Many will have personal memories of the Duke of Edinburgh from meeting him or from his presence in our living rooms on tv or in the newspapers. The Queen has launched an electronic book of remembrance on www.royal.uk. I recommend this for all wishing to send condolences and to record their impressions of him and his service to the Queen and nation. The royal website also has more information about the Duke and his work.
Our thoughts today are with the Queen and members of the royal family on the sad news of the death of her husband, the Duke of Edinburgh. He dedicated his life to serving the public and supporting the Queen as she carried out her duties. I send my condolences from the Wokingham constituency as the nation mourns his loss.
Product type: Nucleic acid testing (NAT) technologies that use polymerase chain reaction (PCR) for detection of SARS-CoV-2
Date: 13 January 2021
WHO-identifier: 2020/5, version 2
Target audience: laboratory professionals and users of IVDs.
Purpose of this notice: clarify information previously provided by WHO. This notice supersedes WHO Information Notice for In Vitro Diagnostic Medical Device (IVD) Users 2020/05 version 1, issued 14 December 2020.
Description of the problem: WHO requests users to follow the instructions for use (IFU) when interpreting results for specimens tested using PCR methodology.
Users of IVDs must read and follow the IFU carefully to determine if manual adjustment of the PCR positivity threshold is recommended by the manufacturer.
WHO guidance Diagnostic testing for SARS-CoV-2 states that careful interpretation of weak positive results is needed (1). The cycle threshold (Ct) needed to detect virus is inversely proportional to the patient’s viral load. Where test results do not correspond with the clinical presentation, a new specimen should be taken and retested using the same or different NAT technology.
WHO reminds IVD users that disease prevalence alters the predictive value of test results; as disease prevalence decreases, the risk of false positive increases (2). This means that the probability that a person who has a positive result (SARS-CoV-2 detected) is truly infected with SARS-CoV-2 decreases as prevalence decreases, irrespective of the claimed specificity.
Most PCR assays are indicated as an aid for diagnosis, therefore, health care providers must consider any result in combination with timing of sampling, specimen type, assay specifics, clinical observations, patient history, confirmed status of any contacts, and epidemiological information.
The UK decided to restore democratic powers by leaving the EU. We can now improve, amend or remove laws and spending programmes as we see fit. The government proposes, Parliament responds and public opinion is brought to bear on the process. If a government makes a mess of using its powers it will be replaced at the next election so the voters are in ultimate control.
Various contributors here believe that green policies and covid policies are somehow the work of hidden powerful advisers and forces. They are, on the contrary very public, and have been through substantial governmental processes. Whilst we have removed the overarching powers conferred by the EU Treaties and enforced by an active and powerful court, our country is still under a number of other important Treaties which governments of most political persuasions will observe and enforce. Anti pandemic policy has been heavily influenced by our membership of the World Health Organisation. The UK’s green enthusiasm has been locked in by the Climate Change Act enacted by the Labour government and accepted by the incoming Conservative one, and by UK agreement to the Paris and other international conference commitments made globally. I was one of just a handful of MPs who did not support the legislation.
The structure and culture of UK government is to abide by international rules and Agreements. There is no need to look for hidden influences urging these policies when they have been signed up to in a public way so the whole might of the UK official machine is bent on enforcing and complying with them. It is true the CV 19 policies are advisory. It is true the green policies require our consent and there is no strong enforcement mechanism like the European Court to make us do them, but government wishes to apply them anyway.
This means if UK citizens do wish to change these policies it is a bit more difficult. There could be arguments about “breaking international law”. When the UK ventured a different view of the Northern Ireland protocol as it needed to do some asserted this was breaking a Treaty and not allowed. I think they were wrong as a good argument can be made from the terms of the Protocol and Treaty themselves that there needs to be change to secure one of its prime objectives, the freedom of the UK single market.
In practice countries do renounce or amend Treaties by agreement, or sometimes reinterpret them . What matters is popular will and national law. Some say of course all Treaties must be obeyed, citing the 1713 Treaty of Utrecht which stated Gibraltar is a UK Crown dependency. I of course favour respecting that Treaty. The truth however is the status of Gibraltar rests with the will and views of the people who live there. It is because 99% voted to stay British that they will stay British and observe the Treaty. If they voted 99% to be Spanish of course there would be change whatever the Treaty says.
So my advice to those of you who disagree with the health or green policy, understand you need to change the policy of the government which in turn will need to amend its promises and proposals to the international community if you succeed.
It’s not much of a story that someone who was Prime Minister six years ago lobbied the Treasury on behalf of a business he is employed by, only to be turned down. To make it interesting the ex PM would have to break the rules over conduct out of office, and he would need to be successful in his lobbying. We are told neither of these conditions were met.
The facts are not going to get in the way of those who nonetheless want a debate about lobbying. Energetic lobbying is a part of a healthy democracy. Charities spend large sums on their lobbying for legislative change and access to spending programmes. Businesses organise themselves into trade Associations and nationwide lobbying bodies to get favourable changes of policy for their sectors. Trade Unions spend large sums on setting out their policy demands. The BBC and other media regularly give privileged slots on news and comment programmes for lobby groups to make their case prior to interrogating any Minister who dares to say No to the lobby proposal.Maybe the media is too kind to these lobbyists and ought to question their motives and views more thoroughly before running their demands.
Ministers of course need to understand what the business or other interest of a person is when they talk to them or have a meeting with them. This usually flows from the person having to make clear who they represent or work for to get the meeting in the first place. Ministers need to have shed all their own business interests, or to exempt themselves from any decision where there could be a conflict of interest. Much of the detailed commercial interface between government and business is handled by impartial officials who are trained to assess bids and proposals on their merits rather than favouring friends of the government. It appears that the wide ranging access Greensill had to UK government in the Cameron years was arranged by the Cabinet Secretary himself, the ultimate policeman of propriety and procedure in government. The interesting questions about the arrangements then in government relate to why the UK state needed to introduce supply chain finance, and why if the problem was late payment of public sector bills they did not just pay them more quickly. Tragically the Cabinet Secretary died young so we cannot find out from him what led him to give Greensill such access.
Some want to believe that a few billionaires have particularly favourable access to governments and end up making the policies that rule us. The answer to that is Ministers have free choice about who they listen to and which arguments they find attractive. We need to concentrate on what Ministers say and do, as they have the power. Usually the policies which most annoy the critics are international policies embedded in treaties or set out by membership bodies like the UN. In the case of the EU they are of course strongly binding on member states through their own court and legal system. These are more difficult for governments to amend or ignore as that may entail renouncing the relevant treaty.
Ministers have daily to defend their choices to Parliament, the public and media and if they are taking bad advice they feel the results. Chasing the possible influencers can divert us from the real task of debating and changing what government itself decides to do, or debating any damaging rules and guidance of the international bodies we belong to. Chasing individual outside advisers is only relevant if there is corruption. As Margaret Thatcher wisely said, Ministers decide and advisers advise. That is usually true. Any adviser who overreaches or ceases to please can be dismissed. Oppositions are there in part to call out influence or lobbying which crosses the line from the acceptable.