My Lords, I am enormously grateful to noble Lords for an incredibly thoughtful debate about measures that were laid only recently and have come into force today.
I start by addressing the two big, chunky issues that were raised by noble Lords. The first is the connection between Test and Trace and local efforts on the ground. I want to take a moment to reassure noble Lords about our commitment to a really strong connection between the national efforts of our test, trace and isolate programme and the work that goes on on the ground. Test and Trace and Public Health England work incredibly closely with the Association of Directors of Public Health, the Society of Local Authority Chief Executives and Senior Managers, the Local Government Association and UK chief environmental health officers as part of this programme. Those conversations happen daily on an institutional and personal basis.
The challenge was put to me that the contact tracing does not include public health experts. That is not quite right. There are 1,000 tier 1 contact tracers working within the core contact tracing service and in health protection teams and field services right across the country. More recruitment is under way. In fact, we have more than doubled the size of local health protection teams since the pandemic began, precisely because of our commitment to the partnership between the national and local efforts.
It was suggested that we should do more to work with local clinicians. We do an enormous amount of work with local clinicians. Thousands of NHS clinicians have signed up as contact people. They are in touch with those who have tested positive and talk them through the process to find out where they have been and who they have been in contact with. They do an incredible job every day and are the expert bedrock of the contact tracing process.
We absolutely depend on and mobilise local know-how, which we do through data sharing. Local public health officials can use the data provided by NHS Test and Trace to follow up cases that the national service has been unable to reach. Together, we can increase the numbers who are reached. More than 90 local authority partnerships across the country have gone live with locally assisted contact tracing, and more are coming on every week. The results are enormous. In England, we have reached more than 650,000 people and advised them to self-isolate. Everyone who tests positive is contacted by Test and Trace.
On the testing service, we are doing 310,000 swabs a day—22 million tests in all. There are five Lighthouse labs, 96 NHS labs and a total of 500—I repeat, 500—local testing sites. As a result of the tracing numbers, last week, 51,000 people tested positive, 34,000 of whom went into the contact system—and we should bear in mind that many would have been in the care service and therefore do not need to be transferred. Of those, 25,000 were reached and it was suggested to 21,000 that they isolate. Without that system, the epidemic that we have today would be worse than it is, and we owe enormous thanks to those involved.
A number of noble Lords asked about the app. There have been some 16.9 million downloads. That is 29% of the over-16 population, and the costs up to 31 July were £13.8 million. We are completely live to the challenge that some people have phones that do not work with the app, but I reassure noble Lords that it works with Apple iOS 13.5, Marshmallow 6.0 and the Huawei OS 8 or anything above.
My noble friend Lord Robathan challenged me about the evidence base for the curfew at 10 pm. My noble friend Lady Noakes quite rightly cited the SAGE notes that make the clear point that I made here yesterday when discussing masks: it is very difficult to put together the precise clinical trials and detailed modelling for individual measures that are brought to bear on the epidemic. But my noble friend Lady Noakes misrepresented SAGE when she implied that there was no evidence for the restrictions overall. The huge growth in the epidemic in recent weeks demonstrates the urgent need for these restrictions. The impact of the epidemic is not just on those who have Covid; it is also on those who find that the hospital beds they need are filled and on those who are put off going to hospital and therefore incur either delays or an impact on their current illness. There is also an impact on those who suffer as a result of any kind of avoidance of medical practice. The impact of Covid is not just on those who get it; it is on all those who seek medical attention. That is why, with the disease growing exponentially, we have to lean into it extremely heavily.
The noble Lord, Lord Birt, asked about the mass media campaign. I reassure him that we have invested massively and applied the best behavioural science to convey the restrictions as clearly as we can, and that that is backed up with quite severe sanctions, fines and police action.
The noble Baroness, Lady Watkins, raised, quite rightly, the challenge of getting visitors to social care settings, many of whom perform really important care duties for those in social care. We are completely live to the challenge of getting a regime of testing for those very important visitors. There are challenges in identifying exactly which visitors should qualify for such a scheme. We are building up our testing capacity to have enough tests available to them, and I shall be glad to update the noble Baroness when we have made progress.
My noble friend Lord Moynihan mentioned gyms. I completely endorse his commitment to fitness regimes, whether inside or on a beach. But it is true that local authorities in Liverpool suggested that closing the gyms would be a helpful way of restricting the epidemic.
We have been asked about balance. The Government’s strategy is one of balance. It is to contain the virus in any way we can while protecting the NHS, our economy and our schools. We are working extremely hard on the vaccine, on therapeutic drugs and on mass testing, which we believe will provide a route out of this horrible disease.
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