Transcripts For BBCNEWS Coronavirus 20200422 15:30:00

This is bbc news. Im sophie raworth. The headlines at 4. 30. The number of people whove died with coronavirus in care homes in england is thought to have doubled in five days figures suggest more than 2,000 have lost their lives. There have been 759 new recorded uk coronavirus deaths in hospitals it brings the total death toll to 18,100. In the first ever virtual Prime Ministers questions, the new labour leader strongly criticises the government over a lack of testing and supply of Personal Protective Equipment. Something is going wrong, there is a pattern emerging here. We were slow into lockdown, slow on testing, slow on protective equipment. I dont accept his premise that we have been slow. We have been guided by the scientific advice, the chief scientific adviser, the chief medical officer, at every step along this way. Borisjohnson is expected to speak to the queen this evening by phone. A number 10 spokesman said he watched Prime Ministers questions from chequers, but that he isnt yet doing government work. Many Holiday Companies could be breaking the law by refusing to give customers refunds for coronavirus related cancellations. Good afternoon youre watching bbc news. Over the next 90 minutes, well bring you the latest developments on coronavirus, including the Daily Briefing from Downing Steet at around five oclock, which will be led by first secretary dominic raab alongside the chief medical advisor and the chief of the defence staff. Between now and then, well hear in detail from the british woman leading a search for a vaccine and the human trials that are beginning here tomorrow. But first, lets look at the other main developments this afternoon. Preliminary figures by the care regulator suggest the number of people dying with coronavirus in care homes in england could have doubled in five days. The Health Secretary, matt hancock, has said 15 social care workers have died during the outbreak. In the uk, another 759 people who tested positive for covid 19 in hospital have died, taking the total to 18 thousand 100. In hospital have died, taking the total to 18,100. The first secretary dominic raab is expected to respond to the figures at todays downing street briefing. Meanwhile, the government insists it will meet its target to carry out 100,000 coronavirus tests a day by the end of the month. And in his first appearance at Prime Ministers questions as labour leader, sir keir starmer said serious mistakes have been made by the government and ministers do need to be held accountable for those mistakes. Lets focus on the detail that more than 2,000 care home residents have died in england since the beginning of the outbreak. This report is from our Health Correspondent Richard Galpin there can be little doubt now that there is a major crisis in care homes, particularly in england. The latest figures are provisional, but indicate the number of deaths in care homes in england could have doubled between april the 10th and the 15th. And that would mean an increase of around 1,000 deaths linked to coronavirus in just five days. Back on april the 3rd, 217 deaths in care homes had been reported in england and wales. On april the 10th, the number had increased to more than 1000. And now, if these latest figures, which are for april the 15th, are correct, then the total, just in england, is around 2000 deaths. We need to be pursuing the preventative agenda with much more vigour than we have been, perhaps, and making sure that ppe is available so that the staff can protect themselves as well as protect the residents in our services. Scotland has also seen increases in the numbers dying in care homes compared to elsewhere. They were 25 of last weeks total figure. This week, they are 33 . Meanwhile, the struggle to get enough protective equipment, or ppe, for health and care workers continues. This raf plane has finally flown back from turkey to the uk with a consignment of protective equipment, three days later than expected. And it is carrying half the 80 tonnes of equipment which had been ordered, which included urgently needed gowns. It is not clear when the rest will arrive. And this as the European Union has now told the bbc the British Government failed to take up offers tojoin a European Union initiative to bulk buy protective equipment. The European Union says the uk has not officially requested to be involved with any of the procurement schemes, despite being repeatedly invited by the eu to do so. But the eu does say the uk can be part of a Procurement Programme in the future. To try to boost supplies of protective equipment, the government has been asking manufacturers in the uk in to help, but some are already frustrated with the government process. We heard nothing for at least a month until we heard from them recently, just to be told we are put in a portal and we will get back to you but so far, to date, we have not heard anything from central government. The government says it has already contacted 3,000 companies. Meanwhile, there are reports some protective equipment is being shipped abroad, despite the shortages here. We are taking in so much more ppe than the small amount we may be exporting. We are a net importer of ppe and literally millions of items of ppe are coming to the uk every week to get to the front line. We had the plane from turkey land this morning, we had a shipment of gowns from myanmar earlier this week. Im expecting deliveries of millions of facemasks this week. With so many countries needing huge supplies of protective equipment, its not easy getting the required amounts, but the lives of health and care workers are at stake. Richard galpin, bbc news. Lets speak to our Health Correspondent Anna Collinson to break down todays latest uk figures. Lets talk first about the latest daily death figures from the uk as a whole, the hospital death figures. It is still a large number. There has been a slight fall since yesterday, but a lot are losing their lives. Absolutely. These figures from the department of health and social care are released every day and they look at the effects the coronavirus is having on the uk. There were 759 deaths reported yesterday in the uk. That ta kes reported yesterday in the uk. That takes the total in the uk to up to more than 18,000. We saw a jump in the figures yesterday following a lag over the weekend. Yesterday there were more than 800 deaths reported. So today we have seen a slight drop in comparison, but we shouldnt read too much into one set of figures, particularly as we are seeing delays in reporting. It is of course important to remember that behind every figure is a family devastated or friends without loved ones. But overall, the trend does appear to be going down. If we think back to the peak of 980 deaths which was on the 10th of april, we are lower. This is backed up by the number of people we are seeing in hospital and the number of cases there. The Health Secretary matt hancock has said the uk has hit a peak of the outbreak, but there will be no relaxation of the lockdown until the government can be sure that there will not be a second wave of cases. So for now, the lockdown measures will stay in place. But these deaths are people who have died in hospital who have been tested. What is now emerging are the numbers of people in care homes, and these are people who have not been tested but are strongly suspected to have died because of covid 19. Exactly. The trends we are seeing with deaths in hospital may not be the same as what we are seeing in ca re the same as what we are seeing in care homes on the wider community. As we know, the elderly are the most at risk of coronavirus, which means ca re at risk of coronavirus, which means care homes are extremely vulnerable. How we got to this finding is figures from the office for National Statistics which were released yesterday. They say there have been more than 1000 deaths in england and wales linked to covid 19 in care homes. The majority of those were in england. But the care regulator for england. But the care regulator for england has now worked with the 0ns and they have analysed the data looking at that in care homes and they have looked at debates between they have looked at debates between the tenth and the 15th of april. And although the figures have not been officially published yet, these findings would suggest that in five days, a further 1000 people have died in care homes, which would take the total to 2000, but it would mean the total to 2000, but it would mean the figure has doubled injust the total to 2000, but it would mean the figure has doubled in just five days, which is shocking. Particularly when you think about the workers in care homes. We have been hearing from care home workers who talk about being in a care home as being part of the family. Seeing that amount of death is extremely distressing. Earlier, matt hancock revealed that 15 care workers have 110w revealed that 15 care workers have now died because of coronavirus. Thank you. The Health Secretary, matt hancock, has said that human trials for a coronavirus vaccine would start tomorrow at the university of oxford, promising to throw everything at its development, allocating an initial £20 million of funding to the oxford team. With me is professor sarah gilbert, who is leading the team at the university of oxford who are preparing the vaccine. Also, im joined by dr chris smith, virologist at the university of cambridge and presenter of the naked scientists podcast. Sarah gilbert, this is all starting tomorrow, is that sure . It is not absolutely certain. There is one last box to be ticked, which is the committee which has oversight of the trial, the data safety monitoring board. They will have a meeting in the morning to give their final go ahead. We are optimistic that they will give the go ahead, but this is not a done deal until then. Talk us through the practical stages. If you get the go ahead, how many people will get the vaccine to start with . We have already had permission to start recruiting volu nteers permission to start recruiting volunteers and screening them. That means that we have put out e mails to tell People Living locally that we are conducting this trier and looking for volunteers, and they have been responding to us through oui have been responding to us through our website. And we had a very high response to that request for volunteers. The website is useful because it enables us to do some initial screening of volunteers. We are looking for people between the ages of 18 and 55 for the first row, and we also need people who live in the Thames Valley region because we dont want people to have to travel a Long Distance to come to this child. If they fall into those categories, the website can select them to visit us in person and have a screening visit and they are given all the information about the trial and shown videos of what will happen, they discuss the risks of taking part in the trial and then they have a health exam and blood samples are taken to make sure they are fit and healthy. Then we get the results back of those and if they turn out to be acceptable on all counts, they will be asked to come and take part in the trial. What happens tomorrow is thatjust two people will get vaccinated. 0ne person will have the Novel Coronavirus vaccine and one person will have the other vaccine that we are using in the trial for comparison, which is a meningitis vaccine. We start with just two people on the first day to make sure everything is well with them and that the procedures are working for the trial and we are ready to move onto larger numbers. So it isjust two people tomorrow. But after that, all being well, we would vaccinate six more on saturday and then we get a much larger numbers the following monday. It will be an amazing moment for you if you get the go ahead tomorrow. You say you have had a huge response, but what are the risks to people taking part . Those fall into two main areas. One is the kind of response to vaccination that you would expect to have. After having any vaccination, people might have a bit of a sore arm or a slight fever. You might have a headache. Those things are quite short lived and they are expected. You might wa nt to ta ke and they are expected. You might want to take some paracetamol, and thatis want to take some paracetamol, and that is what we would expect to see with the volunteers and we will be asking them to record all of that in detail over the first couple of weeks after vaccination to make sure weeks after vaccination to make sure we have captured all of that. There isa we have captured all of that. There is a small theoretical risk from a vaccination against a coronavirus that if you have had a vaccination and then you get exposed to the disease, it could become worse. This is because of some trials of sars vaccines that were done stuff the day of the sars outbreak started. And in some animal trials, when some vaccines were made, they induced the type of immune response that turned out to make the disease worse after vaccination. That remains a theoretical risk with any vaccination against coronavirus or any vaccines going into Clinical Trials. There are a lot of differences between the type of vaccine we use differences between the type of vaccine we use on differences between the type of vaccine we use on the type of immune response we get to that vaccine and the sars vaccines that had the problem. But we cant100 rule it out, so we are making sure our volu nteers out, so we are making sure our volunteers are informed of that and it is up to them to decide if they wa nt to ta ke it is up to them to decide if they want to take part in the trial or not. Everybody is asking about a timeframe. If you get the go ahead tomorrow and if you get all the volunteers, presumably it will be a few months before you know whether or not this works. How long could it be before you get a vaccine that could be mass produced . There are two different components to that. We need to see that the vaccine works and we need to have the technology to mass produce the vaccine. In terms of knowing that the vaccine works, that depends on how much virus transmission there is in the population we have vaccinated. To demonstrate vaccine efficacy and show that it stops people getting infected and becoming ill with coronavirus, some of the people in the control group have to become infected. It doesnt need to be a large number, but unless we see some infections in the control group, we cant be sure that the vaccine is working. And the length of time it will take to achieve that depends on how much virus transmission there is in the population. 0bviously, that is reduced now. The lockdown and social distancing measures have meant we are seeing fewer cases coming through the community. We are still seen cases in certain populations, but not so much in the general community, and that affects our ability to get to that result. So we cant say how long that will take. The other parties having enough vaccine to be able to use it ona enough vaccine to be able to use it on a wide scale. At the moment, our gmp pilot plant, the part of the university that makes the doses of vaccine for the first trials, that has made the dose of vaccine to get us has made the dose of vaccine to get us into the first Clinical Trials but that is only a few hundred. We are going to need a lot more than that, so we are working with a number of manufacturers to enable them to be able to produce a vaccine at the million dose scale, much larger than we can do now. To get them to that point, it will take a few months of preparation. Let me bring in doctor chris smith, put it in context force, a lot of teams are working on vaccines across the globe and the Scientific Community is dealing with something obviously very new but coming together on this . Yes, i think at la st together on this . Yes, i think at last count we are north of 140 different projects exploring many different projects exploring many different avenues to try to build vaccines part of the approach sarah is taken, and congratulations to her, hello, i hope this works and were all rooting for you, but the approach she is taking is one of many. In here herthe approach she is taking is one of many. In here her the way she is approaching it, and so it explained on her behalf, but this is using a different virus to educate the immune system about one part of the new coronavirus looks like. Other people are taking a different approach, taking the genetic message that codes the part of the new coronavirus and introducing that into the body to see if that will produce an immune response. Different viruses from different vectors or different viruses from different vectors or vaccines different viruses from different vectors or vaccines produce different responses and the moment we dont actually know what will be the best one for perhaps everybody or perhapsjust the best one for perhaps everybody or perhaps just some the best one for perhaps everybody or perhapsjust some groups of patients. That is why it is important that everybody is developing a range of different offerings and opening a range of different avenues up so we have a number of clients in the fire. Inevitably, there will be failures, lets hope this isnt one of them but there will be, or things that are not as successful at others in the more cards we have in play, the more chance we have of winning. The more cards we have in play, the more chance we have of winningm there a feeling there will be a vaccine pound or is their concern that you may not find one . Because there are viruses you dont find vaccines for. You never say never in medicine and you never say always andl medicine and you never say always and i was taught at medical school, if the multiple choice question has medical or always in it, it will always be wrong that is the only exception to that line. The answer is you are always cautious with this kind of thing. I remember in the early 80s when we discovered the virus that actually lead to hiv aids, people said, this is ok, we know what the cause is and we will have a vaccine in a couple of years and here we are, about to recognise four decades and about 100 Million People who are passed away because of that infection so its not a given but what we do have is a lot of know how and a very large given but what we do have is a lot of know how and a very large number of know how and a very large number of very bright people all working on this and globally. Therefore we have the best odds we are ever going to have of making this work. Is there anything encouraging about this virus, what youre learning about it, that would point to the pact you might be able to probably be able to find one . To the fact that. Might be able to probably be able to find one . To the fact that. The answer is that as a track record with these sorts of vaccines because they have been trialled in other contexts, albeit with educating the immune system against a different target, for instance against ebola, but the general context and approach used is one that has been tried and tested and is therefore known to be safe and also up to the point that sarah was saying, there are constraints with coronaviruses, but also it drives the kind of immune response we think we will need against this class of virus which is both white blood cells capable of recognising virally infected cells and killing them off, and also producing antibodies which are slightly different, y shaped pieces a protein that are in the bloodstream and are sticky and can utilise things before they get the chance to infect. But we think we need both of those in play in order to defend people in the long term against threats like this. Yes, there is good reason to think this should work. And give us an idea of what its like for you and your team at the moment, sarah. It must be very intense work. You are absolutely throwing everything at this. It is very intense. We have a large team, also having to work under unusual circumstances, as is everybody. 0ur meetings are all video meetings now, we have had to introduce a distancing for the Clinical Trials. Everything is very strange but that is probably true for everybodys working environment at the moment. Its quite High Pressure for us but we have a really good team working together. Everybody is doing what they know how to do. None of it is new to us, the part that is new is doing all of it at the same time and so quickly. But we are managing to cope so far. And are you getting all the support you need . And are you getting all the support you need . Matt and are you getting all the support you need . Matt hancock talked about the funding you would be given but are you getting everything you need . We are. The funding was probably the last piece of the jigsaw. We had a problem a couple of days ago when we did not have the ppe for the Clinical Centre but that has been resolved, and that was because we are not a normal nhs unit but it was recognised this was important activity and a small amount of pp needed was directed to us so we could get on with the trial. People in general have been really helpful in making things available to us so we can go as fast as we can whilst maintaining all the proper regulatory and ethical requirements and looking up at the safety of our volunteers. And doctor smith, obviously people are asking how long this will take and everybody wants a vaccine available but some are far more pessimistic and are talking, one person talked about not being available until the end of 2021. People are being cautious and as we have heard, its very important because there are risks involved. Any kind of drug or intervention is always with some kind of risk. Big and small ones. You can never say never, as i said, apart from in that setting. 0ne never, as i said, apart from in that setting. One is therefore always cautious, you always need a plan b but you always hope for the best and plan for the worst. And talk to me about herd immunity because if you cannot find a vaccine, or it takes a lot longer than people are hoping for, herd immunity is what everybody would be relying on . The word herd immunity, what this term means is you have enough individuals in a population, whether animals or human animals, that there are so few people who are still susceptible to the infection within that familiar that the distance between them is so great that a virus that leads to continuously infect in an infectious cycle like a coronavirus cant keep jumping that this and so it fizzled out in that milieu. Is what we use for measles and mumps and rubella with the mmr and when we get high levels of vaccination uptakes, around 95 of the population which translate into an immune population of 80 of individuals, in that sort of 80 of individuals, in that sort of regime it stops the virus spreading to. If you get that through a vaccine or a 90 of people catch something naturally, naturally infected, the outcome is the same, you end up with a big population are people who are immune and if you have that, the virus cannot spread. What ouraim is have that, the virus cannot spread. What our aim is that we will have a vaccine that will deliver that level of immunity but if we cannot get there, ultimately we will have to get there by some other route and that might well be that we have some kind of gentle staged release people from a lockdown which allows the virus to slowly propagate through the population, ideally in a way that will not overwhelm the nhs and other Health Care Services but will translate into that immunity which we hope will also be long term and long lasting so people wont catch it again. And what about the antibody tests . There are a lot of people out there who say, i think i might have had it, i had symptoms but dont know. So many people say they think they might have had it but cannot be sure at the moment. This is true. 0ne but cannot be sure at the moment. This is true. One way we can beat sure ultimately to look for antibodies in the bloodstream because when a person fights off an infection, or if they are vaccinated, one of the hallmarks of having been exposed to something is that you make antibodies which are like a flag, a Chemical Market in the bloodstream which persist in the long term. We can take a blood sample, look for the antibodies and this highlights, yes, you have been exposed and you have thought of this threat and are now immune to it. The thing is, it is a very new kid on the biological block and is not circulating before. Were learning about the virus all the time and its not simple tojust whip up a test which will deliver the kind of a ccu ra cy test which will deliver the kind of accuracy that we need in order to make clinical and very important decisions. There are other coronaviruses have circulated in the human race for many years, four that are common, and its very difficult to get a test that will accurately discover on it and not be confused by the fact that other people in the publishing will have naturally thought of those coronaviruses and it could compute a test when you go looking for whether or not they have had this one people in the population. That has been a frustration, to produce a test that the government could use at very large scale in laboratories like the one eyed working so we could put a lot of blood sampled in and get very big numbers of results very quickly to give us idea as to who has and who has not had this infection because once we have that sort of data, we will know how far it has gone through the country already. And that will inform strategies to end the lockdown. Sara gilbert, lets end with you and hopefully the big moment when you are able to start the human trials tomorrow. You will be vaccinating around 5000 people as i understand it . Yes, over the coming weeks. How many people have stepped forward to take part . We have had more than 5000 volunteered certainly and have been working through the process of screening them. At the moment we have been recruiting people for the first part of the study which is the 1855 first part of the study which is the 18 55 age group and we have not opened recruitment for the other groups which will come later. They will be part of the 5000 as well and we will have people between 55 and 70, and another group of 70 plus because we need to look at the performance of the vaccine in those groups as well. So far, we have had a lot of applications for the first group, and we will move on to invite people to come forward to take part in the other groups in the trial. Just tell us before you start tomorrow hopefully, what it means to you to be doing this already and how hopeful you are. You to be doing this already and how hopefulyou are. Its you to be doing this already and how hopeful you are. Its absolutely incredible, we started thinking about if we should even make a vaccine against this particular virus at the beginning of january. We were looking at it and viewing it asa we were looking at it and viewing it as a possible lab project, a kind of demonstration project to show what technology could do. Im glad we started when we did because it accelerated and turned into a much bigger project with a bigger need. It is really amazing that we will be starting a Clinical Trial less than four months after we heard about the disease. It really is, very good luck tomorrow and best wishes to you and your team luck tomorrow and best wishes to you and yourteam and luck tomorrow and best wishes to you and your team and lets hope you come up with a successful vaccine. And doctor smith, thank you as well, fascinating to talk to both of you this afternoon. In the next few minutes well take you to downing street for todays coronavirus Daily Briefing. First, more than 1600 people have died in scotland with confirmed or suspected coronavirus since the pandemic began. The figures for all coronavirus deaths up to last sunday come from the National Records of scotland and show that a third of deaths recorded were in care homes. 74 of those who died were 75 or older. First minister Nicola Sturgeon announced the figures whilst speaking earlier at the scottish governments daily coronavirus briefing. National records of scotland now produce a report each wednesday which captures all deaths registered within a seven day period ending on the preceding sunday. That includes not just those with a the preceding sunday. That includes notjust those with a confirmed Laboratory Diagnosis of the virus but also deaths which are presumed to be linked to covid 19 and mentioned on a death certificate. The number of deaths covered under this reporting system is therefore larger than under the daily system when you compare the two figures according to the same date. But it is the comprehensive one. Nrs published the third of its weekly reports today, just around half an hour ago, which covers the period up to sunday the 19th of april which is three days ago. At that point, according to our daily figures, if i can remind you, 915 deaths had been registered are people who had tested positive for covid 19. However the report today shows that by sunday, the total number of registered deaths linked to the virus, confirmed and presumed, was 1616. 651 of these were registered in the seven days up until sunday and that is an increase of 41 from the week before, when 610 covid 19 deaths we re before, when 610 covid 19 deaths were registered. These figures are extremely difficult to report on and i know they will be difficult for all of you to listen to. They are higher than any of us would ever wa nt to higher than any of us would ever want to think about. The first minister, Nicola Sturgeon. We will shortly go to downing street for the coronavirus Daily Briefing but we can speak to our Political CorrespondentJessica Parker who can speak to our Political Correspondent Jessica Parker who is in westminster. We are expecting dominic raab to speak, chris whitty and also the chief of defence staff, nick carter, will bejoining them. A first appearance, i believe, from him . Yes, slightly unusual in that a lot of these Daily Press Conferences as people will know now, you get the politician leading proceedings but they normally accompanied by quite a Senior Health officials but as you said, nick carter is appearing this afternoon. Perhaps that might be a reference to the help army is providing in terms of testing and ppe and dominic raab, the first secretary of state, standing in for borisjohnson early secretary of state, standing in for Boris Johnson early at secretary of state, standing in for borisjohnson early at prime and it is to the armys help in terms of this to be contests at Prime Ministers questions. 0ne this to be contests at Prime Ministers questions. One of the issues the government has been criticised on is this gap between capacity standing at around 40,000 for daily tests and the actual number being carried out hovering around 20,000. Sir keir starmer, the labour leader, who was at his first Prime Ministers questions as labour leader, pressed the government on that gap. Dominic raab said there was an issue of demand. Sir keir starmer said he did not believe that was the case but that was Dominic Raabs argument, saying they wanted to use all the facilities they could including new mobile testing site and also referred to the army in order to make sure these tests reach people and that the capacity is reached. However, sir keir starmer was saying that in terms of those drive through testing sites you are seeing across the country, some front line workers, social care workers, nhs workers are having to travel very Long Distances in order to reach those sites and he raced that as an issue. I in terms of doing things like insuring those tests to reach the right people and it is an ongoing issue as well. Im sorry went up to leave it there. But the press briefing is about to start. Welcome to the press conference. I am pleased to be joined by chief medical officer and also our chief defence staff. The talks to the fantastic work and our brand armed forces have been doing during this crisis was of them to give you an update on the latest data from the coronavirus data file. And i can report that to the governments ongoing Testing Programme as of today, 559,000 have been tested for the virus. 133,495 have tested positive and of those who have contracted the virus, 18,100 have very sadly dried and we died in my heart goes out to every single one of those who have lost a loved one. We continue to take the steps to slow the process of this overwhelmingly adhered to, has meant that fewer people have needed hospital treatment. That has protected our nhs capacity as we continue through the peak of this virus, and it has undoubtedly helped to save lives. At every point in this crisis, we have considered the scientific and medical evidence that we have received carefully and we have been deliberate in our actions so that we take the right steps at the right type. At the right time. I know it has been tough for businesses, for families and vulnerable members of our communities up and down the country. And it has been a physical strain as we adapt to living and working at home while not seeing our family and friends in the usual way we would like to. It has been an economic strain as businesses have had to fellow staff, which is why the chancellor launched the various business support measures to help see businesses and workers through these difficult times. But it has also been an immense mental strain on everyone, people stuck at home, family is worried about their finances, and the elderly, more isolated than we would ever want them to be. We are making progress through the peak of this virus, but we are not out of the woods yet, as sage advised last week. That is why the measures we introduced must remain in place for the time being. The greatest risk for us now, if we eased up on our social distancing rules too soon, is that we would risk a second spike in the virus, with all the threats to life that that would bring and then the risk ofa that would bring and then the risk of a second lockdown which would prolong the economic pain we are all going through. That was a point that andrew bailey, the governor of the bank of england, also made earlier today. With that in mind, last thursday i set out the five principles that will guide our approach Going Forward to the next phase which must be satisfied before we are in a position to make any changes, which will of course be based on the advice we received from sage. That way, we will ensure that our path out of this crisis is sure footed, protecting both the Public Health, but also our economy. If we stick to our plan and take the right steps at the right time, we can get through this crisis and i know we will. There is no hiding the scale of this tragedy. But even in our darkest moments, the crisis has also shone a light on the best amongst us and the nation has come together to applaud our heroic nhs staff, our carers, every week and we pay tribute to their dedication, professionalism and the care with which they look after those who have fallen sick. With general carter hit a day, it is only fitting to page a view to the amazing work of our fantastic armed forces and the whole mod, led by defence secretary ben wallace. They have been there every step of the way, helping us to build the new nhs Nightingale Hospitals to reinforce our Critical Care capacity, supporting our local Resilience Forum is in delivering Personal Protective Equipment where it is needed most, and helping to deliver the mobile labs which are critical to ramping up our Testing Capacity across the country. As a result of those efforts and that teamwork, hospitals have been able to treat more patients and save more lives. And we have ensured that the peak of this virus has not overwhelmed the nhs. Today our armed forces are again part of that team as we announced two new deployments to the nhs nightingale facilities in harrogate and bristol. Across the uk, this extra hospital capacity, which itself comes on top of the 33,000 additional beds we have managed to free up across the nhs, thatis managed to free up across the nhs, that is the equivalent of building an extra 50 district general hospitals. And that has safeguarded the capacity of our hospitals both to ca re the capacity of our hospitals both to care for coronavirus patients, but also to make sure other people get the care or emergency treatment they need. People used to joke in this country that you could never build a hospital that quickly. Well, we didntjust build a hospital that quickly. Well, we didnt just build build a hospital that quickly. Well, we didntjust build one, we built seven and we thank our armed forces for helping to make that happen. For many countries around the world including modern democracies, the sight of their military on the streets in a National Emergency could be a cause for concern or even trepidation. But for the british people, the sight of our armed forces working side by side with our brilliant nhs staff offers a calm reassurance that the task is at hand and we will come through this crisis. I make no bones about it, there have been challenges and are still our challenges. We are not there yet. We continue to ramp up there yet. We continue to ramp up the Testing Capacity, which will play an Important Role in the next phase of the crisis. Amidst a global shortage in Personal Protective Equipment, we have debated 1 billion items to the front line. We have just brought in lord dayton, who helped organise the london olympics, to boost our domestic supply further. And i am on the phone every day pursuing the next batch of deliveries from abroad with the support of our tireless diplomatic service. On the first of several new deliveries landed from turkey in the early hours of this morning. We will only come through this Global Pandemic if we come together as a nation and if we bring other countries around the web together so that we can rise to this international challenge. And as we work with our partners abroad to get the ppe we need and the ventilators we need and to pursue a vaccine for this terrible virus, we are also working night and day to return stranded british nationals from all four corners of the world. We have kept airports open and air lines running to bring over a million brits home and commercialflights, a massive endeavour. 0n brits home and commercialflights, a massive endeavour. On top of that at the fco, we set up a £75 million special charter arrangement with the airlines, and that has already got home 30,000 people in 63 flights from more than a dozen countries. We are organising more flights in the days ahead from india, pakistan, bangladesh, new zealand, nigeria and sierra leone. So at home and abroad, we are meeting the range of challenges that coronavirus presents. If we stick together and if we stay the course, we will defeat this virus for good. I will now turn over to sir nick to brief us on the latest military involvement in the effort. Thank you very much. The first secretary asked me today to give you an update on what the armed forces and defence as a whole is doing in support of the government response to the virus. Up front, i would say that our role has been entirely in support of the heroic Health Care Workers on the front line. That is both the nhs and social care, with humility very much being our watchword in the way we give that support. We have done it ina give that support. We have done it in a variety of ways. We have supported first and foremost the ministry of housing, community and local government and the devolved administrations through the National Spine of local regional fora that the first secretary referred to. And we have had dozens of Liaison Officers embedded into each of those forrer. It is a tried and tested system that has been used in the past, whether for delivering military aid to the civil authorities for foot and mouth or for flooding authorities for foot and mouth or forflooding or authorities for foot and mouth or for flooding or wildfires. Authorities for foot and mouth or forflooding or wildfires. It is frequently exercised and there are close relationships which give great confidence between all of those working on those teams at the lower level. This is important because it is that delegated sense at that level which works because it makes the more responsive and flexible to local demand, whether it is for ambulance drivers, testing or whatever else. With decentralisation being so much of the key to how some of this is done, the first secretary delegated authorities to this level early in the crisis, which has proved to be successful. We have also been giving support to the department of health and social care and the nhs. First and foremost, this has been a logistic task and i would say that in all of my more than 40 years of service, this is the single greatest logistic challenge i have come across. I will give you the scale of the problem. In 25 days since we started working with the nhs, they have gone from some 240 customers they delivered to normally to nearly 50,000 customers. This has involved creating 260,000 square feet of distribution and warehousing, nearly four football fields, and some 38 additional Delivery Routes per day. That is the equivalent to driving three times around the world. It is a major logistic challenge. We have of course been involved in the nightingale is met, which the first secretary referred to, but we have also been involved in planning and command and control, providing additional resilience to hard pressed additional resilience to ha rd pressed staff. We additional resilience to hard pressed staff. We have dozens of people embedded both in skipton house, but also in victoria house, whether the hsc headquarters is. We are involved in testing both in terms of playing a role in helping design the system, but also manning some of the regional test centres and adopting some innovative approaches like mobile pop up centres which will make it possible to get the decentralised areas i described earlier. We have brigadier leslie faithfull davis and her team, who have been imaginative in the way they have taken this forward. And we have provided an Aviation Task force which has been able to support the communities from scotland to the channel islands, in Northern Ireland and from wales to the east coast of england. We have been involved in helping the Foreign Office with repatriations and supporting our overseas territories, where we have security advisory teams deployed in several of them. And we have deployed ships to do just that. We have been involved with the Cabinet Office Rapid Response unit with our 77 brigade helping to quash rumours from misinformation, but also to counter disinformation. Between 3000 and 4000 of our people have been involved, with around 20,000 available the whole time at high readiness. We have at the moment some 73 ongoing tasks, and we have prom ptly some 73 ongoing tasks, and we have promptly completed about 30. It has been very much a whole force, not just of regular military from all the three services, but reservists as well, some 15 of the force has been reservists. It has involved defence civilians, defence contractors, scientists from porton down and something called the engineer and logistics dakar, where we bring in people from industry who work inside the military in times of crisis and provide expert support for how we might link into the civilian community to bring forward skills and industrial support. The scales have been about planning, lodge traditions, medics, engineers and it based people. And the road has been very much about catalysing, designing and supporting. I will single out one individual to give you an example of the sort of backgrounds we are talking about. A young major has been mobilised from the reserve. He has really stepped up the reserve. He has really stepped up to the plate. His daytime job the reserve. He has really stepped up to the plate. His daytimejob is a logistics expert who runs googles transport Network Across europe, north africa and the middle east. He has been part of the supply team that has been working on how we distribute ppe. He has designed a portal in partnership with ebay which will in due course manage individual customers. And he designed a bulk supply chain for distribute in a ppe to all of the nhs regions and trusts. Despite all of this, we are still involved in protecting the country, and there are essential operations that must continue, whether that is defending the homeland with the Nuclear Deterrent or protecting british and uk airspace generally. Whether it is overseas operations in afghanistan, the middle east, africa and further afield or whether it is about building essential operational capability. We take great care not to endanger the population. All of this is a truly national endeavour. We have even mobilised 99 year old vetera ns. We have even mobilised 99 year old veterans. And i think everyone would agree that captain tom moore embodies the sense of service and duty ingrained in our armed forces. 0ur armed forces are drawn from every pa rt 0ur armed forces are drawn from every part of the uk and much of the commonwealth. They take great pride in serving the communities that they are part of. Everyone is experiencing real challenges at the moment, and it makes me feel immensely proud of our collective National Effort in pulling together behind those on the front line to combat this unprecedented challenge. Ifirmly combat this unprecedented challenge. I firmly believe we will defeat it together. Thank you. Thank you very much. Chris, would you talk us through some of the latest data . Cani can i thank the armed forces enormously for the assistance they have given us. These slides are familiar to most people who watch this. The first is a look at transport usage in the country and it is really as a proxy for if people are continuing to stay at home except for essential business. As you can see although there is some bumping along, it is broadly remaining very stable despite the fa ct remaining very stable despite the fact people have had to do this for a considerable period of time now and there is further time we will have to do this if we wish to pull the peak of this right down. Looking at new cases in the uk, these are tested positive weather in hospital or out of hospital. As you can see, this is broadly flat with a slight trend downwards over the last several days. Really back to about the 8th of april. But not a steep descent at this point. Next slide, please. If you look at people in hospital with covid 19, looking across the country, the situation is either improving, and i think it is pretty clear it is improving in london for example, or broadly flat across all four nations. Next slide, please. If you look at people who have sadly died in hospital, this is not all deaths but probably the majority of those who have sadly died with covid, what you can see again is that the very steep upward climb that there was up to the early pa rt of climb that there was up to the early part of this month has now flattened off over the last week and a half. Next slide, please. And this is a slight we use reallyjust to track the trajectory between Different Countries. I should be clear that trying to compare Different Countries with this kind of data is notoriously difficult but it does show the trajectories between the Different Countries with the uk using Hospital Data which is our most steady source of data over that time. Next slide, please. This is just one slight we thought we would add in in addition because i think it makes a point which is important for people fully to understand. What you can see here, this is the seven day rolling average for deaths, sadly, in several countries, including the uk. The reason i thought it was sensible to put this in was for people to see that even in those countries which started theirepidemic in those countries which started their epidemic curve earlier than their epidemic curve earlier than the uk, and which are still ahead, the uk, and which are still ahead, the downward slope from the point where we change is a relatively slow one and we should anticipate the same situation in the uk. We should not expect this to be a sudden fall away of cases. Thank you very much. Thank you, chris, lets turn to the media, the bbc . First secretary, worrying figures today suggest a doubling in care home deaths in england. Ina doubling in care home deaths in england. In a virus which targets the elderly and vulnerable, do you see that as inevitable . the elderly and vulnerable, do you see that as inevitable . I didnt catch the last bit . I will let chris whitty talk about i think the cqc. Would you like me to repeat it . Yes please. We have seen figures suggesting a doubling in care home deaths in england. In a virus that targets the elderly and vulnerable, do you see that as inevitable . No, i dont think anything is inevitable. We are fighting tooth and nail, striving every scene you to make sure we minimise the life lost in every context a point i will let chris whitty say a bit more about the cqc data which i think is going to be published but obviously in ca re to be published but obviously in care homes, whether on ppe testing, delivery, on testing across the whole range of things that we are looking at, were doing everything we can to make sure we provide the support to them and to protect the ca re support to them and to protect the care homes and the workers there and obviously the residents as well. Of course it is a vulnerable part of our community, if you like, and we are targeting all of our efforts to make sure we protect and safeguard as best we can the most vulnerable in society. Chris, do you want to say anything on the cqc . It has not yet published its report but in terms of care home deaths, sadly your starting position is of course correct. In care homes, what we have isa correct. In care homes, what we have is a large number of people of the most vulnerable age for this virus, a virus which is particularly a virus are people who are older and particularly a virus which causes severe disease and death in a minority but an increasing minority as you go up in age. And in those who have coexisting medical problems. And many people in care homes of course and Nursing Homes in particular have coexisting medical problems so they are a very Vulnerable Group, youre absolutely right. The numbers that have been ascribed to covid directly ons statistics are still relatively modest but ive said repeatedly in data, the fact that the ons said in the last weekly report 826 deaths, every one of them a tragedy, but i think that will be an underestimate. What we need to look at in these data and other data if we want to get a true picture is, and ive said this from the beginning, the all because seasonally adjusted mortality over time. That is because, as i have said before, deaths from cobit will be a combination of direct deaths from the virus and indirect deaths, if people are nervous about going into hospital for example. One of the things we have been trying to make clear is its absolutely critical that if people have heart attacks, strokes, children have severe asthma attacks, any of the things that have severity and this would include people in social care settings, that the nhs remains absolutely able to manage emergencies as it always has been able to. But when we look back over this epidemic, and been able to. But when we look back overthis epidemic, and i been able to. But when we look back over this epidemic, and i want to be really clear, we are not anywhere near being able to say that is done and we can look back, but when we are at that stage, i im sure we will see a high mortality rate in ca re will see a high mortality rate in care homes because this is a very Vulnerable Group and people are coming in and out of care homes and to some extent, that cannot be prevented. Did you want to follow up on any of that . Just quickly, families and staff in care homes have heard a lot of promises about protective equipment and testing, but what im being told is that they are still not seeing that on the ground. What reassurance would you give them that they are being made a priority in this . We are conscious that there is a challenge with care homes, i said that in my remarks, but we are doing everything we can put of the situation is improving and we are getting the ppe to those places that need it. We are working with the military in relation to some of the mobile testing labs because we know it is difficult for some people in care homes to access the testing. We have revised the guidance or the nhs has revised the guidance or the nhs has revised the guidance to make sure the discharge, we re guidance to make sure the discharge, were being careful with those going into ca re were being careful with those going into care homes and were doing everything we can. We understand there are concerns and anxiety and i feel for those who are living in ca re feel for those who are living in care homes and nervous about this or their loved ones and were doing absolutely everything we can to protect them. Robert peston from itv . Good afternoon. Representatives of the tssa transport union have been told to prepare for a possible increase in a phased way of the Railway Service between the 11th and 18th of may. We are obviously not looking at an exit from lockdown but is that a timetable for modifications of the lockdown . And secondly, overseas doctors and nurses working in the nhs pay a surcharge of hundreds of pounds a year, thousands if they have families, to use the nhs. Given they are putting their lives on the line to protect us, is there a case for waving that surcharge . To protect us, is there a case for waving that surcharge . First of all, the dates that you described, i dont know where they come from, its not something i recognise and as chris whitty has rightly said, and as the governor of the bank of and as the governor of the bank of and has rightly said, from the Public Health and also the economic perspective, it would be a mistake to ta ke perspective, it would be a mistake to take our eye off the ball right now. The focus is still on delivering us through the peak and we are reliant as i said last thursday come on the data we get back from sage in a couple of weeks in order to even think about the next phase. In relation to people from overseas working in our nhs, i think the home secretary has already outlined some measures to make sure their interests are safeguarded and we pay tribute to the incredible job they do and of course we want to look after them in every way possible. You want to come back on any of that . You didnt really say if the surcharge would be waived. And just on these union representatives, is it just and just on these union representatives, is itjust that their managers have got it wrong . |j their managers have got it wrong . dont know on the unions what information they have got but im telling you that that is not a government timetable. We have had a lot of attempts to put back to us and understand why people try to do that. Its absolutely not a timetable that we are working to and that i recognise all that is under consideration right now. I will defer to the home secretary and the Health Secretary on the issues around the surcharge i think the point i would want to make really loudly and clearly is that we pay tribute to all those from overseas or doing a heroicjob in our nhs on the front line. Beth rigby from sky. Thank you, a question first to professor chris whitty. We have talked a lot about ppe shortages and trying to plug the gaps, but nhs workersjust want trying to plug the gaps, but nhs workers just want to know they have the equipment they need when they turn up at work. Can you tell me when you expect the shortages to be resolved . Is it three days, is it a week . Or cant you answer that question . And to the first secretary, police, the Health Secretary, police, the Health Secretary said today we have reached the peak of the crisis, and you said it was time to reopen the nhs the first secretary, please. Is this the light at the end of the tunnel we have been talking about and waiting for and have been talking about and waiting forand might we have been talking about and waiting for and might we all look forward to some modest easing of restrictions on may the 7th when you review the lockdown . There is certainly a light at the end of the tunnel, there is a glimmer but we are not there yet. I think the way i would describe it, but i will defer to chris on where we are, we are coming through the peak but we are not there yet. I think the Health Secretary was repeating what the cmo has already said which is that one of the positives and successes amidst all the challenges which im open to accept is that we have kept nhs opacity with the headroom notjust to deal with covid 19 patients but all those other people who have got elements or injuries and need treatment nhs capacity. The nhs is still there for them as chris whitty said and i think he wanted to echo that point. In terms ppe, im not an International Procurement expert are so in a sense i will say what im told rather than pretend any expertise in this area but its very clear that at the moment we are tight at different times for different items are ppe put its not everything at all times but Different Things at different points have been close to the line. And of course when you are very have been close to the line. And of course when you are very close to the line, inefficiencies in any part of the system tend to lead to local stockouts. If you are heavily overstocked, that is less true and this is what the support from the armed forces is so critical to try to reduce this. At this point in time, we are still close to the line but at a National Level, we are not under water on anything that im aware of and i under water on anything that im aware ofand i keep under water on anything that im aware of and i keep quite a close eye on this because i care very deeply about this, as do all members of my profession. But of course there may be local issues and im aware of them, from my colleagues, along the way, and all of us want to be ina along the way, and all of us want to be in a position where there is a sufficient excess over a longer period of time that this can all be balanced out. But because every culmination of excellent work from the armed forces and mutual aid where different hospitals and care homes are sharing what they have, we have broadly, and this is a tribute to the services involved, managed a very difficult situation without yet getting to the point where we are no longer able to cope with it. But to promise now that in two or three days its all going to be sorted, in the context of the incredibly difficult, according to my colleagues, and i see no reason to disbelieve them having read the international press, incredibly difficult situation where everybody in every country wants these and the suppliers are very limited, i think it would be a mistake. I think what we need to do is manage it as best it is possible to be managed and im very aware that my expert colleagues in this area are working the whole time on this and i care about it and i check on this the whole time and they assure me that they are, and i can see that they are, and that is why we have managed to keepjust ahead at a National Level with some significant local pressures from time to time. You want to come back . Just quickly, in terms of the lockdown. I understand you dont wa nt lockdown. I understand you dont want to spell out exactly what you intend the irish Prime Minister has told the irish people he will at least give them a road map by may the 5th, give them a sense of how they might begin to work through this. Germany is allowing some small shops to reopen. I understand you might want to flex the model but the british people arent silly. They understand what is facing them so can you not at least give them some idea of what might be coming down the road . That is why on thursday i set out these five principles, and peter that is recognising that we dont want to risk a second spike the virus key to that. The challenge is that as the transmission rate comes down we need more data as to precisely where it is in order to inform the measures we could actively consider. I think the responsible thing to do, at least on the data we have got, is to make sure we have that evidence before we started touting ideas at the risk of them not being able to be delivered or ta ken the risk of them not being able to be delivered or taken them and then risking a second spike point i do think again it is something chris has highlighted, but also and andrew bailey, the gun runner of the bank of england, that we must appoint a second spike and i know people will want more information at the minute we can responsibly do so based on the evidence, we will put at the moment, i think the vast majority of people in the country recognise we have to keep our eye on the ball because we are coming through the peak but done yet. Laura makin, british you have praised the work in the military today but there are 20,000 personnel on standby to help in this crisis and fewer than 3000 have been deployed. So are you under utilising a core of skilled people who could ta ke a core of skilled people who could take the strain of the nhs further, perhaps be deployed to all nhs Nightingale Hospitals . To the chief of the defence staff, the government says it still hopes to reach 100,000 covid 19 tests a day by the end of the month. Will you be helping to ensure that that target is met . Will you be taking over dry through test sites, for example . And to professor whitty if i sites, for example . And to professor whitty if i may, scientists at porton down laboratories are trying to work out what percentage of the population might have been infected with covid 19. How are those figures looking . On the question you asked me, we want to make sure we use all our resources in the right way that supplements the brilliant work of the nhs. We are always considering what more can be done. I talked about the deployment to the new Nightingale Hospitals and i have been talking to the defence secretary about the mobile testing la bs secretary about the mobile testing labs and how we can deploy them in the future. But those are difficult decisions. We have to make sure we deploy our resources where they add the greatest value. Sir nick, i dont know whether you want to a nswer dont know whether you want to answer the second question . dont know whether you want to answer the second question . I want to have a go at your first question as well. We have deployed all we need to deploy at this stage in support of the organisations we are working for. There is more that if we need it, but the sort of skills that are in the remaining 20,000 are not necessarily the ones that people need at this point in time. To your question about testing, yes, we are working with the dhsc and the nhs and more broadly through the local flora that are described in my opening remarks. We are helping to design the right system with the tea m design the right system with the team in the dhsc that can provide the sort of testing that customers need so that you match demand to supply in the right way. That is why the innovative idea of pop ups will bea the innovative idea of pop ups will be a useful way of going. We are trying to upscale that idea so that we have enough capacity to be able to get out into those areas which are harder to reach. So it is an overall system that has been put together at the moment. It will be very sophisticated once it is completed, and there are some really good people designing it and we are working with those people to make it as good as it can be. And the last point . You are right that porton down has some of the best capacity to do what is called serological testing. This is the Antibody Testing. This is the Antibody Testing where you can tell whether someone in the past has had an infection, including covid 19. The problem we have had is that we do not yet have a test that is as good as we would want, even with the expertise of the academic sector, porton down and their expertise and Public Health england and their expertise and industry. Many people are trying to work on an improved test. There are fairly good tests available at the moment, but they are not very good tests. This is one of the critical bits of information we need to make decisions. I dont wa nt we need to make decisions. I dont want to overpromise on this, but i am hoping we will shortly have tests that are good enough to at least have a ranging shot as to what proportion of people in different age groups in different parts of the country have had this virus. But we are not yet at the point where we have a test that can say that reliably. But i am hoping we will do so in the near future. Would you like a follow up, laura . So in the near future. Would you like a followup, laura . If that is all right. We have heard from so many places now that there is a shortage of ppe. Other military themselves going to be protected when they are helping in these incidents . And is there any update on what has happened with the arrival of that ppe from turkey . Is that on the front line with those medical staff now or is it still being checked . We obviously carefully checked all the consignments we get. We have had reports from other countries of ppe thatis reports from other countries of ppe that is then distributed to the front line and is not effective. Not only does it then have to be withdrawn, but you then have to isolate or send into self isolation the care workers, so we do check that carefully. The consignment has landed and we are expecting further consignments in the future. As chris mentioned, it is an incredibly competitive market and it shows you, that turkish challenge, how you need to have excellent cooperation with the turkish government. I have had conversations over the weekend with my turkish opposite number, and also how the mod and the fco have worked together. It is a team effort to get all the supplies we can and we will continue to do it. We will obviously ta ke continue to do it. We will obviously take every step we can to avoid any risk to anyone on the front line in terms of the quality of the ppe. I dont know if you want to say more about that, nick . Yes, those military personnel who are deployed alongside Health Care Workers and their like are equipped in the same way as they are for the function they are performing. Tom newton dunn from the sun. Thank you very much. A question to you and the chief medical officer. We understand that sage, having looked at the issue of wearing masks, decided to advise you that it would be a good idea to wear some sort of covering for people who are asymptomatic but are able to transmit the disease. When are you going to meet to decide on that and what is your advice to people tomorrow morning going to work . Should they or should they not be wearing face masks . And to the chief medical officer, can you talk about work are doing at the moment for the end of the month on restrictions . What sort of shape is that taking . In terms of the first secretarys fifth test about avoiding a peek, how can you get in a position where you are sure of doing that . how can you get in a position where you are sure of doing that . I will let chris and such. Unmasks, sage will look at the evidence on masks. They have been asked to look at the issue again and we have not had any advice back yet, so there will be no change until we have had that and considered it. In terms of look into the future, this is a critical question not just for us, but for other countries. There is an upperand lower but for other countries. There is an upper and lower bound of what is possible. The upper bound of this is, we cannot allow the r, the force of transmission, to go above one at any period. If it does, exponential growth of this will continue. It will resume and we will get back to a situation where the nhs could have its Emergency Services overwhelmed, which we have avoided due to the remarkable work of the nhs itself in expanding its activities, the British Public in heeding the advice to stay at home and significant help of course from the armed forces. But if it goes up and you get exponential growth where you have a doubling over a few days, it does not take long before you move from bad numbers to really bad numbers over a short period of time, and at some point the nhs would find it very difficult. We cannot allow that to happen. At the other end of the bracket of what is possible, this disease is not going to be eradicated. It is not going to disappear, so we have to accept that we are working with a disease that we are working with a disease that we are working with a disease that we are going to be with globally for the foreseeable future. What we are trying to work out is, what are the things which add up to and r of less than one . There are lots of options ministers will have to consider. But that narrows our options considerably if you have to keep the r below one. We have to be realistic that if people think we are suddenly going to move from lockdown into everything being gone, that is a wholly unrealistic expectation. We are going to have to do a lot of things for a long period of time. The question is, what is the best package . This is what we are trying to work out. But if you release more in one area, you have to keep it on board in more of another area, so there is a proper trade off and this is what ministers are having to consider. Tom, would you like to follow u p consider. Tom, would you like to follow up on any of that . Just a quick one. People will be in some doubt as to wear face masks tomorrow morning after your answer, but i dont think i will get much more. Cani dont think i will get much more. Can i follow up with chris whitty . It is interesting, what you are saying about the r. Is establishing r below one enough for you when it comes to easing the restrictions, or would you want it to go down to 0. 5, 0. 25 or whatever . Is itjust would you want it to go down to 0. 5, 0. 25 or whatever . Is it just a would you want it to go down to 0. 5, 0. 25 or whatever . Is itjust a case ofa tiny 0. 25 or whatever . Is itjust a case of a tiny percentage below, or can you calculate something you would be comfortable with . R not going above one is a minimum ask. That absolutely has to happen. There are then, from a health point of view, and this goes back to something i have said before that i will repeat because this may be a different audience, there are multiple different ways in which this epidemic is going to kill people or cause ill health. The direct causes of death from the covid, the potential of the indirect causes of death if the nhs gets overwhelmed, which we are determined should not happen and has not happened. But the third area is people who die indirectly because the Health Service has had to be reoriented towards covid and therefore, you cant do other things like screening and other things the nhs would normally do. But there is also a final group which is if the interventions we have extended deprivation among people, that is also a risk to their long term health. And all of these are going to have to be taken into account from a health point of view. They dont all lead, if you are optimising it for one, you may not be optimising it for another. So we have to think about the best balance of measures that gives us the best Public Health outcome, which does absolutely include people who die directly of cover, but also has to include all these other factors. Can we go next to Gordon Rayner from the telegraph . Can i ask a question for yourself and the cmo . Can you guarantee the public that if the oxford or imperial vaccine trials prove successful, british people who have paid for those trials will be the first to get the vaccines . Can i also ask the cmo, following from toms question, is it possible for us to ease the lockdown measures before we have a Contact Tracing syste m before we have a Contact Tracing system in place which the Health Secretary has been talking about . And lastly, one question for the first secretary specifically. In october 2016, the government ran a pandemic drill called exercise bigness, as you know. It involved all the major Government Departments and simulated an epidemic similar to the one we are facing today. Tens of thousands of people died in the simulation, but its findings have never been published. Can you today commit to making those documents available . No, i cant. If they were conducted in the circumstances you describe, i would conducted in the circumstances you describe, iwould have conducted in the circumstances you describe, i would have to look carefully at the rules around it. But i am happy to look at that. Chris, on the other points . Vaccines, that is a commercial question as much as a scientific one. Obviously, the uk want to get access as fast as we possibly can to any effective vaccine. In a sense, whether it is developed in the uk or somewhere else. But a lot of work has been put into both trying to support the sign so that an initial vaccine can be done and we support this directly in the uk and indirectly elsewhere through other routes. But even once you have got a vaccine, this is a point patrick valla nce vaccine, this is a point Patrick Vallance has made several times, the chief scientific adviser, you then have to go into trials and also into manufacturing and scaling up. All the way along that path, we will wa nt the way along that path, we will want to keep track of this and make sure the uk has access. This is not a straightforward position. In terms of the lockdown question, there are a large numberof of the lockdown question, there are a large number of possible combinations of things you can do. You are right that Contact Tracing is one of those. But what i think we need to do is put to ministers all the various things that are possible and at that point, they will decide what the right combination is that achieves the best Public Health and wider social goals. Gordon, a vaccine is not going to come particularly soon to allow us to ease out of the current social distancing measures into a transition. I think it would be more likely to be of particular value in stopping a Second Global wave down the track if we dont eliminate coronavirus for good. In the long run, the exit from this will be one of two things ideally. 0ne will be one of two things ideally. One of which is a highly effective vaccine and there are a variety of ways they can be deployed, by dampening down epidemics or to protect vulnerable people, and or, highly effective drugs so that people stop dying of the disease evenif people stop dying of the disease even if they catch it or which can prevent the disease in vulnerable people. Until we have those, and the probability of having those anytime the next calendar year, they are incredibly small and we should be realistic about that, we will have to rely on other social measures which of course a very socially disruptive, as everybody is pining at the moment. But until that point, thatis at the moment. But until that point, that is what we will have to do everybody is finding. It will have to be the best combination that maximises it but it will take a long time and we need to be aware of that. Do you want to come back on any of that . Just briefly, to professor chris whitty, if youre saying you dont expect a vaccine to be available in the next calendar year, are you effectively saying we will have very socially disruptive measures for probably the next calendar year . And just to come back on that very quickly, have you personally read the document and had it been made available to all your key scientific advisers . it been made available to all your key scientific advisers . I would have to check. I have read a huge volume over recent weeks, but its not something that immediately springs to mind. On the vaccines, im very hopeful that we will have vaccines which have proof of concept much earlier than a year, to be clear. And there are very large numbers of people around the world, excellent ones in the uk, first vaccine tomorrow, in demand here, but there is a long path between having a vaccine that is proof of concept until we have either a vaccine or a drug, we have managed other epidemics without taxing hiv is one where it is managed with a combination of drugs, but until we have those solutions, what we have available to us our social measures and that is what we are using and what is the optimal combination of those. One thing to add, and its important to reinforce these message from the lower we get the transmission rate, the more options we have which is why the message right now is to focus on keeping up the adherents of the social distancing measures put it is making a big difference and the more we get the transmission rate down, the wider the range of options we have in place. David hughes from pa. Hello. Are you considering a mass Population Programme and how would that be administered if so question mechanical to Contact Tracing, are you planning to rely on this new app that has been developed or thinking there will be a huge amount of manpower needed and if so is that something that general carter and the military would be involved in . will let chris talk about the wider mapping to put it we are boosting the Testing Capacity, looking at the functionality and the way the app would work. The two are big factors, and it leans into the question that Gordon Rayner was asking, that will help give us a greater range as we transition to the next phase, when the evidence suggests we can, getting the transmission level down and the level of testing and functionality of the app, in order to allow us to look at the various different options and control any potential resurgence of the virus. Because we want to mitigate it and keep it as low as possible. That is why we are putting so much effort into it not just why we are putting so much effort into it notjust the testing but also the wider tracking and tracing that could be put around it. As the weeks proceed, that could have a Significant Impact on our ability to ease out of the current social distancing measures. There are a lot of things you can do with testing. 0bviously patient management allows people who are in lockdown with a relative in that house, and they are key workers, to see if they are able to go to work. Obviously, and this is an area where we will do a lot more, testing across the community to find out at the earliest possible stage if we are starting to see a resurgence of this virus. At the moment, we are relying on a situation where people get as far as hospital. If they do that, they will have had five days in which they dont have any symptoms, they might have at up to a week with things getting worse and so you are behind the curve if you rely on that. So we will certainly be doing a lot more population testing and we will go into details about when we have this going shortly. To find at the earliest point if the r is below one and was still going down or is there some part of a country where it is beginning to go up and we then need to act . That is part of a wider range of things to do with the tests. And that is why we set those five principles out last thursday because all of those factors inform the proposals and any future decisions we might make. Would you like to follow up . Yes, just on the Contact Tracing app, do you think the British Public would be willing to install this on their smartphones given the necessary invasion of privacy it would entail . And what about the proportion of the population that dont have a smartphone or would not feel confident doing that . Both good points. I think overwhelmingly what the public expect of us right now is to innovate as best we can to try to ease our way out to the next phase of this virus in a way that protects Public Health also allows us to go back to the kind of economic and social life that is as close to normal as possible. We will innovate in those areas and if we come up with something which is as effective, we will look at those decisions but i think people understand that we are in an exceptional crisis and we need to ta ke exceptional crisis and we need to take measures we probably wouldnt think about doing if we were not in it. Kate wilson from the bristol post. Good evening, firstly to the chief medical officer, as weve already heard, the Health Secretary said this afternoon that the uk has now reached the peak of the coronavirus outbreak. Does that pique extent to places like the bristol area when the number of cases and deaths are lower than in other parts of the countries or could they pick later . And therefore will bristols Nightingale Hospital, which will be ready to take its first patients this weekend, still be needed . Secondly, forthe first patients this weekend, still be needed . Secondly, for the first secretary, we know that two thirds of smes in bristol have stopped trading but if figures have peaked would you consider an earlier exit from lockdown in order to restart the economy here . Thank you. Do you wa nt to the economy here . Thank you. Do you want to go first, chris . the economy here . Thank you. Do you want to go first, chris . I will go on the issue of the numbers. You are of course right that the south west has had probably the least impact from covid so far. Bristol itself has had under 500 cases from memory and it is also true in the social ca re and it is also true in the social care setting. There is a smaller proportion of care homes which have been effected by covid outbreaks in the south west than in other parts of the country. That is absolutely right the think about the peak we are going through at the moment, however, is that it is not, in a sense, the natural peak of an epidemic without us doing anything. It isa epidemic without us doing anything. It is a peak brought about by the british people staying at home and actually not giving the buyer must have the opportunity to spread. Therefore the actual peak of it is likely to occur in most parts of the country at a similar time not giving the virus the opportunity. There is evidence of a slightly earlier effect in london but elsewhere there is a little bit of a regional variation but much less because this is an artificial peak brought about by our activity than there might have been had this been running unmitigated which clearly was absolutely what we were trying to avoid. In terms of the Nightingale Hospital in bristol, and this is true of all the other Nightingale Hospitals, firstly it gave us the ability, if the british people had not heeded to the fantastic extent they had and be more pressure on the nhs, it gave us capacity to deal with emergencies. It still will give us and the other nightingale is will give us flexibility because if you think about the two forms of concern i was talking about earlier, the direct deaths but also the indirect deaths, having the nightingale capacity with enormous help from the armed forces in setting it up so fast does mean that when we are planning forward, it gives us a number of options we would not have had if those were not there. We shall see how they are properly used. Im absolutely delighted that the nightingales have not had to be used in great numbers for temple nacker because that sent a sign of success. We have been able to cope with this because of the emergency environment of the nhs in great numbers for covid. The nhs will be under pressure from covid 19 for quite a long time and having that flexibility is an additional think we can work through in terms of how best to deploy nhs resources for the next several months. Small businesses are the lifeline of our economy and they are going through a really tough time right now. Smes create the lions share ofjobs in our country and happen for a sustained period and we absolutely wa nt to sustained period and we absolutely want to see them through the crisis and they will be part of britain bouncing back in due course. But the risk right now notjust for Public Health but for of those small businesses, is that if we move to ease up on the way your question suggested, not only would we get a second spike in the virus but we would need a second lockdown and that would protract the economic pain and all the uncertainty that goes with it. I can tell you that in terms of the support given to bristol city council, they have been allocated more than £88 million as pa rt allocated more than £88 million as part of the government business support package and we have identified 8000 Business Properties which might be. Have to leave dominic raab and the downing street Daily Briefing for now because we are coming up to the bbc news at six with George Alagiah point that you can continue watching the Daily Briefing on the bbc news channel but now if we eased up too early notjust on Public Health but also for entrepreneurs. Would like to come back on any of that . I would only wa nt back on any of that . I would only want more detail as part of the Nightingale Hospital in bristol. I know that you said they have been helpful in setting up, will they be staffing it as well . The way the military has intended to work with all the Nightingale Hospitals is to support nhs workers and what they are doing. It will depend on the specifications of each Nightingale Hospital that theyre there to support the nhs staff. Is anything you would add to that . Yes in bristol we have allocated combat medics to act as nurses and the like. The general duties personnel will help as well. Thanks very much, kate. I think that is all for this press co nfe re nce. Kate. I think that is all for this press conference. Thank you. It will feel warmer. But the High Pressure starts to lose some of its identity as we go into friday. We have low pressure to the south as well, so well startjust bringing a bit more cloud coming down from the north. Some cloud coming from the south and west, just the hint here that there could be the odd shower in parts of South West England and perhaps south wales. But actually, it looks like another fine, dry and warm day for most, just increasingly hazy in the sunshine. Into the weekend, as that high becomes less established, there is a greater chance that we will pick up a few showers either from the north or coming up from the south. But for most again, it does look like there will be a lot of dry weather and hazy sunshine. What we will notice, because we have a bit more cloud and the breeze from the north, is that it wont feel as one. Even here, 17 to 20 is still above where it should be temperature wise for this time of year. You can see the increasing shower risk. Dont take this as read. There is more uncertainty over the detail of where those showers will be but as ever, we will keep you updated. There is more on our website. Today at six the impact of coronavirus in care homes new estimates of the number of residents whove died. The care watchdog says deaths in england may have doubled in just five days. It is a vulnerable part of our community, if you like, and we are targeting all of our efforts to make sure that we protect and safeguard as best we can the most vulnerable in our society. 78 year old Christine Mullin was in a care home when she was infected with coronavirus and died in hospital. Her dauighter remembers a life well lived. She loved seeing her grandchildren, she loved going out for meals out. You know, she was looking forward to. Like, mothers day, we were going to take her down to rochdale to see family. Also tonight