United Kingdom Coronavirus Briefing Transcript May 1

Matt Hancock: (00:12) Good afternoon and welcome once again to the Downing Street Daily Coronavirus Briefing. I'm joined by Professor John Newton who coordinates our work on testing and by Professor Steve Powis, who's the medical director of the NHS. Matt Hancock: (00:27) Every day we're working through our plan to protect life and protect NHS by slowing the spread and building the capacity so at all times the NHS has got the capacity to give the very best care to everybody who needs it. In today's briefing after setting out the daily statistics, I want to talk about testing. But beforehand, I'd like to share some really good news. Matt Hancock: (00:58) Earlier this week I said that we are now able to begin the restoration of NHS services. Now, we're past the peak, I can tell you about the next step, the restoration of fertility services. Few families have been untouched by the amazing advances in fertility treatments over past generation. And I know just how time sensitive fertility treatment can be and how important it is for the families affected, and I know that this treatment can change lives for better forever. When I say thank you to all of you, everybody watching, for staying at home to protect NHS, of course, I'm saying thank you on behalf of the lives that you're saving, but I'm also saying thanks on behalf of the lives that the NHS can now once again help to create. Because together we've protected NHS, and we're now restoring the NHS and restoring the chance for so many couples to start a family. Matt Hancock: (02:15) Turning to the figures. 177,454 people have tested positive for coronavirus, an increase of 6,201 since yesterday. 15,111 people are currently in hospital with coronavirus and 27,510 people have now sadly died across all settings, an increase of 739. As one, we will remember them and treasure their memories. This is a virus that has a devastating impact on families, on friends, on local communities. Right across government, we're working day and night to defeat it. Matt Hancock: (03:04) At the beginning of last month, at this podium, I set a goal that anyone who needs a test should get a test and that as a nation we should achieve 100,000 tests per day by the end of the month. I knew that it was an audacious goal, but we needed an audacious goal because testing is so important for getting Britain back on her feet. I can announce that we have met our goal. The number of tests yesterday on the last day of April were 122,347. This unprecedented expansion in British testing capability is an incredible achievement, but it is not my achievement. Matt Hancock: (03:57) It is a national achievement achieved by a huge team of people working together. And I tell you this, the testing capacity that we've built together will help every single person in this country. Testing is crucial to suppress the virus. I know from personal experience too, just how much people with symptoms want to know if they've got the disease. I know that I did. It helps remove the worry, it helps keep people safe and it will help us to unlock the lockdown. So many people have tragically died and the challenge we still face is vast, but we're making real progress. Matt Hancock: (04:43) I want to take a moment to thank and pay tribute to the incredible team who did this together and who joined in one of the greatest national mobilizations that we've seen. We brought together the best civil servants, the best minds from the private sector, the best scientists, the best lab technicians and the best of the best in the armed forces. Setting, stretching ambitious goals in a crisis has a galvanizing effect on everybody involved. It is a mission. If we hadn't been so bold, if we'd chosen a safer, easier path, I just can't see how we would have built the capacity that we need. Matt Hancock: (05:23) In a few short weeks, we've created a new test for the virus in PHE, we've built a network of regional testing centers, we've put a fleet of mobile testing units on the road, and created home testing kits so if you can't get to the test, we can get the test to you. We've more than doubled the capacity of NHS Public Health England labs and created three brand new mega labs to analyze the results. Matt Hancock: (05:52) So many people have played a part in this work: British diagnostic companies like Randox and Oxford Nanopore and Medical Wire and DNANudge, and Samba; logistic companies like the Royal Mail and Yodel who were brilliant and got us out of a real hole this week: academics like Professor Derek Crook and Sir John Bell from Oxford and Professor Ara Darzi from Imperial; Deloitte and Boots, who've delivered our drive through centers; AstraZeneca, GSK and Novacyte whose labs go on stream next week; Public Health England and the NHS, of course, who pulled out all stops; Professor Sharon Peacock, Professor John Newton and the UK Biocentre and the Crick, who sets up high tech laboratories. And also it wasn't just a national effort, but from across the world, including ThermoFisher, Hologic, Abbott and Amazon from the US, Qiagen from Germany and Roche from Switzerland. Matt Hancock: (06:50) And this is how we did it. Because everybody worked together with grit and determination to reach a shared goal, and they thrived because the team contained diversity of perspectives, of background and, critically, a diversity of thought. And when things went wrong, which they did every single day, believe me, we didn't ask who we could blame, we asked how we could fit it. Matt Hancock: (07:19) So to my team. I want to say you toiled tirelessly night and day and I'm so proud of what you have achieved. And to all of you, on behalf of government, on behalf of the whole country, thank you. Matt Hancock: (07:33) As prime minister said, a big increasing testing provides a way to unlock the puzzle of coronavirus. And testing forms the first element of our plan to test, track and trace. By mid-May, we'll have an initial 18,000 contact tracers in place. That work is underway as we speak. And if it needs to be bigger, we'll scale it as required. Matt Hancock: (07:57) The combination of contact tracers and new technology through our new COVID-19 NHS app will help tell us where the virus is spread and help everyone to control new infections. People will be able to know if they've been in close contact with someone who's transmitting the disease and take the action that they need to. Matt Hancock: (08:20) Our full-scale test, track and trace model will drive infection rate down; and the lower they are and the lower number of new infections, the more effective the country's system will be. Tracing and tracing will allow us to get R down and hold R down, and so it will allow us to lift lockdown measures. Matt Hancock: (08:45) Now this disease affects us all indiscriminately. We've seen that. In recent weeks, we've had to impinge on historic liberties to protect our NHS and our loved ones, and yet our goal must be freedom. Freedom from the virus, yes, and we will not lift measures until it is safe to do so. But also, we care about the restoration of social freedom and economic freedom too, each citizen's right to do as they please. Matt Hancock: (09:18) For now, we're working together to stay home. We're impinging on the freedom of all, for the safety of all. With this next mission of test, track and trace. I'm seeking a solution that allows us, by each of us participating, to target the measures that are needed with much more precision, and so to reassert as much as is safely possible the liberty of us all. That is our next mission. Matt Hancock: (09:50) But for now the most important thing for everyone to do to keep R down and to get us all through this, is to maintain the spirit and the resolve that's had such an impact thus far. So please, stay at home. Protect the NHS and save lives. Matt Hancock: (10:08) And now Professor Newton is going to set out some more details on testing and then I'm going to ask Professor Powis to set out and take us through the slides. Professor John Newton: (10:20) Thank you very much, Secretary of State. And kind of also thank you on behalf of the program for those kind of thanks. It's been a truly extraordinary collaboration, but thank you very much. We have reached an important milestone, but I want to explain why we need all this testing. Back in March, the country moved into lockdown because the virus was circulating widely, not because we did not have enough tests. Cases were popping up with no obvious connection to other cases and the infection was entering the exponential growth phase. And at that point, access to limitless testing, even if we had had it, would have made no difference. The decision went of going into lockdown would have been the same and would have been taken at the same time. In the same way the risk out of lockdown has not being blocked by low levels of testing, we can relax social distancing only when the government's five tests are met, and that means particularly getting the infection rate right down. Testing will, as [inaudible 00:11:16] just mentioned, help to keep it under control once we're out of lockdown, but our levels of testing have not kept us in lockdown down a day longer. Professor John Newton: (11:25) What about Germany? People talk about Germany a lot. But yes, Germany had a lot of tests available from the get go, but there was also a lot less virus around in Germany when they introduced social distancing and it was circulating in younger people. As CMO pointed out in an earlier briefing, we should not rush to the conclusions about relationships between numbers of tests available and the outcomes in different countries. Nevertheless, as CMO also said, we are all learning from other countries and we have learned from the experience of other countries. Professor John Newton: (11:55) But back to the here and now, where's all this leave us in the UK? Well, the 100,000 tests a day target set for two purposes. As Secretary of State has mentioned it was intended to motivate the program and set the scale of our ambition, and it has certainly done that. More importantly though perhaps, we knew from our calculations that we would need something like this level testing to be ready for the next phase of the response to the pandemic. Professor John Newton: (12:21) Looking to the future then, we now have a very substantial and flexible testing capability in the UK. It will be used to drive extensive contract tracing, control any new infections, to help us keep patients and staff safe in hospitals and care services and tell us with some precision how the virus has spread across the country and is spreading in the future. If we can quickly identify who may have been in contact with someone infected, we can prevent them from passing it on and though drive down transmission rates of the virus. Professor John Newton: (12:57) Now the NHS app for contact tracing is also in development and making rapid progress. The more people who sign up for the new app when it goes live, the better informed our responses will be and the more effective we will be in keeping the virus under control. Professor John Newton: (13:13) All this progress with testing and with our design of the next phase of contact tracing and the app, frees ministers and their scientific advisors to choose whatever future strategies are best suited to keep the country safe. I can assure you that the test capability we have built in the last few weeks is world-leading in its scale and sophistication, and gives us the flexibility we need. As the pandemic evolves, we will have the testing capacity to meet changing demand across the country. It is now there to serve us all. Thank you. Matt Hancock: (13:50) Thanks very much, John. And Professor Powis, if you'll take us through the slides. Professor Steve Powis: (13:55) Thank you very much, Secretary of State, and good afternoon everybody. So as I and others have said on many occasions, the magnificent response of British public- Professor Steve Powis: (14:03) ... many occasions, the magnificent response of British public to the government's request to comply with social distancing instructions, has meant that we have begun to get on top of this virus. We've seen the transmission rate, reproduction rate, fall to below one, and that means that the number of infections is falling within our communities and that means the pressure has been kept off the NHS. The NHS has responded magnificently to make sure that our patients have always had available the treatment they require. And over time, this also has impact on the unfortunate number of deaths that we've seen. As we move to the next phase of managing COVID-19, I think the first thing I'd like to do is to remind everybody of the five tests that the government has set for adjusting the current lockdown. Professor Steve Powis: (14:53) The first, I've already referred to and that's the NHS continues to have sufficient capacity to provide the critical care requirements that are needed but also specialist treatment right across the U.K. Professor Steve Powis: (15:06) Secondly, it's that sustained and consistent fall in daily deaths from Coronavirus and we are beginning to see that, but we need to make sure that that is maintained. Professor Steve Powis: (15:18) Thirdly, it's reliable data to show that the rate of infection is decreasing to manageable levels across the board. And again, as I've said, it's everybody's efforts in complying with social distancing that means that infections have fallen and will continue to fall. Professor Steve Powis: (15:34) Fourthly, this has been a challenge, not just in the U.K. But globally around the operational response to a pandemic that includes PPE. It includes other things. And moving forward we to ensure that those challenges... Testing is one of them... are in hand and we are in a good position going forward to meet future demand. Professor Steve Powis: (15:58) And finally and critically that any adjustments going forward, don't risk a second wave or second peak of infections, that again runs a risk of overwhelming our health systems. Professor Steve Powis: (16:12) So those are five key tasks that have been set and the government will be looking to confidence that it has met those before it moves to the next phase of the lockdown and the measures that we will need to take going forward to stay on top of this virus and ensure infection rates remain low. Professor Steve Powis: (16:34) Now in the next slide we will provide, I'm providing some details of exactly how the public have complied. And the first is an example on how people have been approaching contact, particularly with vulnerable people over a period in middle part of April showing that 84%, the great majority of adults have said they either not left their home or only left the home from permitted reasons and 87% of adults avoiding contact with older or vulnerable people. So a great testament to the efforts that our British public have gone to, to ensure that we reduce infections. And on the right of this slide, some information on the number of people who've been working at home since social distancing issues were introduced and that's 45% of adults in employment are saying that they work at home and compares to around 12% of last year. So again, a great increase in those that are not going up, that are staying at home and managing to work without having to go in their usual place of work. Professor Steve Powis: (17:42) And on the third slide, begin to see the testing information the Secretary of State said as both Secretary St. John have said, the number of tests increased dramatically, but it's not just the fact the numbers have increased. It's the fact that capacity is increased so that we can use testing for a far wider range of purposes and you have already heard some of the areas in which that is going to critical going forward in the months ahead. Professor Steve Powis: (18:11) In the fourth slide, we show new cases as determined by positive tests. You will see that that has increased a bit in recent days, but that should see it in the context of increased the number of tests in the round. So more testing and more testing of different groups of individuals is likely to bring more positive tests as a result. But overall I think the number relatively stable and that is a good sign and reflects that the level of infection is falling. Professor Steve Powis: (18:44) The next slide then moved to people who unfortunately, and again it's a mild illness for the majority of people, but for a proportion who do have to be admitted to hospital, you can see that since the middle of April, numbers of people in hospital with COVID- 19 have been falling and that's particular marked in London. That was ahead in terms of the infection rate and therefore that all has come quickest in London. It is starting to move down maybe at a slower level in other regions of the U.K. But nevertheless overall the trend is downwards. Professor Steve Powis: (19:22) And then that also translates in the next slide to people who, again, small minority but important groups that have to be treated in our critical care facilities, this shows the proportion of people with COVID-19 in critical care beds. Again, that is falling in the four nations. And the absolute number of people in critical care beds, so not just the beds but the absolute number is also declining. Professor Steve Powis: (19:49) And then finally we move unfortunately to deaths, the slide with deaths that occurred. Again, we're not talking, we're not doing deaths in all settings. We previously, up until a few days ago showing deaths in hospital settings. We've now expanded this. And again, you see those numbers do vary from day to day and there's a reporting lag at the weekend, but over all the seven day rolling average, which smooths out those daily variation is showing that the number of deaths is beginning to trend downwards. Professor Steve Powis: (20:20) Then very finally, we show the usual international comparison against other countries. And again this comes with a usual caveat that this sort of comparison is really important. It's now U.K all settings, but a real comparison is in all cause mortality. So in SAS stats in countries that is measured more consistently between countries, but there will be some time before that analysis can be done. So although it's important to show the data, I think it's important to remember that it will be a number of months and perhaps longer before we can see the true comparison between our countries. Professor Steve Powis: (21:03) So finally to remind people that the hardships we've been going through, the compliance, social distancing is working. The key thing is it needs to continue to work. So all must continue to not think that this is over. This is really beginning, but it is translating into benefits in pressure on the NHS and on reduction in deaths. So it's important that we all keep it up. Thank you. Matt Hancock: (21:27) Thanks very much Steve. So the first question is going to be from Andrew from Leeds who joins by video. Andrew: (21:38) Hello. My question is when lockdown restrictions are lifted and schools open, will they find that people choose to keep their children out of school, even if it's open for their age group? And also how will you make sure the public's confident it's safe? Matt Hancock: (21:53) Well thanks, Andrew. That's a really important question. The, our aim is when it is safe to do so, then we'll make recommendations of changes like this. But we will only do it when it's safe to do so. So we are not going to reopen schools if it isn't safe. Now of course this disease thankfully doesn't appear to give children symptoms nearly as bad as adults. So it is much, much, much safer for children. And maybe Professor [Patz 00:00:22:35], you can add something on that. But we will not reopen until it's safe to do so. So that's on your second question. Matt Hancock: (22:42) The first question, of course, you know as in when we reopen schools, our goal is to get back to the norm, and the position as it was before. And I'm pretty, I'm confident that because we'll only do it when it's safe then it will at that point then be entirely reasonable and become normal again to send children to school. Professor Steve Powis: (23:08) Yes, so I think it's as they've said, it's perfectly correct that this virus affects children much less than it does the elderly and older adults. So they are much less acted by the effects of having COVID-19. As we said the last time we were here, there have been some very rare reports about complications in children. We are continuing to look for that and try and understand if there is any link. But the overall message is for children, this is a mild disease or it produces very little symptoms. The science is still evolving in term of transmission between children. So we do need to be cautious as we think about opening schools. We will need to think carefully and advise governments appropriate advice as to how that might happen. But the key thing is that this is not a serious disease for the vast, vast, vast majority of children and indeed younger people. Matt Hancock: (24:10) In fact, it's simple to remember, isn't it, that the reason that we had to take the decision to close schools was because of the impact of schools on transmission, not on the safety of children. Professor Steve Powis: (24:21) Exactly, exactly. Matt Hancock: (24:22) And that's important to bear in mind and I hope reassuring, Andrew. Matt Hancock: (24:26) The next question is from Stuart, from Redditch and Stewart asks, "Given the large investment that's gone in creating the Nightingale Hospitals, will we make use of them going forward to help reduce NHS waiting lists at the right time as we come through the pandemic?" Matt Hancock: (24:44) The answer to your question, Stuart, is that we will do what we need to do to reduce NHS waiting lists as we reopen the NHS. But the Nightingales were designed very specifically for patients who are intubated and therefore they were under anesthetic. So they are specifically designed for COVID, but Steve, you were behind that project so maybe you can speak to that. Professor Steve Powis: (25:12) Yes, the Secretary is quite right. The Nightingale Hospitals have been designed with specific purposes in mind. The Nightingale Center in East London was created in order to be used if we needed extra capacity for ventilated patients. Fortunately we have used the Nightingales in London, but fortunately we have matched that surge because of the combined efforts of the British public to maintain social distancing. So the NHS has done a great job. But those hospitals are designed in a particular way for a particular purpose and that doesn't necessarily mean that they would be fit for purpose for other type of NHS activity. Professor Steve Powis: (25:56) Now of course we also need to keep them as an insurance policy in the next month or two because we need to be confident, as I said in the five tests that we, that we have sustained reduction in hospital admissions. But of course we will always keep things under review going forward. But I think the key thing is that the Nightingale's have shown quite how agile the NHS can be with the support of the military if we need to be, but I think have given us that extra capacity that we have used but haven't had to use to the extent that we might've feared even just at the beginning of April. Matt Hancock: (26:33) Thanks very much, and thanks, Stuart, for submitting your question. Remember that you can submit a question by going onto gov.uk/ask and I think these questions from the public are a great addition to our daily briefings. We'll now turn to questions from the media. First one is from you, Hugh [Pemm 00:26:56], of the BBC. Hugh Pemm: (26:58) Thank you so much, Secretary of State. As you said, there's clearly been a rapid and impressive expansion of lab capacity and testing centers and businesses and staff have put in a huge effort and are fully deserving of praise. I wanted to ask a little more about where we go from here. In your view, you touched on it but a little more detail. How do you intend to further develop and expand the testing network as part of the moves to combat the virus? Matt Hancock: (27:27) Well, that's a really important question, Hugh. I'd like to set out a bit of it, but I think there's two parts. First is that we've grown this testing capacity to do over a hundred thousand 122,000 tests done yesterday. And that's for purpose because by testing you can help to treat patients better. The more we've been testing patients, you can help get people back to work and there's been a big expression of the eligibility to get a test in order to be able to get back to work. And also for... Matt Hancock: (28:03) ... [inaudible 00:28:00] in order to be able to get back to work. And also for surveys and very soon we should get the first results of the surveys that are out in the field at the moment, so that we know how many people have the disease right across the country. And we should get those results very soon. Matt Hancock: (28:19) We plan to continue to expand capacity. As I said, there's a new lab coming on stream next week that AstraZeneca GSK have put together at Cambridge. And we'll keep going from there. But the other really important question is making sure we use this capacity in the best way possible. For instance, to have a real focus on care homes, to make sure that we can tackle the epidemic within care homes as well. John. John Newton: (28:53) Thank you, Secretary of State. Yes, so it is an extraordinary achievement to build this [inaudible 00:28:59] so quickly. There is an element of consolidation required now. We need to move to a more sustainable footing. And we also need to try and integrate work of the new laboratories with existing infrastructure. So, for example, making sure that the results flow back to general practitioners and so on. John Newton: (29:14) So all of that is happening and that will really help us to use this new capacity to its maximum benefit. And then as Secretary says, there are a whole range of other opportunities to support the NHS, the care sector, and also other sectors, such as criminal justice, by making testing available. And I think a really exciting development is this rollout of testing at home, which of course will be very, very helpful for any contract tracing, a really flexible, fast way of getting tests to people when we're using our contact tracing, track and trace, and so on. John Newton: (29:50) So we're very pleased with what we've done so far, but it really is only a start. We do need to apply what we have now to the challenges of the future. Matt Hancock: (30:03) Thank you- John Newton: (30:03) Thank you. Matt Hancock: (30:04) ... very much. Yeah, have you got a follow-up, Hugh? Was that ... Hugh: (30:05) Just one more? Matt Hancock: (30:06) Yeah. Hugh: (30:06) Can you ensure that health and care workers do get priorities- Matt Hancock: (30:10) Yes. Hugh: (30:10) ... so can get tested when they need to be? Matt Hancock: (30:12) Yes, absolutely. This is really important. And within the system that we built, if health care workers need a test, then get one as a priority either through the NHS itself and the NHS's own labs, or through the employer route so they can essentially go to the front of the queue in terms of getting an appointment to one of the drive through centers. And that's an important part of making sure we have the right prioritization. We've always talked about the prioritization starting with patents and then people in the NHS, then [inaudible 00:30:51] workers and then the general public. And that prioritization is built into the system. Matt Hancock: (30:56) Just to build on this point of testing for contact tracing, thing is once we have contact tracing in large scale, then you want to be able to test people as soon as possible so that you know if there's a positive test so that the people that have been in close contact with can be advised to act accordingly and isolate so that they don't pass on the disease. So that is a very important other new part of the priority within testing once we get that up and running by the middle of the month. Thanks, Hugh. Sam Coates from Sky. Sam Coates: (31:36) Matt Hancock, the 122,000 tests has obviously increased in a short period of time. How many of those are home testing kits that were mailed out yesterday, but haven't actually been yet returned and analyzed by lab? Because earlier in the week, number [inaudible 00:31:52] was indicating that they wouldn't count against the target, but now it does seem as if they do. To John Newton, perhaps this morning we got the news that we've been waiting for, that you cannot get coronavirus a second time. That seems to have come out of a study from the South Korea Central Clinical Committee for Emerging Disease Control. How much weight do you put on that seemingly important study and Steve [inaudible 00:32:15], so I was interested that you were seeming to be quibbling with a colleague at Public Health England, Dr. Okereke, who was saying yesterday that children don't seem to be able to transmit the disease. Was she wrong? Matt Hancock: (32:29) Right. Well, a feast of questions. I'll hand over to Dawn to answer the precise numerical questions. We sat out on gov.UK exactly how we count the different types of tests for different reasons because obviously, exactly as you said the question, home tests are produced in a different way to the tests at drive through centers. So John can take us through the exact breakdown of the 122,347 tests yesterday. I'd just add that in total, we now, over the entire testing program since the test was invented, have done over a million tests. Now 1,023,824. So that's another benchmark that we've managed to reach. John and then I'll ask Steve to answer the question about the transmissability of disease amongst children. John Newton: (33:27) Thank you, Secretary of State. So the NHS Public Health England's laboratories, including the laboratories in other countries, all four countries of the UK, undertook 39,753 tests between them, of which the were 2,537 in Scotland, 1,019 in Wales, and 1,319 in Northern Ireland. And it's worth mentioning, we have a partnership with Roche and that partnership, they undertook 13,703 tests. So that a benefit of the public private partnerships. The tests undertaken by the new Lighthouse Laboratories total 79,522. Now, of those 39,153 were undertaken in the drive through centers or by mobile units or in fact by research nurses who administered tests as part of the Office [inaudible 00:34:21] Statistics Survey. John Newton: (34:23) Your question, the home kits delivered, there were 27,497 kits delivered and there were 12,272 tests delivered through the satellite process. And then on the surveillance testing, which is a different, which is the antibody testing, there were 3,072 tests undertaken. And so that's the breakdown of the total 122. So your question was about home kits, 27,000 and then there were 12,000 more that were sent out a satellites. Matt Hancock: (35:01) Thanks very much. Steve. Steve Powis: (35:03) Thanks, [inaudible 00:35:04]. So on the question of transmission in children. I'll say what I think the position is. John, with his public health expertise, will correct me if I get any of this wrong. I think if a child or a young person is symptomatic, then there's no reason to think that they wouldn't transmit the virus in the way that any other person who's symptomatic would be. I think the big question is how many children don't have symptoms, but get virus? And in that particular case or in those cases, how transmissible is the virus between them? And I think that is data that we are still accumulating, an evidence that we are still learning about. And of course it is one of the key questions when it comes to schools and how schools are opened again. So I think the true answer is that the evidence is still emerging over the transmitability of virus in children that don't show symptoms. But John, is that your understanding? John Newton: (36:02) Yes, absolutely. And shall I pick up the question on immunity? Can you get the [inaudible 00:36:08]- Steve Powis: (36:07) Yes, [crosstalk 00:36:09]. John Newton: (36:07) ... twice. So you mentioned a study, the science on immunity is still emerging and I think the general rule is that you would never make a decision from a single study. So we would very much want to see that result replicated in other studies before we decide that that was really the case. John Newton: (36:27) But it's obviously promising. I think people have said before in these briefings it would be very surprising if there was no immunity after an infection, but at the moment I think the science is still not precise about how much immunity you get and how long it lasts. So, but nevertheless results such as the one mentioned are encouraging. Matt Hancock: (36:47) Thanks very much Sam. Victoria Macdonald from Channel 4. Victoria Macdonald: (36:50) Thank you, Secretary of State. Can I just say that I'm not quite sure that Sam's question was answered. There was a report in the HSJ that previously test would be counted only once the sample had been processed, but that that testing is now changed, that it's being counted once it's been posted out. Is that the case? And then Secretary of State, I wanted to ask you specifically, the OS figures today show that you are twice as likely to die from COVID-19 if you live in a deprived part of the country. What is your reaction to that and what policy implications does that have for you? Matt Hancock: (37:29) Yeah, I'll ask John to answer the point from the HSJ, but it's not something I recognize. The point on deprivation and the point that in more deprived parts of the country that it appears to be a greater impact. This is something that we are worried about and looking at and we're looking at it in the context of all of the different ways in which this disease seems to have a different impact on different groups. So right from the start we've known that it has a much more serious impact on older people, it appears to have a bigger impact on men, it appears to have a bigger impact on people from black and minority ethnic backgrounds, it's appears that people who are obese are more seriously affected by the disease, and there's also this a new evidence from the Office for National Statistics of the correlation with deprivation. So we are looking all of these things and trying to understand the impact of the virus as much as we possibly can as and when we get new evidence. John? John Newton: (38:50) Yeah. So there's been no change to the way tests are counted. As we develop new ways of delivering tests, we've taken advice from officials as to how they should count it. So the tests that are within the control of the program, which is the great majority, are counted when the tests are undertaken in our laboratories. But for any test which goes outside the control of the program, they're counted when they leave the program. So that's the tests that are mailed out to people [inaudible 00:39:18], the tests that go out in the satellites. So that's the way they are counted, have always been counted and the way we were advised to count them by officials. Matt Hancock: (39:27) And that's all set out on gov.UK. Sam Lister from the [inaudible 00:11:32]. Sam Lister: (39:35) Thank you, Health Secretary. [inaudible 00:39:38] have been raised about how the over 70's have been treated as [inaudible 00:39:42] in this crisis, including by senior figures in your party. Can you reassure over 70's who are fit and healthy, that they'll be treated exactly same as the rest of the population when lockdown measures are eased? And also it's been made clear today that this is not over, but now we are past the peak people will obviously rightly be hopeful that they can start making plans to see family and friends again, perhaps even have a holiday, or meet up to go and have a holiday together. Is late summer a realistic timescale for this? Matt Hancock: (40:20) Well, so the last question is very tempting to speculate at, but unfortunately we just don't know. It's still too early to say. I'm really sorry to have to give that answer, but it is. The five tests we've set out are there partly to try to give everybody a sense of when we'll be able to make those next decisions that I know people are yearning for. But we will only lift the lockdown measures when safe to do so. This is why test, track, and trace is so important because it will help us to do that. It isn't necessary to put that in place, but it helps enormously. But it is as of today too soon, and hence the message remains to stay at home because that protects the NHS and saves lives. Matt Hancock: (41:16) And on your first point about the over 70's, maybe Steve, I can ask you to answer, but we were always clear from the start. There's a very specific group who we've been in contact with who we're asking to shield, which is ensure that they have as little of contact as possible with other people for their own health reasons. And after that the question is a degree, a gradation of the [inaudible 00:13:44]. Steve? Steve Powis: (41:45) Yes, so of course we know, as you know, that that the over 70's can be absolutely fit and healthy and that it's not the case that everybody over 70 has a chronic health condition or an underlying disease. As the Secretary of State said- Professor Steve Powis: (42:03) ... or an underlying disease. As the Secretary of State said, we very specifically asked a group of individuals, some of whom are in that age bracket, but not everybody, to shield and to do everything they could to stay at home, because we knew that their underlying conditions put them more at risk of serious complications from COVID-19. So that's the group that are being shielded. Of course, everybody is combined with social distancing measures at the moment, being asked to stay at home whatever age you are. So in the generality at the moment, everybody is in that same boat of complying with those measures. Professor Steve Powis: (42:38) I think as we look forward, and as I said at the very start, the government moves to another combination of measures, including track and trace, that will help us keep the infection under control going forward. I think it's a perfectly reasonable question to say, how would that work in age groups and age bands. Although we do know the complications, and unfortunately deaths, are more common in the elderly, even without complications, I think that's a consideration, and that's work, I think, that we will need to do as we move forward. But I think your point is very well met. Matt Hancock: (43:20) Thanks very much, Sam. Allan Preston from the Belfast Telegraph. Allan Preston: (43:26) Good afternoon. I just have two quick questions for the health secretary. Knowing Allan, the impact of coronavirus has not been quite as severe compared to the rest of the UK due to factors like a lower population density, do you think there's any merit in eventually easing restrictions here at a different pace to other parts of the UK? My second question, as far as does not respect borders, do you think it would be better for Stormont work on an all-Ireland basis in fighting the pandemic rather than following UK lead? Matt Hancock: (44:02) Well, thank you. The thing is, that across the UK, the level of the virus has been different in different parts of the country. We saw that in the chart earlier that in London the level's been much higher, and other parts of the country lower. But what's interesting is that the shape of the curve rise, and then the fall in the virus that's just started has been basically the same throughout the country. So that means that moving together, I think it was the right approach at the start, and I can see the case that could be made, and of course, the decisions that are devolved with respect, the devolution settlement. But ultimately, if you look at the shape of the curve, getting our down and getting a level of new cases right down, that's happened in the UK together. Of course the relationship with the Republic is important as well, and we have good relations in terms of political level, but also at a medical level and conversations with the Republic with the decisions that they take. We have very intensive discussions within the UK about the timing of changes within the country. Thanks very much. Steve Ford from the Nursing Times. Steve Ford: (45:30) Good afternoon, Nursing Time survey. As indicated, almost all nursing staff have been more stressed and anxious than usual. The third described the state their mental health is bad during the COVID-19 crisis for reasons including PPA shortages. So my question is, what are you going to do in the long-term to protect the mental health of nurses, other staff, on top of the help lines that have already been announced, as we already have a well-documented nurse shortage. I hope you'd agree that we can't afford to lose any more in the coming months. And secondly, what's your message to black and minority ethnic staff who feel they may have been put at great risk given the emerging evidence from the mortality data? Matt Hancock: (46:11) Thank you very much, Steve. I think that the way that nurses across the HS have risen to this challenge has been admirable. The bravery and the flexibility that nurses have shown right across the NHS. I think that's something the whole country recognizes it, and I recognize it as health secretary. I think that certainly the measures that we have put in place to help people with stress and more serious mental health as a result of work, those measures are important, and I'm very glad that they are place. I've been trying to get them in place for some time, and we've managed to put in place very quickly as the crisis began. But the other thing that is undoubtedly true when you talk to nurses on the front line, the decrease in the number of nurses, so that there are more to do the work that's needed is a really important part of the part of the plan. As you know, we committed in the election to 50,000 more nurses by the end of parliament. We remain committed to that. In fact, we've seen more nurses come into the NAS over the autumn, and then also as a direct result of the appeal for nurses who'd left the profession to come back. So we have got more nurses in back into the NHS, and I want to support and cherish every single nurse who works in the NHS because of the important work that they do. So I'm sure that will be a big conversation as we restore the NHS and thank everybody for the work that they've done during the difficulty of coronavirus. Steve, I don't know if you to add anything. Professor Steve Powis: (48:06) I think your point, again, is a very good point. Of course, it's not just nurses as you pointed out yourself. It's all staff. There's been a tremendous effort by staff across the NHS. They have been working incredibly hard, sometimes in different areas from where they usually work. Of course that brings its own stresses. I know talking to the chief execs and the medical director, executives, medical directors of many of our hospital trusts across the country that as we begin to now stand up some of the services that we have had to take down to manage the surge in coronavirus patients, those leaders locally are thinking very hard about how these support staff, because they absolutely recognize that they have gone through a very challenging, and at times very stressful number of weeks. That support is required both in the short-term and over a longer period of time to ensure as we move back towards a normal, that we can be back to normal while still have COVID, but back towards normal, that staff have the support they need. So I think the comments you've made are very much reflected in the comments I hear from all leaders across the health system. Matt Hancock: (49:21) Maybe you could answer Steve's second question as well. Professor Steve Powis: (49:24) Second question, sorry. The second question, just remind me the second question was, Steve? Speaker 3: (49:29) About the minority. Steve Ford: (49:30) Right, yes. Message for black and minority ethnics staff? Professor Steve Powis: (49:34) Yes, and John might want to answer to some of this as well. I think the message for our black and minority staff is that we absolutely recognize, as secretary said earlier, that this virus is disproportionately affecting staff. I absolutely know the concern, the worry amongst our colleagues in those groups, and I've been talking to them over the last few weeks, as I'm sure were Secretary and others have. So there are things that we do in terms of supporting staff and helping them through the concerns that they have. I think there's another piece of work that John will be able to talk about, which is to understand why it is, and secretary touched on this a little bit earlier, why it is that the virus seems to be disproportionately affecting members of staff and the population, the whole from particular ethnic groups. So that work is ongoing in public health. I think maybe John will be able to say a little bit, because of course, that will also inform what we need to do and the approach we need to take going forward. John. John: (50:38) Thank you. As you know, then the statistics do show increased rates with some ethnic backgrounds. They're relatively small, and they need to be looked at, although very important. But we do to also look at some of the other aspects of the virus. For example, the virus is present at different rates in different parts of the country, and we know that different parts of the country have very different people from different backgrounds. So we look at all of these figures together to try and understand what's really going on, and that there is a cause for concern definitely. We are talking to NHS England about any advice that should be given based on the data. But there is also an important bit of statistical work to be done trying to understand what the real underlying risks are. Sometimes it can be wrong to take these statistics at face value. John: (51:39) We also know that, unfortunately, some ethnic groups have different levels of ongoing health conditions. So for example, people from Asian background tend to have more diabetes. So we're trying to look at, to an extent, those factors might be there as well. But it's a very important issue. One, a number of people are looking at, Public Health England, but also a number of university groups are also studying this, and we're feeding the results back to NHS England so that staff can get right advice as you can accurately, as you say. Professor Steve Powis: (52:08) But I think it's important for us to emphasize that we don't need to wait for that data. That data and analysis is important, but we don't need to wait for that to provide additional support. In fact, when Simon Stevens, chief executive of the NHS wrote out to our healthcare organizations, to hospitals, this week, he made a specific point of ensuring that the local health care leaders who pay particular attention to supporting and do whatever they feel is necessary locally to support our BME colleagues. I know, from even today, talking to some of those local leaders that they are absolutely doing that and providing that support. Matt Hancock: (52:50) Thanks very much, Steve. Does that answer your question? Steve Ford: (52:53) Yes, thank you. Matt Hancock: (52:54) Thanks very much, indeed, everybody. That concludes this daily coronavirus briefing. Thank you.