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Covid-19: Extent of Infection

Volume 803: debated on Wednesday 22 April 2020

Question

Asked by

To ask Her Majesty’s Government what proportion of people in the United Kingdom have been found to have had COVID-19; and what assessment they have made of the impact of that figure on their policies towards lifting the restrictions in place as a result of the pandemic.

The Question was considered in a Virtual Proceeding via video call.

As of 21 April, 129,044 people have tested positive for Covid-19. This represents less than 0.02% of the population. When the evidence demonstrates that it is safe to do so, we will adjust the lockdown arrangements. We have set out the five conditions that need to be met before lockdown measures are adjusted. These include having reliable data from SAGE showing that the rate of infections is decreasing to manageable levels across the board.

My Lords, it is very clear that testing is the way out of this. First, there is the immediate urgency of testing front-line health and care workers exposed to high viral loads through lack of proper PPE, and we could do this now if the Government would give the go-ahead to local private research labs with the necessary level-2 clearance, which would not take resources from Public Health England’s needs. Secondly, there is the urgent need for mass testing. Why are the Government forgoing the first in favour of a gold-standard testing regime that they can control from the centre to deliver the second? Can they not do both?

I thank the noble Baroness, Lady Sheehan, for a very clear Question. I can reassure her on three points. First, front-line staff in the NHS and in care homes are eligible for test on request and we will be opening lines so that they can phone and book their own testing shortly. Secondly, I commend and thank those private research labs already contributing enormously to our testing regime. Thirdly, mass testing is one of the options that we are looking at: the Cabinet Office is devising plans for the medium term and will be publishing them shortly.

First, I very sincerely thank my noble friend for his tireless work during this crisis. Did he by any chance see the BBC report yesterday under the headline “Deaths at 20-year high”? Digging into that needlessly sensationalist headline, intriguingly it reported that the apparent increase was one-third linked to the virus but two-thirds linked to non-virus cases. We all understand that there is an inevitable impact on others while we direct our focus towards the coronavirus, but have the Government undertaken any study of the estimated increase in the number of deaths of non-virus patients during the economic lockdown, and, if so, will they publish its conclusions?

My noble friend Lord Dobbs is entirely right to put his finger on this important matter. The CMO was clear from the very beginning that Britain’s mortality rate came as much from Covid as from non-Covid deaths. We review this situation regularly and thoroughly, and we will be glad to update the House at a future date. We are very conscious of the threat of which my noble friend speaks.

Supplementary question: the noble Lord, Lord Krebs. Lord Krebs? No? In that case, I call the noble Lord, Lord Hain.

My Lords, I declare that my wife is a board member of care providers. How on earth will the Government lift restrictions without universal testing, especially in care homes, where there is virtually no such capacity at all and not even enough personal protection equipment? The charity Leonard Cheshire Disability has been forced to spend an additional £250,000 a month sourcing PPE such as gloves and masks, and a South Wales care provider is spending £100,000 extra monthly. The Government need urgently to give billions more to care homes, instead of leaving them so badly in the lurch during this crisis,

I reassure the noble Lord that testing has been opened up to all care homes. I pay tribute to the CQC, which played a pivotal role in providing access to Britain’s 12,000 care homes in this regard. Mass testing is an option that we are looking at, but I remind the noble Lord that South Korea, where there is an extremely energetic track-and-trace facility, carries out on average 20,000 tests across the country—fewer than we do in Britain on an average day.

My Lords, we all understand the immense pressure that the Minister’s department is under, but does he agree that it is unacceptable that capacity is still only at 38,000 tests a day and that much of that very limited capacity is not being used, not least because the testing centres are often in out-of-the-way places that NHS and care staff cannot easily reach? Was an assessment of public transport accessibility made before these centres were chosen, and will the Minister’s department now urgently work with drive-through restaurant chains and other accessible venues to ensure that testing centres are in places that NHS and care staff can easily attend?

The noble Lord raises a completely valid point on the accessibility of drive-in centres. They suit some people but not all, as he rightly points out. That is why we have brought in at-home testing arrangements, delivered mainly by Amazon. They started on Monday, and we are very ambitious for both their scale and their scope, particularly for the demographics of which he speaks.

Supplementary question: the noble Baroness, Lady Lawrence of Clarendon. Lady Lawrence? No? I call the noble Lord, Lord Moynihan, for his supplementary question.

Over 90% of the population will be unlikely to have suffered from Covid-19 when the restrictions are lifted. Will the Government therefore initiate and support a nationwide fitness and recreation campaign, given that physical exercise can help ensure that immune systems become stronger and less susceptible to infections and their most severe consequences and lead to a greater ability to recover from infections?

My noble friend is entirely right. Fitness and the Covid epidemic are closely connected. The Secretary of State for Health has made it clear that a daily walk should be part of everyone’s lockdown arrangements and we are ambitious to make fitness and diet part of the agenda as we leave the Covid lockdown.

I thank the Minister for being open to communicating with us during the period before Parliament resumed. What assessment have the Government made of combining repeat virus detection with those risk factors that the Intensive Care National Audit & Research Centre’s contemporaneous data has shown are associated with particularly poor outcomes—I refer particularly to high body mass index, indicating obesity—and how will this inform the lockdown exit strategy?

The noble Baroness speaks of anecdotes of which we are very aware. We are conscious of the stories coming particularly from America about a seeming correlation, if not a causation, between obesity and Covid mortality. Clinical trials and data on this are in short supply. The CMO has not made a declaration on it. But I share her instinct that there is a strong connection. As the noble Lord, Lord Moynihan, suggested, fitness and diet will be important parts of our post-lockdown experience.

My Lords, we can understand the epidemiological value of antibody—serology—testing. However, I am interested in the public policy uses that may come from this testing. Is it the Government’s intention to use evidence of antibodies in individuals to say that some people rather than others can return to normal life sooner—particularly people of working age and younger rather than older people?

Serology tests provide important data on the behaviours of the virus. We still do not fully understand what kind of immunity and antibody response will be long-lasting in the body. There are mysteries to this virus that are yet to be solved; serology tests are vital to that and they can play a part in the back-to-work strategy. However, I would remind him that it is a tiny proportion of the population—probably around 5%— who have antibodies. We cannot put the economy back on its feet with just 5% of the population.

My Lords, I am afraid that the time allowed for this Question has elapsed. Two noble Lords were not called; I am sure that this will be taken into account in future lists.