Covid-19 Update

Andrew Murrison Excerpts

Thursday 22nd July 2021 Commons Chamber

[Nadhim Zahawi]

I am grateful for the hon. Member’s question. As I said in answer to the previous question, in public buildings such as this place, and of course in essential travel and essential retail, that will not be applicable. That is very clear.

[Dr Andrew Murrison (South West Wiltshire) (Con) [V]]

Some 22,000 people died from seasonal flu in 2017-18, and the modelling suggests that this year’s season will start early, be severe and affect younger people—a demographic that tends to go to mass events—than covid does. Have the Government also been considering mandating proof of flu vaccination, and can the Minister ensure that vaccination records are transportable between the NHS records of each of the home nations? That is not the case at the moment, to the huge frustration of those seeking second jabs or anticipating the need for the proof of vaccination that he has confirmed today.

Covid-19 Update

Andrew Murrison Excerpts

Monday 12th July 2021 Commons Chamber

[Sajid Javid]

The hon. Lady will know that we have in place financial support for those who need it and who are asked to self-isolate. It is something that is important. It continues to be important, and it is something that we will keep under review.

[Dr Andrew Murrison (South West Wiltshire) (Con) [V]]

Thanks to jabs and far better treatment, the case fatality rate is now 0.085% and falling. Had it been so a year ago, is there the remotest possibility that jurisdictions would have embarked on restrictions of the same breadth and scope? Does it not follow that now is the right time to move to step 4 and release burdens on people, so that we can get society going? Will the Secretary of State please caution the Opposition on their undue reliance on masks? They are not the solution; vaccinations are.

[Sajid Javid]

My right hon. Friend is absolutely right to raise the importance of vaccination. That has been the key to getting us to where we are on our road map, which is why we cannot emphasise enough the importance of continuing with the programme. That is why we have set out that we plan to have a booster programme in September.

Covid-19 Update

Andrew Murrison Excerpts

Tuesday 6th July 2021 Commons Chamber

[Sajid Javid]

The hon. Gentleman is right to point out that there is no risk-free way forward. For the whole world, this pandemic is unprecedented, and leaders across the world are having to balance risks and take the approach that they think is right. He is also right to raise the challenges created by the pandemic and our response to it that are not directly linked to covid itself, such as the increase in mental health issues we have seen across the nation, including in Northern Ireland. We have provided much more funding for mental health, but we need a long-term, sustainable plan to deal with mental health challenges, which have, sadly, increased.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

I very much welcome the statement and I welcome my right hon. Friend to his place. It emerges that the AstraZeneca vaccine made in India—particularly batches 4120Z001, 4120Z002 and 4120Z003—may not be recognised by the European Medicines Agency, despite being recognised by the Medicines and Healthcare Products Regulatory Agency. This has implications for the digital covid certificate that will enable many constituents to travel to Europe this summer. Can the Secretary of State clarify the negotiations with Europe on this, and say whether regulatory bodies in other jurisdictions, notably the Food and Drug Administration, are taking a similar line to that of the EMA?

[Sajid Javid]

I can tell my right hon. Friend that the AstraZeneca-type vaccine being used in India is, I think, referred to as Covishield. We have not used Covishield in the UK, and we are in intensive discussions with our European friends to ensure that they have the facts to hand and that they can respond accordingly.

Coronavirus

Andrew Murrison Excerpts

Wednesday 16th June 2021 Commons Chamber

[Matt Hancock]

Being certified as having had a vaccine includes being on a vaccine clinical trial. The deputy chief medical officer, Professor Jonathan Van-Tam, has written to participants in vaccine clinical trials, who are doing, as my right hon Friend says, a great service to their country and indeed to the world by offering themselves to have an unlicensed vaccine in order to check that it works. I am very grateful to all of them. We will not put them in a more difficult position because of that.

We will make sure that when it comes to someone proving that they have been certified as vaccinated, being on a clinical trial counts as certified and continues to count as certified during a grace period after they are unblinded, so that if they are in the placebo arm, they can get both jabs and will not be disadvantaged for being on the clinical trial. That is a very important point. I am very glad that right hon. Friend raises it. If anybody from any part of the House gets that question from a constituent, please point them to the comprehensive letter by Professor Jonathan Van-Tam that explains and reassures.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

Will the Secretary of State give way?

[Matt Hancock]

Yes, but then I will make some progress.

[Dr Murrison]

I am grateful to my right hon. Friend. May I commend him for the efforts he has put in to keeping colleagues informed and responding to their questions along the way? It has been extremely good. Can I press him on this two-week break point that he and the Prime Minister have referred to? What underpins that? Is it simply a desire to get through a certain number of vaccinations—a figure that he presumably already knows? Or is it uncertainty over the data as it currently exists, because if it is, and given that this should be led by the data, there is every likelihood that in the next few days, we will get some indication as to whether the increase in the delta variant incidence is being translated into intensive care unit admissions and deaths? Can he give me and others considering how to vote this evening any comfort on that two-week point? If we have the sense that there may indeed be a genuine break at that point—if those cases do not translate into deaths or ICU admissions—we will be a little more comfortable.

[Matt Hancock]

As so often, my right hon. Friend, who is one of the most astute medical practitioners in this House—crikey, I could get myself into trouble there, because all the medical practitioners in this House are astute, but he is also a public health expert. I will start again. My right hon. Friend’s point was a really good one and very astute. He is exactly right about our approach: the two-week review is a data review.

Up to around 10 days to a week before the decision making cut-off for the proposal to take step 4 on 21 June, it looked like hospitalisations were staying flat, despite rising case rates. We did not know whether that was because of a lag or because there was now going to be no cases turning into hospitalisations. That remains the case now for the link to the number of people dying, because the number of people dying each day in England is actually slightly falling at the moment—thank goodness —and there has not been a rise in the number of deaths following the rise in the case rates, which started about three weeks ago. Within a couple of weeks, we will know whether that continues to be flat or whether it rises a little. It has risen a little in Scotland; I just put that warning out there. That is precisely the sort of data that we will be looking at at the two-week point. We have been absolutely clear that the goal on which we hang the decision ahead of 19 July is one of delivering the vaccines, and we have a very high degree of confidence that we can deliver the vaccines that we think are needed in order to be able to take step 4 on 19 July.

I hope that was a clear and comprehensive answer, once I untangled myself from my initial response to my right hon. Friend.

--- Later in debate ---

[Jonathan Ashworth]

Even though we will find ourselves in different Lobbies this evening, I think there is more in common between us than perhaps one might expect. I do not want restrictions to remain in place for any longer than they need to. I want to move to a system where we are trying to push down covid infection rates by, yes, rolling out vaccination as far and as fast as possible to everybody, but also putting in place the proper framework so that those who are ill or a contact of someone who has been ill with covid is able to isolate themselves.

We still have a culture in this country of soldiering on; the Secretary of State has referred to it in the past. I dare say that it is true of many of us in this Chamber. I have certainly done it in the past 20 years of my working life. I have gone into work with a sore throat or feeling under the weather, thinking I will just have some paracetamol and get on with it. Things like this have got to change, because although that sore throat may well have been fine for me, we now understand in great detail that it could have been very dangerous for others. We have to change our attitudes. However, there will still be a lot of people who have to go to work because they cannot afford to stay at home, so we need decent sick pay sorted out. One of the things that was revealed in this morning’s Politico email was the leak of a Government document that said that the isolation system is still not effective. That is because we still do not pay people proper sick pay. This is going to become more of an issue because presumably Test and Trace is to stay in place for the next year or so, as my hon. Friend the Member for Rhondda (Chris Bryant) indicated. People who have had two jabs and are asked to isolate themselves will ask themselves, not unreasonably, “If I have had two jabs, why do I need to isolate myself?” This is going to become much more of a challenge and we will need proper sick pay in place.

Let me finish dealing with the point made by the hon. Member for Winchester. I want us to control the virus by doing things such as proper sick pay, proper ventilation support, and investing properly in public health systems and local primary care systems. One of the things we know about this virus is that, like flu, it disproportionately hits the poorest and the disadvantaged because they are the people who have to go to work or the people in those communities where significant long-term conditions such as diabetes and chronic obstructive pulmonary disease tend to cluster. That often makes those people more vulnerable to these types of respiratory viruses.

[Dr Murrison]

On the subject of the poorest and most disadvantaged, what does the right hon. Gentleman then make of the recent observation by the chief medical officer on the annual toll taken by the ill effects of smoking? He said that because he wanted to compare and contrast the number of people that we are losing, sadly, to covid with those we lose every single year to the ill effects of smoking. We have been prepared to countenance some swingeing restrictions on all our liberties for the past 15 months; banning smoking, for example, would be far less restrictive by comparison. It is smoking that is driving up health inequalities, but I have not heard him comment on that yet.

[Jonathan Ashworth]

I have not commented on it in my remarks so far, but I have commented on it in the past and I absolutely agree with the right hon. Gentleman. We need to do more to drive down smoking rates, we need to do more to deal with alcohol abuse and we need to do more with the fact that too many of us eat food that is high in salt and sugar. I am prepared to work with the Government to be more interventionist on these matters. I would look at levies and taxes on tobacco companies, and I would invest more in anti-smoking and public health facilities locally, some of which have been cut back, sadly, because the public health grant has been cut back. So yes, I completely agree with the right hon. Gentleman.

[Dr Murrison]

With respect, the right hon. Gentleman has missed the point. Perhaps I did not make myself clear enough. The chief medical officer was introducing that because he was trying to explain that we are going to have to live with some level of risk. We need to have a discussion about the public’s appetite for risk if we are to live with covid. The reason he cited smoking and the figure of 90,000 a year is that it approximates to the number of people we have lost from covid so far in this pandemic. Does the right hon. Gentleman not agree that we need to have a discussion about where we are prepared to pitch this? Is it 22,000, which is the figure for a bad flu year? Is it 90,000, which is the number we lose every single year from the ill effects of smoking?

Covid-19: Government Handling and Preparedness

Andrew Murrison Excerpts

Thursday 27th May 2021 Commons Chamber

[Dr Andrew Murrison (South West Wiltshire) (Con) [V]]

How does my right hon. Friend account for the yawning difference between the account given to the Select Committee yesterday and rehearsed by the Opposition today, and the balanced and objective accounts that continue to be given by the National Audit Office on this pandemic, notably the one published earlier this month detailing the Government’s response to the pandemic? May I ask specifically how he will take forward one of the principal recommendations of that report—that we need to plan for a sustainable healthcare workforce that can be organised at pace in the event of a future emergency of this sort, and that we particularly need individuals who are properly skilled and updated to fill gaps that may arise as a result of a future pandemic?

[Matt Hancock]

My right hon. Friend is quite right on both points. Not only have we been transparent and accountable to this House, and straight with this House about the challenges, but we have welcomed the National Audit Office into Government throughout the pandemic, and it has published repeatedly. For instance, it published on personal protective equipment, showing that we successfully avoided a national outage of PPE. It has reported on every aspect of the pandemic, and we have learned the lessons that are in those reports. I recommend to the House the National Audit Office’s latest publication, which summarises all these lessons and learnings. My right hon. Friend is absolutely right that one of those is making sure that we have high-quality workforce planning for the future.

Covid-19 Update

Andrew Murrison Excerpts

Monday 17th May 2021 Commons Chamber

[Dr Andrew Murrison (South West Wiltshire) (Con) [V]]

The staggering success of the covid vaccination programme means that on current trends, sadly, non-covid viruses may well kill more people this winter than the coronavirus. Is my right hon. Friend confident that an effective flu jab will be available to address this year’s emergent strains of flu? What will he do to maximise uptake of the flu vaccine by vulnerable groups? What is the latest on a covid booster dose this autumn? Would the flu jab be given at the same time?

[Matt Hancock]

My right hon. Friend is quite right to ask all those questions. In fact, I met Simon Stevens and the Minister for Covid Vaccine Deployment about the matter this morning, because we want to ensure that the flu vaccine programme this winter is a success. We had the biggest flu vaccination programme in history last winter. We are currently trialling the co-administration of flu and covid vaccines—I am waving my hands because one goes in each arm. We are looking at that for the autumn as part of a booster programme for covid. A lot of work is under way in this space; I suggest that my right hon. Friend discusses it with the Minister for Covid Vaccine Deployment, who is now responsible both for the covid programme and for the flu programme, in order to better tie them together.

Covid-19

Andrew Murrison Excerpts

Monday 22nd February 2021 Commons Chamber

[Dr Andrew Murrison (South West Wiltshire) (Con) [V]]

I very much welcome my good friend the Minister’s remarks. The Prime Minister was quite right to say in his statement that there is no credible road map to zero-covid Britain, and the hon. Member for Ellesmere Port and Neston (Justin Madders), who speaks for the Opposition, was right to say that this time has to be the last time—that is to say, this must be the last lockdown—so we need to explore with the public what that means.

In 2014-15, we lost 28,000 people to seasonal flu. Every year, we accept 78,000 deaths from the effects of smoking, but we do not seriously contemplate banning smoking despite the awful toll it takes. If there is no credible road map to zero covid, we need to explore with the public how many deaths every year they are prepared to accept from the virus and, potentially, others too. I do not know the answer to that, but perhaps the figures of 28,000 and 78,000 begin to give us some clue as to the parameters within which we can have that terrible, awful conversation. I do not envy my hon. Friend the Minister and his colleagues in their position as decision makers in this process.

We should never waste a crisis. May I commend Ministers for trying to reboot public health at pace and very effectively? We need to prepare for the next crisis now, because this virus almost certainly will not be the last one. We need to start working up a workforce that will do vaccination in the future as the virus changes and evolves, perhaps capitalising on those NHS returnees who have done the courses mandated and done the paperwork but have yet to be called up. We need to maintain them on the books, as it were, because we will probably need them in the future.

I welcome the lifting of the lockdown. My only question is one of pace. Immunity is like a muscle or a brain cell: it improves with work, and if we do not use it we lose it. Circulation of virus in the vaccinated population will enhance immunity, and I worry that if we are too cautious in lifting lockdown once the great bulk of the population at risk is vaccinated, we will be more vulnerable than we need to be as we re-enter the high-risk winter season. The data on cases and deaths published today on gov.uk is unexpectedly good, and we should celebrate that, but will my hon. Friend review the dates cited today if the data support that?

Finally, I very much welcome the extra money my hon. Friend has provided for research into vaccines in February. It is most welcome. We may find that therapeutics—treating people who are seriously ill with the virus—turns out to be just as important in fighting the virus as immunisation.

Covid-19 Vaccine Update

Andrew Murrison Excerpts

Thursday 4th February 2021 Commons Chamber

[Nadhim Zahawi]

I am grateful to the hon. Lady for that incredibly important question. Her region has done phenomenally well. I want to praise it because it has 91.8% of first doses for the over-80s in the STP. The NHS is already sharing data with local government. We need to make it more granular. We have brought into the deployment campaign Eleanor Kelly, the former chief executive of Southwark Council, so we are totally in line and integrated with local government, because they know exactly where those hard-to-reach groups are. The hon. Lady raises an incredibly important point and that is a big focus for me.

[Dr Andrew Murrison (South West Wiltshire) (Con) [V]]

The Government have done brilliantly well in securing more than 350 million jabs, which is enough, all being well, to vaccinate the at-risk population several times over. Given the UK’s relatively enlightened and co-operative approach to vaccine roll-out internationally—in sharp contrast to the narrow and vindictive nationalism of certain quarters of the European Union, which really ought to know better—what trigger points and timetable does my hon. Friend envisage for the disbursement of our inventory of surplus jabs, and the infrastructure necessary to deliver them to countries that are less advantaged than our own?

[Nadhim Zahawi]

I am grateful to my right hon. Friend for his excellent question. My absolutely priority is to ensure that we have the inventory—as he quite rightly describes it—to allow us to offer the vaccine to all adults in the United Kingdom, and at the moment we are nowhere near that. Supply remains the limiting factor in our first target, which is to vaccinate groups 1 to 4 by mid-February, and then groups 5 to 9 as soon as we can after that, with phase 2, which we have been discussing today, after that. He is absolutely right that we have now ordered or optioned 407 million doses of vaccine. Once we are in a position to secure enough vaccine for the United Kingdom’s population, we will be able to look at where else we can help with our vaccine supply. We have also put £1.3 billion into a combination of Gavi, the Vaccine Alliance, and COVAX. Of that £1.3 billion, approximately £480 million is going to COVAX, which is helping low and middle-income countries with their vaccination programmes as we speak.

Public Health

Andrew Murrison Excerpts

Wednesday 6th January 2021 Commons Chamber

[Matt Hancock]

We have to see the impact of that vaccination on the reduction in the number of deaths, which I very much hope we will see at that point. That is why we will take an evidence-led move down through the tiers when—I hope—we have broken the link between cases and hospitalisations and deaths. We will need to see the protection in lived reality on the ground, but we will watch this like a hawk. My aim is to keep these restrictions in place for not a moment longer than they are necessary.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

I thank the Secretary of State for everything he is doing, but the logic of his anticipating what is going to happen in two, three or four weeks’ time from the number of cases we are getting at the moment is that we can do the same in reverse. That is to say that when we have a sufficient number of people vaccinated, we can anticipate how many deaths will have been avoided in two, three or four weeks’ time. As this cuts both ways, that means that he will be able to make a decision on when we should end these restrictions, as my right hon. Friend the Member for Forest of Dean (Mr Harper) has just suggested.

[Matt Hancock]

The logic of the case made by my right hon. Friend the Member for South West Wiltshire (Dr Murrison) is right, and we want to see that happen in empirical evidence on the ground. This hope for the weeks ahead does not, however, take away from the serious and immediate threat posed now, and I wish to turn to what is in the regulations and the actions we need to take.

The Office for National Statistics has reported that one in 50 of the population has the disease, some with symptoms and some without. The latest figures show that we have 30,074 covid patients in UK hospitals and that the NHS is under significant pressure. Admissions are now higher than at any point in the pandemic, and so on Monday all four UK chief medical officers recommended that we move the country to covid-19 alert level 5. In practice, that means that they believe that without action there is a material risk of healthcare services being overwhelmed. It is for that reason that we have placed England into a national lockdown, alongside action taken in each of the devolved nations. Every single citizen needs to take steps to control this new variant, and this personal responsibility is important. To give the NHS a fighting chance to do its vital work of saving lives, it is on all of us to support it.

The regulations set out that everyone must stay at home save for a limited number of reasons permitted in law, including: essential shopping; work, if it cannot reasonably be done from home; education or childcare if eligible to attend; medical needs, including getting a covid test or getting vaccinated; exercise; escaping domestic abuse; and for support bubbles where people are eligible. These regulations are based on the existing tier 4 regulations, with some additional measures that reinforce the stay-at-home imperative.

These include: stopping the sale of alcohol through takeaway or click and collect services; and closing sport and leisure facilities, although allowing playgrounds and allotments to remain open. I know that these further restrictions are difficult, but, unfortunately, they are necessary, because we must minimise social interaction to get this virus back under control. These measures came into force first thing this morning under the emergency procedure and will remain in force subject to the approval of this House today.

--- Later in debate ---

[Jonathan Ashworth]

The hon. Gentleman asks a perfectly reasonable question. Of course, as we vaccinate more, mortality rates will improve more and we will be able to save people’s lives, but there will be others who remain unvaccinated and exposed to the virus, and will possibly develop debilitating symptoms of long covid as a result of that exposure. I do believe that we can begin to ease restrictions once we increase the proportions of those who are vaccinated, but we will not be able to go back to normal yet, because the virus will still be circulating. Even though they may not end up in hospital and on ventilation, many who have contracted this virus have remained incredibly ill as a result.

[Dr Murrison]

I am really pleased by the generally positive way in which the hon. Gentleman is approaching this; it does him great credit. Can I perhaps help him out by making a suggestion? Every year, we accept a certain amount of deaths—tragic, sad deaths—from seasonal flu, up to 28,000 in recent years. Would it be reasonable to anticipate the number of deaths that are going to be caused by this virus and try to make a political judgment—for a political judgment is what it is—on what we feel is acceptable, and that will give us our criteria for deciding on when to lift this lockdown?

[Jonathan Ashworth]

The right hon. Gentleman makes a reasonable point, like the former Public Health Minister, the hon. Member for Winchester (Steve Brine), but this is not just a simple calculation about the number of deaths that are prevented. The right hon. Gentleman has more clinical experience than I have, obviously, but we know that there are people who suffer long-term, debilitating conditions as a result of this virus, with reports of people developing psychosis, long-term breathing problems, and problems with the rhythm of their heart. It remains an extremely dangerous virus, regardless of whether people end up in hospital and on ventilation. But he is quite right: in the end, this will be a judgment for politicians and a judgment for this House. It is not a judgment for the chief medical officer and the chief scientific adviser, although I would hope that our judgments, in the end, are guided by the chief medical officer and the chief scientific adviser.

--- Later in debate ---

[Dr Andrew Murrison (South West Wiltshire) (Con)]

I certainly will be supporting these regulations tonight, with a heavy heart, but nevertheless, they are clearly required at this particular juncture. I doubt that there is anybody in this country who loathes and detests more the restrictions on liberties and livelihoods that these regulations reiterate than the Prime Minister. I am confident that he would not be recommending them to the House unless they were absolutely necessary in his judgment. However, I think it is important that the House is provided with more granularity on numbers and it needs to have a better idea of what constitutes an exit strategy and the trigger points that would allow for that strategy.

Jabs offered are not the same as jabs put in arms, which is what is crucial. We need to have published—I suggest daily, since Ministers must have this information—what is being contracted for, the factory-gate delivery against that contract, the jabs in arms and the jabs that are awaiting deployment because of the three-week downtime caused by batch and sterility testing. We need to know how many jabs have been applied in the past 24 hours by priority group.

[Steve Brine]

I will add one to that, if I may: jabs given per area. In Hampshire, we are in a good place—I expect to hear so tonight in our briefing call, because we can scale up when the supply is there—but I know, from talking to colleagues across the House, that it is not the same everywhere. We need to know where the weaknesses are—or, rather, the vaccine Minister does, so that he may address that.

[Dr Murrison]

My hon. Friend makes a fair point, and that data clearly has to be available, because it is gathered locally. That would be very useful, particularly for constituency Members of Parliament.

The thing that worries me most is the exit strategy. The Secretary of State, perfectly reasonably, said that we have a sort of exit strategy in that we now have a vaccine, which we clearly did not have at the beginning of last year. However, we need to decide—this is a political decision, ultimately—what constitutes the criteria for coming out of this lockdown. Generally, it has been suggested, that will happen when we have vaccinated everyone up to group 4 in the JCVI’s list of priorities—that is perfectly reasonable—so when everyone over the age of 70 has been jabbed, as opposed to everyone over the age of 70 being offered a jab. The two, as I said, are quite different.

We need to challenge and push back on that, however, because notwithstanding the remarks made by the hon. Gentleman who speaks for the Opposition, the hon. Member for Leicester South (Jonathan Ashworth), long covid, awful though it is for those who are afflicted by it, does not constitute a reason for continued lockdown and the penalty that this country is paying societally, medically and economically for what we are about to vote on this evening. That does not stack up; what stacks up is the awful grisly calculus of lives saved.

We have a benchmark, which is the number of lives that, tragically, we are compelled to accept every year are lost to seasonal flu deaths. That gives a reasonable benchmark of what, politically, in society we might be capable of accepting and, because we can project how many deaths will happen—Ministers are keen to do that in recommending to the House, correctly, that we vote in support this evening—they must have an idea, given the number of people who have been vaccinated in key groups, how many deaths there will be in the ensuing month, or two months or whatever one might choose.

I will just push back, very finally, on one other issue: the people in group 4. It is reasonable, perhaps, for those who can be expected to remain safe through shielding to be considered part of group 5, because that will enable many of people over 65 to be vaccinated, which will enable us potentially to come out of this awful lockdown just a little bit sooner and to meet the challenging targets that have been set by the Prime Minister.

Public Health

Andrew Murrison Excerpts

Wednesday 30th December 2020 Commons Chamber

[Dr Andrew Murrison (South West Wiltshire) (Con) [V]]

None of us went into politics to do this kind of thing —to put restrictions on people’s liberties and their livelihoods. With the exception of statutory instrument No. 1518, which at least reduces the period of self-isolation from 14 to 10 days, I loathe all these regulations, but I judge that this time, based on the evidence available to us right now, they are necessary. However, today’s good news means that we may see the end of these horrible measures sooner rather than later. In particular the news that one jab will bring 70% efficacy is good news indeed, because it means that we may see the back of this sooner than many of us thought possible. That is the good news.

We also need a degree of humility. No set of regulations can govern every vignette of human activity. I feel for those who had to draft the instruments and plough through them, trying to work out what may cause people to be at risk. Producing something that makes at least some sort of sense and that we can sell to our constituents is extremely difficult. We also need to understand that the virus is not orderly; it does not respect the parliamentary timetable, so anticipating what may be required in two, three or four days’ or indeed weeks’ time is almost impossible. Pointing out that statutory instrument No. 1646 has already been overtaken by events is therefore churlish. I am sorry that the Opposition do not cut us a little bit of slack when we are faced with a virus that does not respect any sort of timetable and that will change and change again.

It is difficult to explain to our constituents why, for example, they can go to a garden centre but cannot play golf. It is the duty of all colleagues to explain to the public, who are the unsung heroes in all of this and who, by and large, have kept the faith, why we have to have these restrictions and that all of us are trying to ensure that their liberties and livelihoods are returned to them at the earliest possible opportunity.

I have been troubled by one or two points about tiering. The tiers are based on five points, one of which is the ability of hospitals to cope. In the south-west this has been disappointing, because it has revealed that our capacity is not as robust as in other parts of the country. Partly that is because of staffing. I was disappointed over the summer that many of those who volunteered, either as recent retirees or as people who are not currently in patient-facing roles, were not trained. That has been, to some extent, a missed opportunity. I hope that as we go into the second wave, those skills that are not now in place will not be needed, otherwise there is scope for some embarrassment. I know, because I spoke to the Secretary of State, that he understands and empathises with some of these difficulties. I hope that Ministers will redouble their efforts to make sure that those volunteers are utilised.

I very much welcome the remarks of the Education Secretary earlier on. The contingency framework, which those who are less charitable might say creates tier 5 or tier 4-plus, is correct. If possible, I would like some resolution of the confusion over the scale of the schools that are involved. It seems to be rather more than we initially expected. I urge Ministers to do everything they can to keep schools open. It is vital, for every conceivable reason, that we keep schools open. I again emphasise the work of Ackland and others in Edinburgh, using the Imperial College model, which was published in the October edition of the BMJ. It suggests that closing schools may have a counterproductive effect in terms of lives saved from covid.

I entirely endorse the remarks of the hon. Member for Leicester South (Jonathan Ashworth), who said that we should “go hell for leather” in vaccinating people. That is clearly the way out of this, as my right hon. Friend the Member for Forest of Dean (Mr Harper) made clear.

Finally, Mr Deputy Speaker, may I wish you, the officers and staff of the House who have worked so hard and colleagues a much happier new year?