Boris Johnson COVID Press Conference Transcript January 22: Update on New Variant

Boris Johnson: (00:00) We've been informed today that in addition to spreading more quickly, it also now appears that there is some evidence that the new variant, the variant that was first identified in London and the Southeast, may be associated with a higher degree of mortality. And I'm going to ask Patrick in a minute to say a bit more about that, because it's largely the impact of this new variant that means the NHS is under such intense pressure with another 40,261 positive cases since yesterday. We have 38,562 COVID patients now in hospital, and that's 78% higher than the first peak in April. And tragically, there have been a further 1,401 deaths. So it's more important than ever that we all remain vigilant in following the rules and that we stay at home, protect the NHS, and thereby save lives. Boris Johnson: (01:07) But I also want to answer a key question I know will be uppermost in your minds. All current evidence continues to show that both the vaccines we're currently using remain effective both against the old variant and this new variant. And so you'll also want to know that our immunization program continues at an unprecedented rate. 5.4 million people across the UK have now received their first dose of the vaccine. And over the last 24 hours, we can report a record 400,000 vaccinations. In England, one in 10 of all adults have received that first dose, including 71% of over eighties and two thirds of elderly care home residents. Having secured orders for hundreds of millions of doses, the UK government has supplied vaccines to the devolved administrations according to population size. First doses have been administered now to 151,000 people in Northern Ireland, 358,000 in Scotland and 212,000 in Wales. And I'm glad that the governor of the UK, the whole of the UK, is able to assist the devolved administrations in deploying the vaccine. And I know everyone across the country is grateful for the logistical skill of the British Army. Boris Johnson: (02:35) There is much more to do, and the target remains very stretched indeed, but we remain on track to reach our goal of offering a first dose to everyone in the top four priority groups by the middle of February. And I want to thank all the doctors and nurses, especially at the GP led sites who are vaccinating at a phenomenal rate. As well as I say, as those in our armed forces, our local or authorities, our pharmacies and volunteers who are making this extraordinary national effort possible. Boris Johnson: (03:12) And I want to thank all of you who have come forward to get your jabs, because by doing that, you're protecting yourselves, your communities, and of course, our NHS. And I say to everyone, when that letter arrives, please don't hesitate to book that appointment and get this life saving protection because this is the best and fastest way for us all to defeat this virus and get our lives back to normal. Boris Johnson: (03:44) I'm now going to ask Chris to do the slides. Chris: (03:46) Thank you Prime Minister. First slide please. Chris: (03:49) So the first slide is the Office of National Statistics data showing the estimated number of people testing positive for COVID-19 in England. And that has been on a steady, upward slope since the early part of December. But I'm glad to say that in the most recent data, there has been a turning of the corner on that. And the number of people with infections has gone down, but it has gone down from an exceptionally high level. And their most recent estimate is we're still at a stage in England where one in 55 people have the virus. So there is a definite signs of improvement, but from a very high level, remaining at a very high level, thanks to the extraordinary work that everybody has done together to make sure people stay at home when they do not need to go outside. Chris: (04:39) Next slide, please. This then looks at the number of people in hospital with COVID in the UK and it is increasing all the time. It has been over the last several weeks and is now at an extraordinarily high level as the Prime Minister has just said, but there is no sign of this beginning to flatten out. In some parts of England, particularly the Southeast, the East of England and London, there's now signs of some reduction in the numbers going into hospital, but at an incredibly high rate still. In other areas, there's still some increase in parts of the Midlands and the North of England, for example, but overall there is now a flattening out and we hope to see, following the reductions from a high level in the number of cases, the beginnings of a reduction of cases in hospital, but this will take some weeks to work through the system until we start to see significant falls in the numbers in hospital. NHS staff are working extraordinarily hard across the whole country because of the very, very large numbers of people in hospital with COVID. Chris: (05:53) Next slide, please. And sadly, the number of people who have had a positive test for COVID and then died shortly afterwards, is continuing to climb. And because this is later, this is a delayed effect. So people get infections, then they end up going to hospital, get some more severely ill. And then sadly, some of them die. Most obviously recover. The number of people who are dying has been steadily increasing. And the most recent seven day rolling average is over a thousand deaths a day. So this is a very high rate and it, again, it will take longer to come down and probably will go up over the next week because of the fact there's a delay between people going into hospital. And some people are sadly dying. Chris: (06:45) On that, I'll hand over to Patrick, for some comments about the new variant. Patrick: (06:49) Thank you very much. So there are three major variants of a potential concern. The one that was first identified in the UK, one that was identified in South Africa, and one that was identified in Brazil. Three countries, all of which sequence a lot, and so picked these things up early. I want to talk about the UK one because it's a common variant now comprising a significant number of the cases. Patrick: (07:13) The first thing to say is that we have confidence that this is spreading more easily than the old variants. So we think it transmits between 30 and 70% more easily than the old variant. We don't yet understand why that is the case. It doesn't have a difference in terms of age distribution. So there's no preferential age. It can affect anybody at any age, similarly to the original variant, the original virus. Patrick: (07:44) But I do want to say a word about severity and mortality. When we look at data from hospitals, so patients who are in hospital with the virus, the outcomes for those with the original virus or the new variant look the same. So there's no real evidence of an increase in mortality for those in hospital. However, when data are looked at, in terms of those who've been tested positive, so anyone who's tested positive, there is evidence that there's an increased risk for those who have the new variant compared to the old virus. Now that evidence is not yet strong. It's a series of different bits of information that come together to support that. And I want to put it into context as to what it might mean, but stressing that these data currently uncertain, and we don't have a very good estimate of the precise nature or indeed, whether it is overall increased, but it looks like it is. And I want to give some context. Patrick: (08:47) If you took somebody in their sixties, a man in their sixties, the average risk is that for a thousand people who got infected, roughly 10 would be expected to unfortunately die with the virus. With the new variant for a thousand people infected, roughly 13 or 14 people might be expected to die. So that's the sort of change for that sort of age group, an increase from 10 to 13 or 14 out of a thousand. And you will see that across the different age groups as well, a similar sort of relative increase in the risk. So that's what we're looking at, but I want to stress that there's a lot of uncertainty around these numbers and we need more work to get a precise handle on it. But it obviously is of concern that this has an increase in mortality, as well as an increase in transmissibility, as it appears of today. Patrick: (09:48) Let me say also a word about vaccines. The first is that there's increasing evidence from laboratory studies that the variant in the UK will be susceptible to the vaccines. And so I think that's increasing from a number of different sources, including looking at sera, blood taken from people who've been vaccinated showing that it can neutralize the new virus. And indeed just two days ago, one of the manufacturers of one of the vaccines, the Pfizer BioNTech team, the BioNTech team actually did studies showing that there was very good neutralization of the variant virus by the blood taken from patients or people who've been vaccinated. So I think there's increasing confidence coupled with, I think what is a very important clinical observation, which is that individuals who've been infected previously and have generated antibodies appear to be equally protected against original virus and new variant. So there's good clinical data as well to support the idea that the vaccines should be as effective against this virus as against the old one or thereabouts. So I think good news on the vaccine front. Patrick: (11:07) And then finally a word just about the South African and Brazilian variants. We know less about how much more transmissible they are. We are more concerned that they have certain features, which means they might be less susceptible to vaccines. We will see a lot of information coming out from different laboratories. It's very difficult to compare between laboratories on this data, and we need to get more clinical information to understand how much of an effect, if any, there is on the vaccine, but they are definitely of more concern than the one in the UK at the moment. And we need to keep looking at it and studying this very carefully, which is what's going on in the laboratories across the world at the moment. Boris Johnson: (11:51) Thanks very much, Patrick. And thank you, Chris. Let's go to Tracy in [inaudible 00:11:56] Wales. Tracy: (11:57) We were initially told that we would need two vaccinations against COVID-19 three weeks apart. Tracy: (12:02) Patients against COVID-19, three weeks apart. The first giving approximately 50% protection, then rising to 95% after the second dose. However, the two vaccinations are now up to 12 weeks apart. Will this reduce the levels of protection from either dose, and if so, by what percentage? Boris Johnson: (12:24) Well, thank you very much, Tracy. A very important question. I know that Jonathan Van-Tam was asked that a few weeks ago, but Chris, why don't you take that? Chris: (12:33) Okay. Thank you, prime minister. The thing with the two vaccines ... so the first thing is we are absolutely clear that everybody needs two vaccinations. The first gives the great majority, as far as we can see, of the initial protection, but the second vaccine increases that and probably makes it longer-lasting as well. So, we are still very much committed to two vaccinations. The reason for extending the course of the vaccination is primarily to double the number of people who can get vaccinated. So, there's a public health decision, and the reason for, that we think that this is a reasonable thing to do, is that because our major limitation is the number of vaccinations we actually have to give. It's not our ability to vaccinate. It's the number of vaccines we have to give. If you vaccinate everybody twice in quick succession, half the number of people will be able to be vaccinated over the next short to medium term, the next several weeks to three-month period. Chris: (13:40) So, by extending the time, what we're allowing is many more people to be vaccinated much more quickly, and then they will get their second vaccine, but they will do so with many more people vaccinated. So, that's the broad reason and both process of relatively simple math, you can think that if a vaccine is more than 50% effective, if you double the number of people who are vaccinated over this very, very risky period, when there's a lot of virus circulating and likely to be that, you're overall going to get some substantial benefit. Now, the question you asked is about will the person who's been vaccinated once have the same protection as someone who's vaccinated twice? The answer is slightly different probably between the two vaccines that we currently have deployed in the UK, the Pfizer BioNTech vaccine and the Oxford AZ vaccine. Chris: (14:35) But in both cases, we think that the great majority of the protection is given by the first vaccine, and the second one is going to top that up and to extend it over time. But we do actually have confidence that there will be a loss of protection after the first vaccination. Now, of course, we'll keep that under review, as new data comes in, but there are several lines of data that make us think it is likely that once you get protection, initially, it lasts for a reasonable period of time, including people who've had the natural infection, where they seem to have protection for many months, certainly up to five months in the majority of cases. It also looks as if that's the case with several different vaccine types, which have been tried with one vaccine and then a later dose later on, and they all have the same, essentially the same active component. Chris: (15:25) This is what's called a spike protein and they seem to work. So, that is the reason why we think it is likely that this is a reasonable thing to do. I get quite a lot of emails giving me advice from members of the public and members of the medical profession. In general, people who've been vaccinated, tend to say, why can't I have my vaccine more quickly, and people who have not been vaccinated to say, why can't I have my first vaccine? Those are both reasonable positions that people are taking. But the reality is that by doing this longer interval, many more people, essentially in the medium term, twice as many people will get a first vaccine, which provides the majority of the protection. That is the reason we're doing it. Boris Johnson: (16:07) Thanks, Chris. Patrick, anything you want to add? Patrick: (16:09) [inaudible 00:16:09]. Boris Johnson: (16:11) Thank you very much. Let's go, just to go to Sally in Oxfordshire. Sally from Oxfordshire asks are those of us who have had the vaccine now allowed to mix together with others who have been vaccinated? Again, I think I'd probably better defer to Chris and Patrick on that. Chris. Chris: (16:27) Oh, several things to say, The first one is, even with a very effective vaccine and the two vaccines we currently have are very effective, there is a period of time straight after the vaccine, where there is no effect. You don't expect to see with these vaccines, and you don't see in the clinical trials of any of the vaccines an effect for two or three weeks after the first vaccine. So, the first thing is you have virtually no protection initially, and then that protection will steadily increase from two to three weeks onwards, and probably continues to increase over time. But that protection will not be complete, and even with two vaccines, it won't be complete. It's probably a bit less with the first vaccine, and at the moment, a very large proportion of the people you might come into contact with could well have the virus. Chris: (17:16) You saw the data right at the beginning, and what they showed is that at this point in time, across the England, as a whole, on average, one in 55 people have got the virus and in places like London, where there's a lot, it drops to maybe one in 35. So, the risk is, if you have the vaccine, you still have some residual risk, and the person you're meeting is probably not vaccinated, and there's a high chance they have the virus. So, we need to do three things, vaccinate people who are at risk as we are, and get them their second dose. We need to vaccinate the rest of the population so that the person they come into contact with is vaccinated, and we need to get the rates above all, the rates of the virus right down. Chris: (17:57) That's what everybody is doing by staying at home. Only going out for essential things like exercise, work and essential shopping. That is what is happening, it is getting the rates right down, so if you do go out and you've had the vaccine, ideally the second vaccine, you'll meet people who have been vaccinated, because there's more vaccine and the rates are much, much lower, so your chance of meeting someone with the vaccine improves. So, over time, the answer will be yes, but at this point in time, the answer would be, no, we think you should still be very cautious. And, like everybody else, you should be staying at home and not going out, except when you need to for exercise, essential things or work. Patrick do you want to- Patrick: (18:35) [inaudible 00:18:35] I think to answer that, which is that the vaccines are very effective at protecting severe disease and symptomatic disease. We still don't know exactly how effective they are at stopping you from catching the virus or passing the virus on. So, it's very important for people who are vaccinated, even if they're after two or three weeks, not to assume that they can't catch it and pass it on to somebody else. That's why it's important that we all stick to the rules at the moment, until the rates come right down, and it's possible to release some of the measures. Boris Johnson: (19:05) Thanks very much, Sally. Let's go to Hugh Pym from the BBC. Hugh Pym: (19:09) Thank you, Prime Minister. In the light of the new information, do you expect the daily reported death toll to carry on rising for longer than you'd first thought, and then fall more slowly? And, on a different subject, what do you make of reports from Israel that the first dose of the Pfizer vaccine may not be as effective as first thought? Boris Johnson: (19:32) Well, Hugh, I mean, I'll have a stab at the first, in the sense that we think, looking at the numbers of infections that we've sadly seen as a result of the new variant, that big surge that the country saw in the Christmas period and afterwards, which is sadly still going on as a result of the new variant, the death numbers will continue to be high. I wouldn't really, for at least, for a little while to come. I wouldn't want to go further than that, but I think probably you should hear from Chris and Patrick or Mack, and certainly, on the point about the efficacy of the first Pfizer dose, I think that that message needs to be heard loud and clear from Chris and Patrick. Chris: (20:21) I'll answer the first on., Patrick might want to come onto the data from Israel. On the first one, the shape of when mortality occurs, which is your point about when is it going to occur, that's driven by the rate of increase, and now hope, thanks to what everyone is doing, the rate of decrease of the virus over time, but that's going to be slow from a very high base and it's delayed. But the actual difference, if there is a difference, and so Patrick and I are both quite cautious about saying definitely there's a difference, but the slight increase that Patrick was talking about, won't change the shape of that. Obviously, it could slightly increase the proportion of people who die, who get infected, but the shape of the curve is driven by, are the rates going up or are they as they are at the moment, coming down from a very high base? So, Patrick may wants to talk about the other one. Patrick: (21:09) It's just, I mean, the death rate's awful, and it's going to stay, I'm afraid, high for a little while before it starts coming down. That was always what was predicted from the shape of this, as Chris has said. I think the information about the new variant doesn't change that. In terms of the Israeli data, I think that was information from one of the organizations that organizes health in Israel, and I think there are four. And, it was some preliminary data that came out on the numbers. I think Israeli Health Ministry has said that they're not entirely sure that those are the final data and they're expecting the effects to increase. So, I think it's very preliminary. I mean, these are preliminary information from a subset of people. They haven't followed people out for long enough. We had a discussion with the Israeli advisors yesterday and they're expecting to get more information over the next few weeks. Patrick: (22:02) I think we're going to have to monitor this very carefully. I mean, we're going to have to keep looking at data and understanding the performance of vaccines in the real world, but the trial data, are very persuasive. These are highly effective vaccines and we would expect that to translate into what happens in real practice. Boris Johnson: (22:20) Thanks very much. Let's go to Dan Hewitt at ITV. Dan Hewitt: (22:25) Thank you, Prime Minister. Given what we know about this new variant, how likely is it that the current lockdown restrictions are going to last longer now, perhaps beyond the spring into the summer? And, are you considering tougher restrictions in the short-term and a question of if I may, to Sir Patrick Vallance how much of the South African variant do you estimate is already here and how likely is it that a strain similar to the South African or the Brazilian variant developing here? Boris Johnson: (22:53) Dan, we think this is the right package of measures to deal with the new variant, and we don't want to change them. What we want is to see people enforcing them and to see people obeying them. That's the crucial thing. It's more important than anything. Any new piece of law that government produces, is public willingness to comply. I think we are seeing some signs of flattening in the data. We're seeing some areas, particularly London and the Southeast, where numbers of infections are coming down. That's very encouraging. We're seeing, perhaps a stabilizing of hospital admissions, but the rates are still very high. So, when you think about unlocking, we really can't begin to consider unlocking it, until we're confident that the vaccination program is working, until we're confident that we don't have new variants or changes in the medical, in our understanding of the virus, that might affect our calculations, but- Boris Johnson: (24:03) ... -standing of the virus that might affect our calculations. But I think most important thing is that we've got to be in a position where the rate of infection is not still so high, and it's very high right now, so for unlocking just to lead to another big rebound. I think that would be the wrong thing, the wrong way to approach it. We've got to get those rates of infection down as well. It's not just a question of rolling out the vaccine fast as that is, you can't unlock whilst rates of infection are so very high. That's obviously something we're thinking about, and that's why obeying this current lockdown, making it work, and as I say, the signs are that it is beginning to work, that's why that's so absolutely crucial to this effort. Patrick: (24:49) I think in terms of the numbers here, I think the latest data from PHE suggests that 44 of people have been detected with the South African variant. It may be a bit higher because of some uncertain results at the moment, but I think 71 is the upper limit of what they've found. But there will be cases here. There'll be cases all over the world of these variants. The key thing is to identify, contact trace, and try and make sure that we contain. Patrick: (25:19) Clearly, the lockdown that we're currently in will have a large effect to keep this contained. But it's important to recognize that there's no evidence that the South African or Brazilian variants have transmission advantages over what is already here. They wouldn't be expected to spread more quickly or take over. They may actually have less, we don't know. I don't think the fact that there are some cases here means this is going to take off and become the dominant variant. That's not what you'd necessarily expect, because it doesn't have a transmission advantage as far as we know over the current UK situation. But it's obviously important that we restrict the entrance of more variants and that we identify and contact trace those that are here. Patrick: (26:03) Chris, whether you want to add anything to that? Chris: (26:04) Well, I think the only thing to add is that the variant that we have here, the so-called B117 variant is now spreading quite widely in other parts of the world, including, for example, in Israel, which Patrick talked about. Variants do move around. They've come from the UK and they come into the UK. That's, I'm afraid the nature of these things. Boris Johnson: (26:25) But Dan, just to go back on the point about when and under what circumstances you could conceivably consider beginning to relax, it remains our intention to look at where we are on the 15th. If we can get to that JCVI, first four cohorts done, we will look at the state of the pandemic, look at what is happening and make an assessment. Obviously, we're making assessments every day on where we are. But currently, the rate of infection is forbiddingly high. I think we have to be realistic about that. Boris Johnson: (26:56) Let's go to Sam Coates of Sky. Sam Coates: (27:00) Prime minister, if the new dominant variant in this country is more dangerous than the first one, is it really right that there are more people out and about than during the first wave and that the rules are more lax? Is there not more that you could be doing to keep people safe, like you did last year? Sam Coates: (27:16) To Sir Patrick, you said that this new variant of coronavirus spreads more easily, but you haven't concluded why. Do you have any early theories as to what's going on? Any different competing possibilities? Sam Coates: (27:29) To Professor Whitty, with infections now going down, the R number below one, are we actually at or even perhaps past the peak of infections? Boris Johnson: (27:39) Sam, we are enforcing the law very stringently with increasing toughness. You'll have seen what Priti had to say about fines. We will do it. We will enforce the law. We will make sure that people don't engage in activities that would mean mass transmission of the disease or substantial transmission of the disease. But it depends on all of us. It depends on everybody watching, doing the right thing, avoiding transmission. That is far more powerful and far more effective in stopping the transmission of this virus than police action or new laws from the government. And that's what it takes. The rules are very, very clear, stay at home unless you have a very, very good reason for not staying at home, protect the NHS, and save lives. I think the people of this country really understand that. All the evidence is that they comply with the measures when it's necessary and we'll get it done. As I said, they're all signs that this is working, but it's going to need continued resolve and a determination. Patrick: (28:51) In terms of the why it may be transmitting more readily, people are looking at this in laboratories all over the world for all of these variants. I think one thing that we don't think is the cause is that people have a higher viral load and shed more virus. We don't think that's the case. It may be that it binds more solidly to the receptor for the virus and gets into cells more easily as a result of that. It may be it grows more readily in certain cell types. Those are things that people are looking at, and more information will come. But I think what we can conclude is there must be some mechanism by which it can actually, say, either bind or enter the cell somehow. Chris: (29:37) In terms of the infection rate, if you took the country as a whole and just averaged it, overall, the number of infections is broadly going down, but it's at a very, very high level and it's extremely precarious, and I really want to stress this. A very small change, and it could start taking off again from an extremely high base, and there are some areas of the country and some age groups in which it does not appear to be going down. For example, in people 20 to 30, the evidence is actually, it may still be increasing in some parts of the country. It is not solidly going down and it is very, very high. If it took off again, it would do so from a very high rate. That's in terms of infections. Chris: (30:15) In terms of hospitalizations, which are delayed because of course people get infected, they get ill, and then they go into hospital, again for the country as a whole, it's broadly flat at the moment, still going up in some parts, particularly in the Northwestern parts of the Midlands, for example, going down in parts of the East of England, South, Southeast, and bits of London. But that peak is not yet definitely going down everywhere. Chris: (30:43) And then deaths, which is the last thing, that is going to be delayed further. I think the peak of deaths may well be still in the future. It depends which peak you're talking about, but I'm just going to go back to the first point. Chris: (30:56) This is high, very high and very precarious. If people start took this moment and said, "Right, that's it. It's over." We would get back into very deep trouble, very fast. The NHS is absolutely at the top of what it can manage. If that happened again, we would be in really, really deep trouble. Boris Johnson: (31:15) Gordon Rayner, Telegraph. Dan Hewitt: (31:19) Thank you. Thank you, Prime minister. In a video posted online this afternoon, the health secretary told travel agents that the South African strain could be 50% more resistant to the vaccine than the original variant and that allowing it into the country would take us back to square one. Is that correct? And does that affect the decision you're going to take soon about whether to close our borders to all foreign travelers? Dan Hewitt: (31:48) And just quickly for Sir Patrick, in the nerve type study that you referred to earlier, I believe one of the universities, Exeter University, found that the new strain could be 91% more deadly than the original strain. I just wondered if you could address the discrepancies there between the different universities that studied it? Boris Johnson: (32:13) Gordon, I'll just come back quickly on what we're doing to protect our borders and to make sure that we stop arrivals. We stopped people coming in from South Africa, for non-UK nationals coming in from South Africa on the 24th of December. Our general policy to the world is that anybody coming in now has to test within 72 hours of flying, you have to produce a passenger locator form, and that the airline must ask you to produce both of those things and will kick you off the plane if you don't have it. You then have to quarantine for 10 days, once you arrive, or five days if you get a second test. We're actively taking some pretty rigorous measures to ensure that people do in fact quarantine. Boris Johnson: (33:10) I really don't rule out that we may need to take further measures still, Gordon. We may need to go further to protect our borders because we do not want after all the effort that we're going to in this country, the massive effort, the success that the NHS and the others are having in vaccinating 5.4 million people, as they've done, 400,000 just in one day, we don't want to put that at risk by having a new variant come back in. Boris Johnson: (33:43) As to the details of the changes implied by the South African variant, its resistance to the vaccine or otherwise, I'm going to ask Patrick to comment. Patrick: (33:58) Yeah, I'm sorry. I'm going to be a bore about this because these are difficult laboratory studies and people are trying to look at how effectively antibodies neutralize various forms of the virus or various parts of viruses, and they'll get different results in different laboratories. Not all of the immune response is an antibody response. Taking a result from a laboratory and saying, "Therefore, the vaccine will be 50% less effective," you just can't do it. We're going to see different results coming up on all of these. Patrick: (34:34) Ultimately, it's going to be clinical data that's going to tell us, and we aren't going to get clinical data because there's vaccination occurring in South Africa, there's vaccination occurring in Brazil. We will find out how effective the vaccines are against this. It is the case that both the South African and Brazilian identified variants have more differences in shape, which might mean that they are recognized differently by antibodies and therefore the laboratory studies are suggesting a decreased binding. But I think it's too early to know the effect that will have on the vaccination in people. It's worth remembering that the response of the vaccine is very, very high antibody levels, so that may overcome some of this. We don't know is the answer, but there's obviously a cause for concern. Patrick: (35:24) In terms of your comment about one of the papers, it's worth looking at all of the papers that came to the NERVTAG group, some of them suggested no increase in mortality at all. There's a range of things, and as I've said, there's also data from hospitals showing there's no difference in outcome in patients in hospital, so there's a range of data. The reason we have an expert group like NERVTAG to bring together people from different disciplines to look at this is try to come out with what they think is probably the most likely. At the moment, what they have said is there's a realistic possibility that there could be an increase in mortality. That looks like, as I said, if you- Patrick: (36:03) ... in mortality. And that looks like, as I said, if you were to take somebody in their 60s who might have 10 out of 1,000 people who are infected might die, that would change it to 13 or 14 out of 1,000. That's a sort of figure, but there's a lot of uncertainty. There's a lot more work that needs to go on. I really urge against just picking the highest number and assuming that's correct. I don't think that's the case at all. Chris: (36:26) I'll just add one point to what Patrick has just said, and that is that there are very many vaccines, which even if they don't protect from infection can prevent severe disease. So it is possible we don't know this, but what we could end up with is that the current vaccines still protect to a large degree against severe disease and dying even if they are less effective against an infection because of the change. We don't know this, but that's certainly entirely in keeping with some other vaccine. So vaccination against severe disease is often more effective than vaccination just against infection. And the first thing you're probably going to lose is vaccination against infection. Patrick: (37:04) And the key thing is get these vaccines out there and measure, measure, measure, and assess what we're doing. Boris Johnson: (37:10) Thanks Gordon. Thanks [inaudible 00:37:11]. Peter Walker of the Guardian. Peter Walker: (37:12) Thank you very much. Prime Minister, you've struck quite a cautious note, but at the same time, people are going to look at the vaccination figures and think, well, if we vaccinate all the vulnerable people quite soon, then life could return to normal by Easter, maybe a month or two after that. But scientists this week have been very, very strong in saying that lockdown measures would have to be lifted very gradually, and the mitigation measures might need to be in place for quite some time. Do you think the British public are ready for quite how long it could take? And for Sir Patrick or Professor Whitty? Do you also agree that we could have mitigation measures in for quite a long time? Boris Johnson: (37:53) Well, Peter, I think that we will have to live with coronavirus in one way or another for a long while to come. I think that it is an open question as to when and in what way we can start to relax any of the measures. And it depends entirely, as I said earlier on, on lots of different things. It depends on the vaccine rollout continuing to go well. It depends on there being no further discoveries about what new variants can do. It depends most of all on getting the overall incidents down to a level from which it can't just take off again in the way that we've seen it do before. Boris Johnson: (38:39) We'll look at things continuously. Obviously, we want to do everything we can to open up, but only safely, only cautiously. And I think that that is my view, that is overwhelmingly what the British public want. And I also think that British public and British business, we would much rather we opened safely and cautiously when it was right to do so rather than opening up again and then being forced to close back down simply because the virus takes off again. Boris Johnson: (39:12) And do you see what I mean? I think that is a far more sensible approach. That doesn't mean I'm not optimistic about the rollout of the vaccine and the amazing pace at which it's happening, the change that could mean, that could mean, but at this stage you've really got to be very, very cautious indeed. And I should just to add by the way that the first thing that we want to be able to reopen, if we can make any progress will of course be schools, and that remains the priority. Patrick: (39:48) I don't think this virus is going anywhere. It's going to stay around. And therefore the answer is it's going to be around, I think probably forever as a virus, but it will be controlled. And there is remarkable progress occurring now. The vaccines are being rolled out at an unprecedented pace. We've got more vaccines than we could ever have dreamt over a year ago. The idea that we've got many vaccines coming through the pipeline is incredibly important, including ones that we can alter as needs be. Patrick: (40:18) And there are new medicines coming along, including specific antiviral drugs which will be going into the clinic over the course of this year. So I think there's a very different outlook as we go through the year. The key thing I think is to keep watching, measuring and assessing where we are and not getting too hooked up on specific dates because we don't know at the moment. We need to watch, weight, measure and release carefully as we go through. Would be our advice, Chris [inaudible 00:00:40:46]. Chris: (40:47) I completely agree with the PM and Patrick. Boris Johnson: (40:49) Thanks very much, Peter. Tim Ross, Bloomberg. Tim Ross: (40:54) Question two, Patrick Vallance and Chris Witty. SAGE minutes from a meeting on January the seventh say there's an unquantifiable, but likely small probability of the delayed second dose generating a vaccine resistant mutation. In layman's terms, does that mean that the decision to delay the second dose actually risks making the virus itself more dangerous? And if so, what are you doing about that? And the question to the Prime Minister, you mentioned businesses wanting to avoid the cycle of lock downs and unlocking again, but the furlough program is due to come to an end at the end of April. Can you at least now give some reassurance that you will continue further or consider continuing furlough after that point if restrictions are still in place? Patrick: (41:38) The most risky thing in terms of new mutations is to have very high prevalence. The more the virus is replicating and transmitting between people, the likely, the more the chance that it will get a mutation and alter, and that's what's happening around world. And that's why we're seeing the same mutations pop up everywhere. So these mutations have not come about because of vaccine pressure or anything else. They seem to be mutations that the virus accumulates naturally during replication as it wants to get more efficient at transmitting. And so I think that's the biggest risk. Patrick: (42:19) There's always some risk if you start to have partial immunity, but there's also a benefit, which is partial immunity can actually stop the infection quicker. And so I think that was a statement from the immunologists and appropriately cautious one, but I don't think it's the biggest risk. Chris: (42:36) All of medicine is about balance of risk. And it is important we consider the risks on both sides and we don't try and just only look at the positive sides than the course of action, we look at both sides. That's what SAGE is doing. That's what we've tried to do in all the decisions we've taken. Our overall view was the balance of risk was firmly in favor at this stage of the epidemic in the UK of having many more people vaccinated. But that does mean the delay, but I think most people would agree that the risk that was identified, that particular risk, was a relatively much smaller risk than the risk of not having people vaccinated, which essentially was the alternative. Boris Johnson: (43:13) Tim, and on your point about support for business and for jobs, we'll do whatever it takes to support the people of this country throughout this pandemic. Support jobs, support livelihoods as we have done throughout. But obviously the faster we can roll out the vaccine, the faster we can get on with giving businesses what they really want, which is a certainty about being able to resume something like life and businesses as usual. But getting that depends as I think, has being a pretty consistent message this afternoon. Getting that depends on our ability, not just to roll out the vaccine, but also to make sure that we work together to get the infection rate down, and that means obeying the rules today. Stay at home, protecting the NHS, saving lives. Thank you all very much. Thank you.