COVID-19 Debate 12/01/21

Recent changes to remote participation meant that I was able to take part virtually during this week’s COVID-19 debate in Parliament.

I began my contribution by paying tribute to all the key workers across the UK who have played an incredible role during the pandemic to keep our public services operating, and helped to maintain food and energy supplies.

I then proposed a series of recommendations for the UK Government to pursue in order to curtail the spread of the virus.

Firstly, we must tightly control our external borders in order to prevent the entry of new COVID-19 variants into the UK. This can be achieved by requiring pre-travel PCR testing and enforcing strict quarantine rules.

Secondly, the UK Government must ensure that those who test positive for COVID-19 or come into contact are provided with sufficient financial support to isolate. Although the current £500 isolation grant is welcome, it is less than the minimum wage.

Instead of planning to spend eye-watering sums on lateral flow tests with poor sensitivity and a danger of giving people false reassurance, it would make more sense to fund an expansion of NHS labs to increase capacity and provide quicker turnaround times for PCR tests.

Lastly, the UK Government should ensure that the quality of ventilation in indoor settings, such as hospitality, is improved. Cutting VAT on installation and exploring the most modern technologies are some options.

The UK Government need to make this lockdown count and ensure a systematic approach to covid in 2021.

You can watch my full contribution to the public health debate here:

Dr Philippa Whitford MP

Thank you, Mr Deputy Speaker.

First, I wish to pay tribute to all NHS and social care staff across the UK for the incredible role they have played in this crisis and to all the key workers who have helped to maintain food or energy supplies, and kept our public services operating. I echo the Minister in saying that the best way for all of us to express our gratitude is to stick to the rules and stay at home.

With the novel coronavirus emerging just a year ago, all Governments have had to find their way. There are many aspects of the UK Government’s COVID-19 response that can be criticised, especially being too slow to lock down in March, September and yet again in December, or outsourcing testing and contact tracing to companies with no previous experience, such as Deloitte and Serco, instead of using NHS and public health expertise.

I am sure that many of the issues will be well-aired in this debate, so I will focus on where we are now and on what options should be considered for the next steps.

The first thing is to recognise that it is a false dichotomy to set public health against the economy, lives against livelihoods. People will simply not engage with the economy if they do not feel safe. The countries that have suffered the least economic harm are those with previous experience of SARS. Last February, they quickly acted on their learning from the epidemic of 2002. They initially closed their borders and have since maintained tight border control with testing and strict quarantine of all arrivals. They drove down early outbreaks and then worked to eliminate community spread.

Those countries, such as Taiwan, New Zealand and Singapore, all now have domestic economies that are fully open and societies that are engaged in the pleasures of sporting events, dining out or simply having a few friends round, or, as the shadow Minister said, being able to give a loved one a hug.

So what is the strategy? First, let us avoid importing any more dangerous covid variants by tightly controlling the external borders of the UK, and, through co-operation with the devolved nations and the Republic of Ireland, try to make the whole common travel area covid-secure. 

I welcome the plan to require pre-travel tests for those coming to the UK, but they should be PCR tests, not lateral flow devices that miss more than half of those carrying the virus. We could learn from Pacific countries that enforce strict quarantine for incoming travellers, either in hotels or through digital monitoring at home. Such a strict approach would avoid importing the South African strain or other more concerning mutations that we do not even know about yet. If it contributed to getting the domestic economy fully open, the Government would then be able to focus their financial support on the industries involved in international travel, such as aviation and aerospace.

To avoid creating more mutations within the UK, it is critical to drive down the current rate of infection. It is simply a numbers game. More spread means more viral replication and leads to more mutations. All of this increases the risk of developing an even more problematic variant. The big advance, of course, compared with last March is that vaccines are now available and all four health services across the UK are working as fast as possible to deliver them to those at highest risk of COVID-19. This is the light at the end of the tunnel, but, with just over 3% of the population vaccinated and hospitals in London at risk of being overwhelmed within weeks, it is simply not possible to vaccinate our way out of this current surge, so this lockdown is absolutely necessary.

The Minister mentioned those who undermine the rules by not taking covid seriously. A comparison of the first SARS epidemic and COVID-19 highlights the fact that infectiousness is a greater danger than virulence. SARS had 10 times the mortality rate of covid, but only infected about 8,000 people and killed fewer than 800 worldwide.

In contrast, despite appearing to be a much milder condition, COVID-19 has infected more than 90 million people and already killed almost 2 million. As the new variant is estimated to be 70% more infectious than the original virus, uncontrollable spread is the real threat.

Therefore, rather than already discussing arbitrary end dates for this lockdown, it needs to be maintained long enough to fully suppress the current outbreak. We all know that lockdown is really difficult, but with approximately 55,000 new cases every day that will take time, and if it is relaxed too quickly, cases will simply rebound as they did in the autumn.

Thereafter, the aim is that the test, trace and isolate system should detect and deal with sporadic cases and shut down minor outbreaks so that they do not get out of control. Instead of planning to spend eye-watering sums on lateral flow tests with poor sensitivity and a danger of giving people false reassurance, it would make more sense to fund an expansion of NHS labs to increase capacity and provide quicker turnaround times for PCR tests.

It has been good to see an improvement in contact tracing with the greater involvement of local public health teams, as has been the case in the devolved nations since the start. However, the most important aspect of test, trace and isolate is the isolation of those carrying the virus. Only isolation stops the onward spread of the virus. No amount of testing or tracing will control the epidemic unless we get people isolating when required.

The £500 isolation payment is welcome, but it is less than the minimum wage. It is important to clarify what happens to those whose applications are refused, and also to assess the need for practical support, such as the delivery of shopping or medicines. It is well worth providing such support if it helps stop the onward spread of the virus.

The fourth part of the strategy should be to make indoor settings—such as hospitality, offices and schools—safer by improving ventilation and air purification systems. A Government taskforce could assess the various new technologies available. Removing VAT or providing grants would help hard-hit sectors such as hospitality to reduce the risk of being repeatedly shut down in the future.

Finally, it is important to get the communication strategy right. Public health messaging should be clear, simple and honest, instead of undermining trust by constantly over-promising. Whether it is claims of world-beating apps and systems, or just repeatedly saying that the crisis will be over by a certain date, it is not helpful to have a trail of broken promises. I know from more than 30 years of having to speak and break bad news to cancer patients that honesty is always the best policy. Treat the public like grown-ups and share information openly, whether good or bad.

There was no handbook on COVID-19 at the start of the pandemic a year ago, but there are lessons we should have learned by now from research and experience, from our own mistakes or the successes of others.

The Government need to make this lockdown count and ensure a systematic approach to covid in 2021.