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Covid-19 Update

Volume 816: debated on Wednesday 8 December 2021


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

“With permission, Mr Speaker, I would like to update the House on the Covid-19 pandemic. We are working night and day to understand more about the omicron variant. There is a lot still to learn, but some important data has emerged very recently and I would like to update the House on the latest developments.

There are three reasons why the omicron variant is a threat. The first is that it is far more transmissible than the delta variant. The delta variant was much more transmissible than the alpha variant, and we are confident that omicron is significantly more transmissible than delta. We can see this most starkly when looking at how many days it takes for the number of infections to double for each variant. For delta, this was around every seven days, but for omicron, based on the latest data from here and around the world, our latest analysis is that it is between 2.5 and three days. This has made the virus an even more formidable foe.

The rate of growth in S-gene dropout cases in England, using S-gene dropout as a reliable proxy, is similar to that observed in South Africa. Although there are only 568 confirmed omicron cases in the UK, we know that the actual number of infections will be significantly higher. The UK Health Security Agency estimates that the number of infections is approximately 20 times higher than the number of confirmed cases, so the number of infections is closer to 10,000. UKHSA estimates that, at the current observed doubling rate of between 2.5 and three days, by the end of this month infections could exceed a million.

The second is severity. We do not yet have comprehensive data on the severity of this virus, but rising rates of hospitalisation in South Africa show that it certainly has the potential to cause harm. South Africa is a country where the average age is 13 years lower than in the UK, where they have a high level of antibodies from natural infection, and where it is currently the middle of summer. Even if the severity is lower than or the same as delta, high transmissibility means that the omicron variant can still have a severe impact, with the threat of more hospitalisations and unsustainable pressure on the NHS. This would mean an impact not just on Covid treatment but on non-Covid care that we all rely on, such as emergency care if somebody was involved, sadly, in a serious accident. When we set out plan B, we said we would act if the NHS was likely to come under unsustainable pressure and was at risk in providing the care and treatment that people need. The omicron variant has given us cause for concern.

Thirdly, we have been looking closely at what the omicron variant means for our vaccination programme. New laboratory data which has emerged in the last 24 hours suggests that there is lower immunity against omicron from vaccination compared with the delta variant, so that two doses of a vaccine are less effective at reducing transmission in the community. Early research published today by Pfizer suggests, however, that a third dose of the Pfizer vaccine neutralised the omicron variant to levels that are similar to the impact of two doses against the original strain of the virus. So it is more important than ever that we get the boosters available for all those eligible, and keep strengthening the defences that we have built. Today we have opened booster bookings to 7 million more people in England, so people aged 40 and over, and those in high-risk groups, will be able to get their booster jab from three months after their second dose.

Another defence is new treatments, which have a huge part to play in protecting the most vulnerable from Covid-19, especially for those who are immunosuppressed, for whom vaccines may be less effective. Today we have announced plans for thousands of people across the UK to be among the first in the world to access life-saving antivirals through a new national study. People who are at highest risk from the virus—for example, those who are immunocompromised or cancer patients—will also be able to access treatments outside this study from next Thursday if they have a positive PCR test.

We have built some powerful defences. We have put more boosters in arms than any country in Europe, we have built a huge nationwide infrastructure for testing, and we are leading the world in the deployment of new treatments. Thanks to these defences and our decision to open up in the summer rather than the winter, we are much better protected than we were this time last year, and we need this protection now more than ever. Although omicron will become more and more prevalent over the next few days and weeks, we will see the delta and omicron variants circulating together. Facing these twin threats without these pharmaceutical defences would have been hard enough, but even with them in place, we still face a perilous winter and so, unfortunately, we need to take steps against the threat of this new variant.

When we were moving down our road to recovery, we looked at four tests to see whether we should proceed to the next stage: that the vaccine deployment programme continues successfully; that the evidence shows that vaccines are sufficiently effective in reducing hospitalisations and deaths in those vaccinated; that infection rates do not risk a surge in hospitalisations, which would put unsustainable pressure on the NHS; and that our assessment of the risks is not fundamentally changed by new variants of concern. Unfortunately, the situation is markedly different now to how it was in the summer, when we were able to open up, so we must take proportionate steps to meet this emerging threat. These are not measures that any of us want to take, but these measures give us the best chance of saving lives and protecting our freedom over the next few weeks. It is precisely because we do not want lockdown that we are putting these proportionate steps in place now. As we have seen before, if we act early, firmly and decisively, and come down hard on this new omicron variant now, we can avert tougher action later on.

I know that the news of further measures will be disappointing for many people and that every measure comes with a cost. I can assure the House that in making these decisions we have taken a wide-ranging view, looking at the impact not just on the NHS in terms of Covid and non-Covid care but on the nation’s education, economy, life chances and mental health.

I would like to update the House on the measures we will take to enact plan B. First, we will reintroduce guidance on working from home; it will be updated to say that only people who cannot work from home should continue to go into their workplace. We know that this has an important part to play in slowing transmission, both at workplaces and on public transport. Secondly, we will introduce mandatory certification, based on vaccines or tests, in nightclubs and large events. This will reduce the number of unvaccinated, infectious people in venues, which could limit overall transmission. Thirdly, on face coverings, we will extend the legal requirement for shops and public transport to all indoor public settings, including attractions and recreation, although hospitality will be exempt and we will exempt specific activities where it is not possible or practical to wear a face covering, such as singing and exercise. We will lay those regulations tomorrow, to come into force the following day.

Fourthly, as omicron spreads in the community, we will introduce daily tests for contacts instead of isolation so that we keep people safe while minimising the disruption to daily life.

Fifthly, on communications, we will be urging caution in all our communications on Covid-19 and keep urging people to get their booster doses and follow the little steps that they can to get the virus under control. These regulations will be reviewed on 5 January, when we will also update the House, and they will sunset on 26 January.

Finally, we will also be taking further measures to protect and support social care and we will update the House on a package of measures later this week. It is better to stay a step ahead of the virus rather than reacting to what it brings, taking control of our response now rather than waiting for what comes next. Waiting a few weeks would make it easier to explain the need for these measures, but by then it might well be too late. So we need to act now and take these balanced and proportionate steps. We take these steps with a heavy heart, but we do so confident that we are doing everything in our power to keep our nation safe this winter. We have come so far over the course of this year, thanks to the defences we have built against this deadly virus. Now, as we face this new threat, we must draw on the same spirit that got us here, strengthen our defences and think about what we can do to get this virus under control. I commend this Statement to the House.”

My Lords, that concludes the Statement.

My Lords, I thank the Minister for reading the Statement tonight. On this side of the House, we have always put public health first at every point during this pandemic, so I repeat the words of my honourable friend Wes Streeting, shadow Secretary of State for Health and Social Care, in the Commons an hour ago, when he said

“I want to be clear with the House and the country that Labour will support these measures in the national interest.”

Of course, we know that this decision is not taken lightly. Restrictions impact on people’s lives, livelihoods and liberties and we do not take those for granted on this side of the House.

Everyone wants to be able to enjoy Christmas safely this year, given the trauma of last winter. But the omicron variant is a clear threat, as the Minister has explained, and clearly swift action is needed to limit its spread. I want to ask the Minister a question I have not asked for some time in your Lordships’ House: what is the R number today and what is it predicted to be in two weeks’ time?

On these Benches, we have said that scrapping the guidance on mask wearing was a mistake and have consistently called for masks to be worn in indoor hospitality settings too. We welcome the Government’s reintroduction of that measure, if that is what the Minister said. I seek some clarification on what is actually going to happen; I am not sure I understand the difference between an attraction and hospitality, so could the Minister go into some detail about what will happen in our pubs and restaurants—or will they continue as they are?

The House may remember that we have said that people should have the flexibility to work from home, so we welcome the updated guidance on that. On vaccine passports, I am glad that the Government have listened and responded following their previously abandoned plans to require vaccination status only, and that presenting a negative test will be an option. Can I ask for clarification about whether vaccine passports will be required for access to essential services?

The Minister is correct to say that the greatest tool against the pandemic remains vaccination. How do the Government plan to speed up the booster rollout, which is certainly not hitting the target of 500,000 vaccines a day and is not on track to get everybody boosted by the end of January?

Public health depends and relies on people’s willingness to comply with rules that affect their lives, livelihoods and liberties, and which, in return, relies on confidence in the people making those rules. The damage the Government have done to public compliance with the rules that have governed our lives during the pandemic is very serious indeed. We had the Cummings eye test—that seems like years ago—the former Health Secretary’s tryst with his special adviser, the former Education Secretary’s private party, the Prime Minister attempting to get out of having to isolate, and now the footage of his staff laughing on camera and joking about breaking the rules at a No. 10 Christmas party.

It is hard to overstate how this makes people feel when they have followed the rules and complied, sometimes at enormous personal cost—the businesses that were forced to close; the family weddings that were postponed; the chance to say goodbye to loved ones at funerals that we missed; and the NHS workers, educators and key workers who risked their own health to get us through the pandemic before vaccines and treatments arrived. The headline we saw today is why the laughter in the video from Downing Street is so stomach-turning; it feels as if they are laughing at us.

It is not just that they clearly feel that there is one rule for them and one for everyone else, infuriating though that is; it is the actions of the Prime Minister, which have undermined public trust and distracted from key public messaging at a critical time. This comes from the very top of our country. The problem is that we have a Prime Minister who does not believe the rules apply to him—his own conduct says that—and who also finds it almost impossible to own up, take responsibility and admit that he might have been wrong. The Minister needs to explain to the House how the Government will overcome that.

I was very pleased to hear the news that three doses of the Pfizer/BioNTech vaccine appear to neutralise the new omicron variant, according to preliminary studies; this is very good news indeed. However, it underlines that we have to get more jabs in arms if we are going to make that at all effective.

How will the Government support the people who cannot work from home and who need to continue to go to their workplace? As we know, millions of people who we depend on every day to keep our nation running have continued to go to work throughout the pandemic.

Will the Government set a deadline by which they expect all children to receive their first dose of the vaccine? Will they be able to get them vaccinated over the Christmas period? What are the Government doing to drive up vaccination in areas where there has been low take-up? Are they offering additional support ahead of the winter?

We have discussed in the Chamber before that many critically ill NHS Covid patients are unvaccinated pregnant women. Why is there only one mention of pregnant women in the Government’s COVID-19 Response: Autumn and Winter Plan 2021? In the Whittington Hospital, of which I am a non-executive director, we have set up a room for pregnant women to deal with the issues they may have about vaccination. The Minister might look at that as one of the ways of dealing with this.

Finally, do the Government accept that, if they have not done enough to drive down infection rates by improving ventilation in public buildings such as schools, they must institute a programme of investment in ventilation in schools? This pandemic is clearly a long way from being over and we need our children to be protected.

My Lords, I thank the Minister for repeating the Statement. The chaos to even get it heard in the Commons and the very late notice on whether we were having this or Monday’s Statement sum up the chaos that the Government find themselves in.

As the noble Baroness, Lady Thornton, outlined, the Government have once again lost the trust of the public. My first question is: how on earth will Ministers persuade people to follow these new, very important restrictions, with the chaos going on at the moment?

We understand that restrictions are disappointing but, from these Benches, we have always said we want people to remain safe. As for these proposals, we have said before and say again that we think the Government are once again late to move to plan B.

I note that the arrangements will remain until 5 January and that there is a sunset clause of 26 January. Please can we debate the regulations before they expire—preferably next week, before we rise for Christmas?

Today, there are 131 new cases of omicron, a rise of a third in one day, taking the UK to nearly 600 cases. This confirms that the doubling rate is between two and three days. Scientists are talking about an R rate of between 2 and 4 and it is also following the same rapid transmission trajectory seen in many other countries. Unfortunately, in the last 48 hours, we have seen that South Africa is now showing increasing hospital and critical care bed admissions, showing that, even if there is less likelihood of serious disease, there is still some serious disease.

Ministers are right to be concerned about superspreader events, which are being reported all over Europe. Assuming that doubling continues at this rate and with a million cases possibly by the end of the year, that is very worrying, as is the news of the lower immunity against omicron from the vaccine compared to delta.

Just this afternoon, Antonio Conte, head coach of Tottenham Hotspur, reported that eight of his first team members and five members of staff have tested positive ahead of a big European game. He said:

“The situation makes me very upset … It’s contagious and there is a big infection.”

He is right.

The Statement does not mention that there is a higher percentage of young children both contracting omicron and going into hospital in South Africa. What arrangements are being made to ensure that parents recognise that and understand the different symptoms that young children have?

From these Benches we have been urging the Government to move ahead with plan B since cases started rising steadily in September. Today, all cases—of whichever variant—still number over 51,000, with a further 161 deaths. It is vital that we make sure that those numbers do not go up.

Face masks are vital, especially with increased transmission. But do I understand the Minister to say that singing, which we already know is high risk for transmission, will be exempt? On what medical grounds is that sound? I understand that hospitality has exemptions too. Is this taking us back to when you could take your mask off if you were sitting at a table and eating, but had to wear one when you were moving around a pub, bar or restaurant?

Ventilation is vital. Can the Minister say how many schools have received the air filters they were promised a year ago?

I notice that we are moving now to lateral flow tests rather than isolation. Can the Minister say what the current percentage of false negatives is for lateral flow tests and how that is going to be managed?

It makes sense to follow both Scotland and Wales in asking people to work from home if they can. How is that likely to affect the working arrangements on the Parliamentary Estate, including your Lordships’ House? In particular, and as a minimum, should the House consider returning to remote voting to avoid noble Lords mixing together in large numbers? We know we have a large number of votes over the next few weeks.

There are also a large number of notable omissions from this Statement. The first is the difficult issue of social care and support for those in homes, or housebound, as well as the staff who look after them. I see that the Statement says that there will be information to follow.

The second is the lack of mention of the Covid app. Given that many people are saying that their third dose or booster dose information is still not being recorded properly, can the Minister say if these difficulties have been resolved? The consequences of having to have Covid certification will affect people from Friday.

Thirdly, there is not one word about the clinically extremely vulnerable: that is 3.7 million people, of whom 800,000 are severely clinically extremely vulnerable. Most of the larger group should have had their booster jabs by now, and should be reasonably protected, but can the Minister say yet if that is true of omicron, especially as no one will have had three doses of Pfizer?

I thank the Minister for arranging our meeting next week to discuss the problems that the severely clinically extremely vulnerable are facing. Doctors are already telling this group that they will have a less good and shorter-lived response—if any—to vaccines. Is there any data on vaccinations for this group and omicron?

Other problems remain, as the Minister will have seen from the responses to my tweet this morning. Many people are still finding that their GPs do not know they should have a third dose, because there is no register and their hospital consultants have not had time to write to every patient’s GP. The NHS app still is not recognising third doses. GPs are not sure if it should be eight weeks or 12 weeks between the third dose and the booster.

While the news about the antivirals and retrovirals is good, most CEV people do not want to catch Covid. So above all, following this Statement, where is the specific guidance to both groups who are alarmed by the high number of delta cases, the growing number of omicron cases, and the marked reluctance of people generally to follow mask guidance. This is not a “nice to have”. This is 5% of the population who risk severe disease or dying from Covid. Please can the Minister agree to advise this group in the same way that there will be advice for the social care sector?

I will try to answer as many of the noble Baronesses’ questions as I can. Regarding the more scientific data and evidence, I hope that Peers have received an invitation—if not, I will make sure that it is sent out—to a call with Dr Jenny Harries and me on Friday, during which we will be providing further details and data. It will be an all-Peers call, so noble Lords can discuss a lot of the scientific facts and evidence.

We are advising that you should work from home if you can. If you cannot, you should take lateral flow tests regularly when attending the workplace. We are requiring the wearing of face coverings in a wider range of settings. If noble Lords will forgive me, I will go into some detail here and, if appropriate, I will place these details in the Library.

Last week, we took the initial step of making face coverings mandatory again in England in shops, including contact services such as hairdressers, on public transport and on transport hubs. We are now going further, requiring the wearing of face coverings in a wider range of locations. Police and community support officers can take measures if members of the public do not comply with the law. Exemptions apply for children under the age of 11 and those unable to wear a mask covering due to health, age, equality or disability reasons.

From Friday, the settings requiring face coverings will be attractions and recreation venues—concert halls, exhibition halls et cetera—cinemas, theatres, museums and galleries. I have a longer list and I am happy to share that as appropriate with noble Lords. Other settings include bingo halls and casinos, snooker and pool halls, skating rinks, circuses, other business ventures such as public areas in hotels and hostels, play and soft play areas, sports stadia, other indoor public venues, places of worship, crematoria, chapels, community centres, public libraries and polling stations.

Places that already require face coverings, just to remind noble Lords, are shops and supermarkets, shopping centres, auction houses, post offices, banks and building societies et cetera, estate agents and letting agents, premises providing personal care, veterinary services, retail galleries, retail travel agents, takeaways without space for consumption, pharmacies, public transport and others.

So, face coverings have been reintroduced. We know that they are effective at reducing transmission indoors. I thank the noble Baroness for the support for these measures. We appreciate it on this side of the House.

It will not be a legal requirement to wear a face covering in hospitality settings, restaurants, cafés, canteens, bars, shisha bars and premises other than registered pharmacies providing medical or dental services, including services relating to mental health, and photography studios. The reasoning behind that, I am sure, will be covered in the call on Friday. I do not have all the details and the scientific evidence to hand, given the late notice of this, but I hope that Dr Jenny Harries can share much of that detail with noble Lords.

On the booster rollout, we have already seen nearly 21 million people take up their booster dose, with 1.9 million people coming forward last week. The NHS vaccine programme is to be extended today. People over 40, along with those in high-risk groups, can take their dose.

I was interested to hear from the noble Baroness, Lady Brinton, that people were still reporting that the booster was not on their app. I was not aware of that. In fact, a number of noble Lords had told me that it was on the app. I apologise for not recognising this—this is the first I had heard of it.

I am told the app has crashed. Thank you. I am being heckled about technology now. I will endeavour to look into that and clearly, the relevant people at NHS Digital can do so too. I will try to report back, probably by the Friday meeting.

The NHS will offer anyone who is eligible their booster jab by the end of January and will contact each group to be vaccinated. In addition, as I am sure a number of noble Lords will appreciate, there have been other settings in their area; for example, a number of pharmacies have erected marquees outside their premises and have rolled out to local communities. There have been partnerships with sports stadiums and places of worship, and I have read of a number of inspiring partnerships that have been formed in order to vaccinate as many people as possible.

We have been working with a number of local community groups, experts and others to try to get to those hard-to-reach communities and those who are more suspicious and less trustful of authority. We are looking at ways to do that. I am also grateful to the many noble Lords who have given me their advice on how we should reach more groups. I continue to welcome that advice, but we stress, as noble Lords across the House recognise, that we really need to roll out the vaccines as much as possible.

On ventilation, oxygen monitors were provided for all state-funded education settings from September so staff can quickly identify where ventilation needs to be improved. Letting fresh air into indoor spaces can help remove air that contains virus particles and is important in preventing the spread of Covid-19. Backed by a £25 million government investment, the new monitors will enable staff to act quickly when ventilation is poor and provide reassurance that existing ventilation measures are working.

The noble Baroness, Lady Brinton, also asked about the immunosuppressed. Shielding was introduced at the start of the pandemic urgently to protect the most vulnerable. While the advice serves the important purpose of safeguarding the most vulnerable people from the risk of infection, this has always been balanced against the significant impact that such restrictive guidance has on individuals’ lives and their mental and physical well-being. Following the advice, we ended that shielding and are now doing everything in our power to make sure that the severely immunosuppressed are able to get their third dose and that those at higher risk who test positive for the virus will be able to access the novel monoclonal antibody Ronapreve or the antiviral molnupiravir from 16 December.

My Lords, I thank the Minister for repeating this very important Statement. Many people are concerned about taking the booster because they do not know what the result will be of mixing vaccines such as Pfizer and AstraZeneca. Nobody seems able to give advice. It is very worrying. GP surgeries just do not want to know. What can the Minister do about this? Some of these people are elderly, but there are also young people. How can one advise them? They want to speak to a human being, not just a repeated voice which does not answer their questions. Some of these people are pregnant. The ones I talk to are in a rural area; I do my best to tell them how important it is to have a vaccine, but they just want an official voice. I hope the Minister can give some advice.

I thank the noble Baroness for that question. As far as I am aware, the places administering the booster should be able to give that advice. For example, when I walked in for my booster, they asked which vaccines I had previously had and said that the half-dose I had was sufficient. When I asked about my children, they told me which vaccine was more appropriate for that age group, depending on which vaccine they had. If that advice is not available at the place of vaccination, please let me know. I was not aware of that and I promise that I can look into it.

While I am here, I realise that I did not answer the question from the noble Baroness, Lady Thornton, about the R number. It is currently at 0.9 to 1.1; the latest growth rate range for England is minus 1% to plus 1% per day. As the omicron data comes in, that may well increase, but we have looked at all these measures and are being as precautious as we can in balancing everything up.

In response to the earlier question about the pass—I apologise for the long answer—I have just been told that the NHS has tweeted:

“We are aware of an issue affecting access to the NHS COVID Pass on the NHS App and website. We are investigating this as a priority and will update as soon as we can”.

Clearly, the NHS has been listening to this debate and discussion, and I thank the noble Baroness for raising that. I am sure that noble Lords will agree that that tweet shows the effectiveness of having this debate, so that we can share as much information with the public as possible. I repeat this request: if any noble Lords are aware of any particular problems with the rollout, information et cetera, please let me know and I will investigate as quickly as I can.

Last evening, I mentioned to my noble friend the predicament of the 300,000 people who are housebound and cannot go and get a vaccination. I appealed to the Minister, saying that every GP practice knows who these housebound people are and where they live. Will my noble friend now commit himself and the NHS to making sure that every GP practice is asked to go out and give vaccinations to the 300,000 mainly elderly people who are awaiting vaccination?

I thank my noble friend for that question. As far as I am aware it has always been the advice that, if people are housebound, they should be able to receive their vaccination in their home. If my noble friend knows of any incidents where that has not happened, please let me know and I will chase them up.

We have heard about the advice on face coverings, but could the Minister tell us about social distancing in public places, particularly places of worship?

In many public places, advice has been posted about continuing to socially distance, but the main thing is now to wear a face mask and ventilate indoor spaces. But, if social distancing is again seen to be a factor, we will update as soon as we can.

My Lords, I did not agree with cancelling Christmas last year: I thought that it was disproportionate and far too risk-averse, based on the evidence then. It was cruel, with millions of front-line workers who had worked their guts out during the lockdowns having their parties cancelled and their family celebrations snatched away. Does the Minister understand what has changed now that the public know they were taken for mugs last Christmas? How can seething citizens, including me, give any credibility to data or a risk-averse plan B being based on evidence, rather than a tactic of political crisis management, which is what it feels like?

I understand the frustration of the noble Baroness and a number of civil libertarians, but we have always been clear that we have to have a balance between keeping the British people safe by being cautious and making sure that we follow the data. We have always looked at a number of different factors, including hospitalisations, the proportion of admissions due to infection, the rate of growth in cases, vaccine efficacy and many others—but, quite clearly, when we see this doubling rate of the omicron variant and do not yet have enough data, we are being cautious. By doing this now, we could prevent a worse situation later.

My Lords, when you go on to your app, you do indeed get a message that says, “There are currently issues with accessing the Covid pass on the NHS app and the website”. Given that the advice is that this mandatory certification will be required from Friday, this is an issue not only for the individuals trying to access the certification but for the venues. Can the Minister assure us that, if the problem continues, there will be clear advice to venues as well? Otherwise, there will be untold chaos when this comes in on Friday.

The noble Baroness makes an important point. Let us hope that the NHS will fix it. As the NHS says, it is aware of the issue and will try to fix it and update as soon as possible. But, clearly, if that is not possible, we will have to update the guidance, and I will take that back to the department.

My Lords, I think that my noble friend said that the peak of the omicron infection rate is expected in January. Will he confirm that the lateral flow testing will last through January to March if that is the case? Will he join me in congratulating the Dispensing Doctors’ Association, with which I declare my interest as an adviser, on rolling out specifically the programme to which my noble friend Lord Naseby referred of vaccinating the housebound? Can he look into the fact that the Covid pass that is issued reflects only two vaccines and not the booster vaccination?

I pay tribute to my noble friend for making us aware of the dispensing doctors, and for making people like me, who are much more urban-centred, aware of some of the issues in rural areas. On the Covid pass, up to now, in most countries it has not been a requirement to have the booster shown in order to travel. Clearly, all countries will now be updating their travel requirements and restrictions. I am afraid I have a terrible short-term memory. What was the first question?

Yes. Given the advice on testing, especially if you are pinged and have to test, clearly we will make sure that there are sufficient tests available.

My Lords, can the noble Lord say a word about enforcement? In my observation of the use of face masks on London transport, for example, compliance has increased significantly in the past week, so there is a disposition on the part of many people travelling to comply. But there are still a significant minority—and that minority is important—who do not comply and do not appear to carry or exhibit any evidence of exemption. Will people whose job it is to ensure that people on public transport or elsewhere are wearing masks get the help and guidance they need to understand where the limits of their powers might be?

Enforcement has been a constant concern throughout, and workers have been concerned about having to enforce. The police and certain transport operators may issue fixed penalty notices to those who refuse to wear a face covering when required to do so and are not exempt or do not have a reasonable excuse. This will be used only as a last resort. The fines will start at £200, which will be halved if paid within 14 days. For repeat offenders, the second offence will be £400, the third £800, the fourth £1,600, the fifth £3,200, and the sixth and subsequent offences £6,400. The price mechanism will be used as a deterrent, but I am sure that the authorities will exercise discretion, so they may give an informal warning first, as has happened. They can also take measures if members of the public do not comply with this law without a valid exemption. They can deny access to public transport services, and direct someone to wear a face covering or leave a service if they are not wearing one without a legitimate reason.

My Lords, the Government are effectively outsourcing a lot of the policing of this to the businesses of this country—small, medium and large. Those businesses will not be able to do that unless they have a full understanding of what is expected of them, full public backing from the Government that they have to do this and details of how they will be helped. I understand that it is not the Minister’s portfolio, but I ask that he takes this to both BEIS and the Treasury and that we get quick answers for British businesses, which have to police vaccine passports and the use of masks all over this country for this policy to have any reason at all.

I thank the noble Lord; we had a conversation earlier about the importance of business and of informing businesses as quickly as possible, and the important role that they play. It is clear that the police and transport operators have fixed penalty notices. We know how sometimes it can be difficult for individuals, particularly in retail, to enforce the law—that they are worried about being seen as police officers. But we hope to make it clear that it is an offence not to wear a mask in places where you are required to do so, and we are issuing further guidance on that. I will take the matter back, as the noble Lord says, and get a cross-governmental response.

My Lords, I cannot resist this: my app did not crash because it is Scottish. Can the Minister clarify the government advice to work from home if he can? Is the advice that you should or that you could? Secondly, what advice do the Government have for people who have recovered from Covid on the risk of them spreading the virus, and for how long?

I am pleased to hear that someone’s Covid app has not crashed. I am not sure if it is due to Scotland or if that is a coincidence; some of the people in the devolved Administrations may want to raise that with me. The guidance is that you should work from home if you can, but clearly there are some issues. I know that there were mental health and other issues before, but that is the guidance. On the medical question, I hope that the noble Lord will join the all-Peers meeting with Dr Jenny Harries on Friday, when he will be able to put that question to her. If not, he should write to me and I will put that question to her.

I thank my noble friend the Minister for making a timely Statement, for the boost to the booster programme and for progress on Covid drug treatments. All are very important to our families and friends, and to the country. Against that reassuring background, I think that some of this evening’s comments were a bit over the top and, I have to say, my NHS log-in leapt into life as the Minister was speaking, so it looks as though it is back on track. I have two questions for him. The first is for an update on cancer cases, especially the outstanding number of cancer operations and hospital treatments, and the impact of plan B on their throughput. My second concern is the economic impact of these new measures until the sunset date of 26 January. We have working from home, vaccine passports and enforcement of masks, which will hit travel, entertainment, business, hospitality and so on. What is this wider economic hit? The Government will not publish impact assessments, as they should, despite my efforts to persuade them, but can the Minister expand on the economic aspects and the impact on growth, employment and productivity? The country is indebted as a result of Covid—and the hit has been 10% over the last year—and businesses have been hit by this. We have to look at the economic side as well as the disease control side, which he dealt with so well.

I thank my noble friend for making those two important points. As we know from what happened previously, as a consequence of lockdown, many people were unable to have operations or even diagnoses. In fact, much of the waiting list—80%—is for diagnosis. It is too early to tell what the impact will be, but I will find out and write to her. It is quite clear that there will be a negative economic impact. I do not think one has to be the former head of research for an economic think tank to say that, but it depends on how long this lasts and what economic activity continues in the meantime. I will look at that.

My Lords, the Minister rightly made the point that two variants will shortly be circulating in high volume—the delta and omicron variants. Is he content that there is sufficient genomic sequencing capacity to distinguish between the two and, therefore, understand the epidemiology and the natural history of the two competing virus strains, at a basic level?

I attended a meeting this afternoon with leading epidemiologists, showing the data and separating the omicron variant, the delta variant and the original coronavirus. They have the data, and one of the reasons we have made this announcement is because we are able to distinguish between them. We are constantly reviewing the data for the original coronavirus and the variants but, if the noble Lord has any more scientific or medical questions, he should let me know or attend the briefing with Jenny Harries on Friday.

My Lords, the Statement says that the Government are looking to introduce daily tests for contacts instead of self-isolation. I have a couple of questions. My noble friend Lady Brinton asked what the false negative rate is for lateral flow tests at the moment. Secondly, what will be the legal obligation for a person to take this test and then to upload the result so that people know that contacts are taking the lateral flow test?

I am not quite sure about the latest data, because clearly more people have been taking them, but accuracy was in the very high 90s. However, I will commit to write to the noble Lord. On his second question, I will make sure that we get that information out as quickly as possible.