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Wuhan Coronavirus

Volume 671: debated on Tuesday 11 February 2020

With permission, Madam Deputy Speaker, I will update the House on the response to the Wuhan coronavirus.

I have laid an instrument before the House to confirm the power we have taken to isolate those at risk of spreading the virus, and if necessary to keep them isolated as part of our belt-and-braces approach to protecting the public. The powers are proportionate and will help us slow down transmission of the virus and make it easier for NHS and public health staff to do their jobs.

The clinical advice about the risks to the public has not changed, and remains moderate. As of today, eight people in England have tested positive for coronavirus; all are receiving expert care from the NHS, which is well prepared and equipped to deal with this kind of situation. Contact tracing of the first four cases has been undertaken rapidly and is now complete, while tracing for the latest four cases is ongoing. This contact tracing itself identified five of the cases, a tribute to the skill and tenacity of Public Health England staff, as well as finding a further five British nationals in France, who have also tested positive for the virus. They are now receiving treatment, and the Foreign Office is following up with consular support.

On Sunday, 105 more British nationals and dependants from Hubei province landed safely at Brize Norton. They are now in isolation facilities at Kents Hill park in Milton Keynes and are receiving all the necessary medical attention. I want to pay tribute to the Foreign Office and the MOD, as well as Milton Keynes Council and Milton Keynes hospital and my own team, for their hard work and efficiency in ensuring that this all went smoothly. These steps are, of course, in addition to those for people now reaching the end of their isolation on the Wirral.

Turning to the efforts to contain the outbreak in China, the Foreign Office is advising against all travel to Hubei province and all but essential travel to mainland China. Last week, we issued new advice to all travellers returning to the UK from China, Hong Kong, Macau, Malaysia, South Korea, Singapore, Taiwan and Thailand. That advice is clear: if you develop symptoms of cough, fever or shortness of breath, you should call NHS 111 and immediately self-isolate for 14 days, even if symptoms are minor; if you have returned from Hubei, you should self-isolate and contact NHS 111 even if you have no symptoms.

My officials discussed the incubation period with the World Health Organisation this morning. The current evidence shows that a 14-day incubation period remains appropriate. We will continue to monitor emerging evidence closely with our international partners.

As I said last week, dealing with this disease is a marathon, not a sprint. The situation will get worse before it gets better. We will be guided by the science. Be in no doubt: we will do everything that is effective to tackle this virus and keep people safe. We are investing £40 million in vaccine research and are working with international efforts on therapeutics, and today I can announce to the House the immediate launch of a capital facility to support any urgent works the NHS needs for the coronavirus response, such as the creation of further isolation areas and other necessary facilities.

Finally, there are actions each and every one of us can take—simple but effective steps like washing hands and using tissues. We will take all necessary precautions to keep the public safe, and I commend this statement to the House.

I thank the Secretary of State for advance sight of the statement and advance notice of the regulations and steps he was going to invoke yesterday.

Our thoughts must be with all those diagnosed with novel coronavirus and those in quarantine, and I place on record again our thanks to NHS and Public Health England staff and all other staff involved in responding to the outbreak.

On the specific issue of the quarantine arrangements, I understand the approach the Government have taken, and the Secretary of State will recall that in response to last week’s statement I asked him what would happen should an evacuee wish to leave Arrowe Park. In response he understandably reminded the House that evacuees had signed contracts that effectively offered passage back to the UK in return for compliance with the Government’s quarantine arrangements. However, given that questions were raised around how practically enforceable those contracts were, and indeed wider questions about what was allowed under human rights legislation, I understand why the Secretary of State has invoked the regulations that he is entitled to do under the Public Health Acts. He has our support.

Quarantine arrangements must be seen to be necessary, proportionate and in accordance with the law, and enforcement of those quarantine arrangements, including with powers of restraint where necessary, must be fully transparent, and the rights and freedoms of the quarantined evacuees must be fully understood so as to ensure they are treated with dignity and respect. We agree that a legislative framework for this is far preferable to the ad hoc contracts that were the original basis for the quarantines.

In order to maintain public confidence in these arrangements, that framework must be understood and scrutinised by Parliament. With that in mind, on the instrument the Secretary of State laid before the House yesterday, at what point will the House get an opportunity to consider the regulations and will that be on the Floor of the House? I appreciate that the Secretary of State is not one of the business managers—although there is going to be a Government reshuffle so who knows by the end of the week—but if he can give us some clarity at this point on that, we will appreciate it.

Turning to the UK response more generally, can the Secretary of State tell the House if he is asking clinical commissioning groups and trusts to make plans should this outbreak turn into a pandemic in the coming months? What work is he doing to ensure that the local plans are robust, and can he guarantee they will be fully resourced? What communications have directors of public health in local authorities received and how will they continue to be kept informed?

Is the Secretary of State confident that NHS 111 has sufficient capacity to deal with increased numbers of calls? Will community health trusts, which I understand will be tasked with visiting suspected patients in their homes to carry our swab tests, be given extra resources to scale up capacity, or will they be expected to fund this extra work from their existing baselines?

With respect to the capital facility the Secretary of State has announced, I understand that hospitals are being given specialist pods to quarantine patients and access to this facility. Can he tell us whether GPs have the necessary equipment and resources to cope with patients who may present with novel coronavirus? Will they be able to apply for this capital facility?

I welcome the Secretary of State’s advice on travel arrangements, not least with school holidays coming up next week. Many people will want clarification. Can he assure us that Foreign Office advice is fully aligned with Public Health England advice, and tell us what monitoring arrangements are in place at airports for flights returning not just from China but other places across the world where there has been a coronavirus outbreak?

Finally, can the Secretary of State update the House on international efforts to share research and intelligence, as well as attempts to find a vaccine, and a timescale? He will know that there is a World Health Organisation summit today, for example.

On behalf of the official Opposition, we again thank all our hardworking NHS staff, particularly those on the frontline, some of whom have been diagnosed with coronavirus. We thank the Secretary of State for coming to the House, and reiterate our hope that he will continue to keep the House updated in the weeks ahead.

I am grateful for the support of the Opposition for the measures we have taken. The best way to deal with an outbreak like this is on a bipartisan basis. The approach the House has taken has thus far helped to enable as efficient and capable a response as possible to what is obviously a very difficult situation. I entirely agree with the hon. Gentleman that the use of the powers we brought into force yesterday must be proportionate. Enforcement, too, needs to be reasonable. That is a very important consideration.

The hon. Gentleman is right to ask about NHS 111. We will ensure that NHS 111 services have support available. We have plans in place to expand support for those taking the calls on 111 if necessary. Thus far, we have not had to do that. Compared with the huge scale of the millions of calls to NHS 111 that are made, the number concerning those who think they may have coronavirus is still relatively small, but of course we stand ready to do that if necessary.

On timing, as far as I understand it business managers have not yet scheduled the debate on the affirmative procedure for the statutory instruments I presented yesterday. They are made affirmative—as in, they become law—the moment they are signed and thus are law now. They remain in force, with the requirement for Parliament to debate and pass them within 28 days. We will ensure that that happens. They then stay in force for two years, or until the end of the public health emergency is declared.

The hon. Gentleman asked about links with the local authority in Brighton. That is an incredibly important question. I understand that the links have been very close and that the public health officers in Brighton have been working very closely with Public Health England. I thank them, as well.

The hon. Gentleman asked about access to capital for GPs. If GP facilities or other parts of the NHS need capital upgrades, we will of course look at that. In the first instance, though, it is very important that people do not go immediately to their GP, but rather call NHS 111. If they do go to A&E, we will ensure that pods are available so that people are separated from the vast majority of those going to A&E, as we do not want them to be contaminated.

The advice remains absolutely clear: if you suspect that you may have coronavirus, call 111 and do not leave home until you have spoken to a clinician.

I thank the Health Secretary for the way he has handled this crisis. We are all very aware that appearances before this House are only a tiny fraction of the huge amount of work going on behind the scenes. I also thank the shadow Health Secretary for the non-partisan way his party is approaching this public health crisis.

One of the most distressing things we see on TV in relation to what is happening in China in the affected province is people being denied basic hospital treatment because the hospitals are full, whether because of coronavirus or another illness they happen to have. Will the Health Secretary give some idea of the preparations that are being made to protect people who will continue to have urgent illnesses, such as cancer, which will continue to need to be dealt with very promptly, even in such a situation as the virus exploding in the UK?

This is a very important strand of our prepare and mitigate policy to ensure that should things get worse here the NHS is fully prepared. The NHS has the capability now to cope with the very highest level of intensity and isolation with 50 cases, and the capability to expand that to 500 cases without an impact on the wider work of the NHS. If the number of cases gets bigger, we will of course need to take further steps. As my right hon. Friend knows from his time in my shoes, extensive plans are already in place for how they should happen if we reach that eventuality.

I, too, welcome the Secretary of State’s statement, and we support the use of powers to maintain isolation, as they are critical for the health and safety of other people in the country. I would, however, also support their being transparent and proportionate. I also welcome that the four chief medical officers across the UK are working together on this issue.

The Government are advising symptomatic returnees from the high-risk countries, but should that not be all people returning from high-risk countries? We simply do not know what the prodromal part of the incubation period is, nor how infectious someone actually is before they have any symptoms at all. I have to say that I was surprised to see the bus drivers, who were driving those on their way to quarantine, sitting in the front seat in shirt sleeves besides someone in full hazmat gear. That seemed to me to send out a rather strange message.

It is also advised that only those from Hubei province should self-isolate even if asymptomatic, but we see from the cases in France that this is spreading very quickly, and we already have 40,000 cases across 28 countries. Therefore, if anyone is flying and going through airports, there is the risk of spread, from simply being on an aeroplane with someone coming from China.

I welcome the funding for vaccine research and the expansion to 12 test centres across the four nations, but what publicity campaign is planned to educate the public upfront not to go to their GP and not to go to accident and emergency, where they will actually spread it to someone else? I understand that the information is there on the Scottish NHS inform system or 111, but if someone is not looking maybe we need to be proactive about the message.

Finally, the UK is no longer part of the European Centre for Disease Prevention and Control. While we are able to take part in the early warning and reporting system during transition, we are no longer part of the decision making or central procurement of vaccines. How much of that system is the UK still able to be part of at the moment during transition and in the long term? Does that perhaps raise up the agenda some of the areas of co-operation that need to be sought with European Union agencies?

I am grateful for the broad support expressed by the hon. Lady. I am also very grateful for the work of the devolved authorities in Scotland, Wales and Northern Ireland, and the work of the four CMOs across the UK, who have worked very closely together on what is a public health emergency.

To answer the hon. Lady’s specific questions, all those returning from any of the named countries, which I reiterated in my statement, should, if they are symptomatic, self-isolate. We are taking all measures that are deemed to be effective on the clinical advice. As a clinician herself, I am sure she will recognise the importance of following the epidemiological science wherever possible to make sure we take steps that will be effective and proportionate to the scale of the challenge.

The hon. Lady also asked about the monitoring of those returning on flights. We have enhanced monitoring in place for all those returning, as I said. She also asked about a publicity campaign to get the message across about what people can do—people should wash their hands and follow the advice in the “catch it, bin it, kill it” tissue-use campaign—as well as the important message that the first thing that someone should do is call 111. We have a very significant publicity campaign and I will double-check that that is being co-ordinated with the devolved authorities—I think it is but I will double-check, because that is very important.

Finally, to answer the point about the bus drivers, that decision was again taken on clinical advice to promote the safety of the passengers and balance all the considerations that needed to be taken into account.

The Secretary of State said that this public health emergency is likely to get worse before it gets better, so will he reassure the House today that we are well prepared for any new cases in the UK and that the NHS has the capacity to cope with those new cases, wherever they occur across the country?

Yes, of course I can give that assurance. We have been clear all along that we have expected cases and that we are doing everything we can, but we also need to prepare for what might happen in future.

Given that we are now experiencing spread between people who have not been to China, as the Brighton cases show, will the Health Secretary say something about how people can distinguish between the ordinary symptoms of flu and the novel coronavirus symptoms, because China is now not the only lexicon?

That is a very good point. People should follow the clinical advice for the symptoms they have, with there being, of course, a much higher risk if they have travelled to one of the affected areas. In that case, they should call 111 and present, and have the test. The testing is available precisely to distinguish the difference, because it is not reasonable to ask ordinary members of the public to know the difference between an old coronavirus and the novel coronavirus, or indeed, between flu and coronavirus.

Will my right hon. Friend provide an update on the likely timescales for the development of a vaccine for Wuhan coronavirus, and on Britain’s contribution to that?

We have put £40 million into the global and domestic efforts to find a vaccine, and the work got under way fast. That work is progressing, but it takes time not just to develop a vaccine, but to ensure that it is assured and safe to use. It is in the nature of these things—because of incubation periods and the nature of the science—that it does take time.

Should the outbreak become more widespread, will the Secretary of State say what advice he is preparing for employers, because many people, such as those on zero-hours contracts, will be severely financially penalised, which will create a big incentive for them to turn up for work when they are feeling ill? Will he say what preparations he is making for employers to avoid those circumstances?

That could become an important consideration in due course, but I am glad to say that, at the moment, the impact on employment is very small, because we have only eight cases. However, I will certainly take that into consideration.

I thank my right hon. Friend for updating the House today. I think that that statement will reassure my constituents, some of whom have contacted me with concerns about the way that the disease is spreading. Will he continue to keep the House updated, particularly as infection control measures are rolled out, should they be necessary?

I hope that I have demonstrated my willingness to keep the House informed. In the way that we respond to these public health emergencies, it is incredibly important that we are clear, straightforward and transparent with the public. The ability to communicate in what is inevitably a fast-moving situation is always a challenge, but I pay tribute to Members of the House for responding—and probing, of course—in a reasonable and sensible way, and to large swathes of the media, who have reported on the coronavirus outbreak in a way that is essentially guided by the science.

In Brighton and Hove, our thoughts are with those who have tested positive in our city and those linked to them who are in isolation. The Secretary of State will know that there are real concerns locally, with another health centre closing today. People need and want more timely and accurate information—not just about washing hands and tissue use, vital though that is, but about such things as what self-isolation actually looks like. I think we need a much higher-profile public health campaign, so what steps is he taking to work across Departments—including with the Department for Education, the Department for Work and Pensions and so on—to proactively disseminate key public health messages without causing panic or compromising patient confidentiality? Will he also assure me that the Foreign and Commonwealth Office consular department is proactively offering support and assistance to people who are isolated in countries such as France?

The hon. Lady makes an important point, especially in relation to communicating through, for instance, the Department for Education and schools to make sure that schools get the reassurance that they need. I pay tribute to the way the hon. Lady has conducted herself, given the number of cases in her constituency, and the impact on local health services. We have taken action urgently where contact tracing has shown that it needs to be taken, and we will take that proportionate action. I am also very keen to be able to provide reassurances to people that we are taking the action that is needed and that the threat to the public remains moderate, even as we have seen the increase in numbers.

In my local hospital, staff are being provided with specially fitted masks to ensure their safety when treating patients who may or may not have the coronavirus. Will the Secretary of State confirm that that is part of a wider package of ongoing policies and procedures in the NHS to keep our staff safe when treating these patients?

Yes, of course. Making sure that we have the equipment to keep our staff safe is a very important consideration—keeping medics safe is very important not only for them but for the public, because they provide such an important service.

Will the Secretary of State tell the House about the latest scientific advice he has had on when, as we all hope, a vaccine might be available?

The estimates vary and the answer is uncertain. There are promising signs of the very early stages of development seeing breakthroughs, but after the early stages of development, there need to be pre-clinical trials and then clinical trials to make sure that any vaccine is safe, especially given that—thankfully—the mortality rate from this coronavirus appears to be relatively low, at around 2%. Therefore, it is very important that a vaccine does not do more harm than good. I am pushing as fast as I can on the development of a vaccine, but I am also highly cognisant of the scientific advice and the need to ensure that it is safe.

On the point about mortality, leaked reports are coming out of China that the number of those who are dying is considerably higher than we first anticipated. Is that true? Is that what my right hon. Friend is hearing? Will he also tell the House, and thereby the country, who is most vulnerable? Who is most likely to be seriously affected by this terrible disease?

It is difficult in a country dealing with a very large-scale outbreak, as China is, for the information to be completely accurate. However, a report published in the last 48 hours of a study of 1,099 cases from China has demonstrated that in those cases, the number of children who have been affected and symptomatic is very small. That gives us hope—and some evidence—that the impact is largely on the elderly and frail, less so on people of working age and much less so on children, which is a very good thing for children themselves and for everyone else, because with the flu, if children are spreaders, they tend to spread fast. That is the latest scientific advice coming out of China, although given the nature of the challenges the Chinese health system is facing, it is difficult to get an entirely clear picture.

The Secretary of State has fielded various questions on the timescales for a vaccine. If I may be so bold, the chief medical officer told MPs last week that nothing less than a year should be promised for the development of a vaccine or treatment. Does he agree, therefore, that this is very much a long-term solution and that we must redouble our efforts on the public communication campaign on preventive and self-isolation measures?

Yes, I do. On isolation, in particular, the two go hand in hand. People can play a part in combating this virus by washing their hands and using tissues and, if they are symptomatic, by calling 111 before going to a doctor and self-isolating when necessary.

I thank the Secretary of State and his team for keeping me and my hon. Friend the Member for Milton Keynes South (Iain Stewart) updated throughout this process. It has been a very worrying time, but that information has been very useful. I am sure the whole House will join me in congratulating the professional way the local healthcare professionals, including those at Milton Keynes hospital and beyond, and our wonderful council officers have risen to the challenge of hosting a coronavirus facility in Milton Keynes. It is also worth mentioning the police, who now have additional powers to keep that site safe. Can the Secretary of State assure me and the people of Milton Keynes that all the appropriate processes, procedures and powers are in place to keep our residents and their families safe?

I pay tribute to my hon. Friend and my hon. Friend the Member for Milton Keynes South (Iain Stewart), who, as a Whip, cannot speak but who has also been working incredibly hard on behalf of people in Milton Keynes to reassure them, as my hon. Friend rightly says, that the extra 100 people from Wuhan that the town has welcomed are now safely there in Milton Keynes. The council and the hospital have gone out of their way to make this as efficient as possible and to make those returning from Wuhan comfortable.

My constituents’ mother/mother-in-law has been visiting them from Wuhan on a six-month visa that is due to expire at the end of this month, when normally she would expect to go home. What advice are the Government giving to visiting Chinese nationals, particularly from Wuhan and Hubei province, about extending their visas in this unusual situation? I cannot see anything on the UK Government website, but I can on the Norwegian Government website.

I congratulate my right hon. Friend on the way he and his officials have handled this crisis, which has helped to keep the threat at “moderate”, and Members across the House on the non-partisan approach they have taken. I am concerned, however, that because we have broadcast that the threat is moderate people may become complacent. Will he increase the number of public health messages? I have heard them on the radio, but it struck me at motorway service stations on the way down yesterday that there was no public health information there. In areas of handwashing and bathroom use, it would probably be quite advisable.

That is an excellent idea. We are open to all ideas of that kind and I will look directly into it.

I thank the Secretary of State for coming to the House and making this statement. I have a question about the use of this term “super-spreader”. In past outbreaks, people categorised in that way have often been demonised. Will he take this opportunity to explain to people that these so-called super-spreaders might have no idea they have contracted the virus and should in no way be blamed or demonised for spreading it?

This is a really good point, and I want to make two points on it. First, those who have contracted the virus are ill and deserve our sympathy and support. I know from the incredible way they have responded to the need to undertake contact tracing that all those in the UK who we have been working with because they have tested positive have acted in an exemplary way and done everything that society could have asked of them to make sure the virus is contained. I pay tribute to the way they have responded to public health officials and the NHS and thank them for doing that.

On a second connected point, anybody who thinks it appropriate, in response to this challenge, to demonise or abuse anybody from the British-Chinese community, or anybody of Chinese or east Asian origin, is completely wrong and is being counter-productive to the efforts being made across the country and the world to tackle this virus.

I thank the Secretary of State for his measured statement. Does he agree that we should not allow our proper focus on the risk from coronavirus to blunt our efforts in respect of seasonal flu, which, as the chief medical officer indicated, kills around 8,000 people a year? In those circumstances, the precautions taken—handwashing and observing basic hygiene—are important for all sorts of good reasons.

It is absolutely true that handwashing and “catch it, bin it, kill it” are the right responses to flu as well as coronavirus. We are coming towards the end of the traditional flu season, which this year in England came early, in December, and thus far—touch wood—has thankfully been largely mitigated and gone away. Next year, of course, we will be even more vigilant than normal.

With regard to the capital facility that has been announced, can the Secretary of State outline the total amount of funding allocated to the NHS and can he say whether this is new money or a loan that will have to be paid back?

This will be new money to those NHS organisations bidding for it, and we have not put a cap on it. We are inviting bids from NHS organisations and will very rapidly assess those bids.

With universities in Northern Ireland cancelling trips to China individually, can the Secretary of State outline whether the Government intend to issue guidelines to stop travel between and to infected areas? Further, is there any intention to do routine tests on anyone recently returned from the infected areas?

We have enhanced monitoring in place on flights from the areas I mentioned, which is important, and of course we keep all options under review, because the most important thing is to follow the scientific advice wherever possible and to keep people in this country safe.