Tuesday 31 March
Today’s round up includes:
- Daily press conference
- Office of National Statistics publishes data on COVID-19 related deaths
- Daily testing figures
1. Daily press conference
Michael Gove was joined by Dr Jenny Harries, deputy chief medical officer for England and Dr Stephen Powis, national medical director of NHS England.
Gove set out the current situation, the number of tests and said NHS capacity is increasing with more staff returning to the frontline. The rate of testing is increasing but we must go further faster.
Dr Stephen Powis provided latest data from cabinet office coronavirus stat file – slight plateau in number of new cases, but must stick with social distancing measures. On decelerating rate of infection, Powis said that the next week or two were "critical", but we are at the start of the battle. On end-of -ife care, he said that clinicians, doctors and nurses should be just as good as in normal times, but we need to think about when people are discharged from hospital.
- over 8,000 ventilators deployed in NHS hospitals now. Government is buying more from abroad, including from EU nations, and developing new sources of supply at home - will waive import duties for medical supplies
- this weekend the first thousands of new ventilator devices will roll off the production line and be delivered to the NHS next week - from there they will be distributed to the frontline
- also, the government is increasing capacity to provide oxygen to patients at earlier stages of the disease, hoping to prevent deterioration
- Gove said they are also conducting rapid clinical trials on those drugs, including anti-malarial, which may be able to reduce the impact of COVID-19 to those affected.
- want to increase number of tests, constraints is supply of the chemicals that are needed, working with private sector and academics, and boots have increased number of drive through testing sites
- Powis said that tests were being ramped up
- Jenny Harries said that NHS testing of staff was being ramped up and now stood at approximately 12,700 a day and emphasised the importance of getting the postal testing system fully operational - it was important to ensure each sample submitted via post didn't degrade and result in inaccurate results.
Personal protective equipment (PPE):
- Gove said on PPE that hundreds of thousands of items had yesterday reached the frontline and NHS staff had a helpline they could call if they didn't have access - Harries said that the UK has always had sufficient PPE stocks against the NHS guidelines which are amongst the best in the world. She said that guidance was being continually reviewed. She said that the distribution element had been tricky, but a UK stock and distribution flow was being improved to match critical clinical risk, be it in domiciliary care or in an emergency unit, regardless of what your PPE needs were.
2. Office of National Statistics (ONS) publishes data on COVID-19 related deaths
The ONS has published the first of what will be a weekly bulletin which will include all instances, including non-hospital deaths, where COVID-19 was mentioned on the death certificate.
A total of 210 deaths in England and Wales that occurred up to and including 20 March (and which were registered up to 25 March) had COVID-19 mentioned on the death certificate. This compares with 170 coronavirus-related deaths reported by NHS England and Public Health Wales up to and including March 20. The ONS death figures are based on the number of deaths registered in England and Wales where COVID-19 was mentioned on the death certificate as "deaths involving COVID-19". The number includes all deaths, not just those in hospitals, although there is usually a delay of at least five days between a death occurring and registration. The figures published by NHS England and Public Health Wales are for deaths only among hospital patients who have tested positive for COVID-19, but include deaths that have not yet been registered.
Separate figures from the ONS show that for the 108 deaths registered up to March 20 where COVID-19 was mentioned on the death certificate, 45 (or 42%) were people aged 85 and over while 34 (31%) were people aged 75-84. A total of 21 deaths (19%) were people aged 65-74, seven (6%) were people aged 45-64 and one death was aged 15-44 years.
3. Daily testing figures
As of 9am 31 March, a total of 143,186 people have been tested of which 25,150 tested positive. 8,240 new tests were completed yesterday.
As of 5pm on 30 March, of those hospitalised in the UK, 1,789 sadly died. In England 1651 people have died, up from 1,284 on Monday an increase of 367 – the largest one day rise so far.
Monday 30 March
Today's update includes:
- Daily press conference
- Daily testing figures
Other things to note:
- On the Today programme this morning Professor Neil Ferguson, of Imperial College, a key epidemiologist advising the government, has said we can see some early signs of slowing the spread of COVID-19 in some indicators, such as the numbers of new hospital admissions, which are slowing. He said it 'has not yet plateaued, so still the numbers can be increasing each day, but the rate of that increase has slowed'.
1. Daily press conference
Today's press conference was delivered by foreign secretary Dominic Raab, alongside Sir Patrick Vallance, chief scientific advisor.
The focus was on the activities the government is undertaking to support British nationals abroad.
He addressed criticisms that some UK police forces have been heavy-handed in their approach to enforce new lockdown rules, saying he supported what they were "trying to achieve". "The number one message that the police are rightly trying to convey is that people need to follow the guidance not just to the letter but also in spirit".
Sir Patrick Vallance
- Measures that have been taken are having big effect on contacts. Dramatic reduction in footfall, predicted to have effect on number of people infected. That is predicted to have a very significant impact on 'R' [the numbers being infected by any one person with the virus]". Vallance believe R is already less than one, down from 2-3. Will take 2 or 3 weeks to show curves changing.
- Important to do this now to get numbers below ICS capactiy. Once we know have curve below capacity and stable, then it's time to start thinking about releasing measures.
- reiterated that the coronavirus pandemic will deepen over the next two to three weeks. After that point, he expects cases to begin to stagnate before we experience a decrease. At the moment, data does not suggest that we are experiencing an acceleration of cases.
- at the moment, the UK is seeing around 1,000 new cases of Covid-19 a day.
- "we're tracking roughly along the same path as France" in terms of deaths of patients who have contracted the virus.
- Vallance talked through the latest comparison of COVID-19 deaths with other countries - UK doing better than Spain, Italy and the US, on parity with France, but worse than South Korea, Germany and China.
2. Daily testing figures
As of 9am 30 March, a total of 134,946 have been tested: 112,805 negative. 22,141 positive. As of 5pm on 29 March, of those hospitalised in the UK, 1,408 have died.
Friday 27 March
Today's update includes:
- Daily press conference
- Daily testing figures
- Health and Social Care Committee
1. Daily press conference
Michael Gove, the Cabinet Office minister, led the daily press conference, alongside Dr Jenny Harries, the deputy chief medical officer for England, and Simon Stevens, the CEO of NHS England.
- Gove announced that a new alliance of businesses, research institutes and universities has come together to boost testing capacity for frontline workers has been brought in.
- This will be antigen testing – testing whether people currently have the disease – so that health and social care workers can have security and knowledge that they are safe to return to work if their test is negative. These tests will be trialled for people on the frontline starting immediately, with hundreds to take place by the end of the weekend, dramatically scaling up next week.
- Today over 6,200 confirmed positive coronavirus patients are in hospital across in England and that number is only bound to rise over the coming days, so it is especially important for people to stay at home.
- As of today, NHS England has reconfigured hospital services so that 33,000 hospital beds are available to treat further patients.
- The NHS is also building new hospitals starting with the ‘NHS Nightingale’ hospital in east London. Stevens confirms he has given the go-ahead to the building of two further hospitals: in the Birmingham NEC and the Manchester CCC, with further such hospitals to follow.
- How much spare capacity in London’s critical care beds – 3,000 available beds across London. Bringing on additional beds next week. The NHS Nightingale hospital [in east London] is being configured initially to be able to look after up to 500 patients, but there is the physical capacity to potentially take that up to 4,000 if required.
- rolling out routine testing of NHS staff beginning with critical care and A&E staff, and GPs next week.
- Can you guarantee the NHS is ready for what is to come? What is the one things you need from the government?
- Jenny Harries said the primary objective of testing is to ensure clinical cases are managed safely. Those patients admitted to intensive care with acute respiratory disease syndrome or with pneumonia are the ones we are focusing on. For other admissions into hospitals with those conditions, we test routinely. Also in some other specific areas where people are at high risk, like care homes.
- The basis for this is you must have clinical symptoms. The default is that without this you would not be tested. The only other factor would be the centrality of your role in the Covid-19 response. The prime minister plays a very critical role in that and that is the basis for our testing.
- Simon Stevens says it is urgently important to test frontline staff who are off sick or are self-isolating. The number of tests carried out will be doubled by the end of next week compared to this week.
- staff testing will be roiled out across the NHS, starting next week with critical care nurses and other staff in intensive care, emergency departments, ambulance services, GPs and as the testing volumes continue to increase we want to expand that to a range of essential public workers, including those in our social care services and continuing with the patient testing.
2. Daily testing figures
As of 09:00 today there have been 14,543 confirmed cases of Coronavirus across the UK. This is an increase of 2,885 cases since yesterday. We have currently tested a total of 113,777 people across the UK. As of 17:00 on yesterday, of those hospitalised in the UK, 759 have died. This is 181 more deaths. Regionally we are seeing an increase in cases across the country and in particular in London, the South East and the Midlands.
3. Health and social care committee
The first session on Preparations for Coronavirus heard evidence from:
- Professor Yvonne Doyle, Medical Director, Public Health England
- Dr Chaand Nagpaul, Chair, British Medical Association
- Dr Katherine Henderson, President, Royal College of Emergency Medicine
- Dr Paul Tanto, Registrar in Emergency Medicine, Northwick Park Hospital
- It is possible to transmit the virus up to 5 days before showing symptoms.
- Approximately 30% of people with Covid-19 are asymptomatic and it is not yet known if they can transmit.
- The analysis of the first 386 deaths show that 98% had some form of another condition.
- It is not yet known how many healthcare workers have Covid-19 and have died from it. PHE hopes to have this information in due course.
- There are approximately 570 people in ITU with Covid-19 in London which is below capacity.
- NHS111 is receiving 25,000 calls per day.
- Current daily testing capacity is 7,000 with the targets of reaching 12,000 by the end of March, 15,000 by mid-April and 25,000 by the end of April.
- The government target of 250,000 per day encompasses the target of 100,000 antigen testing of health care workers (for which the Office of Life Sciences is responsible) and antibody testing.
- South Korea’s approach to testing is different as contact tracing was very regional and within particular communities. In South Korea, people were willing to provide very personal information such as bank account details for tracing which has been deemed inappropriate in the UK. Modelling shows that contact tracing in the UK could reach six figure sums. Social distancing is an effective way of breaking transmission.
- Contact tracing in the UK does continue where it can be contained, e.g. in prisons and nursing homes.
- Concerns were raised about local companies being overlooked for testing contracts and were currently exporting internationally.
- Concerns that the lack of testing was forcing healthcare staff to self-isolate putting significant pressure on other staff.
- Estimated that 10% of the population exhibit symptoms of a cough or fever who do not have Covid-19.
- Concerns were raised that PHE guidance diverges from guidance from other international bodies, including WHO.
- Recognition that PPE was starting to filter through the system but there are still shortages.
- PHE said that there is no complete consensus on PPE guidance between all international agencies. The UK’s guidance is largely consistent with the vast majority and was drafted with input from clinicians and pathological experts. Guidance is more protective in risky environments than WHO and is under active review.
- Concerns that PPE guidance was downgraded due to lack of availability. PHE said it was downgraded due to the knowledge that 80% of cases would recover with mild symptoms.
The second session of the Health and Social Care committee yesterday focussed on social care. The meeting was done remotely.
The following witnesses gave evidence :
- Emily Holzhausen, Representative, Care and Support Alliance;
- James Bullion, Vice-President, Association of Directors of Adult Social Services;
- Martin Green, CEO, Care England;
- Sarah Pickup, Deputy Chief Executive, Local Government Association
A number of issues were raised, please find below a summary of the key themes:
- Guidance has been issued for home care, supported living setting and residential care regarding PPE. Guidance for personal assistance is being finalised.
- Generally, the care sector has been following the advice set out by PHE.
- It was reported that the experience of councils and social care providers regarding the delivery of PPE, has been erratic and difficult.
- Care sector has been advised that staff have only been told to wear PPE is they are caring for those who are symptomatic. Not just for general care.
- It isn’t practical given the stocks most council have to give PPE to all care staff, and the guidance doesn’t advise this.
- There are concerns about the next tranche of equipment being received. As a short term measure some PPE is being taken from social care to provide for NHS.
- There was a feeling that national stock should be cascaded – people in social care fall into the highly vulnerable category.
- There was concern that people looking after residents who have Covid 19 are then going to look after other people.
- If staff are going to self isolate, its going to be a major problem for the sector, so it was stressed that testing is vital in order to get people back into the care workforce.
- Overall there were also concerns that there are people that are carers who live with people who are shielding and vulnerable – staff are having to make difficult decisions.
- There is a priority list of people those who need testing. First and foremost those are critical carers in hospital, but care workers are on the list.
The most vulnerable
- Those in the shielding category need to have their basic needs met. There is anxiety at the moment from disabled people that they won’t receive the care they need. At this stage, there haven’t been reports of people not getting the care they need, but it was acknowledged that people are having to be flexible and in some cases family are having to take over and carry out quite intimate care for family.
- One witness raised a concern that there are people who live alone who aren’t on their radar.
Discharging from hospital
- Generally witnesses welcome the move to speed up discharges from hospital where they are clinically suitable.
- They said that it would be helpful if they could get an agreed figure from NHS England on how much it will cost to transfer people out of hospital – they need to get a figure agreed for discharges and then they can work with colleagues in local government.
- They have been pushing for this but not getting anywhere at the moment.
- Capacity: There were discussions about where to put people, and questions about whether they should be thinking about trying to put people in hotels and holiday parks – witnesses said that NHSE, ADASS, DHSC and LGA are working well together to find solutions.
- Morale: There was a point made that social care staff morale needs to be improved – it’s great that people are thanking NHS staff but social care staff need to be valued as well.
- Homeless people: There was a question about those who are homeless and concerns that some hotels might be happy to house NHS staff but they are less likely to do this for homeless people. There was a question about other options. Witnesses said that some hotels have been closing, and that this is distressing. There was agreement that from an equalities point of view , rough sleepers are suffering disproportionately, and pre existing inequality is being made worse by Covid 19. They said that there is close work going on with local resilience networks to resolve the problem.
Thursday 26 March
Todays update includes:
- Coronavirus Act becomes law
- Police given new powers to respond to coronavirus
- Daily press conference
- Downing Street lobby briefing summary
1. Coronavirus Act is now law
The Act can be read here can be read on the online and our briefing on the Bill is on our website. There were no amendments to the legislation in the Commons or Lords.
2. Police given new powers to respond to coronavirus
As of 1pm today, the rules on when and why you can leave home are laws. New public health regulations have been put in place to strengthen police enforcement powers in England, and to ensure people stay at home and avoid non-essential travel.
From today, if members of the public do not comply the police may:
- instruct them to go home, leave an area or disperse
- ensure parents are taking necessary steps to stop their children breaking these rules
- issue a fixed penalty notice of £60, which will be lowered to £30 if paid within 14 days
- issue a fixed penalty notice of £120 for second time offenders, doubling on each further repeat offence.
3. Daily press conference
Rishi Sunak, the chancellor, set out another raft of measures to support the economy through the Coronavirus outbreak, this time focusing on the self-employed. He was joined by Dr Jenny Harries, the deputy chief medical officer for England. The prime minister was not present.
- the government will pay self-employed people a taxable grant based on their previous earnings over the last three years, worth up to 80% of earnings, and capped at £2,500 a month
- it will run for a minimum of three months - equivalent to the support available to the employed
- open to anyone with trading profits of up to £50,000
- open to people who make the majority of their income from self-employment
- only be open to people who are already self-employed and have a tax return from 2019
- 95% of the self-employed will be covered
- the new system will be up and running by June
- anyone who missed the deadline for their tax return will get an extra four weeks.
Mental health impact of social distancing
Jenny Harries was asked about the impact on people’s health from being asked to stay at home. She said this is something they are concerned about and those being told to isolate for 12 weeks are given mental health advice in the letters they are receiving. She encouraged everyone to make the most of the extra time not commuting to exercise.
Well developed public health system in this country, WHO is addressing every country. Encouraging all countries to test. Plan right the way through this, starting with containment phase, tracing all cases. Now in delay phase, not appropriate to test every case, focus on clinical management and on health and social care staff. need to be careful on focusing where clinically most valuable.
4. Downing Street lobby briefing summary
- Boris Johnson is now hoping to get 750,000 people to sign up for the NHS volunteer responders scheme.
- The government could be planning to set up more emergency hospitals around the UK like the one being established in the ExCeL centre in London. Around 10 more sites have been identified for these hospitals and NHS England is actively preparing for a number of scenarios and is working with clinicians and teams of military planners to support the health service around the country.
- The ExCeL hospital, NHS Nightingale, would have 500 beds available next week. Eventually it is due to have 4,000 beds available.
- The government’s decision to commit to buying 3.5m antibody tests even though their reliability is not yet proven was defended.
- Dyson will only be paid for the 10,000 ventilators ordered by the government if they passed the required regulatory tests.
- The UK is not participating in the EU-wide procurement scheme for ventilators. Because the UK is in the post-Brexit transition period, the UK would have been able to participate, however, the government has said that as we are no longer a member of the EU and that the UK was making its own efforts to procure ventilators.
- the way UK coronavirus deaths are recorded and made public is changing. Public Health England is moving to a different reporting time, but it is unclear what else would change.
- The lockdown measures could be extended, if there are further steps that need to be taken, nothing will be ruled out.
- The government was still committed to doing 10,000 coronavirus tests a day by the end of this week. On Wednesday there were 6,643 up from 6,491 on Tuesday and 5,605 on Monday. On personal protective equipment, more than 15m face masks have been delivered to the frontline in the last two days, as well as 24.6m gloves and 1.9m eye protectors yesterday.
Wednesday 25 March
Today’s update includes:
- Prime minister’s press conference
- Coronavirus Bill completes parliamentary passage
- Science and technology committee – Sir Patrick Vallance, chief scientific advisor and Professor Sharon Peacock, Director of the National Infection Service at Public Health England
Other things to note:
- Parliament will rise tonight and not return until April 21 at the earliest, however the health and social care select committee will hold a remote oral evidence session on coronavirus tomorrow.
1. Prime Minister’s press conference
Key points from the press conference:
- 405,000 people have signed up to volunteer for the NHS
- re-emphasised that the NHS had only limited numbers of doctors and relevant equipment, hence the call for isolation to help slow the spread of the disease
- Johnson said that a “huge” national programme of testing was due to take place. He described the programme of support for business and workers as "unprecedented”"and said that tomorrow Rishi Sunak would announce more on support for the self-employed
- said that he didn’t want to see businesses or individuals "profiteering" from the situation but pledged to "look at the legislative framework" to help prevent it going forward.
Chief Medical Adviser Chris Whitty:
- testing for people in hospitals was perfectly sufficient and government had little concern about the scale up
- on testing NHS/critical workers, there was a global shortage, but that was the next priority - once more testing was done for key workers, it would be expanded out to the general public
- the antibody test, telling someone if they have had the virus, would be useful for getting people back into the frontline but was "not quite there yet"
- in reply to Beth Rigby from Sky, asking about the number of people still travelling to work (e.g construction workers) Whitty said that the modelling that the government’s plan rested on factored in that a "high number" of people would still come into work
- once the government was confident about which tests work, it was important to capture data - self-tests were "not something that would be available online next week" and said the right people needed to be tested first.
- expected a substantial increase in the number of critical care beds needed, but said at present the level of demand was no worse than a normal winter day, but expecting demand to go up. Provided everybody continues with the social distancing measures will help to pull down demand. NHS at the same time increasing supply, increasing critical care and ventilator beds over the next few weeks.
Chief Scientific Adviser Patrick Vallance:
- on the study from Oxford academics that said that up to 80% of people may already have had the disease, Vallance admitted that "We simply don’t know how many people have had it asymptomatically – that is what the tests are so important2.
2. Coronavirus Bill completes parliamentary passage
The coronavirus bill, which gives the government a series of extensive emergency powers it may need to deal with the coronavirus epidemic, has now completed its passage through the House of Lords. It was passed un-amended with cross-party support, and now it just needs to receive royal assent before becoming law.
3. Prime minister’s questions
Today’s PMQs was extended to an hour, to compensate for the lack of Prime Ministerial statement on the new coronavirus measures yesterday. It was Jeremy Corbyn’s last PMQs as Labour leader. It had the feel of a statement rather than a usual PMQs session and was dominated by Coronavirus, with no other topics being raised by MPs. It’s almost hard to remember the deeply divided Parliament of the last few years, with the tone of the House (at least for now) consensual, non-partisan and sombre.
Key themes from the session included:
- Support for the self-employed following repeated promises to provide help from the government. It has been confirmed that Rishi Sunak will announce the new package of measures for the self-employed at the daily press conference tomorrow. This comes after the Resolution Foundation identified 1.7m people who have lost out because of Coronavirus.
- Availability of testing in the community and for NHS workers, with Jeremy Hunt calling for routine testing in the community and weekly tests for NHS staff. The prime minister responded that they are making huge progress on antibody testing. Public Health England promise they will be doing more than 11,000 daily tests for coronavirus by Monday. But won't reach 25,000 until April 25.
- concerns about construction workers having to continue going to work even if unwell and calls for the PM to make it clear construction work on non-emergency work should stop now. Johnson responds that construction sites should observe social distancing rules.
- Reports of continued overcrowding on the tube network, Johnson criticises Sadiq Khan by saying he will support him in running more trains. There has been some discussion about whether it is people flouting the social distancing rules, or whether it is due to the reduced timetable which means the trains are still busy.
- Linked to this there was a call for black cab drivers in London to be used to take NHS staff to work safely, on a contractual basis. Johnson says this idea has already been considered.
- support for private renters, calling for legislation to ensure people aren’t evicted.
- an operation to repatriate UK citizens from abroad.
4. Science and technology committee on UK science, research and technology capability and influence in global disease outbreaks
A key thing to come out of the committee is Sharon Peacock saying the government has purchased 3.5 million tests to find out if you’ve had coronavirus. They are currently being tested and then will be distributed to the communities. They will be available in days rather than weeks, you’ll be able to order them via Amazon send back, or get them from place like Boots pharmacy. This was mentioned at the press conference, with both Whitty and Vallance expressing caution about the roll out of testing, saying the thing worse than no tests was bad tests.
The science and technology committee held an oral evidence session on UK science, research and technology capability and influence in global disease outbreaks chaired by Greg Clark MP.
Witnesses included Sir Patrick Vallance, government chief scientific adviser (session can be viewed here) and Professor Sharon Peacock, director at the national infection service at Public Health England (session can be viewed here).
Sir Patrick Vallance:
- SAGE has not published its membership because it is fluid, participants change and are come from a range of backgrounds. Sir Patrick will look into making this information public in due course
- SAGE provides unified advice following robust debate, it would be unhelpful to provide a range of views
- the government has listened carefully to SAGE, challenged them where necessary and has followed advice closely
- while the government initially sought to contain the virus, it has now changed its approach to be more in line with other countries
- testing has been on most agendas, if not all, of SAGE meetings despite views that testing does not have as much prominence in the UK compared internationally
- testing is currently reserved for inpatients and NHS workers as testing is limited but will be scaled up
- self-administered testing is key to ramping up testing and rollout will be done rapidly if tests are confirmed to work
- the media should be responsible and encourage compliance
- the powers to loosen and tighten social distancing are needed to allow the government to adjust to circumstances
- people should wash their food when receiving deliveries to minimise risk but viruses on hard surfaces decline significantly after 24 hours
- government aims to reduce the R0 value to below one (the basic reproduction number)
- in January it was not yet evident that the spread would become a pandemic but discussions were taking place - the government acted as soon as this became evident
- there is clinical representation in SAGE. The CSA and CMO are both medics and there is a clinical subgroup that feeds into SAGE
- implementing all suppression measures would result in a second epidemic and moderate measures would reduce the second wave - however, the shift to suppression was due to modelling of NHS capacity
- SAGE will continue to monitor developments around testing but it is now largely an operational matter for the government
- NHS capacity is, in aggregate, set to be sufficient.
Professor Sharon Peacock
- antigen test detects the presence of the virus, antibody test detects the immune response and should not be administered until at least 7 days after the start of symptoms
- the government aims to roll out 25,000 tests per day by the end of April
- testing began at eight PHE or PHE linked labs and is now being rolled out to all 29 NHS labs
- there are currently sufficient ventilators and rapid scale up of ventilators aims to match demand with supply
- other countries’ responses are being studied but not necessarily replicated as the government seeks to build upon the strength of the NHS
- scientific evidence of modelling will be made available in the coming days
- a batch of home tests are currently being tested in Oxford and will be completed by the end of this week
- 3.5m home tests have currently been ordered and will be available via Amazon and other pharmacies. They will be at a minimal cost to the public, if any
- currently looking at how to record the results with GPs.
Tuesday 24 March
Today’s update includes:
- Matt Hancock press conference
- Treasury questions
- Matt Hancock statement in the House of Commons
- Downing Street lobby briefing
- Update on COVID-19 testing
- NHS volunteer responders
1. Matt Hancock Press conference
Matt Hancock held the daily government press conference alongside Dr Jenny Harries, deputy chief medical officer and Professor Steve Powis, national medical director, NHS England.
- launching a scheme for NHS volunteers
- 11,788 former health staff have agreed to return to help out - they include 2,660 doctors, more than 2,000 other clinical staff and 6,147 nurses
- 5,500 final year medical students and 1,800 final year student nurses will be going into work early
- a new emergency hospital, NHS Nightingale, is opening at the ExCel centre in London. He says it will have two wards which each have space for 2,000 patients
- repeats advice saying people should stay at home wherever possible but can go to work if they can’t do job physically from home, but have to stay 2 metres apart from colleagues he also suggests the tube service has been cut back too far, which has led to scenes of overcrowding on tube lines.
New testing centre in Milton Keynes is opening today. Testing will give insight into population demographics and will be able to learn more about how it transmits, so will be able to close down more tightly. Working hard to ramp up testing.
Over last 24 hours have shipped 7 million pieces of PPE. New hotline for getting PPE out to people who need it.
2. Treasury Questions
The chancellor, Rishi Sunak is coming under increased pressure from MPs on the government to bring forward support for the self-employed. The government said they will make a further announcement in the coming days (but resisted calls for an announcement by the end of this week). The government is not in favour of an universal basic income and is attempting to bring forward support for the self employed which distinguishes between those who actually need help and those who do not. MPs argued that it was not the rich self-employed who were seeking help from the government. The Coronavirus Job Retention Scheme is due to be operational by the end of April. The government reiterated that the NHS will get whatever funding it needs.
3. Matt Hancock statement in the House of Commons
Matt Hancock, made a Commons statement about the new restrictions that were set out by the prime minister last night. Jeremy Hunt asked when routine coronavirus testing in the community would resume. He said he was concerned there was still not enough testing. Hancock said he could not give a date for that, because he did not know when the new test kits would arrive but that millions were coming within the next few days and weeks, and he would be in a position to provide a more concrete timetable soon. Jon Ashworth also called for more testing and asked why aren't companies weren’t being fined for insisting their staff come to work in non-essential roles.
4. Downing Street Lobby briefing
The Downing Street daily lobby briefing is now being conducted by conference call. Key points:
- police would be given the power to impose fines on people who do not comply with the rules announced yesterday. The fines would initially be set at £30, but the level could increase “significantly”, he said. He said that the power to impose these fines would be in place by Thursday, and that they would be used in particular to stop gatherings of more than two people in public. The spokesman said further guidance on how the new restrictions apply would be issued, probably later today.
- The government’s decision to write to research institutes at the weekend asking for equipment that could be used to help carry out tests was defended and said that Sunday was not the first time that the private sector and others had been asked for help. The source said this has been going on for weeks.
- the government was in favour of construction work continuing in England in certain circumstances, for example where workers are able to practice social distancing on site.
- no plans to restrict public transport to key workers.
- Boris Johnson has raised concerns with Sadiq Khan, the mayor of London, about too many people using the underground in London.
5. Update on coronavirus (COVID19) testing in the UK:
As of 9am on 24 March, a total of 90,436 have been tested: 82,359 negative. 8,077 positive. As of 1pm, 422 patients who tested positive for coronavirus have died.
6. NHS Volunteer Responders
The NHS has issued a call for volunteers to help vulnerable people stay safe and well at home. Members of the public can sign up quickly and easily at to become NHS volunteer responders, and can be called on to do simple but vital tasks such as:
- delivering medicines from pharmacies
- driving patients to appointments
- bringing them home from hospital
- rr making regular phone calls to check on people isolating at home.
NHS Volunteer Responders is not intended to replace local groups helping their vulnerable neighbours but is an additional service provided by the NHS.
GPs, doctors, pharmacists, nurses, midwives, NHS 111 advisers and social care staff will all be able to request help for their at-risk patients via a call centre run by the Royal Voluntary Service (RVS), who will match people who need help with volunteers who live near to them. Some charities will also be able to refer people to the service.
Monday 23 March
Today’s round up includes:
- Summary of the Coronavirus Bill debate
- Daily testing figures
- NMC – applications to join COVID-19 temporary register
1. Summary of the Coronavirus Bill debate
- The government announced that emergency powers would be reviewed by the House every six months – an amendment welcomed by the House. This comes after concerns were raised by MPs about a lack of checks on the 2 length period initially outlined in the bill.
- Currently 7563 retired healthcare professionals have answered the call to return to work.
- Jon Ashworth called for the government to enforce the social distancing rules.
Concerns were raised around:
- Lack of PPE – incidents of NHS staff resorting to wearing bin bags due to the lack of PPE. The government have enlisted the military to help with local distribution. A hotline and email address has been established for PPE issues.
- Lack of testing. The government is expanding testing, both case testing and antibody testing.
- Lowering of social care standards – calls to avoid these standards becoming the ‘new norm’. Jon Ashworth suggested the Equalities and Human Rights Commission be given oversight of social care standards temporarily.
- Calls across the House to enforce social distancing.
- Mental health detention and the possibility of misuse/mistakes by doctors due to the loosening of safeguards.
The debate is ongoing. We will share a fuller summary and transcript when available.
2. Daily testing figures
As of 9am today (23rd March 2020), a total of 83,945 have been tested: 77,295 are negative. 6,650 are positive.
As of 1pm, 335 patients who tested positive for coronavirus have sadly died.
3. NMC – applications to join COVID-19 temporary register
As at 11:30am today, the Nursing and Midwifery Council has received 5,633 applications from across the UK to join its COVID-19 temporary register. The temporary register will go live within 24 hours of parliament passing the emergency legislation and when the secretary of state for health and social care declares we are in a state of emergency.
The government has announced new guidance to protect people at the highest risk from coronavirus. A link to this guidance can be found on the government website.
The guidance will apply to people currently living with conditions, or are taking medication or receiving treatment, which health experts have identified puts them at a much greater risk of developing serious complications if they get the virus, which may mean they need hospital treatment. This includes, for example, those who have received solid organ transplants, are living with severe respiratory conditions such as cystic fibrosis and COPD or specific cancers like of the blood or bone marrow. And those receiving certain types of treatment including ones which suppress the immune system – leaving the body less able to fight off the virus.
People identified as belonging to one or more of the at-risk groups will receive letters from their GP practice, specialist or both early next week strongly advising them to stay at home for a period of at least twelve weeks. The NHS will also send daily text messages throughout next week to those in this group, to reach the most at risk as quickly as possible with advice.
Friday 20 March
Today’s round up includes:
- New package of measures from the chancellor for workers and self employed
- PM’s Press conference
1. Chancellor’s announcement of new package of measures for workers and self employed
- the government has announced a Coronavirus Jobs Retention Scheme where any employer is eligible to apply through HMRC.
- The government will offer a grant to cover 80% of the salary of most furloughed workers, up to £2500.
- Payments will be backdated to 1st March and will last initially for 3 months, with the possibility to be extended if needed.
- There is no limit to the funding available.
- The business loan scheme will be interest free for 12 months, increased from the previously announced 6 months and will be available from Monday.
- Further measures will be announced to allow small and medium businesses to access credit.
- The next quarter of VAT payments will be deferred with no businesses paying VAT until June.
- The government has offered £30bn cash to businesses, equivalent to 1.5% of GDP.
- The self-employed can access universal credit, equivalent to full statutory sick pay.
- Self-assessment payments are deferred until January 2021
- Housing benefit is to cover at least 30% of market rents in the claimant’s area.
2. Prime Minister's press conference
- Boris Johnson strengthened the social distancing measures announced on Monday and ordered the closure of cafes, pubs, bars and restaurants, theatres, gyms, and cinemas from tonight and not to re-open. The situation will be reviewed each month. Cafes / restaurants can continue to provide takeaways.
- He urged people not to go out tonight, saying “Please don't 'You may think you are invincible but there is no guarantee that you will get mild symptoms and you can still be a carrier of the disease”.
Other things to note:
The health and social care committee will hold an evidence session on Tuesday next week looking at protection offered to doctors against coronavirus; and the impact coronavirus is likely to have in social care sector. Witnesses include the BMA, Faculty of Intensive Care Medicine, Public Health England, ADASS, Care England and the LGA. More information here - https://committees.parliament.uk/event/365/formal-meeting-oral-evidence-session/
NHS Providers in the news:
Adam Brimelow will be on GNS radio on Monday morning at 0700 – 0800.