United Kingdom Coronavirus Briefing Transcript April 28

Matt Hancock: (00:00) And by deputy chief scientific advisor, Angela McLean. This morning at 11:00 o'clock, we paused to remember the 85 NHS colleagues and the 19 colleagues from social care who've lost their lives with coronavirus. It was a solemn moment of reflection for so many of us, and of unbearable sadness for some. These are the nation's fallen heroes and we will remember them. Every day we're working through our plan to protect life and to protect the NHS, slowing the spread and building capacity so that the NHS, at all times, can offer the very best care to everybody because we've got the beds and the ventilators and the staff available. Matt Hancock: (00:53) So far, thanks to the incredible work of NHS colleagues and the shared sacrifice of everyone who's at home, that plan is working. The latest figure show 3,260 spare critical care beds across the NHS. On the most recent figures, there've been 763,387 tests for coronavirus so far in the UK, including 43,453 yesterday. 161, 145 people have tested positive, an increase of 3,996. 15,796 people are currently in hospital with coronavirus. 21,678 have now sadly died in hospital, an increase of 586 since yesterday. Matt Hancock: (01:54) This morning, the office for national statistics and the CQC published more information on the overall impact, including that there have been 4,343 notified deaths in care homes since Easter. The proportion of coronavirus deaths in care homes is around a sixth of the total, which is just below what we see in normal times. I want to make sure that we bring as much transparency as possible to important information like this. And so from tomorrow, we'll be publishing not just the number of deaths in hospital each day, but the number of deaths in care homes and in the community too. This is something that wasn't previously possible. This will supplement the ONS and CQC weekly publication and all add to our understanding of how this virus is spreading day by day, and it'll help inform the judgements that we make as we work to keep people safe. Matt Hancock: (02:59) Behind every single death is a family's heartbreak, and we must do everything humanly possible to save as many lives as we can. We will not be changing the social distancing rules until our five tests have been met; the NHS protected, infection rates falling, the number of deaths falling substantially, the operational challenges around testing and PPE addressed and no risk of a second spike. Matt Hancock: (03:32) I want to update you on two other issues of major importance. First on testing. At the start of the month, I set a goal of 100,000 tests a day. Every day, we're ramping up this testing capacity on track to meet that goal. We're continuously opening new drive-through centers. There are now 41 with 48 going live this week. For people who can't get to the tests, we're expanding home testing to bring the test to them. We're increasing the dispatch of home test kits from 5,000 a day last Friday to 25,000 a day by the end of the week. Matt Hancock: (04:12) At the weekend, 17 mobile testing units, manned by the army, were operational. By the end of the week, we plan to have over 70 deployed with trained crews right across the country. All of this has led to an increase in daily testing capacity, which now stands at 73,400, and this has allowed us progressively to expand access to testing. We started with hospital patients who've always have the access to tests right away through ramping up to include symptomatic NHS and social care colleagues and their households and then to all essential workers. Today, because we've been able to expand capacity, I can expand access further. Matt Hancock: (05:04) Building on successful pilots, we'll be rolling out testing of asymptomatic residents and staff in care homes in England and to patients and staff in the NHS. This will mean that anyone who is working or living in a care home will be able to get access to a test whether they have symptoms or not. I'm determined to do everything I can to protect the most vulnerable and we now have the capacity to go further still. So from now, we're making testing available to all over 65s and their households with symptoms and to all workers who would have to leave home in order to go to work and members of their households, again, who have symptoms. So from construction workers to emergency plumbers, from research scientists to those in manufacturing. The expansion of access to testing will protect the most vulnerable and help keep people safe and it's possible because we've expanded capacity for testing thus far. Matt Hancock: (06:20) Next, I want to update you on our COVID-19 therapeutics work. This is research to understand whether existing drugs could be used to treat people more effectively once they've developed the disease. Currently no drugs in the world have been clinically proven to treat COVID-19, but our therapeutics task force has identified a number of promising candidates. Currently, six different treatments have been entered into national clinical trials, and the first is ready to enter the next stage, a new early phase clinical trial platform that we're launching today. This is a national effort made possible by government, academia, and industry all working together. Matt Hancock: (07:01) In addition, we have to make the best possible use of all the medicines that we have. We're updating the guidelines for the use of medicines in care homes, removing a barrier so that for the period of the pandemic, where it's clinically appropriate, medicines that have been labeled for use by one patient can be used by another patient who needs them instead of being destroyed. Clinicians and colleagues in social care have called for this change and it's already standard procedure in hospitals. Matt Hancock: (07:32) Right across government, we're working day and night to defeat this virus, ramping up testing capacity, investigating new drugs and treatments, backing vaccine development, securing and distributing billions of items of PPE, getting the NHS whatever resources it needs to make sure that it is always there to treat everybody who needs it. The risk of a second peak is real, but as a nation, we're holding it at bay. So please stay at home, protect the NHS and save lives. I'm now going to turn to the deputy chief scientific advisor to take us through the daily charts. Angela. Angela McLean: (08:15) Thank you very much. If I could have the first slide please. I wanted to go into a bit more detail about the five tests for adjusting the lockdown. So the first of those is that the NHS shall have sufficient capacity to provide critical care and specialist treatment right across the UK. The second is that we should have seen a sustained and consistent fall in daily deaths from coronavirus. Number three says that we must have reliable data to show us that the rate of infection is decreasing to manageable levels right across the board. Fourth is that operational challenges, including testing and PPE, are in hand with supply able to meet future demand. And the fifth test is that we must be confident that any adjustments that we make to our current measures will not risk a second peak of infections that might overwhelm the NHS. Angela McLean: (09:23) And if I could just have the next slide please, here is a description of transport use and how it has changed across Great Britain for a number of different ways of traveling. And it starts on the 16th of March on the left hand side and runs to Saturday, 26th of April. And what you see when you look at this data is how volumes of all kinds of traffic have fallen relative to how much travel there was in the first week of February. So in particular, we remain pleased to see that the use of public transport is below 20% for buses, the tube and national rail. And we just very much hope that all those people in motor vehicles who are not below 20% are practicing really excellent social distancing when they get it wherever it is that they're going. Angela McLean: (10:22) Next slide please. We know that it's been a lot of work for everybody, and this slide is new cases in UK between the 21st of March and the 28th of April. And what it shows is that that ... So this is new positive tests. In dark blue is tests that happened in hospitals and in orange is additional testing that has become available for key workers. And what you see in that slide is how that number of positive tests rose very quickly through the latter part of March and has now stabilized. And the blue line, the numbers in hospital positive tests, is starting to fall, although because of the number of tests is still rising overall, we're still getting about the same number of positive tests across the UK. Next slide please. Angela McLean: (11:26) This instead of counting test counts people. So this is people who are in hospital with COVID-19 again across the UK. And what you see is that overall, that has fallen by 14% in the last ... I think it's in the last week. Sorry, I'm looking for a date. It's yes. Over the last week, that has fallen by 14%, particularly a dramatic fall in [inaudible 00:11:55] peaked early compared with the rest of the country, and several other regions of England now are clearly falling, although a few regions of England, that number of people in hospital, is still stable for now. Next slide please. Angela McLean: (12:15) This is critical care beds in which there is a patient with COVID-19. So this is two kinds of critical care beds, those in the high dependency wards and those in intensive care wards. And the four different lines are England, Northern Ireland, Wales, and Scotland. And what you see is what percentage of those beds that can be used for critical care are occupied by a patient with COVID-19. Again, what you see is across all four nations, that has peaked and is beginning to fall as a percentage. Next slide please. We have to turn to how many people have died from COVID. Angela McLean: (13:03) We have to turn to how many people have died from COVID. And our first way of counting that is daily COVID-19 deaths in hospital. So this is a slide that many of us would be familiar with. It's the way we have been counting for more than a month now. When you look at that slide, the first thing you see is this, well, I guess the first thing you see is that the number of deaths in hospital has started to fall. It's been falling for the last two weeks. You see that most easily by looking at the orange line. The orange line is a seven day rolling average. And the reason we use that is that there are these very strong weekend effects in these data. So what you see is that out of every seven days, there are always two days when it's really low, followed by a day when it's much higher. Because today is Tuesday, it's higher today. Because on a Tuesday, we report results from a few days ago. I think the most important thing to see there is that the orange line is falling steadily. But this is just one of the ways that we can count how many people have died with COVID. Angela McLean: (14:11) Next slide please. This is a different way of counting the same thing. So this is all weekly registered deaths from COVID-19 across the UK compared with what I just showed you, the deaths in hospital. So let's just look at the last bar, which is for the week leading up to the 17th of April. The dark blue bar is what we just looked at but summed up up to then. Whereas the pale blue bar is all weekly registered deaths. So that's everybody, not just the people who died with COVID in hospital. Angela McLean: (14:47) If I could have the next slide, please. So what the next slide does is it takes the pale blue line that we just had and breaks it out into a number of different locations. So what you see is hospital is the right hand bar in a sort of smoky blue. Just the left of that is people who died with COVID in care homes. Just below that is people who died with COVID in their own home. And then the smallest bar is other locations. So what you can see here is that deaths from COVID are dominated by those deaths in hospital, but that is not the only location in which such deaths are seen. Next slide, please. Angela McLean: (15:41) The last slide for today compares UK deaths with those in other nations. So these lines are lined up against the first day when there had been a total of 50 deaths accumulated in each of these nations. And we have two different lines on there describing what's happened in the UK. Towards the right hand side, you see a dark blue line labeled UK hospitals only. And that's the data that we've been collecting and showing for a long time. So it's people who have died with COVID in UK hospitals. Whereas a gray line further over to the left there is people who have died with COVID in the UK in all settings. And not surprisingly, if you count all settings, that line is higher than the people who died in UK hospitals. That's the end of the data for today. Thank you very much. Matt Hancock: (16:39) Thanks very much, indeed. As with yesterday. We're now going to take questions from the public before turning to journalists. And the first, we're going to take two questions today from the public. These are questions that, as with the questions from journalists, we don't see an advance. The first I'll read out from the screen and then the second is going to be relayed by video. So the first question is from Amanda from Hull and she asks, given that grandparents can not be used as childcare, what is the plan for easing the lockdown for full time working parents who have young children that may not be allowed to be in school on a full time basis? Matt Hancock: (17:23) And Amanda, this is a really good question. And the honest answer I can give you is that it is still too early to say when we're going to be able to get schools to go back because there are still too many deaths each day. And the five tests that we set out haven't been met. Now I know, especially as a father of three young children, that there's a yearning from people to know when schools might go back. And of course it's something that we think about and we talk about. And I'm sorry that I can't give you a more definitive answer, but I can't because we don't yet have the number of deaths and the number of infections low enough for that to be safe to reopen the schools and we don't yet know how fast the number of new cases will fall. And so we haven't been able to make that decision yet. Angela, I don't know if you want to add. Angela McLean: (18:29) I'm not sure I do have anything to add on that. We are, of course, all of us, yearning for the number of deaths each day to fall. Matt Hancock: (18:38) Thank you, Amanda. Thank you for your question. And all I can say is that I hope we can be in a position to be able to give a definitive answer as soon as possible. And the best way to get there is for people, everybody watching, to stay at home in order to protect the NHS, to save lives, and to bring that curve down. Thank you, Amanda. Next question. Sadie: (19:03) Hi. My question is regarding my 10 year old son who has cystic fibrosis and autism. Apart from shielding, is there any other option for him and others in the extremely vulnerable category to return to school and be part of society again without a vaccine available? Matt Hancock: (19:20) Thank you, Sadie. The answer to this is yes. We have made sure, in the school's policy, that we're working very hard to ensure that those who have extra needs, for instance, people with autism and cystic fibrosis, get that extra support. It is, of course, very, very hard though when that clashes with the medical needs which have to come first. And for those who are in the shielded category, I'm afraid that the safest thing for them to do is to be shielded, which is not just to stay at home, but really be protected from all contact because of the consequences should they get the disease. Angela McLean: (20:08) Yes. I think I agree. That's right. Matt Hancock: (20:11) Thank you very much and thank you for your question. And of course, you mentioned a vaccine and we're all working incredibly hard to try to get a vaccine as soon as possible. But again, the science behind that is uncertain and so the timings are uncertain. And thank you very much for those two questions from the public. I think that this is working well, having questions from members of the public. I'm very grateful to all those who have submitted and it's something that we're going to keep on doing. So thanks very much. And now we'll turn to Hugh Pym from the BBC. Hugh Pym: (20:46) Thank you very much. I wanted to raise the subject of PPE. I know it's been discussed several times at this occasion before, but it's still a talking point after Panorama and also a survey of doctors suggesting some are of concern still. What assurances can you give front line staff that there will be adequate supplies of PPE in the days and weeks ahead? Matt Hancock: (21:08) Well, thank you, Hugh. The issue of PPE is incredibly important and making sure that there are the supplies of PPE so that everybody on the front line has the PPE and the protective equipment that they need. As you know, we've been moving heaven and earth to get the amount of PPE that we need to the frontline, both buying it from abroad and also then distributing it. That system is getting stronger all of the time, but it is a mammoth effort to do it. Matt Hancock: (21:44) I saw two of the things that you referred to, I'm not sure that they were a fair and objective journalistic assessment of the situation, but what we do have is constant focus on the realities of getting PPE to the front line and we we take full responsibility to getting it to every single person who needs it. Hugh Pym: (22:08) Can I ask a quick follow up? Matt Hancock: (22:08) Yes, of course. Hugh Pym: (22:10) Can you assure staff that stocks are not running low at the moment? Matt Hancock: (22:16) Well, I can assure staff that the PPE that we need according to the agreed guidelines, that is available. We're constantly needing to buy more from abroad and to make more at home to make sure we're constantly replenishing that. And that's a huge effort. Globally, there's a shortage of PPE because the demand for PPE, understandably, in so many countries has shot up. And therefore, we're out buying it around the rest of the world. And I'm really glad that a whole host of factories here in the UK are turning over their production towards PPE. It's incredibly important. It's a huge amount of effort. And we're working on it as hard as we possibly can. Thanks, Hugh. Paul Brand from ITV. We've lost your audio, Paul. Paul Brand: (23:18) Hopefully you can hear me now, Secretary. Matt Hancock: (23:19) Yes. Paul Brand: (23:20) Excellent. Given today's statistics, Health Secretary, do you now recognize that while you've prevented the NHS from becoming overwhelmed, there is now a crisis in the care sector? And given that the number of deaths continues to go up in care homes each day, will it now be your main priority? Matt Hancock: (23:38) Well, of course care homes have been a top priority right from the start. We put out our first guidance to care homes in February and we've been working with them throughout. Now, by their nature, care homes look after and support some of the most vulnerable people anyway. And they support some of the people who are most vulnerable to this disease as well because of the nature of the disease and how it impacts on, especially on older people much more than the rest of the population. So it's been a focus from the start. We've strengthened the rules around what happens in care homes and improved infection control. And also making testing available throughout the care sector I think is incredibly important as we've ramped up the availability of testing. Matt Hancock: (24:36) We keep a close eye on it and I'm very glad that we're now able to publish these daily data, which will keep the focus on what's happening in care homes. I asked for that to start and I think we talked about it a week or so ago and now we've got those data being collected so that we can focus on it day in, day out. And my principle in this is to be as transparent as possible because then you find problems as quickly as possible. And we- Paul Brand: (25:07) You say that you'll keep an eye on it, but carers are frustrated. And I understand this is a complex sector. There's lots of private providers here. It's not like the NHS. And that's a fair point that you have often made. But given that the number of deaths in care homes continues to go up every day, surely this has to be your first priority now. This looks as though this is where the virus continues to spread. Matt Hancock: (25:29) The spread of the virus through care homes is absolutely a top priority, yes. And on the testing, I think John Newton wanted to add something. John Newton: (25:36) Well, yes. I mean, it is absolutely right that care homes are a focus. And in fact, we've done some intensive studies of infection in care homes. And what that showed was that the presence of symptoms was not a very good marker in the care home setting, both amongst residents and staff, for the presence of the virus. So there were significant numbers of residents who were asymptomatic who had the virus. And so we've massively increased the amount of testing available. So we've now tested 25,000. John Newton: (26:03) The amount of testing available. So we've now tested 25,000 residents in care homes and we're rolling out testing now to symptomatic and asymptomatic residents as well as providing testing through the drive incentives and through the other means that Secretary of State's mentioned for staff. And we think that will really make a difference combined with intensive infection control methods informed by much more widely available testing. Thank you. Matt Hancock: (26:26) Thanks, John. Nick Martin from Sky. Nick Martin: (26:31) Very good afternoon. A question for all of you, but the health secretary first. I just want to clarify something you said in your introduction, Secretary of State. You said the proportion of corona deaths in care homes is around the sixth of the total. In week 16, which I think is ending April the 17th, care home deaths were actually 23% of the official COVID deaths. And of total deaths, not just COVID, closer to a third. Are you saying that the number of people who've died in care homes during this crisis is around in line with the number of deaths you would normally see in any other year? Matt Hancock: (27:06) No, I'm absolutely not saying that latter point. What I was saying very clearly is that, in the statistics that have been published so far, the number of deaths from coronavirus in care homes is around a sixth in total. But of course the breakdown of the statistics, exactly as you say, shows that that proportion is changing and we've got to... So, I was putting it in the broad context, but also saying that it is an absolute focus of ours because it's an area which you've highlighted many times in the past under an area where we've got a huge amount of focus. Thanks. Ben Kentish from LBC. Nick Martin: (27:59) Could I just have a followup please? Matt Hancock: (28:00) Yes, of course. Of course, Nick. Nick Martin: (28:02) I'm so sorry. Matt Hancock: (28:03) No problem. Nick Martin: (28:04) A lot of people have died in care homes. I've seen it with my own eyes. And you knew and your department knew that this was a high risk area. You have a huge guidance to care homes repeatedly over the last few months, and yet PP was inadequate, tests for the most part were few and far between, but yet the deaths in care homes seem to take you and your department by surprise. And this isn't meant to be a clever, catch you out question at all, but I wonder if you will take this opportunity to apologize to those families of loved ones who died in care homes because the government didn't properly protect them. Matt Hancock: (28:45) The thing is, Nick, I think that's unreasonable as a question, actually. And I know you care an awful lot about this, but, from the start, we know, we knew that there was a very significant challenge with care homes, not least because of the frailty of the residents and the enormous work that's gone on within government, Public Health England, and local authorities, and the CQC to monitor this from the start. It has been more difficult to get data flowing, and I'm very glad we're able to do that now on a daily basis instead of a weekly basis as before, and making sure that care homes have the support they need has been absolutely at front of mind right from the start. Matt Hancock: (29:36) In fact, I can remember in one of the very early discussions about coronavirus in January, having a discussion about, because one of the first things we knew about this virus was that it had a very strong age profile, as in it was much more dangerous for older people. That immediately drew our attention to the fact that there was a big challenge in care homes, especially because people are more frail, and therefore they are more at risk. It's something that we focused on right from the start and something that's been a huge challenge throughout, and we're constantly learning from what happens and trying to improve the way that we support people across the care sector. Matt Hancock: (30:23) Ben Kentish from LBC. Nick Martin: (30:25) Secretary of State, why didn't you bring in tests earlier? It just seems odd that it took a while for tests to come through. If you knew the risks and, as you just clearly said, why did it take you so long to give the sector what it was crying out for, and that was tests? Matt Hancock: (30:41) Well, we have been testing in care homes right from the start and throughout the crisis. So that's one of the things in your question that I dispute, and I know the passion that you have for this subject. But it is really important to base, for us to explain what's been going on and we've been testing right from the start. John? John Newton: (31:02) It's important to understand that, from the word go, Public Health England has been investigating any outbreaks of coronavirus in care homes. And the approach there would be to test a limited number, when test capacity was limited, we're talking about beginning of April, test capacity was limited to test a number of index cases to clarify that it was an outbreak of coronavirus. Then the whole care home would be treated as if the symptomatic cases were all coronavirus and various measures were put in place, and no doubt many lives saved as a result. John Newton: (31:33) Obviously, now we have more testing and we have more knowledge about the way the virus spreads in care homes. We're able to adapt that and we'll be even more effective. But it would be wrong to say that testing was not available and not used. And it would also be wrong to say that nothing was done about these outbreaks. A great deal was done, but we're confident we can be more effective now than in the past. John Newton: (31:52) The issue of care homes is an international one. Every country in Europe has had a significant problem with a large proportion of the deaths from coronavirus occurring in the care home sector. We are no different in that respect. And the care home sector is a highly distributed system. It's intrinsically difficult to deliver services to that sector. But nevertheless, a huge effort has been made in collaboration with organizations like the Care Quality Commission and also local government. So a lot has been done. We all want to do more and we are, certainly with testing, we're going to be able to do a lot more with this additional capacity that Secretary of State described. Thank you. Matt Hancock: (32:29) Thanks, Nick. Ben Kentish from LBC. Ben Kentish: (32:33) Thank you. Good afternoon to you all. Secretary of State, I know you've said you're following the science on this, but it's been almost a week since your scientific advisors made a new recommendation in relation to the use of face masks, Scotland today becoming the latest country to recommend they are used in public places. Are you able to tell us about the deliberations you're making on that, what the delay is, and when we're likely to hear some sorts of ruling, some sorts of advice on that? And if I could also ask very quickly to Professor McLean another practical question. Experts in some countries have given very clear advice about stopping the spread of this disease from surfaces. I know you've recommended washing hands. But other countries, for example, are saying people should be disinfecting their washing, takeaway boxes, anything really coming into their house. Are you recommending British people do those sorts of things too? Thank you. Matt Hancock: (33:24) They're all questions to Professor McLean. What I'd say is that, on face masks, we are guided by the science, and the government position hasn't changed. Professor McLean will explain the science. The UK Government position hasn't changed, not least because this most important thing people can do is the social distancing as opposed to the weak science on face masks. There is very clear science on social distancing and the importance of it. So that is our absolute priority in terms of the message to the public, that the social distancing, staying at home is the thing that is helping to save lives by flattening the curve. That is the number one thing. Professor. Professor McLean: (34:12) The recommendation from SAGE is completely clear, which is that there is weak evidence of a small effect in which a face mask can prevent a source of infection of going from somebody who is infected to the people around them. Now of course under our current circumstances, anybody who has symptoms really must stay at home. And that's the thing that people have done so brilliantly. But we are also concerned that some people are infected who don't have symptoms or maybe don't have symptoms yet, and that is the reason that SAGE has put so much effort into looking at this question. But the answer is clear that the evidence is weak and the effect is small. And we've passed that on to our colleagues in government with which to make a decision. Turning onto your question about hand washing and keeping surfaces clean, we have always absolutely been really majored on hand washing because that's the way you keep the inside of your house and your family safe when you come in from outdoors. We would also recommend always keeping the surfaces in your house clean. That would seem like common sense to me. Matt Hancock: (35:27) Thanks very much. Thanks, Ben. The next question is from Dominic [Yaton 00:35:32] at the metro. Dominic. Dominic: (35:35) Hello, Secretary of State. You said that you knew from the start that there was a very significant challenge with care homes. So why were care homes not told to ban visitors until March the 16th? And why were figures on deaths outside hospitals not published until March 31st? Matt Hancock: (35:57) The collection of the information from the care home sector has been more difficult than from the NHS by the distributed nature of the care system. There's 15,000 care homes, and they're part of 10,000 different organizations. And so, I'm glad we managed to get the data collection. On the point about visitors, that was based on clinical advice. And I'll explain the reason that our clinical advisors gave us, which is that before there was a widespread incidence of coronavirus across the community as a whole, the critical thing is that, in a care home, having visitors also has a positive impact both against the loneliness of the residents but also on their longevity and their mental health. So these are difficult judgments and there are no easy recommendations to make. And so, absolutely, we are guided by that clinical advice. Matt Hancock: (37:12) When it was necessary to make that change, which is quite a firm change, then we did so. So, I understand. Of course I understand the focus now on care homes and the questions from the media, but it's something we've been working on incredibly hard right from the start. And really, one of the things that has happened in this crisis is that social care alongside the NHS have both been seen as these two absolutely vital parts of our society. And I think that that's a good thing that we recognize and value them in that way. James Kayvan at the Daily Star. James Kayvan: (37:58) Hi. I just wanted to ask, first of all, there's increasing frustration over what people see as mixed messaging from the government around the social distancing measures. On the one hand we've seen long queues at DIY stores, while on the other police are moving people on for sitting alone outside and sunbathing in parks. As increasing numbers of people return to work and roads get busier, can you give greater clarity what you can and can't do outside the house? James Kayvan: (38:20) And second, if I can just ask, there've been reports that ventilator productions is now being scaled back just weeks after you called on British industry to build thousands for the NHS. Will we be in a situation soon where we have a huge supply of these machines [inaudible 00:38:33] demand? And I just wondered what's going to happen with that supply and will the production of new ventilators continue to be scaled back or do you still want more for the future? Matt Hancock: (38:42) Thanks very much, indeed. Look, on the clarity, I can absolutely give you that clarity, James, which is that people should follow the social distancing rules and they should stay at home if at all possible because that protects the NHS. And so far the protection of the NHS is working. And this brings me to the second point, which is that... Matt Hancock: (39:03) This brings me to the second point which is that it is good news that there are spare ventilated beds available in the NHS. There has been no point when somebody's needed a ventilator and a ventilator has not been available, a ventilated bed, because it's more than just the ventilator machine, of course you need the people as well to use them. That has been one of the things in this crisis that people said right at the start, that preventing the NHS from being overwhelmed will be extremely difficult. Some people told me to my face it would be impossible, but that so far has worked, and now with the number of people in the NHS in hospital with coronavirus falling, we can see that we've managed to keep the NHS able to treat everybody who needs it. That brings to the question of ventilators. We are still, yes, producing those ventilators. Matt Hancock: (39:54) There are countries across the world who are now needing them because their curve is in a different position, and so we're still working with those companies who I pay tribute to who've absolutely pulled the stops out and made sure that we have the ventilator capacity that we needed when the number of people on ventilators was at its peak, which I think was about three weeks ago, [inaudible 00:01:20]? About that. So I pay tribute to the ventilator challenge and everybody who participated in it, they've done an amazing job, and they have, and so far it's been successful in ensuring we've always got those ventilators that people need. Chris Lloyd from the Northern Echo. Chris Lloyd: (40:41) Afternoon. Thanks for having me. What is the time lag of the pandemics progress? As the country went into lockdown at the same time, is it possible that the regions, like here in the northeast, were locked down comparatively early and so might not be hit as hard as was once feared? Although I note in your earlier slide there was a slight uptake in all regions outside of London of the number of people in hospital. And will that have any impact on a second wave in the regions? And how will the time lag inform policy on lifting the lockdown? Do you imagine that some areas might ease before others or will we all be in or out of lockdown together, and then, hopefully I'm not outstaying my welcome here. Looking further ahead, northern manufacturing towns bore the brunt of previous economic downturns, so how will the government ensure its measures to help the country recover are regionally applicable in terms of manufacturing, infrastructure, even moving government jobs out of London? Matt Hancock: (41:37) Well Chris, you're very welcome here at the press conference. I'm going to ask Angela to answer the substance of the first part of your question, but the first thing I'd say is I want to pay tribute to the people of the northeast for staying at home and helping to ensure that the number of cases in the northeast has relatively low. And knowing Newcastle well as I do, I know that the people of the Northeast are very gregarious and have done their duty by staying at home, which is what is needed in these circumstances. On the economic question that you rightly raise, absolutely it is a top priority to make sure that we level up this country and that agenda will be, I think even more important once we're through coronavirus and recovering from it. Matt Hancock: (42:37) Northeast councils have been allocated more than 600 million pounds as part of the business support package, and we've identified more than 50,000 business properties which may be able to receive a grant in the Northeast. So we are putting the economic support in place during the crisis, but I'm absolutely sure that after the crisis, the top priority of the government will be to level up and make sure that all parts of this country can recover together because that is going to be a huge task. If I can ask Professor McLean to answer on the shape of the curve. Angela McLean: (43:20) Your observation is absolutely right, that London was always high above the other regions of England and evolved administrations, and interestingly there is a signal in there that London turned over perhaps a little bit earlier than other regions, and various of our scientists around the country are combing through that data and other places where we might be able to see that signal to see if they can find anything to explain why that should be so. If there is an effect, it's quite small actually. It's not a huge, great big difference between the regions. You are right that yesterday's numbers were a little bit higher in most regions and the day before, but it's a tiny effect. It's well within the noise that we see in these data sets. I watched these data incredibly carefully and whilst I would much rather they went down absolutely regularly every day, an increase like that is not something that worries me. Angela McLean: (44:22) The question of whether or not we should have regional policies, I think it's a really interesting one. It's the kind of thing that you can imagine epidemiologists all over the world, not just in this country, are puzzling over. I think there's always a trade off, isn't there, between making sure you do things that are incredibly beautifully tailored to each part of your population. And on the other hand, keeping things simple and actually also carrying on all being in this together. So I don't have an answer for you for that at the moment, but I can reassure you that all the time, one of the things we do is we look at the data altogether and we disaggregate it and look at it in regions. Matt Hancock: (45:05) Thanks very much Chris. Have you got a follow up question? Chris Lloyd: (45:07) Yeah. I mean, I did ask about the time lag as well and whether different parts of the country might be ease from the lockdown at different times because of the time lag, or will we all be under the lockdown at the same time together? Matt Hancock: (45:19) So that is a question that we're looking at. There was a big benefit, I think, as we brought in the lockdown measures of the whole country moving together. We did think about moving with London and the Midlands first because they were more advanced in terms of the number of cases, but we decided that we are really in this together and the shape of the curve, if not the height of the curve, has been very similar across the whole country. It went up more in London, but it's also come down more. But the broad shape has been similar, which is what you'd expect given that we've all been living through the same lockdown measures. Matt Hancock: (46:02) The other thing to say is that it isn't just about the level, it's also about the slope of the curve, and if the R goes above one anywhere, then that would eventually lead to an exponential rise and a second peak and an overwhelming of the NHS in that area unless it's addressed. So although the level of the number of cases is different in different parts, the slope of the curve has actually been remarkably similar across the country. So that argues for doing things as a whole country together. I hope that makes sense. Thanks very much for coming Chris. Appreciate it. Finally, Adam Vaughn from The New Scientist. Adam Vaughn: (46:48) Hi, you said you were recruiting 18,000 contact tracers. I wanted to ask, how many do you have today, what date will you hit 18,000 and how important are those tracers as a strategy for controlling the virus after the lockdown? And secondly, we heard today that the NHS contact tracing out where will be ready within three weeks. What's your goal for the number of people you want to download it and how will you incentivize them to do so? Matt Hancock: (47:16) I knew we'd get some tough questions from The New Scientist. The answer to your questions are as soon as possible and as many as possible. But I know that's not exactly a numerical answer. We're recruiting the contact tracers. I'm sorry I don't have the information to hand as to exactly how many we've recruited, but that is underway. We hope to have the contact tracers who will help when we find a positive test to work out who they've been in contact with and make sure they do the appropriate thing. We hope to have the contact tracers in place before or at the same as the app goes live and you're right on the app. Matt Hancock: (47:59) We're expecting that to be ready by the middle of May and both of these things together, because they work together along with the testing and they'll help us to keep the level of new cases down once we've used social distancing measures to get those new cases down. That's the best thing for health and it's the best thing for the economy. It's a work in progress. I appreciate that, other than saying the middle of May, I haven't given you numerical details. I don't have the data to hand, but I'll try to find that for you. And then on the how many people, the more people who download the app and keep their Bluetooth on, the more effective the app is going to be. Matt Hancock: (48:49) So there is no answer other than as many as possible because if everybody downloads it will just be more effective at spotting who people have been in contact with through contact tracing and helping alongside the human contact tracing for people to be able to keep the R down by catching those who they may have transmitted the disease to. It's also of course tied with the rules around isolation because if you are ... What really also matters is if you've been in substantial contact with somebody who's tested positive, making sure we get the right rules around what that person is then required and asked to do is also a critical part of this, this infrastructure that we're building. Speaker 3: (49:43) Well, I'd just ask a follow up question. From what you've just said, you said that the human contact traces and the app will work in tandem, and you're saying if the app is coming in three weeks, does that mean the target for the 18,000 is in three weeks? Matt Hancock: (49:56) Before or at the same time as the app. Yeah. Okay. Good stuff. Thank you very much indeed. Great to have The New Scientist at the Downing Street briefing and I hope my answer was scientifically valid. Thank you very much for joining us and no doubt see you again soon.