Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place and on Public Transport) (England) (Amendment) (No. 2) Regulations 2020

Motion to Approve

Moved by

That the Regulations laid before the House on 22 September be approved.

My Lords, we are all aware of the rising rate of infection, particularly after this morning’s candid briefings, and the risks this poses. Therefore, noble Lords will understand the importance of taking the necessary steps to keep members of the public safe, while continuing to keep the economy running, the schools open and heading off the need for a second lockdown.

We know that some of the rules put in place have become increasingly complex and difficult to enforce. That is why the Prime Minister has set out today how we will further simplify and standardise local rules by introducing a three-tier system of local Covid alert levels in England. This is not the subject of the debate today, nor does it change the legal requirement to wear a face covering, but it should reassure noble Lords that we continue to work with local leaders to tackle outbreaks with more targeted restrictions that are simple and constructive.

The regulations being debated today introduce the requirement that members of the public should wear a face covering in taxis and private hire vehicles. In addition, they should also be worn when inside a premises that provides hospitality—such as a bar, pub or restaurant—except when eating or drinking, for which they must be seated. This means that people must wear a face covering when entering, leaving and moving around inside these premises. Additionally, staff working in certain retail and hospitality settings should wear a face covering if they are in areas that are open to members of the public and are therefore likely to come into contact with members of the public.

I will now set out why this is a necessary measure, and how we have seen public behaviour change since the introduction of the first set of face covering regulations. A review of recent clinical research published in the Lancet in August suggested that face covering usage

“in community settings with reduced physical distancing might be justified.”

But despite this, the paper concluded that for Covid-19 this evidence is of

“low or very low certainty”

due to the nature of the data collection.

Studies published in the journal Nature have shown different degrees of support for face coverings. In an article at the end of September, the publication concluded that the effectiveness of cloth face coverings is not as well established as that for PPE in a clinical setting. This article recognised that face coverings are intended to protect the public from exhaled virus-containing particles, but points out that

“few studies have examined particle emission by mask-wearers into the surrounding air.”

In a news feature a fortnight later, Nature quoted studies suggesting that face coverings might have the capacity to save lives, but the article outlined the difficulty of establishing definitive proof. The BMJ pointed out on 7 September:

Just for the benefit of noble Lords, let me say that the noble Baroness, Lady Thornton, will not be speaking next; she will be winding up for the Opposition. The noble Lord, Lord Campbell-Savours, will be relieved that he is not winding up for the Opposition, and I call him next.

My Lords, this is the 15th occasion since 9 March on which I have spoken on face masks, and I do not want to repeat much of what I have said in the past. We have made some gains over recent months, and I sense that the noble Lord, Lord Bethell, has certainly influenced events, and for that we are grateful—but there still remains a huge gap in mask policy. These regulations define the circumstances, regulatory requirements, enforceability, penalty and review arrangements, and I broadly support them, limited as they are.

The media criticism of inconsistency in wider virus policy application, which has dominated the national debate, is easy copy. The truth is that it is utterly impossible to avoid inconsistencies—we are in a crisis, and it is inevitable that make-do arrangements will breed inconsistencies. My criticism centres on the general approach to masking. It is quite clear to me, and I have read most of the material, that a more precautionary approach is required over the coming months. I can only repeat my view, held since March, that masks should be mandatory in all conditions of social interaction, apart from in the home. That includes offices, shops, and all public premises and spaces, including the streets, with exemptions for health requirements only. I need only point to the success of masking policies in south-east Asia to make my case.

Furthermore, I remain concerned about the issue of valves, which I raised on 18 September, and to which the noble Lord, Lord Bethell, responded positively. I shall be pressing this issue further, as people are simply not getting the message that masks with valves are suitable only in clinical settings where practitioner wearers are known to be virus-free. The Government have to address this issue at an early stage. Valved masks are still being sold to a wider public, unaware of the danger to others.

However, while concentrating my comments on masking policy, I need to raise the equally controversial and associated issue of herd immunity. I have opposed the herd as premature from the start. The experience of Sweden has been misinterpreted. The problem with the Swedish data is that commentators have sought to equate it with the United Kingdom data, which is a nonsense, as no account is being taken of statistics on population density and income. Population density is critical to the debate—we need only examine population and income stats from within the United Kingdom to see that our worst-affected areas are in our high-population-density industrial and socially deprived heartlands. So I say ignore the Swedish data; the solution is to be found at home.

My Lords, it must be hard work for the Minister to have to come here, make speeches and deal with noble Lords all the time. Trying to do this particular one twice must be a nightmare—fortunately, he was rescued from that.

As far as public consent is concerned, masks are one of the few successes of the Government’s policies and strategies on Covid-19. There is a high degree of compliance with mask-wearing, which is to the credit of people in this country.

When we started again in September, I was very concerned—I was frightened—at the prospect of going on the Underground, remembering what it was like in July, so I brought my bicycle down to London and had a wonderful fortnight cycling in, during the day. My daughter told me that if I brought my bicycle to London, it would be stolen, so I took precautions against that. It was not stolen, but somebody had a go at it and tried to smash it up and I had to take it home to be repaired. I took courage into my hands and went on the Underground. I have to say that, at the moment, the Underground is a safe environment. I have been coming down on the west coast main line, as I did this morning, and I worry how long those trains will run for when it is only me in a whole carriage. At least the public transport I use is safe, and almost all the people I see on it are wearing masks and behaving sensibly. That is good.

The problems seem to be in supermarkets and similar retail premises. People go on social media and get all het up about people not wearing masks in those places. The answer of the operators of retail premises is that they cannot force people to wear masks. But what they can do, and sometimes do do, is refuse to serve people. If the rule was that you could not be served in such places unless you were wearing a mask, it would be much easier to enforce. They would simply say, “I am sorry, I am not serving you.” It is not difficult to sort that out, so the Government ought to think about that and do it.

I am not someone who will march along the street behind the Great Barrington banner; I think that they are going overboard in what they are saying, though some parts are quite sensible and ought to be taken on board. Generally, there are too many people, on all sides, who are proclaimed as experts and believe that they are right about every aspect. Whether they are professor this, doctor that, or even professor-doctor something else, everybody in this debate, and everybody going on television, ought to have a great deal more modesty about what they are putting forward. The truth is that we do not know a huge amount about the virus and the illnesses that it causes, and we will not know everything for a long time, if ever. Therefore, instead of saying that this is necessary or this is essential, it would help if people had greater modesty and relied on evidence when we can get it.

Since the noble Lord, Lord Bowness, has withdrawn from the debate, I now call the noble Earl, Lord Clancarty.

My Lords, in Greta Thunberg style, without being scientists in the relevant fields, many of us have asked the Government whether they have looked at particular scientific evidence, or what the scientific evidence is for the decisions they are taking or the decisions that they might take; we have asked these things about face masks. Unfortunately, although we know that the department is very busy and that the Minister, the noble Lord, Lord Bethell, is again very busy today, we often do not get answers to these questions, and when we do, they can be sketchy. Having said that, however, the Minister has given us much more scientific detail today about the arguments for and against the use of face masks. I would say that it is not an entirely fair appraisal of the scientific material, much of which is very convincing about the effectiveness of their use.

There are two things to consider here. One is that the public need to have confidence that the Government are doing the right thing, and therefore they have to show that they are thinking deeply about these matters. The second is that the public have the right to know what the scientific evidence is, and I would include local authorities in this principle of access. The legal challenges being mounted are surely a direct result of the Government’s secrecy in these matters, which is regrettable, but if the attempts to resolve this crisis were being made primarily through the public sector locally, rather than through private companies, one strongly suspects that there would not be the same concerns.

I would like to ask the Minister about the latest position on the science of face masks, but he has given the answer already. This may seem like going over old ground, although the evidence could be accumulating and may be refined. This is important because while most people in my area of Hampshire are complying with the regulations, there remain a significant minority who do not. This cannot be explained away by exemptions. On my train to and from London, I have had to move seats or even carriages a few times to get away from people not wearing masks. While huge fines are now threatened for not wearing a mask on public transport, I am still not convinced that the Government have won, or have even tried to win, the hearts and minds of people for this measure. Has research been carried out on variations in compliance across the country?

My Lords, I declare an interest as a vice-president of the Local Government Association. I support completely the idea of wearing face masks. It is an incredibly sensible option, particularly for most of us here. However, I point out to the Minister that my experience suggests that it is mostly men of a certain age and of a right-wing persuasion who find it most difficult to wear face masks. Then there are those who wear them but do not cover their noses. It makes their noses look huge and I feel that, from the point of view of attractiveness, we should encourage them to put the mask over their noses as well. Quite honestly, I think of this as a public duty. I hope that other people wearing them will protect me and I certainly hope to protect others by wearing mine. If the wearing of masks helps to reduce the spread of the virus, it is an important part of collective action and solidarity between people.

However, perhaps the Government have not always made this completely clear and I am very glad that we are not hearing any more of their August talk about “returning to normal”, which actually means supporting London businesses but not supporting local businesses, which most of us have been doing. The regulations have added yet more complexity to the legal framework, with yet more piecemeal amendments. With the announcement today of a new coronavirus legal framework, would it not be a good idea to start consolidating the regulations as part of the exercise so that it is all made as simple and as clear as it possibly can be? In the past—and possibly still—the Government have muddled up and blurred the lines between guidance, advice and the law. This has resulted in a huge amount of confusion, especially for organisations such as the police.

I feel it is inherent in the regulations that the Government expect the virus to be around for some time. It is therefore time for an economic package that includes a universal basic income for everyone to support them through the next six months, to make sure that people can not only support the economy but feed their children and themselves and lead a reasonable life.

My Lords, I declare that I am on the BMA ethics committee. I want to consider what we know, what we are doing and where our duty in society lies.

Masks are increasingly reported to be protective. I thank the Minister for his brief summary, but I add to it that no evidence has emerged that they are harmful in Covid transmission. The coronavirus is tiny, 0.1 micrometres across, less than one-800th of a human hair in diameter, but it does not leave the body on its own; it relies on aerosols and droplets to spread, and it goes however far that mist takes it. Think of tobacco smoke spreading; once you get beyond two metres and are not downwind, you are less likely to inhale much of it, even though the aerosol lingers in the air for a long time. Do not forget that in indoor spaces that can be for many hours, which is why the BMA wants masks worn in offices even when alone.

This aerosol, often minute droplets of around double the width of the virus itself, is partly caught in the fibres of a mask. Masks made of double layers of tightly woven mixed fabrics, such as silk and fine cotton, seem to decrease aerosol transfer by up to about one-fifth. The standard mask for use in healthcare settings with aerosol-generating procedures is the N95 respirator mask, which is designed to protect the wearer by filtering out 95% of airborne particles that measure 0.3 micrometres or larger. A review of observational studies estimates that such surgical and comparable cloth masks are around 67% effective in protecting the wearer. That figure may be even higher for the G variant of the virus that seems to transmit faster, but we do not yet know that.

The other protective effect of a mask is that it can cut the viral count inhaled by up to 60%. Where masking reduces the dose of virus that a wearer might receive, it seems that the resulting infection is milder or even asymptomatic, whereas a large viral load results in a more aggressive inflammatory response. So wearing the suitable mask protects the wearer as well as protecting others if the wearer is excreting virus. In Hong Kong a new type of reusable fabric mask, CuMask+, will be issued to all citizens. This patented six-layer mask is washable 60 times and incorporates copper as a key filtering component, although there is some dispute over the extent of claims of efficacy.

My Lords, it is a pleasure to follow the noble Baroness, Lady Finlay of Llandaff, who has considerable scientific knowledge about this issue. I thank the Minister for his explanation of the regulations.

I agree with the use of face masks, particularly in relation to these regulations with respect to taxis and the hospitality industry. I note from the learned journal Nature that science supports the use of masks, but it also says that it is difficult to assess how well they work or when to use them. I think we have all been quite clear that wearing face masks protects not only ourselves but everyone else within our space, as well as social distancing, hand washing and all the other requirements to keep safe.

In relation to all these debates, I take on board the points made by the noble Lord, Lord Campbell-Savours, who has referred to masks in many debates in your Lordships’ House as far back as February, and to herd immunity. Will the Minister say whether the reason the Government, who seem to be followed by the devolved institutions, are not going for a strict lockdown, as back in March, is to build herd immunity? Is that the real reason for all of this?

That brings me to the regulations regarding face coverings. I note that they came into effect on 23 and 24 September without parliamentary scrutiny, that there were errors and that remakes were necessary to provide clarity. I further note that three correcting instruments had to be made within 24 hours, and that the Secondary Legislation Scrutiny Committee noted its surprise that the Government are not doing more to co-ordinate such changes in a more structured way. The committee also stated that it is not helpful to have the law scattered between so many instruments, so I come to the point made by the noble Baroness, Lady Jones of Moulsecoomb, who talked about the probable need for consolidated regulations. There are too many separate amending regulations, and that is where inconsistency and confusion can arise. Will the Minister consider the use of more consolidated legislation, or is that not possible due to the changing nature of the virus? Where is the parliamentary scrutiny in advance of the introduction of such regulations? When will that happen? That point has been made on numerous occasions during various debates in this House, and I recall the regret Motion moved by the noble Baroness, Lady Thornton, to that effect on a Friday about three weeks ago.