Boris Johnson UK Coronavirus Briefing Transcript April 30: Prime Minister Returns from COVID-19 Absence

Boris Johnson: (06:02) Good afternoon. Welcome, everyone, again to this number ten press conference where I'm joined by Professor Chris Whitty, chief medical officer, and Patrick Vallance, our chief scientific advisor. And I'm sorry not to have been part of this trio for so long. I want to thank everybody who's been doing such a good job in my absence. And I want to thank the NHS for so much, including getting me back here and, I might add, for a much happier hospital visit yesterday. Boris Johnson: (06:39) In a few minutes I'm going to hand over to Patrick to update you on the epidemic. But first, I'm going to set out today's latest data. 901,905 tests for coronavirus have now been carried out in the U.K., including 81,611 tests yesterday. 171,253 people have tested positive. That's an increase of 6,032 cases since yesterday. 15,043 people are currently in hospital with coronavirus compared to 15,359 people yesterday. And sadly, of those tested positive for coronavirus across all settings, 26,711 have now died. That's an increase of 674 fatalities since yesterday across all settings. This figure, of course, includes deaths not just in hospitals. Boris Johnson: (07:52) Across this country, therefore, families every day are continuing to lose loved ones before their time. We grieve for them and with them. But, as we grieve, we are strengthened in our resolve to defeat this virus, to get this whole country back to health, back on its feet. And we're determined, urgently and in particular, to overcome those challenges that in the last few weeks have been so naughty and so infuriating. I'm not going to minimize the logistical problems we have faced in getting the right protective gear to the right people at the right time, both in the NHS and in care homes, or the frustrations that we've experienced in expanding the numbers of tests. But what I can tell you is that everyone responsible for tackling these problems, whether in government, or the NHS, or Public Health England, local authorities, we are throwing everything at it, heart and soul, night and day to get it right. And we will get it right. And we're making huge progress. Boris Johnson: (09:05) And I will not underrate the work and the achievement of those who are dealing with global shortages in a global pandemic. They are rising to a challenge we have never seen in our lifetimes. And the same can be said of the entire people of this country staying in in forced confinement, not seeing family, not seeing friends or grandchildren, worrying about their jobs and the future. And so, my message to everyone again today is, your effort and your sacrifice is working and has been proved to work. Boris Johnson: (09:47) Today, the number of COVID hospital admissions is falling. The number of patients in ICU is falling. We've so far succeeded in the first and most important task we set ourselves as a nation to avoid the tragedy that engulfed other parts of the world. Because at no stage has our NHS been overwhelmed. No patient went without a ventilator. No patient was deprived of intensive care. We have five of the seven projected Nightingale Wards. And it's thanks to that massive collective effort to shield the NHS that we avoided an uncontrollable and catastrophic epidemic where the reasonable worst case scenario was 500,000 deaths. Boris Johnson: (10:44) And so, I can confirm today that, for the first time, we are past the peak of this disease. We're past the peak and we're on the downward slope. And we have so many reasons to be hopeful for the long term. The U.K. is leading international efforts to find a vaccine. Today, Oxford University has announced a partnership with AstraZeneca to develop what they believe could soon be a means of inoculating ourselves against this disease. But, until this day comes, and I'm afraid we cannot say exactly when it may be, we're going to have to beat this disease by our growing resolve and ingenuity. Boris Johnson: (11:34) So, I will be setting out a comprehensive plan next week to explain how we can get our economy moving, one, how we can get our children back to school, back into childcare, second, and third, how we can travel to work and how we can make life in the workplace safer. And, in short, how we can continue to suppress the disease and, at the same time, restart the economy. A huge amount of work has been going on on that plan. And, of course, as we produce it, we are being guided by the science. And we will try to build the maximum political consensus as we produce it across all parties and across the U.K. Boris Johnson: (12:33) But there will be five key tests that we must satisfy before we can put that plan into action. We must be sure that we can continue to protect the NHS and its ability to cope. Number two, we must see a sustained fall in deaths. Three, we must be sure that the infection rate is falling. Four, we've got to overcome the operational and logistical challenges on testing and PPE. Fifth, and this is the most important, we must all make sure that the measures we take do not risk a second spike that would overwhelm the NHS. Boris Johnson: (13:26) We've come through the peak, or rather, we've come under what could have been a vast peak, as though we've been going through some huge Alpine tunnel. And we can now see the sunlight and the pasture ahead of us. And so, it is vital that we do not now lose control and run slap into a second and even bigger mountain. And so, to avoid that disaster, our fifth and final test is that nothing, as I say, we do should lift the R or the reproduction rate of that disease back above one. Boris Johnson: (14:11) And, before I hand over to Patrick, I'm going to ask for a short explanatory clip about the one. And, before we come to that clip, let me just emphasize, keeping the R down is going to be absolutely vital to our recovery, keeping the reproduction rate of the disease down. And we can only do it by our collective discipline and working together. I know we can do it because we did it. We've shown we can do it in phase one of this disease. This country came together in a way few of us have seen in our lifetimes to protect the NHS and to save lives. And that's why I'm absolutely convinced we can do it in phase two. Boris Johnson: (15:03) ...absolutely convinced we can do it in Phase 2, as well. Can we play the video now? Video Narrator: (15:05) The government has set out five tests that must be met before we begin to adjust social distancing measures. Video Narrator: (15:14) One of the most important tests is the rate of infection. We have to make sure this is decreasing. All viruses, like normal flu, have a rate of infection. Scientists call this R. R is the average number of people one infected person passes a virus on to. To beat Coronavirus, we need to keep R as low as we possibly can. Video Narrator: (15:43) Imagine 100 people are all infected. If R is more than one, then those 100 people will infect more than 100 people, and in turn, they will infect even more. The virus is spreading quickly. Video Narrator: (15:58) If R is less than one, those 100 people will infect fewer than 100 people, and in turn, they will infect even fewer. The rate of infection is slowing down and coming under control. Video Narrator: (16:13) Scientists around the world have been tracking the R of Coronavirus since the start of the outbreak. In March, at its peak, R was around 3, which seems to be the natural rate for this virus. Video Narrator: (16:28) Since then, thanks to you and the social distancing measures you followed, we've been able to reduce R, and it is now below one. But we've only just passed the peak of the virus and it's vital R stays below one. Over the coming weeks and months, the government will be monitoring R very carefully. It will be a key factor in how social distancing measures are used in the future. Boris Johnson: (17:03) Good. Well I hope that was clear and useful. Patrick, any update please. Patrick Vallance: (17:08) Thank you. Can I have the first slide please? So as the Prime Minister has said, there are five tests that the government has laid down for adjusting the lockdown. And what I'd like to do is just go through some of the data in terms of the epidemic and so show you where we are. Patrick Vallance: (17:22) Next slide please. So, the R is below one. We think it's between 0.6 and 0.9 across the nation. Maybe a little lower in some places, a little higher and others, but it's below one across the country. This shows the number of new cases. But as I've said before, this only really shows in the blue the cases in hospital, and then in the orange the cases that have been tested outside. So it's not the total number of cases. Patrick Vallance: (17:51) We know that the total number of cases is on its way down. You can see in the blue bars here that the number in hospital, you can see, is down. And of course, the orange bars represent others who've been tested, including essential workers. But the number of infections will be coming down. Patrick Vallance: (18:08) Next slide please. This turns into a reduction in hospital admissions for Covid. And this is the NHS data, so this is England only data. But what you can see here, in the blue is inpatients newly diagnosed with Covid. And in the orange is new in patients with confirmed Covid at the time of admissions. These are new admissions into hospital. You can see very clearly from the 20th of March, there was a rise up to a peak somewhere at the beginning of April, and now it's come down. So, the number of cases is coming down. Hospital admissions are coming down. Patrick Vallance: (18:42) Next slide please. And that of course translates into the number of people in hospital with Covid. And this shows the data across the nations and in different regions you can see very clearly the decrease in the number of people in hospital. In London, you can see a slightly flatter situation in some other places. We need to make sure and to stick with what we're doing in order to get the R down further, to continue to keep it down and to make sure that the number of people in hospital comes down right the way across the nation. But you can see the trend here to decrease. That in turn leads the question of how do you get the critical care beds down? And again, when you look right the way across England, Northern Ireland, Wales, and Scotland the number of patients in critical care and those on ventilators is coming down right the way across. It's coming down slowly, as you would expect, but it's on its way down. Patrick Vallance: (19:43) Next slide please. And that in turn starts to lead to the decrease in deaths. Here you can see the number of deaths in all settings, so this isn't just hospital this is across all settings, and you can see it's gradually beginning to come down. It's not coming down as fast as it went up. And I've said before, I expect there to be a bit of a plateau stage here before things really come down further. But you can see, it's on its way down. Patrick Vallance: (20:11) Final slide please. And again, this is the comparison. It's difficult to actually look at exactly what this means because people record things differently. But the message is, R is down. The number of new cases is down. That's turning into fewer admissions, fewer people in hospital, fewer people in intensive care. And, we're beginning to see that decrease in deaths. Thank you. Boris Johnson: (20:36) Thanks very much, Patrick. We're going to go first to members of the public who've got some questions to ask us. So then, I would like to hear from Michelle in Cornwall. Michelle: (20:49) We are getting inquiries daily to book a holiday from June onwards. We're worried there'll be an influx of people coming away from the cities into the tourist hotspots, which could bring a second wave to areas such as Cornwall. Please can we ask how tourism within the UK will be managed in the coming weeks? Boris Johnson: (21:06) Thanks, Michelle. And first of all, obviously I sympathize very much with everybody in the tourism industry who's taken such a hit. It's been one of our jobs to make sure that we look after business as far as we possibly can through our loans, our support schemes to furthering schemes for workers. You will come back, Michelle, we are going to make sure that the UK bounces back as strongly and as fast as we possibly can. But we've got to be sensible. I think the public have been very sensible so far in staying away and obeying the advice. Boris Johnson: (21:44) It's vital, as I say, that that does not fray and we don't see people starting to disregard what we're saying. But we will be saying a lot more next week and in the coming weeks about how and when we propose to unlock the various parts of the UK economy. Boris Johnson: (22:07) What you're going to get next week is really a roadmap, a menu of options. The dates and times of each individual measure will be very much driven by where we are in the epidemic, what the data is really saying it. And we're getting in a lot more data every day now, and in the course of the next few days. Boris Johnson: (22:31) So Michelle, the short answer is you're dead right. We've got to get your business going again. We've got to get tourism going again, but we can't allow such a big influx of tourists as to create a second spike, a second wave of the disease. Boris Johnson: (22:51) Chris or Patrick, is there anything that you want to add to that? Okay. I hope that's okay, Michelle. Thank you, very much, for your question. Katie from Liverpool. Boris Johnson: (23:05) Well Katie asks, "The lockdown has seen an increase in suicide. What help is available for people experiencing a mental health crisis." And clearly, this is a major issue that we've been thinking about. People confined at home can become more prone to existing mental health conditions. That's why it's very important to understand, taking the pressure off the NHS in the way that we have means that we can now, as Matt Hancock said I think on Monday, we can now make sure the NHS is once again prioritizing other urgent care needs across the community. Including people's mental health needs. Boris Johnson: (23:55) Public Health England is doing a huge campaign to reach out to people who have mental health needs, who are feeling in need of comfort in what is a very, very difficult time. If you're experiencing it yourself at home, there are lines that you can call. Go on our website, GOV.UK, to see what you need. We are putting money now into mental healthcare charities across the country to support what we agree, I agree very strongly with Katie from Newport, is an issue that needs to be addressed. It goes to show why it's all the more urgent for us now to begin to come out of lockdown, but to continue to suppress the disease. Happy with that answer, more or less? Chris Whitty: (24:49) Absolutely. The only thing I'd add to that is if you go onto the NHS website, there are contact details both for NHS, things that are available for people who have mental health issues or are feeling lonely or indeed, in this case, suicidal. There are also many remarkable voluntary organizations. Boris Johnson: (25:10) Yes. Chris Whitty: (25:10) Ones that are well known like the Samaritans. But there are others as well, and I would strongly encourage anybody who is feeling they're going into a mental health crisis, or feeling suicidal, or very, very low in mood please do look up those numbers and go to one that's relevant to your particular needs. Call someone, because there are a lot of people out there who would be very keen to help you. Boris Johnson: (25:34) That's absolutely right. And that goes, really, for anybody who is stressed out by the current situation. People where the atmosphere at home has gone wrong. People who are feel at risk of domestic abuse, in particular, there are helplines for you. It's absolutely vital that people should use them. And as I say, there are good, practical health reasons why we don't want to protract this lockdown any longer than it needs to be protracted. Okay, let's go to the media. Could we go to Laura Kuenssberg from the BBC? Laura Kuenssberg: (26:15) Thank you, very much, Prime Minister. There's been such huge suffering. They've been 26,000 deaths since you last stood at that lectern. There's been huge suffering to people's health but also to their country's wealth. So many people are very, very worried about making ends meet. By continuing with lockdown, are you telling the public that the economy just has to wait? And if I could ask, Sir Patrick or Professor Whitty, you said the R is now between 0.6 and 0.9. What level does the R need to be at before you would be comfortable with starting to ease the restrictions? Boris Johnson: (26:48) Well, thanks very much Laura. What you say is of course, totally, right. We mourn for every life lost, and we mourn for the economic damage, as well, that the country is sustaining. And for the dreams of people's that seeing shattered in their businesses, their anxieties about their jobs. We totally understand that. As you know, government has made a huge effort to look after workers, to protect them with our furloughing scheme, colossal sums in loans are going out of the door. We're doing everything we can. Boris Johnson: (27:28) I really pay tribute to Rishi Sunak, the Chancellor, for the speed with which he's come forward with the schemes that he has. I do think that the UK has done very well by comparison with a lot of places around the world. But it's absolutely vital, Laura, that if we're to bounce back as strongly as I think we can, that we don't have a second bad spike. Because that would really do the economic damage, and lasting economic damage. That's why we've got to calibrate our measures so carefully, and make sure that we not only unlock the economy gradually, but also find ways of continuing to suppress the disease. And possibly new ways, and more ingenious ways of suppressing the disease, as well. That's what we're working on now and you'll be seeing a lot more of that I hope next week. Chris, and then Patrick. Chris Whitty: (28:34) So, there isn't a perfect answer to what should the R be, except we are absolutely confident that the wrong answer is anything over one. Because, as soon as R goes above one, then you restart exponential growth. It may be slow if it's just about one, it may be a lot faster if it goes a lot above one. But exponential growth restarts. And sooner or later, and the higher it is, the sooner it is, the NHS will go back to the risk of being overwhelmed and the numbers of cases will tick up. Chris Whitty: (29:04) It is also important, though, from a health point of view to emphasize one other thing. Which is, I've talked before of the fact that you have the direct deaths from Coronavirus, but also indirect deaths. Part of which is caused by the NHS and public health services not being able to do what they normally can to look after people with other conditions. it is therefore important at whatever point we're at, that the NHS not only has the R at or below one, at all times, preferably significantly below in an ideal world, but certainly below. But also that it has headroom, which allows it to operate not just in doing the emergency things, which he does manage to maintain throughout the entire coronavirus first phase. But also to do the other important things like urgent cancer care, elective surgery, and all- Chris Whitty: (30:03) It's like urgent cancer care, elective surgery and all the other things like screening in public health preventive terms, which we need to do to keep people healthy. So those two things from my perspective as someone who's responsible for talking about health and thinking about health as chief medical officer. Absolutely. Those two to me seem critical. Patrick Vallance: (30:24) I completely agree with that and I think it's worth just thinking at the beginning of this, we talked about the doubling time of the epidemic. We're now talking because the R is below one at the halving time of the epidemic and we want to keep it going down, so it has to be below one. And then we need to get the numbers down to a level which is manageable and gives us some head room in order to be able to make changes. Boris Johnson: (30:49) Thanks very much, Laura. Can we go to Robert Peston of ITV? Robert Peston: (30:53) Good afternoon gentlemen. Good to have you back, Prime Minister. You made the important point that we've avoided the reasonable worst case of 500,000 deaths, but by our own chart, the death toll in the UK is possibly the worst in Europe, certainly amongst the worst in Europe. As we head into the second phase, what lessons have you learned from that seemingly worrying outcome? And secondly, because of the unprecedented help you are giving to struggling individuals and struggling businesses, the national debt is rising by hundreds of billions of pounds, a record amount in peace time. Prime Minister, how great a risk is there when we are through this crisis, you will feel compelled to cut public services and move us back into a new era of austerity? Boris Johnson: (31:51) Okay. Well, first of all, Robert, on the UK's international comparison, I think it's very, very important that people should understand that the collating of data internationally is bedeviled with difficulties and comparisons are very, very difficult. And actually I think that the only real test, any real comparison is going to be possible at the end of the epidemic when you look at total excess deaths. I'll ask Chris or Patrick to say a bit about that. And I genuinely think when I look back at what the UK has has done, I think that... And by the way, when we put in the lockdown, it was earlier in the curve of our epidemic than it was relatively speaking in France, Italy and in Spain. I think we did the right measures at the the right time. Boris Johnson: (32:58) And don't forget that people are talking about the difficulties of lockdown and some very good questions about mental health suicides. It's a very, very demanding thing to ask a population to do very tough. And so I think it was completely right to make our period of lockdown coincide as far as we possibly could with the peak of the epidemic. That peak, as I said, just now has passed. I do think that broadly speaking, we're learning lessons every day Rober. We're learning lessons every day. But I do think that broadly speaking, we did the right thing at the right time. And since you make international comparisons, let me remind you that at the time we had to take those very difficult decisions we were looking at a situation in which it seemed all too plausible that people would not get ventilated beds in the way that was happening in other countries. Boris Johnson: (34:00) And it seemed really possible that people would not have access to intensive care as we were seeing happening tragically in some other places around the world. And together, this country really did come together to protect the NHS, to enforce to obey the social distancing rules, and to save lives. So overall I'm not going to pretend that we're not learning lessons every day. Of course we're learning lessons every day, but those are the conclusions that I draw on the international data, wait and see till to the end of the epidemic. On your second big picture question, which is an entirely legitimate one. Well, you know what my instincts are Robert, I think the economy will bounce back strongly. I think that this government will want to encourage that bounce back in all kinds of ways, but I've never particularly liked the term that you just used to describe government economic policy and it's certainly not be part of our approach. Austerity by the way was the term you just used for viewers. You've forgotten what Robert said. Sorry, Chris and Patrick. Chris Whitty: (35:16) I come from a profession as Patrick does, where learning the lessons after you've gone through something is absolutely critical. Totally accept the basic premise of your question, which is we must learn lessons at the right point, but what you don't do frankly is do that in the middle of something. We are no where near the end of this epidemic. We are through and it is very good as the prime minister said, we're through the first phase of this. There is a very long way to run for every country in the world on this and I think let's not go charging in to who's won and who's lost at this point. Let's actually try and take it quite carefully learning lessons from one another as we go along, but if you want to see how this actually is difficult to do technically there's an excellent article in today's Guardian by professor David Spiegelhalter- Boris Johnson: (36:04) [inaudible 00:00:36:03]. Chris Whitty: (36:04) ... yes. Which is actually lays out why comparing Covid deaths as you see on the grass is very, very difficult to do and should be done with extreme caution. I've said repeatedly and I will say again the metric we should be using when we do get to the point this is the right thing to do, which is definitely not yet is all cause mortality adjusted for age. That is the key metric. We've discussed it today amongst a lot of the scientists. Everybody agrees this is the key metric and the reason for that is every country measures its Covid cases in a slightly different way. So comparing it with them to one another is largely a fruitless exercise, but there are comparisons to make and there are certainly technical things all the time. Chris Whitty: (36:46) We can learn from other countries and to be clear other countries can learn from us. For example, the ability to get people into trials at the moment is something where the UK is taking a very leading role. So I think lessons go in every direction, but I think let's do the post action review, which we absolutely must at the right moment and we are definitely not at that stage yet, sadly. Boris Johnson: (37:09) Patrick? Patrick Vallance: (37:09) Absolutely nothing to add. Boris Johnson: (37:10) Thank you very much. Thanks Robert. Dan Wootton talkRADIO. Dan Wootton: (37:16) Experts believe there is a ticking cancer time bomb as a result of this crisis. Professor Karol Sikora and a group of leading oncologists predict that 60,000 extra cancer patients could die as a result of a lack of treatment and a lack of diagnosis. So professor Witty first, have you done any similar modeling? And if so, can you give us an idea of what those numbers look like and Prime Minister as we move into the second phase of the lockdown, can you guarantee that anyone who needs life saving cancer treatment will be able to get it? Boris Johnson: (37:53) Chris? Chris Whitty: (37:56) Well, we looked actually across the board, so throughout this, what I've said is there are four ways in which people will suffer ill health and die as a result of this epidemic directly from Covid, which we've been talking about. Indirectly because the NHS is overwhelmed, which as the prime minister of state is one of the things that we've managed to avoid so far and to turn and to continue to avoid. But the third group is all the things which under normal circumstances, health and preventative service would be doing but which it is not able to, efforts for the NHS and public health that had to be reoriented. And then finally the impacts of increasing deprivation. Now on that third group, which is the one you're talking about, it's not just cancer's actually. We're very concerned, for example, that there has been a fall away in people coming to accident emergencies to emergency hospital things with things like strokes and heart attacks. Chris Whitty: (38:49) They must be going on and one of the worries we have is that people are thinking, "Well, I can't go to the NHS because it can't deal with these emergencies. It definitely can." But you are absolutely correct that what we are very determined to do is to make sure that as much of normal non-emergency services for the NHS and public health are switched on in a responsible way where we can do it with in a phased way to ensure that the period where actually there has been a delay is minimized and to prioritize the things that are the most urgent first and then other things which are as important but are less urgent, we kind of do slightly later in the system. And a lot of thought from my NHS and public health colleagues is going into how you get that phasing back on again right. Boris Johnson: (39:36) Yeah. Well, Dan, you're asking an incredibly important question because I think one of the things we've become increasingly concerned about is as we've seen the decline in Corona, in Covid cases in the NHS, particularly in intensive care and elsewhere is are we seeing an unnatural displacement? Are people frankly reluctant, scared to go to hospital when they should be going to hospital is very important if people have urgent conditions that need treatment, they should go to a hospital and I can certainly say that when it comes to urgent cancer care, Dan, people will get the treatment that they need and we absolutely care about that. Can we go now to Francis Elliott of The Times? Francis Elliott : (40:28) [inaudible 00:40:28] Prime Minister, you've made the R rate of the kind of guiding star of your policy going forward. But you can only say that it's somewhere between 0.6 and 0.9 that's quite a wide range of uncertainty there. And I press again on what is a manageable R rate going forward and what are manageable numbers, so professor Alan's talked about. And secondly you've also talked about that you'll give some guidance to safer workplaces next week, and transport, can we expect some clarity on face masks please? Boris Johnson: (41:02) Yes. But both points look on... Thanks Francis pretty much. On the R... And I'm going to sort of give my layman's kind of it and I hope that Chris and Patrick may want to either to correct me or explain further. On the R, at the moment there are different Rs in different environments. And the crucial thing is to stop the overall national R from going over one again, because as Chris has and Patrick have explained, that's the moment you get the risk of another exponential curve upwards. I think that the change now in where we are is that we're starting to get much more and much better data about where things are and that will continue to improve so that as we go forward with our plan for phase two, we'll be much more sophisticated in the way that we're able to respond to what we think may be changes in the R, whether locally or regionally or indeed nationally. Boris Johnson: (42:08) I hope you understand what I'm saying, but I think people need to understand that driving down the R is of course our collective endeavor and the better we can do it locally, nationally, and across the country, the faster we will be out of it. And on your second excellent point which was about masks and face coverings, I think what... And again I'll defer to Chris and Patrick, but what I think Sage is saying and what I certainly agree with is that as part of coming out of the lockdown, I do think that face coverings will be useful both for epidemiological reasons but also for giving people confidence that they can go back to work. You're going to be hearing more about that and that kind of thing next week. Patrick Vallance: (43:04) [inaudible 00:43:04] with the R. At the moment were we using a calculated R looking at all sorts of things including contacts, looking at Genomics, looking at data from ambulance, hospital admissions and so on to calculate the R and it's right that it's got a range. It would be falsely precise to say we know exactly what it is and different models give slightly different rates. And as the prime minister has said, it's not exactly uniform across the country. In London it's probably somewhere between 0.5 and 0.7. Patrick Vallance: (43:35) What we're doing now, which is a really important part of this going forward, is actually measuring the R by measuring the number of active infections in a random population survey that's going on this week. It'll go next week, it'll go on the week after, so we start to get a measured value of R and that together will start to help us refine exactly where the R is. And it's always the case in an epidemic that you get closer and closer to a precision value. It's never going to be absolutely precise, but we will narrow it down and it'll be more of a measured R, which I think is an important point. Boris Johnson: (44:11) Chris, anything to add? Chris Whitty: (44:12) No. Boris Johnson: (44:13) Okay, good. Thank you. Thanks very much. Thanks Francis. Richard Vaughan of The Eye. Richard Vaughan: (44:21) Following on from Francis's question really, giving you have a better idea of how many people are actually infected. What figure do you think you need to get to in order for test and trace to be effective? And prime minister if I may, you've obviously contracted Covid-19 yourself and needed serious hospital treatment. Has it changed your approach to tackling the crisis at all? Boris Johnson: (44:46) Okay, well and good. Thanks very much, Richard. I mean on how far you need to get the new cases done, they're done to be able to do... As new cases is the key variable that I think probably I'll ask the scientist to answer... Boris Johnson: (45:03) I think probably I'll ask the the scientists to answer that, Chris and Patrick. Chris Whitty: (45:08) You can do things like track and trace at any stage of the epidemic, but it has a greater effect and a higher proportion of the heavy load can be taken by it if you're doing it a much lower level of numbers of cases a day. That, I think, is broadly the answer. Putting exact numbers on that, there's no really precise way of doing that, but this is one of the things that modeling groups that Sage and others have looked at in a lot of detail, and indeed Patrick and I were discussing this with a lot of teams earlier on today, because we need to look at the range of possibilities. But to be clear, there isn't a magic number, but in broad terms, the lower the number, the more effective it will be as an intervention. Boris Johnson: (45:51) Thanks. Yeah, so, Richard, on your question about my own case, look, I was very, very lucky. I had wonderful care, as I said, wonderful treatment. And let's be Frank, tragically thousands of people who have been less fortunate than I was and that's why the objective of this government is to save lives across the country, to minimize, to minimize the suffering that this epidemic is causing and is going to cause. And that's been our objective frankly from the beginning. It's unchanged. It will continue to be our objective. Boris Johnson: (46:38) Thanks very much, Richard. Can we go to Alex Wickham of Buzzfeed? Alex Wickham: (46:43) Hello, Prime Minister. The NHS has stayed under capacity, which is obviously a good thing, but given the number of spare ICU beds available during the peak, why is the UK's death rate so high, particularly in care homes? Alex Wickham: (46:56) And for the experts, in the US last night, Anthony Fauci said that the antiviral drug remdesivir had a clear cut effect on reducing recovery time and was proof that drugs could block the virus. The PM just now mentioned some other ways we might be able to manage this later on. Do you two share that confidence about remdesivir, and is the UK working on procuring this drug for Britons? Boris Johnson: (47:23) Alex, I think, on your first question, I'm really going to ... I think there are all sorts of discussions about all sorts of factors, comorbidities and so on, that increase the risks of coronavirus in this or that country. It's a huge debate already opening up. I think really what I'm going to do is sort of defer to the answer that Chris gave earlier about the vital importance of waiting to the end before making these international comparisons and just looking at the total excess mortality and trying to draw some lessons and some conclusions there, because, at the moment, I just think the data is not clear. Boris Johnson: (48:11) And on the other point, I defer. On remdesivir, I defer to the experts. Patrick Vallance: (48:17) Yes. Happy to speak to that. So remdesivir is a drug that was made for Ebola and has been tried for COVID. It absolutely does hit a particular part of the virus. That's been shown. Actually there are some structures of proteins from the virus which you can show the drug binding to. Patrick Vallance: (48:37) And there are two big studies that have reported out, one from China and one from the US. The one from China was a bit smaller. It didn't show any overall benefit in terms of outcome, and it was stopped early, partly because the number of cases were decreasing. The one in the US, which was a bigger study, showed a benefit in terms of the time to recovery. So down by about four days. It didn't have a statistically significant effect on death, although it looked like there were fewer deaths, or there were fewer deaths in that group, but it wasn't statistically significant. Patrick Vallance: (49:11) So I think the answer is this is a really promising first step. In other words, it shows that if you've got a drug that you know binds to a bit of the virus and inhibits it, you can actually get some effect. Patrick Vallance: (49:25) And that effect isn't very large at the moment. It could get bigger as more studies are done. There are other studies going on at the moment, and the UK has been part of those studies, but it's a very promising first start. It's definitely not a magic bullet to cure this, but it does show that drugs are going to be possible to have an effect on this virus, and therefore there'll be more that come along, and ultimately it may need to be a combination of drugs that comes together to make this really effective. Chris Whitty: (49:54) I'll just add two things to that of which I was agreeing with. The first thing is, and this is the cautious medical scientist in me, that you should always wait until you've seen the published paper that's been peer reviewed in a journal before jumping to conclusions. So we had a very encouraging verbal report of this. I think let's see the data before we over-interpret where we are, but clearly, encouraging first step. Chris Whitty: (50:21) And the second thing, just building on Patrick's point, is I think people often imagine that you move suddenly from a situation where you have no treatment or no vaccine, particularly this is true for treatment, to you suddenly have the treatment. Actually, what tends to happen is, by incremental steps, you move forward. Things steadily improving, sometimes combinations of drugs start, each one of which has a small effect, but if you put them together, the additive effect is very considerable. Chris Whitty: (50:47) So I should think we should see this as encouraging, provided it holds up under publication, first step along a long path towards significantly better treatment for this disease. But I am very confident that if we looked back at this disease from one or two years out, we will have significantly better treatments in the future than we have today. Chris Whitty: (51:08) And my final point is I'd really like to thank those in the UK who are taking part in clinical trials because the way that you actually learn about drugs and for the future help to improve treatment for others is for these trials to go on. And the trials in the UK are recruiting at an absolutely extraordinary rate due to people volunteering. Patrick Vallance: (51:29) So first step, one that says, yes, it is going to be possible to do something. There'll be more work to be done to get more drugs out on this. Boris Johnson: (51:39) Thanks very much, Alex. And can we go finally to Joe Byrne from the Stoke Sentinel? Joe Byrne: (51:49) Hi. Good afternoon, Prime Minister and gentlemen. Can you hear me? Boris Johnson: (51:53) Yes, well. Joe Byrne: (51:55) Okay. Stoke-on Trent's key workers are being told they must drive an 18-mile round trip to Manchester Airport for coronavirus tests. Many workers that need to test don't drive or have access to transport. There is a testing facility at Stoke City's bet365 Stadium, but it's only for emergency workers and the NHS. Will the Prime Minister make more testing available for essential workers in Stoke-on-Trent and will the bet365 testing be expanded to include all key workers and their families? Joe Byrne: (52:25) And for Chris and Sir Patrick, I think you've just touched on this, but given that 600 patients at Royal Stoke University Hospital are undertaking drug treatment trials to combat the virus, how vital of a role are Royal Stoke patients playing in reducing the overall number of deaths through these trials? Boris Johnson: (52:44) Well, thank you very much, Joe, and, first of all, thanks to all key workers in Stoke. Thanks to the entire people of Stoke for what they're doing to help us collectively to get this virus down, get it under control, to pass the peak in the way that we have done today. Thank you for bringing to my attention at this point about the 18-mile round trip for testing. We'll bring it up immediately. I'll check it out immediately with with the NHS and with the huge team that we now have responsible for testing. Boris Johnson: (53:16) You're going to be hearing a lot more in the course of the next couple of days, as you can imagine, about where we are with testing. You heard me say earlier on today that we've got the numbers up to, I think, 86,000 plus, but there is clearly a massive way to go. Boris Johnson: (53:34) In principle, every key worker in this country should be able to get a test, and we want that to happen. We're massively ramping up testing, and I think I'm right in saying, though I know that Matt Hancock will undoubtedly be telling you more about this tomorrow, I think I'm right in saying that we're now doing about as much testing as any other country in Europe if you look at the more recent figures. I know we're supposed to deprecate these international comparisons, but we have massively ramped up our testing operation. We're going to wrap it up even further. Boris Johnson: (54:17) And on your specific point, Joe, about making sure that key workers in Stoke get the tests they need on time without having to do an 18-mile round trip. The best I can tell you is that we'll be onto it and we'll come up with a way to ensure that they get the tests they need without going through that kind of that kind of palaver. So I want to wrap up this session. Chris Whitty: (54:45) What about his second one? Boris Johnson: (54:46) Oh, sorry. Chris Whitty: (54:46) Trials, yes. Boris Johnson: (54:47) Trials. I'm sorry. The second question. Sorry. I don't want to wrap up. Chris Whitty: (54:51) [crosstalk 00:54:50]. Yeah, really extraordinary that so many people in Stoke, and indeed many other cities around the UK, but absolutely in Stoke, have volunteered for this. And I'd just like to say a huge thank you on behalf of future patients who are going to actually benefit from the fact that people have volunteered to do this. And that means we will learn, as Patrick says, whereas new drugs come through, as old drugs are tested against this, and we will be able to treat this better, and that will be down to people in Stoke and elsewhere who are taking part in these trials. So enormous thanks. Patrick Vallance: (55:23) I echo that. It's incredibly, but it's the only way we can find out what works. It's really generous of people to volunteer for this, and it makes a massive difference because otherwise, the world's full of anecdote. And what this does is allow you to really understand what works and what doesn't. So, big thank you. Boris Johnson: (55:39) Thank you very much, everybody, and see you all again in the course of the next few days. Thank you.