Today's roundup includes:
Prime minister Boris Johnson, was joined by Professor Chris Whitty, chief medical officer, and Sir Patrick Vallance, chief scientific adviser.
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.
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.
Does the economy have to wait?
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.
Today’s roundup includes:
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.
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.
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.
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.
The public administration and constitutional affairs committee heard evidence from the Rt Hon Michael Gove MP on the work of the Cabinet Office.
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.
Matt Hancock was joined by professor John Newton, testing coordinator and Professor Angela McClean, deputy chief scientific adviser
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.
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
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.
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.
Other things to note:
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.
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.
Additional support for businesses.
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.
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.
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.
Media to watch out for:
Chris is on any questions on BBC Radio 4 at 8.30pm tonight.
Other things to note:
Reasons to be cheerful:
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.
Dr Jennie Harries
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.
Manage people’s expectations about timescale?
Screening at airports
Brexit talks – limited progress made
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.
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
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
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.
Also worth noting:
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.
Sir Patrick Vallance:
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.
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.
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.
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.
Stopping people going to beaches at the weekend
Scottish government plan to release lock down
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.
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:
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.
The International Trade Committee had a meeting on its inquiry into The COVID-19 pandemic and international trade. The first session heard evidence from:
The second session heard evidence from:
Today's update includes:
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
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
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.
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.
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.
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.
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
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.
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.
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:
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.
Today’s update includes:
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.
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.
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.
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:
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.
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.
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.
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.
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.
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.
Below are the key points from this week’s ONS data.
Today’s update includes:
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.
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.
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.
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.
Today’s round up includes:
The Chancellor has announced that he is extending the furlough scheme for an additional month to the end of June
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.
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
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.
The first session heard evidence from the following witnesses:
Jeremy Hunt invited other influential select committee chairs along to both sessions taking place this morning. They were:
Hunt asked the three witnesses to give a brief update about what’s going on:
Top concern – availability of PPE. Staff is under increased stress and we need to make sure that staff remain resilient.
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.
The second session heard evidence from:
Data and NHS staff:
Other health conditions:
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.
Today's roundup includes:
1. Daily press briefing
2. Daily testing figures
3. ONS figures – registered deaths in March
Dominic Raab, first secretary of state was joined by Chris Whitty, Chief Medical Officer and Sir Patrick Vallance, Chief Scientific Adviser
Sir Patrick Vallance:
Slides and data sets
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.
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.
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.
Why are we not making better progress against Italy. Cases are coming down, R is coming down. Flattening off of ICU cases.
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.
Relationship with china after this. Needs to be inquiry and learn lessons after this. But has taught us value of international cooperation.
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.
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.
Today’s round up includes:
1. Daily press briefing
2. Daily testing figures
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.
Slides and datasets
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:
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.
Today’s roundup includes:
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.
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.
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.
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.
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.
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.
Full data can be seen on their website.
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.
Today's update includes:
Chancellor Rishi Sunak was joined by Steve Powis, national medical director, NHS England, and Angela McLean, the chief scientific adviser for the MoD
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
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.
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.
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?
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.
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
Today's roundup includes:
Led by Dominic Raab. He was joined by Professor Chris Whitty, chief medical adviser, and Sir Patrick Vallance, chief scientific adviser.
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
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.
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:
Number of deaths
Number of COVID-19 deaths
% of COVID deaths by place
Hospitals (acute or community not psychiatric)
Other communal establishments
ONS also provide a detailed summary with interactive charts here: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsregisteredweeklyinenglandandwalesprovisional/latest
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.
Today's update includes:
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:
Angela McLean, deputy chief scientific adviser (the slides will be available later today)
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.
Complicated to work out how these fit together.
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.
Today's update includes:
Matt Hancock delivered the daily press briefing, alongside Professor Jonathan Van-Tam, Deputy Chief Medical Officer, and Ruth May, chief nursing officer for England.
Professor Jonathan Van Tam (Deputy Chief Medical Officer for England)
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.
Today’s update includes:
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.
Professor Stephen Powis:
Prof John Newton, Public Heath and Epidemiology, University of Manchester:
Key points from this afternoon’s lobby briefing:
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.
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.
Today’s update includes:
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.
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.