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Covid-19 Update

Volume 813: debated on Tuesday 6 July 2021


The following Statement was made in the House of Commons on Monday 5 July.

“Thank you, Mr Speaker, and I am extremely grateful to you for accommodating the timing of this Statement.

I would like to update the House on the pandemic and our road map to freedom. This morning, I joined some of the remarkable people who have been at the heart of the pandemic response at a service to mark the NHS’s 73th birthday at St Paul’s Cathedral. Together, we reflected on a year like no other for the NHS and for our country. I know that honourable Members on both sides of the House will join me in celebrating the decision by Her Majesty the Queen to award the NHS the George Cross. I can think of no more fitting tribute to the NHS. I know that everyone in this House—indeed, everyone in this country—will celebrate that award.

There is no greater demonstration of our high regard for the NHS than the manner in which we all stepped up to protect it. Now, it is thanks to the NHS and many others that we are vaccinating our way out of this pandemic and out of these restrictions. Eighty-six per cent of UK adults have had at least one jab, and 64% have had two. We are reinforcing our vaccine wall of defence further still. I can tell the House that we are reducing the dose interval for under-40s from 12 weeks to eight, which will mean that every adult should have had the chance to be double-jabbed by mid-September.

And those vaccines are working. The latest data from the Office for National Statistics shows that eight in 10 adults have the Covid-19 antibodies that are so important in helping our bodies to fight this disease. When we look at people aged over 50—the people who got the jab earlier in the programme—that figure rises to more than nine in 10. Allow me to set out why all this is so important.

Before we started putting jabs into arms, whenever we saw a rise in cases, it would inevitably be followed by a rise in hospitalisations and, tragically, a rise in deaths. Yet today, even though cases are heading upwards, in line with what we expected, hospitalisations are increasing at a much lower rate and deaths are at just 1% of the figure that we saw at the peak. Our vaccines are building a wall of protection against hospitalisation. And, jab by jab, brick by brick, that wall is getting higher.

For those people who sadly do find themselves having to go to hospital, we have better treatments than ever before. Last week on my visit to St Thomas’ Hospital, clinicians were telling me just how transformative dexamethasone has been in their effort to save lives. Taken together, the link between cases, hospitalisations and deaths is being severely weakened. That means that we can start to learn to live with Covid.

As we do that, it is important that we are straight with the British people. Cases of Covid-19 are rising and will continue to rise significantly. We can reasonably expect that, by 19 July, the number of daily cases will be far higher than today. Against this backdrop, many people will be understandably cautious about easing restrictions. After many months of uncertainty, that is entirely natural. But we can now protect the NHS without having to go to the extraordinary lengths that we have had to in the past. That is not to say that this is going to be easy.

Of course, the pandemic is not over. The virus is still with us; it has not gone away. The risk of a dangerous new variant that evades vaccines remains real. We know that, with Covid-19, the situation can change and it can change quickly, but we cannot put our lives on hold for ever. My responsibility as Secretary of State for Health and Social Care includes helping us to turn and face the other challenges that we know we must also address, from mental health to social care to the challenges of long Covid. I am also determined to get to work on busting the backlog—the backlog that has been caused by this pandemic and which we know will get a lot worse before it gets better.

As I set out to the House last week, I remain confident that we can move to step 4 in England on 19 July and that the Government will make their final decision on this on 12 July, so today I wish to set out further details of what step 4 will look like. In essence, our national response to Covid will change from one of rules and regulations to one of guidance and good sense. We will revoke all social distancing guidance, including the 2 metre rule, except for in specific settings such as ports of entry and medical settings, where of course it would continue to make sense.

It will no longer be a legal requirement to wear face coverings in any setting, including public transport, although we will advise this as a voluntary measure for crowded and enclosed spaces. It will no longer be necessary to work from home. There will be no limits on the number of people we can meet. There will no limits on the number of people who can attend life events such as weddings and funerals, and there will be no restrictions on communal worship or singing.

We will remove legal requirements on how businesses operate. Capacity caps will all be lifted and there will no longer be any requirement to offer table service. All businesses that were forced to close their doors will be able to open them once again. And we will lift the cap on named care home visitors so that families can come together in the ways they choose to do so. Ministers will provide further Statements this week on self-isolation for fully vaccinated people, including for international travel, and on restrictions in education settings, including the removal of bubbles and contact isolation in schools.

Today, I can also confirm to the House that we have completed our review of certification. While already a feature of international travel, we have concluded that we do not think using certification as a condition of entry is a way to go. For people who have not been offered a full course of vaccination and for businesses, we felt that the impact outweighed the public health benefits. Of course, businesses can use Covid-status certification at their own discretion and, from step 4 onwards, the NHS Covid pass will be accessible through the NHS app and other digital routes. This will be the main way that people can provide their Covid status—a status that they will achieve once they have completed a full vaccine course, a recent negative test or some other proof of natural immunity.

Taken together, step 4 is the biggest step of all: a restoration of so many of the freedoms that make this country great. We know that, as a consequence, cases will rise, just as they have done at every step on our road map, but this time our wall of protection will help us.

While step 4 will be the moment to let go of many restrictions, we must hold on to those everyday, sensible decisions that can help make us all safe. The responsibility to combat Covid-19 lies with each and every one of us. That means staying at home when you are asked to self-isolate. It means considering the guidance that we are setting out, and it means getting the jab—both doses. When you are offered it, please, please take the jabs. This is something that everyone can do to make a contribution towards this national effort. It may even mean, for some people, that they will get three jabs in a single year. Last week, the Joint Committee on Vaccination and Immunisation provided interim advice on who to prioritise for a third dose, and our most vulnerable will be offered booster Covid-19 jabs from September in time for the winter.

And preparing for the winter ahead is not just about Covid, but flu as well. Because of the measures in place this winter, almost nobody in the UK has had flu for 18 months now. That is obviously a good thing but it does mean that immunity from flu is down. This winter’s flu campaign will be more important than ever, and we are currently looking at whether we can give people the Covid-19 booster shot and the flu jab at the same time.

Step 4 is the next step in our country’s journey out of this pandemic. I know that, after so many difficult months, it is a step that many of us will look upon with a great deal of caution, but it is one that we will all take together, with a growing wall of defence against this virus—a wall that each and every one of us can help build higher. It is vital that each of us plays our part to protect ourselves and to protect others into better days ahead. I commend this Statement to the House.”

My Lords, I thank the Minister for bringing the Statement today and for the debate that we are about to have.

The past 15 months have been so hard on all of us. We all want to find the light at the end of the Covid tunnel and take a step closer to a life of normality. However, caution, care and clarity are needed as we step forward into new freedoms. We all want to see the restrictions end, but what the Secretary of State said yesterday was not a guarantee that restrictions will end; it only described what the end of restrictions will look like.

Can the Minister confirm that the ending about to be announced will be based on SAGE advice and data? Yesterday, the Secretary of State said that he believes the best way to protect the nation’s health is to lift all restrictions. Is that the Secretary of State’s own view or SAGE’s advice? If the latter, where does SAGE say that? The advice that I read yesterday about the spread of the virus was much more cautious, saying:

“There is significant risk in allowing prevalence to rise, even if hospitalisations and deaths are kept low by vaccination.”

It went on to say that, depending on what happens and whether the variant morphs—my word—restrictions might need to be introduced. Is that the Minister’s understanding?

Where I come from, in West Yorkshire, the mayor Tracy Brabin said yesterday:

“Here in West Yorkshire, Covid cases have risen by 62% in the last week. So, we really do need a clear message from the government that puts people’s safety first, based on the science and live data.”

Surely she is correct. If only 50% of people across the UK are fully vaccinated and another 17% partially vaccinated, infections will continue to rise steeply; and hospitalisations are rising. Inherent in the strategy outlined is an acceptance that infections will surge further, that hospitalisations will increase and that we will hit a peak later this summer. Some of those hospitalised will die, and thousands—children and young people—are being left exposed to a virus with no vaccination protection, leaving them at risk of long-term chronic illness and personal impacts that might be felt for years to come.

We may have to accept the Government’s argument for a “learning to live with Covid” strategy, but how many deaths, and how many cases of long Covid, does the Minister consider acceptable? Yesterday’s message put the onus on individuals and businesses to self-manage what in recent months has been mandatory. I suspect that this may have left many people confused. As we on these Benches have said on many occasions, ambiguity in a pandemic costs lives. As demonstrated by the lively debates in today’s media, advice can be divisive, leading to disagreements on the interpretation of what is safe. We have government Ministers saying different things about what they personally intend to do; last night, we had a clear message from the CMO about the circumstances under which he intends to wear a mask. So I think that we have every right to be concerned that the debate may cause confusion and compromise crucial safety.

Let us look at public transport, for example. I have been using public transport throughout. I started wearing a mask long before it became mandatory. I still do not feel safe on a very crowded Tube, and I still do not want anyone to sit next to me. I test twice a week, and I have self-isolated twice since January when I got pinged. I do not think that I am unusual or nervous, but I feel strongly that I have a duty not to unwittingly spread the virus, and I do not want people to infect me. In a recent travel study, a majority of passengers said that they would lose confidence if the use of face masks were reduced. Many people, especially those who are more vulnerable, may become more anxious about using public transport if face masks become voluntary.

What is the Minister’s answer to these legitimate concerns? Does it go with the view that we let the virus rip and take the consequences? Given that we know that bus and taxi drivers experience Covid and death, what does the Minister have to say to them about their safety in these circumstances? Masks do not restrict freedoms in a pandemic when so much virus is circulating; they ensure that everyone who goes to the shops or takes public transport can do so safely. Who suffers most when masks are removed? It is those working in the shops, those driving the buses and taxis, and low-paid workers without access to decent pay, many of whom live in overcrowded housing and have been savagely, disproportionately impacted by this virus from day one.

We know that masks are effective when a virus is airborne. Given that high circulations of virus can see it evolve and possibly escape vaccine, what risk assessment have the Government done on the possibility of a new variant emerging? Will the Minister publish that assessment?

Given that the Statement says that isolation will still be needed, does the Minister think that living with the virus means the low-paid will be properly supported, or does he think they would game the system, as the previous Health Secretary suggested to a Select Committee?

As the Prime Minister announced, we can all crowd into pubs. Meanwhile infection rates in school settings continue to disrupt schooling, with nearly 400,000 children off in one week. With one in 20 children off, I look forward to a sensible announcement from the Secretary of State for Education, but I am not holding my breath.

We are not out of the woods. We want to see lockdown ended but we need life-saving mitigation to be in place. We still need sick pay. We need local contact tracing. Mask wearing should continue where it is needed. We need ventilation, and we need support for children to prevent serious illness.

On many occasions in the last year I have stood here and warned the Minister and the Government about not quarantining properly, of a chaotic test and trace system, of not having a circuit-breaker when it was needed and of taking decisions too late. I really do not want to find myself saying in September or October, “We warned you that you needed to take this more slowly and weigh the risks more carefully.” We should keep some measures—for example, mask wearing—until, say, two-thirds of the population are fully vaccinated.

My Lords, on the 73rd birthday of the NHS yesterday we supported and echoed the thanks to everyone in the NHS and the care sector for their extraordinary and humbling response to the pandemic, which continues to this day. We are far from being an NHS back to normal, whether through increased Covid cases, the backlog of hospital appointments and life-threatening delayed diagnosis, all the way through to the more routine but also vital services. So, our best present to the NHS will be to lift restrictions and return to normal in the safest way possible for them, for patients and the wider health of our country.

For months, the Prime Minister has talked of “data, not dates”. The data shows cases running at over 25,000 per day and predicted to rise to 50,000 per day by the end of the month. Hospitalisations are up and even ventilator bed use is up, which, while not as bad as in the previous two waves, is putting pressure on the hospitals dealing with them.

There is a large surge of cases in the north-east, and there are concerns that a new variant may exist there. Cases in the UK of the lambda variant from Peru are now being investigated as it appears more transmissible and possibly more resistant to vaccines. If the UK is following the route out of the pandemic used by Israel and the USA, we should note that both those countries are now finding that that system is not working for them: Israel’s proportions are picking up again and Florida is struggling to cope with a very large surge in cases.

Yesterday’s Statement was a case of ideology over science. It says that the vaccine is a “wall of defence”, but it is a wall with holes in it. First, one-third of adults have not yet had their second jab; nor have any children. That is a reservoir of millions—not just thousands, as the noble Baroness, Lady Thornton said—who are at risk of catching Covid, whether seriously or not, and passing it on to others. Secondly, double-jabbers are not conferred with magical total immunity and protection, and we know that they can transmit it too.

We on these Benches want to start with a return to normal and to lift restrictions. We desperately need to kick-start the economy, to start to socialise again and, as my noble friend Lord Scriven said last month, to live with Covid as it is now endemic and will be with us for some years to come. However, that means providing the safety net needed to ensure that people are as safe as possible. Asian countries that managed their pandemic well learned from SARS. The use of face masks became routine and a matter of personal and wider social responsibility, allowing life to continue in the flu season and in the pandemic. They also maintain strong and effective test, trace and isolate systems all the time. We will be discussing test, trace and isolate in detail following the Statement that is due to come to your Lordships’ House on Thursday, but the proposed reductions in test, trace and isolate will remove the UK’s ability to manage outbreaks swiftly, during which time others will catch and pass on Covid.

When we drive into our towns and cities, we rely on local authorities to set up traffic systems, including traffic lights, to help to guide us on safe journeys, regulate movement and reduce harm and damage. But it is as if “freedom day” is getting rid of all our traffic lights.

Proportionate responses are needed, and these include face masks. Early last year, even the WHO was equivocal on the use of face masks but, as the world became aware that this is a respiratory disease passed on through droplets, most countries moved to face mask mandates. On 19 July we switch to rules that make it only the responsibility of individuals. Thankfully, most people have taken that responsibility seriously, but not everyone has. That is important because, despite what the Minister said in response to my question yesterday about the clinically extremely vulnerable, there is no direct reference to the CEV in this Statement—unless he meant the passing reference to them being part of the priority group that will get the third jab. They need to know where they stand. There is no new advice, just the burning of the remaining rules that keep them safe.

Last night the Government published the Health Protection (Coronavirus, International Travel and Operator Liability) (England) (Amendment) (No. 5) Regulations 2021 and brought them into force at 6 am this morning. This amendment allows supporters of foreign teams with tickets for the final stages of the Euros to travel. Tens of thousands of foreign fans will be waved in, despite the high number of daily cases and despite 1,300 cases among Scottish fans after they travelled to Wembley to play England last month. I am not surprised: it is a crowd-pleaser. But as a legislator I find it extraordinary and unacceptable that the Explanatory Memorandum states this amendment is needed “to protect public health”. Frankly, that is in complete contradiction to the regulations themselves. Such inconsistent behaviour from the Government typifies a desire to please people, rather than think ahead and manage scenarios.

What we need is careful planning when lifting restrictions that keeps people safe by having effective measures in place: face masks in risky environments; test, track, trace and self-isolate rules that protect people; and funding for those who have to self-isolate. That is the way we can move to a new normal, to an economy that can work again, with health traffic lights around us to manage and minimise Covid.

My Lords, I am enormously grateful for the thoughtful questions from the noble Baronesses, Lady Thornton and Lady Brinton. I will address the first question from the noble Baroness, Lady Thornton, on where we get our advice from and will try to explain a little bit about how these decisions are made.

We get advice from a wide variety of inputs. They include the NHS, and we look very carefully at NHS capacity and projections for trying to catch up with the very large waiting lists that we have for electives. We get advice from schools about the prevalence of infection and attendance at schools. We look to Parliament for guidance, scrutiny and challenge. We have talked to GPs about the front-line picture that they see. We look to the JVCI for epidemiological advice. SAGE provides an important challenge and interesting support, particularly in terms of modelling, but it is not the sole repository of all the evidence for our decision-making. We are extremely grateful for its input but we have to take on board a very large set of perspectives when we make these decisions. We cannot rely on just one data set from one group. It is a holistic situation, and we have to balance a lot of different and competing needs at the same time.

That is why the decisions made in the Statement yesterday and in the Statement made by the Secretary of State an hour ago are proportionate and have, I hope, the caution, care and clarity that the noble Baroness quite rightly referred to. She is right that some infections will, very sadly, lead to severe disease, hospitalisation and, in some cases, death. But the proportion of those infections is much smaller than it was before the vaccine arrived. We have successfully vaccinated a huge proportion of those who are the most vulnerable to this disease. As a result, although infections are rising, the impact on hospitalisation and death is a very small fraction of what it once was.

We need to proceed with caution, keeping a very close eye on those relative relationships, but the picture that we see at the moment is relatively straightforward: the vaccine works. The statistics for both the BioNTech and the AstraZeneca vaccines are incredibly impressive in terms of both hospitalisation and transmission.

The noble Baroness challenged me to explain what I thought might be an acceptable level of deaths. I do not wish to split words with her, but the honest truth is that I do not accept any deaths as acceptable. I am not just trying to be smart with the language. It is our mission, particularly in the Department of Health but in the Government as a whole, to try to tackle all deaths as well as we possibly can.

All health decisions are always based on a balance of risk, whether it is a GP taking your blood pressure in his or her surgery or whether it is for big demographic interventions of the kind that we are debating today. Balance is the essence of public health decisions, and we are trying to make the best possible decisions around this. They have to take into account the huge challenge that the NHS faces in tackling business-as-usual disease. Millions of people have not turned up for the diagnostics that they should have taken or to have examinations of the lumps and bumps that they are worried about. There is a huge catch-up in terms of the waiting lists, and those have an impact on illness, long life and death. We have to balance the priorities of the pandemic and those of our existing healthcare system, and also the usual life of our communities. That is why we are taking the route that we are.

The noble Baroness, Lady Thornton, raised public transport. That is not only a practical and very important context for this discussion; it is iconic of the decision to move from mandation to a voluntary principle on behalf of a large amount of the public for a large number of the measures that we did, at one point, put into law. We are trying to seek a new covenant with the country based on consideration for each other. The noble Baroness put it extremely well, and I entirely share her scruples. I have four children—who are vectors of infection, to put it politely—and I attend a large number of business meetings, including here in the House, and I regard myself as a high-risk candidate for carrying the disease. I have never caught it myself and I have been vaccinated but when I sit on a Tube train I wear my mask, not to protect myself but to protect the person next to me. That is my personal assessment and my personal decision. That is the spirit in which we are inviting people to step forward and make their own decisions and to be considerate to each other.

We cannot have laws on all these matters for the rest of time. At some point we have to ask the country to step up and take responsibility and to have personal agency in these decisions. If we do not put that challenge to the country in the summer months, when our hospitals are relatively safe and the virus has the right conditions, when will we be able to make those decisions?

I agree with the noble Baroness about the position that many workers find themselves in. She is right that PHE data is very daunting when you look at the low-paid, front-line workers who drive taxis and buses or are in all sorts of other front-line positions. They have been hard hit by the pandemic, partly because of their living conditions, partly because of their environment and partly because of the prevalence of comorbidities, but also because of the risk that they personally put themselves at. I call on everyone to be considerate on that point. We need to think about the kind of risk that people are putting themselves at when they go about their normal day-to-day work. I ask people to be thoughtful about infectious respiratory diseases and, in fact, all diseases. That is why the Prime Minister has talked in the terms that he has.

In the meantime, we are making changes to the way we are doing things. The noble Baroness, Lady Thornton, asked me about children. To be clear: the Secretary of State said in his Statement that anyone under 18 who is a close contact of a positive case will no longer need to self-isolate after 16 August. Instead, children will be given advice about whether they should get tested, dependent on their age, and will need to self-isolate if they test positive. These measures will come into force on 16 August, ahead of the autumn school term. That is a proportionate response to the changed situation we find ourselves in, with the massive rollout of the vaccine and the evidence that we can see in front of our eyes of the impact of the disease on those who are under 18.

In reply to the noble Baroness, Lady Brinton, I spoke about the Secretary of State’s speech yesterday, in which he said very clearly, on the clinically extremely vulnerable, that guidelines will be published, and that remains the case. We are extremely sympathetic to those whose immune system does not allow the vaccine to have an impact. What use is a vaccine that supports your immune system if your immune system does not work very well? That is a challenge that more than a million people in the country face, and we are working extremely hard to address that issue. That work includes a huge amount of research through the OCTAVE study and a massive investment in the antivirals task force and the therapeutics task force. Those who are clinically extremely vulnerable, particularly those who are immunosuppressed, have not been forgotten and are very much the focus of our efforts, but it is an extremely difficult challenge to meet.

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

My Lords, I support the move from legislation to guidance in relation to the measures in the Statement. But does my noble friend agree that there is a case for continuing regulation of the circumstances where somebody is the contact of somebody who has tested positive? Can he update the House on what the Government are proposing regarding relaxing some of the restrictions for those who are contacts of positive tests?

My noble friend puts it very well. Clearly, with the infection rates rising but with a very large proportion of the country vaccinated, it is worth reviewing this. As the Secretary of State said in his Statement earlier this afternoon, from 16 August the Government intend to exempt people who have been fully vaccinated from the requirement to self-isolate if they are a contact of a positive case, with a similar exemption for under-18s. Anyone who tests positive will still need to self-isolate regardless of their vaccination status. Symptomatic testing will continue to be available. This is a proportionate direction, given the state that we are in.

My Lords, how much research is being done into long Covid? Many people feel misunderstood and frustrated as they want to get better and many long Covid clinics are not yet open.

My Lords, I completely sympathise with the frustration that many feel when they have the symptoms of one of the many syndromes associated with long Covid. According to the ONS, more than 1 million are in that situation. Those symptoms might range from extreme tiredness, aches and pains, to cardiac or respiratory exhaustion. Our fears are that long Covid will be a horrible legacy of this disease. NIHR has half a dozen research projects at the moment, and I understand that it will be looking for more. The clinics the noble Baroness described are being rolled out at speed and I pay tribute to the NHS, which has a 10-point plan for dealing with long Covid. I would be glad to share a copy of that with the noble Baroness.

My Lords, while there continue to be understandable anxieties and not least concerns about potential pressures on the NHS, many will welcome the prospect of the removal of restrictions on gathering in a range of settings including, I note, for communal worship, singing and performances. Given the move from rule and regulation to guidance and good sense, do Her Majesty’s Government intend to issue any guidance specific to places of worship and in relation to communal singing in settings such as community choirs, other choral groups and schools, or is that to be left to the good sense of those responsible?

The right reverend Prelate puts it extremely well. I pay tribute to all the community groups which have an influence on the thinking of the nation. I encourage them to use that influence to engender and support a spirit of community consideration so that we can try to come together as a nation and approach public health in a way that is considerate to each other.

On the specific point of singing, as I took my place, I noticed that the Secretary of State for the Department of Digital, Culture, Media and Sport was in the process of making a Statement, and I refer the right reverend Prelate to that. I am afraid I have not had a chance to read it.

My Lords, as the Government have already admitted, one result of their new controversial policy will be an extra 100,000 cases a day of Covid-19, possibly within the next month, which will lead to further heavy demands on an overpressed NHS. How do the Government intend to retain the already overworked and burned-out health workforce going into this battle on an offer of £1 a week pay rise after all the effort they have put in?

My Lords, I pay tribute to the NHS, but the rise in infections among mainly very young people will not necessarily lead immediately to a large increase in the demands on the NHS. An extraordinary aspect of this disease is that it targets the elderly and those with comorbidities and leaves the young largely alone. The proportion of people who have the disease in the months to come will mainly be the unvaccinated. Those are mainly the young and our modelling, which is supported by the NHS, suggests that our resources in healthcare can support that kind of situation.

My Lords, the Health Secretary this morning said that there could be 100,000 cases per day by mid-summer as a result of lifting the restrictions in the Statement. Professor Neil Ferguson’s analysis today, based on the delta variant and the age group affected, shows that would equate to about 100 deaths per day. That will mean an extra 15,000 deaths by the end of the year. Is the Minister aware of and comfortable with that projection of extra deaths, when he says from the Dispatch Box that the policy he now advocates leads to a low level of deaths?

I am not comfortable with any deaths. The suggestion that we are going into any of this with a sanguine, devil-may-care attitude is quite wrong. We approach the matter with extreme caution. But many people are dying because they have missed their cancer appointments. There will be people who die of flu this winter; there will be many people who die of all manner of diseases. We cannot focus only on Covid—we cannot make it the sole priority of our healthcare system and our entire economy. At some point we need to move on.

We will remain extremely cautious; we have all sorts of back-up resources in place that we can pivot to should there be an escalation of Covid hospitalisations and deaths. I do not need to list from the Dispatch Box any of the things we are all worried about. This is the right decision right now; it is proportionate, and it gives us the space to address the many other health issues we have as a nation.

My Lords, I congratulate the Minister and the Government on taking this decisive decision to start getting the country back to normal, and in particular, to start getting the economy back to normal. Of course, this could not have been done without the success of the vaccine rollout. All that goes back to last March and April, when some very decisive decisions were made. The Prime Minister made it clear on a number of occasions that the way out would be vaccination.

I urge the Minister to go a little further and start getting the Government back into their offices in Whitehall and elsewhere and start helping those businesses which are so dependent upon our town centres—and, indeed, even this Whitehall area—to get them back together. I also urge him to start looking at the traffic light system, especially as Germany has now opened its borders to India. Now is the time to start trusting the vaccines.

My Lords, I completely concur with my noble friend’s analysis. This is an opportunity for the economy to bounce back, and I am really encouraged by everything I hear from the private sector in terms of the energy, enthusiasm and resilience of the UK economy. The large number of people who will be holidaying at home this summer provides one shot in the arm for the hospitality industry, which I know it is taking advantage of.

When it comes to borders, we have to be careful. One does not like to think about it, but the existence of millions and millions of people with the disease today means that the possibility of further variants has to be on the agenda. That is why we take it one step at a time, and I pay tribute to those in Border Force and the managed quarantine scheme for the work they have done. It is ironic that the variant delta, which started in India, is now so prevalent in the UK that it is possible to think about India coming off the red list. But there are variants elsewhere that we have to be wary of.

My Lords, is the Minister aware—I think he may not be given his recent response to the right reverend Prelate—of the latest government-sponsored PERFORM-2 scientific research? It substantiates what noble Lords have been telling the Government for weeks: there is no difference in aerosol droplets between professional and amateur singers. Given this, is it not time now to finally stop an indefensible farce that restricts amateur choirs from singing, just as they observe tens of thousands of football and tennis fans chanting away? It is no good on counting on 19 July to sort it out as there may be further prohibitions in the future.

My Lords, I am not aware of all the details of the latest Statement. It is my understanding that there is substance there; I gather that there will be change and I look forward to reading about that.

The noble Lord gives me an opportunity to reflect widely, and I hope he does not mind if I do so. There have been lots of uncomfortable inconsistencies and moments of disproportionality where noble Lords have rightly challenged the Government as to whether they have got every dotted “i” and crossed “t” absolutely right. The singing issue is probably the most graphic and certainly the most discussed example. I will personally be hugely relieved if we can move on from the current situation.

My Lords, is it not obvious that if you reduce mask wearing on public transport and in public places, those who believe they are more exposed to the virus will then reduce their use of public transport and avoid public places? People who are fearful of more liberated environments will avoid them, leading to a slowdown in the return to work that the Government want. Indeed, it is the reverse of what the Government want. Why remove those restrictions that offer the only way of securing public confidence in the new regime that is being proposed?

I applaud the noble Lord for his advocacy of mask wearing, but of course this issue cuts both ways. He is right that we need to build back trust in sharing space with one another, but I am not sure that mandatory mask wearing either builds trust or erodes it. If we give people the impression that wearing masks is somehow a panacea that protects everyone on a tube train or in a lift, that is a false impression. Masks are not a panacea. In fact, for some people, they can be a source of grave concern and be enough to send them back home to seek safety. I take the noble Lord’s point that we have to be clear about this, but I am not sure that mandatory mask wearing, or even ubiquitous mask wearing, is either a universal antidote to the spread of the disease or necessarily builds trust in the manner he describes.

My Lords, continuing on this theme: “masks work” is the clear message from Public Health England. Both Sir Patrick Vallance and Professor Chris Whitty have said that they will continue to wear a mask in crowded indoor spaces, primarily because it protects others. Critically, it does not hold back the opening up of the economy, but rather provides a safeguard as social distancing rules are relaxed. Can the Minister tell me why there is so little in the Statement about our social responsibility to others, including front-line transport and shop workers, and the clinically extremely vulnerable? In this scrapping of masks, we are condemning millions with poor immune systems to be trapped in their homes, too afraid to go to the shops or their workplace or to use public transport.

Since this is the second question on masks, I hope the noble Baroness will not mind if I go off on a tangent. Masks do work a bit; they are not a panacea. What is really important is that when you are ill, you stay at home. That is the big behavioural change that will make a big difference in the year to come. That is where Britain has got it wrong in the past. Too often we have put our workmates, fellow travellers and school friends at risk by heroically going into crowded indoor places and coughing all over them. I hope that is one habit that will stop and that that will be a legacy of this awful pandemic.

My Lords, I congratulate the Government on the progress made on a well-financed vaccination programme that continues to win the war against the worst effects of the virus. Will my noble friend the Minister and his colleagues now ensure that as much effort and commitment will be put into a lead role for the new office for health promotion in his department, to co-ordinate government policy and ensure that we place national well-being, physical and mental health at the centre of policy priorities for all age groups as we emerge from Covid?

I am very grateful to my noble friend for raising the office for health protection, because it is an office that I am extremely hopeful for. It will be giving clinical leadership from the CMO. It will bring together all the enormous resources of data that we have brought together in the pandemic response. It will, I hope, capture the national mood around healthy living, including, as my noble friend rightly points out, eating habits and physical activity habits. It will work through local authorities, it will not be a large organisation like UKHSA is, but I hope it will have an enormous impact. I look forward very much indeed to discussing it more in this Chamber.

My Lords, come 19 July it will be all too easy to assume that everything is okay in the arts and night-time economy. Is the Minister aware of the recent Public Accounts Select Committee report which says that without a government-backed insurance scheme there is a “survival threat to festivals”—pretty strong words. The report also backs further support for freelancers and the technical supply organisations decimated by Covid. It will be a hard road back, and I hope the Government continue their support, including plugging the gaps in support that remain.

My Lords, I do think we have an opportunity, now that the pressure has backed off a bit, to be thinking a lot more about the exactly the sort of subject that the noble Earl raised. I am an avid festival goer, and extremely sad about the way in which they have been hit so hard. The role of freelancers in the arts is absolutely critical. I know that my right honourable friend the Secretary of State for Digital, Culture Media and Sport has these points very high on his list of priorities.

My Lords, one person’s choice is another’s imposition. Even when mask wearing was mandatory on the tube, some broke the law and there was no policing. So-called choice will cause conflict and confusion. Can the Minister assure me that the Government are not reverting to type and their original herd immunity policy based not on the science but on “let us see how it falls”? Although he does not accept any deaths, as he said, what assessment has been made of the impact of this new policy on death rates and long Covid rates?

My Lords, I do not have the figures to hand, but I reassure the noble Baroness that the policy on masks was very diligently imposed and a large number of people did get fined. We have to ask ourselves as a society whether we really want to live in a country where simple behavioural habits, such as wearing a mask or not, make you susceptible to arrest or fines. That is a very uncomfortable place for a country to find itself. The noble Baroness is right: that does introduce ambiguity, but we are sophisticated people and can live with a degree of ambiguity. We need to learn how to live not only with this disease but with each other. The dilemma that the noble Baroness points out is one that we will all have to debate, understand and learn to live with. We are not in any way letting this disease get on top of us. We are fighting it through the vaccine, we are supporting the vaccine with test and trace, and we have a tough borders measure. We are taking the battle to the virus and will continue to do so.

My Lords, I welcome this Statement. As my right honourable friend Sajid Javid says, he is Health Secretary not just Covid secretary. The successful vaccine programme means that we must urgently address the shocking build-up of other health damage, physical and mental. Not opening now would cause more deaths from non-Covid causes. I have two questions for my noble friend. First, will he confirm that the Government recognise that so-called zero Covid is unachievable and we cannot stop people catching it? Secondly, will he provide details of the Government’s winter contingency plans for the NHS and Covid?

My Lords, I wish zero Covid was possible. I wish we had never had it at all in this country, but it is a fiendishly clever virus and it gets around the measures we put in place to try to fight it. I can, very sadly, confirm that zero Covid is not something we can plan for in this country. What we can plan for is the winter. I reassure my noble friend that the NHS has extremely thoughtful and diligent plans for the winter. It has a specific winter plan and I would be happy to write to my noble friend with a copy.

Does the Minister agree that reliance on the good sense and responsibility of the public should be supported by clear guidance, backed by scientific evidence? If so, will he please tell the House whether the Government are planning to provide such guidance and explanation? How will it be made available in an easily accessible form?

My Lords, that is an extremely broad question. I reassure the noble Baroness that we have published thousands of pages of guidance, many of which have been across my desk, and it has been a privilege to read it all. We have developed better thinking on how we do guidance: I would like to think that it is now written in clearer English and in more languages, and has been made more accessible to those who have reading challenges. We have developed those important learnings over the pandemic.

Does the Minister agree that it would be preferable if the guidance was similar throughout the whole of the United Kingdom, especially for those of us who travel regularly from Scotland to London? What discussions and meetings does he have planned with the Ministers in the devolved authorities to try to achieve that?

I am sympathetic to the noble Lord’s travel arrangements, but I do not philosophically think that harmonisation of all regulations across all the nations of the United Kingdom is necessarily desirable. It is important that people have trust, and sometimes that trust is built on local leadership that takes a different perspective or has different circumstances to try to manage. There has been a large amount of discussion about the differences in the guidance between the nations. My personal experience is that, like DNA, 99% of it is common, with very small differences—although they are inconvenient to handle and manage. I have been travelling up and down the country as well, and, in fact, the consistency has been very large.

Until last week, British citizens who were four years old and younger returning to this country were not required to be tested while quarantining. Why was this change made last week, so that four year-olds, three year-olds, two year-olds, one year-olds and newborn babies now require testing in order for fully vaccinated families who have been properly tested and are negative to be able to get out of quarantine? What is the medical evidence that suggests that testing these babies will help?

My Lords, I confess that the noble Lord’s question is new to me. I will look into that matter and write to him with an update.

My Lords, while I very warmly welcome this Statement, my noble friend will be aware that some batches of the AstraZeneca vaccine have yet to be approved by the European Medicines Agency, placing a question mark over the eligibility of some 5 million double-vaccinated Britons for the EU vaccine passport. Can my noble friend assure the House that the Government are working towards a swift resolution of this issue, which ought to be achievable?

I am extremely sympathetic to the situation that my noble friend and a large number of other people find themselves in. I reassure him that we are seeking a solution to this issue with the EMA, and I am hopeful that we will get there some time soon.

My Lords, given the significant increase in Covid-19 infection rates in the UK in recent weeks, what assurances can the Government give to people in the social care sector that there will not be a repeat of what happened in early 2020, when 30,000 people in care homes died of Covid-19? What is the difference between making people wear a seatbelt in a car and a face mask on a train? Both are in the interests of health and safety and are surely in the spirit of community consideration.

My Lords, I completely understand the noble Baroness’s concerns about those in social care. In the provisions that we have put in place for the vaccine, I reassure her that we have those who are elderly and vulnerable absolutely at the top of our minds. As she knows, we are putting in place arrangements for a third shot for those who were early on the prioritisation lists, and we are working on booster shots, should those prove to be necessary. The vaccine is our absolute front line in the battle against the virus. We are seeking to protect most those who are in social care, the elderly and the vulnerable, which is why the vaccine arrangements have been prioritised in that way.

My Lords, I welcome the Minister’s conversion to living with the disease, which I have said for some time that we have to do. In answer to my noble friend Lady Altmann’s question, he mentioned that there was a winter plan. I would also welcome a copy of that and an assurance from him that plans will come forward to tackle the waiting lists, both regionally and by specialisation, so that we can deal with the huge backlog that the NHS now has to face.

My Lords, I remind my noble friend that we have awarded £1 billion to kickstart elective recovery, supporting providers to address backlogs and tackle long waiting lists. We have also awarded a further £6.6 billion to recover health services from March to September. These are substantial investments and will go a long way to address this considerable challenge.

In light of the eagerly awaited easing of restrictions, but noting the continual penetration of the delta variant in particular, do the Government remain confident that there are sufficient supplies of the necessary vaccines to win the race against a virus that continues to prove itself disruptive and dangerous?

Yes, I can reassure the noble Lord that we have in place a strong supply chain that will meet the schedule that has been outlined by my friend the Minister for Vaccinations, Nadhim Zahawi. We are also seeking to develop new vaccines, should they prove necessary—because it has been one of the surprising but reassuring aspects of our vaccination policy that a third boost is as useful and efficacious as it is. However, should another variant emerge that somehow eludes the current suite of vaccines, we have in place arrangements to develop, manufacture and distribute more.

My Lords, the Statement is about the need for a return to normality—[Inaudible] —businesses depend for their trade on those who go to work in offices in cities and town centres, so can the Minister—[Inaudible]—and what instructions will they get about 19 July?

My Lords, I did not quite catch all the details, but I got the gist of the question. I reassure the noble Baroness that the return to offices and our high streets and towns is of paramount importance, and we are working on guidelines on that matter. I cannot guarantee that absolutely everything will go back to exactly what it was: we have learned lessons from the pandemic, and we want to put this country into a shape where we are resilient should another one emerge. However, it is my hope that the economy will bounce back extremely quickly, and there is good evidence that it will.

My Lords, as a strong supporter of the Government’s policy on the coronavirus, I was nevertheless critical of them being very slow to enunciate a clear policy on masks over a year ago—so I have a lot of sympathy with those noble Lords who have expressed concern about the imminent lifting of compulsion regarding masks. Surely one possible compromise might be to keep masks where you have passengers on public transport sitting or standing next to each other?

My Lords, I hear my noble friend’s words loud and clear. The Government have indicated that we will leave it to those who run the transport systems themselves and to local politicians. There is a good case for a degree of devolvement and subsidiarity in this matter. He is right that masks do perform an important role, but they are not a catch-all, and it is therefore reasonable to leave those who run the transport systems to make decisions for themselves.