Covid-19 Update

Statement

My Lords, with the leave of the House, I shall now repeat a Statement made in another place by my honourable friend the Parliamentary Under-Secretary of State for Health and Social Care. The Statement is as follows:

“With permission, Mr Speaker, I would like to make a Statement on coronavirus. Even through the warm summer days, we drew up our autumn and winter plan. We used the time to plan and prepare, because we know that Covid-19 thrives in colder weather. With winter now around the corner, Covid-19 is re-emerging, as expected. It is clear that this pandemic is far from over: new cases of the virus are high; the pressure on our hospitals is steadily growing; and, sadly, we are seeing over 100 deaths a day. We must therefore be prompt and proportionate in how we enact the plan. We will not be implementing our plan B of contingency measures at this point, but we will stay vigilant and ready for all eventualities, even while pursuing plan A to its full extent.

Vaccines are our first line of defence. Eighty-six per cent of everyone in the UK over 12 has received at least one dose, and 79% of people have had at least two. Two steps naturally follow from this. The first is to plug any gaps in the wall by doing all we can to get vaccines into the unvaccinated. There are 4.7 million people over the age of 18 in England who have not accepted the vaccine, so we are working hard to encourage those who can take it to do so. It is never too late to come forward. We are also working with parents and schools to ensure that this life-saving protection is extended to over-12s.

Our vaccines continue to save countless lives, but early evidence shows that their protection can wane over time, especially in older and more vulnerable people. Our second step has therefore been to reinforce our wall of defence still further. That means third doses, not only for the immunosuppressed but booster shots for all those in phase 1 of our vaccination programme. We have given more than 4 million third doses and boosters in England so far. It is good, but it is not good enough. I want all those eligible to come forward. Over 85% of people have done it twice; there is no good reason not to do it again.

Those who are over 50 or in another priority group, and who had their second jab over six months ago, will be eligible for a booster. The NHS will send an invite once an individual is eligible. But if the invitation has not arrived despite a person becoming eligible, they should contact the national booking service. Boosters can be booked online or by calling 119, because there is zero room for complacency when it comes to this deadly disease and we all have our part to play.

Vaccines are not our only line of defence. Antivirals can stop a mild disease from becoming more serious. Our antivirals taskforce has been looking for the most promising new drugs, to speed up their development and manufacture. Yesterday, we signed a landmark deal for hundreds of thousands of doses of two new antivirals from Pfizer and Merck Sharp & Dohme. Should the MHRA approve their use, we will work with the NHS to make sure that they quickly get to those who need them.

There are, of course, further lines of defence: those that form plan B of our autumn and winter plan. We have always sought to maintain measures that are proportionate to the stage of the pandemic that we are in. We detailed plan B so that people and businesses would know what to expect. This includes face coverings in certain settings, encouragement to work at home where possible, and Covid certification. None of us wishes to implement these measures, but they are clearly preferable to having to close businesses or enforcing further lockdowns.

I recognise vaccine certification is of particular interest to my colleagues in this House. As we set out in our plan, we would seek to provide a vote in Parliament ahead of any regulations coming into force. However, at this time, we remain on Plan A and we will continue to monitor the situation carefully. We are identifying new variants all the time, including a new version of the Delta variant known as AY.4.2, which seems to be growing in prevalence.

Equally, we are monitoring the situation in our hospitals. I want to thank everyone in the NHS and social care for everything they are doing to keep us safe. Today, I can confirm to the House that we are making £162.5 million of additional funding available for social care through a workforce retention and recruitment fund to help local authorities work with providers to boost staffing and support existing care workers through the winter.

In closing, I want to underline just how many things remain within the control of each and every one of us. When we are offered vaccines for Covid-19, we can take up that offer. When we are offered a flu jab, we can take that too. When we have symptoms of Covid-19, we must isolate and get tested. Even if we are well, we can wear face coverings, meet outdoors, let the air in when we are indoors, regularly wash our hands and make rapid tests part of our weekly routine. Let me be clear: rapid tests are a vital tool. A quarter of the positive cases we are identifying at the moment come from lateral flow tests. They also help to give people peace of mind when they visit vulnerable people, such as grandparents.

Even before Covid, winter has always been a tough time for people across our country, for the NHS and for social care. We have another tough winter ahead. But we have a plan. We are prepared and, if things have to change, measures will be prompt and proportionate. We all have a part to play in protecting each other and the people we love.”

I commend this Statement to the House.

My Lords, I thank the Minister for reading the Statement.

Yesterday, the Secretary of State said that the pressures on the NHS due to Covid-19 are “sustainable”. Today, we have the Commons Statement desperately trying to reinforce this message when, in reality, we see ambulances backed up outside hospitals, patients waiting hour upon hour in A&E, cancer operations cancelled and NHS staff worn out and exhausted. Yet still, as we head into winter, the Government refuse to trigger plan B or tell us what the criterion is for doing so. Can the Minister spell out exactly what evidence and criteria will be used?

The British Medical Association is the latest front-line body to call for plan B’s immediate implementation. Why can we not just make the wearing of masks on public transport, for instance, mandatory now? We must remember that SAGE, the Government’s scientific advisers, called for plan B-type measures when the Government’s autumn and winter plan was first launched, with Sir Patrick Vallance stressing the importance of going early with measures to stop rising cases.

Once again, the Government have failed to learn the lessons of the early stages of the pandemic. This hesitation to follow advice will lead to more cases, more hospitalisations and more deaths. The Secretary of State’s warning that cases could rise to 100,000 is chilling. Today, we have the sobering update from the Government’s own Covid dashboard showing 52,009 new coronavirus cases—the highest daily total and the first time the daily tally has topped 50,000 since 17 July.

It is obvious that plan A just is not working. The vaccination programme is stalling, particularly given the very late vaccinations for 12 to 15 year-olds and the mixed messages and worryingly low uptake of booster jabs. Ministers cannot blame the public when 2 million people have not even been invited for a booster jab, and on current trends the booster programme will not be completed until March 2022. Currently, there are just 165,000 jabs a day. Will the Government commit to 500,000 booster jabs a day and ensure that the programme is completed by Christmas, as it needs to be, particularly given the growing evidence of waning vaccination protection among double-vaccinated older and more vulnerable people? We learned from leaked data yesterday that only a quarter of care home residents have received a booster vaccination. Can the Minister confirm that this is correct and tell the House what urgent action the Government are taking to address this?

My Lords, I too welcome the Minister’s reading the Statement from yesterday. We are discussing this on the day when more than 50,000 Covid cases have been recorded in the UK for the first time since 17 July. There have been over 52,000 cases and 115 deaths; 8,142 people are in hospital with Covid, and 870 of those are on a ventilated bed. We are discussing this just hours after the Royal Cornwall Hospitals NHS Trust has declared a critical incident because of the pressures it is under serving the people of Cornwall.

That shows why this Statement is not a master class in providing a range of effective public health measures to tackle a virus that spreads at speed, and more a master class in trying to keep the libertarian wing of the Conservative Party happy. The “jab, jab, jab” message is important but, when some people go on to the booking system now, they are not able to book. They are told to ring 119, as my honourable friend in the other place, the Member for St Albans, Daisy Cooper, said early today; when they ring 119, operators tell them that they cannot override the system. I ask the Minister what is going on with the booking system and how soon it will be repaired. The “jab, jab, jab” message is important, but it is not, in itself, going to deal with the severity of the public health crisis we face. As Professor Adam Finn, a member of the JCVI, said yesterday, vaccinations in themselves are not going to stop us falling off the edge of the Covid cliff.

I want the Minister to explain these different rates, if plan A, of vaccination, is working. The seven-day rolling averages for Covid-19 cases per 100,000 of the population are: in the UK, just under 500, and rising sharply; in France, approximately 60, and falling; and in Spain, approximately 50, and falling. Even considering the variation in testing rates, the UK is clearly an outlier. Take a look at three months ago, when the Government removed all mandatory mitigation measures. The picture tells you the true story of why “jab, jab, jab”, as a public health strategy, is not enough to deal with the Covid-19 problems. Then, the UK had approximately 300 cases per 100,000, and it now has 500; France had approximately 220, and it now has 60; and Spain had approximately 350, and it now has 50. It is because France and Spain, as well as other countries, have jabbed, jabbed, jabbed but also mitigated, mitigated, mitigated. Indecision is our greatest enemy in the fight against this disease.

My Lords—

My Lords, it is the turn of the Front Bench.

My Lords, I thank the noble Lord and noble Baroness for their questions, and I will try to clarify some of the issues. I also thank the noble Lord for his acknowledgement of my newness to the job and for giving me some bandwidth on it, if that is fair enough.

Let me be quite clear on the questions that were asked in terms of threshold. There is no pre-set threshold for considering plan B; we consider a range of evidence and data—as we have done throughout the pandemic—to avoid the risk of placing unsustainable pressure on the NHS. For example, while the number of Covid-19 patients in hospital is an important factor, the interaction with other indicators, such as the rate of increase in hospitalisations and the ratio of cases to hospitalisations, will also be vital. We will need to make a judgment on whether plan B is necessary based on the interaction of all those indicators, and informed by advice from the Government’s scientific and clinical experts—I will come to that question later. As I have said, we have an effective vaccine and much-improved treatments, so we are not where we were last winter.

The Government’s objective is to avoid a rise in Covid-19 hospitalisations that would put unsustainable pressure on the NHS. The Government will monitor all the relevant data on a regular basis to ensure that we can act if there is a substantial likelihood of this happening. The Government monitor a wide range of Covid-19 health data which, to give a taste, includes cases, immunity, the ratio of cases to hospitalisations, the proportion of admissions due to infections, the rate of growth in cases and hospital admissions in the over-65s, vaccine efficacy and the global distribution and characteristics of variants of concern.

In assessing the risk to the NHS, the key metrics include hospital occupancy for Covid-19 and non-Covid-19 patients, intensive care unit capacity, admissions in vaccinated individuals and the rate of growth of admissions. The Government also track the economic and societal impacts of the virus to ensure that any response takes into account these wider effects. We also monitor a range of metrics on other NHS pressures, including winter respiratory hospitalisation rates, influenza, urgent and emergency care pressures, elective activity and ambulance response times.

My Lords, I declare my interest as chair of Genomics England. Does the Minister agree that, as well as testing, sequencing is critical to tracing the pandemic as cases rise? In addition to delta, we are now observing the delta subtype, AY42, and we need to be constantly on our guard for vaccine escape. Can he say what steps are being taken to ensure that our so far really very good pathogen sequencing programme will be as responsive as it needs to be to the winter surge?

I thank my noble friend for that question. The UK is world leading in genomics, and it is something that we can all be proud of. COVID-19 Genomics UK has now sequenced 1 million genomes, and the UK is working with global partners to fill global sequencing capability gaps. This includes building the new variant assessment platform, which will offer UK expertise to assess and detect new Covid variants emerging globally.

My Lords, I apologise for having stood up too early a moment or two ago; I am still very much learning my trade in this House, but I follow the dictum of Martin Luther, that if you must sin, sin boldly.

I am grateful for the Statement, and assure the Minister that the faith communities, which did a lot last year to get health messages to some of the harder-to-reach groups in our society, stand ready to do the same again this winter, but I wonder whether the Government have made a rod for their own back in having plan A versus plan B. It seems a very polar way to deal with things when, actually, we need a more graduated method. Perhaps I might encourage the Government not to be the prisoner of their own rhetoric and for the Minister to share with his colleagues in another place that perhaps we could have steps between a plan A and a plan B: we need gradual, incremental stages as the virus levels rise. I encourage him to try that.

I thank the right reverend Prelate for his advice, and for pointing out the very important role that faith communities paid played helping many people get through the lockdowns. They play an important role in this country; many people often assume that it is down to the state, but faith communities play a really important role and complement many of the things we do.

In answer to the right reverend Prelate’s specific question, it should not be seen as plan A or plan B; it is sequential. The Government would prefer that plan A works and that we vaccinate more and make sure that we reach those who have not yet been vaccinated. But if the figures, and the various factors we are looking at—scientific, but also socio-economic—suggest that we have to go to plan B, then we will. At the moment, we are hoping that plan A will work, but we are reliant on the advice that we get from the various scientific advisers that I outlined, but also the other stakeholders, to ensure that we test plan A. Hopefully, it will work, but if it does not, we will move to Plan B.

My Lords, I have recently returned from Germany, where medical masks are worn indoors in settings such as shops, restaurants, theatres, conferences, churches and, of course, on public transport. To enter, you have to show a Covid green vaccination pass—the QR code is checked—or, alternatively, a same-day antigen test performed and certified in a pharmacy. It is easy, it is acceptable, it is working and people feel safe. The death rate is much lower. Will plan B provide the same security and reassurance to British citizens as I experienced in Germany by mandating face masks and green passes, and will this happen soon enough to prevent more deaths? We started the pandemic with a first lockdown that was too late; plan B may be too late.

I thank the noble Baroness for sharing her experiences from Germany. We are relying very much on a range of scientific advisers to tell us whether we need to move to plan B but at the moment, because we are not where we were last winter and because we have broken the link between cases, hospitalisation and deaths, we would prefer to try plan A. If we have to move to plan B, we will—on the advice of our range of scientific advisers—but there are also some concerns, as the House can imagine. I think it was Professor Mark Pennington of King’s College London who said, when assessing Covid-19 and the response to it, that you have to look at it as a complex system. When one thing happens, there might be a reaction elsewhere but also unintended consequences.

One concern we have heard about mandating face masks at the moment is: who enforces that? Do we suddenly have more police enforcing it and become a police state? Transport workers are also concerned about having to approach certain people and ask them to put their mask on in the proper place, for fear of abuse, so we have to get the balance right. We will try to stick to plan A, given that we have broken that link between cases, hospitalisations and deaths, and encourage more people to get vaccinated while reaching out to those hard-to-reach groups. But if the numbers and the various indicators are there and the scientific advice tells us to move to plan B, we will do so.

My Lords, I too thank the Minister for repeating the Statement. It is such a pleasure to follow the noble Baroness, Lady Blackwood, to whom I had the pleasure of referring by name a week ago today in my maiden speech. SAGE is so crucial to the advice given to the Government. So far as I understand it, in the first half of this year SAGE met on at least a dozen occasions. Yet since July it appears to have met only three times. Is it true that SAGE has not met since 9 September and, if so, why? On 9 September, SAGE’s official advice was that the epidemic was

“entering a period of uncertainty”

because of waning immunity and “changes in contact patterns”—which meant people going back to work and children going back to school. SAGE then

“reiterated the importance of acting early to slow a growing epidemic.”

When SAGE advises the Government, as it did on 9 September, that

“Late action is likely to require harder measures”,

does the Minister agree?

I thank the noble Viscount for his question and welcome him to the House. The Government are taking a range of advice, including from SAGE, but also from the Chief Scientific Adviser, the Chief Medical Officer, the UK Health Security Agency and the NHS. We have to balance a number of different views. We want many scientific experts to contribute directly to ministerial discussions and believe that we have benefited from that wide range. I know that SAGE has met regularly; I do not have the latest date for when it did so but I can forward that information to him.