Dear Matt

         Thank you for your tireless work to bring down the death rate and slow the spread of this nasty disease.    You have asked MPs to share ideas and concerns with you as you battle the virus. You have always rightly stressed that you will take advice from medics and scientists and be guided by their professional expertise. In your position you have access to the best advice the country can offer,  to various strands of  academic work on the nature and behaviour of the disease, to the experiences of doctors dealing with seriously ill patients and to pharmaceutical companies seeking drugs and a vaccine.

           There are various opinions coming from medics and scientists as they seek to understand and treat this new disease. Your medical and scientific advisers have to draw together the strands and make judgements about what is best advice.  I think it would help the public understanding and support for the policy if you could set out more information about current professional thinking in the following important areas.

1. Treatments for Covid 19. Several existing drugs have been proposed as alleviating symptoms or shortening time to recovery. The UK is I believe undertaking trials of these drugs to see which if any works. Can we have a progress report?
2. Understanding the serious forms of the disease. Is it correct that whilst some die of a pneumonia like disease of the lungs, some die from excessive blood clotting and others from attacks on various organs of the body?  If so, what different treatments are  being used to combat the different versions of the disease?
3. Given the way the disease spreads in hospital and care home settings, why do we not move to identifying some hospitals as isolation hospitals specialising in Covid 19 and free others for non Covid patients?
4. You place great emphasis on R or the transmission rate, and are now supplying  calculations of this rate by region. Does the UK yet  have random sampled test results of the population as a whole ,as this over time would presumably give the most accurate view of the transmission rate. When we will we have a sufficient time series of such data to be more accurate over R which is often currently expressed as a wide range.
5. Face masks are regarded as an important part of protective clothing for nurses and doctors treating Covid 19 patients. We all agree they should have them and supplying them is the priority. Both voluntary and commercial effort could make other masks for people going into social and work settings to offer some protection against spreading a disease they may not know  they have. Is guidance going to be modified, subject of course to the overriding priority of supplies of surgical grade masks for those nursing and treating  Covid patients?
6. What do your advisers think about the use of Vitamin D to strengthen people’s defences against the virus?

Yours

John

Unemployment has risen sharply, and many people on furlough are worried about whether and when their jobs will return. I have been pressing hard for more people to be allowed back to work in safe ways.

I am pleased to report some progress in recent days. Many of you wanted Garden Centres to re open and waste tips. Both have done so this week with social distancing rules in place.

The Government passed its new Agriculture Bill through the Commons this week. I wrote about my contribution yesterday. I am pressing hard for more of the government support to be grants to assist the expansion of market gardening. There is considerable scope for the UK to grow more of its own fruit, vegetables and flowers, and to expand the glass house space to do so. It will also create many more jobs for local people to help.

Builders are resuming work and homes can be bought and sold again. Car factories are starting up and other industrial production is underway. There will still be a substantial hit to output and incomes, given the way social distancing limits how much can be produced in any given factory.

The government has set out a timetable for limited returns to school before the summer break. Some of you are very keen to see the schools re open, conscious that children need formal education and will miss out without school. Some are nervous about safety. The good news is CV 19 does not  normally cause health problems for children. The bad news is grandparents may need to stay isolated from their grandchildren for longer, especially where they are vulnerable through other medical conditions.

The worst affected areas remain leisure, entertainment and hospitality. There will be delays before they are allowed to re open, and substantial restrictions on how many people they can serve once they are allowed to trade. Shops too are struggling, with more being done on line. There are no easy answers to these problems, where the businesses themselves are going to have to adapt to changed circumstances.

I have successfully urged a strong response from the Bank of England to make money available and from the Treasury to provide grants and loans to individuals and businesses who have lost their incomes. I am now urging the government to put in place more policies for economic recovery. These include tax  cuts to assist the self employed, small businesses and individuals wanting to buy a house or  car .

I passed on wishes to allow more sport and outside activity. It was easiest making the cases for fishing and golf which have now been relaxed. All of us can now go for walks or runs as often as we like.

On Wednesday I had booked  slots to speak on the Amendments to the Agriculture Bill about trade, and on Third Reading where I wished to discuss how we promote more home grown and home reared food. I joined the debate remotely and listened to  it, only to discover they had booked more slots than available spaces. I was not called on the Amendments, and the 3rd Reading debate lasted for 3 minutes, front benches only.  So let me tell you some of what I wanted to say. My views are being sent to ministers as well.

I want us to have more free trade agreements and high standards of food production. I see no need to accept food from countries with unacceptable animal welfare practices,  nor to lower our standards in order to secure a Free Trade deal. More importantly, the government has promised it will not dilute our current standards. Free Trade Agreements with other countries will need Parliamentary approval and will be properly reported and debated in the House. It is common in Free Trade Agreements to respect each other’s regulatory systems through the doctrine of equivalence, where there is possible. Where it is not then the trade continues under WTO rules.

The government has decided to keep certain EU permitted practises for the time being, though one of the wins from leaving the EU is we can impose our own higher standards where we wish. We will, for example, continue with rules which allow chlorine wash of salads and vegetables. The EU disagreement over chlorine washed chicken is not with the  chlorine washes which they accept. Do those who object strongly to US chicken wish to see us ban chlorine washes for other items?

The government is pledged to maintaining levels of financial support to farmers that they were receiving under the EU policy, but to spend the money differently. The Bill grants powers to allow the government to support investment in better food production and requires the government to consider and report on food self sufficiency levels. I want the government to have ambitious plans to promote much bigger output of fruit, vegetables and flowers here at home by providing financial and regulatory support for more greenhouses and more mechanised market gardening. We also need to recruit more local labour to help with this important industry.

As the lock down drags on, so the summer season will rush by. We need to ask what does the future hold for those who have invested their lives and savings in small hotels, B and Bs, pubs. clubs,  tourist shops and  attractions.

If the climate remains hostile to larger gatherings of people for July and August as well as May and June, the summer season will be badly damaged for these supporting businesses. In areas of great beauty or historical interest small businesses depend heavily on the summer income to see them through winters of low volumes or partial closures.  Visitor numbers are often driven by access to festivals, sporting events, great houses open to the public and magnificent scenery which is best in sunshine.

It is possible for many of these businesses to survive for the time being. They can put their staff on furlough. They can get some delay on taxes and rent. What they cannot do is go a whole year without the higher revenues of summer. They need a clearer picture of what July and August might bring, when government is cautious as it depends on success with limiting the spread of the disease.

It is also a question of what business  model can these enterprises come up with to be compliant in an age of social distancing. How realistic is it to run a restaurant with 2 metres between diners? Can screens be used instead? How do people get served drinks in a pub without a jostle at the bar? How many people can a small hotel or B and B handle whilst keeping people apart and keeping common areas free of virus from the occasional infected person who is unaware of their condition?

The long decline of the High Street will be accelerated by recent events. So might  we end up with fewer pubs and fewer tourist businesses. How long can a firm keep workers in furlough before there has to be revenue earning employment or redundancy?  

I would be interested to know how you would respond to some relaxation in these areas? Would you go to a pub or restaurant if they opened soon? What changes would you want them to make to handle the virus? Would you consider a week-end break or a holiday somewhere in England later this summer?

The government yesterday confirmed there would be no abrupt end to the furlough scheme to help pay to keep workforces together and ready to return to work. The Chancellor also accepted the advice of many of us that it needs to be more flexible, allowing part time work for the employer by some of those in furlough with appropriate reductions in financial support.

We await the details of the extended scheme, which could last until October. It is important to help businesses keep a workforce together who are banned from working by law. Such a business needs a grant,  not a loan, as it cannot help itself by earning revenue. This money can be borrowed  by the state, with the burden spread over many years ahead. Clearly there are  limits to how long this can go on, as the state cannot borrow for a long period  to keep a workforce together that is  not allowed to earn its own income. It is now equally important that there is a path back to work for these enterprises.

There will be hard cases. Where businesses that were viable in areas like hospitality face delay before they can resume working, the risks of eventual redundancies are higher. Where this is compounded by those businesses expecting to have to operate at much reduced levels of sales owing to the social distancing rules, they may end up with a business which cannot pay its way let alone make a profit. It is difficult to know how many cafes, restaurants, hotels, pubs and clubs will re open with a way of doing business that can pay all the bills. Clearly keeping a 2 metre distance between customers and staff is going to prove very difficult in many of the properties and locations previously used for such activities.

I am glad that some of these businesses have already shown great enterprise and flexibility turning to take away meals, looking  at  how they can use gardens and other under used spaces to spread customers out and introducing screens or other barriers to allow closer spacing.

None of this is good for the recovery of the High Street. Rents and business rates remain high, when we need adjustments to the new reality of reduced earning power in many places.

Today we should learn more about how people can get to work given the advice that public transport cannot be used by great numbers to avoid the virus spreading.

I am pressing for more relaxed conditions over parking near to factories and offices for those who live too far away to walk or cycle. The government could offer to help Councils financially if they will waive some parking fees. They should encourage Councils to make more areas available for commuter parking into towns and cities.

The government should also make money available to Councils to make it easier for vans and cars to get into and out of urban areas through a series of measures to increase capacity across junctions and bridges. I have before identified various proposals to optimise traffic lights, segregate right turning traffic from the rest, put in more roundabouts and add to road capacity near and across junctions where the main delays occur.

The economy is relying more and more on van deliveries of on line orders and will now need to let  more people get to work by vehicle to allow social distancing from other travellers.

There should also be more discussion of safe working practices in  offices and factories where people do need to work outside their homes. This will be based on a combination of greater distancing between people and the provision of protective clothing.

I would be interested in other ideas to make safe working easier for more people, so we can begin to rescue our economy and people’s livelihoods from the damage done by the last few weeks of lock down.

There is understandable impatience by many over the illegal migrants turning up across the Channel after chancing to people traffickers. It is high time the governments on both sides of the Channel clamped down more effectively on this wicked and dangerous trade.

Whilst governments will want to help anyone in  peril on the sea, they should also wish to send clear signals to all involved that people trafficking will not profit the organisers and will not gain the objective of the customers. If both parties think they will get what they want out of their rash and dangerous actions, they are likely to continue. If the traffickers deliberately put the customers at risk in an unsuitable boat, forcing rescue by government, it is important that the  people trafficker is apprehended and not remunerated.  The UK  and France need to step up joint action, and France needs to try harder to stop the boats leaving their shore or proceeding far out to sea with the danger that introduces.

I am asking about the detail  behind the PM’s statement of approach on Sunday night. In particular

1. Can Garden Centres open on Wednesday as briefed?
2. Is it right that Fishing, golf and other sports and pastimes where an individual can avoid contact with others are  now allowed?
3. Is there any change in the range and purpose of shops which can  now open with suitable precautions?
4. What are the rules on use of public transport to get to work?
5. As cars are being encouraged as safer ways of going to work, what additional support will there be to make it easier for cars to get  into towns and cities? What advice is there on staggering hours?
6. Is there now agreement on the advice and guidance for employers for safe working practices?

In order to get out of lock down the government will want to put in place a system of tracking and testing for the presence of the virus, to ensure those with it self isolate to stop the spread. They will doubtless want to follow WHO advice on these matters.

The WHO proposes that a country combines technology with people driven systems. Technology can help, but not everyone has smartphones and not all smartphone users will want to download the app. Some who do will get flat batteries or forget to switch on from time to time.

In practice any system relies on  people in the country to identify symptoms and self isolate   if there is good reason to think they have the virus. They should now have access to tests so they can find out more quickly than 14 days if they need to continue with their self isolation.

It means a person who does have a test and tests positive for the virus also needs to co-operate over recent contacts. The smartphone app could help. Otherwise they need to  list their contacts to the authorities who can then in turn advise those people. Even with the app there may well need to be interpretation of the contact advised by the phone, as some may not  be serious or lasting contacts, or there may have been some physical separation or barrier which the phone could not see.

As we are dealing with millions of people and possibly thousands of cases, there will be many cases where judgements are made that others may disagree with.  What matters is that overall, the  majority of cases successfully self isolate all those with the disease and those who came into too much contact with them pending their own tests. It also rests on quick reliable and easy tests. I trust the government now has in place these measures which it says it wants, to allow a more general return to work which is vital for livelihoods and the supply of goods and services.

The good news is the NHS has coped with the surge in Covid 19 cases in late March and early April. National capacity is Well above the current number of Covid 19 patients, with numbers of new hospital admissions falling. Short of a massive unexpected  surge in cases to levels much higher than early April we can conclude the NHS has the beds and staff to handle this virus. The Royal Berks has plenty of spare Intensive care beds thanks to the efforts to expand facilities. The large emergency Nightingale hospitals mercifully have no new cases to look after.

There is still much to do to cut the death rates further, to limit the spread of the virus and to safeguard those most vulnerable to the severe version of this disease. Thames Valley MPs have a weekly meeting with the Local resilience Forum and with the local police by conference calls to see what needs doing and to tackle Ministers where Central government needs to take action. This week’s meetings reported no problems with the supply of protective clothing and equipment, and demonstrated good progress on expanding the number of tests and test centres, including mobile and home testing. I am in regular and varied contact with Ministers as and when an issue arises that needs UK government involvement.

Government did respond when I passed on – as others doubtless did – the danger of letting elderly patients out of hospital and back to care homes without checking they no longer had the virus. This I am assured has now been sorted out. Those Care Homes that do have cases of the virus now need good infection control to stop it spreading throughout their vulnerable residents. Care Homes are often privately owned and run, but are now being offered national , regional  and local government assistance with protective clothing and training to limit the continued spread in homes that have cases.

I have also raised the issue of the need for the NHS to resume more of its regular work, which government confirms they are ready to do. The NHS assures us it has   very good infection control in general hospitals which undertake a range of work in addition to handling Covid 19 patients. It is important that everyone with a serious condition that could benefit from hospital treatment feels confident to go to hospital to receive it.

I have been critical of the poor quality of the statistics Ministers and the public receive daily to monitor progress and to make decisions about future policy. The estimates of the Transmission rate are very wide – 0.5 to 1.0. This looks at how many people an infected person infects, and needs to be as far below 1 as possible for the disease to wane quickly. The national numbers were not based on  testing of a proper sample of the whole population which should give the best figures over time. I am told this is now being remedied. The figures for deaths have been changed several times, with different definitions and standards for registering a death as a Covid 19 death. This means we do not see an accurate plot of true trends in deaths over the last couple of months. The international comparisons are not comparisons as they do not even adjust for size of populations.

I have put this to Ministers and spoken about it  in the Commons this week. It matters, because government needs to make decisions to get  more people back to work safely, and needs accurate and consistent figures on deaths, transmission rates and hospital use to do so. I have also been working hard on the economic issues of jobs, small business and livelihoods which I will write to you about next week.