United Kingdom Coronavirus Briefing Transcript April 23

Matt Hancock: (00:00) 138,078 people have tested positive for the virus. That's an increase of 4,583 cases since yesterday. 17,615 people have sadly died. 17,615 people, sorry, are currently in hospital, I correct myself, with coronavirus down from 18,189 on the 21st of April. Sadly of those hospitalized, 18,738 have now died. That is an increase of 616 fatalities since yesterday. Matt Hancock: (00:47) Although this number is lower than it has been in previous days, I still stop and think of each one. They will not be forgotten and their stories will live on. We must maintain our resolve and follow the social distancing rules because they are working, they are protecting the NHS and they're saving lives. To lift the measures too soon and to risk a second peak would be a mistake. It would undo all of the hard work that's been done. It would be both bad for our nation's health and for our nation's economy. We can only start to change the measures when the NHS can continue to cope, when the operational challenges have been met, when the daily death rate falls sustainably and consistently, when the rate of infection is decreasing, and most importantly, when there's no risk of a second peak. Matt Hancock: (01:54) We need to bring the incidence of new infection right down. We'll then use a rigorous program of test, track and trace and keep it down so we can safely release more of the restrictions. Today I want to set out the progress that we're making on test, track and trace, which is such an important part of the measures that we're taking and the work that we're doing. Matt Hancock: (02:22) First testing, we set the goal of 100,000 tests per day by the end of this month. I knew when we set it that this was a challenging target. Capacity is now ahead of our plans and even overnight has increased from 40,000 to 51,000. Because capacity has increased so substantially, we're now able to expand who can get the tests. Our ultimate goal is that everyone who could benefit from a test gets a test. But of course we had to start by prioritizing patients in hospital followed by NHS and social care colleagues and by those in care homes. As we expanded the capacity from just 2,000 tests a day at the start of March to 10,000 tests a day at the start of this month, so we've been able to further expand access. Matt Hancock: (03:18) Today I can go further. We can make it easier, faster and simpler for any essential worker in England who needs a test to get a test. From today, employers of essential workers who will be able to go on gov.uk to get a test for any of their staff who need a test. From tomorrow, any essential workers who need a test, we'll be able to book an appointment on gov.uk themselves directly. This all applies for people in essential worker's households too who need a test. It's all part of getting Britain back on her feet. Those included as essential workers will be based on the list for schools and education set out on gov.uk. Matt Hancock: (04:11) The whole process will be free. Once you've entered your details on the website, you'll get a text or an email inviting you to book an appointment. After you've had your test, results will be sent out by text and a help desk will be available to deal with queries. People who can't go online can still apply through their employer. I want to make it as easy as possible for people to get a test, not least because we're talking about people who are ill. Our network of regional test sites has now reached over 30 locations right across the UK and more are being set up each day. Matt Hancock: (04:47) I just want to take this moment to applaud the private companies who've been involved as well as my team, the team in Public Health England and the NHS. Boots, Amazon, Thermofisher, Randox, Roche, Oxford Nanopore, GSK and AstraZeneca, they've really stepped up to the mark and I'm grateful to each and every one. We're also introducing home test kits and with the support of the armed forces, mobile testing sites too. The armed forces and the MOD have played a vital role here. I want to pay tribute to their work. I thought that at yesterday's briefing General Sir Nick Carter when he said that coronavirus had presented the single greatest logistical challenge in his 40 years of service, I thought that spoke a truth. Our armed forces have played their part in rising to this challenge and I want to thank them all. Matt Hancock: (05:43) In addition to testing essential workers, we're also using testing to find out how many people have coronavirus and how many people have had coronavirus. These are critical pieces of information to inform our battle against this novel virus and that we'll use to learn and we keep learning about every day. This week we've begun one of the biggest virus infection and antibody studies that this country has ever seen. This is a joint project with the Office for National Statistics bringing their experience of running large household surveys and the University of Oxford bringing their world-leading scientific expertise. In total, 25,000 people will take part in the first phase with plans to expand it to up to 300,000 people over the next 12 months. Matt Hancock: (06:32) Participants will provide regular samples taken from self-administered swabs and answer a few short questions during home visits by trained health workers. We will use these tests to help us strengthen our scientific understanding and inform us on the big choices that we have to make about social distancing measures and how we start returning to a more normal life. Letters are arriving on doorsteps from today. Please, if you're asked, take part in this vital research for your country. The early signs from today are that there is huge enthusiasm for those who've received letters taking part in this survey. If you get a letter, please respond to it as soon as you can because you will be doing your bit. Matt Hancock: (07:20) As we ramp up our ability to test in large numbers and as we slow the spread of the virus, we also need to make sure we've got the ability to trace contacts just as effectively. As we look ahead, this is critical to keep the virus under control. We're putting the infrastructure in place now so that we can roll out contact tracing on a large scale. We're currently testing the new NHS contact tracing app. If you become unwell with symptoms of coronavirus, you'll be able to tell the NHS via this app. The app will then send an alert to other app users that you've been in significant contact with in recent days, even before you have the symptoms so that they know and they can act accordingly so we can get the test to people even if they're asymptomatic. If we're worried that they've been in significant contact with someone who has the disease, we'll be able to let them know. Matt Hancock: (08:17) But it's not just about the technology, we need the people to. We need to be really kickstarting contact tracing as the new number of cases begins to fall. We're preparing for this now by hiring an initial 18,000 people, including over 3,000 clinicians, including public health specialists. We'll be training up the mass ranks of our contact tracers over the coming weeks and roll out the service. Matt Hancock: (08:47) This test track and trace will be vital to stop a second peak of the virus, but recent weeks have shown that there is something we can all do. That's to follow the rules on social distancing. I am acutely aware of how difficult this has been and especially as we enter Ramadan, a month that is so special for so many people. This Ramadan, many Muslims who served their country in the NHS and in the armed forces and in so many other ways, will not be sharing the joy of this month as they normally do. I want to say to all British Muslims, thank you for staying at home. I know how important the daily iftar is, how important communal prayers are at night and how important the Eid festival is. Matt Hancock: (09:38) Thank you for making major changes to these vital parts of your practice. I want to say to you all, Ramadan Mubarak and thank you for your service and citizenship and thank you for your sacrifice. This will help so that we can together emerge from this challenge all the more united, all the more grateful to one another and all the more safe. We've traveled together too far to go backwards now, so please stay at home, protect the NHS and save lives. Matt Hancock: (10:15) I'm now going to ask Sir Patrick to set out the latest data on the charts. Sir Patrick Vallance: (10:20) Thank you very much. Can I have the first slide please? A reminder on this slide that this virus spreads between people when we get too close, when we have coughs, when we exchange because of contact. All of us have done a good job actually at staying away from multiple contacts. You can see on this slide, actually 90% or more in some cases people have stayed away from people outside the household. We've tried to avoid contact with vulnerable people, however difficult that has been, but it has made a big difference. Sir Patrick Vallance: (10:58) You can also see that actually the number of people who've managed to work from home has actually increased. That has been a really important part of making sure that we reduce the chance of this virus spreading. It's very clear that actually the transmission in the community is way down from what it was. In terms of the infection spread amongst the population, the social distancing is having a very big effect. Sir Patrick Vallance: (11:24) Next slide please. This shows new cases, but I've said this before and I'll say it again. This is new cases as determined by testing. There are many more cases, but we know that those cases are coming down. Here it looks fairly flat because it's the testing slide. What you can see here though is that the number of people who have been tested for medical reasons in blue is coming down slightly even on this, even though there are many more tests being done and of course, it's now possible to test the number of essential workers in the orange bar. Sir Patrick Vallance: (11:57) But the real acid test is what's this turning into in terms of the effects? Next slide please. This is the number of people in hospital with COVID. Here you can see a very clear decline in London. You can see that in other areas there are declines such as in the Midlands. You can see in nearly all areas this is flat or on the way down. This speaks to the point, that as we've radically reduced the number of infections in the community, this has turned into a reduction in the number in hospital. We're still at that period coming through the peak, but you can see it's headed very much in the right direction. Sir Patrick Vallance: (12:39) This in turn with a delay translates into what happens in intensive care units. Next slide, please. In intensive care units, you can see here the percentage of beds being occupied you can see that the number went up, of course, reached a plateau and is gradually decreasing. As I've said before, you'd expect this to be a gradual ... Sir Patrick Vallance: (13:03) ... decline and to take longer than the decrease in admissions. I do want to say one other thing about what's happening in hospitals though. There is a very large clinical trial going on trying to work out which medicines may make a difference in this disease, and one of those studies has recruited 7,000 patients and there'll be results coming out from that in due course. I would just urge as we enter the phase where the plateau has been reached, slight decrease we can see, we continue to make sure that we enroll patients in clinical trials so that we get the answers to the critical questions about which medicines may work. Final slide please. Sir Patrick Vallance: (13:50) Not surprisingly, we know this is a problem in terms of the severity of the disease that although the number of patients in intensive care units is coming down slowly, the deaths remain at a plateau coming down slightly, not coming down fast. I would expect that to continue for another couple of weeks and we will then see a faster decline thereafter. It's crucially important, going back to the beginning, that we all keep firm with our attention to social distancing because it's at that end that we stop the progression through hospital intensive care unit, and ultimately unfortunately for some people to death, and I think it's crucial that we all do our part to keep this going and you can see it's headed in the right direction and we must stay firm with the measures we're taking. Matt Hancock: (14:42) Thanks very much. John, if you'd update us on where we are on on the testing program in a bit more detail. John Newton: (14:48) Thank you secretary of state. I want to use this opportunity to talk about the why and the what of our national testing program. Why do we need it, and what are we doing to make sure everyone who would benefit from a test can get one? I should first explain when we talk about testing, we are talking about two different types of tests. The first type is a swab test for the presence of the virus. The second type is a blood test to show who has previously had the virus. Swab testing is currently our main focus because relatively few people have had the virus at this point in the pandemic. Swab tests can tell us what treatment the patient should receive when they come into hospital, who needs to be isolated in any care service and which key workers who are currently self isolating can safely return to work. Some two thirds of those that we've been testing have returned to work, which is very gratifying, and we've seen some reductions in the NHS sickness absence results as a result. John Newton: (15:46) In hospitals or care homes where social distancing is more difficult to achieve, testing is vital to help control outbreaks of infection where they occur. And finally, swab tests can help us understand the spread of the across the population through carefully designed surveys of the type the secretary of state just described, the one led by the Office of National Statistics and Oxford University. Now, although a positive swab test is very reliable, I want to stress the negative result does not absolutely guarantee that you're free of the virus. It is, however, a very good guide for whether it's safe to return to work. Blood testing, by contrast, can tell us who has previously had the infection, again, improving our understanding of the spread of the virus when you used in surveys. And in individuals, it may also be able to tell us about the risks of future infection, which of course is so important. John Newton: (16:44) Now, if you have had the virus, you may have acquired some degree of immunity. I stress may because the science on immunity is still uncertain and in any case it also takes some time for that immunity to build up and for the test to be positive. Our five pillar national testing program is designed to ensure that everyone who needs a test can have one. To make that happen, we're doing two things, increasing capacity for testing and increasing access. May I have the first slide please on testing? Here we can see that our secretary of state said we've now performed more than 500,000 tests in the UK, which is and has been steadily increasing over time. John Newton: (17:33) If I could have the second slide please. This slide shows the increase in the capacity to undertake tests, and we're talking here about the swab tests and compared to the start of the month, you can see that we have increased substantially so that we can now do more than 51,000 tests a day. And the shape of the curve is exponential. You can see that it's rapidly increasing at this point, which is what we expected. Now, we've done this by securing supplies of kits and consumables from some of the leading manufacturers that secretary of state mentioned, and now these are the very best of their kind available in the world. We've also introduced new tests, new types of tests, so at least, for example, at least two NHS labs are now using a test that has no RNA extraction stage, which means no need for the chemical reagents, which are in such high demand around the world. And we've also developed technology within the NHS to direct capacity to where it's needed most, and that's made a huge difference. John Newton: (18:39) In addition, we have the three new lighthouse labs, which are all now on stream. These are the ones in Milton Keynes, in Manchester and in Glasgow. Each of these labs will be able to process tens of thousands of tests per day and we're introducing automation into those processes, which really ramps up the capacity. We've also entered into partnerships with leading labs in industry and academia, in addition to these other labs I've mentioned already, and this will help increase volume still further. So we are currently on track to reach 100,000 tests per day as planned. In fact, we're somewhat ahead of where we thought we would be at this stage. Now, a huge amount of work has gone into this across the board, and I want to take this opportunity to thank everyone involved. John Newton: (19:28) Next we're increasing access to testing. So if I could have the next slide please. So you can see here from the map particularly we already have more than 30 drive through centers, and these are increasing to around 48. As the secretary of state mentioned, home testing option is also now in place, and we will increase this further. We also want to use an approach we call a satellite approach where test kits are delivered in batches to a single site and then returned in batches, and then finally, as you heard, we are also currently working with the army on a new pop-up mobile testing option which was developed for us by the army, and it was really working very well. So we're going to have 48 of these pop up facilities which can travel around the country to where they're needed most. For example, in care homes. John Newton: (20:23) Now, a key development that will transform access is the web portals for employers and for essential workers to refer themselves for a test. All of this together means that any essential worker or member of their household who has symptoms and would benefit from a test, will be able to get one. At the same time, we are developing new and better blood tests. Now, these could be used to help people assess their individual risk, although, as I said, the science on this is incomplete and the existing tests on the market do not work well enough for individual advice. In fact, no country in the world is using them for that purpose. The existing tests can however be used with care in surveys to understand the spread of the virus. So just like our national effort on vaccines, the UK's top scientists are working with industry and the NHS to develop better blood tests. John Newton: (21:19) We've made good progress and several candidate tests and now being evaluated. Once we've identified the accurate tests, they can be provided in labs in large quantities relatively easily, much more easy to scale up than the swab tests. And finally, a public private consortium, the UK rapid test consortium is working on a method of getting antibody tests to people at home. So of course all this testing capacity is needed now, but not just now, also for the future to support the government's strategy as we move to the next stage of the response to the pandemic. In the coming weeks and months, as you've heard from secretary state, we will need testing to keep the virus under control with a test, track, and trace program. We will also need, as I've mentioned, intensive testing in settings like hospitals and care homes, including of people who may not have symptoms, to prevent spread, protect staff and save lives. John Newton: (22:17) Finally we will need testing capacity to support these large repeated surveys of the population to assess the ongoing situation. So let me summarize the current state of play as far as testing goes. We have exponentially increased our testing capacity and we are on target to have capacity for 100,000 tests a day. We're opening up access so that all essential workers and members of their household who have symptoms and could benefit from a test can get one. At the same time, as we've heard from Sir Patrick, the success of social distancing has almost certainly reduced the number of people who would benefit from a test at this stage of the pandemic. Perhaps most important though is that as we move to the next phase of the response to the pandemic, I can say with confidence that we will have the testing capability that we need. Thank you. Matt Hancock: (23:08) Thanks very much John, and now we'll open up to questions. The first question, Laura Coonsburg of the BBC. Laura Coonsburg: (23:16) Thank you very much, secretary of state. There is broad public support for the lockdown, but the Scottish first minister, the opposition and some of your own MPs think you should be more transparent about what might come next. Are they all wrong? Because the five tests you've set out are all about when it might be time, but not about how we might move on into that next phase. And if I could ask Sir Patrick, what do you think the gap between the peaks in terms of time could be in different parts of the country? Thanks. Matt Hancock: (23:46) Thanks, Laura. Well, I understand the thirst for knowledge, but the tests that we've set out, which are the basis from which others, for instance, the Scottish government have then developed their plans, those tests are the critical tests for when changes can be made. And of course monitoring what's happening and making sure that we move at the right time is absolutely critical. But the message remains to your viewers and to everybody across the country, the message remains the same, that people need to stay at home to protect the NHS and save lives. And the reason that we have clarity on that message is that it has succeeded in bringing down and flattening the curve, but we are not through that yet. And there's an awful lot of work that still needs to be done, and we're absolutely determined to avoid a second peak. So we've set out precisely, as you say, the five tests for when we should move. We haven't met them yet and therefore we must keep the social distancing measures in place. Patrick? Sir Patrick Vallance: (24:59) It's worth remembering that what we've done has really suppressed the numbers. So this isn't a natural peak. This is a suppressed peak. And I think London is ahead of the rest of the country maybe by a couple of weeks, but there's quite a lot of synchrony right across the country actually, it's not massively different, so I can't be absolutely sure about this, but I think two or three weeks is the sort of order where you might expect to see some differences across the country. Matt Hancock: (25:26) Thanks very much. Robert Peston, ITV. Speaker 3: (25:30) [ inaudible 00:12:30]. Matt Hancock: (25:32) Thanks Robert. Robert Peston: (25:34) Good afternoon. Couple of quick ones. First of all, if you look at the ICNARC intensive care surveys, it does seem that people who are overweight are more at risk of becoming acutely ill, but being overweight is not something that on the whole you talk about it as a risk factor. Is being overweight a risk factor, and secondly, just to Sir Patrick, it wasn't that long ago, Sir Patrick, that you said- Robert Peston: (26:02) ... 20,000 deaths would be a good result. It's very clear there are going to be more than 20,000 deaths. This is not a blame thing, but what have you learned about this virus and how it's behaving, explains why it's going to be considerably more than 20,000 deaths? Do you have a sense of, in this phase, how many deaths we're likely to see? Matt Hancock: (26:27) Thanks Robert. I'll ask John to answer the first and Patrick to answer the second. John Newton: (26:32) Yes. Thank you, Secretary of State. Well, yes Robert, the data you mentioned showed a number of differences between the characteristics of people receiving care for coronavirus and the general population. In fact, Secretary of State has asked Public Health England to undertake a detailed piece of research to look into this working with academic colleagues. So we're certainly looking at the relationship between obesity and outcomes, but also a number of other factors such as ethnicity, age, and gender even are all important factors. John Newton: (27:04) So there's quite a lot of work to do. In the data that we have, there are some techniques to try and assess by linkage and so on how important these differences are. So there's a certain amount of statistical work to do, but it should be possible to get an answer to some of those questions reasonably soon. Matt Hancock: (27:26) Thanks very much. Patrick. Sir Patrick Vallance: (27:28) In a way, your first question to some extent, answers the second one. There's a lot we don't know about this virus. I mean, it's odd that you see this obesity signal. It's odd that its got such a gender difference. There are lots of things about this new virus that we don't understand. There are lots of things that are being learned quite fast. There are lots of things that we need to understand about the immunity to it. Sir Patrick Vallance: (27:49) In terms of the numbers of deaths, I think it's difficult to speculate exactly what that will look like at the end of this. It's very clear that there have been large numbers right the way across the world. And I think the key statistic that we need to look at going forward is the overall excess deaths, which encompasses direct and indirect, as the CMOs laid out repeatedly. So I'm not going to try and put a number on that. Clearly every death is absolutely regrettable and affects many people. And our job is to try to make sure we suppress this as far as we can and keep those numbers down. Matt Hancock: (28:27) Thanks very much. Beth Rigby at Sky. Beth Rigby: (28:31) Thank you, Secretary of State. Mr. Hancock, first a question for you. Does a proper scale dock testing and tracing system have to be up and running before you're even countenance ease in the lockdown? And if so, can you get that ready by May the 7th? And to Sir Patrick, if I may, do you intend to establish what you think is a tolerable level of community transmission based on not overwhelming the NHS, so allowing some spread of the virus through the population? Or is your aim to push daily new cases as low as possible to control the virus? Matt Hancock: (29:13) Well, thanks. Both of those questions are ultimately for politicians because they are the big judgments. I'll ask Patrick to comment on the science of the latter, but ultimately the judgements are made by the Cabinet on the advice of the scientists. Matt Hancock: (29:34) On the first, there is no automatic link between the two. There is no automatic link between the scale of test, track and trace and any changes to the social distancing measures. So I wouldn't put a deadline on it in the way that you did. What I would say is that test, track and trace, done effectively, can help to suppress the transmission in a way that allows you then to have lesser social distancing rules. And critically, test, track and trace works more effectively when the rate of new cases is lower. So the lower the rate of new cases, the more effectively you can keep it down using test, track and trace rather than having to use heavier social distancing measures. Matt Hancock: (30:32) So the link between the two is in fact, that once you have full-blown tracking and tracing with the test capacity that, as John set out, we're increasing, that allows you to hold down the level of transmission under lesser social distancing rules. But you've got to get it down there first for test track, and trace to be effective. Matt Hancock: (30:58) And that comes to the second point, which is that our objective is to get the rate of transmission down. And that seems to have happened because instead of an exponential rise as we saw before, we now see a flattening of the curve. And then crucially, to get the level of transmission down as in the number of new cases. So it's both about the rate of change and the level. So it appears that we have got the rate, R figure, the rate of transmission lower because we've flattened the curve, but we've got to see the number of cases as well, come down because then you can use test, track and trace to hold it down. Matt Hancock: (31:41) So that's the way that those two things fit together and it's all part of a piece, and both of your questions are entirely tied to each other, which is why all of this becomes a strategic question rather than purely a scientific question. But it is of course based on the science. Patrick does that ... Sir Patrick Vallance: (31:59) Absolutely right. I mean, we advised on what measures needed to be put in place to keep the numbers down below NHS critical care capacity. That was absolutely crucial, and looks like that has been achieved. And therefore that's one really important step. And we are advising now on what measures need to be in place in order to get those numbers lower for the reasons Secretary of State said, and what numbers are necessary in order to get down to trace and test, track and trace approaches. But the decision on how far to go and which measures should be released and so on are ones for ministers. Matt Hancock: (32:41) Thanks very much Beth. Ben Kentish from LBC. Ben Kentish: (32:46) Thank you Secretary of State. Everyone agrees that the contact, the track and trace method that you've been talking about is going to be very important in the coming weeks. I wondered if I could just ask you to give us a few specifics. How many of those 18,000 traces are in place? When do you think you need to get to the 18,000? How low roughly, do case numbers need to be before track and trace can start to be in any way effective. Ben Kentish: (33:12) And just a second question, if I may, on science and face masks. We were behind other countries in going into lockdown. We've been behind other countries in scaling up our testing capacity, and it seems we are behind other countries in the use of face masks. When I asked about this two weeks ago, for example, that there was no effective [inaudible 00:33:35], and that advice may change. Is there a sense though that we are a bit slow compared to other countries in following the science, at a risk that delay might mean, given other countries have been buying face masks for their citizens for many weeks now, that there is a problem when it comes to British people having access, given international shortages, to effective protection face masks. Matt Hancock: (33:58) Thanks very much. So on the first question, we're recruiting now, and we've set out in the first instance that we're recruiting 18,000, of whom 3000 will be clinical personnel, and train up the other 15,000. That process is ongoing. And in terms of when it will be ready, it's in a matter of weeks. And that will then help, but critically it's needed when we get the level of transmission down. Matt Hancock: (34:31) On the second question, we've discussed the timings many times before. I don't accept the premise of the question because we followed the science throughout this, building on that science. And the science develops as we learn more about the virus. Matt Hancock: (34:51) And as for making sure that we are ready for any change in the science, many countries have been buying face masks, as have we. But the position on face masks is unchanged. We, of course constantly the science on that is being reviewed, and we'll consider updated scientific advice if that's what we get as and when we need to. And also consider the sort of knock-on implications that you talk about because it is absolutely critical that the face masks that we buy are first and foremost for people in the NHS and Social Care and other places where they are clearly in clinical need. And that's what we've been buying the face masks for. Matt Hancock: (35:35) Patrick, anything to add on that? Sir Patrick Vallance: (35:36) I don't think so. I mean, the evidence on face masks has always been quite variable, quite weak, quite difficult to know exactly. And there's no real trials on it. And we've undertaken a review, we'll give our advice to ministers and they'll make decisions about what to do around that. Matt Hancock: (35:52) Thanks very much. Macer Hall from the Express. Macer Hall: (35:56) Thank you Secretary of State. Question first to Sir Patrick. In the early stages of this crisis, you've told us that social distancing measures shouldn't be introduced too quickly because of the dangers of longterm public fatigue. What is your behavioral modeling telling you now about the public's willingness to continue enduring these restrictions? And is the increased road traffic and people on the streets that we've seen this week, is that a sign that some people's patience is beginning to wear out? Macer Hall: (36:24) And Secretary of State, as we prepare to applaud our NHS workers again tonight, can you tell us what progress the government has made into providing improved support for the relatives of those doctors, nurses and other medical staff who lose their lives in this emergency? Dozens of MPs have been calling for a scheme similar to that that operates for grieved armed forces families. Is this something that you would consider? Matt Hancock: (36:48) Thank you very much, Macer. I'll ask Sir Patrick to answer the first on the endurance of people's support for the lockdown measures. All I'd say is I think it's been absolutely phenomenal how the British people have responded when we've asked them to do something that is quite difficult to follow those new social distancing rules. They have risen to that and I'm very proud of them. Matt Hancock: (37:20) On the second point, of course it isn't just applause for the NHS, it's clap for our carers, including Social Care. And I think one of the good things about this crisis is the clarity with which people who work in Social Care and do such important work that I have seen, that the country cares for and is grateful to them too. Matt Hancock: (37:44) On the important question that you ask about support for the families of those who've lost their lives, of course is something that I'm looking into, and I hope to be able to say something more about it very soon. Patrick. Sir Patrick Vallance: (37:59) Well, on the social distancing, we said at the outset that it's important to break transmission between households to lower the rate of transmission. And social distancing clearly is the way that you can do that, and it needs to be sustainable. And I think if you look at the evidence, the data actually looks like people are really doing a very, very good job in that. And it is sustaining. So I don't think there's evidence that this is tailing off, and it's important that we carry on with it for all the reasons that have been said. So I think at the moment things look very good there and it is reducing the R, it has reduced the R dramatically, and we suspect there will be far fewer infections in the community as a result. Matt Hancock: (38:39) Final thing I'd say Macer, is that I pay tribute to the support that the Daily Express has shown for our health and care staff throughout this crisis with constant messages of support, which I know that my colleagues appreciate. Joe Murphy from the Evening Standard. Joe Murphy: (39:01) Secretary of State- Joe Murphy: (39:04) ... It's really encouraging to see that curve for London coming down. So Patrick said London was two weeks ahead of other regions. Wouldn't it make sense, and perhaps save thousands of firms from going bust, and hundreds of thousands of jobs from being lost if London could stop coming out of lockdown two weeks ahead of regions who also lucky at the moment? And could I just ask Professor Newton at the same time, doctors are telling us that you can't rely on certificates of cause of death to make figures on how many patients have died. Sorry ... How many people in the community have died of coronavirus because doctors are not always writing COVID-19 on the certificate because they don't know without a test. Wouldn't it make sense to start testing every person who dies in a care home with any sorts of symptoms so that the figures can be more accurate? Matt Hancock: (40:01) Thank you. I'll ask Sir Patrick to answer the first, and Professor Newton to answer the second. The only thing I want to add is that the point about supporting those who live in care homes is incredibly important and front of mind, and we've already expanded the availability of testing to those in care homes, including to asymptomatic residents in care homes. It's a very important part of the testing program. Sir Patrick. Sir Patrick Vallance: (40:38) What I said was that there's more similarities than differences, and there may be up to two or three weeks differences in some places. So it's not that London's two weeks ahead of everywhere. There is actually a lot of similarities across a number of areas, including big urban areas. So I don't think you should take the message at all that there is two weeks difference between London and the rest of the country. They may be up to two weeks in some parts of the country. That's the point. Sir Patrick Vallance: (41:04) In terms of releasing measures, you've only had to look at the way in which this disease can spread in cities and in urban environments to know that the release of the measure is something you want to do absolutely when you're sure you've got on top of it, that's the right time to do it, and to make sure that you don't get reimportation across the country. So how this is done I think is a matter for ministers to make decisions on. But you can see it's really not the straightforward as saying because you hit the peak two weeks early, you can release things two weeks early. It depends on absolute numbers and it depends on a number of other factors. Matt Hancock: (41:40) Thanks Joe. Did you have another? Sorry? Of course. John Newton: (41:44) Yes. So Joe, you're absolutely right. So one of the reasons for wanting to have more available testing is to get better statistics and understand the data better. But in fact, we have always been testing people, residents in care homes. Over 11,000 people have already been tested in care homes and the Secretary of State, we're rolling out very significant capacity to test all people in care homes. But in any case, Public Health England has been looking at these days at carefully. John Newton: (42:08) So we're able to, even if the doctor doesn't write coronavirus on the desk certificate, we know by linking together the data that we have on the test with national records when a patient dies, which goes through to a national register. So we were already able to pick up quite a lot that way and so we will have been missing a few, but perhaps not as many as your question implied, but it's very important to emphasize the fact that we need better data in care homes and that will help us to look after people, protect them, and save lives in care homes as well as in the NHS. Matt Hancock: (42:46) Okay. Thanks Joe. I've got Jody Doherty-Cove from the Brighton Argus. Jody Doherty-Cove: (42:55) Yeah. Good afternoon. It was 46 days between the first case in Brighton and Hove and a nursing home in the city calling out for proper protective equipment and testing after a cluster of cases among patients and staff. What steps has the government now taken to reduce outbreaks in care homes and have you considered limiting agency workers to one or two homes to reduce the spread between them? Secondly, many people are still coming down to Brighton Beach, flouting lockdown rules, despite efforts from the local council and police. What else can be done to limit the number of people coming to destinations like Brighton on the weekend? Matt Hancock: (43:30) Well, thanks very much Jody. There's a huge effort underway to limit the spread of this disease in care homes and I followed the reports from the care homes in Brighton very closely and as you say, there was a significant gap between the first positive case in Brighton and the first reported cases in care homes. What we've been able to do recently is expand the amount of testing so that anybody who has symptoms in a care home now gets tested. Matt Hancock: (44:07) And as of yesterday we've introduced the testing of people who don't have symptoms in care homes for exactly the sort of reasons that you set out. So that everybody who can benefit from a test, who is a resident in a care home can now get a test. The amount of work that's gone on reflects the importance of supporting people who live in care homes and trying to make sure that they are protected, not least because people who live in care homes are often amongst the most vulnerable to this disease. Matt Hancock: (44:49) As for people going to the beach in Brighton, I think the police have done a good job. I've also seen reports of the police stopping people from having barbecues on the beach and making sure that people follow the social distancing rules, and the rules are there for a reason and that's because people need to follow the rules in order to protect the NHS and to slow the spread of this virus. What I'd say to people in Brighton, and the rest of the country, is that the measures that we're taking are working, they're supported by the vast majority of people in this country, and everyone should follow the social distancing rules because that is how we come through this as a city and as a country. Matt Hancock: (45:37) Finally, Hannah Rodger from the Herald. Hannah Rodger: (45:46) Hello. Matt Hancock: (45:47) Hello. Hannah Rodger: (45:48) Hi there. So I've got a question for the Secretary of State, and one for Sir Patrick. So today the Scottish government has produced a detailed 25 page report on their exit strategy from the lockdown. Nicola Sturgeon, our first minister say that she wants to have an adult discussion, and she wants to receive feedback from the Scottish public on her plan. My question to you is, why has the UK government been unable thus far to produce a similarly detailed plan, which not only can be scrutinized by the members of the public, but can also be used to get people some hope? Hannah Rodger: (46:28) My question for Sir Patrick is, the Scottish government report today says, one of the ways forward out of the lockdown could be to vary restrictions based on geography, professional sector, and by specific demographics, and groups of the population. Do you agree that this is something that should be considered, and is it something that you yourself might take into consideration when looking at the exit strategy for the UK? Matt Hancock: (46:59) Thanks very much Hannah. We've set out the five tests that are needed for us to make changes to the lockdown measures, and the Scottish government's proposals are based on those tests. I think that having the four nations of the UK work together on this has been important thus far, not just on social distancing but also for instance on testing, and I think that the country has essentially moved together, and you can see that in the flattening of the curve which has essentially happened in all regions and nations of the UK together. I think that it's important that us having set out the test, and now the Scottish government having set out their approach, which is very similar, and based on those five tests we've set out, I think that the UK wide approach is the best way to go. Patrick. Sir Patrick Vallance: (48:10) Just to echo that the scientists are all working together and actually we're very closely working with the chair of the Scottish Science Advisory group who joins us as well for all our meetings and we share information and we look at all the same things, and the modeling is shared so that people don't have to repeat what others are doing. So this is very much a unified approach to looking at the different options and the impact that they could have in terms of social distancing, which is the key thing. How do you make sure you reduce the contact in a way that allows the r to stay below one, and allow things to return more towards normal in due course. Matt Hancock: (48:53) Thanks very much indeed. That concludes the Downing Street coronavirus briefing for today, and I'll no doubt see you again soon. Thank you.