Viscount Waverley
Main Page: Viscount Waverley (Crossbench - Excepted Hereditary)Department Debates - View all Viscount Waverley's debates with the Department of Health and Social Care
(2 years, 7 months ago)
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Lord Bethell (Con)
I am very grateful for the questions and I will take them one at a time. I am enormously grateful for the advice of SAGE; the work it does is invaluable. However, it is not regarded as the key medical adviser to the Government—that is the role of the CMO, who advises the Government on medical matters.
On the circumstances for moving to plan B, that is a reasonable question. We do not have a specific formula or algorithm, because it is extremely uncertain how things will play out. Undoubtedly, pressure on the NHS is one of the biggest drivers of that decision, and if we were to see a spike in hospitalisations, severe disease and deaths, and beds being used up and capacity being drawn down to an extreme level, that would be one of the key drivers. But we have to also look at variants of concern, other diseases and the state of the NHS in the fightback, as well as at the flu epidemic that may or may not come. Therefore, I cannot give an easy and simple answer to that question—there is not a “four tests” type of answer to it—but we are looking at it extremely carefully.
On the criticism on speed, I remind the noble Baroness that, at the beginning of this year, the Government laid out a very clear steps process, whereby we left the last round of regulations. That was extremely well considered; there were at least five weeks between each step, and it was done in a proportionate and empirically based manner, and I think noble Lords would recognise that it was a thoughtful and reasonable way of doing things. To characterise the Government’s approach this year as being behind the curve is not reasonable. As I said, we are trying to accept the risks that we have in front of us, and Covid is only one of them: there are other pressures on the NHS, including the huge catch-up that we need to do, and the possibility of flu and other epidemics on the horizon. We cannot just focus entirely on this.
Viscount Waverley (CB)
My Lords, quite rightly the Minister is in popular demand this evening. This is nothing against Boots the Chemists, which by the by does an excellent job, but with not shy of 2,000 eligible candidates on the parliamentary estate, could not the testing facilities on the estate be designated as official testing areas for flying purposes and for any other reason that tests are required? Furthermore, notwithstanding the announcement to which the Minister referred, which may or may not address this point, why, oh why, do we need day 2 testing, having had a valid test 48 hours prior to arrival in the UK from, for example, the continent?
If the Minister is minded, given that I do not think that another noble Lord is going to ask a question, could he possibly also say a word about the issue of mixing and matching booster vaccination types? Can the flu jab, to which the Minister referred, be taken at booster stage?
Lord Bethell (Con)
Like the noble Viscount, I pay tribute not just to Boots—an excellent chemist—but all the other pharmacies, which have contributed so much in this epidemic in looking after the communities that they serve, not only in trying to provide essential services during lockdown but in their contribution to the vaccine rollout programme. It really has been a demonstration of the enormous amount of value in big and small chains and community pharmacists across the board.
As for the testing provisions here on the estate, those are of course LFD asymptomatic testing provisions, and for flying purposes you need a PCR test, so I am not quite sure whether it would necessarily read across directly.
Viscount Waverley (CB)
My Lords, just from first-hand experience— Sorry, I apologise for intervening.
Lord Bethell (Con)
It is an interesting and creative idea, and certainly one that would be worth looking at.
On day 2 testing, I recognise that it is inconvenient to do the follow-up testing if you are travelling but, for the protection of this country, it is an important part of our border public health measures.
The pre-flight testing regime is helpful; it catches some disease, but in no way could it be thought of as a reliable barrier to infection into the country. I am afraid that there is simply, as I am sure noble Lords know, too much variance in the quality of that testing regime, to put it politely. Our estimate is that it catches between 10% and 20% of disease, but we know from our own testing in this country that it certainly does not catch all of it. In fact, most people will not travel if they are blazingly ill, so almost all travel infection is asymptomatic. That is why we look to day 2 testing, because it has the benefit of catching those people who might either have asymptomatic disease or are incubating the disease and would not be caught even by a PCR test.
The day 2 test is an effective way of catching those with the disease; it is an essential part of our surveillance. We would not know how much disease was coming into the country, what VOCs were coming into the country or which countries had disease, because so few have sophisticated testing, let alone genomic sequencing. It is literally the only way we know what is coming into this country and where the threats are from around the world. That is why it has played such an important part in our testing regime to date. The Secretary of State for Transport will be making announcements tomorrow and I look forward to his update on that.
On mixing and matching, one of a great many surprising medical outcomes from this disease is the idea that you might have one vaccine one day and another one three months later. When that was first posited to me, and when I first made that suggestion in this House, it was greeted with surprise and with some concern, but actually they somehow provoke different parts of the immune system, they somehow complement each other and there is strong and growing evidence that this is a very effective and complementary way of administering programmes. They work for different types of people in different ways, and different mixes and matches complement each other in a strange Rubik’s cube of complicated arithmetic. I would have to leave it to JVT, the deputy CMO, to explain it in more detail if noble Lords would like more information on that.