United Kingdom Coronavirus Briefing Transcript April 7

Dominic Raab: (00:00) A lot of people would be concerned about that. I can tell you he's receiving the very best care from the excellent medical team at St. Thomas's hospital. He remained stable overnight. He's receiving standard oxygen treatment and breathing without any assistance. He's not required any mechanical ventilation or non-invasive respiratory support. He remains in good spirits and in keeping with usual clinical practice, his progress continues to be monitored closely in critical care and we'll give further updates on the PM's condition when there are any material developments. I know that there's been a groundswell of messages of support from people here at home, from leaders across the world and I know that everyone will want to join with me in wishing the prime minister a very swift recovery. As you all know, the prime minister asked me to deputize for him whilst he recovers. Dominic Raab: (00:54) In line with the prime minister's instructions, this morning I chaired the meeting of senior ministers tackling coronavirus and this afternoon I chaired an update for members of the Cabinet. I think it's probably worth just remembering that as will be the case for many people up and down the country who knows someone at work who's fallen ill with a coronavirus, it comes as a shock to all of us. He's not just the prime minister for all of us in Cabinet, he's not just our boss. He's also our colleague and he's also our friend. So all of our thoughts and prayers are with the prime minister at this time, with Carrie and with his whole family. I'm confident he'll pull through because if there's one thing I know about this prime minister, he's a fighter and he'll be back at the helm leading us through this crisis in short order. Dominic Raab: (01:49) Of course, for us in Cabinet, we know exactly what he wants from us and what he expects from us right now. Following the Cabinet discussion today, I can reassure the prime minister and we can reassure the public that his team will not blink and we will not flinch from the task at hand at this crucial moment. We will keep all of our focus and all of our resolve with calm determination on delivering the government's plan to defeat the coronavirus. It's with that objective and with that unity of purpose that the Cabinet turned to business today. We had reports from four ministerial groups on the action we're taking across all of the strategic priority areas, including NHS capacity, procurement of ventilators, and personal protective equipment, the delivery of public services including social care, on the economy, and our support for both businesses and workers, and of course on the international action we're taking to reinforce our efforts on the home front. Dominic Raab: (02:49) As we've explained before, our action plan aims to slow the spread of the virus, so fewer people need hospital treatment at any one time and that will help us protect the NHS's ability to cope. At every step, we've been following the scientific advice, the medical advice, and we've been very deliberate in the actions that we've taken so that we take the right steps at the right moment in time. We're increasing our NHS capacity by dramatically expanding the number of beds, key staff, lifesaving equipment on the frontline so people have the care they need when they need it most. As we've consistently said, we're instructing people to stay at home so we can protect the NHS and so that we can save lives. Dominic Raab: (03:37) So today, I can report that through the government's ongoing monitoring and testing program that again, as of today, 213,181 people have now been tested for the coronavirus, 55,242 people have tested positive. The number of people admitted to hospital with coronavirus symptoms now stands at 18,589. Of those who have contracted the virus, 6,159 have, I'm very sorry to say, died. Every death in this pandemic is a tragedy and our thoughts and our prayers are with their loved ones at what must be an incredibly difficult time. I think these figures reinforce that the single most important thing that we can all of us do right now in this national effort to defeat the coronavirus is keep on following the government's advice, which is to stay home, protect the NHS and save lives. I'll now turn to Sir Patrick who I think will talk us through some of the data. Sir Patrick: (04:39) Thank you very much. May I have the first slide, please. It's worth remembering this is a brand new illness. It transmits relatively easily and in some people of course, it's severe. It's therefore important that we break the transmission in society we do not allow this virus to go from household to household and that's what the social distancing measures are about, trying to slow the rate of transmission. In order to know whether those measures are working, we track a number of things and here you can see the transport use change which we've shown before indicating very substantial reductions in the use of London Underground, the buses, national rail and indeed, use of all motor vehicles. This and other measures show that the contact between people has reduced dramatically as a result of the social distancing measures that have been put in place. That, in turn, should lead to a substantial reduction in the transmission of the virus in the community. Sir Patrick: (05:44) This, if I can have the next slide, please, moves then through into the fewer new cases appearing is the aim to try and reduce the number of new cases. This shows the number of cases since the 16th of March through to the 7th of April and what you can see is there is not that big upswing of growth that we talked about at the beginning. There is a fairly steady increase in numbers. It's possible that we're beginning to see the beginning of change in terms of the curve flattening a little bit. We won't know that for sure for a week or so, but what we're not seeing is an acceleration. It's important that we keep these new cases down because of course, this in turn, leads to the number of people going into hospital. The aim all along is to reduce the number of cases below the capacity for the NHS and to save lives. Can I have the next slide, please? Sir Patrick: (06:43) This graph shows the number of hospital admissions in London at the top and then in other areas you can see, again, there's been a steady increase since the 16th of March up until the 7th of April, but there hasn't been the accelerated takeoff. Again, it's possible that we're beginning to see the start of a change where we might see numbers flattening off. We won't be sure about that for a week or so and we need to keep looking at it, but it does begin to suggest that things might be moving in the right direction in terms of numbers. It's important that we carry on with the measures we've got in place in order to make sure that this does go in the right direction. The important thing beyond these numbers is what happens in intensive care units and that we keep the intensive care unit number down as well. That's another thing which may be moving in the right direction, but I do want to, here, say a big thank you to everybody in the NHS, the frontline staff who are working so hard to make this work. Sir Patrick: (07:49) One other point, as well as looking at numbers, there are clinical trials starting trying to look at treatments that might make a difference. As of this afternoon there are over 1,900 patients in clinical trials across a hundred hospitals. That's an important part of how we're going to tackle this. The ICU beds are important, and the next slide, please, shows that the number of ICU beds has been increasing. So this is a graph over time from the 21st of March, the 6th of April showing an increase in the ICU beds that's been most marked in London, which has had the biggest outbreak so far, but it'll increase in the rest of the country and the new Nightingale hospitals in London, Birmingham, Manchester, Bristol, Harrogate, and further increases in capacity of what the NHS is planning for to cope with the numbers that we're talking about. Sir Patrick: (08:44) Finally, I've talked about the beginning, I talked about the fact that we need to see that coming through into admissions to hospitals and to ICU, and then it takes a few weeks for that to feed through, unfortunately, for some people into death and I'd like to just show the death figures. So these are the graphs showing the numbers of deaths across different countries. You can see that despite a little uptick in the numbers today and the numbers do bounce around the UK is on track. We're roughly a couple of weeks behind France, a few weeks behind Italy in terms of the numbers, but you can see that broadly, things across Europe move in the same direction. We would expect the numbers of deaths to lag after the ICU cases by a couple of weeks. So we should expect these to start coming down in two or three weeks time. Thank you for foreign secretary. Dominic Raab: (09:34) Thank you, Patrick. I'm now happy to take some questions from the media. Laura Kuenssberg from the BBC. Laura Kuenssberg: (09:41) Thank you very much for foreign secretary. With the prime minister, absent at this vital time, if there is a genuine disagreement in the Cabinet, who actually makes the decision? If I can ask the chief scientific advisor, you've shown that there has been an increase in the capacity of the number of intensive care beds available around the country, but on the current numbers, will there be enough beds as this grows? Dominic Raab: (10:05) Well, first of all, decision-making by government is made by collective Cabinet responsibility. So that is the same as before, but we've got very clear directions, very clear instructions from the prime minister. We're focused with total unity and total resolve on implementing them so that when he's back, and I hope in very short order, we will have made the progress that you would expect and that the country would expect. Sir Patrick: (10:30) In terms of the ICU beds, and Chris Whitty has being clear about this as well, there are always times in every winter when ICU beds top out in individual hospitals and that may happen and I can't guarantee it won't. What we can say, though, is that the numbers as we look at them now, look as though we should come in about right. There shouldn't be an overall increase above the number of beds available. The NHS I think has done an amazing job of increasing the capacity of ICU and so things seem to be tracking in the right direction, but I don't think I can say more than that. I don't know, Chris, whether you want to add anything. Chria Whitty: (11:05) I agree. Dominic Raab: (11:08) Laura, is that okay? Did you want to come back on any of it? Laura Kuenssberg: (11:11) Yeah. The Foreign Secretary Cabinet always, in theory, runs on collective responsibilities, but there are always times when, in the end, one person has to make the decision. In normal circumstances, the prime minister is the ultimate decision-maker. In these circumstances, are you that person or what happens if there is no agreement? Dominic Raab: (11:30) Well, as I said, we've got collective cabinet responsibility but the arrangements are very clear. The prime minister has asked for me to deputize for him to start just starting the responsibilities for as long as he's unable to do that. We've got in the discharge of those responsibilities and frankly the direction instructions, he's given very clear plans. So we're all focused with a unity of purpose in a clear and calm determination to get that done from the procurement of PPE, getting it to the front line to supporting businesses and all of the work in DFID and the foreign office that we're doing out on the international level to reinforce that effort on the home front. Robert Peston, ITV. Robert Peston: (12:12) Good afternoon. Mr Raab, you say that you have very clear instructions from the prime minister about what to do, but if there needed to be a significant change of direction, do you have the authority to make that change of direction or would you wait for the prime minister's return? If I could ask Sir Patrick and Mr. Whitty, your own chart today does show the rates of growth in the number of deaths in Germany is much slower than the other European countries, including the UK that you cite. What is there that we can learn from Germany? Dominic Raab: (12:56) Well, Rob, on your question to me, I'm being tasked when I was appointed, given very clear steer from the prime minister and obviously, as we've been going through this crisis, very clear instructions in terms of dealing with coronavirus. He's asked me to deputize for him for as long as is necessary, but the normal Cabinet collective responsibility and principles that inform that will apply. Patrick. Sir Patrick: (13:19) We look at all of the countries and try and understand what differences there are in terms of responses. We look right the way across the world in regular contact with the chief scientific advisors and chief medical officers in other countries to try and understand different approaches taken and different effects. You're right, the German curve looks as though it's lower at the moment and that is important. I don't have a clear answer for you to exactly what it is the reason for that. There are obviously two things that one we'll look at in terms of any response to any outbreak. Sir Patrick: (13:51) One is the virus itself and the other is the society into which that virus comes. There are things to do with demographics, there are things to do with the way systems are organized and, of course, that may be differences in the way certain responses have been taken and we don't know, but we're in regular contact with the other countries. Again, I'll see if Chris wants to add anything to that. Chria Whitty: (14:09) What I think that the one thing I'd add to that is we all know that Germany got ahead in terms of its ability to do testing for the virus. There's a lot to learn from that and we've been trying to learn the lessons from that. Dominic Raab: (14:20) Did you want to follow up there, Rob boy? Robert Peston: (14:22) Well it was just, you didn't quite say that you feel confident that if you had to make a change of direction and you weren't able to communicate with the prime minister, would you have the confidence in doing that? Dominic Raab: (14:37) I've got total confidence in the arrangements that the prime minister has put in place so that I can discharge the responsibility for him, deputizing for him while he's out of action. Obviously, we hope that we'll be for a very limited period of time. Mark Austin from Sky. Mark Austin: (14:52) Thank you very much indeed, foreign secretary. First and foremost, everyone on this program and everybody at Sky News send their very best to the prime minister. We wish him a speedy recovery. My question is this, the prime minister is in intensive care. The health secretary caught the virus, the chief medical officer caught the virus. We're very pleased to see him back at work, but three key people responsible for telling the country how not to get it, got it. So with respect, and I mean it is with respect, how did it come to this and how was that allowed to happen? Dominic Raab: (15:28) Because you have a virus which is totally indiscriminate. We follow, all of us, the guidance as carefully as possible, but it's a very dangerous virus. It's very contagious and it just goes to show that no one is impervious to it and we all need to follow the guidance, both to the letter and spirit. Did you want to come back? Mark? Mark Austin: (15:57) Yeah. And Chris, does he have an answer? Chria Whitty: (16:00) Well, the answer is exactly the same, really. We all know that this is an extremely easy virus to pass on. That is exactly why the lockdown was necessary. That was why the very large number of things that we've had to ask people to do and not do are in place because it is extremely easy to catch this virus and it is extremely easy to pass it on, even if people take really careful precautions in terms of things like washing their hands, which remains critical. So I think it's a very clear illustration of the fact that this is why we're having to do this to ensure that we protect the NHS and save the lives of other people. Dominic Raab: (16:38) Jason Groves from the Daily Mail. Jason Groves: (16:43) Thanks, Mr. Raab. You mentioned that you've had instructions from the PM. I wonder, have you had instructions about what he wants to do about the looming decision on whether to extend the lockdown and can you give the country any idea of what that might be? We're seeing Germany and Austria level with people about how long things might take and how they might be lifted. A question for Sir Patrick, last month in that room you told us we were three or four weeks behind Italy. We've seen, given the shocking death told today, to still be getting a similar outcome to Italy. Are there things that we could and should have done or was this outcome always inevitable and are things we can do now to make a difference? Dominic Raab: (17:27) Well, Jason, just in terms of the review, we're not at that stage yet. We will take any decision when the time is right based on the facts and the scientific and medical advice. Our number one and our overriding focus right now, as has just been demonstrated by the previous question, is to remain absolutely focused on conveying the key message, which is everyone needs to keep adhering to this guidance. We've got a long bank holiday, Easter weekend coming up, warm weather. We understand that people are making big sacrifices to follow this guidance. It is helping. It is contributing to our ability to tackle the coronavirus. The worst thing now would be to take our foot off the pedal to ease up on that and risk losing the gains that have been made. So it's absolutely critical that people keep up that discipline and the vast majority will and we hope everyone will follow that example because it is the way to make sure we consolidate the progress we've made and don't lose the progress we've made. Chris, [crosstalk 00:18:31]. Chria Whitty: (18:31) It was Patrick- Dominic Raab: (18:31) Oh, it's Patrick. Apologies. Sir Patrick: (18:32) So this is a pandemic meaning it's everywhere and that's why we're seeing it across many different countries and across all populations. We are probably three or four weeks behind Italy in terms of the outbreak. It doesn't mean we end up with the same numbers and of course it's important that as the ICU capacity has been built up, this idea of keeping the numbers below the ICU capacity, that's absolutely critical. It's also worth just reflecting on the fact that the most important thing we can do is to implement the measures that are in place now to keep this suppressed. That's really, really important. It's what we need to be focused on now. It's how we're going to come out the other side to be able to say that the numbers are under control and we can then move on to the next phase. Dominic Raab: (19:21) Do you want to come back, Jason, on any of that? Jason Groves: (19:24) Well, just to clarify, Mr. Raab, it sounds like the instructions you're getting from the PM is that this lockdown is going to have to stay. We are going to have to keep our foot on the pedal for a few more weeks at least. Is that a fair interpretation? Dominic Raab: (19:36) No, I think we've been clear all along. We'll be guided by the evidence that are the measures that we put in place on social distancing, on everything else, the impact that they've had. Once we've got reliable data on that, which will come up in the days ahead, we can consider whether and when and how we want to take any further decisions. But our number one focus right now is to keep the discipline of compliance with those measures because it will help us make progress. That's the way we'll get through this crisis and get out the other side as quickly and as effectively as possible. Heather Stewart from The Guardian. Heather Stewart: (20:13) Oh ,hello. This is a follow up to Jason's question, to some extent. Were you suggesting now there that we won't see a three-week review of the lockdown measures as we were promised when they were put in place, that we won't see that if the prime minister is still in hospital. Will you wait until he's not in hospital to do that? Slightly more broadly that the modeling that was published on Friday with the London School of Hygiene and Tropical Medicine suggested that measures might have to stay in place for many months, social distancing for many months, at least, they said, with periodic lockdowns in order to keep the outbreak within the capacity of the NHS? I wonder whether that seems plausible and whether it's now time to level with people, with kids who are wondering whether they're going to see their friends before the end of the summer term and so on, that this is going to have to go on for months, not weeks? Dominic Raab: (21:02) Well, I think we have leveled with everyone from the outset. We've been as transparent as possible in relation to all of the data and all the information. That's why we've got the chief scientific advisor and the chief medical officer here. But the critical thing is to take evidence-based decisions. So we've said that we will take any review once we've got the evidence, the measures are working and having the kind of impact taking us past the peak, which means that they can be responsibly done. We're not at that stage yet. CMO, do you want to add anything? Chria Whitty: (21:31) Anything I'd add is really what we said yesterday. I think it's really important that we get to the point that we all are confident that we're beyond the peak and then at that point, start making it clear what combination of things and over what period of time seems a sensible combination to take us through. Because as I said yesterday, there are a large number of different things we need to take into account here in terms of the impact on health, the direct effects of the virus itself and also the indirect effects on the health service more widely. Dominic Raab: (22:02) Heather, do you want to follow up or anything else you want to- Heather Stewart: (22:05) Yes. In terms of when we might see that review, it depends on when you feel you have enough and relevant enough data? We won't necessarily see it [inaudible 00:22:17] Dominic Raab: (22:16) It'll be evidence based and so we'll rely on the evidence we get from the impact of the measures that have already been taken. As Chris said, what we need to do is get beyond the peak when we can responsibly take any further decisions based, as I said, on the evidence that we've got, we've set that position out all along and we want to follow it because it's the right thing to do. Again, it's the right thing to do to get as effectively and as quickly as possible through the coronavirus challenge. Joe Murphy from The Evening Standard. Joe Murphy: (22:45) Mr. Raab, I join you in wishing the best to the prime minister and his recovery. Can you say how the government is doing on course to meet the target of 100,000 tests per day? As the man who's now in charge, will you ensure personally it's delivered by the end of the month? Professor Whitty, a lot of people are worried that care homes for the elderly are not getting the same support of other branches of the health and care service. Can you address such worries whether doctors and nurses will go into homes rather than simply [inaudible 00:23:20] patients, whether there'll be medically qualified professionals going in and whether you can stop agency nurses from, or carers rather, from looking after more than one home and then risking spreading? Why are the deaths in care homes not included in the daily tally of figures? Dominic Raab: (23:40) Thanks, Joe. So just on the most recent data that's been released on tests, there were 14,000 in a single day and so that shows progress. We've had 7,500 NHS workers and their families tested and we've got nine drive through sites currently operational in Nottingham, Chessington, Greenwich, Wembley, Sandwell, Manchester, Belfast, Edgbaston and Glasgow and Cardiff will be the 10th, which will be open shortly. So we're all making progress on that. In terms of the data, a question on RNS versus the NHS, I don't know whether Sir Patrick, you wanted to address that. Sir Patrick: (24:16) I'm happy to do that. The international reporting standard for death, all the other countries are based on hospitalized deaths confirmed and that's the same as the data that you're seeing. The ONS data, which are important look at overall deaths on death certificates where coronavirus is mentioned so that they are not confirmed deaths necessarily. It's important to have both of those, but that's what the difference between the two numbers is. Joe Murphy: (24:41) So is that on the care homes? Chria Whitty: (24:42) On the care homes, so firstly, just to add to that, the ONS data does include care home deaths. The hospital data obviously does not, so it's one of the key differences. In terms of the looking after the residents of care homes and indeed nursing homes, we've said right from the beginning that this is one of the most difficult things we have to do and one of the most important things we have to do. That needs to, in a sense, balance the needs to have the right nursing, medical and other care support for the care homes whilst minimizing people going into care homes unnecessarily because almost by definition, most residents of care homes are relatively vulnerable people. Chria Whitty: (25:25) It is important we get that balance right, that we protect people, for example, when they come back from hospital that they do get the right medical care. But as I said right at the beginning of this epidemic, care homes and nursing homes are going to provide us with some of the biggest challenges. We have seen already that over 9% of care homes have reported cases. I regret to say, I think the number will go up over time despite excellent work by the care homes staff, by nurses who go in and by doctors. I would encourage people not to go into care homes unless they need to. Dominic Raab: (26:03) Rob Merrick from the Inde. Rob Merrick: (26:04) Thank you very much, foreign secretary. A question first for Professor Whitty. The Independent has sent a letter to GPS from Jenny Harris, which appears to raise concerns that some highly vulnerable people who need to be shielded are not being shielded. We've spoken to the family of a 95-year-old deaf, blind woman who's totally dependent on her daughter for care. She doesn't meet the criteria, she's been told. Are you concerned that there are many, many people out there who are not being shielded as they should and what are you going to do about that? And a question please, for you, Mr. Raab, returning to Joe's question, the government made a promise to the British people last week that a 100,000 daily tests would be carried out by the end of the month. We learned yesterday that the antibody tests won't be ready by that date. So can I just be clear? Are you now promising you will carry out 100,000 daily antigen tests, the test for the virus itself by the end of the month? If you can't meet that commitment, will somebody carry the cap? Dominic Raab: (27:03) Well, just on that, I think the health secretary was very clear on the target. What I've tried to set out is the progress that we've made. Clearly more work to do, but important that we've made the progress we have so far. Chris. Chria Whitty: (27:14) So the situation of shielding, is that there are broadly three groups of people who we've asked to do different things. There's everybody who we really want to stay at home unless they're going out for work, for necessary food and medicine, for medical care or for exercise. We've really been very clear about that because that is the way we protect everybody, including the people who are shielded. Then there's a higher risk group of people who are people, on the whole, who are over 70 and have pre-existing health conditions, which makes up roughly 16 million people overall. Chria Whitty: (27:52) The recommendations are the same for those, but we really need them to do it for their own protection. It's not just to protect the NHS and to protect wider society or that helps with that, but it also really helps to protect them. But there's this particularly vulnerable group of around about just under 1.5 million people. The exact numbers are kind of being sorted out at the moment, who we are very keen to have the absolute minimum contact possible for quite a long period of time. I think what we've been very clear is that there's a group of people who we are able to identify, which is the great majority, who have been identified and written to in the first wave and there's a second wave of letters going out today from NHS digital, over this week, which is we have identified centrally from their medical records, this is necessary. Chria Whitty: (28:44) There are additional people that have been identified either by specialists, medical groups, or in some cases, by GPs who know that someone has got a group of conditions or a particular condition that isn't on the list but makes them particularly vulnerable. But equally, so people are being added to the list as a result of that. Equally, there've been some people who will have taken a decision in discussion with their GP that they simply do not wish to be part of this, that the idea of being for many weeks completely cut off, at least physically, from a society except for the absolute basic necessities. Of course, we hope people will be linked to people by social media and other areas that this is not something they wish to do. Chria Whitty: (29:26) This particularly, for example, might apply to people who have had a terminal diagnosis and doing palliative care and are on the last stages where they would just make a rational life decision that was not what they wish to do. So there will be people in terms around the big group who will have been identified. There will be some people who go into the shielding program who are not initially identified and there'll be some people who initially were identified who either because their medical condition is different from how it has been centrally recorded or because of their own choices in discussion with their doctor who will choose not to be part of that. That was always something we expected to happen. Dominic Raab: (30:05) Did you have a follow up, Rob? Rob Merrick: (30:07) Can I come back to you, Mr. Raab? I don't think you really answered my question. Just to be clear, we know that the antibody tests will not be ready by the end of the month. Can you say, is your promise now today that the government will carry out 100,000 daily antigen tests by the end of the month? Dominic Raab: (30:23) Well, I'm not going to say anything different from what the health secretary's already said. What I hope people understand is that we are striving every sinew to get both sets of tests to the highest level we can. That involves tapping the domestic sources and supplies, but also using the foreign office network. We're teaming up with DFID and the Department for International Trade to try and get as many international suppliers. But of course, lots of these things are in very high demand, but we are doing everything we can on every front to get all of the testing capabilities we need. Yes, the health secretary's 100,000 per day target still stands. Thank you all very much.