Professor Carl Heneghan:

Often, people try to make points and look for evidence. For instance, the committee just heard about Vietnam. It is a classic fallacy. The median age in Vietnam is 30.5 years. The temperature and humidity are radically different from here. We do not even know whether people in Vietnam have pre-existing infections, cross-reactively, from SARS-CoV-1, of which it had outbreaks. With these issues, people say "here is the evidence and because they did that, we are going to do this". I find that very difficult to understand from an evidence-based perspective.

Second, we have heard much about pubs. Pubs are interesting. People talk emotively about what we should do and say we should close the pubs. Ireland has 7,200 pubs while the UK has 47,600. In the UK, we have had fewer than ten outbreaks. Every pub is an outlier and it is an opportunity to study what is going on. When people break the rules there might be quarantine for two weeks. If they break the rules they should have to stop. However, we should have an evidence-based approach for some of them and sample what is going on. There has been a knee-jerk reaction of closing all pubs.

I reiterate that to go for a zero-Covid strategy, we need an effective vaccine in place now. Otherwise, we would need to follow the New Zealand approach to the letter of the law, which means locking down, having 14 days' quarantine, driving it out and not letting any people in. There are no fudge factors. The alternative is to look to countries like Sweden and Denmark, which are taking a much more sensible approach right now. Denmark is not mandating masks but is doing randomised controlled trials of masks, which are due to be published soon. Following this approach results in a very intelligent mitigation strategy.

I would look to the evidence of where we think significant transmission will happen before we have a vaccine. There is some preliminary evidence about that. I cannot go in to all of it now but I refer to things like mass events beyond the 1,500 people allowed, particularly indoors. We look for the areas where we can make a difference versus the knee-jerk reaction, which is what we have seen in the UK. A very good example of that would be, for instance, the recent lockdown in Leicester. I believe one of the Deputy's colleagues alluded to that. To be clear about what is happening, at the height of the pandemic, Leicester, which has a population of approximately 340,000, had 45 admissions. Since the city locked down in July, there have been seven admissions. While the number of detected cases was going up, and we must remember that is not the same as cases, the city had seven admissions in the whole of July, and we are working on this. What is happening with the disease, therefore, is not the same as what is happening when we detect cases. That strategy is to have a test and trace system and manage the cases.

When we think about lockdown, it is important that we think about the impact of Covid-19 on morbidity and mortality and not its impact on cases. At the moment, the number of detected cases is going up. That is not the same as cases but in terms of the impact of the disease, admissions, critical care units and deaths are at a historic low level. I would watch that information to drive the policy of the Deputy's country as opposed to detected cases, which are increasing.

I will tell the Deputy the reason the number of detected cases is going up, and this is my last point. The UK is picking up about 100 cases per 1,000 people. On a daily basis, therefore, we are getting about 1,000 people a day but the Office for National Statistics, ONS, survey data tell us that in terms of the background rates in the UK, between 2,000 and 8,000 people actually have the disease right now. Wherever more testing is done, one will pick out what is in the background. What one should not do is use that to get stressed and anxious and come up with a knee-jerk policy. It should be done to reflect on what is working and what is not working.