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Covid-19 Update

Volume 812: debated on Tuesday 15 June 2021


The following Statement was made in the House of Commons on Monday 14 June.

“Mr Speaker, these past six months, we have all been involved in a race between the vaccine and the virus. Our vaccination programme has been delivered at incredible pace: we have delivered 71 million doses into 41 million arms; and over 93% of people aged 40 and over have now received at least one dose. Because of this pace, we are able to open up vaccinations to those aged 23 and 24 tomorrow.

It is this protection that has allowed us to take the first three steps of our road map, meaning that right now we have one of the most open economies and societies in Europe. We have been able to remove the most burdensome of the restrictions and restore so many of the freedoms that we hold dear. At every stage, we have looked at the data, set against the four tests that the Prime Minister set out to this House in February. The fourth of those tests is that our assessment of the risk is not fundamentally changed by new variants of concern.

The delta variant now accounts for over 90% of cases across the country. We know that the delta variant spreads more easily and there is evidence that the risk of hospitalisation is higher than for the previously dominant alpha variant. Case numbers are rising, up 64% on last week in England, but the whole purpose of vaccination is to break the link between cases and hospitalisations and deaths. That link is clearly weaker than it once was. However, over the past week, we have seen hospitalisations start to rise; up by 50%. Thankfully, the number of deaths has not risen and remains very low.

Sadly, before the vaccine, we saw that a rise in hospitalisations inevitably led to a rise in deaths a couple of weeks later. The vaccine in changing that, but it is simply too early to know how effectively the link to deaths has been broken. We do know that, after a single dose of the vaccine, the effectiveness is lower against the delta variant, at around 33% reduction in symptomatic disease. However, the good news, confirmed with new data published today, is that two doses of the vaccine are just as effective against hospital admission with the delta variant compared with the alpha variant. In fact, once you have had two doses, the vaccines may be even slightly more effective against hospitalisation if you have caught the new delta variant. This gives me confidence that, while the protection comes more from the second dose, and so takes longer to reach, the protection we will get after that second jab is highly effective—and, if anything, slightly better—against the delta variant. So, for the purpose of the restrictions, while it will take us a little longer to build the full protection we need through the vaccine, all the science is telling us that we will get there. Of course, all this says that it is so important that everyone gets both doses when the call comes. Even today, I have had messages from people who have had their jab, and I am so grateful to each and every person for making our country safer. At every stage of the road map, we have taken the time to check it is safe to take the next step. Our task is to make sure the vaccine can get ahead in the race between the vaccine and the virus.

I know that so many people have been working so hard, making sacrifices, being cautious and careful, and doing their bit to help this country down the road map. I know that people have been planning and arranging important moments and that businesses have been gearing up to reopen. So it is with a heavy heart, and faced with this reality, that we have made the difficult decision not to move ahead with step 4 next week. Instead, we will pause for up to four weeks until 19 July, with a review of the data after two weeks. During this crucial time, we will be drawing on everything we know works when fighting this virus and will use the extra time to deliver the extra protection we need.

Despite the incredible uptake we have seen in this country, there are still people we need to protect: 1.3 million people who are over 50 and 4.5 million over-40s have had a first jab but not yet a second. The pause will save thousands of lives by allowing us to get the majority of these second jabs done before restrictions are eased further. We are today reducing the time from first to second jab for all people aged 40 and over from 12 weeks to eight weeks to accelerate the programme. If, like me, you are in your 40s and you have a second jab booked 12 weeks after your first, the NHS will be in touch to bring it forward, or you can rebook on the national booking service. Our aim is that around two thirds of all adults will have had both doses by 19 July. I can tell the House that we have been able to deliver the vaccine programme faster than planned, so we can bring forward the moment when we will have offered every adult a first dose of the vaccine to 19 July, too. In this race between the vaccine and the virus, we are giving the vaccine all the support we can.

We have always said that we will ease restrictions as soon as we are able safely to do so. Even though we cannot take step 4 on Monday, I am pleased that we are able carefully to ease restrictions in some areas. We are removing the 30-person gathering limit for weddings, receptions and commemorative events—subject, of course, to social distancing guidelines. I am very grateful for the work of the weddings task force on this relaxation. We will be running another phase of our pilots for large events at higher capacities, including some at full capacity, like the Wimbledon finals. We are easing rules in care homes, including removing the requirement for residents to isolate for 14 days after visits out, and we are allowing out-of-school settings to organise residential visits in bubbles of up to 30 children, in line with the current position for schools. I thank my honourable friend the Member for Altrincham and Sale West (Sir Graham Brady) for his work in this area.

Even though we have not been able to take the full step as we wanted, I know that these cautious changes will mean a lot to many people and move us a little bit closer to normal life. As we do this, we will keep giving people the support they need. We are extending our asymptomatic testing offer until the end of July. We have put in place one of the most extensive financial support packages in the world, and we will continue to deliver enhanced support for the worst-affected areas.

We have seen how this approach can work—for example, in Bolton. Cases in Bolton have fallen by almost a third over the past three weeks. Even as hospitalisations have risen across the north-west, in Bolton, they have fallen by more than half. Last week, we introduced enhanced support in Greater Manchester and Lancashire, and I can now tell the House that we are extending these extra measures—surge testing, cautious guidance and extra resources for vaccination—to Birmingham, Blackpool, Cheshire, including Warrington, and the Liverpool city region. We know from experience that this approach can work, but we need everyone to play their part, so I urge everyone in these areas to get tested and to come forward for the support that is on offer. When you get the call, get the jab and help keep us on the road to recovery.

Finally, none of this would be possible without our vaccine programme. Without the vaccine, faced with these rising cases and hospitalisations, the clinical recommendation would have been to go back towards lockdown. The Vaccine Taskforce is critical to the work to deliver supplies, the work on booster jabs and ensuring we are protected for the future. Dame Kate Bingham did a formidable job in melding the best possible team, and I would like to congratulate her and everyone else who was recognised in Her Majesty’s birthday honours this weekend. I am delighted to be able to tell the House that Sir Richard Sykes, one of Britain’s most acknowledged biochemists and industry leaders, has agreed to take up the position of chair of the VTF. Sir Richard brings to bear experience from leadership positions in both the public and the private sectors, and I am delighted to have him on board to lead the team in the next stage of this mission.

This race between the vaccines and the virus is not over yet. These difficult restrictions challenge our lives in so many ways, but they play a vital role in holding the virus back and protecting people while we get these jabs done. So let us all play our part to keep us safe from this dreadful disease. I commend this Statement to the House.”

I thank the Minister for this Statement. These Benches agree with Mr Speaker; in the statement he made prior to the Secretary of State’s Statement last night, he expressed a deep frustration on behalf of all parliamentarians about the Government’s conduct. The announcement yesterday was both predictable and, sadly, predicted. I sigh, because the Prime Minister is now referring to 19 July as “terminus” day instead of freedom day, which has probably brought eye-rolls everywhere. When will the Prime Minister learn that caution and the use of data means also being cautious about how you express these matters?

The Minister will know that on these Benches we support the Government’s decision to delay the move to the next stage of the road map, but do so with a deep sense of anger, if not despair, that this should be necessary. Since the delta variant of coronavirus, first discovered in India, was detected in the UK in April, cases have surged across the country, with the variant now making up 96% of new infections. Experts confirmed last week that the variant is 60% more transmissible than the alpha variant, first discovered in Kent in 2020. Scientists at the Wellcome Sanger Institute have used genomic sequencing to produce maps which show how rapidly the delta variant has taken over in England, and I commend them to noble Lords. They are alarming in that they show the rapid spread to almost the whole country by the end of last week. It is doubling week by week—still with small numbers now, but that will change if this doubling continues.

There were warnings of a new variant in India on 25 March. It is reported that Ministers first learned that the delta variant was in the UK on 1 April. I must ask the Minister: is that true? The Government red-listed Pakistan and Bangladesh on 9 April, but did not red- list India until 23 April, by which point 20,000 people had arrived from India. As my right honourable friend Jon Ashworth said yesterday in the Commons,

“Our borders were as secure as a sieve, and all because the Prime Minister wanted a photo call with Prime Minister Modi.”—[Official Report, Commons, 14/6/21; col. 77.]

On 20 April I said to the Minister:

“With regard to protecting our borders, this week Hong Kong identified 47 Covid cases on a single flight from Delhi.”

We were closing our borders on 23 April, and I asked him:

“there will be hundreds of people arriving on flights from India. Is this not very risky?”—[Official Report, 20/4/21; col. 1769.]

I now return to that question. How many people arrived from India carrying the virus during the period from when the Government were aware of the variant at the beginning of April to 23 April, when India joined Pakistan and Bangladesh?

It is unforgiveable that Ministers have consistently promised to take control of our borders and conspicuously failed to do so, particularly at the very moment when it mattered most: when we were succeeding in the vaccination rollout and the gradual loosening up. The Prime Minister not only opened the back door to this variant; he failed to take measures to suppress it when he could.

There has been growing prevalence of this variant among school-age children, yet mandatory mask-wearing has been abandoned in secondary schools. I have raised this with the Minister at least once before. He has to explain why this has happened, despite being repeatedly asked in both Houses. We also know that isolation is key to breaking transmission yet, 16 months on, people are still not paid adequate financial compensation to isolate themselves. When asked about this at the Select Committee last week, the Secretary of State claimed that people would game the system. Does the Minister believe that this is true? After all the sacrifices and rule-following of the public, does the Minister have the same low opinion of our fellow citizens as his boss?

Yesterday, the Prime Minister and the Secretary of State supported extending restrictions by pointing to plans to go further on vaccination. But even after extending the doses as outlined in the Statement, large proportions of the population will still be left unprotected —having had one dose or none—and exposed to a variant that, if left unchecked, will accelerate and double every week. That would mean more hospitalisations, more long Covid, more disruption to schools and more opportunities for variants to emerge. What will happen under these circumstances? Will the Prime Minister still lift the restrictions?

My reading of this announcement and the terms in which is it couched is that the science points to us being in a very dangerous position. We could lose the battle that is going on between the vaccine and the virus. Will there be vaccine surges to counter this in areas where the virus is most prevalent? What is the plan to bring down infections and extend vaccination rates in hotspot areas? We have learned that in some places—Leicester, Chorley, Tameside, Salford and Wigan —the dose numbers have gone down. Has vaccination surging been abandoned in those hotspot areas? Will the Government bring forward accelerated second doses, and how are they working further to overcome vaccine hesitancy?

The Chief Medical Officer said last night that we would be lifting restrictions were it not for the delta variant. The Prime Minister should have moved at lightning speed to prevent the delta variant reaching our shores. Instead he dithered, and today he is responsible.

My Lords, we on these Benches echo the support of the noble Baroness, Lady Thornton, for the Commons Speaker’s statement yesterday on the Government’s continued abuse of Parliament.

We repeatedly warned the Government that sending out mixed messages about lifting restrictions on 21 June would cause problems. Even in March, the Prime Minister made it evident that he wanted us out of restrictions “irreversibly”—his word—by next Monday. What is worse is that we are now in a fourth Covid wave because of his desire to visit President Modi in India in mid-April. The resultant dangerous dithering about putting India on the red list contrasted sharply with the TV news. Every evening, we saw that the then delta variant was scything through India. Even then, Indian epidemiologists were talking about a much faster transmission. We on these Benches have repeatedly asked why India was not added to the red list on 2 April.

At yesterday’s press conference we were warned that the current delta variant wave will likely peak in mid-July, as cases, hospital admissions and patients needing ICU increase steadily. Even if vaccines mean that hospitals are not being overwhelmed, there is an increase. The UK now faces continuing restrictions entirely because of the Prime Minister’s delay.

The academic paper Estimating the Failure Risk of Hotel-based Quarantine for Preventing COVID-19 Outbreaks in Australia and New Zealand, published in February this year, calculated the risks and likely seeding of variants in the light of infection control and surveillance used locally. It now provides an essential baseline to assess seeding of cases coming from abroad. Devan Sinha of Oxford University and other UK scientists have used this to look at the seeding of the delta variant in the UK. He noted that 96% of the seeding of the delta variant occurred after 2 April—that is, after Pakistan and Bangladesh were added to the red list but India was not. He estimates that putting India on the red list on 2 April would have delayed the current wave by a further four to seven weeks. That four to seven weeks would have meant that all over-40s had had access to a second dose and, at seven weeks, most over-30s. He said that the wave would have been

“much smaller and mostly neutered”.

What have the Government learned from this delay? Why did it take so long for the delta variant to be moved from a variant of interest to a variant of concern? Despite MPs, Peers and scientists all asking in early April, Matt Hancock told the Commons that it would be listed as a variant of concern on 20 April. In fact, it was not listed until 7 May. Even worse, surge testing did not start until May either. If it was serious enough for India to be added to the red list by 23 May, why was it made a variant of concern only on 7 May? Was the delay with PHE or with Ministers?

The necessary continuation of restrictions at the current level means that a number of support schemes are now out of kilter with the restriction levels. These include lifting the embargo on evictions, the reduction in furlough support while people are still being asked to work from home if possible, and other business support mechanisms. Please can the Minister say whether they will be extended until we know that we are lifting restrictions completely? When, oh when, will any of these Statements or communications make it clear to the clinically extremely vulnerable and their families and friends what they are expected to do?

The Statement lists the areas where restrictions are to be lifted, many of which will be welcome, especially the 30-person limit on attending weddings, receptions and commemorative events, and out-of-school residential visits in bubbles of up to 30. But I ask again about mask wearing in schools, given the continuing increase in delta variant cases among children. Will there be specific guidance for these events, including lateral flow testing before and after, so that any outbreaks at a wedding could be tracked and managed? What level of new Covid cases per day would change the pilots on large events with higher capacities, especially the ones planned at full capacity?

It is good to see the removal of enforced quarantine for care home residents after trips out of homes. I never did understand that one, given that staff and visitors did not have to self-isolate.

It was good to hear the emphasis in the statement from Professor Whitty and Sir Patrick Valance on the importance of the second dose. I repeat my regular plea that all Ministers use this as a reference point. Far too many only ever use the number of people having had the first dose. With the delta variant, it is even clearer now that two doses are essential.

Why on earth did the Prime Minister say yesterday that 19 July is definitely the terminal day for restrictions? We all hope that he is right, but if he and Ministers are led by data, how can he say that?

Finally, the Statement refers to surge testing in areas where the variant is also surging, but maps show such a steady rise in cases across the country. Can the Minister confirm that there are enough test, trace and isolate staff to manage effectively this fourth wave of Covid?

As ever, I am also grateful to my own Benches for their support in these difficult times.

This Statement from the House of Commons has been reflected on very thoughtfully and accurately, as shown by some of the questions. I remind noble Lords that the rollout of the vaccine is happening at pace, but it deserves to have a breath and the space to be seen through, all the way, before we make categoric steps towards opening up. I emphasise in reply to these questions that the supply of the vaccine has stepped up. Pfizer’s forecasted supply in June will be 30% more than in May; in July, it will be 80% more than in June; and we hope to have that sustained level in August. By the week commencing 19 July, we will have offered all adults a first dose, as well as a second dose to those aged over 40 who have had their first dose by mid-May.

This rollout will be absolutely transformative. It will mean that we overtake an important inflection point: the numbers of those who have had their second dose, and who are therefore, as statistics show more and more clearly, highly resistant to this virus, and certainly to severe disease and death. This variant is undoubtedly much more transmissible, by between 50% and 80%. It is therefore completely proportionate and reasonable that we take this moment to delay step 4 and give the vaccine rollout the space that it needs.

I will build on the point from the noble Baroness, Lady Thornton, about the work done by the Sanger Institute on genomic sequencing. It is only because of enormous investment, and the skills and expertise of those in genomic sequencing in the UK, that we understand as much as we do about the variant. In her comments on India, the noble Baroness, Lady Brinton, spoke about the process of analysing VOIs and VOCs. She is entirely right to allude to the fact that this is an extremely complicated matter. This analysis is down to the scientific judgment of those who have a copy of the variant. It took a very long time to get a physical copy of the variant from India, or even to have a digital sequence of it. That is why these things can take some time.

This demonstrates why we need to tidy up and invest in international systems for surveillance. An enormous amount of energy went into the G7, and I can report to noble Lords that, during the health track, we made great progress in the pandemic preparedness work stream in setting up an international scheme for exactly this kind of surveillance. It is imperative that we know what is happening in communities all the way around the world, because we are all touched by the mutations of this virus, wherever they happen. We continue to invest in the national variant assessment platform, which is our offer to the world to genomically sequence any variant sent to the Sanger, so that we can share that data with countries around the world.

We have also invested enormously in the control of our borders. Through both its red list and its amber list, the managed quarantine service has done an enormous amount to stop the transmission of new variants into this country. I pay a huge amount of tribute to Border Force and those in MQS, who have done a terrific job of bringing in this completely new infrastructure and this service that has done a huge amount to keep out variants—including the Manaus variant, the South Africa variant and others—through the red-listing process.

The noble Baroness, Lady Thornton, asked about school-age children and mask wearing. It is important that we keep a balance. Even though the infection rate is creeping up among school-age children, we need to protect the life they have in schools. In areas of enhanced response, the wearing of masks is now a recommended option for those who seek to take it up. That is a proportionate response in areas of rising infection. But across the estate, we think it is proportionate to step away from that at the moment.

On isolation payments, I can share with the noble Baroness that we are putting £2 million of funding into an agreed pilot across the Greater Manchester area, testing ways to encourage people to comply with self-isolation rules. The pilot will include support and engagement teams who will work with households within 24 hours of a positive test. The pilot is expected to reach 13,000 people over 12 weeks, and I am hopeful that it will guide the way forward in this area.

The vaccination surge is absolutely working. We saw a dramatic change in the vaccination uptake among the community in Bolton in particular. That is one area of Britain where the infection rate is coming down, which demonstrates the effectiveness of both the vaccination surge and the testing surge. We are now focused very much on accelerating second doses, particularly for over-40s. Millions of over-40s have had their first dose; some have an appointment for their second dose and some do not. It is very much the focus of our efforts to ensure that we get those people over the line and finish the job, to protect them and the ones they love.

This is an important development in our steps programme. It is frustrating, but there is an enormous amount to be optimistic about and it is in that spirit that we have made this decision.

We now come to the 30 minutes allocated for Back-Bench questions. I ask that questions and answers be brief so that I can call the maximum number of speakers.

My Lords, what is the point of this Statement? It was briefed to the newspapers over the weekend and the contents were given to members of the press for scrutiny. So Laura Kuenssberg has done the job and there seems to be little for us to do—which may account for the grumpiness I see around the Chamber. Has my noble friend seen the excellent report of the Constitution Committee of this House published on 10 June, entitled COVID-19 and the Use and Scrutiny of Emergency Powers? It is damning of the Government’s use of secondary legislation without proper consultation—of which today we have yet another example. Will the Government mend their ways and accept the recommendations in this excellent report?

My Lords, I absolutely pay tribute to the Constitution Committee. It was generous enough to have me appear in front of it, and I gave several hours of evidence. I am glad to see that my noble friend read the report; I hope he enjoyed my evidence in it as well. In that evidence I made it absolutely crystal clear that the Government work with the laws at our disposal; that is what we have to hand. There may be a time when Parliament chooses to review those laws. Now is not the time, but when it is we will do it.

My Lords, is the Minister aware that many people would like to know whether, having had two vaccinations, they have antibodies? Is this possible? Also, there has been a shortage of the Pfizer vaccine. How can this be increased worldwide?

My Lords, I agree with the noble Baroness that many are curious about whether they have antibodies, but I warn her that the presence of antibodies does not necessarily correlate with immunity. Some people have strong immunity and no antibodies, and some have antibodies but not immunity. This is one of the mysteries of the body’s response to the disease and one of the reasons why it has been such a confounding disease to fight. But if anyone does want an antibody test, they should ask their GP and it can be arranged.

My Lords, very bluntly, we are facing this unpalatable Statement today because of the Prime Minister’s inability to take decisions. The Government learned of the arrival of the Indian variant as early as 25 March, yet took no action for 30 days, allowing 20,000 people to enter the UK. The result is that they put the public’s health at risk. As a consequence, we now face a further four weeks of restrictions, with accompanying hardships. Have the Government learned their lesson?

My Lords, I am not sure whether I accept the characterisation presented by the noble Lord. We have worked incredibly hard to bring in a managed quarantine system that is a novel, new introduction into the UK. We have done extremely well in fighting off many of the variants that have come to our shores, including the Manaus variant, the South African variant and others. We have strong links with Pakistan, India and Bangladesh, which means there is a lot of traffic between our countries. I am not sure whether it would ever have been possible to prevent this variant making landfall in the UK at some point. But we have done an enormous amount in the UK to delay and prevent the arrival of these variants, and for that I am enormously grateful to those involved.

My Lords, following the data is the Government’s mantra. Using the Government’s own test and trace data, for the two weeks prior to Bangladesh going on the red list it had a positivity rate of 3.7%; India’s was 5.1%. Of all variants entering the UK, including the delta variant, more than 50% of cases came from India and fewer than 5% from Bangladesh. So if the Government were following the data on 2 April, why was Bangladesh put on the red list and not India?

The noble Lord is enjoying the benefit of hindsight very much indeed; we can all use the retrospectoscope. The data he refers to was not available to us at the time. We did not know that the variant now known as India 2 was a variant of concern. We did not know that it was going to be the most transmissible one. There were three variants in India; we did not know at that point which of them would present the most problems. It is extremely easy to sit here, look back and say that one person should have done this and another should have done that. I ask the noble Lord to try to sit in the seat of those who made the decisions at the time.

My Lords, regardless of matters of hindsight, does the Minister agree that prolonging the restrictions might be justified for certain reasons? I do not demur from that, but the prolonging of inconsistencies is a serious impediment to public adherence to the rules. You do not have to look very far to see where the discipline broke down a long time ago. For example—this is not special pleading; it is just at the forefront of my mind—you can sing in a pub but not in a church. This is what brings the rules into disrepute, and therefore people do not agree with them.

Secondly, can the Minister say something in response to Michael Gove’s reported comments about acceptable death rates? We have learned to live with acceptable death rates from flu and other seasonal diseases. Will the Government do some work on what might be an acceptable death rate from Covid in future and be up-front with the country as to what that might be? I think we can take it.

I hear loud and clear the frustration of many noble Lords on the question of singing in churches; it is enormously frustrating to those who have a passion for singing. But I would be pretending to be other than I am if I did not level with the right reverend Prelate and say that this is an airborne, aerosol disease. It is breathed into buildings at huge risk to those inside, and there is a direct correlation between infection rates, that aerosol and that kind of singing. The decision has been made with huge regret and not without a huge amount of scientific analysis, and those who have made their case have been heard loud and clear—but we have to fight this virus and prevent people getting sick.

I do not accept the right reverend Prelate’s view that discipline has broken down. Quite the opposite: I am astounded by the British public and their adherence to voluntary guidelines and arrangements. I pay tribute to the British public, and I do not think that the right reverend Prelate does any favours when he suggests that discipline has broken down.

Lastly, I really do not accept the concept of an acceptable death rate. That is not how we play the health system in this country. We are here to save lives; that is our priority. There is a balance between the economy, freedom and lives, but as a Health Minister my starting point is to save lives.

My Lords, it is great to see the data on the efficacy of vaccines against the delta variant, but we know that that might not always be the case in the future. The announcement from the Prime Minister that we will share 100 million of our excess vaccines is a welcome first step, but the G7 failed to achieve its 1 billion target, let alone the 11 billion that the WHO says is needed. Does my noble friend the Minister agree that variants present one of the greatest threats to the unlockdown here in the UK and that the pandemic is not over here unless it is over everywhere? What are the next steps to ensure that low-income countries are vaccinated as soon as possible? Given the success of our vaccine programme, will the UK take a leadership role in this, as we continue our G7 presidency?

Yes, I entirely agree with my noble friend on this matter: we are of course only safe when we are all safe. As chair of the G7, we have done an enormous amount to try to show leadership in this area. The G7 committed to share at least 870 million doses directly over the next year and to make these doses available as soon as possible. But the numbers involved are absolutely enormous: 870 million is an astonishing figure, but it is not near to the 8 billion that we ultimately need. At the end of the day, we need manufacturing in all the regions of the world. That is why, as the supporter of the AstraZeneca vaccine, which is made on a profit-free basis and on extremely generous terms to manufacturers of the world, Britain has given an enormous benefit to the world. I very much hope that the manufacturing can ramp up to meet that need.

My Lords, I welcome the small but vitally important concession to care home residents in the Statement. However, the Prime Minister has left in place the cruel and unnecessary controls over care home visits. Even visitors who have had two vaccinations and a negative test before visiting must wear PPE and maintain social distancing—no hugging, for example. This is inhuman, particularly for people with dementia, and the risk must be close to zero. Will the Minister plead for immediate changes to those really unnecessary rules? They are well overdue.

The noble Baroness makes the case extremely well, and I agree with her sentiment that the rules are extremely tough. I have heard loud and clear the many noble Lords who have made this case, and we look at it very carefully and thoroughly. At the beginning of the pandemic, one of the most alarming images—and one that has always stuck in my mind—was that of care homes in Spain in Italy, where so many of the residents had died. What we know for sure is that, even with the vaccine, the virus can spread through a care home at great pace—typically half of residents will be infected the moment the virus arrives in a care home. Even with the vaccine, we still have to step carefully, and that is why these measures are still in place. I very much hope that they will be lifted, and I will celebrate that along with all noble Lords who have made this case to me in the past.

My Lords, following the comments of the noble Baroness, Lady Sugg, when Gordon Brown called the G7 summit an “unforgivable moral failure”, was he not right? With potentially billions to vaccinate, the West has miserably abandoned the moral high ground on vaccine supply, leaving it to the Chinese and Russians to win new friends and secure influence worldwide. Has not Prime Minister Johnson, with his short-sighted, unimaginative approach, damaged our credibility across the world? We should have been a major worldwide vaccine distributor-producer; we failed, and we failed miserably.

No, I am afraid the noble Lord completely overstates the case; I do not accept the characterisation he has made at all. The challenge is enormous, and he is right to feel that this is one of the most important tasks for humanity in the round—I cannot emphasise that enough. But the practicalities are that, in Britain, we make hardly any vaccine at all. It is not for us as a nation to manufacture the vaccine. Where we have contributed is, first, through the science—particularly the AstraZeneca vaccine—and, secondly, through global leadership. The Prime Minister, through the G7, has sought to use that post as much as he can, in order to promote the vaccine. I do not accept that China and Russia have in any way contributed anything like the West has done; the numbers simply do not support that. We are working extremely closely with the regions of the world—with Africa, South America and beyond—in order to set up the kind of manufacturing that those countries need to provide their people with the safety from the virus that they deserve.

My Lords, urgent decisions on Covid restrictions are needed elsewhere in the United Kingdom as well. Does the Government accept, however, that decisions that are for a devolved Government to make must be that devolved Government’s responsibility, and their responsibility alone? For Westminster to impose its will on the Assembly on devolved matters would be totally unacceptable and would lead inevitably and inexorably to a collapse of confidence in devolved institutions.

I am enormously grateful to all the devolved authorities for the work that they have done with the vaccine and in healthcare. Generally, it has been a very close collaboration, and one that I hope continues.

My Lords, in early April, when the Government put Pakistan, along with Kenya and the Philippines, on the red list, they gave us reasons which many people believe did not add up—but I am not going to argue with that. What we did not know, and still do not know, are the criteria for those countries to be taken out of the red list, as there are millions of people affected by that. In April, in Pakistan, new cases were running at over 6,000 a day. That has now been reduced to just over 1,000 a day. Pakistan has made a huge improvement in reducing the number of Covid cases. Will the Minister tell the 1.4 million British people of Pakistani origin living in this country when the Government plan to take Pakistan off the red list, and what are the criteria?

The noble Lord is entirely right to ask about the route out. That is exactly what we hope to be thinking about very soon. The criteria will include how much vaccination we have here in the UK and the efficacy of that vaccine against all the variants present in the world. They will also include the presence of variants in the other countries; there is a stepped process for analysing that. Lastly, they will include the infection rates in those countries. We hope to be able to take concrete steps on that shortly. The treaties necessary to have mutual vaccine recognition are being discussed at a high level as we speak.

My Lords, my noble friend will not be surprised if I ask him whether he can guarantee that, by 19 July, all care home workers will have been vaccinated. But could he also answer this question? Why is he allowed to go down to his local pub and sing “Roll Out the Barrel” but he cannot go into his local church and sing “Guide Me, O Thou Great Redeemer”?

I completely accept the challenge. These anomalies exist and he is entirely right to beat up the Minister for this kind of stuff. It is unbelievably difficult to write guidelines that touch so many different parts of life, and I would not pretend for a moment that there is 100% consistency in everything that is done. But I have made the point emphatically: these things are done to save lives and protect people from infection. They are done with a heavy heart, having looked at the scientific evidence, with a sense of regret that we are letting down those with a passion for singing and religious worship, and in the hope that we can get rid of them very soon. We are taking concrete steps as quickly as we can to deliver the vaccines. In terms of care homes, as he knows, there is a consultation in process and that consultation is working its way through.

The Prime Minister rightly says that we have to learn to live with Covid. Therefore, does the Minister agree that, while vaccinations provide protection and effective test and trace is essential, it will continue to be necessary to take sensible precautions for self-protection if we have to learn to live with this virus and its variants? Does he also agree that there is a need for continuous public education and clear, consistent guidance to explain why these precautions are necessary? If so, apart from the effective rollout of vaccinations and test and trace, what plans do the Government have in the longer run for promoting a public education health programme?

I am enormously grateful for the question from the noble Baroness. She gives me an opportunity to lift my head for a moment and think about a brighter future, because she is entirely right. One of the possible benefits from this awful virus is a different approach to public health that is much more effective in fighting contagious diseases, where we have much more effective tests for everything from flu to RSV to things like Covid as well, and where we can get therapeutic drugs to people the moment they test positive so that they do not fall sick. We can use this investment in public health to help level up some of the health inequalities that have beset this country so heavily.

My Lords, is there not a problem in looking for a different approach in the future? The precedent set by the Government’s attitude to Parliament fills one with a great deal of concern about the way our parliamentary democracy is going to work. Can he simply tell me why the Prime Minister did not make a Statement to the Commons last night?

My Lords, the Secretary of State was there. I thought he presented the steps regulations extremely clearly and did a great job.

Can I ask the Minister what we have learned from the treating of this pandemic to help us face the future? We have learned very clearly how much countries depend upon one another. Our first vaccines came from Belgium. Can we make sure we do not build walls, but build bridges, as we look forward to the future?

My Lords, I am extremely touched by the noble Lord’s words, and I completely endorse his meaning. It was awful last year when we saw multilateralism and global co-operation fracture and decay. We had to look to our friends and resources within our own borders to answer the pandemic. That did not work and will not work. The noble Lord is absolutely right. From a pragmatic point of view, we depend upon global supply chains for the benefit of global science. From a personal and human point of view, we depend upon the solidarity of humankind to get us through these awful moments. I completely endorse the noble Lord’s point.

My Lords, I commend my noble friend for all his work helping fight this dreadful pandemic; I know his dedication is second to none. I hope he will forgive me for asking: what is the endgame? He has said today that we must prevent people getting sick, but that seems to mean just getting sick with one illness: Covid. What about the suicides, heart attacks and cancers that are being missed because of lockdown? Covid is responsible for less than 1% of deaths right now. Can we not trust the British people to be sensible and choose the risks they are willing to take, along the lines the noble Baroness, Lady Meacher, said, using the example of the Government banning hugging for care home residents? I find this intrusion in our private everyday lives deeply frightening.

My Lords, I absolutely forgive my noble friend because that is an extremely sensible question. I take it on board completely. The endgame is to end a contagious disease that has exponential growth. As she knows, R is currently between 1.2 and 1.4. If it goes unchecked, this disease will spread pretty much through the whole population. The vaccine is excellent at keeping people out of hospital, but not everyone. It is excellent at preventing deaths, but not for everyone. It is good at stopping the disease, but only half of the disease. We must get enough vaccine out there so that the disease will not run through the entire population and lead to the deaths of thousands, tens of thousands, or more. That is the endgame of this project.

My Lords, will the Minister confirm that the Covid cases reported daily in the media are not clinical cases? They are not sick people but positive results of the PCR test. Given that the PCR test is incredibly sensitive and can detect tiny numbers of virus particles, what proportion of positive tests is likely to develop clinical disease?

My Lords, the PCR test is very sensitive. Most people who take the test are presenting a symptom, so a very high proportion of those positives are people who have the disease when they take it. Of course, there are many who have the disease and do not take a test at all, so there is more disease in the population than accounted for in the positive tests. There is a very small proportion of people who might have shreds of the virus from a previous infection who then test positive, but it is thought that that proportion is very small.

My Lords, yesterday the Prime Minister said that this extension of restrictions will

“save many thousands of lives”

and he was backed up by the Health Secretary. Since 18 May, the weekly average number of deaths per day from Covid has been in single figures—almost all of whom will have had underlying health conditions—while each day about 450 people die from cancer. Will the Government publish, or will my noble friend give Parliament the opportunity to see, the evidence and research behind the “many thousands of lives” saved?

My Lords, I completely understand the point. There is a lag to the deaths. At the moment, we are seeing the infection rate go up, which is leading to a small increase in hospitalisations. As my noble friend quite rightly points out, that increase has not been seen in deaths yet, and thank goodness for that. We do not know for sure what proportion of infections will lead to severe disease or death. We know it is a percentage; we do not know exactly what percentage. But should the disease spread through millions in the population, which is entirely possible without the NPIs we have in place, then the number of deaths will be very significant—possibly as many as we have seen already.

I do not think the Minister should dismiss so lightly the questions about inconsistencies in the regulations. This really does get home to whether the public are going to believe in and carry out those regulations. Can I give him one example? Wimbledon is going to be full to capacity with singing, clapping and cheering—yes, outside—but how on earth then can weddings and outside receptions not be allowed to sing, cheer and do all the things that happen at weddings? These inconsistencies do not make common sense. The Minister needs to understand that.

I hope that the noble Baroness will accept my apology if I have in any way suggested that I am flippant about inconsistency—I am not. What I have in my mind is the huge amount of work that is done by policy officials in order to try to be as consistent as possible. I pay tribute to the colossal human effort that goes into trying to make sure that everything we do is aligned. It is a monumental and very difficult task.

The noble Baroness is right to say that Wimbledon is a big event pilot, quite different in its ambition and its tone to some of the other events—for instance, the care homes that the noble Baroness, Lady Meacher, referred to. What we are trying to do is to take fairy footsteps out of the pandemic. Wimbledon, for instance, will account for many hundreds of thousands of tests as we use very rigorous testing procedures to try to protect the rate of infection in that big event. If it is successful, it will help us lead our way out of this horrible arrangement.

At a personal level, I feel very sorry for the Minister. He must realise that there are considerable doubts across both Houses about the Prime Minister’s sincerity and truthfulness. Have we been told the whole truth and nothing but the truth about the delay over dealing with India?

My Lords, in this pandemic, as always, the difficult judgment that has to be made is between lives and livelihoods. Decisions have been taken to protect lives by retaining the existing measures for a further month. The Minister will no doubt appreciate that I and other noble Lords have been extensively lobbied by musicians, independent workers in the hospitality and entertainment sectors, who have fallen through the cracks with no support. Does he not agree that it is reasonable to argue that an equitable balance now would be to provide targeted financial support to those self-employed and freelance workers who have not had a fair deal throughout this crisis?

My Lords, having worked in the music industry for 15 years, I absolutely identify with the challenge he describes. However, I remind him that we have been emphatically forthcoming in trying to support workers through this difficult pandemic. We have provided £70 billion for the furlough scheme and £33 billion for the self-employment income support scheme, which would touch many of the musicians to whom he refers. We have stepped forward financially in a very big way and will continue to do so until the end of this awful situation.

The Minister has said several times that there are grounds for optimism. Does he not realise that this delay has caused despair? The Minister urged opponents to sit in the seats of decision-makers. Can I urge him to sit in the seats of the trashed events industry today and those likely to lose their jobs in hospitality, sport, theatre and so on? I appreciate that many people and the public remain nervous of living with the virus, despite the wonders of the vaccine. However, is it not the job of the Government to lead with courage, to reassure people not to be unduly frightened or succumb to fatalism, and to protect the unquantifiable non-Covid-related social fabric of society, which they are tearing up?

My Lords, I sympathise with those in the events and hospitality industry. As I said a moment ago, it is an industry I have a huge affection for. I worked in it for many years and I know through my friends and family who work in it how hard hit it has been, in particular for those who work on a casual basis and enjoy it from an aesthetic point of view as well as needing work of a casual nature. But these decisions are tough and hard. It would have been easier, perhaps, to have given ground in areas where we have been pressed and lobbied, but we have, where necessary, made the tough decisions based on the science and the advice that we have from clinicians in order to protect both life and the economy. At the end of the day, we do not have an economy if we have a pandemic running through our society. We do not have trust and we do not have people going out and about and enjoying normal lives if there is disease. That is one important reason why we have backed the decisions we have made.

Sitting suspended.