United Kingdom Coronavirus Press Conference Transcript April 10

Ruth May: (00:00) And we feel their loss deeply. I'd like to offer my sincere condolences to the family, the friends, and the colleagues of every member of NHS staff who have died in the recent weeks. Every single person in this country can help our nurses and our NHS staff. You can keep yourselves and others safe and out of our hospitals by staying home. We freed up more than 30,000 beds, the equivalent of 50 just at general hospitals in the past few weeks, and that's before opening the extraordinary NHS Nightingale Hospital in East London. I'm pleased to announce today that alongside the new hospitals in Birmingham, Manchester, Howard Gates, and Bristol, I can confirm that Sunderland and Exeter will soon see Nightingale Hospitals in their communities too. Ruth May: (00:58) These extra hospitals, if we need them, will be part of the NHS's nationwide response to coronavirus. The greatest healthcare challenge the NHS has ever faced. And I'm proud that continuing the tradition dating back to the founding of our NHS 72 years ago, nurses are at the heartbeat of this people's health service. Ruth May: (01:24) These are difficult days, but amid this dark news that each day brings, my colleagues are sustained by the extraordinary shows of support for the NHS has been received from our public. The rainbows, the NHS signs in the window lift me and they lift my colleagues. I'd never thought to see people across this country clapping and showing your thanks every Thursday. It means a great deal to me and my colleagues more than I can say. But there is one thing, there is no doubt that the single greatest thing you can do to say thank you to our NHS and social care staff is for people to follow the advice. This is a long weekend. We need you to stay at home and stay safe. Thank you. Matt Hancock: (02:21) I'll now ask a Professor Van-Tam to take us through the slides and the data that we publish every day. Jonathan Van-Tam: (02:29) Thank you, Secretary of State. May I have the next slide, please? Okay, so you'll recall that one week ago I presented some data to you on transport use and how that had changed over time as the public had followed our social distancing advice. I'm pleased to report to you today, you can see on the slide that in the week that has passed since I last stood at this podium, the trend has continued that use of various forms of public transport have all stayed at low levels. I can't tell you how important it is that you just keep going with this. This is not over. When I move onto the next slide, you'll see it's not over. We have to keep pushing as a nation to maintain our social distancing. We have to take the pain now to make the gain in a few weeks time. Next slide, please. Jonathan Van-Tam: (03:35) So this is a slide which shows you from the 16th of March on the left through to the 10th of April on the right, new UK cases. And these are based on the day on which the laboratory test was completed. So of course there is a little variation there between when the test was taken and the test was completed, but nevertheless you can easily see the broad trend that we have been in an increased phase and now we are at a point where we're at a high level. The numbers are varying day by day, but they're at this high level. We are in a dangerous phase still and I need to reinforce that again to you that this is not over. Next slide, please. Jonathan Van-Tam: (04:28) If you look at people diagnosed with COVID-19 who are now occupying hospital beds in Great Britain, you can see that again over the period of the slide from 20th of March through to the 9th of April, there has been a steady increase. But possibly, you can see that the curve is bending. It's impossible to say that we have peaked. London has gone down in the last day, but the Northeast and Yorkshire have gone up. However, I suggest to you that the curve is beginning to bend and that your hard work is beginning to pay off. But again, I say this is just not over. It needs to continue. Next slide, please. Jonathan Van-Tam: (05:18) If you look at critical care, the slide talks for itself of the extent to which London has been the epicenter of our wave, our first wave. You can see that the other parts of Britain are at a lower level, but the trend overall is pretty much the same that there has been the sharp increase. There may be some signs that the curve is beginning to bend, but it's premature absolutely to say that we're at a peak and the push that we're making with social distancing just has to continue. Jonathan Van-Tam: (05:57) I would add a personal touch here and say that my mother-in-law is a healthcare assistant. Two of my best friends, one is a nurse, another one is an operating department professional who's been repurposed to high dependency to work on this crisis. This really matters and it really matters that we keep going with it. Next slide, please. Jonathan Van-Tam: (06:28) If you look at the global death comparison on this slide again, as last week, these are synchronized so that day naught is the day at which each country reported 50 deaths. And you can see that again, there is this broad similar trajectory across many countries that report data with one or two outliers. The UK continues to be broadly in line with what is happening in other countries. It's still a dangerous situation. We have to keep taking measures to bring this under control. Thank you, Secretary of State. Matt Hancock: (07:07) Thank you very much. So if we now go to questions. The first question we've got is from Hugh Pym at the BBC. Hugh Pym: (07:16) Thank you very much. Secretary of State, you and other ministers have said repeatedly in recent weeks that you have plans to get protective equipment to the NHS and social care. Health and care workers are saying to us they are still struggling in some cases to get that equipment. They feel unsafe. Aren't you now acknowledging that previous plans were just not enough, were not sufficient? Matt Hancock: (07:39) Thanks. What I'm acknowledging is that this is an enormous challenge, a Herculean logistical effort. We've so far delivered 742 million pieces of protective equipment. But it is a task that needs a constant effort because of the 1.4 million people who work in the NHS and the over 2 million people who work in social care using PPE has gone from being something that happens in a relatively small way to right across the board. And the critical thing is that people use PPE like the precious resource that it is and that we get the PPE to them so that they can always have what is clinically needed. Matt Hancock: (08:29) Now, of course, I listened to the concerns that are raised with me and what I can tell you is that the team who are trying to deliver on this have themselves put in an enormous effort. We are getting the PPE out there, but there's clearly a huge task ahead to keep it flowing and to make that those who need it get it. I don't know if Ruth wants to say anything in terms of a report from the front line as a nurse herself. Ruth May: (09:07) Absolutely. So I know as a nurse that PPE is very important for their safety but also the feeling of being safe. I know that I also want to make sure that people are using it and they're wearing it to the right level and the right environment. And that's really important. But I also know and I hear that it's a challenge, it's a struggle right now to making sure we've got it everywhere we needed at the right time. That is what the Secretary of State has already set out in his strategy is being launched today, but making sure that the government is doing just that. And collectively, we're wanting to do it. But it's really important we're doing that. Ruth May: (09:47) I know also I was yesterday, at the London XL Nightingale Hospital receiving my refresher training about how to put my PPE on and off and it's a challenge. It's tough wearing PPE. So I want to also recognize that for all of our staff right now. Matt Hancock: (10:06) Thanks very much. [Sejal Maria 00:10:07] from ITV. Hugh Pym: (10:10) Can I come back? Matt Hancock: (10:11) Sure. Yes, Hugh. Sorry. We'll go back to Hugh and come back to you Sejal. Hugh Pym: (10:15) Yeah. Just very quickly. I mean you've published plans before and given reassurances about protective equipment. There will be a lot of skepticism won't there still about another plan being published. I mean what guarantees can you give that people will be made to feel safe with the right equipment? Matt Hancock: (10:33) Yes. Well, we have made progress on PPE throughout this. I think what you might be referring to in terms of published, what we published before, was last week making sure that we brought clarity to what PPE is needed in what settings. This plan is about that, but it's also about how we then deliver with details of how the supply chain works and also crucially how British manufacturers can step forward and deliver to specifications that we've published the technical details of so that manufacturers can come forward to replenish the stocks that we've got. What I'd say is that it is a constant effort to get the PPE to the front line. A huge logistical effort. Matt Hancock: (11:19) We acknowledged the challenges, of course we do. We face them every day and we are doing everything in our power to get that PPE to the frontline. And those with concerns about PPE at the frontline, we're making sure that they have a place that they can go in order to call for help. So it's a detailed plan set out in public both so that we can encourage more suppliers to come and replenish the stockpile, but also so that everybody can see the challenges that there are and how we're proposing to overcome them. If we go to Sejal Maria now, ITV. Sejal Maria: (12:02) Thank you, Secretary of State. It's good news that the Prime Minister's health is improving. Does he accept though that he is unlikely to be able to return to work soon? And is the government ready to take key decisions such as whether the lockdown will be extended in his absence? Given the Republic of Ireland just announced their lockdown will continue until the 5th of May, shouldn't you level with everyone that we are heading for a much longer than a three-week lockdown too? Matt Hancock: (12:35) Well, the Prime Minister is recovering and I'm sure the whole nation is delighted to see the news that he's getting better. The fact that he was so ill demonstrates once again just how serious this disease is. I'm delighted about that. The good news is that the government in his absence has been functioning very efficiently, very- Matt Hancock: (13:03) ... effectively. The foreign secretary yesterday made clear that we don't have enough information yet to be able to make any changes to the social distancing arrangements and that Sage will meet next week and they will look at the data then. And the way that we make that decision has been set out very clearly and is functioning very well. I think the foreign secretary is doing an excellent job in chairing the committee of that that makes these decisions in the prime minister's absence. But that is within the context of a strategy that the prime minister very clearly set out and that we're working through and we're able to get on with the day to day things like publishing today's PPE plan and do the things that are needed whilst the prime minister recovers. Thanks very much. Ben Kentish from LBC. Ben Kentish: (14:05) Thank you health secretary. Many people around the country, many LBC listeners they're asking why the UK is continuing to allow people to enter the country from virus hotspots and planes to land without the people on those planes even being tested or asked to quarantine. Isn't that a real risk that once we do pass the peak, all the efforts that we've made to reduce the number of cases risk being undermined by people continuing to enter the country unchecked from other countries where the number of cases is still much higher? And what measures will you put in place to stop that? And if I could just ask professor Van Tam, health secretary said there that staying behind your front door is better than any face mask but other countries are not seeing it of course as an either or Germany this week becoming the latest to say that the face mask would be a key part of their exit strategy, a key part of their plan to tackle this virus. Ben Kentish: (14:56) The UK risk becoming a bit of an outlier here because the government's position is that there's no real benefit to those asks. Can I just ask what evidence our decision has been based on and why you think other countries have taken such a different approach if the science does say that masks aren't particularly effective? Thank you. Matt Hancock: (15:14) The answer to both questions Ben is the same, which is that we follow the science and we've followed the science in terms of international travel all along. And we saw right at the start of this pandemic that the country that the two countries that brought in the most draconian international travel restrictions, the United States and Italy, both of them have now got serious problems themselves. So I think that the science which said that which we followed on international travel has been born out by events. Matt Hancock: (15:52) On the second question as well, I'll hand over to professor Van Tam but I just want to absolutely underline the same point, which is that we follow the science. And the science on the use of face masks says that they don't have a material impact outside of those settings which the Public Health England have set out. But also here we are following the international evidence too, the world health organization have themselves looked into this very recently and came to the conclusion that face masks should be saved for those in health and care who really need them. So it is not a risk free option for everybody to wear face masks because that means that it's harder to get hold of face masks for the people where the science says that they are needed. Professor. Jonathan Van-Tam: (16:47) Thank you secretary state. Thank you Ben. To your first point about closing borders, our scientists have been very clear from the outset that that would not work as a measure to prevent the ingress of coronavirus into the UK. Coronavirus is now in the UK and transmitting very widely. I understand the point you're making and I see where you're coming from in terms of when we get this under control doesn't that change the situation? But we won't go from a position of widespread community transmission amongst our own people to a position of zero transmission amongst our own people, which of course was the case back in December, 2019. We will likely go back to low levels of transmission and the virus will continue to be here in and around us in our communities I suspect for a very long time even if we can keep the levels right down. Jonathan Van-Tam: (17:55) So from that perspective, I hope that adds a bit of sense to the context of the question around travel. Now in terms of face masks and general wearing of them by the public, I do know that this is a very vexed and very emotive issue with citizens all around the world frankly. And we have kept this under very careful and repetitive scientific review. Our expert advisory committee Nervtech met again this week to consider all of these matters and we do remain convinced that there just isn't the evidence base to support general mask wearing use by the public. You've probably seen the paper that was released four days ago on bio XIV by Paul Hunter's team from the university of East Anglia. They have been through all of that evidence again. Jonathan Van-Tam: (19:03) We have looked at all of that evidence in that paper again and it remains the case that we do not see at this point a persuasive argument for general mask wearing by the public. But I want to assure you personally and of course those who are listening in that we will keep the science evidence under review and we are going to be guided by the science and if the science evidence changes then we will change. Matt Hancock: (19:34) Thanks very much. Charlotte at talk radio. Charlotte: (19:39) Thank you Mr. Hancock. And could I firstly ask how many frontline NHS workers have died from COVID-19. And secondly can I ask when health care worker does pass away has there been some form of investigatory process put in place so that we can learn lessons from what happens to them and make sure it doesn't happen again too their colleagues? Matt Hancock: (20:01) Yes. I think this is a question for you Ruth. Ruth May: (20:05) Okay. Thank you very much. We know that any death due to coronavirus is a tragic one, we also know that a death of one of our workers, one of our family is for me heartbreaking. We do have a numbers of people that have died, whether they're nurses, midwives, healthcare assistants, doctors. It would be inappropriate for me right now to go into listing them and numbering them because we haven't got necessarily all of the position of crossing them with all of the people's families given us the permission to talk about them. But I recognize that we will and will want to make sure that we are learning any lessons to be learned, but it'd be inappropriate for me to comment on any individual deaths that we've seen, whether that is one of our healthcare workers or not. Matt Hancock: (21:06) Thanks very much Charlotte. Anna Mikhailova from The Telegraph. Anna Mikhailova: (21:14) A question for the health secretary. Economists are on average predicting that there's going to be a 14% drop in GDP in the second quarter of this year and understand some in government fear that it could be even worse. What would the impact of that be on the numbers of deaths that are not directly related to coronavirus? Matt Hancock: (21:35) This is a really important question and one that I worry about a lot. The goal that I have as health secretary is to protect life, but you've got to make sure that you look at that in the widest context. Of course protecting people from deaths directly due to coronavirus that's actually the subject in most of the discussions at these press conferences and a huge amount of effort to make sure that the NHS capacity is there. The second type of mortality that we protect against is deaths that occur because the NHS is overrun. And I'm very pleased that thus far in this crisis there is no point at which the NHS has been overrun and every single person with coronavirus has been able to access the best possible care in the NHS because we've taken the action to expand the NHS, source the ventilators and increased capacity with the Nightingale hospitals to make sure that there is always the capacity there and that is obviously absolutely top priority as we repeat at the start of each of these press conferences. Matt Hancock: (22:50) The third type of impact is the impact due to delaying NHS activity because we're responding to coronavirus. Some of this you have to delay because for instance some treatments for cancer require you to take immunity down to very low levels, which is a dangerous thing to do when there's a very significant virus around. And then the fourth impact on mortality that we consider is the economic impact. Now we do not yet have an established estimate of the impact of the huge problems in the economy that have been caused and that impact on itself back onto the health of the nation. But it's a piece of work that I'm working on jointly with the chancellor to make sure that when we make decisions about the big policy decisions, especially around social distancing we take into account the entire impact on the health and wellbeing of everyone in the country. Not just on the highly visible impact on the deaths from coronavirus, but right across the board including indirectly through the economic impact of the crisis. Matt Hancock: (24:13) So it's something that I, as a trained economist, I'm very alive to. I work very closely with Rishi on it and it's something that will be at the heart of our judgments as we make the decisions in the future. But what's clear is that right now it is too early to make those judgements and so the position as of this weekend and the most important message for everybody this weekend is to stay at home because that's what saves lives. Did that answer the question? Charlotte: (24:49) All right, well can I just quickly follow up, you say that work is ongoing I understand if it is too early to tell what exactly the economic impact will be, but it's been reported today that there is existing government modeling of 150,000 deaths but could be unrelated to coronavirus, but because of all these other impacts that you've just listed does that sound plausible to you as a ballpark? Matt Hancock: (25:12) No, I saw that figure in the Telegraph this morning, but it's wrong. It's not part of our internal analysis and when we do do that analysis and are in a position that we've got confidence in it, then I'm sure we'll be able to answer the question more directly. But that 150,000 figure is not correct. Tom Newton down at The Sun. Tom Newton: (25:45) Thank you very much health secretary. Question to the chief nursing officer if I may first. When you're out and about, you're driving around you see people flagrantly disregarding social distancing mucking around in parks, there've been reports of hundreds of house parties being broken up by the police in Manchester. Tom Newton: (26:03) ... reports of hundreds of house parties being broken up by the police in Manchester. How does that make you feel, personally, after the very emotive words you just said about your service and the colleagues you've lost? And a question to the Deputy CMO, if I might. Obviously, it's too early to start talking about relaxing the lockdown restrictions because you don't have the dataset, but when the time does come for that, in weeks in advance, maybe, what are the sort of numeric targets you would consider happy for case loads in hospitals, admissions, overall fatality rates, whatever it might be? What's the level we have to get down to before you're happy to advise the government that it's now time to start thinking about relaxing them? Can you give the British people some sort of target they can look out for some time in the future? Matt Hancock: (26:48) I'll ask obviously, Ruth, to answer the first, and Professor Van-Tam to answer the second. But just before I do, I just want to correct something in the premise of the second question, which is that it's not that we don't yet have data, it's the information that we do have so far shows that we're not there yet. It's because if you look at the curves, whilst they are flattening, they're not flattening far enough to be able to make any changes, and that's what SAGE will look at again next week. So just, it's a important nuance in the way that the question was put, but I'll ask JVT to answer, if you're happy with that marginally reframed question. Ruth. Ruth May: (27:30) So Tom, it's very, very frustrating. It's personally frustrating to see people clearly not doing social distancing and clearly coming out in large groups. I was only on the way here going over Westminster Bridge, seeing a whole horde of cyclists coming together. It is enormously frustrating. The reason that it's frustrating is because there's also still occasions where my colleagues are getting abuse from their neighbors for driving off to work. So Sam, a nurse in a mental health organization in East of England, had grief from her neighbors because she was traveling to work. Our nurses, our healthcare staff need to be able to get to work. It's right and proper they do. But my ask of everybody, please stay at home, save lives, and protect my staff. Matt Hancock: (28:23) Thanks very much. Professor. Jonathan Van-Tam: (28:25) Thank you Secretary of State. So Tom, thank you for the question. I completely understand that everyone wants a number or a figure or something that they can say, "Can I look out for this? Will that then begin to tell me that we're finally beating this for real, for good." In this wave, if you see what I mean. That advice, unfortunately, is complicated. It will come from SAGE, from the Scientific Advisory Group for Emergencies, and it will be based upon looking at the number of tests that are positive that are coming through the system. It will be based upon the number of new hospital admissions with confirmed coronavirus. It will be based upon the number of people going to ICU and the number of deaths. Jonathan Van-Tam: (29:21) All of those indicators will need to be taken into account to give us a proper reliable picture that things are definitely on the downturn and that we feel constant confident that it is consistently now the case. And you've seen on the figures I've shown today with new cases, you know the figures are kind of bouncing around a bit, and that's entirely normal. That is random variation that you get with any biological phenomenon, any disease phenomenon involving humans, and much as I'm itching to give you one thing you can go on, and say, "This is the signal that we're looking for." Then I just can't. It is just too soon and it is a more complicated judgment than that based on a number of indicators. Matt Hancock: (30:21) Thank you very much. Does that satisfy you Tom? Tom Newton: (30:26) Just a very, very quick follow up. I completely accept Mr. Van-Tam's point. Can you in which case, just define what we mean, or what you mean, by, 'the peak' because obviously there's weeks apart from hospital admissions in cases to fatalities. What exactly is the peak, and how do we know when the peak is past? Jonathan Van-Tam: (30:43) Right, so in terms of the indicators I've given you, this whole concept is a bit like a hose pipe in your garden with a tap at one end and when you turn that tap off water still comes out the hose pipe for a few seconds before it dies down. So it is with the indicators here, there are people being infected with coronavirus today. They will develop their symptoms at some point over the next two weeks. Regrettably, some of them will become ill enough to go into hospital, possibly, about seven days after the onset of their symptoms, and then, not all of them will need intensive care, thankfully only a very small proportion, but they won't all need intensive care the moment they're admitted to hospital. Jonathan Van-Tam: (31:37) Some will perhaps take a few days before that happens and that's a further delay. Then those that are unfortunately going to succumb to this disease don't succumb instantly and again, that takes time for those deaths to show from infections that occurred maybe two weeks before that. So from that perspective, we work all the time with these lag periods and the peak of each of those indices will be different and you do need to have a composite understanding of all of them and to be thoroughly assured that this is now turning down for good in this wave before you can signal to the government that it's time to think about what happens next on social distancing. Matt Hancock: (32:32) Okay, thanks Tom. Hannah Al-Othman from Buzzfeed. Hello. Hannah Al-Othman: (32:38) Hi, I'm Mr. Hancock. How exactly you're going to get from 19,000 to a hundred thousand tests by the end of the month if two of the three mega labs that you set up won't be up and running for another couple of weeks? And what will you do if you don't? And a question that Jonathan Van-Tam. Doctors have told us that they're being asked to ration oxygen, what are you doing to ensure not just that the oxygen tanks are full, but hospitals have the capacity to deliver those supplies to patients at the rates that they need? Matt Hancock: (33:14) Thanks very much. I've set the clear goal of 100,000 tests a day by the end of the month, and I'm pleased that the number now is over a 19,000 a day. I was setting out how we've got four mega labs coming on stream. The first three of those already got going, it's the Cambridge one little come on-stream at the end of this month, and we also have all of the existing labs within Public Health England and the NHS, and some other research institutes that we're using. As I say, this is a part of a national effort and one of the things that's happened since I announced the goal for the nation as a whole, and for the life sciences industry, of 100,000 tests a day by the end of the month, is we've had a huge number of offers of people who've come to us and said, "Well we can turn this facility, which hasn't been a coronavirus testing facility, into a coronavirus testing facility," and facilities that we didn't know about or equipment that we didn't know about that they brought to the task. Matt Hancock: (34:25) The other thing about the mega labs that we're opening is that many of them are staffed by volunteers, and volunteers who are super specialist in exactly what we need, and meeting many of them yesterday, it was incredibly inspiring to see what they're doing because they know that this is vital for the national effort and they've brought their skills to us to help everybody through this because testing is so important. So I've set that goal of 100,000, we're working 24/7 to hit it. Everybody can see the daily trajectory which has almost doubled since I set it and we've clearly got a lot of work to do to get to 100,000 but we are on track. The second question was to you professor? Jonathan Van-Tam: (35:22) Yes. Thank you Hannah. Oxygen. This disease is unlike anything I've seen in my almost three decades in medicine. It is really, really unusual in that the requirement for patients who are hospitalized to have oxygen is very high, and sorry to go back to the host pipe analogy, but if everyone in a certain area turns on their sprinkler in the garden at the same time, the water pressure will go down for a while, and it is a logistic and engineering challenge to create all those thousands of extra intensive care beds that we have done, with ventilators, and also secure the oxygen supply that goes behind them. Jonathan Van-Tam: (36:21) Now, I do know that there has been absolutely enormous logistic work 24/7, behind the scenes, to keep hospitals supplied with oxygen. But you're right, we have seen one or two reports of where something has gone slightly wrong with an oxygen supply and that's partly about the stress on the whole engineering system of a hospital that is required to produce the oxygen demands for double the number of ventilators, and we have to learn as we go along, and our engineers have to adapt, and you are going to see these isolated incidents and we'll learn from them. But oxygen supply, you're right to flag it. It's an unprecedented demand with this virus. Matt Hancock: (37:18) You might've been referring to the challenges that we have in Watford last weekend in the question. I don't know if there was more detail you wanted to ask about? Hannah Al-Othman: (37:25) Specifically, to our own story, we spoke to doctors across the country who said they were concerned by things that they were being told such as, that they may not be able to give oxygen to palliative care patients. Then when we spoke to the BMA they said they were really concerned by those reports and it's something that the government should be taking seriously. Matt Hancock: (37:48) Okay. So the truth is that in all the challenges in oxygen supply that Professor Van-Tam has just set out, in all cases that has been available ventilated oxygen to be able to treat those who need it. In fact, we have currently over 2000 spare beds with ventilators. So we have spare capacity, and in fact, the spare capacity is currently going up faster than need so the overall capacity is going out faster than need. So the spare capacity is increasing. Matt Hancock: (38:27) So to anybody listening or watching, the message is very clear, which is there is enough capacity in the NHS to look after you no matter if you catch it, how serious it gets. But it's very important that we don't allow the spread of the virus to accelerate because we've got to keep that demand below the levels of supply even though, as we increase supply. Matt Hancock: (38:52) On the point about whether an individual patient should be put onto a ventilator, that is a different question. It's not about the capacity. It's not about the ... Matt Hancock: (39:03) ... availability of beds. It's about a clinical judgment for each and every person and that should never be made on a blanket basis. It should always be made on the basis of advice of clinicians as to what is in the best interests of the patient. It's something that came up, I think last time Ruth and I were at this press conference, and we talked about it with respect to do not resuscitate notices, which are standard part of any healthcare system, but there is no link between the capacity of the NHS and the needs of an individual because we have, thankfully, so far in all circumstances managed to keep the available capacity above the demand curve. Matt Hancock: (39:56) The reason we've been able to do that is because people are following the social distancing advice and staying at home. If they weren't, that would be much more of a challenge. So if anybody needs another motivation as to why you should stay at home and follow the social distancing rules, it's precisely because we don't want the concerns that you raised, understandably, in your question to become the reality across the NHS. I don't know whether you've got anything else to add Ruth? Ruth May: (40:27) I mean, you're absolutely right. Secretary of State, clinicians from all sorts of backgrounds are making those decisions all of the time, even when patients are not in intensive care, people are needing oxygen and clinicians are doing that day in, day out. They'll make sure that if a patient, a person at home, wherever they are, if they need to have oxygen, clinicians will be needed to do that, and they will. Matt Hancock: (40:51) Thanks very much. Dave West from the Health Service Journal. Dave West: (40:55) Hi there. Firstly, for the Secretary of State, we've heard consistently from yourself and from government about the vital importance of staying at home to really relieve pressure on the NHS and to save lives. We've also heard that if you do need to travel to work, you should, if humanly possible, keep going social distancing measures and stay two meters apart from each other. We've been told since your illness and the prime minister's illness that government is conducting its business in a way so as to achieve this as far as humanly possible. Dave West: (41:31) Yet we've learned that a number of times in recent days, you've continued to hold meetings, yourself, in your office, with between 10 and 20 senior officials and their assistants, clearly not able to observe those rules, staying two meters apart and not working from home. Senior NHS officials dialing into those meetings have expressed concerns to us about the example that sets to their staff and why they will behave and concerns that they will in turn think that they need to be turning up to work and it's irresponsible not to. So are you going to stop holding those meetings in that way or do you think that it's impossible for you to meet those rules? Dave West: (42:17) And then the question to Ruth or to Jonathan is a followup on Anna's about the wider health impact. Although Mr. Hancock said, thankfully, the NHS hasn't been overwhelmed by the demand that's there, there are many people choosing not to come to accident and emergency even when they have serious health complaints, and it is much harder to get an ambulance, a call out, for example, a much longer wait and as well as on top of the care that's having to be canceled, so there obviously has an impact on health care. I wondered your view, Jonathan, or Ruth, about whether you agree with professionals in the NHS who are concerned that there could be a rebound effect over the next few weeks or month, which can be quite a substantial and sharp effect or follow up demand many people seeking and needing access to healthcare services over that period? Matt Hancock: (43:12) Well, thanks Dave. On the first one, I work from home when I can, and we have enormous numbers of meetings on Zoom and other video conferencing facilities, which I think has been, in many cases, extremely helpful. When I do come into the office, I follow social distancing rules and that's very clear around my table. There's now only a small number of chairs when there used to be, like everybody, even these podia here used to be closer and we've moved them further apart. So like the rest of the country we follow social distancing guidelines and I think that's really important. On the second question, I think if I ask Professor Van-Tam to answer that, Jonathan Van-Tam: (44:02) Yes. Thank you Dave. I think I'd answer that in a fairly simple way really, that because of the extraordinary efforts that people are making on social distancing, we have stopped the NHS from becoming overwhelmed because without it, I can assure you it absolutely would have been, and several weeks ago. What that means is of course that by stopping the NHS from being overwhelmed, we protect its other vital functions and other emergencies will go on if we know that. Road traffic accidents will still occur. Obviously, at lower levels now the traffic density is down very dramatically. But cardiac emergencies will continue, and an important message for the British people is that for those emergencies, the NHS is open business as usual and that's the great thing about having stopped it from falling over with coronavirus that it can stay open for those critical things. Matt Hancock: (45:07) Thanks. I'll just add one further comment to that which is really important, which is that if you need the NHS for something unrelated to coronavirus, then you should use it. In the first instance, a phone up your GP or call 111. We've seen a fall in the number of people self-reporting for at risk of cancer diagnosis. We've seen a fall in the number of people self-reporting chest pain and risk of stroke, and we want the message to get out there loud and clear that if you have a significant health problem, then please do access the NHS. Matt Hancock: (45:54) If you're worried about coronavirus, which is entirely understandable, then phone first, either your GP or 111, or of course, if it's urgent, call 999 because we clearly want people who have other health problems, especially, if they are urgent and or life threatening, to contact the NHS so that they can get the amazing service that the NHS provides to us all. Ruth May: (46:25) [crosstalk 00:00:46:25]. Matt Hancock: (46:25) Yes, of course. Ruth May: (46:26) One quick point, and that's particularly important for women that are pregnant too. We want to make sure that you have the confidence to contact your midwife. If your fetal movements are less than they were, please contact your midwives because those are really important, and about the demand, that's exactly why we have recruited and we've got 8,000 people now, 8,000 nurses, are coming back onto our front line to support to make sure that we up and running, and indeed over 12,000 student nurses and midwives are there ready to come back and support us. So we are ready to care for you, whether it's COVID or non-COVID related. Matt Hancock: (47:09) Okay. Thanks very much. Well, that concludes our press conference today from Downing street with huge thanks to a Deputy Chief Medical Officer, Jonathan Van-Tam and the Chief Nursing Officer, Ruth May. Thanks very much indeed.