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Baroness Andrews: My Lords, in general we have to respond to persons coming into the UK in the same way, irrespective of the reason for their coming here. As to the emphasis we place on them, if they are liable to have been in contact with SARS sufferers or if they have any symptoms, obviously the appropriate steps must be taken. However, when they are symptom free, whether they are children, students or people coming to a conference, we have exactly the same problem irrespective of why they are coming into the UK.
As regards school students, on 14th April the DfES wrote to all chief education officers in LEAs and drew their attention to the Government's advice to boarding schools and other institutions. The advice was that, if symptom free, students returning from SARS-affected countries are not a risk to others and should be allowed to continue their schooling as normal, but they are advised to seek medical advice if they develop any symptoms suggestive of SARS up to 10 days after their return. They should certainly not return to school if they have any symptoms. In exceptional circumstances where a student has come into close contact with a known SARS case, it would be prudent if the student's health was monitored for 10 days. Different boarding schools have put in place different strategies. It is largely their privilege to do so, and different rules will apply. However, that is the advice being sent out by the DfES in this instance. As regards conferences, the advice will depend entirely on individual circumstances. I suggest that there should be a case-by-case judgment.
Lord Soulsby of Swaffham Prior: My Lords, this new "plague", if we can call it that, emphasises the concept that the price of freedom is eternal vigilance. Whether, indeed, there has been a lapsus in vigilance as a result of SARS coming out of China we shall not know for some time. We know that there is frequently a spontaneous re-assortment of genes in viruses such as the influenza virus but this is not a straightforward influenza virus.
Can the Minister tell the House the latest information on the origin of the SARS virus in China in terms of whether it is animal, human or animal-human? What are the active surveillance undertakings being carried out by the British Government on this virus and other viruses coming out of China in food materials, animals and, indeed, human and animal products which might give us a lead as to what might come next beyond the SARS virus?
Baroness Andrews: My Lords, I am much in awe of the noble Lord's expertise in this area. We do not know the origin. We do not have the science to tell us whether there has been a transmission across species from animal to human. It is hoped that over the next few months, or maybe longer, we shall begin to
Lord Campbell-Savours: My Lords, my noble friend referred to the fact that the UK is dispatching personnel to departure points overseas in areas at risk to monitor the screening arrangements for travellers returning to the United Kingdom. If that is the case, are other countries doing precisely the same? If so, should there not be a co-ordinated effort to continue to monitor all flights by a single officer representing an international authority, even if it means countries increasing the available budget of that organisation, whatever it might be?
Baroness Andrews: My Lords, as regards our own efforts to work out how effective screening programmes are in other countries, we alerted our embassies in areas in which relevant airports are sited. We are collecting information from embassy officials, and we shall build on that information when our own specialists go out. I do not know what other countries are doing. However, one of the features of this response has been its global dimension. For example, there are daily conference calls between the WHO and all the countries affected to update information and ensure that everyone is sharing as much knowledge as possible. There may well be some exchange of information about how screening can best be developed and improved. Certainly, screening at ports of exit was done specifically on WHO advice.
Baroness Masham of Ilton: My Lords, is the virus which is travelling round the world mutating? If so, will that not make it much more difficult to find a vaccine in due course? What is the particular advice given to health workers when looking after SARS patients? If patients, or provisional patients, are isolated in their own homes, surely such information should be made available to the general public so that they know what to do if someone develops SARS.
Baroness Andrews: My Lords, I am informed that all viruses mutate, or are very likely to mutate. The question is whether they mutate significantly and we do not know; the jury is out. However, the scientific consensus is that this is a coronavirus, so we have made progress in at least identifying that. As regards health workers, the advice which has gone out today from the Chief Medical Officer to chief executives reinforces the standard practice which we give in each of these situations as they arise. It is stringent advice concerning the importance of control of infection. It emphasises early recognition of suspected cases, rapid isolation, reducing the risk of cross-infection, high quality sterile practice, no inappropriate re-use of medical devices, and so forth.
The noble Baroness asked about people who may be at home with SARS. From the cases that we know and the surveillance practice we have seen, suspected cases have been picked up extremely quickly and are being investigated in hospital. I do not have any information concerning patients who may be at home in that situation.
Lord Brooke of Sutton Mandeville: My Lords, the Statement makes wide reference to the occasions when the Government are following the advice of the WHO. Can the Minister shed some light on how much universal advice the WHO gives to countries and how much tactical freedom it allows individual countries to make their own determination, as presumably in our own case with notifiability?
Secondly, the late Lord Phillips of Ellesmere was wont to remark that there was no way that a country of our size could maintain a position on the frontiers of every aspect of available science, simply because of resources. I have a highly simplistic question: can the Minister indicate on a scale of one to 10 where our country presently stands in terms of strengths in the disciplines challenged by SARS?
Baroness Andrews: My Lords, the noble Lord asks two very challenging questions. As far as I know, the advice put out by the WHO is universal as to the processes that contain the spread of the disease, whether it is through advice on screening, on treatment and so on.
Each country has its own political culture on issues such as notifiability. I presume that a fair amount of discretion will be built into that. Certainly, our medical and scientific experts would, I am sure, consultas they do on a daily basis with WHOshould they think that notifiability is an important step forward. It is difficult to draw tight boundaries here. There is a great deal of communication and exchange. This is a pragmatic situation that is managed nationally and in terms of the WHO.
Regarding where we are and our position in the research leaguewhether virology, communicable diseases or whateverthe reputation of our Central Public Health Laboratory in Colindale is excellent. It has made a significant contribution. It is one of the 11 laboratories world-wide which have been involved in the research. I think that we can be extremely proud of our reputation and our effectiveness in that field.
Lord Turnberg: My Lords, while it is obvious and clear that we must take every precaution, I wonder whether the risk of this disease has been somewhat exaggerated, compared with, for example, most other infectious diseases. My question is: what information have we regarding the relative risk of infection and of death from this disease compared with, for example, TB, hepatitis and influenza in China, in Singapore, Hong Kong and in the UK?
Clause 41 [Engaging in sexual activity in the presence, procured by inducement, threat or deception, of a person with a mental disorder or learning disability]:
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