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Covid-19 Update

Volume 686: debated on Wednesday 30 December 2020

Today marks a great stride forward in our plan to get us out of this pandemic and to return to normal life. Our strategy throughout has been to suppress the virus until a vaccine can make us safe. 

Suppressing the virus has got a whole lot harder because of the new variant, and we must take more action today, but the vaccine is the route out of the crisis. The approval this morning of the Oxford-AstraZeneca vaccine is another world first for Britain and it is the single biggest stride that we have been able to take since this pandemic began.

It is almost exactly a year since we first heard about what we now know as covid-19 circulating in Wuhan in China. Within weeks, the scientists at Porton Down had sequenced the viral genome. Scientists at Oxford University’s Jenner Institute received the genetic code for the new virus, and like the great British codebreakers before them, they set to work at lightning speed. We took the decision to back them from the start with funding and access to the NHS for clinical trials. Partnered with AstraZeneca, they have done a brilliant job to develop and manufacture a safe and effective vaccine at speed.

I am sure the whole House will join me in congratulating everyone involved in this huge British success story. Not only is it a triumph of science and ingenuity in cracking a modern-day Enigma code, but in truth it is a victory for all, because the Oxford vaccine is affordable, it can be stored at normal fridge temperatures, and it offers hope not just for this country but for the whole world. Like so much else in the pandemic response, there has been a big team effort, and although this is a great British success, it is also the British way. We are at our best when we collaborate with people from around the whole world, and this is another example. The vaccines programme has shown Britain as a life sciences superpower, and the Brexit deal that this House has just passed, with a very significant majority, will help us to strengthen that yet further. I thank the National Institute for Health Research, the UK Vaccines Network, the Vaccines Taskforce, AstraZeneca of course, and Oxford University, all the volunteers who stepped up for science and took part in the trials, as well as everyone else involved in making this happen.

From the beginning, we focused on the vaccine as a way out of this pandemic, and now it is a reality. We need to vaccinate as quickly as supply allows—following the necessary safety checks, of course—and the NHS stands ready to accelerate deployment at scale from Monday 4 January. We have a total of 100 million doses on order, which combined with the Pfizer vaccine is enough to vaccinate every adult in the UK with both doses. We will vaccinate according to the Joint Committee on Vaccination and Immunisation priority, but today’s news means that everyone who wants one can get a vaccine. We already have 530,000 doses available to the UK from Monday, with millions due from AstraZeneca by the beginning of February.

The clinical advice is that the Oxford vaccine is best deployed as two doses up to 12 weeks apart. The great news is that people get protection after the first dose. This means we can increase the speed at which we vaccinate people for the first 12 weeks before we return to deliver the second doses for longer term protection. It brings forward the day on which we can lift the restrictions that no one in this House wants to see apply any longer than is absolutely necessary, but we must act to suppress the virus now, not least because the new variant makes the period between now and then even more difficult.

Although we have the good news of the vaccine today, we have to take some difficult decisions. The NHS is under very significant pressure. Right now, more than 21,000 people are in hospital with coronavirus, and we can see the impact that this is having. The threat to life from the virus is real, and the pressures on the NHS are real too. I want to put on the record my thanks to all those working in the NHS, in particular those—including our chief medical officer—who have been working selflessly on the wards over Christmas. They deserve our thanks, our gratitude and our support. We owe it to them to fulfil our responsibility to keep the virus under control.

Sharply rising cases and the hospitalisations that follow demonstrate the need to act where the virus is spreading. Yesterday alone, 53,135 new cases were registered, the majority of which are believed to be the new variant. Unfortunately, the new variant is now spreading across most of England, and cases are doubling fast. It is therefore necessary to apply tier 4 measures to a wider area, including the remaining parts of the south-east, as well as large parts of the midlands, the north-west, the north-east and the south-west. I have laid a comprehensive list in the Library of the House and published it on Even in most areas not moving into tier 4, cases are rising, and it is therefore necessary to apply tier 3 measures more broadly too, including in Liverpool and North Yorkshire. The rest of Yorkshire remains in tier 3. These changes will take effect from one minute past midnight tomorrow morning.

The new variant means that three quarters of the population will now be in tier 4 and almost all the country will be in tiers 3 and 4. I know that tier 3 and 4 measures place a significant burden on people and especially on businesses affected, but I am afraid that it is absolutely necessary because of the number of cases that we have seen. Where we are still able to give places greater freedoms, we will continue to do so.

Today is a day of mixed emotions—the joy that we have in the vaccine, giving us a route out of this pandemic; the pride that Britain is the first country in the world once again to approve this British vaccine; the sorrow at the deaths and the suffering that the virus has caused; and the determination that we must all stick at it during the difficult winter weeks ahead. We end 2020 still with great challenges but also with great hope and confidence that in 2021, we have a brighter future ahead. I commend this statement to the House.

As always, I thank the Secretary of State for advance sight of his statement. I totally understand why he has had to come to the House this afternoon to move further areas into tiers 3 and 4. As he says, almost the whole of England is now in a form of lockdown. My constituents in Leicester and, I am sure, constituents in Greater Manchester will be deeply worried that our areas have now been in a form of restrictions for months and months. It is having a huge impact on families and small businesses in cities such as Leicester and, I am sure, areas in Greater Manchester. He has also moved Liverpool into tier 3. Liverpool was the great success story, so is it his view now that mass lateral flow testing is not enough to contain the spread of this virus? Our constituents will be asking how long he expects these lockdowns to be in place.

We will vote for the regulations tonight, because the situation we are in is truly horrific. As he has outlined, the virus is out of control. Yesterday, over 47,000 cases were reported in England. In the last two weeks, nearly half a million cases were reported in England. There are now more patients in hospital—over 20,000—than at any time in this pandemic, with admissions rising day by day, including almost 2,000 on Christmas day. Hospitals are close to or at surge capacity. We see ambulances queuing up outside hospitals because there are not enough beds for patients. We have London hospitals requesting to transfer patients in need of intensive care to Yorkshire. Frontline healthcare workers warn of oxygen supplies running low. Can the Secretary of State assure us that there will be no disruption in oxygen supplies through this second wave?

Our NHS staff are exhausted. Morale is low. Staff absence is said to be double its normal level. Leave for many is cancelled. And this time, there is no evening applause on our streets; just long, dark, hard nights for our NHS staff. The Nightingales were opened at great expense and fanfare, but now we hear that some of them, such as London’s, have been emptied. Will they be used? If so, given the staff shortages across the NHS, how will they be staffed? There are reports today that only one in eight retired NHS staff—just 5,000 out of an eligible 30,000 who applied—have been brought back to help. Should we not be making full use of this resource, especially to help with vaccination?

Today’s AstraZeneca news is indeed a tremendous boost, and I congratulate all involved, but can the Secretary of State confirm how many doses we currently have ready to go? We are in a crisis now. Mass vaccination needs to start straightaway. We need to go hell for leather to get these jabs rolled out with no delay. We have already lost more than 600 healthcare workers to this horrific virus, including a disproportionate number of black, Asian and minority ethnic staff. Frontline NHS staff need the protection of the vaccine ASAP. Will the Secretary of State set a clear target for when all NHS frontline staff will receive the life-saving jab, and can he tell us when all care home residents and staff will be vaccinated? He will recall that I raised with him the situation facing those with terminal illnesses. Will he clarify the JCVI’s guidance for that group today?

This is a race against time, because the more the virus circulates, the more opportunities there are for further variants to emerge. The new B.1.1.7 variant is 56% more transmissible and is the dominant strain in London and the south-east and east of England. The New and Emerging Respiratory Virus Threats Advisory Group minutes from 18 December suggest it could add at least 0.4 to the R. Given that the first lockdown brought R down to about 0.6, and the second down to about 0.8, it will surely be harder to bring infections under control, so harder measures will be needed. Will the Secretary of State publish in realtime the advice he receives from the Scientific Advisory Group for Emergencies on the restrictions needed?

This is a global crisis, but let us be clear: this is a national emergency. Our national health service is becoming overwhelmed. I hope that tier 4 restrictions are enough, but many believe that even tougher restrictions are now inevitable. Does the Secretary of State agree? We need not put more lives in jeopardy when vaccines are so near. Let us give the achievements of our scientists the best chance to save lives. The country sacrificed so much in 2020. Let us not repeat the same mistakes. We must start 2021 by right now doing everything it takes to save lives and support our NHS. Only then can we look forward with confidence and hope.

The hon. Gentleman is quite right that this virus has thrown up problems and challenges right around the world; we have seen the impact in other countries in some of the news from other parts of Europe today. He is also right that, thanks to the approval of this vaccine, alongside the Pfizer-BioNTech vaccine, the end is in sight. That should give us hope that, while we have difficult weeks ahead of us, we can see the route out of this pandemic and normal life returning, with all that that means and entails.

The hon. Gentleman talked about the pressures on the NHS, which are significant. One advantage of having a national health system is that when one area of the country faces particular challenges, others can come to its mutual aid. That is in process—it is happening—and means that people are sometimes taken across the country to receive care where there is spare capacity. That is necessary; it is how the system works when it is under significant pressure.

The hon. Gentleman asked about the vaccination of NHS staff. I can confirm that, thanks to the decision announced by the regulator today, we will be able to accelerate the vaccination of NHS staff already in priority group 2, as well as of the over-80s and of care home residents and staff. He asked about the number of vaccines we have available. I mentioned in the statement that we have 530,000 across the UK available for deployment in the first week of January. The NHS is doing a fantastic job of constantly increasing and expanding the scale of its operation.

Finally, the hon. Gentleman asked what more can be done in areas where rates are very high and continuing to rise. The true answer is that it is on all of us—it is about how everybody behaves. If we collectively decide to stop this by taking personal responsibility and not coming into contact with others unless absolutely necessary, we can slow the spread of this virus. The tiers restrictions are of course necessary, but ultimately it is about how we all behave. That is how we will get through the next few weeks together, and then the vaccine can come and save us.

The news from AstraZeneca is fantastic. The Secretary of State and British science in general deserve enormous credit.

The NHS is now busier than last April; in parts of London it looks like it may fall over. However, back in April, schools were shut, but next week primary schools are due to reopen. In September, we came to regret allowing university students to go back en masse, but some universities will start to go back from next week. Why, in the middle of winter, when the NHS is under such pressure, when we have a dangerous new strain of the virus, are we taking such huge risks? Should not our entire focus for the next eight to 12 weeks be on saving lives, getting the first dose of the vaccine out to every single vulnerable person, stopping the NHS collapsing and putting NHS frontline staff at the front of the queue for the vaccines so that we keep safe the people upon whom our safety depends?

Order. Before the Secretary of State replies, may I remind Members who are not in the Chamber that they should have the same dress code even though they are virtual? It is only fair that we treat each other with the same respect.

I share my right hon. Friend’s desire and the strategy of keeping this virus supressed while we get the vaccine rolled out as fast as possible. One of the other good pieces of news from this morning’s announcement is that we can roll this vaccine out faster because we only need to give the second dose after 12 weeks; that means that we can get the first dose of the vaccine into more people. The data shows that that gives that immunity, so we can get through the protection of the nation faster than we previously could have done.

The points that my right hon. Friend raises about education are of course important. The Education Secretary will set out in a statement shortly the details of how we will manage the very difficult balance between needing to keep children in education as much as possible and ensuring that we do not add upward pressure on the R number and spread the virus any further. I commend to him the Education Secretary’s statement.

As chair of the all-party parliamentary group on vaccinations for all, I absolutely welcome the authorisation of the AstraZeneca vaccine. Storage in normal fridges will make it much easier to deliver here, and particularly so in low and middle-income countries, which would have struggled to maintain the cold chain at -70°, as required for the Pfizer vaccine.

Delivering the vaccine will still be a herculean task for all four UK health services, and they will struggle if they are also dealing with surging covid cases. Hospitals in London and the south-east are already reporting shortages of critical care beds and even oxygen, so there is an urgent need to get the new variant under control. Does the Secretary of State recognise that, when dealing with a spreading infection, getting ahead of it is critical? Taking action only once cases in an area are soaring is simply too late to bring it under control. All three devolved nations are already under level 4 restrictions to try to prevent the new variant from getting a grip and getting out of control. Given the greater levels of the new variant in England—as the Secretary of State just stated, cases are rising everywhere—does he not think it is time to put the whole of England under tightened tier 4 restrictions?

I have just announced the need to move a significant proportion of England into tier 4 restrictions, and I welcome the implicit support for that measure. Where it is possible to keep some of the freedoms that we all cherish, we should do so, and that is the basis for our tiered approach.

I of course welcome the hon. Lady’s support for the roll-out of the Oxford-AstraZeneca vaccine, which will happen right across the UK from Monday. It has been a pleasure working with Jeane Freeman, the SNP Government’s Cabinet Secretary for Health in Holyrood, to ensure that this vaccine, which has been bought, developed and supported effectively by UK science right across the country, can be deployed properly to everybody in the whole of the UK on a fair and equitable basis according to their clinical need. I look forward to working very hard to make sure that happens.

Many businesses in Gloucestershire are gutted to be placed in tier 4. This makes the roll-out of the vaccine even more important. However, there is a worrying increase in anti-vax information in Stroud that is causing a lot of distress and upset for local people. It is appalling that our Gloucestershire Hospitals NHS Foundation Trust had to spend its precious time during this pandemic defending itself against films on social media that were wrongly claiming that the hospital is empty. Will the Secretary of State assist me to reassure Stroud about the vaccines and encourage people not to share covid information from unofficial sources to stop this dangerous, damaging and disrespectful behaviour?

Yes, I strongly agree with my hon. Friend, who speaks very powerfully about the need for proper, authorised information about these vaccines, which save lives. We have been very careful to ensure that the independent regulator makes the decision on how these vaccines should be deployed, and indeed whether they should be deployed, and it is confident in their safety and their efficacy. It is that information, and all the information that is set out by the NHS, that people should look to if they have questions—if they want to know how and why the vaccine works, and who it should be used for. I pay tribute to all those who work in the hospitals of Gloucestershire. It is hard work at the moment in the NHS. Rates of coronavirus in Gloucestershire have really shot up over just the past two or three weeks, and unfortunately that is why we have had to take the action that we have on restrictions. I want to thank all of the NHS for doing all the work that it has been doing over Christmas and will have to do over the weeks ahead.

I, too, welcome the fantastic news about the Oxford AstraZeneca vaccine and congratulate all those involved.

I found it frankly shocking that the Secretary of State’s statement made barely any reference to the immense pressures our hospitals are facing on the ground and what the plan is to help them with this situation. Major incidents have been declared in Essex and London. Ambulances are queuing outside hospitals and intensive care unit patients are being transferred across the country. The Nightingale hospitals were meant to be the insurance policy, but we hear that only 28 covid patients are in the Nightingale hospitals across England. If now is not the time to use the Nightingales, when is? If there are insufficient staff, why on earth did the Secretary of State spend £220 million on building the Nightingales? What is the back-up plan?

I am not sure that the hon. Lady was listening when I said in my statement that the NHS is under very significant pressure. Of course we are working hard to ensure that that pressure is alleviated as much as possible. Over the summer, we built significant extra capacity into the critical care facilities of the NHS, including across London. The Nightingale hospitals are there, as she puts it, as an insurance policy—as back-up. The London Nightingale hospital is there on standby as back-up. I have seen some stories circulating saying that it has been decommissioned. Those stories are wrong. It is better for people if they are treated inside a hospital, but the Nightingales are there for extra support should it be needed. It will require changes to the working patterns of staff if we do need to have patients in the Nightingales once more, but it is crucial, in my view, that we have those Nightingales there ready in case we need them.

I can confirm to my right hon. Friend that Essex has declared a major incident. It is also, at this very moment, submitting a MACA—military aid to the civil authorities—request to assist with the construction of community hospitals for additional hospital capacity, supported and partly staffed by the armed forces. It would also like armed forces help with the roll-out of the vaccine to accelerate that in Essex and to assist with testing in schools. Will he look into the German BioNTech test as an alternative to the lateral flow test, as it is as reliable as the PCR—polymerase chain reaction test—and turns around in one hour?

I will absolutely look into, and get back to my hon. Friend about, the BioNTech test. Of course, BioNTech is an absolutely fabulous pharmaceutical company, as the whole House knows. What he says about the pressures in Essex is very significant, and it is important. Of course, I will look favourably on any request for military assistance, working closely with my right hon. Friend the Defence Secretary, who has been incredibly supportive, as have the whole armed forces, during this whole year. They have done so much. They are already involved in the roll-out of testing, as my hon. Friend knows, and we draw on the ingenuity, reserve and sheer manpower of the armed forces when we need them. I am very grateful for my hon. Friend’s support for the work that we all need to do in Essex to support the NHS there and to try to get the number of cases down.

May I first thank the Secretary of State, as always, for his good news on the TV this morning? At this time of the year, I think it has given every one of us a skip in our step to know that the vaccine can be delivered.

Can the Secretary of State confirm what discussions have taken place with devolved UK Administrations about the roll-out of the vaccine, the timescale for the completion of that and the approach to education and business production to ensure that a UK-wide lens with regional approaches is possible, while still ensuring that the message remains that we can save lives and the economies if we simply do the right thing?

Yes, absolutely. This is a UK vaccine that is being deployed across the UK fairly, according to clinical need. I spoke to my opposite number in Northern Ireland this morning, and I can confirm that, across Northern Ireland, the roll-out of the Oxford vaccine will start on Monday 4 January, as with the rest of the United Kingdom of course. We cannot give timelines on when any roll-out will be completed, because it does depend on the delivery schedule and the manufacturing schedule of the vaccine, but the good news is that we have on order enough approved vaccines now to ensure that every adult who wants one can have the vaccine, and that is true right across Northern Ireland and the whole of Great Britain.

This is a bittersweet day for us here in Rushcliffe: we have the great news of the Oxford AstraZeneca vaccine approval, on which I congratulate my right hon. Friend and everyone involved, but we are confronted with the depressing reality of going into tier 4. Could my right hon. Friend tell me when the new vaccine will start to be administered to my constituents in Rushcliffe, and will the easier handling requirements enable the roll-out to be sped up so that we can start to get back to normal as quickly as possible?

Yes. My hon. Friend catches my emotions as well, and I am sure the emotions of most of the House, in that we have this extra and new hope of a vaccine, but we also have some very difficult weeks between now and when it is rolled out to protect the most vulnerable. The extension of the time interval needed between the two doses from about three or four weeks to 12 weeks means that we will be able to inoculate more people with the first dose. The news that the first dose is effective in protecting people is very good news, because it means that we can speed up the roll-out and we can all get out of this situation faster than we otherwise would have been able to, and we can save more lives along the way. So that is good news, but I absolutely appreciate my hon. Friend’s emotional turmoil because it is also tough, especially across Nottinghamshire and the other places that have had to go into tier 4. The message is really clear, which is that help is on its way—it is here in the form of the vaccine—but we have to get through the next few months with the minimum pressure on the NHS and keeping the virus under control until then.

Yesterday, the Government announced that 1,500 armed forces personnel are being deployed to help secondary schools and colleges roll out mass testing. I am sure the Secretary of State is aware that there are over 3,000 secondary schools and colleges in England. This means that schools will get the support of less than half a soldier each. Could I ask the Secretary of State what specific tasks those armed forces will be carrying out, and if the Government will commit to giving overstretched headteachers and school staff more resources for the huge operation that they are expected to carry out?

Yes, there is of course support for the testing of schoolchildren, and I am sure that my right hon Friend the Education Secretary will be happy to set out more details in his statement shortly. The support of the armed forces, especially from those who have experience of the mass testing roll-out so far, will be incredibly helpful, but it is not the only thing that will help the roll-out of mass testing in schools. I am really grateful to the schools that have been involved so far for the enthusiasm that they have shown and for the extra effort they have put into making this work. I look forward to seeing that happen across much more of the country.

The Secretary of State, with his announcement, has effectively locked down most of England. In a previous interview with Andrew Marr, he said we will effectively be staying in that place until the vaccines are rolled out.

On this morning’s excellent news about the AstraZeneca vaccine, the chief executive of that company said that it could produce up to 2 million doses a week if the Government’s ambitious schedule for rolling it out could match that. Will the Secretary of State match it so we can get everyone over 65, which is nearly 90% of those at risk of death and hospitalisation, done in seven weeks, by the third week of February, and we can then remove these restrictions? Every focus of the Government now has to be on that task. It is the central, overriding task of government. Are the Government up to doing it?

I am absolutely delighted to be able to agree with every single word that my right hon. Friend says. He and I have not always agreed on every dot and cross of the policy on how to handle this pandemic but, regarding how we get out of it from here, it sounds like we are aligned on needing to roll out this vaccine as fast as possible.

The NHS can deliver at the pace my right hon. Friend mentions if we can get the manufacturing up to that speed. Of course, we are working with AstraZeneca to make that happen. I was on the radio at the same time as the chief executive this morning, and I was delighted to hear his commitments. AstraZeneca has worked so hard to make this happen and, crucially, we have to protect the most vulnerable. The fact that only one dose is needed to give protection is incredibly helpful, and that way we can get rid of these blasted restrictions as soon as possible.

It is very welcome news that the Oxford-AstraZeneca vaccine has been approved, but many of my elderly North Durham constituents, such as 94-year-old Joyce Ridley from Tanfield who contacted me yesterday, are still waiting for the vaccine. The Government promised before Christmas that they would prioritise those aged 80-plus to get the vaccine. Can I ask the Secretary of State, as I did when he made his statement before Christmas, when my elderly residents in North Durham will receive the vaccine? I do not want spin or flannel; a straight answer will do. If he does not know the answer, could he at least write to me so that I can reassure those who are worried that they have been forgotten?

I will absolutely arrange a meeting between the vaccine roll-out Minister, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), and the right hon. Gentleman to look into that case in particular. Around seven in 10 of the vaccines deployed so far have gone to those over 80. The rest have gone to NHS and care home staff, and to some residents in older persons’ care homes who are under the age of 80. We are deploying the Pfizer jab to older people right now, and we have to do that as fast as possible to make sure that, when there are cases such as the one he raises, we get it sorted.

I begin by joining the Secretary of State in thanking those in the NHS for the work they are doing at this incredible time. I also recognise that he has never shirked from taking really tough decisions, and that has no doubt saved lives.

I have many care homes in Fylde, including lots of small care homes, family-run care homes and assisted-living homes. Can the Secretary of State assure me that work is being done to ensure that we can get the vaccine into those small care homes very quickly and speedily in the coming weeks?

Yes, absolutely. My hon. Friend is kind in what he says, and I am grateful for his support for the approach that we have taken throughout the pandemic—I really appreciate it. As he says, it is precisely in order to save lives that we have taken the actions that we have. It has been harder to get the Pfizer jab to the smaller care homes because of the minus 70° storage requirements. That is much easier with the AstraZeneca vaccine, and today the NHS has written to GPs who are running the vaccines programme to stress the importance of getting the vaccine to care home residents and staff as soon as possible.

The news of the Oxford vaccine is welcome, but from tomorrow my constituents will face further difficult tier 4 restrictions. We cannot allow a choice between saving lives and saving livelihoods, so will the Government act to close the gaps in support that have left two in five people who rely on self-employed income excluded from the current support schemes?

The hon. Lady’s question is one for my right hon. Friend the Chancellor of the Exchequer, who has done more than almost any Finance Minister in the world to support people—whether in employment or self-employed—with some of the most generous schemes that have ever been put together. We appreciate that it is not possible to save every job, but we have done the most that we possibly can. I will make sure that someone from the Treasury gets back to the hon. Lady with a clear answer.

The Secretary of State knows that the vaccine roll-out programme in Hampshire is in a very, very strong position. What he will not know is that, by the close of play today, just over 40,000 people in the county will have had their first dose, which is impressive work by Nigel Waterson, who is leading that—sorry, I meant Dr Nigel Watson; Nigel Waterson is a former colleague. The only thing holding us back, I am told, is supplies, so does today’s decision mean that the county’s endeavour can match its ambition? How many doses exactly will be in the country by the turn of the year?

I want to thank Nigel Watson and all his colleagues who have delivered this fantastic effort across Hampshire. It is true that the current rate-limiting factor on the roll-out of the vaccine is the supply of the approved vaccine. Not only do we need to have it manufactured and in the country, but each batch needs to be checked, because it has to be in pristine condition. The worst thing we could do is inject someone with something that we think is vaccine, but does not work because it has not been stored properly. That takes time.

We have 530,000 doses of the AstraZeneca jab ready to go, and they will be deployed from Monday. In addition, we have over 3 million doses of the Pfizer vaccine that are ready, because we needed to hold one dose back. Once we move to the 12-week window for dosage—for the Pfizer vaccine, too—which has been recommended today by the regulator and by the Joint Committee on Vaccination and Immunisation, we will be able to roll those out. That will happen through January, rather than immediately. The end result of all that is that we can significantly accelerate the roll-out of the vaccine programme.

I have asked the Secretary of State on several occasions for a timetable for the roll-out of the vaccination programme. Now that, thankfully, the AstraZeneca vaccine has been approved, can he provide some certainty and a timetable that prioritises unpaid carers, given that many of them care for extremely vulnerable people? He has been asked for that several times today, and people really need hope to carry on in these difficult times.

I totally understand why people want the answer to that question, because of the hope that the vaccine gives us. What I can tell the hon. Lady is that the speed of the roll-out will be determined by the speed of manufacture. While we have 530,000 doses ready to go from Monday, we also need to make sure that we receive more approved doses. We are working closely with AstraZeneca on that, as we have with Pfizer. That is what will determine the speed of the roll-out. The NHS has a plan, and it is ready to go.

I have nothing but praise for the NHS workers who have been rolling out the vaccination programme thus far, but many of my elderly and vulnerable constituents have had to queue for more than an hour after their appointed hour for vaccination. Will my right hon. Friend confirm what those many people who have already had the first dose of the vaccine should do about the second dose? Should they attend at their appointed hour, or should they wait for a new appointment in several weeks’ time?

Those with appointments before 4 January should attend their appointment, and those with appointments from 4 January onwards will have them rescheduled. I understand that that will, obviously, require effort, especially in primary care, and that some people are looking forward to their second dose. However, the overriding health priority and all the clinical advice is that, because we can get protection after the first dose of the vaccine, in order to save lives we need to move to the 12-week window rather than the three-week window that we had with the Pfizer jab.

On people queuing and the need to make sure that that system is as efficient as possible, I have not heard about that happening elsewhere in the country. If I may, I will arrange a meeting between my hon. Friend and the vaccine roll-out Minister, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), to make sure that we can get to the bottom of it and that things are running as smoothly as possible in Harrow.

On this glorious and momentous Brexit day, I celebrate with others that another vaccine has been approved. Will my right hon. Friend join me in thanking all NHS providers in Southend for their heroic efforts throughout the pandemic? As a result of the increased number of infections, will he and his splendid team see what further help they can give us, particularly with delivering the new vaccine?

Yes, of course. The Brexit deal that the House has just passed with such an enormous majority will help to support UK life sciences. This vaccine also shows what we can achieve as a country. We work with international partners, absolutely, but this shows what we can achieve with British science, British industry and the British Government all working together, and with the NHS, to make this happen. I will absolutely work with my hon. Friend to support the NHS in Southend, which is under pressure. The case rate is very, very high in Southend. I say to everybody in Southend that the single thing that they can do is to limit all social contact unless it is absolutely necessary. It is not a nice thing to have to say and it is not easy to do, but it is absolutely necessary in Southend.

Covid is a truly horrible disease that poses potentially long-term consequences for even the young and the healthy, so today’s vaccine approval is truly welcome news and makes eliminating community transmission of the virus more possible than ever before. As such, is it the UK Government’s plan to loosen restrictions only when the most vulnerable have been vaccinated or when a vaccine has been given to a significant proportion of the population as a whole? If so, what will that proportion be?

We have not set that out yet, because while our general approach is to vaccinate, as soon as possible, as many as possible of those who are vulnerable to this disease, and to then be able to lift restrictions, as I said in my answer to my right hon. Friend the Member for Forest of Dean (Mr Harper), the exact timing depends on the roll-out of the vaccine and its impact on bringing down the rate of transmission. The change in the dosage schedule from four weeks to 12 weeks means that we can get the protection to as many people as possible sooner, and in a more accelerated way, than we would previously have been able to do.

The approval by the Medicines and Healthcare Products Regulatory Agency of the Oxford-AstraZeneca vaccine is great news at the end of a truly wretched year. Does my right hon. Friend agree that the speed of roll-out should be governed only by the rate of vaccine production? Will he assure me that his Department will cut through all and any pettifogging rules and bureaucracy to ensure that newly retired nurses and doctors, or those on career breaks, can be approved as vaccinators, so that the only limiting factor is vaccination production, not the availability of vaccinators or locations?

Yes, that is our goal. We changed the law to enable more people to inject vaccines and we have a big training programme on now. At the moment, it is the supply that is the rate-limiting step. We want to increase the rate of supply and the NHS’s capacity to deliver it at the same time.

By not needing extreme refrigeration, the new Oxford-AstraZeneca vaccine is a real breakthrough. Will the Health Secretary tell us how it will be administered to over-80s in care homes or at home who are too immobile to travel and who perhaps have carers, including dementia patients, under the hub-and-spoke model? Locally, ambulances are needed, ICU is full, Ealing Hospital is on a black alert and the way that doctors are being told to use oxygen sparingly is raising suspicions that it is running out. Hub-and-spoke is good on paper, but it may be time that the Secretary of State revisits it, because it keeps throwing up loads of anomalies.

The ability of the Oxford vaccine to be easily transported makes a huge difference, because it means we can take it to care homes—we can take the vaccine to the people—rather than the other way round for those who are immobile. Of course, for people who find it easy to travel, it is much more efficient to do it the other way round, so we will have a combination of community roll-out where we take the vaccine to the people and vaccination hubs where people come to get vaccinated. It is all based, as per my previous answer, on optimising the speed of delivery of the vaccine. That is what will both save lives and get us out of the restrictions as fast as possible.

We all want to ensure that classrooms remain open so that our children’s education continues with as little disruption as possible. We have seen the impact that armed forces personnel have had in Liverpool and Dover in helping to carry out mass testing. Will my right hon. Friend confirm whether plans will be put in place to utilise our armed forces to assist with regular testing in schools, colleges and universities?

The Education Secretary is about to make a statement to set out more details, but the armed forces have been brilliant in all sorts of parts of the response to the pandemic, one of which is supporting schools to get mass testing under way in an appropriate way, using the experience they have gained by helping us so much over this crisis.

As we have heard, by mid-October more than 600 health and social care staff had already died from covid. Professor Andrew Goddard, the president of the Royal College of Physicians, said today:

“Frontline NHS and care staff must be vaccinated in the next couple of weeks as a priority, as the current pressures on the NHS will be impossible to withstand without a fit and protected workforce”.

With today’s further good news on vaccines, will the Secretary of State give our NHS workforce the undertaking that they will be vaccinated in the next couple of weeks?

We will vaccinate NHS and social care staff as soon as we can. They are, of course, in the priority list. They are in priority group 2, except for social care home staff, who are in priority group 1. The groups are all set out according to clinical need. That is the basis on which we will vaccinate. We will also vaccinate at pace, which often means that spare vaccines that are left at the end of the day in a hospital or primary care setting are used to vaccinate staff who are to hand, where that can be done. That is being done right now. In short, the answer is that we are trying to do this as quickly as we possibly can.

I congratulate my right hon. Friend and his team on the work they have done to put us in such a relatively strong position to vaccinate in the coming months, and I pay tribute to the team here at the Epsom and St Helier University Hospitals NHS Trust for the work that they are doing at the moment. This area has been in tier 4 for 10 days, and there is a continuing acceleration in the number of infections reported locally. By definition, those are not happening in the business premises that were closed as a result of moving to tiers 3 and 4. What information does the Secretary of State have about where these infections are being transmitted under tier 4?

The majority of infections happen within the household, from one person in a household to another. That is, perhaps, inevitable, because we are physically closest to those with whom we live. Over the last 10 days, it has not yet been possible to do a full analysis of where we think the transmission is happening within tier 4. The reason for that is simply that the data are not available, and the data are particularly difficult to interpret over the Christmas period. I am very happy to keep talking to my right hon. Friend to try to understand as much as we can about where the transmissions are happening, because that is the route to keeping them under control in the least damaging way possible until we can complete the vaccine roll-out.

I, too, welcome the vaccine news. I know the Secretary of State is a keen advocate of the use of lateral flow tests in care homes. In one group consisting of three homes in my constituency, it is taking a thousand staff hours a month to deliver just under 4,000 tests. That is not manageable without neglecting other vital duties. What can the Secretary of State offer by way of help?

We have put in more support to help care homes with the challenges that covid throws up, in relation to both testing and other things such as PPE that are so necessary. I am very happy to arrange a meeting between the hon. Gentleman and the Minister for Care, my hon. Friend the Member for Faversham and Mid Kent (Helen Whately), to see what more can be done, and in particular whether the burden that he describes—the time taken to do these vital tests—can be minimised in some way.

I welcome the work that the Secretary of State is doing, and particularly his answer to my hon. Friend the Member for South Thanet (Craig Mackinlay) about the importance of getting enough vaccinators. Even within London boroughs, I am conscious of a difference in the speed of roll-out, even to very vulnerable people. In my constituency, I have a number of recently retired medical people—doctors, clinicians and nurses—who would willingly volunteer if they were asked. In addition, will the Secretary of State make, or has he made, approaches to private healthcare providers? As I understand it, many of them have capacity and, I am told, they would be willing in some cases to make their staff available on a pro bono basis to help the NHS to roll out this vaccine.

Yes, I am pretty sure that that has been done. If it has not, I will absolutely check and get back to my hon. Friend. If anybody who is clinically qualified comes forward, we are very enthusiastic to hear from them. NHS Professionals, the body that is responsible for extra staff in the NHS, is organising the distribution of those who want to come back into service in order to help to vaccinate, and we look forward to hearing from people.

My constituents will be gutted today. We are making sacrifices and our beautiful town’s economy is tanking. More so, the tiering system is not working. Areas that previously moved into tier 4 still have rising infection rates, so what evidence is the Secretary of State using that shows that moving South Shields from tier 3 into tier 4 will reduce the spread of the virus?

It is not easy moving from tier 3 to tier 4. I understand that, but the rates in South Shields are going up sharply. With the support of the council and, indeed, all the councils across the north-east, we have taken this action. The evidence base is that for those areas that have been in tier 4 the longest, we are starting to see a reduction in the rate of increase and in some places a fall, particularly in some parts of Kent, but there is still an awful lot more to do. This new variant, which we can now sadly see in the north-east of England—much in the way that it started in the south-east—spreads so much more easily. It is much harder to keep control of. The job of suppressing the virus has got harder with the new variant at the same time as the approval of the vaccines has made the job of getting out of this easier. That is the challenge we face.

Yesterday, I went to visit the vaccination hub at Peterborough City Hospital. After everything we have been through, and after seeing hope behind the smiles of those waiting for the jab, I must confess to feeling almost emotional during my visit. I place on record my thanks to everyone working at the hub and within the wider Peterborough NHS. With the superb news today of the approval of the Oxford-AstraZeneca vaccine, is now the time to prioritise the vaccination of NHS staff to prevent staff shortages and ease NHS winter pressures?

Yes. My hon. Friend speaks so powerfully for Peterborough. I am glad that the vaccination centre is working well in Peterborough. This new vaccine does mean that we can accelerate the roll-out of the vaccine to NHS staff, and that is good news in Peterborough and across the country.

The Secretary of State has today announced 23 more areas that will move into tier 4. Three quarters of the country is now in tier 4. How long before he looks at this again and can make other announcements? What further escalation will he be considering if even tier 4 does not bring down these soaring infection rates?

For areas in tier 4 where we still need to get the infection rate down, the most important thing we can all do is take responsibility to restrict the spread of infection, because this new variant spreads so easily from person to person. Everybody has to behave. If everybody behaves like they might have the virus and therefore restricts their social contact, that is the best way we can get these rates down. It does take all of us do this; it is not just about the rules that are set out from this Dispatch Box and voted on by this House.

I know that people in Wallasey and across Liverpool have done so much and got the rates right down under control, but unfortunately they have started to rise again, and with the new variant, it has been necessary to put Liverpool into tier 3. I just hope, like the rest of the country, that we can get out of this after the next few difficult weeks.

Buckinghamshire health services are under severe pressure with escalating rates of covid and hospital admissions. On behalf of all my colleagues in Buckinghamshire, may I give an enormous public thank you to our healthcare staff, who are working round the clock in a growing emergency, as well as providing testing and vaccinations at multiple sites in the county? Despite those pressures, the trust is establishing a centre to help people with the effects of long covid, which are now causing increased concern. It will be at Stoke Mandeville. What extra resources can the Secretary of State make available to support our valiant health workers and, in particular, to help those now suffering from the effects of long covid, which are very serious in some cases?

My right hon. Friend is absolutely spot on. The issue of long covid is very serious, and we have put more support into the NHS and into research to try to understand long covid better. I know about it very much myself, and I understand the impacts that it can have, which can be debilitating on people’s lives. I am delighted that there is a long covid centre at Stoke Mandeville. It is such an excellent hospital, and I am not surprised that it is doing all the cutting-edge work that is needed, but the single most important thing we can do to support those who have long covid is to understand better the causes and therefore understand what we can do to help people get their lives back to normal.

The Secretary of State has said in many statements over the past 10 months that we have the virus under control. Only two weeks ago, he said that we cannot risk letting cases rise again, yet that is exactly what is happening under his watch. Yesterday, the UK reported a further 53,135 cases of coronavirus, which is the highest daily total since the pandemic began. With many hospitals in London and the south-east at breaking point, it is clear that the Government have lost control of the virus. With schools set to go back in a week’s time, what public health strategy does he have in place to keep our children, their families and teachers safe?

The new variant of this virus makes it very difficult to control, which is why it is so important that everybody follows those public health messages. That is the challenge we are all dealing with, together, and we just have to remember that we are all on the same side in that great battle. Help is on its way, in the testing for schools, in the measures that my right hon. Friend the Education Secretary is shortly to announce and in the vaccine, which will help to protect those who are most vulnerable. Once we have got through all the clinical prioritisation, we can then move on, in general, to the under-50s. Their risk of death from covid is, thankfully, low but it is highly likely that they will still want to have a vaccine to protect themselves from this disease.

First, I wish to commend the Secretary of State for making it clear that the vaccine will be available to all over-65s—by the end of February, we hope—as that is really important. This should be a joyous day. We have been given the gift of a free trade agreement with the EU by our Prime Minister and the gift of a new vaccine—we also have a new vaccines Minister—by our scientists and world-leading Government objectives. But the gift people really want this Christmas is to know that their jobs, livelihoods and civil liberties will be given back to them as soon as possible, so will the Secretary of State make this clear today by telling us at what point on the priority list of vaccinations he will allow restrictions to be lifted?

We have to remember that the vaccine is a great symbol of hope, but it is a means to an end, and the end is the lifting of restrictions and the restoration of our liberties and the freedom for us to act as we please. That is the goal of this programme: to make people safe so that we can get life back to normal and, of course, protect the NHS. On the timing, it is absolutely right, as I said in my response to my right hon. Friend the Member for Forest of Dean (Mr Harper), that the speed of roll-out can be accelerated because of the decisions announced this morning. The precise timing of that has to be determined by the manufacture, because although we can forecast that, we cannot know exactly how much will be delivered. On the question of how far down the priority list we need to go before people are safe, we will observe that as we observe the reduction—I hope—in transmission that we get, as well as the protection of individuals. So we will keep this under review, but the good news is that I am highly confident that by the spring we will be through this. It was not possible before the approval of this vaccine to say that.

What information has the Secretary of State received from the experts in the Scientific Advisory Group for Emergencies about the roles that schools played in the spread of infection in places such as south-east London? Does this suggest that we should have a roll-out of a mass vaccination programme for schools?

We will vaccinate according to clinical need, because that is the best way both to protect lives and to be able to lift the restrictions.

Even once vaccinated, some older and clinically vulnerable people will have no one to look after them if their unpaid carers get ill with coronavirus. Vaccinating unpaid carers would be a clear way of reducing pressure on the NHS and social care, with the double benefit of protecting carers and providing the care that the NHS and social care system would then not need to provide. So will the Secretary of State give an unequivocal commitment that unpaid carers will be included in priority categories for vaccination?

As I have said, we will absolutely vaccinate according to clinical need. Once we are through those clinical need cohorts, there is a very important call on the next set of prioritisations, which we have not yet set out, and both teachers and unpaid carers have a good case to make.

As the Health Secretary has said, today is clearly a day of mixed emotions. I hugely welcome the news about the Oxford vaccine and pay tribute to Cobra Biologics in my constituency, which has been manufacturing it and has been involved since the outset. However, moving Staffordshire to tier 4 is very tough on the people of Newcastle. We have worked hard to get our rate down and it is currently stable and, indeed, falling slightly. I understand the risk of the new variant, but will he confirm that there is a way out of tier 4 and that he will take into account vaccination rates and the effect on the NHS, and not look purely at case numbers once we have the vaccination programme rolled out?

Yes, I absolutely will. We already look at the impact on the NHS, of course, but that will become more important as more and more people are vaccinated and, we hope, the correlation between cases and future hospitalisations, which is currently stable, starts to go down and there are fewer hospitalisations for every individual case. Obviously we should take that into account.

As everyone knows, the vaccine is important and necessary, but we also know that the effects of corona have fallen disproportionately on the most vulnerable within our society. The World Health Organisation asked for special consideration to be given to those with disabilities, yet a wholly disproportionate number of the deaths that have occurred have been people with disabilities. Those with learning disabilities have often lost out on the support they would normally receive, and we have 1.5 million children facing mental health problems, if not crises, at the present time. Can the Secretary of State assure us that work will be done to support those with disabilities and, in particular, that work will be done and greater support given to young people and children who are suffering often quite profound mental health difficulties as a result of the stress of isolation that they have suffered over the past nine months?

Yes, of course. This has been looked into in great detail, and the clinical prioritisation includes those who are under 50 but are clinically vulnerable to the effects of covid-19. They come into the prioritisation in categories 4 and 6 alongside the over-70s and over-60s, taking into account precisely the sort of considerations that the right hon. Gentleman sets out.

Given that the main effort is the protection of the NHS, surely, the moment we start to get a reduction in hospital admissions, we can start lifting the restrictions?

Well, yes—in principle. The point is to protect the NHS and to stop people dying from the disease. While at the moment cases are a very clear proxy for future hospitalisations and future deaths, as the vaccine is rolled out, we would hope that for every number of cases we would have fewer hospitalisations and fewer deaths. It is that protection from hospitalisations and deaths that the vaccine gives us, which is why it is the route out of the crisis.

I pay tribute to Homerton University Hospital in the heart of my constituency, where the staff are working flat out now with the rising number of cases, and to the Royal London Hospital in a neighbouring constituency, which of course had a queue of ambulances with covid patients waiting to be treated. Given the pressure on the NHS, which I know the Secretary of State also feels very strongly about, what is he doing to ensure that the nurses and other staff we need are available? Recent press reports suggest that of the 71,000 available nurses, only just over 1,000 had been deployed. Is he working with the Nursing and Midwifery Council to track down those with the right registration and skills and to get them into the right places?

Yes, it is incredibly important that we support the NHS with the workforce that it needs—both the permanent workforce, where we have increased the number of nurses by over 13,000 in the past 12 months, and a temporary workforce for the difficult few weeks that we have ahead of us in the NHS. I am working with the NHS and others on exactly the question that hon. Lady rightly raises, and I join her in praising the team at the Homerton, who are doing a great job.

There is no doubt that the news of the vaccine and the Brexit deal are a grand finale to what has been a difficult year, albeit one with mixed emotions, as constituencies such as mine go into tier 4. As a fitting way to end this statement, will my right hon. Friend join me in thanking everybody working in the NHS and social care, not just across my constituency but in all constituencies, for the work they have done this year and especially those who worked tirelessly over Christmas to help to keep the most vulnerable safe? Will he also extend an extra special thank you to all those caring for children with disabilities and special needs, such as Lifted Spirits, who are a bunch of mums and dads in my constituency? As I am sure he will agree, this has been a particularly challenging year too for those who are carers.

In what I hope is my last statement of the year, and most likely my last answer of the year, I thank my hon. Friend for her question, and not just for praising those at Lifted Spirits and others who are doing so much to care for others, but for giving me the opportunity and the prompting to thank NHS staff who during 2020 have done more than in almost certainly any other year since its formation, and the social care staff of this country, who have gone out of their way to care for others and those who are most vulnerable, not just to covid but to other health problems. There is no limit to my gratitude to those who are working so hard; they really put their shoulders to the wheel. The attitude of the NHS—that when there is a crisis, we lean in, we come together and we fix it—inspires me, and I know inspires so many other people.

In order to allow the safe exit of hon. Members participating in this item of business and the safe arrival of those participating in the next, I am suspending the House for three minutes.

Sitting suspended.