Skip to main content

Coronavirus (COVID-19)

Volume 802: debated on Tuesday 3 March 2020


My Lords, before my noble friend repeats the Statement, I have been asked, in view of the importance of this subject, that Back-Benchers should have more time. I am pleased to say that I have agreed that they should have an extra 10 minutes, so there will therefore be 30 minutes available for Back-Benchers. However, I shall make the point—the Companion is quite clear on this—that this is an opportunity for questions, not speeches. My noble friend is very keen to answer as many questions as possible, so we would like short, focused and challenging questions— but, above all, short.

My Lords, with the leave of the House, I shall now repeat a Statement made today by my right honourable friend Matt Hancock, the Secretary of State for the Department of Health and Social Care. The Statement is as follows:

“Mr Speaker, with permission I would like to make a Statement on the Government’s coronavirus action plan. The situation facing the country is increasingly serious. Globally and at home, the number of cases continues to rise. As of 9 am today there were 51 confirmed cases in the UK and it is becoming more likely that we will see widespread transmission here in this country.

Our approach is to plan for the worst and work for the best. Yesterday I attended a COBRA meeting chaired by the Prime Minister, in which we finalised our four-part action plan to contain, delay, research and mitigate the virus. This plan has been jointly agreed between the UK Government and the devolved Administrations. Copies of the plan have been sent to Members of both Houses and made available in hard copy. The plan is driven by the science and guided by the expert recommendations of the four UK Chief Medical Officers and the Scientific Advisory Group for Emergencies.

Our plan sets out what we know so far about the virus and the disease it causes, what long-term planning we have undertaken to prepare for a pandemic, what actions we have taken so far in response to the coronavirus outbreak and, crucially, the role the public can play in supporting our response, both now and in the future.

The UK is well prepared for infectious disease outbreaks of this kind. The international data continue to indicate that for most people, this disease is mild and the vast majority recover in full. We have responded to a wide range of disease outbreaks in the recent past. The NHS has been preparing for a pandemic virus for over a decade. We have world-class expertise to make sense of the emerging data. We have a strong base on which to build.

While Covid-19 is a new virus, we have adapted our response to take account of that fact. Our plan sets out a phased response to the outbreak. Phase one is to contain—this is the phase we are currently in. Contain is about detecting the early cases, following up with close contacts and preventing the disease taking hold in this country for as long as is reasonably possible. This approach also buys time for the NHS to ramp up its preparations. If the number of global cases continues to rise, especially in Europe, the scientific advice is that we may not be able to contain the virus indefinitely.

At that point we will activate the delay phase of our plan. Delay is about slowing the spread, lowering the peak impact of the disease and pushing it away from the winter season. We are mindful of scientific advice that reacting too early or overreacting carries its own risks. So, subject to our primary goal of keeping people safe, we will seek to minimise social and economic disruption.

The third part of the plan is research. Research has been ongoing since we first identified Covid-19. I pay tribute to scientists at Public Health England, who were among the first in the world to sequence its genome. Research is not just about developing a vaccine—which we are actively pursuing but is many months away, at the earliest—but also about understanding what actions will lessen the impact of coronavirus, including what drugs and treatments, existing and new, will help those who are already sick.

The fourth phase is to mitigate. We will move on to this phase if coronavirus becomes established in the UK population. At that point, it would be impossible to prevent widespread transmission, so the emphasis will be on caring for those who are most seriously ill and keeping essential services running at a time when large parts of the workforce may be off sick. Our plans include not just the most likely case, but the reasonable worst case. We will identify and support the most vulnerable and, if necessary, take some of the actions set out in today’s plan to reduce the impact of absentees and to lessen the impact on our economy and supply chains. We prepare for the worst and work for the best. We commit to ensuring that the agencies responsible for tackling this outbreak are properly resourced, have the people, equipment and medicine that they need, and that any new laws they need are brought forward as and when required.

This is a national effort. We need everyone to listen to and act on the official medical advice. We need employers to prioritise the welfare of their staff. The single most important thing everyone can do to help—and I make no apologies for repeating this—is to use tissues when coughing or sneezing and wash your hands more often. It is in your interests, in your family’s interests and in the national interest. We will get through this. Everyone has a part to play.

I commend this Statement to the House.”

My Lords, I thank the noble Lord—the government spokesperson—for repeating this Statement. Our thoughts are always with those who have contracted the virus and we pay tribute, again, to the extraordinary efforts of the NHS and our public health staff. We, on these Benches, are clear: the public health interest must, at all times, be the priority. All the Government’s decisions must support this strategic aim and, where they follow the medical and scientific advice, they will have our support.

I start by raising the issue of the EU early warning and response system, of which, of course, until Brexit, the UK was a member. This early warning and response system has played a vital role in pandemic preparations in the past. It is rumoured that No. 10 overruled the Department of Health, which wished, quite rightly, to be part of the European Union’s safeguarding system at this time. The Prime Minister has said that keeping the public safe was the Government’s number one priority but has refused to seek to retain or apply for membership of the EWRS because of the negotiations taking place at the moment. I understand that the Secretary of State agrees with those of us who believe that tackling fast-moving, global outbreaks—including this virus—could become harder if the UK loses access to the EU’s early warning system for cross-border threats, so I urge the Government to urgently review this stance.

The PM says that there is significant risk of the virus becoming widespread, meaning further measures might be necessary, and that emergency legislation may be necessary to give the Government the powers they need to implement the action plan. I would be grateful if the Minister could set out some kind of timetable for emergency legislation. Will it be primary and secondary legislation, and which department will take the lead?

The plan sets out what the Government could do to contain the virus on the basis of scientific evidence. Drastic steps, such as closing schools, would have major social and economic consequences, so can the Minister advise the House on how they plan to seek a balance?

We agree with the Government’s strategy to contain, delay, research and mitigate, and indeed it has our endorsement. However, can the Minister explain why we have not followed other nations by imposing a travel ban to the UK from higher-risk countries such as Italy, Iran, China and South Korea?

Are the Government undertaking workforce planning as a consequence of self-isolation? This has huge implications both for this stage and the peak stage, in which the Government recognise that up to a fifth of workers could be absent from work. The Prime Minister said today that workers who self-isolate will be considered to be on sick leave. Can he confirm that those who need to self-isolate will not need to visit a GP to receive a sick note?

Two million workers on low pay or insecure contracts in the gig economy do not even qualify for statutory sick pay. The GMB trade union points out that NHS trusts have a huge number of outsourced staff and that a large number of companies providing NHS services do not pay sick pay for the first three days. Therefore, we are looking at cleaners, porters and catering staff who might put their own health at risk when we need them to contain the coronavirus, because they will not be paid if they go off sick. Therefore, I ask that NHS trusts, for example, guarantee that all staff are given full sick pay if they have to self-isolate.

Equally, what action will be taken to reduce the requirements placed on those in receipt of benefits who will not physically be able to attend appointments if they need to self-isolate? Can the Minister guarantee that no financial sanctions will be imposed? No one should be faced with having to make a choice between their health and hardship. Therefore, when the Government consider emergency legislation, will they bring forward legislation to remove those barriers to self-isolation so that all workers can get the sick pay that they deserve?

We know that the elderly and those with chronic underlying long-term conditions such as diabetes or cardiovascular conditions are vulnerable. What is the Government’s latest advice to providers of social care for those in residential settings or staff visiting elderly and vulnerable people in their homes?

On the NHS more broadly through the mitigation phase, we know that last week 80% of critical care beds were occupied. Can the Minister clarify how many beds are available should we need them, and how quickly can ICU beds be opened up? Can we be assured about the extra resource that will be made available to health trusts? Every sample for testing will carry a cost, and that will soon build up. As people self-isolate, that will affect the NHS workforce, and trusts will be forced to take on more agency staff. If retired staff are encouraged to return to practice, the wage bill will increase. Can the Minister explain how retired staff returning will be engaged and protected, and what oversight will be put in place to ensure that they deliver safe care if the revalidation process is to be suspended for retired returnees?

Will the Government provide emergency funding to cover the NHS resource budget and support the NHS through this next challenging period? For example, it is possible that thousands of elective surgeries will have to be cancelled.

Directors of public health are preparing a local response to Covid-19, yet they still do not know what their public health allocation for the next financial year, starting next month, will be. It means that they will be cutting the nurse workloads that they are commissioning at a time when we need those nurses to cover these cases.

Finally, on global efforts to contain the virus, I have already mentioned the European Union EWRS. We will not contain the virus internationally, nor will we be able fully to protect ourselves if the outbreak becomes uncontrolled in countries with weaker health systems. What assistance are we offering the World Health Organization with the international response to Covid-19?

We will continue to raise our concerns responsibly when we have them but, on these Benches, we also pledge to work constructively with the Government, because the public health interest must always come first.

My Lords, on behalf of the Liberal Democrat Benches, I thank the Minister for repeating the Statement. We repeat our thanks to the staff of the NHS and the Department of Health and Social Care, as well as to all those working cross-department on preparing for the various possible outcomes in the event that this escalates.

We also echo the points made from the Labour Benches about No. 10’s announcement that we will not take part in the EU early warning system. It was clear from the media yesterday that the NHS and medical experts all say that we must be part of it. To have No. 10 say, “No, we won’t”—presumably because it has the dirty letters “EU” in it—is extremely unhelpful. Will the Government please review this position as a matter of urgency and, as they said in their Statement, take scientific and medical advice on whether we should be involved?

We welcome the two amounts of £20 million that the Government have put forward for research into Covid-19—the first for the Coalition for Epidemic Preparedness Innovations, but particularly the £20 million for Covid research here in the UK, including on epidemiology and treatment in hospital. Far too often we focus only on blue-sky research. This needs to be very practical and it is—these Benches welcome that.

I apologise for being a broken record on this. However, I am sorry to say that the advice for those who are either vulnerable or have underlying medical conditions is still not clear. The Minister and I have had an email exchange on this matter. The WHO and the American CDC still offer clearer advice to members of their public about what to do if you are either elderly or have underlying conditions than we do in this country, whether you are travelling abroad or in a community that may have some cases. Can this be beefed up? There is a statement in the action plan report that this will be strengthened in due course, but that will be once we get to mitigation.

There are already concerns in the medical and disabled communities about whether people should be shaking hands. I was somewhat concerned to hear the Secretary of State affirming confidently on television this morning that shaking hands was still fine. I am sorry: if you have an underlying condition, you do not want to be shaking hands with people. You should be washing, not doing that. Wearing hand splints, I have learned over the years to wave at people. It is much easier. Perhaps we could get a trend going with that.

We know that emergency legislation is coming up. That is heralded in the action plan. There are some concerns from our Benches on the extent of the mobilisation of retired and former staff. There has rightly been an emphasis on clinical staff. There will be questions that our Benches will look to have responses to. If people, particularly doctors, have been deregistered, perhaps because of retirement, will there be an expedited system, a reduced appraisal system, or a system to take people on who perhaps have not been reregistered but could work under supervision? It is important that these things are both clear and done at speed. But we are extremely concerned that there is no mention of people in other core parts of the NHS and social care system who are not clinical staff. The cleaning, catering and admin staff also keep the NHS and our social care system going. What arrangements are being put in place to provide extra support for them?

Once we move into mitigation and discussion about the possible closure of schools, surely it more important to keep schools open, even if there is only a reduced number of pupils in those schools, if the pupils’ parents are key workers—essential workers in the NHS, the police and other key areas. There is no sign that that has been thought about at this stage. It seems to us that this is an important point to cover.

Finally, after a nearly a decade in your Lordships’ House, I should not be too surprised when Ministers, particularly the Prime Minister, use very positive frames for things. The idea that the NHS will move out of a winter crisis into a landscape of delight once we get to the summer is extraordinary. We know that our social care system is at breaking point. The social care system was grateful for the £240 million provided by the last Chancellor in the autumn. However, the Local Government Association and almost every health think tank say that our current social care system is short of £2.5 billion now, without any impact from coronavirus. Of course, our social care system will have the patients most at risk of serious illness should coronavirus move into our communities. So, without heralding anything in the Budget, which I understand the Minister cannot speak about, can the Minister reassure the House that there will be serious support: for ensuring that there are no delayed discharges because there will be adequate support for social care in the system?

My Lords, I thank all the other parties for their spirit of collaboration and support during this awesome challenge. That was reflected in the debate last Wednesday and is reflected again today.

I start by reaffirming the commitment of this country and this Government to international co-operation. That co-operation is being led by British scientists, who were the first to crack the genome of this virus and who immediately published their material freely on the internet, which instigated a huge advance in the research being done around the world on Covid-19. Britain remains committed to the WHO initiative and is a very active leader and supporter. Our scientists are flying to some of the hardest-hit countries of the world. Without diminishing our own capability, we are very active contributors of intellectual, practical and personnel support to those in need around the world. I pay tribute to all involved.

On the EWRS, mentioned by the noble Baronesses, Lady Brinton and Lady Thornton, I reassure noble Lords that, in line with the withdrawal agreement, the UK has continued access to the EWRS during the transition period. We continue to share key updates with our European counterparts via this system. As set out in the UK’s negotiating mandate, we are open to exploring further co-operation between the UK and the EU on all matters of health security, including the exchange of information and expertise on infectious diseases such as coronavirus. We are open to exploring mechanisms for the UK and EU member states to continue to share and act on real-time alerts and information on new and emerging health threats, as currently carried out by the EWRS.

Regarding the Bill, as part of the Government’s plans, we are considering what additional powers may be needed to contain and mitigate the spread of the virus and to manage any impact. That Bill will be brought when it is needed; the timing and schedule have not been finalised.

The noble Baronesses, Lady Thornton and Lady Brinton, both brought up school policies. The noble Baroness, Lady Brinton, put her finger on a key and important point of the Government’s policy in this area. It is absolutely essential that services such as schools continue to be open for as long as they reasonably can be, so long as the medical advice supports that decision. Those who provide essential services, including social care and running the infrastructure of this country, depend on schools to be able to go to work. That is why the direction to school heads is, where possible, to keep the schools open. It is possible that, at some point in the future, as part of the delay strategy, the recommendation may change—but it would be done under the guidance of our medical advisers, and with strong epidemiological evidence that such a decision would make a profound difference to the spread of the virus. We are not in that situation yet, so the policy on schools remains, now and for the foreseeable future, that they should remain open where the medical advice confirms that.

On the question of a travel ban, it is true that this Government have not banned travel as some countries have done. That is based on the advice of our medical advisers, who suggest that trying to put in place travel bans to countries such as Italy would be like creating a medical Maginot Line; travellers will seek ways around the ban, tracing contacts will become impossible, and finding evidence of the origins of the virus will be lost in deception. Italy is one country that put in place serious travel bans around the world, and it is facing many of those challenges now with, sadly, a high rate of infection and challenges in tracing the origins of those infections.

Both noble Baronesses asked about sick leave. It is absolutely right that concern should be had for those who make the correct and responsible decision to self-isolate. Government lawyers have looked at sickness pay arrangements and it is very clear that those who self-isolate qualify immediately for statutory sickness pay. They may self-validate for seven days. After the seven days, they may seek an email confirmation of the diagnosis by dialling 111, thereby avoiding an unnecessary and potentially dangerous trip to either their GP or to hospital.

The practicalities of the gig economy, which were quite rightly raised in the debate so far, are challenging. There are provisions in the welfare system, and provisions among employers to behave generously, but this is an area that the Government clearly need to continue to review.

Tributes should be made to health staff, who provide absolutely essential support to keep our hospitals and surgeries open. It is, in fact, at times like this that one realises the profound and important contribution made by non-clinical staff. We owe it to them to provide generous and open-hearted arrangements, so that they can continue their work and, if necessary, self-isolate in financial security and confidence, and the Government are committed to reviewing those arrangements.

The noble Baronesses, Lady Thornton and Lady Brinton, both asked about social care. It is undoubtedly a concern that we all have for those who are older and more fragile—this virus is clearly targeting them. Provisions for social care are absolutely uppermost in the Government’s mind. A huge initiative will be made to recruit both professional and volunteer staff to support the social care industry during this period, when many workers will be self-isolating and support for people—whether they are in homes or living on their own—will be stretched. That recruitment is absolutely key to the Government’s plans.

Arrangements to ensure that that recruitment can include retired professional staff, who may have allowed their qualifications to lapse, may form part of forthcoming legislation, but I reassure the Chamber that the adequate management, supervision and scrutiny of those people will be maintained. This will very much include non-clinical staff as well as clinical staff—which, as I have explained, will be all-the-more important during an epidemic like this.

The noble Baroness, Lady Thornton, asked about funding. I reassure the House that, while the Treasury is carefully controlling the money spent, no clinical decision supported by medical evidence is being held back by financial considerations. The budget has been put in place and the moneys are available to do whatever it takes to manage this epidemic in a responsible and effective fashion.

The noble Baroness, Lady Brinton, is absolutely right to raise the issue of advice to those who are most vulnerable to this virus: those with medical conditions. It was one of the most moving moments of the debate, last Wednesday, when the noble Lord, Lord Davies, also raised it. I have taken these concerns to the CMO, whose office is looking at the modelling and the communications. It is absolutely a number one priority.

New communications are being put together. There is an issue with sequencing: it is the view of the experts that there is little point in seeking to mobilise behaviour change in people before it is required, in case they make those changes to their behaviour, feel that they are unnecessary, lose trust in the system and go back to their old behaviours. So the communication of some messages, the distribution of some advice and the recommendations from the Government need, at times, to obey the logical sequencing of this virus.

My Lords, there are so many questions but maybe I can be brief. I declare an interest as a member of Imperial College, which, as the Minister knows, is doing much of the research and co-ordination in this country. Does he feel that the advice to people is sufficient? Not shaking hands seems to be only part of the problem; we should not be doing social kissing, but it is very easy to do that. Somebody has tried to kiss me twice today—

I do not mean that in a way that might concern my wife, who might be listening to this debate. We also have to realise that we should not be touching our nose, mouth or eyes, all of which are likely to be contaminated. That is very important in not spreading the infection if you happen to be infected.

Perhaps I may raise one issue, because there are so many. It is the question of screening and diagnosis. News is coming through that people in New York are already finding it difficult to get screened for the virus when they have symptoms. That seems a bit of a problem with a virus that presents in a variable way, not a standard pattern. Sometimes you might be almost sub-clinical but then develop a much more serious, raging infection. One concern that we in this House must have—we have drawn attention repeatedly to this—is the massive difficulty of having properly managed pathology labs. We have excellent pathologists in this country but our pathology is always really stretched, without this virus. Is the Minister clear that we may need more staff to ensure that we can diagnose as accurately and rapidly as possible, as making a diagnosis is clearly one way of controlling the infection?

My Lords, the noble Lord is absolutely right about kissing. Kissing is wonderful but potentially dangerous. I share with the Chamber that we have had detailed conversations about kissing, shaking hands, fist-bumping and all manner of social intercourse. The analysis and guidance from the CMO is clear: it is the touching of your own nose that is the real problem. The average person touches their own nose between 70 and 100 times a day. That is why we focus on the message about washing hands. If your hands are clean, it does not matter how many times you touch your nose; but if they are dirty, whether that is through shaking hands, touching a door handle or whatever, the germs are there and can be conveyed. That is why we focus on that.

My Lords, the coronavirus action plan emphasises that risk increases in elderly people and those with underlying health conditions, particularly men. The Secretary of State emphasised handwashing but he also mentioned social distancing. Given the demography here in a self-regulating House, might it be advisable for us to model a kind of social distancing and make behavioural choices? I understand the Minister saying that maybe one should not adopt behavioural change too early because it might discourage people. But I wonder whether it is necessary for people who have no intention to speak to come here at a time when perhaps a little more space might keep Members of the House safer, and the work of the House safer so that it continues. Have the House authorities considered the possibility of engagement through web-based debate or digital voting, in the event that attendance at the House really needs to be minimised?

My Lords, it is not the role of the Department of Health and Social Care to lead on this matter, but I am aware that the House authorities are very sensitive to the points made by the noble Baroness. Ultimately, it will be up to the Leader’s Office, working with the House authorities, to make decisions on the matters she describes.

My Lords, this is a grave issue, but my noble friend’s response has been incredibly balanced. A huge number of people, including me, are concerned that we will overreact—although the Minister has said that we will not—and cause panic in the country, where panic should not be seen.

The noble Lord makes an important point. Polling to date has demonstrated that the British public have left the moment of complacency and are now seriously focused on this issue. Their trust in the Government remains high, and their engagement on solutions is profound. That feels like the right place to be.

My Lords, I noted what the Minister said about schools and I support his position. However, I also note that the Chief Medical Officer for Wales is today reported as saying that the peak in infection may be in May and June, coinciding with the time when up to a million young people will be taking public examinations in large sports halls. Can he reassure me that Ofqual is having conversations with examination boards about a contingency measure for delaying those examinations if necessary, and with universities about the admissions process if A-level results come out later?

The noble Lord makes an extremely important point, which I cannot answer specifically, as that would be for the Department for Education. If I may answer in the round, it is Government’s objective to avoid as much economic and social disruption as possible, while making safety our number one priority. That is our guiding star.

My Lords, in 2009 the Science and Technology Committee of this House, which I chaired, conducted a report on pandemic flu. I recommend that the Government look back at it. We spent a lot of time considering antiviral drugs, including that there should be enough of them in this country and that they should be distributed adequately. Was our recommendation on that topic fulfilled, and will those antiviral drugs be available?

We are grateful for the work of the noble Lord, Lord Broers, which is well known. The epidemiology of this virus is not yet fully understood. We do not understand whether it will respond to traditional and conventional antivirals in the way that other viruses have. To date, there is no evidence that the usually stockpiled conventional antivirals will necessarily be effective. For that reason, I cannot provide a direct answer.

My Lords, the Government seem very dependent on people using NHS 111 telephone lines, NHS 24 in Scotland, or NHS Direct Wales. I seek the Minister’s confirmation that the resourcing of NHS 111 and the other similar lines will be sufficient to meet the demand the Government are anticipating with trained staff who can give good-quality advice.

My Lords, the pressure on 111 has risen over many weeks. It was identified as an incredibly important part of our response to this pandemic at a very early stage. Thank goodness we have 111; without it GP surgeries would really be struggling. I can assure the House that massive resources have gone into providing additional support.

My Lords, I draw attention to my registered interests. Is the Minister content that the current regulations governing the evaluation of medicinal products for human use are sufficiently flexible in the current circumstances, such that they will not present an impediment to the rapid testing of new therapies for the prevention and treatment of this coronavirus?

My Lords, this Government are committed to doing whatever it takes medicinally to tackle this epidemic. We will not allow regulations to stand in the way.

My Lords, I listened very carefully to the Minister’s comments on behavioural change and discouragement, but there is nothing of any substance in this Statement on the provision of early information that could affect personal conduct—which is very important on this—particularly for the elderly, apart from hand-washing and tissue cover when coughing. The public want detailed information now on transmission points—where they are and what they are—and on the life of the virus under various conditions. Detailed, authoritative information will influence personal conduct. In my view, personal conduct may well be more important than what the Government do. At the moment, all we have is an internet riddled with rumour, speculation and unattributable advice. The Government have missed a real opportunity. Can we have far more detailed information at this stage?

I am also concerned about the conflation of statistics on the risk of mortality. The 1% to 2% figure is misleading. Among the over-70s, the figure is 8%; among the over-80s, it is 14.8%. If you have underlying health conditions, it is even higher. Why can Ministers not be more up front on the elderly? I understand that the stats I have just given are now being repeated by the Government, but not openly.

My Lords, there is an enormous amount of detailed information on the Public Health England website. I will be glad to forward the noble Lord a link if needed. I completely share his profound desire to know all the details of how the virus behaves, but at this stage we simply do not have that information. It is not being withheld; there is no secret to this. The behaviour takes time to be analysed and pinned down. Our scientists are working incredibly hard to get that information and it will be shared as soon as we have it. I share his frustration about the fake news and data; different people are using different numbers and there are clearly people muddying the waters. The Government are organising significant investment in resources to tackle fake news.

My Lords, coming back to the nature of the virus, has my noble friend noticed Chinese health officials’ reports that 14% of patients discharged from hospital after recovering from the virus later test positive again? Even if 14% is an exaggeration, has that tendency been noted and is there validity to the claim?

These stories have been seen. They are not fully understood. It is possible that those thought to have recovered did not actually recover—that their symptoms were subclinical and there may have been an issue with the original testing.

My Lords, will the Minister tell the House whether specific briefings will be held for the public service interpreters who work in the NHS and whether advice and information to the public will be provided in languages other than English?

The noble Baroness asks a very important question. I do not know the precise answer but will be glad to reply to her later.

My Lords, I commend the Minister for his excellent and balanced answers and for the clarity provided by the action plan today. It is clearly right that we remain in the containment phase. Listening to the debate today and outside, there are a lot of questions around which social distancing measures might be introduced in the delay and mitigation phases, when they might be implemented and what the social and economic costs might be. Could the Minister explain what work is ongoing to understand the effectiveness of specific distancing measures and on whose advice there might be recommendations for them to be implemented?

In all these matters, the Chief Medical Officer guides the Government’s decision-making. We are looking at the modelling done by SAGE—the Scientific Advisory Group for Emergencies—which guides our decision-making. It has sophisticated computer analysis, which all this information is being plugged into, and that helps inform the decisions that we make about the guidance on isolating and social distancing. It is not possible to lay out today exactly what guidance we will issue or what decisions we will make in the weeks or months to come, but when those decisions are made they will be broadcast with energy through public communications.

My Lords, the Minister will know that residents of nursing homes and care homes are overwhelmingly in the high-risk category. In the containment phase, is any advice being given about restricting visitors to such homes, either family or those who provide much-needed activities? When we get to the mitigation phase, is any advice being given about how to deal with staff shortages? I remind the Minister that when we talk about volunteers going into such institutions, volunteers themselves are overwhelmingly aged, and therefore in the high-risk category.

The noble Baroness raises an issue that is uppermost in our minds: the care of and provision for the aged, who are clearly the most vulnerable to this virus and whose support will be most hard-hit by the virus itself. It is clearly a dilemma that the Government are struggling with. We are seeking to delay the spread of the virus as much as possible so that the peak does not knock out in one go all those who provide support, so that mitigation provisions can be put in place. I reassure the noble Baroness that when we talk about volunteers, we are not talking just about family members: we are talking about full community commitment.

Can my noble friend advise us on the accuracy of the screening tests? Do we know whether there is a degree of false negatives, where people test clear but in fact have the virus? Are there any false positives, where tests show that people have the virus when they do not? For example, they might have a different kind of coronavirus—one of the common cold ones.

This question arose in the debate last week and I followed it up with the Chief Medical Officer. As far as I understand it, there is no issue with the testing. It is possible that some people seemingly recover—their symptoms fade from view—but they are still infected with the virus. We are working hard to understand how this works.

My Lords, first, as I understand it, currently the test is laboratory-based. How much emphasis are the Government, in their research, putting on a rapid diagnostic test that can be used at the bedside or immediately? The differential diagnosis between diseases that manifest with high temperature and a cough is absolutely essential in this area. I say this based on my experience: I was in Sierra Leone during the Ebola outbreak. Secondly, the one piece of behavioural advice that is very clear is about washing hands. If you were in Sierra Leone or west Africa during that time, you did not enter a public building without washing your hands. It was fairly crude—it was a bucket of water with disinfectant in it—but it was in the high commission and every hotel and office. The idea that the only kind of handwashing that is acceptable is conventional handwashing in circumstances that people expect might not be sufficient if this goes further.

The noble Baroness is absolutely right to emphasise the question of diagnosis. I know from my own experience that the delays that people experience create huge anxiety and prevent them making the important decisions they need to make for themselves and their families about how to do the right thing—self-isolating if necessary and making provisions for their other family members. A ferocious race is under way at the moment. The Government have instructed six private companies, which are all seeking to build exactly what the noble Baroness describes: a bedside testing kit that can be rolled out across the country to provide swift, on-the-spot diagnosis. We are hopeful that that will come shortly. On handwashing, I too have travelled in Africa and know exactly the kinds of provisions she talks about. The advice from the CMO is that we are not there yet but nothing is off the table.

The noble Baroness, Lady Thornton, referred to the Telegraph story about the conflict within the Government regarding the EWRS scheme. That same story referred to the Health Secretary wishing to travel to meet his European counterparts and not being allowed to by Downing Street. Can the Minister reassure your Lordships’ House that any necessary visit to Europe by a Minister or an official will be allowed to go ahead? As the Minister rightly said, we are in the EWRS until the end of this year. However, I asked a Written Question last week, to which I have not yet had a response, on the European Medicines Agency rapid approval and procurement system for vaccines and drugs. As I understand it, we are not in that system now that we are not part of the EU. Switzerland is also not in that system but has asked for special access. Have we asked or will we ask for special access?

I reassure the noble Baroness and the House that we are clearly in the midst of a global pandemic, and nothing will stand in the way of the Government’s best efforts to work with our international partners, in Europe, through the WHO and abroad, to find a proper solution to this challenge.

My Lords, there is a consensus on the necessity of handwashing. Will the Government ensure that sufficient quantities of gel are readily available around the country? There are reports that, nationwide, stocks are just not there to supply people who wish to get hold of that product to follow government advice.

The noble Viscount is right; I have also read the reports of sanitiser shortages. I wish I was in a position to reassure the House that we could somehow guarantee that there was enough sanitiser in the country for the next six years. I am not sure whether that is either reasonable or possible. However, I can tell noble Lords that the CMO’s guidance is clear: washing your hands with soap and preferably hot water is much better than using sanitisers.

My Lords, can my noble friend indicate a little more about the search for a vaccine for this disease? Who is leading the search, and is the United Kingdom involved?

Public Health England is leading the search and British scientists are playing an incredibly important role. However, the guidance I would give the House is from the CMO: the heaviest impact of this epidemic is likely to be within weeks, whereas the search for a vaccine is likely to take at least months and possibly years.

My Lords, the Minister is to be congratulated on the way he is answering questions in difficult circumstances, trying to keep the balance right. There is one area where we have great problems in controlling what happens. We have nearly 6 million people who are self-employed. We have talked about what you could do with people in employment and the support that could be given to them. What attention is being given to the issue of the self-employed? The Minister also mentioned that the Government have looked at the way in which the sequencing of communications should take place. Perhaps he might say a little more about that. Perhaps we might explore the opportunity to be positive. We have many people who are lonely, and I hear that many people are fearful—very frightened. Perhaps we should start getting some positive messages to them as well somewhere in the sequencing, so that they can feel less fearful than they are at the moment.

The noble Lord is quite right to ask about those who are either in the gig economy or unemployed. The Government need to look at this matter more closely. Provisions have been made on statutory sick pay and there are welfare arrangements through universal credit, but if those are not enough and do not provide the financial security and necessary provisions for those in need, we will review them and make the appropriate changes. The noble Lord’s points on the community are well made. I confess that we in the Department of Health are super-focused on the medical challenge, but one cannot help feeling that this may be a moment for the country to come together. If communities seek to support those in need, there may well be a silver lining to this cloud.

My Lords, apropos the testing, I understand that a Northern Ireland company is currently testing a rapid diagnosis in China. My important question relates to the action plan. At paragraph 4.50, it states that the Government

“will implement a distribution strategy for the UK’s stockpiles of key medicines and equipment”.

Can the Minister tell us: what stockpile, what medicine, what equipment and how much?

The noble Lord is right to refer to this. I cannot give him an exact inventory of the stockpile. All I can share with the House is that, partly because of our no-deal preparations, the warehouses are bursting with medicines and medical equipment. This is an inadvertent but not unwelcome aspect of the situation we are in.

My Lords, one issue that has not been raised is public transport. There is no more dangerous place than public transport when infections are rife. Has thought been given to restricting the number of people who can travel on buses and trains—perhaps one in two seats? That could be of some help if distance is an important factor.

My Lords, this is exactly the type of dilemma being considered by SAGE and the CMO. It will be the focus of work between the Department of Health and the Department for Transport.

My Lords, I am delighted that at Randox, my former constituents are leading the research into this virus. Can the Minister assure us that the Government’s plans to tackle this will be carried out or taken forward equally across the United Kingdom, and that the necessary finances will be made available to the Northern Ireland Executive to tackle this serious issue?

I reassure the noble Lord that the four CMOs from all parts of Britain have worked extremely closely and that their decision-making has been done on a joint basis. Work on a possible Bill has also been run past the Executives and Assemblies of all the nations; there is extremely close collaboration between all parts of Britain.

My Lords, I thank the Minister for repeating the Statement. Throughout this transitional phase, are the Government still availing themselves of the medical expertise in the respiratory field that is available through the European reference networks?

The noble Baroness is more of an expert on those networks than I am. All I can say is that we are going about this epidemic by focusing on all our strong relationships to make the most of everyone we know. We are throwing ourselves into every opportunity we have with gusto.

My Lords, many passengers use our airports in transit. I fear that our staff may be vulnerable to people making such journeys. Obviously, they are not British passengers, but they are using our airports. What are the Government doing to protect our staff on the ground?

The noble Lord is quite right to raise the issue of airline staff, who are very clearly on the front line of this epidemic. They are in confined spaces and are sharing aeroplanes with people from all sorts of destinations. It is not the role of the Government to intervene in this, but we are encouraging all employers, as a matter of principle, to care for their staff and to put staff welfare at the top of their priorities.

My Lords, can my noble friend say what action the Government are taking to work with local authorities so that they can help hard-to-reach communities? Not all communities are a homogenous group.

My noble friend is absolutely right. Work through the MHCLG is ongoing. The Department of Health does not lead in that matter, but I reassure her that, in matters such as social care, which is at the front of everyone’s minds, the work of local authorities will be absolutely essential, and they will play a key role on the front line of this epidemic.