On Tuesday 14th September the Government announced their Covid-19 Autumn and Winter Plan. I shall summarise this below, but you can read the full document here; https://www.gov.uk/government/publications/covid-19-response-autumn-and-winter-plan-2021
The Chief Medical Officer and Chief Scientific Officer were clear that the autumn and winter still present a risk of unsustainable pressure on the NHS due to the combined pressures of hospitalisations caused by Covid-19 and other respiratory illnesses such as the flu.
Prof Chris Whitty also warned that we are entering the autumn with a "much higher" level of cases compared with last year when cases were only beginning to rise. We are entering the autumn with more cases, hospital admissions and deaths than there were at this time last year While the vaccination programme has changed the situation, we still must be cautious as viruses are "hugely advantaged" during the cooler winter months and the delta variant is more dangerous.
The best and primary weapon against the virus is vaccination, and I encourage everyone who has not done so already to book a vaccine appointment – it is quick and easy to do here: https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/book-coronavirus-vaccination/
The Government has also announced that booster jabs will be offered to 30 million people in the following categories:
- Adults over the age of 50
- Frontline health and social care workers
- Older adults in residential care homes
- People aged 16-49 years old with underlying health conditions which put them at greater risk of severe Covid
- Adults who share a household with vulnerable people
The jab will be offered at least six months after a second vaccination and is likely to be either Pfizer or Moderna.
We will also see a very large programme of flu vaccination, and the MHRA has confirmed that having a flu vaccine and covid vaccine at the same time is safe.
Alongside this, the Chief Medical Officers of the UK have recommended that children aged 12 to 16 should be offered one dose of a Covid vaccine. Prof Chris Whitty said this would be an "important and useful tool" in reducing school disruption in the coming months and when combined with the health benefit identified by the JCVI.
If the data suggests the NHS is likely to come under unsustainable pressure, the Government has prepared a Plan B for England. The Government hopes not to have to implement Plan B, but given the uncertainty, it is setting out details now so that the public and businesses know what to expect if further measures become necessary.
Plan B would include:
- Introducing mandatory vaccine only Covid status certification in certain, riskier settings.
- Legally mandating face coverings in certain settings, such as public transport and shops.
- Communicating clearly and urgently to the public if the risk level increases.
Thanks to the success of the vaccination programme, it should be possible to handle a further resurgence with less damaging measures than the lockdowns and economic and social restrictions deployed in the past.
Protect the NHS
I understand that some people are completely opposed to any prospect of any further restrictions. We have all certainly sacrificed a lot over the last 18 months and it has been incredibly difficult for many.
However, I have said all along, that on weighing such matters, I must take any threat to NHS capacity seriously. If the NHS is overwhelmed this will impact to access the highest level of care for anybody who requires emergency treatment for whatever reason, such as an accident, not just those with Covid-19.
Whilst we have all made sacrifices, I am very aware of the additional burdens and stresses faced by NHS staff over the last 18 months. Not only have they, like all of us, been apart from our friends and family for long periods of time, but they have heroically served the public in the most stressful conditions. For example, many doctors and nurses were moved from their current specialities to provide care in adult ICU, where they have little or no experience, which is an incredibly stressful undertaking.
As the Queen expressed so eloquently, "Over more than seven decades, and especially in recent times, [NHS staff] have supported the people of our country with courage, compassion and dedication, demonstrating the highest standards of public service.
I believe that most people respect and admire the work the NHS do, recognise that this pandemic is putting the NHS under unpresented pressure, and want the NHS to be there to care for our loved ones if necessary.
Therefore, I think it is right that as a society should be prepared to take reasonable steps if necessary to protect the NHS and to respect and show solidarity to the NHS staff who work so hard to save lives.
The Vaccines are Highly Effective
Getting vaccinated is the best defence against this virus, protecting both you and everyone around you.
As of 9th September, more than 92 million doses of the vaccine have been given across the UK. The latest Public Health England estimates suggest that 143,600 hospitalisations 112,300 deaths and 24,702,000 infections had been prevented because of the vaccination programme.
The vaccines are highly effective, providing around 95% protection against severe disease and unvaccinated people were three times more likely than fully vaccinated people to test positive for COVID-19. This is a key point, if you are less likely to be infected, then you are consequently less likely to spread Covid-19 to those around you.
Being fully vaccinated against Covid-19 not only cuts the risk of catching it, it also cuts the risk of an infection turning into long Covid by 50% compared to being unvaccinated. Long Covid is a debilitating condition which can have severe consequences for people of all ages.
Furthermore, Professor Chris Whitty pointed out that the data shows an unvaccinated person in their 30s has roughly the same risk of hospitalisation as "someone in their seventies who is vaccinated". Therefore, it is so important that people at every age get vaccinated. So many doctors and nurses I speak to are finding the numbers of severely ill unvaccinated patients, including young adults, incredibly depressing and demoralising.
I encourage everyone who is eligible to come forward for both their jabs as quickly as possible, you can do this here: https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccinat…
Vaccine Certification
I have been contacted by many constituents with a range of views on vaccine passports and Covid-19 status certificates.
It is right that all options are considered to stop the spread of this virus. Whilst the vaccine programme is the most essential part of this strategy, it must be remembered that no vaccine is 100% effective.
I believe it is extremely sensible for there to be an authoritative record of vaccination available. This is particularly important for international travel, where other countries may require vaccination as an entry condition. There is nothing the UK Government can do to stop another country insisting on this, and it would be akin to having to have proof of yellow fever vaccination which some countries require. Therefore, to suggest a record of vaccination is, of itself, a limitation on freedom is historically and factually incorrect.
Now that such an authoritative record exists via the NHS App, then it is right to consider using this domestically.
All rights are balanced with responsibilities and the rights of others. I recognise there is a moral dilemma here; is vaccine and testing certification a mechanism to creating a safer society or an unacceptable intrusion of privacy and erosion of civil liberties?
Individuals should be free to choose to refuse vaccination for their personal reasons or refuse to show any such evidence. However, this freedom is balanced by the freedom of others to remain safe from a highly infectious and dangerous disease.
I recognise that some people cannot be vaccinated for medical conditions, have conditions which may make the vaccine less effective or have vulnerable relatives. It would be unfair to penalise them as these people have not chosen these risks, and on this basis, some have written to me in support of vaccine passports. They are concerned that they will not be able to fully participate in society should cases rise, though no fault of their own, as they will not be protected enough against Covid-19.
Therefore, I believe it could be necessary, in the context of this pandemic, to impose conditions which might limit the freedoms of those who have chosen to be unvaccinated to protect those who have made no such choice. I only refer to those who have chosen not to receive the vaccine here. I explicitly do not refer to those who have a valid medical exemption, as this is not a choice.
Choices have consequences, it is not unusual for society to intervene to reduce the risks to the many due to the choices of the few. Vaccinated people are less likely to catch Covid-19 and less likely to suffer severe illness and are therefore less likely to pass it on. For example, in the UK it has been decided that the right to carry firearms is outweighed by the right to be safe from firearms, and so we have very restrictive gun laws.
Therefore, the key as to whether so called vaccine passports should ever be used is the rationale, the implementation, and the expiry of such a measure. As ever, I shall look very carefully at any firm if the Government seeks to their domestic introduction.
Vaccination of Children
In the UK, the MHRA approved the Pfizer/BioNTech SARS-CoV-2 vaccine for use in people aged 16 years and over in December 2020, and in those aged 12-15 years in June 2021.
An independent scientific committee called the Joint Committee on Vaccination and Immunisation (JVCI) advises the Government on whether an approved vaccine should be used, which vaccines should be used in which groups and on dosing schedules.
For 12 to 15 year olds who do not have underlying health conditions that place them at higher risk from severe COVID-19, the JCVI considered that the size of both the risk and the benefit are at an individual level very small, and the overall advantage for vaccination, whilst present, is therefore not sufficiently large to recommend universal vaccination on their usual criteria. They deemed the extent to which vaccination might mitigate the impacts of COVID-19 on education was beyond the usual remit of the JCVI. They recognised however that given the substantial scale of the impact of COVID-19 on all children and young people, which goes beyond normal clinical benefit and risk, wider issues could, exceptionally, be relevant hence their suggestion to consult UK CMOs.
At an individual level, the view of the MHRA, the JCVI and international regulators is that there is an advantage to someone aged 12 to 15 of being vaccinated over being unvaccinated. The COVID-19 Delta variant is highly infectious and very common, so the great majority of the unvaccinated will get COVID-19. In those aged 12 to 15, COVID-19 rarely, but occasionally, leads to serious illness, hospitalisation and even less commonly death.
The JCVI have already recommended that children and young people aged 12 to 17 with specific underlying health conditions, and children and young people who are aged 12 years and over who are household contacts of persons who are immunocompromised are offered two doses of a vaccine, normally Pfizer BioNTech BNT162b2. They have recommended all young people 16 to 17 are offered an initial first dose of vaccine.
Therefore, this was not the JCVI recommending against childhood vaccination, as some claim. It was the JCVI recommending that Ministers take a wider range of views, which they did.
Overall, the view of the UK CMOs is that the additional likely benefits of reducing educational disruption, and the consequent reduction in public health harm from educational disruption, on balance provide sufficient extra advantage in addition to the marginal advantage at an individual level identified by the JCVI to recommend in favour of vaccinating this group. They therefore recommend on public health grounds that ministers extend the offer of universal vaccination with a first dose of Pfizer-BioNTech COVID-19 vaccine to all children and young people aged 12 to 15 not already covered by existing JCVI advice.
I would encourage you to read the full letter from the Chief Medical Officers here: https://www.gov.uk/government/publications/universal-vaccination-of-children-and-young-people-aged-12-to-15-years-against-covid-19/universal-vaccination-of-children-and-young-people-aged-12-to-15-years-against-covid-19
Finally, with regards to consent, the process will be the same as for existing school vaccination programmes.
In short, Medical professionals administering the vaccine can (in law) assess whether children have sufficient understanding and intelligence to make decisions regarding their own health. This law was set out in 1985, and so medical practitioners are extremely used to dealing with these issues.
You can watch Professor Chris Whitty set this out clearly here: https://www.facebook.com/DHSCgovuk/videos/916464938947062/
Coronavirus Act
Finally, a small number of constituents have contacted me about the Coronavirus Act. The Coronavirus Act is a critical part of the Government’s response to the pandemic, as it continues to support the NHS in retaining emergency staff, enables Statutory Sick Pay to support self-isolation, as well as enabling remote participation in court proceedings among other necessary provisions.
The Public Health (Control of Disease) Act 1984 gives emergency powers to be used in pandemics if they present significant harm to human health. This was used as the legal basis for national restrictions in England. No changes to the Public Health Act are planned.
At step 4 of the roadmap, the vast majority of COVID-19 regulations were removed.
The Government has reviewed the remaining regulations and decided, subject to agreement from Parliament that it is necessary to extend the following regulations until 24 March 2022, at which point they will be reviewed:
a. The Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) Regulations 2020, which impose legal requirements to self-isolate on positive cases and unvaccinated close contacts. Self-isolation will remain crucial in breaking chains of transmission throughout autumn and winter.
b. The Health Protection (Coronavirus, Restrictions) (England) (No. 3) Regulations 2020, which enable local authorities to respond to serious and imminent public health threats.
c. The Health Protection (Coronavirus, International Travel and Operator Liability) (England) Regulations 2021, which impose testing and quarantine requirements on arrivals in England, will remain.
The Government formally reviews the Coronavirus Act 2020 every six months to ensure that Parliament has an opportunity to expire any temporary non-devolved provisions that are no longer necessary to manage COVID-19. As part of the third six-month review of the Act due in September 2021, the Government is committed to removing those legal provisions that are no longer necessary or proportionate. The Government intends to recommend to Parliament that the following temporary non-devolved provisions are expired:
a. Section 23 (UK wide) enables changes to the timings of urgent warrants under the Investigatory Powers Act 2016.
b. Section 37 (Schedule 16) (for England) gives Ministers the power to direct the temporary closure of educational institutions and providers.
c. Section 51 (Schedule 21) (for England) allows restrictions to be imposed upon potentially infectious persons including detention, and screening for COVID-19.
d. Section 52 (Schedule 22) (for England) enables Ministers to restrict or prohibit gatherings or events and to close and restrict access to premises during a public health response period.
e. Section 56 (Schedule 26) (England and Wales) provides that appeals imposed under powers set out in Schedule 21 of the Coronavirus Act can be heard by telephone or video in civil proceedings in the Magistrates Court.
f. Section 77 (UK wide) increases the rate of the basic element of Working Tax Credit.
g. Section 78 (for England) is a power for local authorities to change how they meet in meetings held before 7 May 2021.
The Government also intends to expire parts of Section 38/Schedule 17 of the Act. Schedule 17 allows the Secretary of State to disapply or modify existing requirements in education and childcare legislation. Expiring parts of schedule 17 includes removing the ability to modify the duty on local authorities to secure the special educational needs provision in a child or young person’s Education and Health Care plan.