Thursday 22 October 

1. Chancellor's statement

The chancellor of the Excheqeur, Rishi Sunak, gave an economic update to the House which covered financial support for areas in tier 2. He said:

• A regional tiered approach is the right way to control the virus
• He outlined the existing financil support for local authorities, businesses and areas in tier 3
• He announced three further sterps:
  1. New grant scheme for businesses impacted by tier 2 restrictions, even if they remain open. Local authorities will recieve direct cash grants - they may decide  these grants - enough to give every business £21,000 for every month tier 2 restrictions apply (equivalent to 70% of grants for closed businesses in tier 3). Grants may be applied retrospectively.
  2. Job Support Scheme - government will cover up to two-thirds of employees' wages for those who have not worked for a week or more. Changes to Short Time Work Scheme - employees only need to work 20% of hours (down from one-third previousy) to qualify for the government topping up wages. Employer contribution will be cut from 33% to 5%
  3. Self-employed - doubling income support from 20% to 40% increasing to up to £3750 per month.

Further details can be found here. 

2. Ministerial statement on the disparate impact of COVID-19

Kemi Badenoch, minister of equalities, gave a statement to the House on the disparate impact of COVID-19. Government press release can be found here and the report is here.

• Work so far has been looking at the impact of COVID-19 on ethnic minority people. Steps taken include: 
  • 95% of Black, Asian and minority ethnic NHS staff have had a risk assessment
  • NHS is working hard to restore services inclusively 
  • Revised guidance issues highlighting Public Health England (PHE)
  • £4m extra spedi to reach ethnic minority people through tailored messaging
  • Messaging in over 600 publications targeting ethnic minority readership 
  • 5 million people reached through the ethnic minority influencer programme
• PHE report stated what disparities, risks and outcomes were and not why and therefore made recommendations
• Funding for research which is taking place
• Socioeconomic and geographical factors contribute, such as population density, underlying health etc.
• Part of excess risk remains unexplained – further analysis planned
• Interventions for the entire population are most likely to disproportionately benefit ethnic minority groups
• CMO says we must assess the impact of COVID-19 based on all-cause mortality – on specific metric early evidence suggests no disproportionate  impact on ethnic minority groups – most ethnic minority groups have better overall health and lower rates of causes of mortality than white groups
• Keen to understand co-morbidities and occupational risk
• Ethnic minorities are underrepresented in vaccine trials
• New Community Champion Scheme – £25m funding for local authorities  and volunteer and community sector to improve communications on COVID-19
• Report outlines recommendations and next steps:
  • Mandating recording of ethnicity on death certificates
  • Appointment of two expert advisers appointed
  • Development of a risk model

• Measures are first steps in a year long review – a further update will be given at the end of the next quarter.
  
  

Tuesday 20 October 

The Prime Minister Boris Johnson held a press conference this afternoon accompanied by Stephen Powis National Medical Director for NHS England and Prof Jonathan Van-Tam one of England's Deputy Chief Medical Officers. He announced that Greater Manchester (GM) had been placed into Tier 3 restrictions after talks with leaders in GM broke down. There is still no clarity about the funding support Greater Manchester will receive, but the Prime Minister said “we will keep talking to Andy Burnham and his teams” but stressed that GM couldn’t be offered more than Liverpool and Lancashire.

 

Prime Minister

Link to full statement

• Countries that are doing the best against Covid around the world are adopting local and regional measures
• Data shows clearly why the government must act
• R is below natural level but remains above 1 – need to take action to control the virus especially in areas where the virus is most prevalent
• GM will move to very high alert level from midnight on Thursday
• Trying to avoid a national lockdown, don’t rule it out but the distribution of virus is uneven – right response is to go for local and regional approach

 

Jonathan Van Tam

briefed on the latest data nationally and focused on the situation in Manchester - Slides and datasets.

 

Questions:

With 'firebreak'’ announced in Wales and Ireland – should that now be the approach in England as well? JVT – trying to walk fine line but don’t think firebreak is the right policy based on epidemiology at the moment. Steve Powis – more patients in GM than in entire SE.

 

On test and trace - would a more localised approach have been beneficial before now? JVT - a combination of local and national is needed but a local approach to deal with hard to reach cases is essential.

 

Friday 16 October

The prime minister, Boris Johnson, held a press conference earlier this afternoon to give an update on COVID-19. He was joined by Dr Susan Hopkins and Patrick Vallance.

1. He thanked local leaders for having worked with the government this week to put in place local restrictions
2. He said these decisions were necessary – admissions to intensive care are going up – it’s the right and responsible thing to do
3. In Manchester he said the number of patients in ICU beds are 40% higher than the first wave and this will rise. He urged the Mayor of Greater Manchester, Andy Burnham, to rethink his current stance – if agreement cannot be reached Johnson said that he would intervene to save the lives of Manchester residents
4. He said he wants to avoid a national lockdown
5. On testing he said that there are new tests that are faster and cheaper; government has bought millions of these tests and they will start distributing and trialling these in the next few weeks.
6. Cautious approach to this technology – need to take time to get it right and do it properly
7. Patrick Vallance delivered a set of slides with the latest data

 

Questions from the public:

What’s the guidance for single parents who live in areas with differing levels (e.g. mum lives in high risk, dad lives in v high risk area)
Johnson said go on the website – there are restrictions on household contact.

 

Shielding? Will it be reintroduced?
No not at present - keep it under review

 

Questions from journalists

BBC: Talks with local leaders are causing delays – do you make a quick decision to impose restrictions or give them more money to persuade them?
Johnson: better if we can work together. Greater Manchester is the outstanding issue, hope the mayor will come with us

 

Sky: Why not act more draconically today?
Johnson: Don’t want to be draconian – local approach is the best one for now but if we need to apply stricter measures we will

 

Talk radio: Can you rule of a circuit breaker in the next month or so?
Johnson: I rule nothing out

 

Sun: Are we looking at a Xmas circuit breaker?
Johnson: want local approach to work, giving it our best shot

 

Monday 12 October

1. Coronavirus briefing with Jonathan Van Tam

Prof Jonathan Van-Tam, deputy chief medical officer gave a briefing on the current epidemiological situation in England and preparations for the NHS. He was joined by Prof Stephen Powis, NHS England and Dr Jane Eddleston, Greater Manchester medical lead.

Slides here.

• Lag between cases and rises hospital admissions and rise in deaths
• Current admissions related to cases about three weeks ago when there are fewer cases of COVID-19
• Resurgence of cases are mostly in adults who are of 20-29 years of age
• First line of defence: hands, face, space, Second line of defence: test and trace, Third line of defence: hospital care for the sickest
• Paris and Madrid: 40% of ICU beds are occupied by COVID patients – UK is following similar path
• Hospital admissions rising fastest in areas where infection rates are highest, particularly NW
• Wishful thinking that we can just fence off the elderly and take no further action
• If the infection rate continues to rise, hospitals could be treating four times more patients than in the initial peak
• NHS has prepared well and learnt a lot – new life saving treatments (e.g. dexamethasone), survival rates have increased, increased supply of PPE (enough for four months), use of independent hospitals for elective and planned care, IPC control measures, more money into 111 and online services, direct booking into A&Es for the first time.
• Announcing two further measures:
• Introducing regular testing for staff in high risk areas (even without symptoms)
• Nightingale hospitals (Harrogate, Manchester, Sunderland) to mobilise and be ready to accept patients
• Still no cure nor a vaccine
• NHS has continued to care for patients with and without COVID-19: 123m GP appointments, average 1800 babies born daily, 10m tests and checks
• During peak with 20k COVID patients, there were double that number of non-COVID patients
• Powis urged people to continue to use the NHS for your health needs “the NHS is here to protect you from ill health”
• Dr Eddleston shared experiences in Manchester:
• NW has 40% of all cases
• Three fold increase in ICU patients in past five weeks, eight fold increase in patients overall
• 30% of beds occupied with COVID patients
• 25% of ICU patients need a mechanical ventilator within 24 hours
• JVT: COVID is building nationally, NHS is there for everyone – not just COVID, massive collective responsibility to play their part to defeat the virus.

 

Questions

Fergus Walsh, BBC: In the first wave the NHS cancelled non-urgent services and cancer screening – how close are we having to do that in NW? Is there evidence that closing hospitality will slow transmission?

Powis: We had to stand down elective services during the first wave, waiting lists have increased and determined to reduce waiting lists and continue services. The key is reducing infection rates.

JVT: Will not pre-empt any announcements with regard to closing bars and pubs. Three Cs: closed spaces, crowded spaces, and close contact – and duration and volume – these settings are where virus will thrive and spread.

 

Richard Pallot, ITV: Are transmission happening in community rather than hospitals and care homes? How worried about transmissions in educations settings – restrictions in hospitality has not curbed transmission in Bolton?

Powis: Data shows a problem of community transmission rates.

Eddleston: Hospital staff adhere to hands, face, space.

JVT: Infection data across schools show very low rates of infection up to the age of 16, but slight increase in 17 and 18 year olds. Children are not drivers of infection in the same way that they are for influenza.

 

Nick McDermott, The Sun: Are we in a better or worse position that you expected for winter? Has test and trace, the second line of defence, failed us?

Powis: Better position than in March and April. Rate of increase in infection is not at the doubling time as it was in March. But R is above 1.

JVT: Difficult to build a system and run it at the same time. Testing and tracing in any system will be more challenging as infections pick up. Could be the case that situation could be worse without Test and Trace.

 

Clive Cookson, FT: Can you tell us more about new evidence which changed the map showing spread further south? Who will be tested in health and care?

JVT: Epidemic has picked up pace earlier in north than in first wave. Disease levels never dropped as far as the south during summer.

Powis: As capacity has increased and new technologies have been discovered, testing more staff. Want to extend to primary care settings.

 

2. Prime minister’s statement to the House

Boris Johnson has just made a statement in the house. Please see below a summary of what he announced and the response from Keir Starmer.

Transcript here.

• Number of cases has quadrupled in the last three weeks. There are more in hospital now than when we went into lockdown on the 23^rd March.
• Some people are saying we should go into a full lockdown again – don’t agree, we don’t want to do damage to children’s education and the economy. But some think that public patience is exhausted.
• But, we need to do something. Can’t let the virus take hold among the young and fit – it will spread
• We have been controlling the virus by changing our behaviour. If we did nothing, each person would infect between 2.7 and 3 other. Now SAGE says that the R is between 1.2 and 1.5.
• Today we are simplifying and standardising 3 tiers
• Three tiers – medium, high and very high
• Medium applies to most of the country and means the current national measures (rule of 6 and 10pm curfew)
• High alert – reduce household to household transmission – rule of six will only apply outdoors
• Very high will apply where cases are growing most rapidly – social mixing between households can’t take place inside or out and pubs and bars will close. Retail, schools and university will remain open

• Merseyside will be on very high alert from Wednesday – as well as pubs and bars, gyms, leisure centres, casinos will close
• NW, NE and York and Humber – dialogue is continuing with leaders there
• We can’t let the NHS fall over when lives are at stake
• Regulations are being laid today, they will be debated and voted on tomorrow and in force by Wednesday. There will be a 4 week sunset clause for intervention in v high risk areas
• This is a narrow path that the country has to tread – weeks and months ahead will be difficult and testing but we will succeed.
• Keir Starmer responded: We are at a critical moment, a tipping point. Virus is spreading in all areas of the UK. We will consider the package and look at the small print and discuss with local leaders.
• Sceptical that the govt has a plan to control this – previous measures  (e.g. rule of six) hasn’t worked. Tests aren’t being turned around quick enough. Leaks and briefings have eroded public confidence. Local authorities should be in charge of test and trace.

 

3. Prime minister’s news conference

The Prime minister held a news conference with Rishi Sunak, chancellor of the Exchequer and Chris Whitty, chief medical adviser.

 

PM:

• The PM began by repeating points from his statement to the House
• More patients in hospital now that when UK went into lockdown in March
• Asking people not to travel in and out of very high alert areas
• Additional funding and support for those in lockdown areas
• Liverpool: gyms, leisure centres, casinos, adult gaming centres will close – working with other local leaders to discuss how best to tackle the virus

 

Chancellor:

• Comprehensive plan to protect jobs and businesses
1. Job support scheme will protect jobs from November with government subsidising wages for businesses remaining open, for closed businesses the government will cover the cost of two-thirds of salaries. Scheme to run for six months. Welfare system more generous and responsive.
2. Cash grant up to £3000 for businesses.
3. Additional funding for local authorities, up to half a billion pounds for activities such as contact tracing and enforcement

 

Chris Whitty:

• Discussed the slides from today’s coronavirus briefing with Jonathan Van-Tam.
• Rise in cases of over 60s will translate to rise in hospital admissions
• Rates would be significantly hirer across the country if not for social distancing efforts

 

Health related questions:

Public: What restrictions will be in place over the Christmas period?

PM: Trying best to get back to normal but depends on everyone’s effort to get the virus down.

 

Laura Kuenssberg, BBC: Is a national lockdown inevitable? Are current announcements enough to spread the disease? What should the clinically vulnerable be doing with regard to shielding?

PM: Hope current measures is enough to get the R down. Do not what to go down the extreme route of a national lockdown right now. Balanced approach necessary.

Whitty: Confident that measures will slow virus. The base would not be sufficient for areas in tier three. Always advise shielding group to take extra precautions but recognise difficulties including mental health, loneliness and stress.

 

Robert Peston, ITV: How can we be confident than these lesser measures than national lockdown will protect us?

PM: Stand ready to work with local leaders.

Whitty: The case is that we will have to do more, in some areas significantly more. No illusions that we can do this without causing harm. Every country in the world is struggling – a balancing act.

 

Beth Rigby, Sky News: Are you struggling to take regional leaders with you. Some areas, e.g. Bradford, in local lockdowns have still not come out of them – what is going on?

PM: Want to take local authorities with us. If we cannot get an agreement it is the duty of the national government to protect public health.

Whitty: Bradford may be in a worse situation if not for the restrictive measures. No evidence that people are flouting the rules.

 

Gordon Rayner, Telegraph: What will happen if there is no vaccine? Inconsistencies of which areas go into which tiers?

PM: Drugs and treatments are changing for the better.

Whitty: Confident that going into the next winter we will be in a remarkably better place.