Covid-19 Update

With permission, Mr Speaker, I will like to make a statement on coronavirus.

The virus remains a powerful adversary, but we are marshalling the forces of science and human ingenuity. Those forces are growing stronger, and I have no doubt that in time, we will prevail. The latest figures show that the number of cases continues to rise, so we must all play our part to get it under control. As I have said many times at this Dispatch Box, our strategy is to suppress the virus, supporting education, the economy and the NHS, until a vaccine can be deployed. That is our plan, and with the resolve that we must all show, we can see that that plan is working.

Before turning to progress on testing and on vaccines, I want to update the House on our response to the new variant strain of coronavirus that has been identified in Denmark. This shows how vigilant we must be. We have been monitoring the spread of coronavirus in European mink farms for some time, especially in the major countries for mink farming such as Denmark, Spain, Poland and the Netherlands. Spain had already announced the destruction of its farmed mink population in April. On Thursday evening last, I was alerted to a significant development in Denmark of new evidence that the virus had spread back from mink to humans in a variant form that did not fully respond to covid-19 antibodies.

Although the chance of this variant becoming widespread is low, the consequences, should that happen, would be grave. So working with my right hon. Friends the Home Secretary and the Transport Secretary and all the devolved Administrations, we removed the travel corridor for travel from Denmark in the early hours of Friday morning. On Saturday and over the weekend, following further clinical analysis, we introduced a full ban on all international travel from Denmark. British nationals or residents who are returning from Denmark, whether directly or indirectly, can still travel here, but they must fully self-isolate, along with all other members of their household, until two weeks after they were in Denmark. These are serious steps, and I understand the consequences for people, but I think that the whole House will understand why we had to act so quickly and decisively. Be in no doubt, we will do what needs to be done to protect this country.

We do not resile from our duty to protect, and to suppress the virus, we must harness new technology to keep people safe and, in time, to liberate. Our ability to suppress the virus begins with testing for it, and the House will know that we have been driving forward testing capacity based on new technologies and old. Yesterday, our polymerase chain reaction—PCR—testing capacity stood at 517,957, which is the largest testing capacity in Europe. Over 10 million people in the UK have now been tested at least once through NHS Test and Trace, and our NHS covid-19 contact tracing app is now approaching 20 million downloads, yet this historic expansion is just one part of our critical national infrastructure for testing. Just as we drive testing capacity on the existing technology, so, too, have we invested in the development of the new. I have been criticised for this obsession with new testing capacity, but we have not wavered from the task, and we are now seeing the fruits of this effort.

Last week, we expanded the pilot in Stoke-on-Trent to Liverpool, where we have deployed enough of the cutting-edge lateral flow tests to offer tests to the whole city. These tests can deliver a result on someone’s infectiousness in under 15 minutes, so that they can get almost immediate reassurance about their condition and so that we can find and isolate the positives and reassure the negatives. To make this happen, NHS Test and Trace has been working side by side with the logistical heft of our armed services and Liverpool City Council, and I want to thank Mayor Joe Anderson and his whole team for their work.

Next, these tests allow us from today to begin rolling out twice-weekly testing for all NHS staff, which will help to keep people safe when they go into hospital and help to keep my wonderful colleagues in the NHS safe, too. The next step is to roll out this mass testing capability more widely, and I can tell the House that last night I wrote to 67 directors of public health who have expressed an interest in making 10,000 tests available immediately and making available lateral flow tests for use by local officials according to local needs at a rate of 10% of their population per week. That same capacity—10% of the population per week—will also be made available to the devolved Administrations. By combining the local knowledge of public health leaders with our extensive national infrastructure, we can tackle this virus in our communities and help our efforts to bring the R down. Testing provides confidence, and it is that confidence that will help to get Britain back on her feet once more.

While we expand testing to find the virus, the best way to liberate and to get life closer to normal is a vaccine, and I can report to the House the news of the first phase 3 trial results of any vaccine anywhere in the world. After tests on 43,000 volunteers, of whom half got the vaccine and half got a placebo, interim results suggest that it is proving 90% effective at protecting people against the virus. This is promising news. We in the UK are among the first to identify the promise shown by the vaccine, and we have secured an order of 40 million doses. That puts us towards the front of the international pack, and we have placed orders for 300 million further doses from five other vaccine candidates that have yet to report their phase 3 results, including the Oxford-AstraZeneca vaccine.

I want to make it clear to the House that we do not have a vaccine yet, but we are one step closer. There are many steps still to take. The full safety data are not yet available, and our strong and independent regulator the Medicines and Healthcare products Regulatory Agency will not approve a vaccine until it is clinically safe. Until it is rolled out, we will not know how long its effect lasts, or its impact not just on keeping people safe but on reducing transmission. The deputy chief medical officer, Jonathan Van-Tam, said yesterday that this was like the first goal scored in a penalty shoot-out:

“You have not won the cup yet, but it tells you that the goalkeeper can be beaten.”

And beat this virus we must, we can and we will. Yesterday’s announcement marks an important step in the battle against covid-19, but, as the Prime Minister said, we must not slacken our resolve. There are no guarantees, so it is critical that people continue to abide by the rules and that we all work together to get the R number below 1.

If this or any other vaccine is approved, we will be ready for begin a large-scale vaccination programme, first for priority groups, as recommended by the independent Joint Committee on Vaccination and Immunisation, then rolling it out more widely. Our plans for deployment of a covid vaccine are built on tried and tested plans for a flu vaccine, which we of course deploy every autumn. We do not yet know whether or when a vaccine is approved, but I have tasked the NHS with being ready from any date from 1 December. The logistics are complex, the uncertainties are real and the scale of the job is vast, but I know that the NHS, brilliantly assisted by the armed services, will be up to the task.

I can tell the House that last night we wrote to GPs, setting out £150 million of immediate support and setting out what we need of them, working alongside hospitals and pharmacies, in preparing for deployment. The deployment of the vaccine will involve working long days and weekends, and that comes on top of all that the NHS has already done for us this year. I want to thank my NHS colleagues in advance for the work that this will entail. I know that they will rise to the challenge of being ready, when the science comes good, to inject hope into millions of arms this winter.

The course of human history is marked by advances where our collective ingenuity helps us to vanquish the most deadly threats. Coronavirus is a disease that strikes at what it is to be human, at the social bonds that unite us. We must come together as one to defeat this latest threat to humanity. There are many hard days ahead, many hurdles to overcome, but our plan is working. I am more sure than ever that we will prevail together.

As always, I thank the Secretary of State for advance sight of his statement. May I just take this opportunity to congratulate President-elect Biden and Vice-President-elect Harris? I am sure the whole House looks forward to close international co-operation to defeat this virus.

I welcome the announcement, in the past 24 hours, of routine testing for frontline NHS staff. The Secretary of State will know that that is something that the Chair of the Health Committee and I have been pushing for, for some months. It is welcome that we are now in a position to extend that testing. It is important not just to protect our NHS staff—I join him in thanking them—but for infection control in healthcare settings, too.

On the roll-out of the lateral flow test that the right hon. Gentleman announced today, I understand he is giving discretion to directors of public health. Does he agree that relatives of care home residents should be given priority access to those tests, so they can go into the care home, see their loved ones and even, maybe, hold their hand or hug them?

Testing is only one part of the jigsaw, of course. To avoid this lockdown becoming a let-down, we need to put contact tracing in the hands of public health teams from day one, so will the Health Secretary update the House on how he is fixing contact tracing? He may have seen Dido Harding at the relevant Select Committee just now. She confirmed that when it comes to isolation, people find it “very difficult” and that the “need to keep earning and feed your family is fundamental”. Will he therefore now accept that a better package of financial support is needed to ensure that isolation is adhered to?

On the vaccine, this is a moment of great hope in a bleak dismal year that has shattered so many families. We are optimistic, although cautious—quite rightly. We need to see the full results and, the demographic details of the trials and to understand the implications for severe cases. There will be clinical judgments by the relevant committee on the priority lists, which we all understand, but can the right hon. Gentleman outline the latest clinical thinking on the vaccination of children? Will the disproportionate impact of the virus on minority ethnic communities be taken into account by the relevant clinicians when drawing up the final priority list? What is the Government’s current working assumption of the proportion of the population that needs to be vaccinated to establish herd immunity and bring R below one? Over what timeframe does he envisage that happening and how many doses does he think we will need? As we vaccinate the most vulnerable, there will be fewer people at risk, and deaths and infections will come down. However, the virus is now endemic, so is it the Government’s current working assumption that social distancing and mask wearing will need to continue until that herd immunity is reached?

I am very grateful to the hon. Member for his questions and for the approach that he is rightly taking. Like him, I am delighted that we are able to roll-out routine testing to NHS staff. That starts today. I am grateful to him for his support and I am grateful for the support and the urging of the Chair of the Health and Social Care Committee, my right hon. Friend the Member for South West Surrey (Jeremy Hunt).

On contact tracing, we continue to work on the constant improvement needed, but, as the hon. Member said, the expansion of testing in a radical way because of the new technology that we have invested in and spent months working on, means that we will now be able to find more of the primary cases and more of the people who have the disease and then will be able to get them and their contacts to isolate. The single most important challenge is finding the people who have the virus in the first place.

The hon. Member mentioned children. The vaccine will not be used for children. It has not been tested on children. The reason is that the likelihood of children having significant detriment if they catch covid-19 is very, very low. This is an adult vaccine for the adult population.

The hon. Member asked about the JCVI prioritisation. It is really important that we prioritise according to clinical risk. The JCVI has looked into all the risk factors, including ethnicity. It has concluded that age and whether a person works in health and social care are the two prime risk factors, which far outweigh any other, and so they are the primary risk factors that cascade into the draft interim prioritisation that it published on 25 September, which of course will be updated as it gets the final data that comes through from the clinical trials.

The hon. Member asked about the proportion of the population that needs to be vaccinated. The honest truth is that we do not know what proportion of the population the vaccination needs to reach in order for it to stop the epidemic. The reason we do not know that is that a clinical trial can check for the impact of the vaccine on protecting the individual—43,000 individuals, half of whom have had the vaccine. What cannot be checked is the impact on the transmission of the disease by those people, because a significant proportion of the population have to have had the vaccination to understand that. That is the difference between a so-called disease-modifying vaccine, which tests how much it affects the disease that an individual suffers if they get covid-19, and an epidemic-modifying vaccine, which is about the impact on the spread and transmission of the disease. We cannot know that until after the vaccine has been rolled out, so we will monitor that very closely.

I warmly congratulate the Health Secretary on securing access to the new vaccine. Choosing which vaccine to back must be a bit like playing roulette, and to secure 40 million doses of the first vaccine to prove efficacious is an enormous achievement for the country. He deserves great credit for that. I also thank him for bringing forward the introduction of weekly testing of NHS staff to the end of next week. That will reassure our very hardworking frontline staff that they are not infecting their patients, which is one of their primary worries.

The biggest issue we now face is the fact that only around one fifth of those who we ask to isolate comply with that, and we do not even know all the people who we would like to isolate. What does the Secretary of State think of Sir John Bell’s suggestion to the Health and Social Care Committee this morning that, instead of asking people to isolate, we should give them 48-hour lateral flow tests, and ask them to isolate only if they are positive?

I am grateful to my right hon. Friend. He is generous with his words. I also direct his warm words of gratitude to the vaccine taskforce, which has done so much work to ensure that we procure and secure the supplies of these vaccines, should they prove safe as well as efficacious. On Sir John Bell’s comments, that option of testing people regularly—not if they are a primary case and have the virus, but if they are a contact—would not be open to us had we not secured the huge capacity for lateral flow testing that we now have in this country. I very much look to clinicians for advice. Sir John Bell is a highly respected clinician and expert in this area, and I am sure that everybody will want to look closely at that issue.

With three and a half weeks left of the current lockdown in England, what does the Secretary of State plan to change so that covid-19 does not get out of control again when restrictions are eased? He mentions the pilot project of population testing in Liverpool, using newly developed lateral flow tests, but there are not yet published sensitivity or specificity data for those tests. What is the risk of false negative or false positive results? Has the UK National Screening Committee been involved to help assess the risks, benefits, and costs of such mass population testing?

I welcome the progress made on the Pfizer vaccine, but it will take time before it is widely available, and, as the Secretary of State said earlier, we do not yet know if it will reduce transmission, so it does not remove the need to control viral spread using current measures. While I also welcome the expansion of PCR testing, I am sure he recognises that what matters is not just the number of tests available but that testing is part of a test, trace, isolate and support system for it to be effective. Five months on, Serco is still struggling to reach even 60% of contacts, so will he copy the more successful approach of the devolved nations and fund local public health teams to lead contact tracing in their areas?

An effective test and trace system can identify those carrying the virus rather than isolating everyone in a lockdown, but it is isolation that actually breaks the chains of infection. Is the Secretary of State therefore concerned that so few people are isolating when they should? How can that be improved? People will not stay off work if that means they cannot feed their family, so how will he make access to the Government’s isolation payment easier?

Of course, we are working to ensure that, by us all working together and making sacrifices, we can come out of this lockdown and into the tiered approach we had in place beforehand. That is the goal, and the more that people follow the rules during the lockdown, the more effective it will be. We obviously monitor the data closely on that.

The hon. Lady asked about lateral flow tests and their sensitivity and specificity, which is an incredibly important question. The assessment of the tests we are using in Liverpool and now rolling out elsewhere was made at Porton Down. We then tested 5,000 lateral flow tests alongside 5,000 polymerase chain reaction tests of the same people in the field, and we have a high degree of confidence that they can find people who are infectious. In fact, the lateral flow tests have a lower false positivity issue than the PCR tests, so they are very effective for the right uses, including mass population testing.

The hon. Lady asked about isolation. Of course, isolation is important. I would mention that we have test and trace systems in place across the UK and it turns out that there are differences in how a successful contact is measured. In England, we are much stricter in requiring contact to be a confirmed contact with somebody rather than just sending them a message, which does count as contact in some of the devolved and local systems. It is really important that we measure the same thing, rather than trying to make divisions where divisions do not exist.

Finally, it is vital that people isolate when they test positive or when they are asked to by NHS Test and Trace. I gently say again that the 20% figure is not particularly robust, because it implies that 80% of people are not doing anything to isolate. That is not what the survey found. Nevertheless, we should all urge and require people to follow the rules. When someone tests positive, they must isolate, and contacts must isolate. That is part of our social duty.

It is indeed a relief to have some hope introduced into our discussions about covid. I am glad that the Secretary of State has announced that use of the rapid result lateral flow tests will be expanded to new geographical areas. As the roll-out continues, will he consider offering tests to specific groups and perhaps in particular close relatives of care home residents who are desperate to make regular visits?

Yes, of course. I have seen some heart-rending stories and I have met people who are affected by their inability to see their relatives in care homes. The lateral flow tests that we are sending to directors of public health can be used for cases that they think are important locally, so they can use them for this purpose if they so choose. But we are also looking at a broader solution to this problem, which is a conundrum we have discussed many times in the House: we need to keep people in care homes safe but at the same time, of course, we want to allow as much visiting as can be safe, which directly impacts on the health of many residents.

It would be very helpful to know how long the roll-out of the vaccinations will take once the Secretary of State gets the go-ahead. He has outlined a major Government project that does not stop with the first vaccinations, and with the mutations rife in Denmark and elsewhere, it could affect children in future, so as part of his major project planning, how will he make sure that we can logistically get this out through the entire population if that does, sadly, become necessary?

That is a very good question from the Chair of the Public Accounts Committee—I would expect nothing less. The critical answer to how long this takes is that it depends on the speed of manufacture in the first instance. My goal, and the goal I have set the NHS, is to be able to roll this out as quickly as it can be manufactured. That manufacturing schedule is uncertain because this is really hard stuff to make. We have got the Major Projects Authority in the Government involved in many of the projects that we have built up in the Department over the past nine months, because I respect its views and its ability to kick the tyres. The roll-out of the vaccine is a huge endeavour, but it builds on the annual roll-out of the flu vaccine—it is just bigger and needs to be done faster.

The past few months have been a rollercoaster ride for families, businesses and public services as they have tried to make plans for the future. The Secretary of State has rightly spoken of the need for caution about the role of the vaccine, but I think what my constituents would like to hear from him, if he is able to say, is when they can safely start to consider family events and holidays and when businesses will be able to get back to something like business as usual.

I understand the yearning for certainty. All I can say to my hon. Friend, in honesty, is that I want us to get back to normal as quickly as possible, and yesterday’s news is a big step forward, but it is not the only step. There are more steps that are needed. The scientists are now offering views on that sort of timetable, but the Government’s view is that we must make this happen as quickly as possible and be ready to roll out as fast as any safe vaccine can be manufactured, but we will not put safety at risk. That is a lodestar of the programme and therefore we have to await the clinical safety sign-off before we can take this to the next stage.

We know that those in the most deprived areas are around twice as likely to die from covid-19 as those in the least deprived areas. We also know that the most deprived people in society are less likely to take up the vaccine and health services, so will the Secretary of State tell me what plans he has made to ensure a high take-up of any covid-19 vaccine among the most deprived and if he will consider setting an inequalities target for this?

We are of course concerned about that and will put in enormous efforts to try to ensure that the take-up of the vaccine is as equal as possible. The starting principle is that we will roll out the vaccine according to clinical need across the whole UK, across all four nations, working of course through the devolved NHSs, which will be critical to actually delivering the vaccine in the devolved nations. But the procurement of this vaccine is a UK programme—we have been working very closely together—and in terms of the roll-out among deprived communities and harder-to-reach communities, we have a particular emphasis on trying to make sure that we get as equal a roll-out as possible. The starting point must be clinical need.