Covid 19: Winter Plan — House of Lords, 2020-11-24
Topic: Health
Natalie Evans (Conservative, Centre-right): I thank the noble Lord and the noble Baroness for their questions. We have published our winter plan, the aim of which is to take us through to spring. I will first answer a few questions on the tier system, which both the noble Baroness and the noble Lord touched on We have adapted our tiers in this plan on evidence that gives us the best chance to control the virus, developing community testing with scientific advice from national advisers and local directors of public health. The noble Baroness is right: these tiers are designed to reduce and keep the R below 1 and to support areas moving down tiers. That is the aim of where we are going. I will move on to vaccines, mass testing and other elements that we think will play an important part as we move towards the spring and, I hope, some kind of normality The noble Lord and the noble Baroness are absolutely right. To provide clarity and consistency, all tier restrictions have been standardised and will not be negotiated locally—so that is tiers 1, 2 and 3. Both asked about decisions on moving out of tiers. Decisions on the areas that go in and out of tiers will be based on a range of indicators, including: case detection rates in all age groups; case detection rates in the over-60s; the rate at which cases are rising or falling; the positivity rate—so the number of positive cases detected as a percentage of tests taken; and pressure on the NHS, including current and projected occupancy. Tiering allocations will be reviewed every 14 days, so there is a process and range of measures that will be published around which decisions will be made. While we appreciate that people would like to see firm thresholds, because areas and localities are different we will need to take into account local factors as well, but the indicators that I mentioned are key ones The noble Baroness rightly asked about local engagement on the basis that there is now some consistency among tiers. Absolutely, there will be local engagement. In particular, we will offer local authorities in tier 3 areas the opportunity to participate in a new community asymptomatic testing programme to help to find people who have the virus but do not show symptoms. Local authority directors of public health will be able to select their own approaches for delivering tests and priority testing targets and, as the noble Lord said, we hope that will mean that there is proper targeting of local areas, and some of the issues around take-up that he mentioned can be addressed through this local programme The programme will involve a six-week surge of testing capability to enable regular testing to be rolled out to the community in a way that works for the local authority with support from national government, including sufficient test supply, funding to cover support set-up costs and staffing test sites and support for extra contact tracing to break up clusters before they become outbreaks. That is where the additional funding that the noble Lord mentioned for test and trace will be focused The noble Baroness asked about contracts, and I can only reassure her that we will, of course, follow all the proper processes, procedures and oversights in awarding any future contracts In relation to Christmas, just as we came in discussions finished with the devolved Administrations, and they have reached some conclusions. Between 23 and 27 December, up to three households will be able to join together to form an exclusive Christmas bubble. The noble Baroness rightly asked about the clinically extremely vulnerable. Everyone must continue to take personal responsibility for spreading the virus and protecting their loved ones. For someone who is clinically extremely vulnerable, forming a Christmas bubble carries additional risk, but it will be a personal choice. People should take all precautions, including maintaining social distance from those they do not live with at all times, and they should consider seeing their bubble outside, where the risks are lower—but that will be a personal choice for people From 23 to 27 December, travel will be permitted between tiers and nations for the purposes of joining a Christmas bubble. People coming to or from Northern Ireland—and I see the noble Lord sitting there—will be permitted to travel a day either side of 23 and 27 December. I am sure there will be further information coming out, but that has come hot off the press In relation to care homes, we have launched testing pilots across 20 care homes, using PCR and the new rapid turnaround tests to allow up to two specific visitors to take two tests a week so they can do indoor visits to residents, including some physical contact. We intend to roll out this approach in a phased way across December, because we have made a commitment to provide tests to enable care home residents to have two visitors tested twice a week The noble Baroness and the noble Lord asked about vaccines, which is a key part of our route out by spring, we hope. It is about a combination of the mass testing that I have talked about and, obviously, the improved therapeutics that we have, which are having an impact when people are in hospital, but also vaccines. We anticipate that a number of safe and effective vaccines will be available in 2021, and we have taken steps to ensure that the UK has access to them. As everyone will know, we have agreements with seven separate vaccine developers, but we accept that the shift will not happen overnight, which is why spring is the timescale that we are looking towards. The noble Lord, Lord Newby, asked about a vaccination certificate. I am not aware of that, but I will take that issue back and raise it. I reassure him that an enormous amount of preparation is taking place to make sure that we have adequate provision, transport, PPE and logistical experts to ensure that the rollout is successful. As he rightly says, the NHS is working from a great base—every year for the flu vaccine we have to roll out a vaccination programme, so we are starting from a good base I will attempt to answer the question from the noble Lord, Lord Newby, on interaction in places of worship. Social distancing rules should continue to be followed within places of worship, including during communal worship, which can of course now take place in all three tiers. That means that in areas under tier 1 restrictions, people should attend only in groups of up to six—the rule of six—and in tiers 2 and 3, people must not mix outside their household or household bubble. People should stay socially distanced. There should be closer distance only when absolutely essential to enable a faith practice to be carried out—for example, contact with a faith leader—and time spent in such contact should be kept to an absolute minimum.