness, Lady Anelay, and the one earlier this afternoon are really opening this House to ridicule, with the lack of ability for us to debate some of these important issues properly.
I live in the Scottish Borders and from next week we will begin to see people again travelling across the border frequently or every day on public transport for retail purposes or for business or securing public services. From next week, those people will also have an unacceptable level of uncertainty over the guidance, legal requirements or ministerial requests on the use of face coverings if they are under 60 or medical face masks if they are over 60. Therefore, I want to ask the Minister a very specific question. Next week, what will be the law—not guidance or ministerial requests—for those crossing the border on public transport to secure public services without being able to socially distance and for those carrying out business activities?
My Lords, this is the Government’s history on the issue of face masks. On 6 March, NERVTAG expressed concern that the public did not understand why face masks were acceptable for healthcare staff but not for them. The minutes explained that, unlike the public,
“healthcare staff are trained to use the masks and know when to change the masks when they become soggy or contaminated.”
In the remainder of March, as lockdown measures were introduced, face masks were not discussed. On 7 April, NERVTAG concluded that the increased use of face masks would have minimal effect on stopping people becoming infected. SAGE agreed. There was no further mention of face masks in SAGE until 11 May, when the Prime Minister issued advice that the public should wear “face coverings” in enclosed public spaces. On 4 June, the Transport Secretary said that face coverings would be mandatory on public transport from 15 June.
I support the use of face masks, but what on earth is the scientific rationale that justifies this handbrake turn in policy? We cannot expect people to know what they are doing unless the Government explain what they are doing. Until they do so properly, people will conclude that the Government do not know what they are doing.
4:20 pm
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In setting out my case, I thank Mr Philip Collett of Banbury, who has been of invaluable help in carrying out my research. First, on the evidence of transmissibility in the absence of masks, there have been innumerable case reports. In the particularly interesting Hunan bus case in China in January, more than half the people infected were more than two metres away and three were infected at 4.5 metres. People wearing masks were not infected. In a call centre in South Korea, of 1,100 people tested, nearly 100 tested positive—that incident speaks for itself. On 10 March, the US Centers for Disease Control and Prevention reported that one person in a choir in Skagit County, Washington, infected 53 choristers, of whom two died. The virus was spread by a superspreader. This well-documented case was a clear indicator of breath-borne transmissibility. In another choir case, this time in Amsterdam and again well documented, a single chorister infected another 102 choristers. The list goes on. These and many more similarly documented cases should have alerted policy- makers to the dangers of transmissibility and the need for masks.
What has been the response of government? We now have the revised WHO guidance, which recommends mask wearing not only on public transport but in grocery stores, at work, at social and mass gatherings and in closed settings—including schools, churches and all places of religious worship. Then we have the view of the US Centers for Disease Control and Prevention, which strongly recommends the wearing of face coverings in public settings including stores and pharmacies. We have the Royal Society’s working group now strongly supporting masked protection. We also have the comments of KK Cheng, professor of public health at Birmingham University, who charges that without masks we have no defence whatever against asymptomatic superspreaders.
We then have the views of Professor George Gao, who heads the Chinese Center for Disease Control and Prevention. He is a highly respected veterinarian with an Oxford PhD in biochemistry. He did his post- docs at Harvard, specialising in immunology and virology. He states:
“The big mistake in the US and Europe, in my opinion, is that people aren’t wearing masks.”
You have to wear a mask, otherwise droplets come out of your mouth when you speak. He continues:
“Many people have asymptomatic or pre-symptomatic infections. If they are wearing face masks, it can prevent droplets … escaping and infecting others.”
He has co-authored papers in the New England Journal of Medicine and the Lancet. Researchers at the National Institutes of Health used lasers to demonstrate transmissibility at up to five metres—that is with people without symptoms. That is said to be responsible for half of all cases. Now we have the BMA view. Again, I quote:
“Given there remains a considerable risk of infection … wearing masks can reduce the spread of the virus … measures should not be restricted to public transport but to all areas where social distancing is not always possible - the risk will be much less if the public adopts this now - not mid-June … the Government should ensure a supply of face coverings for the public, similar to practices in other nations.”
Yes, that is the BMA. The Government say that they go on the advice of experts; now they have it in that presentation.
On 14 May, 100 of the world’s top academics released a statement asking for mask wearing in all public places. During our researches, we were able to identify over 80 highly reputable research sources pointing to the use of masks in reducing onward transmission. I was particularly interested in the suggestion of the noble Lord, Lord Skidelsky, about distributing disposable face masks to all households, because it brings us to the nub of the problem. There can be no doubt that the failure to organise procurement, and inadequate mask-manufacturing capacity in the United Kingdom, have influenced policy.
To put it simply, in wartime the Government direct; we are in a war, with hundreds of thousands of lives lost and many more at risk, yet our approach to procurement has been appalling. We need a Beaverbrook Ministry of Supply, not a Hancock. Ministers are far too preoccupied with hiding behind preconceived views on virus transmission. They should spend more time more accurately interpreting reports from the Covid-19 Mobility Data Network.
Where do the public stand? In this debate, YouGov’s recent polling shows that 73% want compulsory masking in shops and 64% want masking in crowded spaces, such as town centres. The public are not stupid; they live in the real world. So where do I stand? I believe that a combination of track and trace, vaccination and masks will bring it all under control and avoid a second wave. We should have mandatory masking inoffices, shops, schools, libraries, factories, hotels, pubs and garages—indeed, all confined areas apart from, obviously, one’s own home. A combination of these measures should bring it all to an end.
Finally, in Stop Press, I hear that only yesterday a Cambridge University modelling study, backed by considerable data, called for the immediate and universal adoption of face masks by the public. It stated that if widespread face-mask use by the public is combined with physical distancing and some lockdown, it may reduce the all-important R factor and offer an acceptable way of managing the pandemic, while reopening—before there is a vaccine—economic activity. That is all we want; let us just all get on with it.