Thursday 30 April 

Today's roundup includes:

  1. Daily press briefing

 

1. Daily press briefing

Prime minister Boris Johnson, was joined by Professor Chris Whitty, chief medical officer, and Sir Patrick Vallance, chief scientific adviser.


Boris Johnson:

Full statement 

  • 81,611 tests were carried out yesterday.
  • There have now been 26,711 coronavirus deaths in the whole of the UK in all settings, an increase of 674 on yesterday.
  • UK is past the peak and on the downward spiral.
  • Announced he will unveil his plan to lead Britain out of coronavirus lockdown next week - but not when it will be put into effect.
  • The government will be setting out a comprehensive plan next week to explain:            
    • how we can get the economy moving
    • how we can get children back to school
    • how we can travel to work, and how we can make work in the work place safer
    • how to suppress the disease and restart the economy.
  • The government will try to build maximum political census.
  • There will be five key tests that the nation has passed,  before  this plan can come into action.
    1. We must be sure that the NHS remains protected.
    2. There must be a sustained fall in deaths.
    3. Infection rate must be falling.
    4. The operational challenges of testing and PPE are overcome.
    5. The measures taken mean there will not be another peak - nothing will raise the R to above 1.
  • A video was played which explained the R value (indicative of the average number of people that an infected person would spread the virus to). The average R had been 3. It is now below 1.

 

Patrick Vallance:

Slides and data sets

  • R is below 1 - between .6 and .9 across the country
  • number of cases coming down
  • reduction in hospital admisions for COVID-19
  • number of people in hospital with COVID-19– coming down
  • decrease in deaths in all settings, gradually coming down.

 

Questions

Public questions:
Michelle, Cornwall: how will tourism in the UK be managed in the coming weeks?
PM – vital that people keep following the advice. Don’t want to see people disregarding the advice. Will be saying more in the coming weeks about how will unlock parts of the economy. Next week will get a road map and dates and times will be driven by the data.

 

Katie, Liverpool: increase in suicide, what support is available for those in mental health crisis?
PM – can now make sure NHS is prioritising urgent care needs across the community. PHE is conducting campaign to support those with mental health issues.

 

Journalist questions:

Laura Keunnsberg, BBC: What level does R need to be at before you would be comfortable easing restrictions?
CW – confident that that as soon as R is above one, exponential growth starts, and then risk of overwhelming the NHS. Indirect deaths have been spoken about before, therefore important that R is significantly below 1 and NHS has headroom to respond to COVID-19 and do the other important thing such as cancer care, screening and elective surgery. Those two things seem critical.
PV – at the beginning of this we talked of doubling time, now talking about halving time, R has to be below 1 and need to get numbers down to keep things manageable and give us some head room to be able to make changes.

 

Robert Peston, ITV: Death toll in UK is possibly worst in Europe, what lessons have you learned from that outcome?
PM – collating of data internationally is difficult, the only real comparison will be possible at the end of the pandemic. Put in place right measures at the right time.
CW – accept that we must learn lessons, but nowhere near the end of pandemic, very long way to run.

National debt rising, how great a risk is there that you will feel compelled to cut public services?
Instinct is that economy will bounce back quickly, austerity will not be part of this government’s approach.

 

Talk radio: 60,000 extra cancer patients could die. Can you guarantee that anyone who needs cancer treatment will be able to get it?

CW - it’s not just cancer, very concerned that there has been a fall away of A&E attendances, stroke and heart attacks. Period where there has been a delay is minimised, and urgent cases are dealt with. A lot of thought is going into how you get phasing back into this right.

 

Francis Elliot, Times: R rate, what is a manageable R rate going forward?
PV - At the moment using a calculated R, looking at genomics, contacts to calculate the R. It’s right that it has a range. Not uniform across the country. London 0.5 and 0.7. Now measuring the R by measuring the number of active infections through random population survey, that will help us refine where the R is.

Can we expect clarity on face masks?
PM - As part of coming out of the lockdown, face coverings will be useful, both for epidemiological reasons, and also to give people confidence to go back to work. More on this next week.

 

Richard Vaughn, I : How far do you need to get new cases down to make track and trace effective.
CW – can do track and trace at any stage, but more effective at lower level of cases a day. No precises way of putting exact figures on this.  

 

Alex Wickham, Buzzfeed: NHS has stayed under capacity, but given number of spare critical care beds why is the death rate so high?
PM -Antiviral drug, could block the virus, do you share the confidence in this drug PV – developed for ebolda, does hit a part of virus, 2 studies, didn’t show any overall benefit in terms of outcome. US showed a benefit in recovery time, but didn’t have statistically significant impact on deaths. Promising first step, but not a majic bullet, but does show drugs are going to be possible, may need to be a combination of things.

CW – should always wait to see the published, peer review paper before we over interpret where we are. Confident that if we look back in one or two years, will have better treatment than we do today.

 

Stoke sentinal: accessing to testing, for essential workers in Stoke on Trent.
PM – will check out immediately with NHS. Will be hearing more in next couple of days on testing. Still a massive way to go.

 

Other topics:

Does the economy have to wait?

 

Latest figures

As of 9am today (30 April), there have been 901,905 tests, with 81,611 tests on 29 April. 687,369 people have been tested of which 171,253 tested positive.

As of 5pm yesterday (29 April), of those tested positive for coronavirus across all settings, 26,771 have sadly died. This figure includes hospitals, care homes and the wider community.

 

 

Wednesday 29 April


Today’s roundup includes:

  1. Daily press briefing
  2. PMQs summary
  3. Public Administration Committee summary – Michael Gove
  4. Summary of the Science and Technology committee on the digital contact tracing app

 

1. Daily press briefing

Dominic Raab, first secretary of state and foreign secretary, was joined by Professor Jonathan Van Tam, deputy chief medical officer and Professor Yvonne Doyle, medical director, Public Health England.

Dominic Raab:

  • 818,539 tests have now been conducted throughout the UK, 52,429 tests were conducted yesterday.
  • Government is moving to an improved daily reporting of covid-19 deaths so that all settings are included, rather than just those in hospitals. 3811 deaths in additional deaths have now been recorded. These numbers are from care homes and the wider community. These are spread over periods of March and April.
  • 26,097 people have now died from covid-19 in hospitals, care homes and in the wider community.
  • We are still coming through the peak and that this is a "delicate and dangerous moment" at this stage of the pandemic.
  • A second spike would be harmful to public health and the economy. This would also cause significant harm to public confidence.
  • The next step in this crisis should be a sure footed one and that the Government will make the right decisions at the right time and shall always be guided by the science.
  • Eligibility for testing has been expanded to include those over 65 with symptoms, all care home residents and staff and those who are out the home working.
  • UK shall continue to source ventilators and PPE both at home and abroad. In the last 10 days, the UK has secured over 3m masks from china.
  • Since the outbreak in Wuhan, 1.3m British citizens have returned to the UK through commercial flights. 20,000 have been taken back by over 21 chartered flights.  Raab emphasised that the Government will continue with these efforts.
  • UK will provide £330m each year to International Vaccine Alliance over the next five years.
  • SAGE will meet in early May and consider the five tests on easing the lockdown that have been laid out by ministers.

 

Yvonne Doyle:

Slides and datasets

  • Reminded the public of the five government tests for adjusting the lockdown:
    • the NHS has sufficient capacity to provide critical care and special treatment across UK
    • a sustained and constant fall in deaths from COVID-19
    • reliable data to show that the infection rate is decreasing
    • operational challenges are dealt with, including ensured capacity of testing 
    • PPE to cope with any future demand and that there is no risk of second wave.
  • There has been a slight uptake in usage of motor vehicles and that this is the highest working day statistic for motor vehicles since the lockdown began. This is slightly worrying.
  • Cases have remained broadly stable over the past few weeks. Number of people in hospital is showing a decrease of 16% across the whole of the UK. We are however still going through the peak and are not out yet.
  • Deaths in all settings are showing a 20% divergence from the previous data. She said it is good that this data is available as it helps in understand the outbreak.
  • People in critical care beds – 40% of beds being used – there is spare capacity

 

Questions:

Hugh Pym, BBC:
What support will you give care homes in administering tests?
DR – have expanded eligibility, distribution issue, but doing everything we can. YD – huge local effort and increasingly support nationally to get tests they need.

Couldn’t testing have started earlier?
YD - Scale and speed of epidemic, huge national and local endeavour to test and understand measures that will make a difference in care homes.

 

Dan Hewitt, ITV:
Hospices are being excluded from PPE deliveries, and are still relying on donations of PPE?
DR - Have been guided by NHS as to where shortfalls are.
YD – important we can understand where these problems are. There is no differentiation, but what may be lacking is the knowledge. Ways in which hospice can make known what they need.

 

Beth Rigby, SKY:
What does new data tell us about peak in care homes?
DR – constantly looking at improving the data we collect. Have know about this challenge and doing everything we can to meet it. need to make sure we control ebb and flow of people into care homes.

Numbers could still be underreported? Should we expect a further upward revision?
YD - May expect more than currently have, yes, because of the way deaths are recorded.
JVT - Have moved to a system of recording deaths that is more granular. At some point will be able to look at 'excess deaths' to work out what our departure from total number of deaths, so will be able to compare more accurately internationally.  
YD - Cant say just yet, whether can say whether deaths in care homes are going up. Majority of deaths do occur in hospital.

 

Andy Bell, channel 5:
Right now how many of 5 tests are we passing?
DR – will need the advice from sage – don’t know yet. Positive signs in data, but still coming through peak, still focusing on social distancing measures.

 

Jason Groves, Daily Mail:
How helpful are private sector initiatives like the Daily Mail’s campaign for PPE ?
DR – pays tribute to Daily Mail and work they are doing.

How virus spreads and difference between indoors and outdoors?–
JVT – have learnt a lot by studying influenza, getting more data about COVID-19 as we go. Definite truism that ventilation is the most critical part of reducing transmission of respiratory viruses. Outdoor spaces, with higher ventilation are helpful. SAGE keeping all evidence under detailed review, guidance being put forward to ministers on periodic basis.

 

Dan Bloom, Daily Mirror:
If ther had been able to have higher testing rates, e.g. testing those who come out of hospitals, would we be seeing fewer deaths?
DR - Key thing is to manage transmission and flow of people into care homes that might carry the virus. On top of testing and PPE, this is really important.
YD – where there have been outbreaks in care homes there have been interventions. Virus is affecting predominantly older people, so if infected, they deteriorate quite quickly. Might not have been possible to test before this happened. Movement of staff is critical at how virus moves around the care homes.

 

Public questions:
Why has the government not introduced quarantine for people arriving in the UK?
DR - the government has looked at this, but the scientific evidence so far has been that this would make very little difference. But it is being kept under review.
YD - this is being looked at as the situation changes.

 

Using extra capacity in Nightingale Hospitals to take people out of care homes?
DR - the Nightingale hospitals are not just there for current cases. They need to be available for the future and their use is being kept under review.
YD - the Nightingale hospitals are adaptable. They can be used in different ways, this would be one option, but you would have to consider whether this was a suitable option for frail care home residents.

 

Other topics:

  • economic help for people who aren’t eligible for universal credit
  • schools reopening
  • repatriation flights.

 

2. PMQs summary

Starmer/Raab exchange

Starmer starts by highlighting the number of coronavirus deaths, saying there are now at least 27,241 coronavirus deaths and that the UK is on track to have one of the worst death rates in Europe.  On Monday the PM talked about the UK’s apparent success on coronavirus. But this is not a success, he says. He says these figures are "truly dreadful". Raab responds that he shares Starmer’s horror at the number of deaths, but that it is too early to make international comparisons on deaths. Delicate and dangerous moment in pandemic. Need to wait for further guidance before moving to second phase.

Starmer moves onto care homes, welcoming the clearer breakdown in figures, and says that while it appears number of hospital beds and deaths in hospital is going down, that isn’t the case in care homes. He asks why coronavirus continues to spread so fast in care homes? And asks for Raab to outline the number of health care staff and care staff who have died. Raab says he has already given that figure and acknowledges that there is a challenge in care homes. Made clear that we have made good progress in community spread, principle challenge in care homes is ebb and flow of people coming into care homes. Comprehensive plan to ramp up testing in care homes, to overhaul way PPE is delivered and expanding the workforce by 20,000.

Starmer asks about PPE and says he recognises that distributing this is difficult. But the situation seems to be getting worse. He highlights the Royal College of Physician’s survey published on Monday which said one in four doctors was not getting the equipment they needed. He also highlights the RCP president who says things are getting worse rather than better.  aab says there are some positive signs coming out of care homes, but they are “within the margin of error”. Raab says he does not accept Starmer’s claim that the situation in care homes is getting worse not better. In relation to PPE, Raab says Starmer has to recognise that the UK faces a global supply shortage. Every country is facing this and that flights with PPE are coming in from places like China, Turkey and Myanmar.

Moving on to testing Starmer welcomed the clear increase in testing since last week, but said there is still an issue with capacity and the number of tests being carried out. He asks whether the 250,000 set out by the Prime Minister is still a government target, and when will it be achieved. Raab says testing capacity has doubled since last week. The latest figures showed 43,563 tests being carried out daily. He says the 250,000 target is still a milestone, but he won’t put deadline on it.

Starmer moves on to ask about the easing of the lockdown, and calls on Raab to say when the government will publish an exit strategy. Raab says when Sage last reviewed the lockdown, it advised against any change. He says Sage will review this again early next month and that it would be wrong to make proposals now, without knowing what Sage will recommend.


Starmer says the problem with Raab’s response is that the UK risks falling behind, and highlights the exit plans published by other European countries and the other UK nations. Raab repeats that it would be wrong to set out an exit strategy now. He says the Scottish government’s document, does not set out an exit strategy. It explains principles, in line with the five tests set out by Raab. He also highlights the news this morning that Germany is having to think twice about easing of some of the measures to avoid a second peak

 

Health and social care questions

James Cartlidge, Conservative:  asks what can be done to free up the NHS so that patients with cancer and other conditions can be treated. Raab responds that the government is planning to ensure the NHS can treat more non-coronavirus patients.

Geraint Davies, Labour, Co-op: asks about the government opting out of the EU PPE scheme, and whether it was a political decision. Raab says that the original issue was a failure of comms, and will look at any future procurement wide schemes such as around vaccines. He also states that the government is working very closely with EU partners on repatriation of citizens.

Allan Dorans, SNP: calls for assurance that, when a vaccine becomes available, it will be distributed around the world on the basis of need, not on the basis of wealth. Raab says the government is contributing to international vaccination programmes and agrees with what Dorans said.

Cheryl Gillan, Conservative: even before the crisis two out of three autistic adults were not getting the help they need. The situation may have got worse. Can Raab ensure they will not lose out? And how many councils have used emergency powers to justify cutting back their provision? Raab responds that vulnerable people should get the help they need. He says he will get back on her specific question about the number of councils.

Sir Jeffrey Donaldson, DUP leader at Westminster: what is the government is doing to ensure cancer patients and other patients can access the NHS treatment they need. Responds that he is aware this is an issue. He says the Nightingale hospitals have created capacity that will allow other NHS patients to get treated.

 

Other topics:

  • Garden centres and nurseries reopening
  • Brexit extension
  • Young enterprise schemes
  • Financial support for businesses
  • State support for businesses that are based in tax havens
  • Shortage of nursery school places and support for staff who can’t access furlough schemes
  • Local police station closures and knife crime
  • Business interruption schemes
  • Universal basic income

 

3. Public Administration and Constitutional Affairs Committee – summary


The public administration and constitutional affairs committee heard evidence from the Rt Hon Michael Gove MP on the work of the Cabinet Office.

Key points:

  • Did crisis planning have provisions for a pandemic like the current one? Work was done in anticipation of a flu pandemic or one like SARS. Did not anticipate a pandemic of this type.
  • Why are there no restrictions on seaports and airports? Some countries with restrictions on seaports and airports have higher incidents than those without, continuing to learn about the virus.
  • Will the government follow Scotland’s example with face mask recommendations? Requires finely balanced judgement, face masks may reduce asymptomatic transmission but may foster complacency, issue is under review.
  • Can divergence by the devolved nations cause confusion? Would seek a coordinated response but documents published by Wales are broadly in line with government recommendations anyway.
  • Should easing lockdown be decided regionally given that some regions have empty hospital beds, has decision making been too London centric? A UK-wide approach is preferred. Possible for lockdown in islands to be eased first, Isle of Wight may pilot contact tracing approach before being rolled out to the rest of the UK.
  • Did local resilience fora have the autonomy to procure own supplies including PPE? Do they need a clearer mandate to do so? Early examples of them procuring own PPE including prisons, encouraged to use own initiative.
  • Will the report on the pandemic exercise be made public? Would need to check with the Propriety and Ethics team.
  • What lessons were learnt from the pandemic exercise? Increasing NHS capacity through repurposing, exercise revealed a lack of PPE with led to the development of a pandemic flu stockpile. This novel coronavirus has required a recalibration of PPE.
  • Is there an overreliance on complex supply chains? Apparent overreliance on a small group of nations to produce the bulk of PPE, looking to increase domestic production.
  • How many offers to supply PPE has the government responded to? Have received 10,579 offers, 800 offers are currently undergoing robust checks. PPE is a specialised sector and many offers are not appropriate (such as from those in costume design).
  • Have there been instances where the government has moved too slowly and missed procurement opportunities? Possibly but checks are needed as many offers come from middle men operating on the fly.
  • Why has the Daily Mail been able to procure 1m pieces of PPE but the government has not? Amount of PPE secured by government dwarves that by Daily Mail in conjunction with others. PPE market in China is not wholly transparent.
  • Will SAGE membership be made public? Some SAGE members are public such as Chris Whitty, some have identified themselves. Members have a right to anonymity. Instances of threats issued against members and past instances of lobbyists attempting to influence.
  • When will there be greater clarity on easing lockdown? Closer to review point on 11 May. Balance between reassuring people and sending wrong signals.
  • Was one of the five tests diluted from ‘avoiding a second peak’ to ‘avoiding a second peak overwhelming the NHS’ in order to give more weight to the economy? No, aim has always to be flatten the curve, a case of elucidation not alteration.

 

4. Science and Technology Committee

Yesterday (Tuesday 28 April) the Science and Technology committee held an oral evidence session looking at how and when a digital contact tracing app could be introduced in the UK and issues relating to privacy and how these could be overcome. Witnesses included Matthew Gould, chief executive, NHSX and Professor Christopher Fraser, senior group leader in pathogen dynamics at the University of Oxford Big Data Institute.

 

Key points:

  • the contact-tracing app being developed by the government, which should tell people if they have been in contract with others who subsequently test positive for coronavirus, would be trialled in a “small area” before potentially being rolled out nationally, subject to its performance in those trials. These trials could start as soon as next week, with the app being rolled out in mid-late May.
  • On Privacy, he said people using the app could be confident their personal data would not be compromised. What we have is identifiers rather than identities, which sit on people’s phones until they choose to share it with us. So there are a series of protections that allow people to be confident in using it that their privacy is being protected.
  • They would be aiming for as many people to download the app as possible, but acknowledged it would tough to get 80% of smartphone users to install the app. He said the message needs to be: if you want to keep your family and yourselves safe, if you want to protect the NHS and stop it being overwhelmed and at the same time we want get the country back and get the economy moving, the app is going to be an essential part of the strategy for doing that.
  • Prof Christopher Fraser, told the committee that if roughly 60% of the population used the app, that would be enough to keep the reproduction number (the infectivity rate of the virus) below one, meaning the pandemic could be contained. But he said that number would rely on people paying heed to other warnings about sharing data with the app rather than simply downloading it, and self-isolating when symptoms developed.

Tuesday 28 April


Daily press briefing

Matt Hancock was joined by professor John Newton, testing coordinator and Professor Angela McClean, deputy chief scientific adviser

 

Matt Hancock

  • Government has 3,260 spare critical care beds.
  • Government has carried out 700,387 tests, including 43,453 yesterday
  • 21,678 people have now died in hospital with coronavirus - an increase of 586 since yesterday.
  • Hancock announces that from tomorrow will be publishing daily deaths in care homes and communities to supplement weekly ONS data. 
  • Will not be changing social distancing rules until 5 tests have been met. 
  • Testing: Every day we are ramping up testing capacity. Continuously opening new drive through centres, expanding home testing, increasing dispatch of home tests to 25,000 a day by the end of the week. 
  • 70 mobile testing units deployed by the end of the week. Daily capacity now stands at 73,400 allowing us to expand access to testing. 
  • Expand access further - testing asymptomatic residents and staff in care homes and in the NHS. Access to a test whether have symptoms or not. 
  • From now, testing is available to all over 65s and their households, and workers who have to leave the house if they have symptoms. 
  • COVID-19 therapeutic work - currently no drugs have been clinically proven to treat covid. Have been looking into this and the first is ready to enter the next phase, launching today. 

 

Angela McClean

  • Transport use - volumes of all kinds of transport use have fallen, in particular, use of public transport below 20%
  • Over last week people in hospital with COVID has fallen by 40% over the last week 
  • "strong weekend effect" in terms of daily death figures

 

Questions: 

Public 

Amanda in Hull. She says, given that grandparents cannot look after grandchildren, what can full-time working parents with young children do when they need to go back to work. Hancock responds that it is too early and the government is not in a position to lift lockdown measures yet.

Sadie asks about children such as hers who has cystic fibrosis and autism whether they will be able to get back into society without a vaccine. MH - the education plan makes allowance for children with special health needs. But shielding them must take priority, because their health comes first.

 

Journalists

Hugh Pimm, BBC

PPE - what assurances can you give frontline staff that there will be adequate supplies of PPE? MH - working hard to make sure everyone has the equipment they need. suggests that Panorama looking at the government’s record on stockpiling PPE was not fair and objective. The government is working hard to make sure PPE is available and is coninuing to source it from UK manufacturers and abroad.

 

Paul Brand, ITV

Do you recognise that whilst you protected the NHS, there is a crisis in the care sector? 

MH - of course care homes have been top priority from the start, first guidance in feb, working with them throughout. 

AM - Studies of infections in care homes, presence of symptoms is not a good marker in care homes, so have increased the number of tests - symptomatic and asymptomatic residents. 

 

Nick Martin, Sky 

Care home deaths are ⅓ of all deaths, PPE inadequate, testing inadequate - deaths seem to take department by surprise - apologise to families of those in care homes?

MH - care homes are absolutely a focus. The breakdown of statistics has suggested that the proportion of total fatalities is changing. From the start we knew that there was a very significant challenge with care homes, not least because of the frailty of residents, and the enormous work that has gone on within Government from the start. It has been more difficult to get the data flowing... and making sure that care homes have the support they need has absolutely been at the front of mind right from the start.

JN - a testing strategy had been in place for the care home sector since the outset

 

LBC

Face masks - When are ministers going to update the advice on face masks? And why is it taking so long? MH - the government is guided by the science. The UK government position has not changed - the most important thing is to maintain social distancing. 

AM - the recommendation from Sage is clear; there is “weak evidence” of face masks having a “small” protective effect. SAGE has passed that advice on to government for ministers to make a decision.

 

Metro 

Care homes - why weren't care homes told to stop visitors until March 16th - based on clinical advice. Before there was widespread incidence, having visitors to care homes has a positive impact on residents - mental health - difficult judgements and no easy recommendations to make

Collection of data has been more difficult, 15,000 care homes, part of 10,000 different organisations.

Ventilator production is being scaled back? MH - still producing ventilators, countries across the world needing them, so stil working with those countries. 

 

Adam Vaughn new scientist 

Tracing app -  goal for people to download it, as soon as possible and as many as possible. Recruiting the contact tracers, don't have figures of how many we’ve recruited. Contact tracers in place for when the app goes live. App will be ready by the middle of may.




Monday 27 April

  1. Daily press briefing
  2. Daily testing figures
  3. Summary of PM’s statement
  4. No. 10 lobby briefing  
  5. Chancellor's statement in the House of Commons

 

Other things to note:

  • No 10 is now inviting members of the public to submit questions for the afternoon press conference. One question will be selected every day (alongside the questions from journalists), and the questioner will be invited to record a video, or to just submit their question in writing. You can apply to take part here.
  • Greggs have announced plans to reopen a small number of stores for takeaway and delivery next week.

1. Daily press briefing  

Matt Hancock held today’s briefing and was joined by Prof Chris Whitty, the government’s chief medical adviser, and Steve Powis, National Medical Director of NHS England.

 

Matt Hancock

  • 719,910 tests for coronavirus in the UK, including 37,024 yesterday. 157,149 people have tested positive, an increase of 4,310 since yesterday. 1,5051 people have been hospitalised with coronavirus, down from 15,259 yesterday and of those hospitalised with the virus, 21,092 have now died - an increase of 360 fatalities.
  • The death figures include 82 NHS staff and 16 workers in social care.
  • The Government is setting up a life assurance scheme for NHS and social care frontline staff – families of those who die from coronavirus in the course of their essential frontline work will receive £60,000 payment.
  • A&E attendances have dropped to 221,000 in last week compared to 477,000 in the same week last year, more than 50 percent. Some of the drop is due to social distancing rules, some due to people accessing the NHS in other ways, but in some cases it is due to people not coming forward and use the NHS for critical things that matter.
  • Starting tomorrow – restoration of other NHS services, starting with the most urgent like cancer care and mental health support.. The pace will be determined by local circumstances on the ground, local need and coronavirus cases that hospital has to deal with.

 

Chris Whitty

Slides and data sets here.

  • Set out a reminder of the 5 tests for easing lockdown:
    • The NHS has capacity to provide critical care in the UK
    • A sustained and consistent fall in daily deaths from coronavirus.
    • The rate of infection decreased to manageable levels across the board
    • Operational challenges including testing and PPE are in hand with supply to meet future demand.
    • Confident that any adjustments to the current measures will not risk a second peak
  • Data remains largely unchanged on transport metrics in term of social distancing.
  • The has been a slight increase in walking, but overall the data shows that a great majority of people are following the advice.
  • The trend is flat and slightly down in terms of positive cases; the number of people in hospital trend shows that over the country as a whole we are going through the peak, with a bigger fall in London.
  • The number of critical care beds used is gradually trending down. This is a very gradual peak.
  • The overall trend in deaths is a gradual decline, but we are not consistently passed the peak across the country at this time

 

Questions:

 

Lynne from Skipton. She says she is missing her grandchildren. Will being able to hug grandchildren be one of the first steps out of lockdown. Whitty says it will depend very much on whether Lynne is in a shielded group, and on her age.

 

Hugh Pimm, BBC

testing, hearing varying reports about how easy it is to book tests on line. MH – on track for 100,000 target, big increase over the weekend – 37,000 tests yesterday. Home tests v popular, delivered 5681 of those yesterday.

Want testing to continue to increase, important part of controlling the virus.

 

Robert Peston, ITV  

will overseas and those who came back to NHS be eligible for money.  MH - yes frontline staff working in the NHS and social care will be eligible and will be looking at other groups of key workers.

Transmission rate (R ) has to fall to 0.5 – how can you be confident we know what the R is? CW – haven’t said target is 0.5 – what I have said is it is important we don’t go above 1 as you get to growth, and threat to the NHS. Lower we can get it the better but it is in the middle of the range at the moment 0.5-1.

 

Beth Rigby, Sky

Hospital deaths are above 21,000, not including community and care home deaths, updated expectation of realistic number. CW – number will definitely exceed 20,000, need to view epidemic over long run, very long way to run. Cautious about putting out absolute numbers.

What level of testing do you need to get track and tracing – lower the number of cases, the more effective, test, track and trace will be. South Korea peaked at 20,000 tests a day, but is now much lower as number of cases is lower. Gaps between capacity and number of tests done.

 

Garry Gibbon, C4

If we’re in the middle of R range is that good enough, or does it need to be 0.5 to release lockdown. CW - Larger the gap between R and 1, the more room for manoeuvre we have.  Reasonable degree of confidence that it is below 1. Ministers will have to consider how we keep R below 1, given what measures we have taken.

What is R in hospitals and care homes – difficult to separate those out. Its falling in hospitals, but hard to measure in care homes. There are some care homes with no outbreaks, some with considerable. Clear that infection rate in hospitals is falling.

 

Sebastian Payne, FT

Antibody testing – yet to find one that has clinical level of results that we are happy with. currently have tests that are good enough to give us a feel for who has been effected in community. Likely to happen in a series of improvements.

 

Has government started measure the impact of the lockdown – mental health, domestic violence. MH - fewer people are coming forward to use non-covid services around the world. We are concerned about this, which is why we want people to come forward.  

 

Remains the case that majority of children don’t get COVID or symptoms are minor. Relative to adults much less likely to transmit. There is no doubt it does contribute to increasing the R.

 

Access to medical treatment has never been part of lockdown. But because now have capacity in the NHS, it means we can start reopening services, locally determined. Continuing to comply with restrictions will mean the NHS is better to cope. SP - the NHS is not undertaking some of the services that were paused - some cancer treatments were delayed for good clinical reasons.

 

Dave West, HSJ – more about restoration of services, - elective surgery – timeframe for that activity to get back to normal – role of nightingale hospitals? MH – local approach, system by system. Most urgent treatment brought back first. Gradually, starting from tomorrow.

 

How many beds keep open in case of second peak? Got to make sure don’t have second peak, so NHS is making sure can reopen where locally appropriate. Taking into account the nightingale hospitals? not going to be used for non-covid cases but the fact they are there helps us to restore core NHS. Will keep under review how best to use nightingales.

 

Warnings about small numbers of children becoming ill, which could be linked to coronavirus – looking into this. Not sure at the moment whether there is a link, advice to parents that this disease is rare, but do talk to GP, call 111, or 999.

V rare, but plausible that it is caused by this virus.

 

Other questions:

Additional support for businesses.

2. Daily testing figures

As of 9am today (27 April), there have been 719,910 tests, with 37,024 tests on 26 April. 569,768 people have been tested of which 157,149 tested positive.

 

As of 5pm yesterday (26 April), of those hospitalised in the UK who tested positive for coronavirus, 21,092 have sadly died.

3. PM's statement

Boris Johnson returned to work today, delivering a statement on the steps of Downing Street this morning. He gave a strong indication that we could see another extension of lock down measures on 7 May, saying he believes we are turning the tide, but for the meantime we carry on, to ensure we don’t see a second outbreak of the virus. He said we should only ease up on the lockdown when the government is confident there will be no second peak and wants “maximum transparency” about how the decisions to relax restrictions are taken, involving the opposition parties as much as possible.

We could expect to see an outline of what to expect as the lockdown is eased towards the end of the week, but there was no indication from Johnson that this easing would come before 7 May, although he did talk of preparing to “fire up the engines of the economy one by one” perhaps signalling a gradual easing such as we’ve seen in other European countries.

4. No.10 Lobby briefing

  • The prime minister’s spokesman said that the government would not be able to say on Thursday whether or not it had met the target of reaching 100,000 tests a day by the end of the month.  It takes 72 hours for the results of home testing kits to be delivered, “and therefore show up in the numbers”.
  • The government now has the capacity to carry out 53,000 tests per day. The most recent daily figures show more than 29,000 tests being carried out.
  • More than 40 drive-through testing centres are now open. There will be 48 by the end of the month, as well as 96 mobile testing sites by early May.
  • Further evidence from Sage submitted to the government about coronavirus will be published this week.

 

5. Chancellor’s statement in the House of Commons

 

Rishi Sunak, the chancellor, made a statement in the House of Commons about the economic response to the coronavirus crisis.

He outlined what has already been done for the economy, including providing an extra £16bn for the NHS. 500,000 employers have used the coronavirus job retention scheme to pay the wages of more than 4m workers. And another scheme for the self-employed is being implemented.

He also announced a new micro-loan scheme for businesses. Firm will be able to get loans worth up to 25% of turnover, with a maximum payment of £50,000. The government will pay the interest for the first 12 months. He described them as “bounce back” loans, and he says people will be able to apply from Monday next week. There will be no forward-looking eligibility test.

Friday 24 April

  1. Daily press briefing
  2. Daily testing figures
  3. Summary of science and technology committee with Chris Whitty

 

Media to watch out for:

Chris is on any questions on BBC Radio 4 at 8.30pm tonight.

 

Other things to note:

  • The telegraph is reporting that Boris Johnson could return toNo.10 on Monday following calls this week with Donald Trump and The Queen, however No.10 .
  • The Scottish and Welsh governments have  released their plans for ending the lockdown, putting additional pressure on the UK government to follow.

 

Reasons to be cheerful:

  • Captain Tom has reached No.1 for his 100th birthday with his cover of ‘you’ll never walk alone’

 

1. Daily press briefing

 

Grant Schapps, transport secretary was joined by Dr Jennie Harries, deputy chief medical officer for England. The focus of today’s briefing was on a package of support outlined for transport, so most of the questions focused on transport.

 

Grant Shapps

  • 612,031 tests done in the UK 28,532 tests done yesterday 143,464 tests have been positive That’s an increase of 5,386 on the day before 17,049 are in hospital; down from 17,615 on day before and 10% down in a week 19,506 have died; increase: 684.
  • He outlined a new package for transport support measures:
    • Tri-lateral agreement with French and Irish Governments to keep freight lines open during this crisis
    • Operators on many of these routes have been under financial pressure as a result of this crisis
    • £17m for funding for ferry routes between GB and N Ireland
    • £10.5m will be directed at links to the Isle of Wight and the Isles of Scilly so critical freight can continue
    • Air links to Belfast, Derry and Londonderry will continue, as they are key for critical workers.
    • The Government have now launched a Transport Support Unit – helping frontline staff.
    • More funding (not specific) will be given to tram services, helping light rail networks in Greater Manchester, Sheffield, Nottingham, the West Midlands, and Tyne and Wear to keep operating.
    • Praised Network Rail who helped kit out NHS Nightingale Hospital
    • Given green light to trial of Drones to deliver essential supplies, beginning on the Isle of White
    • There are no more British holidaymakers stranded on cruise ships globally

 

Dr Jennie Harries

Slides and data sets here.

 

  • Transport use has risen a little in the last week. Important to maintain reduction in contacts.
  • Number of cases reported – total number of cases has risen, but the curve is flattening, indicating the reduction in transmission. With the increased number of testing available, will expect to see increase in numbers.
  • People in hospital with COVID-19 – has fallen in London, need to keep social distancing measures.
  • Critical care bed use has significantly fallen and capacity continues to increase
  • Deaths confirmed in hospital – increase as epidemic spread, gradual decline in deaths.

 

Journalist questions

Hugh Pimm: Online booking for testing – what assurances can you give about future demand being met? Seen difference between capacity and number of tests done. 16,000 of those were booked. Site is being brought on to book more tests now.

 

Dan Hewitt, ITV: 5,000 home testing kits, and 15,000 drive through – have you raised expectations unfairly? Will you consider bringing in checks? Will have to see how we balance demand with availability of tests.

 

Politico: Dangers of spreading disinformation following Trumps announcement last night – JH – clearly would not support this action. People should use treatments that are evidence based and tested.

 

Why is the virus having disproportionate effect on BAME: Hugely complex subject. Looking at different groups. Data has to be good, and recording of ethnicity has to be accurate. Hugh amount of work going on. PHE doing detailed review. Also looking at other underlying conditions they have, conditions they are living in.

 

Testing capacity – still far away from target. Capacity rising fast. But sufficient people aren’t coming forward to be testing.

When will testing be open beyond key workers.

Contact tracing, are we expecting to follow south Korea? Ambition is to digitise this, younger generation will be ready to do this. So single model will not be possible.

 

Other topics:

Manage people’s expectations about timescale?

Screening at airports

Brexit talks – limited progress made

2. Daily testing figures

 

As of 9am on 24 April, 612,031 tests have concluded, with 28,532 tests carried out on 23 April.

444,222 people have been tested, of whom 143,464 have tested positive

As of 5pm on 23 April, of those hospitalised in the UK who tested positive for coronavirus, 19,506 have died.

 

3. Science and technology committee oral session on COVID-19

 

The Science and Technology Committee held an oral evidence session looking at the response to COVID-19 across the four nations.

 

Witness(es): Dr Frank Atherton, Chief Medical Officer for Wales; Dr Michael McBride, Chief Medical Officer for Northern Ireland; Dr Gregor Smith, Interim Chief Medical Officer for Scotland; Professor Chris Whitty, Chief Medical Officer for England, Chief Scientific Adviser, Department of Health and Social Care

 

Key points:

 

Did SAGE give advice on 100,000 target of tests? SAGE consistently advises that there is a need for greater capacity to test – that is now happening. Aim to increase it would have been suggested by SAGE and while the actual number was not specifically suggested by SAGE, increasing testing is following SAGE advise.  

 

Does SAGE have a view of what volume of testing should be? SAGE is developing a view at the moment about what the optimal amount of antigen / antibody testing under a number of different scenarios Including greater testing within hospitals of people who don’t currently have symptoms and greater testing in care home

 

Also looking at what the other things we could use extra capacity in testing for. Will be giving advise to the UK government about what broadly the numbers should look like.

 

Is SAGE looking at the economic impacts?

SAGE is focusing on health – but there are a number of impacts looking at:

 Direct deaths from COVID-19

  1. Indirect deaths – as a result of the health care system being overwhelmed
  2. Indirect deaths by downscaling other health issues, public health issues – delayed
  3. Impact of socio-economic factors – gradient between health and deprivation is established – economic downturn, deprivation, will have an impact – SAGE has looked at this. There is advice coming in that is on the economic side.

 

Are there estimated figures for collateral damage? Initial analysis is being done as real data is now available. NHS capacity for emergencies has always been available.

 

Jeremy Hunt: Is the lower death rate in Germany due to its extensive testing? Germany is operationally ahead of the UK and testing does allow for a better response but it is one of multiple components.

 

Did SAGE not advise to lockdown until 24 March? No, thing happened in stages. Unclear whether it was the right approach and end of epidemic will be the time to look at this.

 

What is the current effectiveness of antibodies tests? Around 80% accuracy. Need for higher accuracy to understand transmission in the population.

 

Will an app be effective for contact tracing? Usual contract tracing is highly laborious. App may ease this.  

 

Are there data sets that look into different people? Over representation of people from BAME backgrounds and PHE are looking into it.

 

Will ethnicity be recorded on death certificates? Unlikely to change for this particular reason but ethnicity and gender should be better recorded across multiple sources.  

 

Implications if vaccine is not found? If people who have had the virus only have a short period of immunity then a vaccine is unlikely. But even without a vaccine, treatment is still possible (e.g. HIV).

 

Did the pandemic exercise show findings for PPE and ventilator shortages? It focused on cooperation and surge capacity, not aware of any findings on shortage of PPE and ventilators.

 

With hindsight, would SAGE have recommended a lockdown earlier? Yes, but only by a matter of days although it is an unsupportable proposition that this would have prevented current situation. Untrue that nothing happened before 23 March, there are significant downsides to lockdown that were considered.

 

What is the position on the recommendation on face masks? Have yet to give advice to ministers and therefore will not inform public yet. Evidence is difficult and the availability is also being taken into account. All institutions, including WHO, advise against the public using face masks it will impact availability for the health service.

 

It seems likely we will exceed the estimated number of 20,000 fatalities. What is the new estimated figure? Likely higher though cautious of putting a number on fatalities. Only getting through the first wave and further ways are always a possibility.

 

Imperial College modelling shows all forms of social distancing are needed to keep R value below 1. Is this your understanding? R value currently between 0.5-1 which gives scope for some relaxation of lockdown. Working out exact package will be a difficult task.

Thursday 23 April

  1. Daily press briefing
  2. Daily testing figures
  3. Social care recruitment campaign announced
  4. No.10 lobby briefing
  5. International Trade Committee inquiry into the COVID-19 pandemic and international trade

 

Also worth noting:

  • Conservative MPs are starting to break rank to discuss what they think the government should be doing to ease the lockdown. There were reportedly a tense meeting of the 1922 committee of backbench MPs yesterday with some saying the lockdown needs to be relaxed after the first week of May, otherwise risk thousands of businesses going under, with suggestions that garden centres and DIY stores should open immediately.

 1. Daily press briefing

Matt Hancock, the health and social care secretary, led today’s briefing and was joined by Sir Patrick Vallance, the government’s chief scientific adviser, and Prof John Newton, the government’s national testing effort coordinator.

 

Matt Hancock:

 

  • Number lower than it has been in previous days, must maintain and follow social distancing rules. They are working, protecting the NHS and saving lives.
  • To lift measures too soon would risk a second peak.

Testing

  • Goal of 100,000 tests a day – capacity is now ahead of plans, and has increased to 51,000 overnight. Now able to expand who can get the tests. Had to start by prioritising patients. Can make it easier, faster and safer for any essential workers to get a test.
  • From today employers of essential workers can go on the gov.uk website and book a test for their staff. From tomorrow, essential workers will be able to do this themselves too. Relatives will be covered too. And the whole process will be free.
  • Results will be sent out by text.
  • People who cannot go online will be able to apply through their employer.
  • There are more than 30 test sites across the UK and home tests kits are being introduced, and mobile testing sites led by armed forces.
  • 25,000 people will take part in first phase.
  • The government is introducing a contact tracing app, will also use manual tracing. 18,000 people, including 3,000 clinicians, are being hired to work on contact tracing. They will be trained over the coming weeks

 

Sir Patrick Vallance:

Slides and data set

  • Number of people being tested for medical reasons is coming down
  • Number of people in hospital – can see very clear decline in London, in nearly all areas flat or on the way down.
  • % of critical care beds occupied is gradually decreasing
  • Deaths remain at a plateau – coming down slowly, but not coming down fast.

 

John Newton:

  • Two different types of test
    • swab testing – currently main focus. Can tell us what treatment, who needs to be isolated, and which key workers can return to work. Can help us understand the spread of the disease across the population. Positive swab test is reliable. Negative result does not absolutely guarantee free of virus.
    • Blood testing – can tell who has previously had virus and risk of future infection. Science on immunity is still uncertain.
  • Increasing capacity and access
  • Can now do more than 51,000 tests a day
  • 3 new lighthouse labs on stream. Introducing automation
  • Partnerships with leading labs in academia
  • Currently on track to reach 100,000 tests a day.
  • More than 30 drive through centres, increasing to 48
  • Home testing will be increasing,
  • Satellite approach, tests delivered in batches.
  • Working with army on mobile testing option- 48 to travel where needed most
  • Also developing new and better blood tests. Existing tests do not yet work well enough.

 

Journalist questions:

Laura Keunssberg, BBC

Scottish first minister, opposition and own MPs, think you should be more transparent about how to move to next phase. MH – tests we have set out are critical for when changes can be made. Monitoring and making sure move at the right time.

What could gap between different peaks in different parts of country: Not a natural peak – we’ve suppressed the natural peak. 2 or 3 weeks could be the difference.

 

Robert Peston, ITV

Overweight people is it a risk factor? Looking at relationship between obesity and death, as well as ethnicity, age and gender.

 

What have you learned from this virus and how it’s behaving as to why 20,000 deaths, a lot we don’t know about this virus. Odd about obesity, and gender. Things we are learning quite fast. In terms of numbers of deaths, difficult to speculate, large numbers across the world. Overall excess deaths is the key figure to look at.

 

Beth Rigby, SKY

Testing, track, trace up and running before releasing the lockdown. No automatic link between scale of test, track and trace and any changes to social distancing measures. testing, tracking & tracing, done effectively, can help to suppress the transmission in a way that allows you to have lesser social distancing rules. The lower the rate of new cases, the more effectively you can keep it down using TTT. Objective is to get rate of transmission down and level of transmission, also need to see number of cases coming down.

 

Ben Kentish, LBC

How many of 18,000 tracers are in place? How low do case numbers need to be before it can be effective. Will be ready in a matter of weeks, will be needed when cases are down.

 

Face masks – position is unchanged. Constantly review science and will consider updated advice when we need to. Critical that facemasks we buy are for NHS and social care.                                                                                                                                                 

 

Express

Publics willingness to lock down - Increased road traffic and people on street – patience wearing thin? Social distancing needs to be sustainable. People doing a good job and sustaining. At the moment things look good. R reduced dramatically. No evidence that people are flouting measures.

 

Improved support for relatives of health workers who lose their lives, similar to support for armed forces personnel. MH - looking into what more can be done to support the families of NHS workers who have lost their lives. He hopes to be able to announce something soon.

 

Evening Standard

Encouraging to see curve for London coming down. Could London start coming out of lockdown ahead of other regions? It’s not that London is two weeks ahead of everywhere – but shouldn’t rely on that. In terms of releasing measures, only have to look at spread in cities to know that you have to be absolutely sure you can limit spread.

 

Start testing every person who dies in care home? Have always been testing people in care homes, and rolling out increased capacity. PHE has been looking at data carefully. Newton says one reason for having more testing is so as to get better statistics. He says even if the doctor does not write coronavirus on a death certificate, if someone has tested positive for coronavirus, that will be picked up.

 

Brighton

Limited agency staff to 1 or 2 homes to stop spread. MH - Huge effort to limit spread in care homes. Expanding amount of testing, introduced testing of those who don’t have symptoms.

 

Other topics:
Stopping people going to beaches at the weekend

Scottish government plan to release lock down

 

2. Daily testing figures

As of 9am 23 April, 583,496 tests have concluded, with 23,560 tests on 22 April.

425,821 people have been tested of which 138,078 tested positive.

As of 5pm on 22 April, of those hospitalised in the UK who tested positive for coronavirus, 18,738 have sadly died. That is a daily rise of 616 people, yesterday the equivalent daily rise was 759.

 

3. Social care recruitment campaign announced

The Department of health and social care have launched a recruitment campaign  "Care for Others. Make a difference" to encourage more people into the social care sector.

 

In development are free e-learning course and webinars for local authorities and care providers. Key topics will include:

  • Safeguarding
  • Person-centred care
  • Dementia
  • Mental Capacity Act
  • Infection control
  • Supporting care at tome to reduce pressures on the NHS

 

The DHSC is calling for relevant organisations, such as care providers and recruitment agencies, to ensure vacancies are advertised on www.everydayisdifferent.com.

 

Campaign assets can be downloaded here.

 4. 10 lobby briefing

  • Fifty mobile laboratories are planned to help the coronavirus testing effort. Four mobile laboratories were already operating, including in Teesside, the Isle of Wight and Salford. There are 28 drive-through testing centres already open, and the government wants to extend that to 50 by the end of the month.
  • The capacity for testing has reached 48,273 tests a day, he said. But the latest daily figure for the number of tests carried out (in the 24-hour period up to 9am yesterday) is 22,814 tests. The number of people tested in that period was just 13,522. (Some people need to be tested twice.) The spokesman said that 111,637 NHS and care workers and their relatives in total have been tested - up more than 10,000 on the previous day’s total. The government is committed to getting the number of tests carried out up to 100,000 a day by the end of this month.
  • The government is recruiting 20,000 households to take part in antibody testing to establish how widespread coronavirus infection has been in the population. Eventually the study aims to cover 300,000 people over the course of year
  • NHS England staff absence rate linked to coronavirus was now 4.2% for doctors and 8.3% for nurses, down from 4.4% and 8.4% respectively the previous day, and 6.6% and 9.5% respectively on 4 April.

5. International Trade Committee inquiry into the COVID-19 pandemic and international trade

The International Trade Committee had a meeting on its inquiry into The COVID-19 pandemic and international trade. The first session heard evidence from:

 

  • Dr Samuel Roscoe, senior lecturer in operations management at University of Sussex
  • Dr Richard Torbett, chief executive at Association of the British Pharmaceutical Industry

 

Key points:

 

  • NHS uses around 12,000 prescription only medicines and the supply chain has largely been resilient – of these, 20 medicines are used for ICU patients and are in high demand globally.
  • There have been around 54 export restrictions since January and diplomatic channels have been used to lift some bans.
  • Initially some well-intentioned prescribers were writing longer prescriptions putting additional pressure on supplies leading to NHS England communicating that this should not happen.
  • Buffer stock has been sufficient but challenges may arise depending on length of crisis.
  • Likely a fundamental shift to shortening supply chains and increasing domestic manufacturing in the long term.
  • Supply chain for prescription only medicines is not fragile.
  • NHS’s 12,000 prescription only medicines would not exist without patent rights, the financial markets would not allow for it.  
  • Pharmaceutical industry is focusing on producing a cure, keeping supply chains going, and supporting NHS in any way possible – an important part of the healthcare community.

 

The second session heard evidence from:

 

  • Peter Ellingworth, chief executive at Association of British HealthTech Industries
  • Mark Roscrow CBE, chair at Health Care Supplies Association


Key points:

 

  • Doubtful that joining the EU procurement scheme would have been more beneficial given international demand – need to be agile, responsive and to avoid bureaucracy as normal procurement approach does not fit what is required.
  • We now have the ventilator supplies needed.
  • Questions were raised around the implications for the EU procurement scheme given that Germany and France have banned exports of PPE.
  • UK had pandemic supply contracts in place with France which were triggered but France stopped the export last minute.
  • The Chair quoted Chris saying that the UK had a large stockpile of PPE and questioned why there was now a shortage.  UK’s pandemic and Brexit stockpile did not anticipate the scale of need. Volume of stock was built around last flu pandemic and costs of disposing unused stock and of storage were a factor.
  • 90% decline in passenger flights have affected logistics. Reports of seven fold increase in freight costs.
  • Examples of fraudulent and substantial products being sold to the UK – China is now inceasing export scrutiny.
  • The Chair quoted Chris saying that the supply of oxygen was a problem and questioned if that was the case. There is sufficient oxygen.
  • Reports of attempts by the US to divert deliveries to the UK to the US with greater, last minute offers of money.
  • Question on whether it is possible to strike trade agreements for pandemics given countries prioritising their own need. Pandemic planning will need to be factored into future trade agreements.
  • NHS needs to adopt new innovation and new clinical pathways.

Wednesday 22 April

Today's update includes: 

  1. Daily press briefing
  2. Daily testing figures
  3. First virtual PMQs
  4. Commons statement on coronavirus

 

1. Daily press briefing

 

Dominic Raab, first secretary of state was joined by Prof Chris Whitty, the government’s chief medical adviser, and General Sir Nick Carter, the chief of the defence staff.

 

Dominic Raab, first secretary of state

Full statement here 

  • We’re making progress through the peak of this virus, but we’re not out of the woods yet as SAGE advised last week.
  • That’s why the measures we introduced must remain in place for the time being.
  • The greatest risk for us now, if we eased up on our social distancing rules too soon, is that we would risk a second spike in the virus with all the threats to life that would bring, and then the risk of a second lockdown which would prolong the economic pain that we’re going through.
  • Set out the five principles that will guide our approach going forward to the next phase, and which must be satisfied before we are willing and in a position to make any changes, which will of course be based on the advice that we receive form SAGE.
  • We continue to ramp up the testing capacity, which will play a really important role in the next phase of the crisis.
  • Amidst a global shortage in Personal Protective Equipment, we’ve distributed over a billion items to the front line, where its needed most.
  • We’ve just brought in Lord Deighton who helped organise the London Olympics to boost our domestic supply even further.
  • And I am on the phone every day pursuing the next batch of deliveries from abroad with the support of our tireless diplomatic service. The first of several new deliveries landed from Turkey in the early hours of this morning.

 

Prof Chris Whitty

Slides and data sets: https://www.gov.uk/government/collections/slides-and-datasets-to-accompany-coronavirus-press-conferences?utm_source=9d19886d-6054-49ae-8183-edf0fab5bcf6&utm_medium=email&utm_campaign=govuk-notifications&utm_content=immediate

  • Travel has broadly remained stable
  • Numbers of people in hospital improving or broadly flat
  • People who have died from coronavirus – steep upward climb has now flattened off
  • Trying to compare different countries is difficult
  • 7 day rolling deaths – downward slope is a relatively slow one

 

Journalist questions:

 

Alison Holt, BBC

Figures suggesting a doubling in care home deaths in England – do you see as inevitable? No not inevitable, fighting to make sure we minimise life lost. CQC data – numbers are relatively modest. Trying to make clear that NHS remains able to manage non COVID emergencies. 

What reassurance will you give that they are a priority – working to get PPE to places that need it and mobile testing labs. Revised guidance

 

Robert Peston, ITV

TSSA – told to prepare for phased increased in railway use. Is that a timetable for modifications of the lockdown? Not dates I recognise, would be a mistake to take eye of ball. Focus is still delivering through the peak. Not a government timetable. 

NHS surcharge for overseas staff? Should it be waived? Home secretary has already outlined measures.

 

Beth Rigby, SKY

PPE –NHS workers just want to know they have the equipment they need – when do you expect the shortages to be resolved? Clear that we are tight for different items at different times. Still close to the line, but at a national level we are not underwater at the moment, but there may be local issues. All of us want to be in a position where there is an excess. 

Health sec said we’ve reached the peak and time to reopen the NHS – is there light at the end of the tunnel – coming through the peak but we are not there yet. One of the positives has been that we have kept sufficient NHS capacity to deal with non-covid cases. 

Lockdown – need to make sure we have the evidence before we start sharing ideas that we might not be able to deliver. We have to be very realistic if people are hoping it’s suddenly going to move from where we are in lockdown to where suddenly into everything is gone, that is a wholly unrealistic expectation

We are going to have to do a lot of things for really quite a long period of time, the question is what is the best package and this is what we’re trying to work out.

If you release more on one area, you have to keep on board more of another area so there’s a proper trade-off and this is what ministers are having to consider.

Hoping that we will shortly have tests available that will be able to tell us which proportion of people have had this virus.

 

The Sun

When are you meeting to decide should people be wearing face masks to protect people? SAGE are looking at evolving evidence, haven’t had advice back yet, nothing will change until we’ve had this. 

Upper and lower band of what is possible – cannot allow R to go above 1 for any period of time, otherwise NHS could be overwhelmed. If it goes back up it does not take long before you move from bad numbers to really bad numbers – so cannot allow this to happen. This disease is not going to be eradicated, will be with it globally for foreseeable future. What are the things that add up to R of less than 1, but narrows options. Have to be realistic that we are not going to move from lockdown to opening everything. Have to think seriously about what will give us the best public health outcomes.

 

Gordon

Is it possible to ease lockdown measures before there is a vaccine. UK is going to want to get as early access to vaccine as possible. Work going in to support science, will want to keep track and make sure UK has access. There are a large number of possible combinations of things you can do to ease lockdown, including contact tracing. Very hopeful we will have vaccines much earlier than a year. Until we have vaccine or drugs what we have available is social distancing.  In the long run, the exit from this is going to be one of two things, ideally. A vaccine, and there are a variety of ways they can be deployed ... or, and/or, highly effective drugs so that people stop dying of this disease even if they catch it, or which can prevent this disease in vulnerable people. Until we have those, and the probability of having those any time in the next calendar year are incredibly small and I think we should be realistic about that.

We’re going to have to rely on other social measures, which of course are very socially disruptive as everyone is finding at the moment.

But until that point, that is what we will have to do but it will be the best combination that maximises the outlooks but it’s going to take a long time and I think we need to be aware of that

Pandemic drill in 2016 – findings never published, will you make documents public. Would have to look at rules around publishing. 

 

PM

Contact tracing – are you planning on relying on this new app. Boosting testing capacity, looking at functionality. 2 factors, getting transmission rate down and. Do you think people will be willing to download, or people that don’t have a smart phone ? We think the people are going to be willing to do what they can to support a releasing of the social distancing measures.

A lot of things you can do with testing, allowing key workers to go to work. Will be doing more of testing across community to limit a resurgence.

 

Kate Wilson, Bristol Post

Could other parts of country with lower cases peak later? Peak we are going through at the moment is not the natural peak – actual peak is likely to occur at the same time. Nightingale hospitals gave us the ability to deal with emergencies, and flexibility having nightingale capacity means that when planning it gives us a number of options we wouldn’t have already had.  The fact they haven’t had to be used is in fact a sign of success in our current strategy.

 

 

2. Daily testing figures

As of 9am 22 April, 559,935 tests have concluded, with 22,814 tests carried out on 21 April.

411,192 people have been tested, of whom 133,495 have tested positive.

As of 5pm on 21 April, of those hospitalised in the UK who tested positive for coronavirus, 18,100 have died, an increase of

 

3. First virtual PMQs

An historic PMQs took place today as the House was dragged into the 21st century with some MPs asking questions virtually on Zoom. Keir Starmer made his first appearance at the despatch box as Labour leader facing Dominic Raab as First Secretary of State. There were, of course, some technical issues but on the whole the session ran smoothly for just over 45 minutes. The full transcript of the session can be found here.

 

Starmer/Raab exchange

Raab began by informing the House that the PM is recovering and in good spirits. Starmer sent his best wishes to the PM and expressed his condolences to those who have lost loved ones to coronavirus. Starmer set the tone of the debate with promises of giving constructive opposition, he wants the government to succeed but will challenge the government when it is getting things wrong.

 

Starmer asked how the government will reach its target of 100,000 tests by the end of April when yesterday’s testing figures stood at 18,000. Raab said testing capacity is at 40,000 but acknowledged that an exponential increase is required. He said a super lab in Milton Keynes is currently fully functional and additional super labs will be opening soon.

 

Starmer asked what the government is doing to ensure capacity is filled. Raab said testing is being broadened out to include key workers.

 

Starrmer asked what reassurances the government can give to care home workers that access to testing will improved. Raab encouraged more people to come forward for testing and acknowledged that there were logistical issues.

 

Starmer asked how many NHS workers and care home workers have died. Raab said 69 NHS workers have died but he did not have a figure for the number of care home workers. Starmer said he will continue to ask about care home workers until he gets a figure.

 

Starmer asked when frontline workers will get PPE to keep them safe. Raab agreed that frontline workers need PPE but that there was a huge international challenge to source it. He said 1bn items of PPE have been delivered but recognised the need to strive harder to source PPE which is why Lord Deighton, former chief executive of the London Olympics, has been hired to lead on domestic efforts. 34m items of PPE have been distributed to across local resilience forums and a new website is being piloted.

 

Starmer said British manufacturers offers of PPE have been ignored and have been supplying other countries. The government has been too slow in acting. He asked the government to commit to working with the opposition to take up offers from manufacturers. Raab said the government has been guided by science, taking the right decisions at the right time. He said offers from manufacturers are not necessarily up to UK standards with instances of PPE being recalled from other countries resulting in health workers self-isolating. Government has had 8000 offers which have been responded to with 3000 offers being taken up.

 

Health related questions

Barry Gardner, Lab asked if the government had actually been following scientific advice when advisers had recommended a lockdown three weeks before it actually being put in place. Raab said the government had listened to scientific advice at every stage with the right decisions at the right time.

 

Nick Fletcher, Con asked what steps is the government taking to ensure adequate supplies of PPE? Raab repeated that 1bn items of PPE have been delivered and the government is working with the devolved nations, the army, local resilience forums and Lord Deighton on PPE.

 

Matt Vickers, Con welcomed the writing off of the NHS’s historic debt and asked the government to commit to record levels of investment and also for capital investment in his constituency hospital. Raab said record levels of investment has been enshrined in law and the Chancellor has announced £14.5bn for the emergency coronavirus response.

 

Sir Ed Davey, LD asked for an independent inquiry into how the crisis was handled. Raab said the full focus was on saving lives and protecting the NHS. He said he would not commit to an inquiry right now but questions will be asked later.


Liz Saville Roberts, PC asked for unanimous agreement across the four nations when lifting lockdown. Raab commended the excellent cooperation of the devolved nations and said he is committed to working continue working with them.

 

Angela Eagle, Lab asked for assurances that the UK is committed to the WHO unlike the US. Raab said the UK fully supports international efforts and acknowledged that while the WHO needs reform, he recognises its role.

 

Other topics

  • Universal basic income
  • Banks
  • Hospitality, tourism and steel industries
  • Armed forces
  • Financial support for zoos
  • Repatriation

 

4. House of Commons Statement on Coronavirus

Matt Hancock, secretary of state for health and social care delivered a statement on coronavirus. His opening statement covered much of the same ground as the daily press briefings. The full transcript of the session can be found here - https://hansard.parliament.uk/commons/2020-04-22/debates/F992E234-D1A9-47AF-86F7-985C33DA1C05/Covid-19Response

 

Statement key points:

  • We are at the peak. But before we relax any social distancing rules or make changes to them we have set out the five tests that have to be met.
  • Non-covid NHS services are open for patients - people with non coronavirus symptoms (heart attacks, cancer symptoms) you must seek medical help.
  • Brought in armed forces to help meet demand
  • Record numbers of ventilators available, including medicines
  • NHS PPE supply chain is currently supplying 58,000 separate settings
  • Have delivered over 1bn pieces of PPE since start of pandemic
  • Working to make more at home, thank UK businesses and members for putting in touch with business in constituencies – now have 159 potential UK manufacturers
  • Expansion of capacity – ramping up availability of testing, making easier to access tests, mobile centres and home labs. 3 lighthouse labs.
  • Vaccine trial ready for human testing tomorrow

 

Jonathan Ashworth:

  • What is the explanation for why our death rate is so high? Constantly looking at this
  • Publish SAGE minutes?
  • Evidence as to why we are following 7 day isolation rather than 14 day rule as outlined by WHO? – guided by science which recommends the 7 day rule
  • Convene clinical scientists to share understanding of disease – think royal colleges are doing this but will check
  • Update us on inquiry into deaths of BAME staff – will make sure he has a copy of results as soon as concluded
  • Ensure all deaths recorded on a daily basis, CQC suggests double. All deaths in care homes are recorded, the data measures different timescales.
  • Testing – mobile units, home kits increasing number of drive through centres
  • PPE supply – new service to directly provide PPE care home and domiciliary care
  • How many general and acute beds are empty – could they be ready for social care or elective surgery 10,000 beds spare in NHS, want to reopen safely and carefully as soon as safe to do so. First step is to send message that people with suspected conditions should come forward to be treated in NHS
  • PPE – frontline staff aren’t getting PPE – publish all information about EU scheme
  • Testing – testing and contract tracing is vital – upscaling contact tracing – can we use the 750,000 volunteers, will the app be voluntary – how will ensure taken up. App is currently in trials, going well. App is helpful but also need mass contact tracing. Working on scaling this up.
  • 15 social care staff have lost lives. Constantly looking at this.
  • PCR test – returned false results, how many have been affected?

 

Other questions:

Jeremy Hunt, chair health and social care committee – WHO say one of 6 essential criteria is tracking and tracing – will that be in place in next two weeks? Will he appoint big hitter to make sure this is delivered

Ramping up testing capacity and contact tracing in a matter of weeks to make sure we can use as and when transmission

Effectiveness of test track and trace is determined by incidents in community – goal is to test everybody that needs it

 

Phillippa Whitford, SNP – ensure care workers are paid real living wage, does he accept testing and contact tracing must be in place before any easing of lock down

How accurate are the tests?

Yes all health and social care staff are paid the living wage – has led to rise in pay of those in social care. That is the law.

Evidence on asymptomatic transmission does occur

Test track and trace – agree a critical part in keeping spread low.

 

Greg Clark, Conservative – has SAGE advised on whether 100,000 tests a day target is the right one. Target was set because that is what estimated was needed. Need t make sure demand increases, widening access. Did take scientific advice.

 

Hilary Benn, Labour  – if the advice changes and recommends everyone wears masks – is the government policy to provide masks – what is plan to source them or will public be expected to source their own?
Will follow advice and listen to what SAGE advices, cant promise to give everyone masks and need to make sure we have sufficient for health and care staff

 

Jeremy Corbyn, Labour - the director general of the World Health Organisation said “test, test, test” was the way to address this problem. But that did not happen. Will it happen now? Hancock - testing has been developed “at pace”. The UK was one of the first countries in the world to develop a test. The government has had “its foot on the gas” the whole time.

 

Lucy Powell, Labour – should we be testing all health and social care staff and all patients? Hancock - we are testing all those who leave hospitals to go to care setting. Absolutely things we are looking at.

 

Barry Sheerman, Labour - management and leadership of this present crisis has been shambolic. The UK has lagged behind Germany and that a death toll of around 800 people is equivalent to two jumbo jets crashing. NHS whistle-blowers have been leant on not to tell the truth about conditions in the NHS. 

Hancock responds that Sheerman had misjudged his tone, and missed what the government was doing. The prime goals were to flatten the curve, and to ensure the NHS was not overwhelmed. Both of those challenges had so far been met. He is wrong to say whistle-blowers have been silenced.

 

Laura Trott, Conservative – current level of instances in community is unknown until we expand testing, but think it is higher than we need to be. Hancock - confident that at a peak and need to see it come down. Fewer new cases, more effective test track and trace is, more social distancing can be lifted. But haven’t seen curve start to come down yet.

 

Rosie Cooper, Labour -  messages from patients whose treatment has been interrupted. What is he doing to ensure there isn’t a gap between his words and what is actually happening. Death in service benefits to all staff affected by COVID-19. Hancock - there is some cancer treatment that it is clinically unadvisable to undertake, so cant give guarantee that all cancer treatment will go ahead. But do want treatment to go ahead where it is safe to do so.

 

Luke Evans, Conservative – support mental health of frontline workers, both now and in future? Hancock -  helpline in place to support all frontline workers, will make sure it stays in place.

 

Maria Eagle, Labour – was it a mistake to let the Liverpool / Atletico Madrid match go ahead? Hancock - this is a question for the scientists, what matters now is that people get the treatment they need and get the virus under control.


Tuesday 21 April

 

Today’s update includes:

  1. Daily press conference
  2. Daily testing figures
  3. ONS registered death data

 

1. Daily press conference

Matt Hancock, secretary of state for health and social care was joined by Professor Jonathan Van Tam, deputy chief medical officer, and Professor John Newton, national co-ordinator of the UK coronavirus testing programme.

 

Matt Hancock:

Record high of spare critical care beds. Primary goal was to slow spread and flatten curve. That plan is working. But much further to go. Over half a million new tests had been conducted throughout the UK. 17,366 people have died in hospital, an increase of 852. Will not release social distancing rules until 5 tests have been met.

 

PPE:

1 billion items of PPE have been delivered. Constantly working to improve delivery system. Buying from around world and manufacturing more in the UK. Direct talks with factories that produce PPE and fabric. 8331 offers of PPE equipment – investigating all of these. Not everyone that approaches us can deliver on their offer at scale. Working with 159 UK manufacturers that are beginning to come on stream.

 

Vaccines:

The best way to defeat is through a vaccine. New disease, uncertain science. UK at forefront of global effort for vaccine. 2 of leading vaccine developments are taking place at Oxford and Imperial. £22.5m to support imperial project. Making £20m available to Oxford team. Vaccine from Oxford will be trialled in people from this Thursday. Investing in manufacturing capacity, to make available for British people as soon as possible.

 

Professor Jonathan Van Tam:

Slides and data sets

Important to continue to monitor the extent to which British people are following social distancing, and restricting travel. Continuing to follow government advice.

New cases diagnosed in UK – day to day variation, but numbers remain high and no clear downturn at this point.

People in hospital – there has been a peak in London, and now looks to be in decline. In other parts of the UK, there appears to be a plateau. Not clear that number of cases are dropping or that there has been a peak. Not out of danger at this point. Curve is flat but not very clearly going down.

 

Journalist questions:

Laura Kuenssberg, BBC

Why is government still scrambling now to get equipment they need and allowing companies to sell their PPE abroad?
MH – have now shipped over 1bn items and replenishing the sticks. Have brought a huge proportion from overseas.

How do you explain the gap? And the experience of those on frontline. Not taking part in EU scheme in?
MH – as far as I am aware there was no political decision. We are now members of the scheme, but hasn’t yet delivered PPE. Concentrating on where we can get the most numbers from.

 

Robert Peston, ITV

Advice on masks?
MH – advised by science on this. Meeting of SAGE that addressed this today and look forward to hearing about that.

Dramatically increased capacity but only 20,000 happening – seems to be a problem in carrying out the tests and delivering to labs. Care homes not getting help to test. MH - Terrific we’ve increased capacity, increased capacity means can expand who gets the testing. Have introduced home testing, so the individual doesn’t need to leave home.
JN - Capacity has hone up dramatically, meeting requirement in hospitals, and to test NHS and care staff. Have tested over 100,000 staff, NHS absence sickness falling. Drive in centres are not necessarily piloting a number of ways to get tests out to people including mobile delivery. 

What is the priority for face masks?
JVT – we will keep evidence under review, absolutely doing that. Will change if feel evidence if changing. SAGE met today and advice will go to ministers in due course. Absolutely enduring principle – don’t want o jeopardise supply to health and social care workers.

 

Victoria MacDonald, C4 

Spoken to number of suppliers that have talked about obstacles getting through procurement system – satisfied that you are clearing away obstacles?
MH - Encouraging the numbers that are coming forward and have to sort out the want to engage with all companies, accelerating the progress of getting back to all of those companies. There is a global shortage of PPE – need to be as nimble as possibly can.

 A lot of numbers - 1bn sounds a lot but clearly not enough.
MH – enough is to get it out to everyone that needs it according PHE guidance. Billions per month – numbers vast. Hence need to manufacture at home and buy from abroad.

 

Chris Smyth, Times:
Asymptomatic transmission - Can current tests pick up cases that aren’t showing symptoms. Should we be testing all staff?
JVT - Asymptomatic transmission means it is very difficult and challenging to trace. At the beginning didn’t have enough information to understand, now have more  and clear that a proportion of patients shed virus before onset of symptoms. Can still detect in asymptomatic. Now trying to understand how infectious those that are pre-symptomatic / asymptomatic are. Impossible to rule out that there are cases where spread occurs with people without symptoms. But vast majority of spread is still coming from people with symptoms.
JN – yes test will detect in asymptomatic. Using current capacity to do studies in general populations. Need to go in and do intensive testing in settings where social distancing can’t be maintained. Need good level of testing capacity to provide testing for infection control.

Spread of transmission in health care settings: Study from new York, small proportion who were asymptomatic and had positive tests. Test is not a screen, couldn’t really be used in this way. Use tests to understand spread of virus to put in place measures to control virus. Keep an eye on science if it changes, then testing strategy will need to change. Will be testing asymptomatic staff as part of target.

 

Daily Mirror:

EU scheme – invitation came into DHSC, to participate in associate way. I said yes, as far as I’m aware shceme has not yet delivered any PPE.

 

Yorkshire post:

NHS staff being threatened with referrals to professional regulators for speaking out about the conditions they are working under: People should be able to talk to publically about the conditions they are working under.  

 

Reuters:

10% of total deaths taking place outside of hospitals, today ONS says about 40% - UK could surpass Italy – feels like plan isn’t working: 40% is not an accurate representation of these figures. Very important to look at data and look at size of country and different characteristics of the county. At the start of this crisis said there were 2 critical tasks – flatten the curve, ensure NHS not overwhelmed – have achieved both of these – everyone who needs treatment is getting it. One those tasks the plan is working, but doesn’t mean nothing has gone wrong and everything is done. Huge amount still to do.

 

Other issues:

  • China disinformation campaign, and what the UK government is doing.
  • Airports: screening at airports and ports – why haven’t put in place restrictions and temperature tests
  • Closure of veterans helpline

 

2. Daily testing figures

As of 9am 21 April, 535,342 tests have concluded, with 18,206 tests on 20 April. 397,670 people have been tested of which 129,044 tested positive. As of 5pm on 20 April, of those hospitalised in the UK who tested positive for coronavirus, 17,337 have sadly died.

 

3. ONS registered death data

Below are the key points from this week’s ONS data.

 

  • In week 15 a third of all deaths in England and Wales were a direct result of COIVD19.
  • 83.9% of all deaths involving COVID have occurred in hospital with the remainder taking place in care homes, hospices or private homes
  • In Week 15, 16.8% (826 deaths) of all deaths occurring in care homes involved COVID-19. This is lower than 57.8% of COIVID hospital deaths (4,957), but higher than the 8.0% (330 COVID deaths) that occurred in private homes.
  • When comparing the DHSC and ONS figures they have written this article – as you will see it isn’t very east to pull out which figures represent the gap but if we go with their tweet this morning – there were 13,121 deaths in England and Wales compared to 9,288 over the same period reported by DHSC – this is a gap of 29.5%. 

 

 


Monday 20 April

 

Today’s update includes:

  1. Daily press briefing
  2. Daily testing figures
  3. Daily lobby briefing on testing capacity
  4. Joint committee on human rights on the NHS app being developed

 

 

2. Daily press briefing

Chancellor  Rishi Sunak was joined by Prof Dame Angela McLean, the deputy chief scientific adviser, and Prof Yvonne Doyle, the medical director for Public Health England.

 

Rishi Sunak:

  • He started by addressing concerns about PPE
  • PPE - international challenge. Working hard to get PPE frontline NHS and social care staff need.
  • Paul Deighton (led on delivery of Olympics) has been appointed to lead on domestic efforts to make and increase the supply of PPE.
  • Receiving shipments of PPE regularly. Working to resolve turkish shipment following unexpected delays. Today unloaded 140,000 gowns from Myanmar.
  • Today HMRC has opened the Coronavirus Job Retention Scheme, over 140,000 firms have since applied. Over 1 million people will receive wages they otherwise would not have. Firms will receive the money within 6 working days.
  • The economic crisis is unprecedented, it is important to put aside ideology. The state must support its people.
  • The goal of the scheme is to maintain as many people as possible in their existing jobs, to support viable business and protect the incomes of the self-employed.
  • In order to plan for economic recovery post-crisis, we must not only maintain jobs but encourage businesses, jobs and technologies of the future.
  • 2 initiatives have been launched to support innovative firms, worth £1.25bn:
    • A new Future Fund worth £500m to ensure high-growth firms can continue to access investment – this will be launched in May and offer loans.
    • £750m of grant and loan funding for innovative firms across all sectors, regions and nations in the UK.
  • Testing figures: 501,379 tests for coronavirus have now been carried out including 19,316 tests carried out yesterday. 16,509 people have sadly lost their lives due to the virus, an increase of 449 fatalities since yesterday.
  • Before lockdown measures are eased, the Government must be satisfied that the 5 tests set out last week are met.

 

Angela McLean:

Slides and data sets

  • for all kinds of public transport, use since mid-March is down to less than 20% of what it was in February – rail and tube use is down 95%
  • the number of daily new UK cases has stopped rising and is now "pretty much stable and flat"
  • the number of coronavirus patients in hospital has stabilised everywhere across the country other than London, where the numbers have fallen for the 7th day in a row

 

Journalist questions:

Hugh Pym, BBC

Hearing concerns about PPE are you ashamed that NHS staff are worried about their safety?
RS - Everybody working on the frontline deserves to have the right equipment. Improving sourcing internationally and domestically to make sure we have the equipment they need.
YD - Trying to make sure deliver to where it’s most needed. 12 million pieces of PPE had been delivered over the weekend.

 

Robert Peston, ITV

Deaths in hospitals are being underestimated by 40%, will we see death rate 40% higher than numbers so far reported?
YD - Hospital data does not tell whole story - don't know if 40% is correct. 9 out of 10 deaths do occur in hospital. Will see uneven pattern. Will know for sure later this week.

 

Beth Rigby, Sky

Bodies representing medics are concerned about downgrading of PPE guidance based on availability rather than safety.

YD - Guidance remains the same. Advice has been produced about how to be safe in circumstances where supplies might be at risk. Trying to ensure people are safe when there might not be enough supplies. Guidance has not been downgraded. Medics feel nervous, of course we understand anxieties. Advice has been put out to give them info in those circumstances. Consistent on what WHO says should be done in exceptional circumstances.

 

Andy Bell, Channel 5

If a doctor says they are not prepared to go into work, would you support decision?
YD - Difficult to give local advice. Guidance says what is right thing to do and what is self. People have to make decisions based on situations. Difficult to legislate on that.

In principle, is it ok, would you support that?
RS - they should talk to local managers. Have put in place hotline to support where supplies are at risk. Doing everything we can to get them the equipment they need.

 

Other questions:

  • small business difficulty accessing loans
  • estimated of cost of furlough scheme
  • was the government too slow to cancel major sporting events and festivals such as Cheltenham?
  • does economic intervention signal a shift in government policy?

 

2. Daily testing figures

As of 9am 20 April, 501,379 tests have concluded, with 19,316 tests carried out on 19 April. 386,044 people have been tested, of whom 124,743 have tested positive.

As of 5pm on 19 April, of those hospitalised in the UK who tested positive for coronavirus, 16,509 have died.

More information is available on the government's website.

 

3. Daily Lobby briefing - key points

Testing capacity: the government now has the capacity to carry out 36,000 coronavirus tests per day. But the latest daily figure for the number of tests carried out, in the 24 hours up to 9am yesterday, was just 21,626. More than 16,000 of those tests were carried out in NHS laboratories, and the rest by commercial partners in drive-through centres. More than 88,000 NHS and social care staff and their relatives have now been tested, the spokesman said, up from 66,000 at the end of last week.

 

4. Justice Secretary at Joint Committee on Human Rights

  • In a discussion about the app being developed by NHSX that alerts users when they have been in contact with someone with coronavirus, the justice secretary, Robert Buckland told MPs any tracing app designed to mitigate the spread of Covid-19 would be "functionally limited" to prevent a "mission creep" that would change the relationship between the individual and the state. He said so far he had seen a "proper prioritisation of privacy and indeed security". Experts have warned that digital contact tracing will fail unless governments build the technology in a way that respects user privacy.
  • Buckland told the committee: "On every occasion that government or its agencies seek to create a device or mechanism that has potential of infringing rights or other fundamental civil liberties then the greatest care has to be taken. The lead will be Department of Health and Social Care, and the work of the NHS itself, who are developing a contact-tracing app. Thus far, I’m seeing a proper prioritisation of the need for privacy and indeed for security when it comes to the data that might be contained in such a tracing device. Clearly speed is of the essence, because of the situation we’re in, but the need for an ethical approach and legal approach is very much at the heart of what the NHS is doing".
  • He also said a consultation had taken place with the information commissioner, the National Data Guardians panel, and the Centre for Data Ethics and Innovation. "The issues of patient data, that are familiar to us in an offline form because they’ve been around for a number of years, are being fully reflected in the development of a tracing app. We’re not there in terms of the finalised design. The source code will be provided so there will be independent scrutiny of that, so the transparency element is going to be at the heart of the development."
  • The app would be compliant with the GDPR, the Human Rights Act, and the Equality Act. "This is not an app that’s being designed for enforcement. That’s a very important point when considering the potential ramifications of this".

 

 

Friday 17 April 

Today’s round up includes:

 

  1. Daily press briefing
  2. 10 lobby briefing
  3. Health and Social Care Committee
  4. Daily testing figures

 

To note:

The Chancellor has announced that he is extending the furlough scheme for an additional month to the end of June

 1. Daily press briefing

 

Alok Sharma, Secretary of State for Business, Energy and Industrial Strategy, was joined by Sir Patrick Vallance, Chief Scientific Adviser, and Prof Yvonne Doyle, Medical Director for Public Health England.

 

Alok Sharma

 

  • Five tests must be satisfied before lockdown restrictions can be eased:
    1. Confident in NHS’ ability to cope
    2. Sustained and consistent fall in the daily death rate
    3. Reliable data from SAGE showing infections falling
    4. Sufficient operational capacity to ensure supply matches demand e.g. for PPE
    5. Assured that adjustments will not result in a second peak
  • Announced a Vaccines Task Force to coordinate government, academia and industry to accelerate the finding of a vaccine led by Sir Patrick Vallance and Jonathan Van-Tam.
  • Government has greenlighted 21 research projects to help fight coronavirus, receiving £14m.
  • A vaccine will shortly begin a clinical trial phase.


Sir Patrick Vallance

 

Slides can be found here: https://www.gov.uk/government/publications/slides-and-datasets-to-accompany-coronavirus-press-conference-17-april-2020

 

  • Transport has fallen but unevenness in areas where there have been limited coronavirus cases – everyone should adhere to social distancing measures.
  • Gradual decrease or flattening of numbers of people in hospital beds with COVID-19. This will not be a sudden drop but a while before numbers come right down.


Journalists’ questions

 

Fergus Walsh, BBC

How will gov. reach 100,000 tests by the end of the month? Continuing to work to reach target, currently have 26 drive through centres, 2 super labs and another lab opening soon. Currently more capacity than is being used so expanding testing to social workers and other key workers.

When a vaccine is available, who and how will people be prioritised? A vaccine is far off yet and have not yet reached that stage but the most vulnerable will be vaccinated before rolling out more widely.

 

Emma Hutchinson, ITV Anglia

Can you offer any hope to the tourism industry? Gov. has introduced a set measures to enable businesses to bounce back.

Are we expecting a surge of cases in the East of England? The R value is below 1 across the country but will take a while to feed through but expecting a gradual decrease in cases. Recognise that R value will be higher than 1 in some places such as hospitals and care homes.

Thomas Moore, Sky

Oxford trials are confident in success and are manufacturing 1m doses. What is gov. doing to secure supply of vaccines and ensure Britain is at the front of the queue? Gov. is working with industry to prepare for manufacturing.

How to balance rapid development and ensuring vaccine is safe? Over 100 vaccine projects globally, 3 of which have entered clinical trials. Each project does not have a high probability of success despite enthusiasm. Vaccines must be tested properly before used widely.

The gov. has been late on testing, late on ventilators, will it be late on vaccines? A task force has been established for full focus and UK is backing a lot of horses globally.

Charlotte Ivers, TalkRadio

Are there general findings from investigations into NHS workers’ deaths? Currently looking into BAME deaths. Important to have right answers when factors are so complex.

When will preliminary results be available? Important to get investigation right than to rush.

Gordon Rayner, Telegraph

What did you mean when you told CBI that businesses must get used to a new normal? Are some restrictions to stay in place until a vaccine is available? Businesses must adapt to new ways of working in safe way which are in accordance with PHE guidance.

Dan Martin, Daily Mail

Will the gov. be easing lockdown in some areas while restricting in others? Five tests must be met before any easing of measures. Focus is on keeping numbers down.

Is the gov. considering recommending face masks? Masks are effective for use in hospital and social care settings. It is difficult to get reliable evidence and currently following WHO guidance. Masks must be available for hospitals.

Joshua Mortimer, Left Food Forward

Was it a mistake to brand people as low skilled labour? With only £96 sick pay, NHS workers may continue working  - is it a public health risk? Frontline workers are health heroes and they must accept testing.

Peter Madly, Express and Star

Why does West Midlands have a higher number of cases than others? Will hospitals be better stocked next week? There is global shortage of PPE and plan to manufacture more domestically. Over 2m items were delivered to the West Midlands. A high concentration of populations in the Midlands but community transmission is decreasing.

With forecasts of economic damage, why is the gov. proceeding with HS2? Measures are in place to help businesses bounce back. Vital to keep the economy going.

 2. 10 lobby briefing

 

  • Dominic Raab spoke to the prime minister on Thursday.
  • The PM is “continuing his recovery at Chequers and he is not doing government work”. Johnson has not had any calls with foreign leaders.
  • Downing Street also suggested summer holidays should not be booked yet as there is no certainty of when the lockdown will be lifted and travel can resume. Foreign Office advice continues to be that you should go abroad for essential travel only: “As of today, it is a fact that both the guidelines and the official Foreign Office advice do not allow for people going on holidays.”


3. Health and Social Care Committee

 

The first session heard evidence from the following witnesses:

 

  • Dr Alison Pittard, Dean, Faculty of Intensive Care Medicine
  • Dame Donna Kinnair, Chief Executive and General Secretary, Royal College of Nursing;
  • Professor Anthony Costello, Professor, UCL Institute for Global Health

 

Jeremy Hunt invited other influential select committee chairs along to both sessions taking place this morning. They were:

 

  • Yvette Cooper (Home Affairs)
  • Tom Tugendhat (Foreign Affairs)
  • Greg Clarke (Science and Technology)
  • Clive Betts (Housing, Communities and Local Government)

 

Hunt asked the three witnesses to give a brief update about what’s going on:

 

  • Dr Alison Pittard: She said that there are lots of issues with PPE and testing. She stressed that everyone on the frontline is working hard to meet demand. Dealing with demand has meant working in different ways, with non-critical care staff helping – people are being spread more thinly but there is guidance in place to ensure what they are doing is safe. There is a concern that if they spread themselves more thinly, safety could be compromised.

Top concern – availability of PPE. Staff is under increased stress and we need to make sure that staff remain resilient.

  • Donna Kinnair: She said that nurses on the frontline are working really hard. She mentioned volunteers, saying that you don’t always get the same staff all the time so she felt this could compromise safety standards.

Key issue – testing for nurses. She said that usually an employer would be able to tell their employees how to go about getting tested, but this isn’t the case. Some nurses are driving two hours to testing centres when they are ill, and being sent away and told come back another time. She stressed that they need clear direction – this is really important for nurses in the community who don’t have the same support/infrastructure as hospital nurses.

  • Prof Anthony Costello: He said we need a system in place at district and community levels if we are going to suppress transmission. It will fall to GPs and public health to put a system in place in the community and care homes. We need to test and trace – systems errors have led us to have probably the highest death rate in Europe – could be 40,000 by the end. We didn’t do things quickly enough.

 

  • Tugendhat asked about the implication of the spread of the virus in the developing world. Anthony Costello explained that social distancing in poorer countries will be really hard. Africa will struggle with testing – some countries only have a few ventilators and their ICU isn’t sufficient.  He stressed the need for a coordinated effort. He also said that if the virus behaves in Southern countries as it has in the North, it’s very worrying, but we don’t know this yet.  He stressed the need to maintain aid budgets and support.

 

  • Luke Evans asked Alison Pittard about the Nightingale hospitals and how much input the Faculty of Intensive Care Medicine had had. She said that they weren’t directly involved but clinicians have been looking at sites and how they are run. She said a lot of that depends on geography and population density. She talked about long term recovery of those who have been critically ill, saying that we need to look at this work stream – it can take a long time to get back to normal (18 months perhaps). She said this could hinder the speed at which we can get back to normal healthcare practice. When asked about coronavirus patients being safe enough to be transferred she said that they do it all the time with critically ill patients – they know what they are doing and are highly trained.

 

  • Sarah Owen asked about changing advice regarding visitors and end of life care and whether there is sufficient PPE – Donna Kinnair said that she is worried about the shortage of PPE and it is difficult enough to get it for staff let alone relatives.

 

The second session heard evidence from:

 

  • Matt Hancock, Secretary of State for Health and Social Care
  • Jonathan Van-Tam, Deputy Chief Medical Officer for England

 

Key points

 

Update:

  • Hancock set out a battle plan with six elements:
    1. Social distancing
    2. Building up NHS capacity – currently 2769 spare critical care beds, highest figure yet
    3. Supply
    4. Test, track and trace
    5. Vaccines and treatments
    6. Shielding

 

Data and NHS staff:

  • Collecting data from outside of hospitals takes longer due to the registration process which takes several days – rather than holding up hospital data, the decision was made to publish hospital figures with an overall figure after.
  • COVID-19 deaths in care homes are likely higher than the reported 2% – gov. is working with ONS to reduce lag and working to publish data on all care home deaths, whether died in hospital or care home.
  • Deaths of NHS workers with COVID-19 likely higher than the verified 27 number, Hancock will provide an update and aims to publish numbers daily.
  • 50,000 NHS workers have been tested so far and all symptomatic staff can get tested.
  • Current COVID-19 related absences in the NHS workforce are at 7.1%, down from 8%.
  • Deaths of NHS workers are investigated by the NHS, HSE is not the right body to do this.

 

Testing:

  • Currently 22 drive-through testing centres and the number will increase to 50. Then aim is to introduce mobile units and home testing when the technology is proven.
  • In the last 24 hours there have been over 18,000 tests.
  • Anticipate testing all symptomatic people will be available soon. Testing is being expanded to include police, fire service, some people in local authorities and DWP.
  • Mass community testing remains part of the strategy and will be introduced when possible – the ship has not sailed.
  • Testing capacity has been increased to 30,000 which is 10,000 more than yesterday – NHS staff should come forward for testing. Mass testing asymptomatic staff is not yet available.
  • Excess demand and excess supply is being matched up across the country.
  • Decision for whether tracing should be carried out locally or centrally has not yet been made.

 

PPE:

  • Jeremy Hunt asked whether there are enough gowns to see through the weekend. Hancock said PPE is an incredibly difficult challenge in acquisition and logistics. The country is currently tight on gowns but 55,000 gowns are arriving in the country today. Guidance increased the use of gowns albeit to be used sessionally. Aim is to get gowns to all who need it this weekend.
  • Hancock will look into concerns that PPE is not used in care homes for non-COVID residents when such residents would otherwise be shielding if in their own home.
  • Clipper service enables social care providers to access PPE not otherwise available on the open market. NHS Supply Chain has shifted from a wholesale distribution model to a retail distribution model.
  • There are over 10,000 different locations of people working in domiciliary social care.
  • NHS has delivered 1bn items of PPE across the UK, 11m of which was to Scotland.
  • Latest figure of COVID-19 outbreaks in care homes (2 or more cases) is 15% but expect that figure to rise. Over 10,000 care home residents have been tested.
  • Hancock urged companies able to manufacture PPE to come forward – gov. is speeding up certification process.
  • Claims that the national stockpile was reduced by 40% under Hancock’s predecessor are wrong.

 

Other health conditions:

  • The policy is that no urgent cancer treatment is to be delayed. Earlier reports of delayed cancer treatment were a localised staffing issue which has since been resolved. The drop off in first presentations is concerning and gov. will be working to get the message out urging people to seek medical advice and that they will be treated safely. Hancock believes it is unlikely that there will be more deaths caused by cancer treatment delays than from coronavirus.
  • is providing direct support to healthcare charities including hospices.
  • There are numerous reasons for the delay in radiotherapy – not necessarily due to COVID-19. Hancock committed to looking into cancer treatment delays.

 

Other:

  • decided not to lockdown London sooner to ensure country is acting in lockstep. Locking down London would not have prevented transmission to rest of the country and separating London would have had downsides to national unity.
  • With the collapse in numbers of international travellers, people entering the country are not deemed by epidemiologists as a significant route of transmission. Gov. will continue to review situation once incidence of transmission is much lower. Hancock will ask the CMO to publish the analysis behind the decision not to ask people entering the country to self-isolate.

4. Daily testing figures

 As of 9am on 17 April, 438,991 tests have concluded, with 21,328 tests carried out on 16 April. 341,551 people have been tested, of whom 108,692 tested positive.

As of 5pm on 16 April, of those hospitalised in the UK who tested positive for coronavirus, 14,576 have sadly died.

Thursday 16 April

Today's roundup includes: 

1. Daily press briefing
2. Daily testing figures
3. ONS figures – registered deaths in March

 

1. Daily press briefing

Dominic Raab, first secretary of state was joined by Chris Whitty, Chief Medical Officer and Sir Patrick Vallance, Chief Scientific Adviser

 

 

Dominic Raab

  • Today's data shows that 327, 608 people have been tested, 103, 093 have tested positive, and 13,729 have died.
  • There are indications that the measures have been successful in slowing the spread of the virus
  • Mixed and inconsistent picture. In some settings, infections are still like to be increasing.
  • The rate of infection is at less than 1, meaning that every infected person infects less than 1 other person on average.
  • The advice we have received is that any change to social distancing now would risk a second peak in the virus. This would undo the progress made to date.
  • The advice from SAGE is that relaxing social distancing now would damage public health and the economy. Therefore, the current measures will remain in place for at least the next three weeks
  • 5 specific things we need to be satisfied of before we consider relaxation of measures:
  1. Confident we are able to provide sufficient critical care and specialist treatment
  2. Sustained and consistent fall in death rates from coronavirus
  3. Reliable data from SAGE showing rate of infection is decreasing to manageable rate across the board
  4. range of operational challenges including PPE are in hand with supply able to meet future demand
  5. that any adjustment to measures would not result in second wave that would overwhelm the NHS

 

Sir Patrick Vallance:
Slides and data sets 

  • Highly likely that transmission is below 1 – infected person will be infecting fewer than 1other person - R is below 1but cant say by how much.
  • New cases tested in hospital – flattening and possible decrease.
  • People in hospital beds with COVID – numbers decreasing in some areas they are flat, but consistent that R is below 1. Closer to 1 more likely that even small changes could lead to R increasing, then virus will start to grow again and run risk of second peak
  • Expect deaths to plateau and stay up for a little while and then start to decrease
  • R is below 1, changes have made a difference and important that we continue in order to drive numbers down

 

Journalist's questions


Laura Keunssberg, BBC:
Can you give public any hope of when restrictions might start to lift? Can’t give definitive timeframe. We are making progress but must keep up social distancing measures.

 

Tom Clark, ITV:
Serology data to get a sense of how many people have had the virus. Results haven’t yet been published, is this because these tests aren’t delivering reliable results? CW – serology data will be critical, so can work out what proportion of people have been affected. Substantial work going on to try to find accurate test. Three things that have slowed us down: 1. Don’t yet have a serology test that we can rely on, 2. don’t yet have good sampling frame – trying to get that set up across the country so have wide view. 3. Takes 21 days for the tests to be reliable. Data will become more useful in time.

Will new data on transmission outside of hospital change approach? PV – important to have both death rates. ONS data doesn’t necessarily mean they had COVID. Sage view is looking at transmission in community, but data might not help with that. Will be looking at transmission in hospitals and care homes. R overall is below 1 so do expect to see slowing of epidemic. ONS data gives indication of excess mortality, that has been changing over time. Additional deaths on top of what we would expect at this time of year. Critical for people to realise that if they are having a medical emergency – heart attack, stroke – they should go to A&E. NHS is open for business – there is sufficient capacity to cope.

 

Sam Coates, SKY news:
70% of health and social care staff who have died are from BAME background, what is message for that community: CW – critical to find out which groups are affected by this disease. It is clear that age, 90% had one other disease, male sex is clear risk factor. BAME is less clear, Public Health England is looking at this.

Elderly people are worried that they might be kept indoors. Haven’t made up our mind on relaxing of measures. Know that data shows elderly people are vulnerable and want to safeguard them. Aim is to get the numbers down, social distancing needs to stay in place to reduce infection in community so fewer people carrying infection. Once at this stage can look at what measures can be relaxed and do in a way to allow everything to move back to normal. May be necessary to look at how to do this in a safe way.

 

Ben Kentish, LBC:
Spread in care homes and hospitals is on the way up, is the protection inadequate? Virus doesn’t spread in a uniform way. Health sec set out a plan to make sure care home residents are tested.

Indirect deaths, have you modelled what would be expected? Are you confident that we are still far from the point where these outweigh COVID deaths? CW – four things we are thinking about 1. Direct deaths, 2. Indirect deaths because of lack of capacity. 3 indirect deaths because of diversion 4. Deprivation – looking at how these interact and need to take into account all of these. SAGE looking at in detail. PV. At the moment there is not a tension between economy and health. Need to get down to level where virus is manageable but are looking at long term impacts.

 

Metro:
Significant level of distancing until we have a vaccine. How do we do in a reliable way to protect the NHS. PV – way out is vaccines, and therapeutic programmes, those will be critically important in reducing effects and transmission of disease. Social distancing measures are needed to reduce down to low level, then there might be decision about what to relax and not relax, but aim will be to keep R down. Will be some changes that will need to be maintained.

Do you agree with WHO assessment of our success in handling outbreak.

How many daily tests will need to be done to roll out community testing: SAGE will feed back on evidence and what we need to consider and how that interacts with tracing and testing.

 

Evening standard:
Are you warning us of more deaths to come? There might be places where R is not below one, important to tackle this and control infection in these settings. Measures being taken to try to get on top of issues.

Masks – how have you decided masks wont reduce spread. CW – masks is a live issue that we are looking at. Relooking at evidence. Evidence is weak but there is a small effect under certain circumstances. We are continuing to look at this.

 

Bloomberg:
Why are we not making better progress against Italy. Cases are coming down, R is coming down. Flattening off of ICU cases.

 

Yorkshire Post
How are we tackling mental health impact of pandemic? Loneliness and delivery of MH services is something we are thinking about. Have been looking at how to improve MH services. Looking at what we need to differently.

 

Other topics:
Relationship with china after this. Needs to be inquiry and learn lessons after this. But has taught us value of international cooperation.


2. Daliy testing figures

As of 9am 16 April, 417,649 tests have concluded, with 18,665 tests on 15 April.
327,608 people have been tested of which 103,093 tested positive.
As of 5pm on 15 April, of those hospitalised in the UK who tested positive for coronavirus, 13,729 have died.

 

3. ONS figures – registered deaths

The ONS today published their monthly round up of figures relating to registered deaths in March. This is a monthly breakdown with a little more analysis around pre-conditions and mortality rates, than the weekly figures. 

 

  • 91% of deaths there was a pre-existing condition, mortality rate significantly higher in England than in Wales, mortality rates in males were double that of females in March.
  • There were 3,912 deaths involving the coronavirus (COVID-19) that occurred in March 2020 in England and Wales; of these, 3,372 (86%) had COVID-19 assigned as the underlying cause of death.
  • Of the deaths involving COVID-19 that occurred in March 2020, there was at least one pre-existing condition in 91% of cases.
  • Taking into account the age structure of the population, the rate of deaths due to COVID-19 was 68.5 deaths per 100,000 persons; this was 69.7 per 100,000 persons in England compared with 44.5 per 100,000 persons in Wales.
  • COVID-19 was the third most frequent underlying cause of death for deaths occurring in March (behind dementia and ischaemic heart disease).
  • Males had a significantly higher rate of death due to COVID-19; the rate was double that of females.
  • The rate of death due to COVID-19 increased significantly in each age group, starting from age 55 to 59 years in males and age 65 to 69 years in females; overall, one in five deaths were in age group 80 to 84 years.
  • Ischaemic heart disease was the most common main pre-existing condition found among deaths involving COVID-19 and was involved in 541 deaths (14% of all deaths involving COVID-19).

 

Wednesday 15 April

Today’s round up includes:


1. Daily press briefing
2. Daily testing figures

 

1. Daily press briefing

Matt Hancock, health and social care secretary was joined by chief medical officer, professor Chris Whitty and deputy chief scientific adviser, Professor Dame Angela McClean.

Hancock

  • Spare capacity in NHS critical care has reached record high of 2657 beds. At no point has the NHS been unable to offer critical care as a result of coronavirus.
  • As of today, 313,769 people have been tested for the novel coronavirus. Of those, 98,476 have been tested as positive; and 12,868 have passed away. That is an increase of 761 deaths today.
  • He set out the new social care action plan and said the aim is to protect residents and support 1.5m colleagues working in social care. There has been an additional £1.6bn so far spent.
  • All patients discharged from hospitals will be tested before entering a care home setting.
  • All symptomatic residents will be tested. Tests will be available for all care home staff, and their families, who need to be tested. Increasing PPE supplies to social care. Over the next three weeks, priority drops to local resilience forums who distribute to social care setting. This will be as the online system is developed.
  • Introducing a single brand for social care workers. A badge of honor to display their work, similar to the NHS blue badge identifiable with NHS staff. Social care staff will get the same priority access to supermarkets as NHS staff.
  • Strengthening the national recruitment campaign to attract people to social care. The Government will pay for initial induction training.
  • Government are introducing new procedures so that where possible, closest loved ones will be given a chance to say goodbye.
  • Advanced care plans will not be applied in a blanket fashion for any group.

 

Angela McClean
Slides and datasets 

  • From 19 March-14 April – all forms of travel down to less than 1/3 what it was in February
  • Two weeks of flattened curve
  • People in hospital beds with COVID – fell by 1% nationally yesterday, 5% in Greater London


Journalist questions:


Hugh Pimm, BBC
How is testing for social care staff be achieved? Glad to say testing regularly NHS staff across the board. Started also testing social care staff. Testing capacity is being increased, and as this capacity is built up, even more people will be able to be tested.

 

Robert Peston, ITV
Data seems to suggest we are at or past the peak – other countries already talking about releasing the lockdown. Why wont you talk about easing the process of the lockdown? CW - We probably are reaching the peak, but we expect to see an increase in number of deaths tomorrow. We may say a jump in number of deaths over the next couple of days, following a bank holiday lag. Very important we don’t make any judgements before it is ready. Not yet at the point to say confidently we have passed the peak. Do not know where the force of transmission is (r ) once we do it will be easier to judge how we get to the next stage. AM – need to observe what happens with new cases as they arrive in hospital. Crucial to understand what changes are possible. Have tried to lay out impacts of having to re-orientate the NHS to focus on COVID. Information will help us balance these impacts on health.

Social care settings have been saying they aren’t getting the right guidance – can you extract people with symptoms and put them in safer settings? Part of plan is about more isolation. There is further guidance in the action plan we are publishing today. Advice has to be tailored to settings.

 

Alex Thompson, C4
Late in dealing with care homes and care home staff – have people died in care homes unnecessarily? First put out guidance to social care in February, have repeatedly updated guidance in terms of support available. Today we’ve updated the guidance and improve polcicies, builds on work we have been doing since February.

 

Nick Martin, Sky
Push back from hospitals that would suggest the elderly are being "cleared out" of hospitals. The decision to admit and discharge patients was based on an individual, clinical basis
Tests in social care settings – 1.6million people working in social care how many tests have you put aside for social care, and what is the time scale you’ll deliver them in? currently have capacity to increase testing. CQC are doing work to find where tests are most needed and actively referred. Also working with ADASS, LGA and CQC to see how best capacity is ramping up to 100,000 a day by the end of the month. Vast majority will be for NHS and social care as a whole.
Social care providers finding that local councils are not releasing funds – MH have funded councils to support front line. Working with communities sec to make sure this happens.
Timeframe – immediately for residents. Staff started getting tests on Friday,. Definition of who needs it is in first instance those with symptoms, or if a member of household is symptomatic. As capacity expands will be able to expand definition.

 

Laura Hughes, FT
You said you would reach 25,000 tests by mid April, but you haven’t reached targets. Why should we believe you can achieve 100,000 a day? Hancock says it’s wrong to say he's missed deadline of 25k tests by mid-April, as deadline was actually the end of April (and then increased to 100k) The government committed to 10,000 by the end of March – hit that, then increased to 100,000 – ramping it up. Demand for testing has been lower over Easter weekend, but the goal is still clear to reach 100,000 by the end of this month. A few journalists have pointed out that the press release on March 18 said capacity for 25k tests "ready within 4 weeks" – the government has missed that target.

Can we expect whole of UK to follow Northern Ireland and lock down for another 3 weeks? – matter for cobra tomorrow.

 

Other topics that came up:
Domestic abuse


2. Daily testing figures

As of 9am 15 April, 398,916 tests have concluded, with 15,994 tests on 14 April. 313,769 people have been tested of which 98,476 tested positive. Of these tests 12,081 were carried out by NHS laboratories, and 2,486 by the government’s commercial partners in drive-through centres.

As of 5pm on 14 April, of those hospitalised in the UK who tested positive for coronavirus, 12,868 have died.


Tuesday 14 April

 

Today’s roundup includes:

  1. Daily press briefing
  2. Daily testing figures
  3. ONS statistics on deaths in the community
  4. OBR report on the impact of the coronavirus outbreak on the economy.

 

1. Daily press briefing

The chancellor Rishi Sunak was joined by Prof Stephen Powis, national medical director, NHS England and Dr Yvonne Doyle, director for health protection and medical director, Public Health England.

The slides and datasets can be seen on the government's website.

 

Rishi Sunak:

  • OBR figures are not a forecast or prediction -might not be most likely scenario.
  • OBR figures suggest scale will have series implications on the economy
  • expects a bounceback in growth
  • Matt Hancock, health and social care secretary, would be providing an update on social care support tomorrow
  • testing: 302,599 people been tested
  • 19,706 have been admitted to hospital, down from 20,184 yesterday.

 

Steve Powis: 

  • main strategy is social distancing – reducing spread of virus
  • continue to see evidence that public are complying with instructions
  • continue to see reduced activity in public transport and vehicle transport use
  • reduction in infection rates, will translate to fewer cases, plateau in number of new cases
  • will translate into number who require hospital beds
  • evidence that number of hospital admissions is plateauing
  • number of deaths continues to rise, and will take the longest to come down.

 

Journalist questions:

  • Laura Keunssberg, BBC:

Will we be feeling costs for a generation?

Measures can mitigate impact, to ensure fewer people unemployed. Hope measures will allow us to bounce back. Include the number of deaths in care homes and community in these statistics. Working with ONS to get quicker information of deaths in care homes and communities. Need to be clear that the cause of death is right, which is what takes time. Working towards being able to provide this data more quickly.

 

  • Paul, ITV:

Isn’t it just unfair to produce a graph comparing UK figures, without care home deaths, to French figures, with care home deaths?

Can provide data for hospitals – working with a smaller number, and used to providing data regularly to NHS England. In hospitals know deaths are caused by COVID, but the data in community is only based on supposed diagnosis – not always confirmed cases. Important to compare to other countries, but differences in reporting in all countries which needs to be taken into account.

 

  • Francis Elliot, The Times

Numbers of newly acquired infection rates in hospital?

Hospital acquired infections: likely to see looking at carefully, and will try to get on top of very quickly. Hospitals using standard infection prevention practices. Actively looking at. Cant give you the exact number – data is not clear enough to give you this figure. Will continue to look at this. Each day get information from local teams about what is going on in care homes.

 

  • Emilio, Politico

One thing you wish we had done differently? Or do you think UK response has been without fault?

Have been working since January, and have learnt a lot, which I wish I had known in January. Once thing I wish I’d known is when was this virus first around? Steve Powis, always looking back, learnt that you can come to those conclusions too early, have to wait and learn right lessons and do right analysis. Still at early stages of this. Answer will be different. Too early to jump to conclusions.

 

Other questions focused on future tax policies, and long term impact on public finances.

 

2. Daily testing figures

As of 9am on 14 April, 382,650 tests have concluded, with 14,982 tests carried out on 13 April. 302,599 people have been tested, of whom 93,873 tested positive. As of 5pm on 13 April, of those hospitalised in the UK who tested positive for coronavirus, 12,107 have died.

 

3. Office of National Statistics data on deaths in the community

Full data can be seen on their website.

 

Key figures

  • 16,387 deaths registered in England and Wales during the week ending 3 April (week 14 of the year) – the highest total recorded deaths since data collection started in 2005 
  • Of these, 6,235 deaths in England and Wales were involving COVID-19.
  • The data says that the 6,235 COVID deaths compares to 4,093 deaths reported by DHSC on 4 April 2020. This is an increase of over 2100 deaths and 52%.  BUT the ONS quote the difference as only being 15% for England at the beginning of their quote on the data page (see below).
  • Of the deaths registered, 3,475 mentioned coronavirus, which is 21 per cent of all deaths, compared to 539 deaths and 4.8 per cent of all deaths in the previous week.
  • 90.2% of deaths occurred in hospitals.
  • 5% of COVID 19 deaths in England and Wales occurred in a care home (217 or 4,122).
  • The highest number (1,231) and proportion (24.6% of deaths in this age group) of COVID-19 deaths were among those aged 75 to 84 years.
  • The region with the largest number and proportion of deaths involving COVID-19 was London with 1,170 deaths; 46.6% of all London deaths and 33.8% of all COVID-19 deaths.
  • Deaths in males were higher in every age group compared to females.

 

 4. OBR report on the impact of the coronavirus outbreak on the economy.

The Office for Budget Responsibility has published a report which looks at the possible impact of the coronavirus outbreak on the public finances. They say note should not be viewed as a central forecast of what is most likely to happen. It is instead an illustrative scenario, based on particular assumptions regarding the duration of the measures and their economic impact, It says GDP could fall by 35% in the second quarter of the year and see unemployment rise by 2 million.

  • In addition to its impact on public health, the coronavirus outbreak will substantially raise public sector net borrowing and debt, primarily reflecting economic disruption. The government’s policy response will also have substantial direct budgetary costs, but the measures should help limit the long-term damage to the economy and public finances – the costs of inaction would certainly have been higher ...
  • We do not attempt to predict how long the economic lockdown will last – that is a matter for the government, informed by medical advice. But, to illustrate some of the potential fiscal effects, we assume a three-month lockdown due to public health restrictions followed by another three-month period when they are partially lifted. For now, we assume no lasting economic hit.
  • Real GDP falls 35% in the second quarter, but bounces back quickly. Unemployment rises by more than 2 million to 10% in the second quarter, but then declines more slowly than GDP recovers. Policy measures support households and companies’ finances through the shock.
  • Public sector net borrowing increases by £218bn in 2020-21 relative to our March budget forecast (to reach £273bn or 14% of GDP), before falling back close to forecast in the medium term. That would be the largest single-year deficit since the second world war.

 

 

Wednesday 8 April 

Today's update includes:

  1. Daily press briefing
  2. 10 lobby briefing
  3. Daily testing figures

  

1. Daily press conference

Chancellor Rishi Sunak was joined by Steve Powis, national medical director, NHS England, and Angela McLean, the chief scientific adviser for the MoD

 

Chancellor:

  • Step by step action plan, slow the spread and protect the NHS’s ability to cope.
  • 232,708 people in the UK have now been tested. 60,734 were positive, an increase of 5,492 cases since yesterday.
  • 19, 438 people have been admitted to hospital, 7,097 of whom have now died, an increase of 938 fatalities since yesterday.
  • Announced a plan to support charities.
  • £750m of funding for the charity sector, £370m of which will support small, local charities working with vulnerable people.
  • In England, this support will be provided for organisations through the National Lottery communities fund.
  • And the government will allocate £60m of this funding through the Barnett Formula to Scotland, Wales and Northern Ireland.
  • It will also provide a further £360m directly to charities providing essential services and supporting vulnerable people. Up to £200m of those grants will support hospices, with the rest going to organisations like St John Ambulance and the Citizen’s Advice Bureau, as well as charities supporting vulnerable children, victims of domestic abuse or disabled people.
  • The government will also match pound-for-pound whatever the public donates to the BBC’s Big Night In charity appeal, starting with at least £20m to the National Emergencies Trust appeal.

 

Angela McLean:

Slides found here - https://www.gov.uk/government/collections/slides-and-datasets-to-accompany-coronavirus-press-conferences?utm_source=3e8e23f9-974a-4116-ab2c-8f173ab7be12&utm_medium=email&utm_campaign=govuk-notifications&utm_content=immediate

  • Footfall in railway stations down 94% in the last week of March compared to the first week of March.
  • Has worked in sense that count of new cases is not accelerating out of control.
  • Number of people in hospital beds with Covid – slower responding record of new infections, rate rising is getting slower. Beginning to get to flat curve.
  • Covid patients in critical care, increased by just 4% in last 24 hours and does seem to be going down.
  • Said that new cases of Covid 19 showed the spread of the virus was not accelerating
  • They expect the fatalities number to rise even after the curb begins to flatten as there is sometimes "reporting lags" with fatalities.
  • So much depends (school openings and end of lock down) on what happens over the next couple of weeks. 

 

Journalist questions:

Laura Keunssberg, BBC: Do you accept there is a trade off between protecting health and protecting jobs? Trying to ensure as soon as we’re through this we can bounce back as soon as possible.

 

Tom Clarke, ITV: Yesterday CMO said Germany’s lower death toll is due to testing should the government now admit that people will die because of our failure to test. Chief Scientific Adviser said that testing was one of a range of factors. Important that all countries learn from each other.

Lower rate could be because you’re counting more cases.  All agree testing is important but one part of things that need to be considered.

 

Andy Bell:

Lockdown in Wales will continue, will you accept it will continue through next week. COBR meeting tomorrow to talk about approach to the review, review will be based on evidence and data available from SAGE next week.

 

Will different parts of country emerge at different times? Don’t want to start speculating about future. Focus on the advice.

 

Other topics:

Reopening schools – intensive work going on to think about next stage

Fraud of companies claiming support that they don’t need

Could social distancing be more rigorously followed?

Brexit – good idea to leave the EU if in or coming out of recession?

Unemployment figures

 

2. 10 Lobby briefing

The Prime Minister "remains clinically stable and is responding to treatment".

Number 10 also confirmed that Johnson is now "not working", meaning is that Dominic Raab is, to all intents and purposes, now running the country.

In response to Trump's offer of American ventilators, the PM’s spokesman did not exactly deny when he said: "The NHS has ventilator orders in place with manufacturers around the world, including those in the US."

The spokesperson also said "The UK supports the role that the WHO is playing in co-ordinating the global health response to the pandemic".

The PM's spokesman insisted there will be a decision on whether to ease the movement restrictions or not at some point next week, regardless of the Prime Minister’s medical condition.

 

3. Daily testing figures

As of 9am today (8th April), 282,074 tests have concluded, with 14,682 tests on 7 April. 232,708 people have been tested of which 60,733 tested positive.

As of 5pm yesterday (7th April), of those hospitalised in the UK who tested positive for coronavirus, 7,097 have died. More information here - https://www.gov.uk/guidance/coronavirus-covid-19-information-for-the-public?utm_source=210a994c-8689-4c99-a566-80ab9738f126&utm_medium=email&utm_campaign=govuk-notifications&utm_content=immediate

 

 

Tuesday 7 April

Today's roundup includes:

 

  1. Daily press briefing
  2. ONS registered death data (England and Wales only) week ending 27th March
  3. Downing street lobby briefing
  4. Daily testing figures

 

1. Daily press briefing

Led by Dominic Raab. He was joined by Professor Chris Whitty, chief medical adviser, and Sir Patrick Vallance, chief scientific adviser.

 

Dominic Raab

  • Updated on PMs condition, remained stable overnight, not required mechanical ventilation
  • Increasing NHS capacity, expanding beds, number of staff
  • Instructing people to stay at home to protect the NHS
  • The Cabinet has reports from four ministerial groups on the action being taken across strategic priority areas, such as PPE and the economy.
  • Action plan aims to slow the spread of the virus to protect the NHS. At every step scientific and medical advice has been followed, so the right steps are taken at the right time.
  • Through the Government's ongoing monitoring and testing programme, 213,181 people have been tested. 55,242 people have tested positive. The number of people admitted to hospital with Coronavirus symptoms now stands at 18,589. 6,159 have died having contracted the virus.
  • Figures reinforce that the most important thing that all can do in the "national effort" is to follow the advice to stay home.

 

Sir Patrick Vallance. The slides can be found here - https://www.gov.uk/government/collections/slides-and-datasets-to-accompany-coronavirus-press-conferences?utm_source=73073aeb-8813-43cb-b3ca-e09dd48bd505&utm_medium=email&utm_campaign=govuk-notifications&utm_content=immediate

 

  • Brand new illness, in some people severe, transmits easily
  • Social distancing is about trying to slow rate of transmission
  • To know if working track a number of things – transport very significant reduction in transport
  • Contact between people has reduced dramatically, should lead to reduction in transmission in the community.
  • Aim to reduce the number of cases, to below the capacity of the NHS
  • possible beginning to see beginning of change, wont know that for a week or so, not seeing an acceleration
  • Number of hospital admissions, steady increase but there hasn’t been accelerated take off – possible beginning to see the start of the change
  • Important we carry on with measures in place
  • Important thing is what happens in intensive care units – another thing that is moving in the right direction . Increase in ICU beds, most marked in London. New nightingale hospitals are kbring in extra capacity
  • Clinical trials starting to happen - 9,100 patients taking part in clinical trials.
  • UK is a few weeks behind, Italy and France, would expect to start coming down in a few weeks time

 

Journalist questions:

 

Laura Keunsberg:
Based on the current ICU numbers, will there be enough beds as this grows? Sir Patrick – always times in winter where ICU beds top out, can say numbers as we look at them now, should be about right, shouldn’t be more cases than beds. Things seem to be tracking in the right direction.

 

Robert Peston:

Chart today shows rate of growth in Germany is much slower than other countries – what can we learn from Germany?  Don’t have a clear answer as to reason for that. Virus and society into which that society. Demographics and way systems are organised. In regular contact with chief medical officer and scientific advisers in other countries. Germany got ahead on testing, and there's a lot to learn from that" reflecting on graph starting to show Germany diverging from UK/European trend on deaths

 

Jason Groves, daily mail:

Is the outcome inevitable and are there things that can be done to stop us following Italy. This is a pandemic, why we’re seeing across many countries. We are 3 or 4 weeks behind Italy. Important as ICU capacity is built up and keeping it below capacity is important. Most important thing is to follow measures to keep this under control.

 

Heather Stewart, Guardian:

Wont see a three week review of lock down measures? Will wait for PM? Should you level with the public that the measures might have to stay in place for many months, with periodic lockdowns to keep within control? Really important to get to point where we’re confident we’re beyond the peak. Large number of different things we need to take into account.

 

Joe Murphy, evening standard

How doing on target of 100,000 tests a day:

14,000 tests yesterday, 7,500 NHS workers and their families tested

9 drive through sights operational: Nottingham, Chessington, Wembley, Edgbaston, making progress on that

 

Care homes not getting the same support as other parts of the NHS. Why are the deaths in care homes not included in the daily figures?

International reporting standards are based on hospital deaths. ONS look at overall deaths with COVID mentioned on death certificate but not confirmed deaths by COVID. ONS does include care home deaths. This is one of the most difficult things we need to do. Need to have right care for people and minimising the number of people going into care homes. Care homes and nursing homes are going to provide us with some of the biggest challenges.

 

Rob Berrick, independent

Letter to GPs from Jenny Harries, raising concerns that vulnerable people are not being shielded as they should. Concerned that many people not being shielded.

Broadly three groups 1. Everybody – stay at home 2. Higher risk group, over 70s, with pre-existing 16million people overall. Need them to do it for their own protection. 3. 1.5million vulnerable that are being contacted at the moment, minimum contact possible for quite a long time. Great majority have been contacted, second wave being contacted this week. There are some people who will have decided that being cut off from society, that this is not something they wish to do.

 

Promise on Testing: if the antibody test won’t be ready by the end of the month are you promising that you will carry out 100,000 antigen tests?

Not going to say anything different to health secretary. Striving to get both sets of tests to highest level we can. Using domestic supplies and international supplies. Doing everything we can on every front to get testing capabilities. Target still stands.

 

Other things that came up:

  • Who makes decisions if there is disagreement?
  • Three key people got it, who are responsible for telling the country how not to get it.
  • How long might the lock down last and what is the exit strategy?

 

 

2. ONS registered death data (England and Wales only) week ending 27th March

 

Key points

  • The provisional number of deaths registered in England and Wales in the week ending 27 March 2020 (Week 13) was 11,141; this represents an increase of 496 deaths registered compared with the previous week (Week 12) and 1,011 more than the five-year average.
  • Of the deaths registered in Week 13, 539 mentioned “novel coronavirus (COVID-19)”, which is 4.8% of all deaths; this compared with 103 (1.0% of all deaths) in Week 12.
  • 9% of the COVID deaths occurred in hospital and the remaining 7% outside hospital.
  • In each age group there have been more deaths involving COVID-19 in males than in females.
  • The 539 figure is slightly lower than the figures reported by the Department of Health and Social Care (DHSC) for Week 13 (739) as it takes time for deaths to be reported and included in Office for National Statistics (ONS) figures.
  • For the total number of deaths that occurred up to 27 March, there were 1,568 deaths in England registered by 1 April involving COVID-19 compared with 1,649 deaths reported by NHS England for the same period in a newly published dataset.
  • Year to date a total of 150,047 deaths were registered in England and Wales between 28 December 2019 and 27 March 2020, and of these, 647 involved the coronavirus (COVID-19) (0.4%); including deaths that occurred up to 27 March but were registered up to 1 April, the number involving COVID-19 was 1,639.
  • Of deaths involving COVID-19 in Week 13, 92.9% (501 deaths) occurred in hospital with the remainder occurring in hospices (2), care homes (20) and private homes (15).

 

 

 

Number of deaths

Number of COVID-19 deaths

% of COVID deaths by place

Total

11,141

539

4.8%

Home

2,785

15

0.5%

Hospitals (acute or community not psychiatric)

5,105

501

9.8%

Hospice

504

2

0.4%

Care Home

2,489

20

0.8%

Other communal establishments

33

0

0.0%

Elsewhere

225

1

0.4%

 

ONS also provide a detailed summary with interactive charts here: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsregisteredweeklyinenglandandwalesprovisional/latest

 

 

3. Downing Street lobby briefing – Summary (from the Guardian)

 

  • Boris Johnson does not have pneumonia and is currently not on a ventilator
  • The spokesman said that Johnson was “stable” overnight and “remains in good spirits”
  • Rishi Sunak, the chancellor, would take over if Dominic Raab, the foreign secretary who is deputising for the PM, got ill, the spokesman said. The spokesman said there was an established order of precedence in the government. After Raab, Sunak, is the next most senior person in the government, the spokesman said.
  • Raab does not have the authority to “hire and fire” people in government while he is deputising for the PM, the spokesman said.
  • The spokesman refused to say when the government would announce whether or not the lockdown measures are being extended. 
  • While there is no legal need for the lockdown to be renewed, the Health Protection (Coronavirus, Restrictions) (England) Regulations 2020, which give legal force to the lockdown measures in England, have to be reviewed every 21 days, with the first review due by 16 April. And the regulations expire after six months.
  • The spokesman refused to speculate on suggestions that schools could be opened before other lockdown measures are reversed
  • The spokesman rejected claims that the PM was getting special treatment at the St Thomas’ Hospital. When asked about claims that a ventilator was being set aside for the PM, the spokesman said there was “significant spare capacity” available in hospitals, including ventilators.
  • The spokesman rejected claims that No 10 has not been fully frank with the media about the PM’s health. “We have a commitment to be as transparent as we can be throughout this process,” the spokesman said.
  • The spokesman said Raab would be able to authorise military action in the PM’s absence. The spokesman said that, if a national security council was needed, Raab would chair it in the PM’s absence. There was a robust national security architecture in place, the spokesman said. And he said it had the authority and ability to respond to a military threat in the PM’s absence.
  • The spokesman said Johnson had not spoken to Raab today.
  • Raab will not participate on the PM’s behalf in the weekly audience with the Queen, the spokesman said. The spokesman said that it has been agreed with Buckingham Palace that these weekly audiences will be suspended while the PM is ill.
  • Sir Mark Sedwill, the cabinet secretary, is working as usual, the spokesman said. But he said Dominic Cummings, the PM’s chief adviser, was still staying away from the office. Asked about the shortage of staff in No 10, the spokesman said it was “fully operational”.

 

 

4. Daily testing figures

 

As of 9am on 7 April, 266,694 tests have carried out across the UK, with 14,006 tests carried out on 6 April. Some individuals are tested more than once for clinical reasons.

213,181 people have been tested, of whom 55,242 tested positive.

 

Today's figure for people tested does not include Manchester and Leeds due to a data processing delay.  

 

As of 5pm on 6 April, of those hospitalised in the UK who tested positive for coronavirus, 6,159 have died.

 

Monday 6 April

 

Today's update includes:

  1. Daily press conference
  2. Daily testing figures


Daily press conference

Today was delivered by Dominic Raab, foreign secretary, Chris Whitty, chief medical officer and Professor Dame Angela McLean, deputy chief scientific adviser.

 

Steps taken to defeat virus:

  • Step by step action plan to slow spread of virus. Following scientific and medical advice. Unprecedented action is currently being undertaken to increase the NHS' capacity, but increasing the number of beds, key staff and facilities
  • 208,837 people have been tested. First Secretary of State Dominic Raab: Tested: 208,837 tested, Tested positive: 51,608 Hospitalised: 17,911 Deaths: 5,373
  • Hospital admissions 17,911
  • PM in good spirits, in hospital under observation, continues to lead the government.
  • Working with other governments and airlines to bring british citizens home.  The government has helped over 20,000 Britons get home from Spain since the start of the coronavirus pandemic, as well as 13,000 from Egypt and 8,000 from Indonesia.
  • The Foreign Office is deploying its diplomatic network around the world to source and buy ventilators and protective equipment for the NHS, says Raab
  • Thank all NHS staff for their hard work

 

Angela McLean, deputy chief scientific adviser (the slides will be available later today)

  • Transport use down across the board - change rail usage - has fallen down to 20%  usage compared to Feb
  • Measures working – growth in number of cases in hospitals isn’t as bad as if social distancing measure hadn’t been put in place
  • Is virus spread slowing down enough? Admissions starting to slow down
  • Watching numbers very carefully, hoping that they will stop rising
  • It is still too soon" to know the effect of social distancing, because we're only two weeks in. The hope is hospitalisation will soon stop rising
  • They do expect the number of deaths to continue to rise however, as it takes time to report these deaths, and also because those in the ICU may still die despite receiving the best treatment.

 

Questions:

Most focused on PMs health and whether he was well enough to continue to lead the country and on a possible exit strategy from the lock down.

 

  • On the PM, Raab said he was in regular contact with the PM (although then admitted they hadn’t spoken since Saturday) and that he is being kept abreast of all the relevant developments, although Raab had chaired a meeting that Johnson would usually chair.
  • Likely exit strategy from these? Good data to be able to tell what the impact of the measures is. Too early, need people to carry on following instructions, so can tell how well restrictions are working.
  • "We need to know how well the current restrictions are working, before we can say anything sensible" about the exit strategy.
  • Witty says there are several things to consider when deciding on an exit strategy for the UK’s coronavirus lockdown:
    • Direct effects of people dying from coronavirus.
    • Indirect effects of the NHS being overwhelmed by patients.
    • Effects of other healthcare being postponed during the outbreak.
    • Long-term health effects of the socioeconomic impact.

 

Complicated to work out how these fit together.

  • If we have reasonable data then will be able to assess – only really able to start collecting that data now.
  • Number of patients in ITU beds in London, compare with what you’re planning now. Will you need the extra beds at the Nightingale? principal aim of social distancing and NHS expansion is to ensure there is always some room to spare in terms of intensive care beds, some "head room. If we end up with more ICU beds, than we need, that will be a success. ‘Head room between what we need and what is available for covid and other conditions.’
  • Is it case ITU is performing better than accepted? Not complacent, but do have some extra capacity. Antibody test: at most useful at a later stage of the epidemic. At this point small proportion of population will have anti-bodies. Most of the labs would say 28 days would be the timescale talking about. Current tests, it is a new disease, inevitable feeling way to some extent, confident we will develop antibody tests, not surprising that the first phase were not effective. The more accurate they are, the more useful – will become more accurate in time. Seemed relatively hopeful there’ll be appropriate technology for mass community testing within months and possibly within weeks
  • Whitty stated “we need to be confident we are at the peak" before discussing any easing of the public restrictions. Any discussions on this at the moment would be a "mistake".
  • The exit strategy is "complex", due to a number of reasons: regional distribution of the need for resources; the effect of the lives lost; there are other indirect effects on the NHS due to the system being overwhelmed; other health care will have to be postponed – this will cause issues along the line; social economic status plays a role, those that are more vulnerable will suffer further health consequences.
  • Whitty makes clear that the lockdown period is not going to be over in a couple of weeks, with likelihood it lasts at least another four weeks.

 

Daily testing figures

As of 9am 6 April, 252,958 tests have concluded, with 13,069 tests carried out on 5 April . Some individuals are tested more than once for clinical reasons. 208,837 people have been tested, of whom 51,608 tested positive.

As of 5pm on 5 April, of those hospitalised in the UK who tested positive for coronavirus, 5,373 have died.

 

Friday 3 April 

Today's update includes:

  1. Daily press conference
  2. 10 lobby briefing
  3. Daily testing figures 

 

1. Daily press briefing

Matt Hancock delivered the daily press briefing, alongside Professor Jonathan Van-Tam, Deputy Chief Medical Officer, and Ruth May, chief nursing officer for England.

 

  • Over 2000 critical care beds are available across the country
  • 3 national clinical trials have been established covering each major stage of the disease: primary care, hospital care and critical care for the most seriously ill. One of these trials was put together in nine days.
  • One trial – “Recovery” – which deals with hospital care is “the largest of its kind in the world” with 926 patients involved.
  • He called for greater patient volunteer numbers to see if these clinical trials would actually work.
  • The advice to stay at home, especially over the warm weekend, was an "instruction".
  • When asked about the impact on mental health of people being in isolation in hospital, Hancock flagged the £5million additional funding put into Mind.

 

Professor Jonathan Van Tam (Deputy Chief Medical Officer for England)

  • Showed data which indicated that there was a behavioural change in the social distancing, which suggested that people were increasingly staying at home, and mobility rates had declined overall- which was positive.
  • dramatic decline in overall use in trains, tubes and buses especially.
  • Hospital admissions were increasing overall.
  • Clinical trials were being used behind the scenes- acting as a "golden standard" of finding out if a drug is useful. However, it required substantive research and logistical support.
  • There are three trials up and running in the UK, from primary care to critical care. The recruitment rate had been high, at 920 patients at the critical care levels.
  • The initial focus has been on "re-purposed medicines" which is the reuse of medicines such as those already used to tackle diseases such as malaria. But this was just to start, the next round of clinical trials was in phase I and phase II which would explore a greater set of technologies. This is expected to take a few months
  • a taskforce is looking at the loss of taste and smell as a symptom of Covid-19. He says that limited data suggests it is true but does not contribute anything on its own to the overall affinity of the diagnosis.
  • there is no evidence that generally wearing of face masks by the public who are well effects the general spread of the disease in society

 

2. No.10 Lobby briefing

  • The ambition of 100,000 tests is for England only and not the whole UK. The 250,000 target has not been dropped but 100,000 by the end of April is the immediate goal.
  • The UK is not following other countries in suggesting people wear masks outside.
  • There will be an update on the lockdown and whether it will continue after Easter.
  • The prime minister’s letter will be arriving on doormats by the end of next week.
  • The government is not considering forms for people to say they can move around, as has been introduced in France.
  • The Brexit talks continue as David Frost is now out of isolation. The system has moved to continuous dialogue on legal texts rather than blocks of time set aside as in the previous timetable. The UK is still leaving transition period by the end of the year.

 

3. Daily testing figures

As of 9am today (3rd April), a total of 173,784 people have been tested of which 38,168 tested positive. There have been 10,590 new tests since yesterday’s figures.

As of 5pm yesterday (2nd April), of those hospitalised in the UK who tested positive for COVID-19 (Coronavirus), 3,605 have died.

 


Thursday 2 April


Today’s update includes:

  1. Daily press conference
  2. No.10 lobby briefing
  3. New PPE guidance issued
  4. Daily testing figures

 

1. Daily press conference

Matt Hancock, secretary of state for health and social care, delivered todays press conference. He was joined by medical director for NHS England, professor Stephen Powis, and professor of public health and epidemiology professor John Newton.

 

Key points:

  • the rate of infection is currently believed to be doubling every three-four days
  • £13.4bn historic NHS debt written off and £300m made available for community pharmacies
  • all frontline NHS staff will get tests they need by the end of this month
  • detailed plan for making sure that we have the full supply of medicines, sedatives and all the medicines needed for those who have COVID-19 and people being ventilated
  • Hancock finished by thanking the staff working for Public Health England, saying they don’t always get the recognition but are all working incredibly hard.

 

Testing:

  • the roll out of Public Health England (PHE) COVID-19 diagnostic test is the fastest deployment of a novel test in recent history including faster than in the Swine Flu pandemic in 2009
  • there is a global shortage of the items needed for testing and the UK started at a lower base than Germany
  • the "ultimate goal" is that anyone who needs a test should have one. The goal is achieve 100,000 tests a day by the end of the month
  • the plan:
    1. Swab testing in PHE labs and within NHS hospitals: this is to find out if you currently have the virus.
    2. Swab testing with commercial partners - partners such as Amazon, Boots and university new network of labs will be used to test people for the virus. Will be used solely for frontline NHS staff and their families to start.
    3. Blood tests: to check if people had virus and are now immune. The can be done at home in 20 minutes with a finger prick. They are currently working with nine companies who have offered these tests.
    4. Surveillance: conducting surveys to find out what proportion of the population has the virus, using antibody test to track the spread of the virus and inform our understanding about exiting lockdown.
    5. Building new industry: collaboration between pharmaceutical companies and other companies to build the ventilators and equipment we need.

 

Professor Stephen Powis:

  • physical distancing is key to reducing the spread of the virus and the number of cases
  • transport usage has decreased, but motor vehicle use went up a few days ago – this needs to come down
  • the number of new cases is increasing, but this is expected as before lockdown
  • hospital admissions rising most in London and the Midlands, but the level of increase is constant which is some indication it could flatten off in a week or two
  • the number of deaths is rising and is expected to do so until physical distancing measures bear fruit
  • second wave possible but no means inevitable. Every country will be working hard to develop strategies to ensure don’t face a second wave. Focus of our work.

 

Prof John Newton, Public Heath and Epidemiology, University of Manchester:

  • the initial priority is for the swab tests; the antibody tests are ideally done 28 days after an infection so the requirement for these tests is not immediate
  • the need to increase testing was recognised from the outset, but the requirement for testing is increasing exponentially. We could not increase testing exponentially in the NHS, so that is why these mega labs were needed outside the NHS, three of them are in existence already and they have started to do tests.

 

2. 10 lobby briefing

Key points from this afternoon’s lobby briefing:

  • Boris Johnson may not be able to leave isolation tomorrow as planned. The prime minister still has symptoms and people are advised to stay at home if they have a temperature.
  • Matt Hancock, will give the government’s daily press conference later setting out an action plan for increasing testing, which is likely to include more private sector involvement.
  • There are two strands of testing: drive through tests, 2,800 tests, and tests on NHS and PHE sites - significant number but no exact figure.
  • Confirms UK are testing nine different tests to see if people had the virus. Some tests have been supplied that would not have met required levels of accuracy, though it is unclear if that’s part of the nine.
  • Speeding up testing: Two new labs to open for testing in addition to Milton Keynes;,in Cheshire and Glasgow, to cover North and Scotland. NHS has approved new swab design to allow manufacturer of new ones.
  • No 10 "cannot stress enough the vital importance of staying at home wherever possible", amid worries that an increase in car use could be an early sign of the lockdown breaking down already. Downing Street still will not confirm. whether it used mobile phone data on people’s movements when it took decision to order the lockdown.
  • On the Labour leadership election, the prime minister will want to have a "good and cooperative" relationship with the new leader of the opposition when they take over on Saturday.
  • On the possibility of “immunity passports” to allow some people who have had coronavirus to leave the lockdown, No 10 said: That is something other countries have done. We are always watching what other countries doing and looking to learn.

 

3. New PPE guidance issued

The government has published updated guidance on PPE. The guidance details how PPE should be used across different clinical scenarios and settings; advice on sessional PPE use and reusable PPE; change in close-contact distance; advice on washing forearms if exposed; and advice on acceptable respirators.

The main changes are regarding enhanced PPE recommendations in both health and social care settings, which are communicated via a fairly extensive table list. Clinicians working in different care settings, interacting with patients with suspected/confirmed covid-10 should wear apron, gloves, surgical mask and eye protection. Other changes include that where aprons are used instead of gowns, forearms are thoroughly washed; that clinicians carrying out aerosol generating procedures wear higher levels of protective equipment; and that where possible, FFP3 masks are used. (WHO recommends FFP2 masks which are a grade below in terms of protection – and so FFP2 can still be seen as effective. The guidance assures WHO approval of the UK’s guidance, confirming it is of the highest level of protection.

 

4. Daily testing figures

As of 9am today (2 April), a total of 163,194 people have been tested of which 33,718 tested positive.  That is 10,215 new tests since yesterday. As of 5pm yesterday (1 April), of those hospitalised in the UK who tested positive for coronavirus, 2,921 have sadly died.

Wednesday 1 April


Today’s update includes:

  1. Daily press conference
  2. 10 lobby briefing
  3. Daily testing figures

 

1. Daily press conference

The business secretary, Alok Sharma, gave today’s press conference. He was joined by Professor Yvonne Doyle, Public Health England’s director for health protection and medical director.

Professor Doyle said there had been three days of new UK coronavirus cases in a row, but that it was too early to say whether plateau has ended.

The latest figures also show a slight rise in the number of people using their car.

The journalist questions focused on testing, I’ve included the key bits below. There was also a question about the government’s exit strategy for getting us out of the lockdown and the role testing will play in that. Sharma said the restrictions were for an initial three-week period then will be reviewed, but want to avoid a dangerous second peak. The prime minister will review the situation after Easter, based on scientific information and clinical evidence as to how the epidemic is progressing. Doyle said the testing strategy is to increase rates among healthcare workers but also in the population at large.

 

Testing:

  • testing strategy is to increase, not just in health care workers but across the population
  • on testing targets, Sharma said increasing testing capacity is the government’s top priority - we’re now at 10,000 tests a day and 390 million products have now been distributed by Public Health England
  • Doyle added that capacity has increased and the commitment is to go to 25,000 tests per day
  • Doyle said there is capacity for almost 3,000 tests and that will increase - in the second strand there will be five centres where people can drive-through and get tested and the intention is to get from thousands to hundreds of thousands within the coming weeks
  • Sharma added the accuracy of the test is incredibly important, so it’s crucial to get that right before launching the test itself
  • Doyle said staff in contact with the sickest patients will be tested first
  • she added that the reagents that work best are those that work best with the machines they are intended for. As the head of the industry has said, there is a global market for this
  • Sharma said we’re looking to create lab-based testing which is the medical equivalent of building a car factory – on a huge scale, but we are making progress.

 

PPE:

  • over 390m PPE products had been delivered over the last two weeks and a 24-hour NHS hotline that staff could call to request PPE if needed
  • the intention was to ensure deliveries rapidly reached where they were needed most.

 

2. No.10 lobby briefing

  • at the daily No. 10 briefing of lobby journalists, Downing Street said just 2,000 people out of 500,000 frontline NHS England staff have been tested for coronavirus and one in four frontline staff are estimated to be isolating
  • there is a global shortage of the specialist chemicals for testing, contrary to claims by the British Chemicals Association
  • he insisted that care homes were getting lots of face masks but said a new ordering hotline had been set up to get them more equipment
  • he could not say whether it was normal practice for NHS staff to prevent parents from staying with children who are sick with coronavirus after a 13-year-old boy died in hospital alone
  • he refused to say whether mobile phone companies were handing over tracking data to the government, which is allowed in emergencies

 

3. Daily testing figures

As of 9am today (1 April), a total of 152,979 people have been tested of which 29,474 tested positive. 9,793 tests were carried out yesterday. As of 5pm yesterday (31March), of those hospitalised in the UK who tested positive for coronavirus, 2,352 have sadly died.