Commons Urgent Question
The following Answer to an Urgent Question was given on Wednesday 17 June in the House of Commons.
“I am grateful for the chance to update the House on the urgent matter of coronavirus.
Yesterday’s treatment breakthrough shows that British science is among the best in the world. As a nation, we can be incredibly proud of our scientists. The UK is home to the best clinical trials, the most advanced immunology research, and the most promising vaccine development work of any country. We have backed the science from the start, and I am sure the whole House welcomes the life-saving breakthrough that was announced yesterday. Today, I will briefly update the House on all three aspects of that national scientific effort.
First, on clinical trials, our recovery programme, which looks at the effects of existing treatments in real-world hospital settings, is the largest of its kind. As of yesterday, 11,547 NHS patients had been recruited to the programme, which is operating across 176 sites in all four nations. In Oxford University’s dexamethasone trial, over 2,000 NHS Covid patients were given a course of the drug—a commonly used steroid—over 10 days. For patients who were ill enough to require oxygen, the risk of dying fell by a fifth, and for the most seriously ill patients on mechanical ventilators, the risk of dying fell by over a third.
This is an important moment in the fight against this virus, and the first time that anyone in the world has clinically proven that a drug can improve the survival chances for the most seriously ill coronavirus patients. In February we began the trial, supported by £25 million of government funding, and in March we began recruiting patients, and started the process of building a stockpile in case the trial was successful. As of today, we have 240,000 doses in stock, and on order. That means that treatment is immediately available, and already in use on the NHS. I am incredibly proud that this discovery has happened right here in Britain, through a collaboration between the Government, the NHS, and some of our top scientists. It is not by any means a cure, but it is the best news we have had.
Throughout this crisis, our actions have been guided by the science, and that is what good science looks like: randomised control trials; rigorous and painstaking research; moving at pace, yet getting it right. The result is that we now have objective proof—not anecdotes, but proof—that this drug saves lives, and that knowledge will benefit many thousands of people all around the world.
Seven other drugs are currently being trialled as part of the recovery process, and a further nine drugs are in live clinical trials as part of the ACCORD programme, which is looking at early-stage treatments. We look forward to seeing the results of those trials. I thank everyone involved in that process, and put on the record my thanks to our deputy chief medical officer, Professor Jonathan Van-Tam, who led the work in government, as well as to NHS clinicians, the scientific teams, and the participants in the trial who took the drug before they knew that it worked.
Our immunology research, again, is world leading. Last month I announced a new antibody testing programme to help us understand the immunological response to the disease, and whether someone acquires resistance to coronavirus once they have had it and recovered. I am part of that programme, and as of yesterday, 592,204 people have had an NHS antibody test. The nature of immunity research means that it takes time, and we must wait to see whether someone with antibodies gets reinfected. However, with every test, we improve our picture of where the virus has been, and we grow the evidence to discover whether people who have had the disease and have antibodies are at lower risk of getting or transmitting the virus again.
Crucially, that work will help to inform how we deploy a vaccine, and it is moving at pace. Earlier this week Imperial College began its first phase of human clinical trials, and 300 participants will receive doses of the vaccine. Should they develop a promising response, Imperial will move to a large phase-3 trial later this year. Yesterday, AstraZeneca signed a deal for the manufacture of the Oxford vaccine, AZD-1222, which is the world’s most advanced vaccine under development. Its progress, while never certain, is promising.
None of that happened by accident. It happened because the British Government, scientists and the NHS put in place a large-scale, programmatic, comprehensive, well-funded, systematic, rigorous, science-led system of research and innovation. We have been working on it since the moment we first heard of coronavirus. There is more to do in this national effort, but that is how we will win the battle. We will leave no stone unturned as we search for the tools to hunt down, control and ultimately defeat this dreadful disease.”
To follow on from the question asked in the previous debate by the noble Baroness, Lady Rawlings, in the last week the Secretary of State, when explaining the failure of the NHSX app, said that the Government are committed to trying and supporting any innovation that might work in this pandemic. That attitude is to be applauded, as long as it is not linked to exaggerated promises—and of course it means that some things will not work. It is therefore puzzling that the Government refuse to partner and adapt the Covid Symptom Study app, which might close the gap on the two-thirds of infections not currently being identified and fit into the existing human contact tracing effort. Some 3.5 million of us take 30 seconds a day to report our health; with government support, that could easily and quickly be 10,000,000. The founders from King’s College and ZOE have written to the Prime Minister today. In the spirit of trying everything to find a solution, will the Minister encourage a positive response to that initiative?
My Lords, I pay tribute again to those at KCL who developed the symptom-tracking app. The information from it has been enormously helpful over the last few months. In many ways we have benefited from the app’s independence as a source of important front-line intelligence. I am aware of the letter written to the Prime Minister, and I hope very much that we will be able to work more closely together. The information on asymptomatic references is very important. However, I stress that the ONS study suggests that, unfortunately, many people who declare the symptoms of coronavirus are mis-self-diagnosing, and we have to bear that factor in mind.
Following last week’s Urgent Question, the Secretary of State responded to questions about new outbreaks in local areas and local authorities not being given access to all the necessary data. He said:
“We have provided more data to them, and we will continue to do more.”—[Official Report, Commons, 17/6/20; col. 810.]
I am still hearing from local authorities that the data sent to local areas is still incomplete, which means that vital urgent local tracing teams are trying to do their job with one hand tied behind their back. This includes the outbreak at the meat-processing factory in Kirklees. When will local authorities and directors of public health get the data they need?
The noble Baroness, Lady Brinton, is right that the creation of a seamless network between the centre and local authorities is challenging. A huge amount of work has gone into refining the accuracy and speed of the exchange of data, and the joint biosecurity centre is investing a huge amount of effort in getting this right. The responses to Kirklees, Leicester and Cardiff show the progress that has been made, but also some of the shortcomings. We are fully aware of the challenge and difficulty of getting this right; we are very much focused on it and it is our top priority.
As obesity makes one more likely to suffer with Covid-19, and as more than half of people in the UK are obese, will the Government launch an all-out campaign this summer to reduce obesity by persuading people to put fewer calories into their mouth before the next pandemic arrives to kill even more people? Exercise is good for general health but will reduce weight only in grams, whereas eating puts on weight in kilos.
My noble friend makes a tough but serious set of points. It is undoubtedly true that this country has been hit hard by Covid because of the prevalence of obesity, and it is a truth long explained by Public Health England that there is a direct correlation between calorie intake and weight—there is no getting away from that. The Government are looking at how to address this issue, public health remains a massive priority for us and, when the time is right, we will look at ways of using marketing to communicate the message on this.
My Lords, it is very good news that the trials of dexamethasone have gone successfully and that other trials are progressing well; I hope that the vaccine trials will also yield success. However, can the Minister confirm reports that more than a third of care home patients have not yet been tested? When will all care home patients and staff be tested fully and regularly? Secondly, with the good news coming from the Prime Minister—we hope—of the economy opening up from 4 July, will widespread testing be available for businesses on top of the two-metre social distancing being reduced to one metre?
My Lords, the progress on testing in social care is dramatic. The rollout of testing to all care homes is complete, and tests have been offered to all those who are symptomatic. The focus is very much on staff who travel between more than one home, and asymptomatic testing. As for the economy, all those who show symptoms can have a test, but we are talking to business about how businesses can also contribute to their own testing regimes, and we look forward to developing those plans.
My Lords, knowing who has and who has not had the virus is clearly essential in knowing who should be isolating themselves. The Minister has failed to answer my questions on what proportion of the self-testing kits are being returned, and on the estimated number of false negatives as a result of people not swabbing themselves properly or because of inherent weaknesses in the test itself. However, at the moment, NHS staff are being given antibody tests and many who have palpably had the virus and been exposed to it are showing as negative. What is the department’s working estimate of what proportion of false negatives there will be in those antibody tests?
My Lords, the noble Lord makes an important point. How it is that some people have palpably had the virus, as he rightly says, but do not show a positive antibody test, is a mystery that we do not fully understand. It seems that the tighter—more minimal—the amount of antibody left in the bloodstream, the less likely it is to register in the test. We are undertaking a massive antibody testing programme through the health service to understand this phenomenon more closely, and we look forward to publishing those results as a priority.
My Lords, successfully passing a test does not predict the future. We know that 20% of people who have contracted the virus did so in hospital. So those in certain professions come into daily contact and will require periodic, regular tests. What plans do the Government have to ensure that those in the professions at greatest risk receive a regular test?
My noble friend Lord Pickles is entirely right to say that people in some professions are clearly at higher risk. Bus drivers, taxi drivers and hospital porters are three such professions, and I pay tribute to those who put themselves in harm’s way in order to serve the public. The Prime Minister announced, I think two weeks ago, a special programme to introduce regular, asymptomatic testing to protect people in those professions, and we are working very closely with their representatives to roll out the necessary schemes at pace.
My Lords, in view of the large number of cases that have been confirmed at a meat processing plant in Anglesey and the likely reduction in social distance, will the Government seriously consider extending the mandatory wearing of face masks for people in enclosed spaces, including workplaces, for staff and customers in shops, and certainly for staff in restaurants and pubs?
My Lords, the introduction of face masks is something that has been recommended by the Government, but the mandatory wearing of them is not. We are looking at the various recommendations from SAGE to inform the proposals that might come after the lifting of social distancing, but our focus remains on hygiene, social distancing and isolation. Those are the three most effective measures and we remain committed to them for the moment.