UK Downing Street Coronavirus Press Conference with Matt Hancock Transcript January 25

Matt Hancock: (04:28) Good afternoon and welcome back to Downing Street for today's Coronavirus briefing and I'm joined by Deputy Chief Medical Officer, Jenny Harris and Dr. Susan Hopkins, who is the Chief Medical Advisor to Public Health England and NHS Test and Trace. I want to update you on the latest Coronavirus data and the vaccine rollout. Matt Hancock: (04:50) In the last week in the UK, we have seen 37,258 cases of Coronavirus on average each day. The NHS is under intense pressure across all parts of the country with 37,899 people in UK hospitals with COVID-19 and that includes 4,076 people on ventilators. Sadly, today 592 more deaths were reported and we must never forget the real impact of this disease. The loved ones that we've lost, the grandparents, parents, friends, colleagues, we grieve for each one and the pressure on the frontline I can tell you is just so relentless. Matt Hancock: (05:43) And when I talk to colleagues who are working in the COVID wards, they are flat out and they are stretched to the limit. They're doing everything they can and I want to say a huge thank you to all those colleagues who are working so hard they're pulling a huge shift and it's a duty on all of us to support them. I want to extend that thanks also to our ambulance workers. And in particular, I want to thank ambulance service staff who stepped up over the weekend when an appeal went out from the Scottish ambulance service for extra help and ambulance services from the other nations have stepped forward. Matt Hancock: (06:22) Our health systems across the UK, routinely work closely together, offering support when it's needed and from vaccines to ambulance services, we are stronger together and the UK is stronger together in the fight against this pandemic. And I know how tough that fight is. Thankfully, there are early signs that the actions that we're taking are working. The rise in the number of cases is slowing and falling in some parts of the country like London and Scotland. At the same time, the number of vaccinations is going up. Like many of you I've been talking to members of my family who've just had the call to be vaccinated. It's a really emotional moment when people get vaccinated, it means so much to people because this vaccine brings safety to that individual and it marks the route out for us all from this pandemic. Matt Hancock: (07:23) And I'm very proud to be able to tell you that as of last night, we have vaccinated 78.7% of all over eighties. That's almost four in five of everyone, age over 80. And I'm delighted that you can see from these figures that there's so much enthusiasm for vaccination amongst the over eighties, because octogenarians know what scientists know, which is that the vaccine saves lives. Of course, the rate limiting factor to this vaccination program remains supply. As we know, supply is tight. We've had a very strong performance in this past week and I'm confident that the NHS will be able to deliver every shot that's made available to it. Matt Hancock: (08:12) To help with that, today we've opened a further 32 large scale vaccination centers, including at Blackpool Winter Gardens, the Black Country Living Museum, better known to many as the set of Peaky Blinders and London's Francis Crick Institute, which itself is no stranger to human ingenuity. And I'm determined to get vaccine take-up as high as possible. Today we're funding councils to enhance their vital efforts to engage those who are hardest to reach through our community champion scheme. Matt Hancock: (08:46) As of today, 6.6 million have now received a vaccine against COVID-19. That's more than one in nine of the adult population. On Saturday alone, we gave nearly half a million jabs. And in the last week, two and a half million people have been vaccinated across the UK. That's a rate of more than 250 people a minute. We're on track to offer everyone in the top four priority groups a jab by the 15th of February. And if you are in one of those groups, one of the top four priority groups, and you haven't had the call yet, don't worry. The NHS will be in touch. Matt Hancock: (09:28) It is a truly national effort and alongside the GPs and the pharmacists and the other NHS staff, and of course the armed forces who are working so hard, alongside all of them working every weekend, every evening often, I particularly want to thank the 80,000 people who've stepped forward to help deliver this, doing things like volunteering to stand in carparks for eight hours a day in the freezing cold to ensure that elderly people can safely get to the vaccination center. It's truly heartwarming and we've seen this selfless attitude towards the vaccination program, and it makes me really proud, and I'm very, very grateful to all those who've stepped forward because we know that the responsibility for the fight back against this disease rests on all of us. Matt Hancock: (10:18) This is equally true when it comes to maintaining the rules and social distancing. Social distancing works by denying the vaccine the social contact that it needs to spread. And I want to reiterate an important point made by the chief medical officers and the clinical advice that they've been giving. Even if you've had the jab, the rules still apply. There's two reasons for this. First, because the protection takes time. Your body's immune system is only fully trained up around three weeks after your jab. And even if you have the protection yourself, we still don't know whether you'll be able to pass Coronavirus on to someone else. Matt Hancock: (11:03) ... Whether you'll be able to pass coronavirus on to someone else. We're monitoring that very carefully, and we'll publish information on it as soon as we have it available. So this is not a moment to ease up. The success of the vaccine rollout means we cannot, we cannot put this progress at risk. Matt Hancock: (11:19) The final thing I want to say is this, there is no question that the new variants have made this fight a whole lot tougher. And I want to set out again, precisely, what we know about the new variants. As with all science, as we have threw away unprecedented crisis, we're learning more all of the time, and the new variant that was first discovered in Kent, which comprises now a significant number of our cases, it is spreading 30 to 70% more easily than the existing variants. Matt Hancock: (11:50) And based on analysis conducted by academic colleagues in a variety of studies, there is a realistic possibility that this variant may be associated with increased mortality compared to the old variant, as well as increased transmission. And because of our extensive genomic sequencing, we've identified cases of the new variant, first identified in South Africa, and that one that was first identified in Brazil. And further scientific work is underway to understand more about these variants. Matt Hancock: (12:22) But in the meantime, it reinforces the critical message that we must be cautious. For all of us, our response must be extra careful. Stay at home, maintain social distancing. And we've all, frankly, sacrificed too much. And it's so important that we protect lives. And we're making progress with the vaccine. And the end is in sight, and we cannot put that progress at risk. And there are promise, there's a promise of better days that lie ahead. We have to hold our nerve and persevere through this difficult winter. Matt Hancock: (12:57) So it's incumbent on us all, wherever possible, to stay home, protect the NHS, and save lives. We're now going to go straight to questions. And the first question is from Colin from Sunbury-on-Thames, by video. Colin: (13:15) Some estimates suggest up to one in 10 people now have antibodies for COVID-19. If this is the case, how close are we to herd immunity? Matt Hancock: (13:25) Thanks very much, Colin. This is very much a scientific question. So I'll go first to Dr. Hopkins, and then ask Dr. Harris if there's anything she wants to add. Dr. Hopkins: (13:35) Firstly, to say, Colin, that one in 10 people having immunity is a far away from where we need to be in. The herd immunity is a word that we use to describe the immunity that we get from vaccination. The big job here is to roll out the vaccination to those individuals. First of all, to those who are at high risk of death and hospitalization, and then to the rest of the population. Once we've done that, then we will have herd immunity. We should not be focusing on getting infection and the consequences of this infection getting us out of wherever we are right now. Matt Hancock: (14:08) Thanks very much. Jen? Dr. Harris: (14:10) Just to add Susan's comments, I think the important thing here is, as secretary of state has said, we are still learning a lot about this virus, about the new variants, and our body's response to it. So it's really important we might measure antibodies at one time. We need to understand how those antibodies remain over time, and what happens if they're challenged again in the future. So this is still very much a learning landscape. Matt Hancock: (14:33) Thanks very much. Next question from Julie from Walsall, also by video. Julie, Julie: (14:40) When the current lockdown ends, will you revert back to the previous tier system or will not be revamped in a new tier system in place? Matt Hancock: (14:49) Thanks, Julie. We're looking at this question right now, and we're looking at the impact that the different tiers had, and we're also looking at where we found transmission happened. It's a question that will be driven by the science. So on that point, it's Dr. Hopkins who leads within NHS tests and trace on the clinical advice to that question. So, Susan, will you set that where we're up to? Dr. Hopkins: (15:20) I think we need to see our death rates fall much lower and our hospitalizations and those numbers of individuals in ICU decline. We're at the highest number of individuals in ICU today. And numbers of hospitalization are still twice as high as the peak. We will look and monitor these and use that to help inform and advise government on when and how the tiering should look in the future. Matt Hancock: (15:44) Thanks very much, Julie. Next question is from Laura Kuenssberg of the BBC. Laura. Laura Kuenssberg: (15:50) Thank you very much, secretary of state. I bit like Julie's question, because everybody very much wants to know when this is all going to be over. Can you, secretary of state, spell out how, if not when, lockdown will start to be lifted? And if you won't tell us, why not? And also, to all of you perhaps, if a new variant of the disease emerges, that is more resistant to the existing vaccines, what plans are there for the UK to be able to develop an updated vaccine on its own? How fast could that happen? Or would we be dependent on supply chains from other countries? Matt Hancock: (16:25) Thanks very much, Laura. These are absolutely critical questions. The first thing I want to say, in response to the first question about the lifting of measures, it's so important, firstly, to understand where we are right now. Right now, we have 37,000 people in hospital with Corona virus. That is almost twice as many as at the first peak back in April when there were 19,000 at the highest. And there are more people on ventilators than at any time in this whole pandemic. Matt Hancock: (17:02) So the pressure on the NHS remains huge, and we've got to get that case rate down. But of course I understand why the yearning people have to get out of this. The thing is that we have to look at the facts on the ground, and we have to monitor those facts. And of course everybody wants to have a timeline for that, but I think most people understand why it is difficult to put a timeline on it, because it's a matter of monitoring the data and the facts. This is a state-contingent, not a time-contingent question. Matt Hancock: (17:39) The prime minister has said, when we went into this national lockdown, that we will be looking at the death rate, the number of hospitalizations, whether there were new variants that significantly affect the course of the pandemic, and of course the success of the vaccine rollout. So we'll look at all of these factors and make sure that we take the steps as soon as safely possible to do so, of course, but when it is safe. Which means that we've got to be careful. Matt Hancock: (18:14) I'm going to ask Jenny Harris to comment on the clinical input into these decisions. Because I understand why people want to know the answer, but it is difficult, hence we've set out what we'll be looking at. And the prime minister set out when we will be reviewing these measures. And then on the second question, I'll ask Dr. Hopkins to come in on that, because that is a very live and very important point. Matt Hancock: (18:41) Y'all have seen the announcement today from Moderna, but we're doing significant work here in the UK to make sure that if we need to update the vaccination program, then we will, and in the same way that we've managed to be right at the front in terms of the vaccine. We want to obviously stay there. So there's an awful lot of work going on to deliver a vaccine that works under all circumstances. Jenny. Dr. Harris: (19:13) Thank you, secretary of state. Thank you, Laura. I think, as secretary said, it's really important to realize just where we are at the moment. The lockdown was initiated as we moved into the level five, and that meant a serious risk to our health services. And we now have twice the number of people in hospital than we had at the peak of the first wave. So we just need to keep these figures in proportion. We are not out of this by a very long way. And there are three different large areas, I think, we're juggling with clinical care. Dr. Harris: (19:42) One is obviously the current rates that we've just described, and particularly looking at those in 60-year-olds and above. We know those are the ones who still are likely to require hospitalization and intensive care use. The second one is to wait for our understanding. We have to be really patient about the understanding of the implementation of the vaccine program. Dr. Harris: (20:04) And the third one, which I think we perhaps haven't mentioned, if many of you look outside, I'm sure you'll see some snow out there. Alongside all of this, our health service has to deal with the increased rate of clinical admissions due to a winter and cold weather. So it is not simply a matter of COVID, it is actually a balancing of all of these indicators alongside the main COVID ones, to ensure that our health services can continue to treat us all. Matt Hancock: (20:30) Thanks very much indeed. Dr. Hopkins. Dr. Hopkins: (20:32) Thank you. From the point of view of vaccine, it's a very live issue, Laura. We are ensuring that we look at all of the new variants that are emerging globally. We're understanding which of the mutations in these variants are common and that are likely to be the ones that will come together to cause vaccine evasion. We will then use our global scientific networks to try and work with WHO and other global partners to decide what the new vaccine should look like. Dr. Hopkins: (21:01) However, in the UK, we're already leading these discussions with our vaccine task force. And we are coming together with scientists to build what we think is the likely mutations that will cause changes in our immunity and our immune response to vaccines. And we're already looking at how fast a new vaccine could be built and rolled out in this country. Matt Hancock: (21:23) Thanks very much. In addition to that on the vaccine program, the critical point is that we have a high degree of confidence, that this vaccine that we're rolling out in the UK right now works against the variants, both the old variant here and the new variant. What matters, in practice, right now, to everybody watching, is when the NHS calls get that vaccine. But of course, we're also doing the work, casting forward in case there's need for an update, in the same way that the flu vaccine is updated every year. Thanks very much, Laura. Matt Hancock: (22:03) ... updated every year. Thanks very much, Laura. The next question is from Tom Clark at ITV. Tom. Tom Clark: (22:08) Hello. I should say thank you. Firstly, can I just get a bit more of an update on those new variants from both South Africa and Brazil you mentioned we now have in the UK? Can you tell us how many cases of each or whether we have sustained transmission of them or whether they are very much isolated? Secondly, on the efficacy of vaccines against new variants, I think all the lab studies indicate that yes, they will work well against the UK variant, but the real proof of that will be in data from the real world. What evidence do you have from the vaccine already rolled out that it is effective against the UK variants? And can you share it with us? And just finally, if we indeed do end up needing to do some sort of boost strategy with a new version of the vaccine, like perhaps the one being announced by Moderna today, what capacity do we have to do that? And will we mix and match vaccines if need be? Matt Hancock: (23:03) Thanks very much. Well, I'll set out where we are on the variants identified here and then ask Susan again to set out the details in terms of any future updated vaccine, but really, I want to precursor all of that by saying that I set out the numbers of the new variants that we've found from South Africa and Brazil, set those out yesterday. These are very, very small numbers in the grand scheme of things. What matters today is that people get the vaccine when the NHS calls. On the new variants, we have identified and are putting in place what's called enhanced contact tracing, which means that for each one of those people who is identified as having a new variant vaccine that we are worried about from abroad, there's a special focus to the contact tracing to make sure that they and their contacts self isolate, that we check that everybody self isolates, they get all the support possible, because it is so important that we get those new variants from abroad under control. Matt Hancock: (24:15) We have a high degree of confidence that this vaccine works against what you call the UK new variant. I think it's best described as the new variant that was first discovered in the UK. And so, for the purposes of the vaccine rollout, whether people have had the old or the new variant, it doesn't matter. What you need to do is get vaccinated when the call comes. And so the critical thing for everybody watching is this makes it even more important to follow the rules, and it means that we're taking the more cautious approach to international travel that we've introduced in the last couple of weeks, including for instance, removing the travel corridors. And under this lockdown, it is illegal to travel abroad unless you have a reasonable excuse because it's illegal to leave your home unless it's for one of the very small number of reasons set out. Matt Hancock: (25:16) So, the change to the international rules was because we don't want to see any of the new variants that have that risk from the vaccine arriving on our shores here and we're dealing with the ones that we've found here. Susan. Dr. Hopkins: (25:34) Thank you. So there are four laboratories in the UK doing detailed vaccination and convalescent serum studies, and that's in Imperial, Oxford and two PhD laboratories, [Port-in-Diane 00:25:45] and Collindale. The consensus view from those four laboratories have all done different experiments, is that the current vaccine works against the variant that was first discovered in the UK. That is very, very reassuring. We also know from following clinical cohorts where we are looking at everyone who's had prior infection and who gets a subsequent [PC-Or 00:26:08] that we can't see any change in the immune response and the reinfection rate, and those that have had a previous infection through our routine datasets. We're starting to do that work on South Africa, the variant that was first found in South Africa. That hasn't reported yet, but we will continue to look and watch this. And we expect each of those sites to publish that data in its final format independently. But the consensus view, as we released in our technical statement is that this is working against the current variant. Matt Hancock: (26:40) Thanks very much. Dr. Harris. Dr. Harris: (26:41) Just to add, I think, to Susan's comments, it's important that we realize that it's quite normal for viruses to mutate, and we will have numerous mutations as we go forward. Not all of them, in fact, the vast majority of them will not be of concern. And I think importantly, even though the work is ongoing to ensure that we understand exactly how the vaccines work with these different mutations we've identified, it's quite unlikely in clinical terms that vaccines would not have some degree of effectiveness, even for new virus mutations that we identify. Matt Hancock: (27:15) Thanks very much indeed. Next question is from Andy Bell at channel five. Andy. Andy Bell: (27:22) Hello. Thank you very much. Secretary of State, just to go back to control of borders, do you now personally believe the time has come for enforced hotel quarantine for all people coming from all destinations? Do you feel we've got to that point? And the question for Dr. Harris, you and, to be fair, many other colleagues, right at the beginning of this, felt that there was no point in controlling people coming in once the virus had arrived. Do you feel now looking at what's happened since, that that was a mistake? Matt Hancock: (27:57) Well, thanks very much, Andy. I think it is incredibly important that we are cautious at the border, and we have changed the rules around travel in the last two weeks to remove those travel corridors, and the lockdown rules mean that it is illegal to travel abroad, unless you have one of the reasonable excuses that's set out in the legislation, for instance, to travel abroad for medical reasons. Although frankly, given that we've got the NHS here at home, I can see little reason to do that. So people shouldn't be traveling abroad unless they have one of those reasons. And that's just part of the stay at home regulations. It is important that we protect from new variants, should they have vaccine evasion. And it is also reasonable to take a precautionary principle to protect this country whilst we work on the science and the analysis of the different variants that are discovered around the world. Dr. Harris. Dr. Harris: (29:06) Thank you. Yes, I think what we've always said for public health professionals is that once you have significant infection in the country, actually the proportion of cases which are coming in on your borders is very small, and we need to take really firm action to manage infection both domestically and any that might come in. I think what is slightly different now is we are identifying new variants, and as the Secretary of State is highlighted, there are particular measures in place, which certainly at the start of understanding of a variant is important for us to be able to learn about its transmissibility and what the impact might be in the country. And I think the third point is it is usually when there are low rates where this becomes a really important point. So having very effective test and trace when the rates have gone right down, and just to reiterate, we are not there yet. There is a lot of work to do still with everybody's help to get those rates of infection right down, but when they are down, then that's the time probably to be really harboring in on infections. Matt Hancock: (30:16) Thanks very much. The next question is from Hannah Geissler at the Express. Hannah. Hannah Geissler: (30:23) Good afternoon, Secretary of State. A couple of questions on variants. You said the evidence suggests that vaccines will still be effective against the new variant identified here in the UK, but considering the increased mortality risk, is there any evidence on whether treatments such as Dexamethasone are any less effective in patients with that new variant? And then we've heard time and again that vaccine uptake is going to be crucial. Now that we're several weeks into the rollout, do you have any figures on the percentage of people offered the vaccine who are taking it so far? And if not, when will you be able to share that data? Matt Hancock: (30:54) Well, I'm delighted to say that the proportion of people who are invited to come forward, who are not taking up that chance is very, very, very low. I'm absolutely thrilled that with the support of the Daily Express and all the other serious UK media outlets, this vaccination program is going well and people's enthusiasm for taking it is increasing. And we're seeing that uptake getting to really high levels. In fact, I was talking to a group of doctors and their team in Yateley and Hampshire today, where they've reached 98% of all the over 80s locally who've been vaccinated. That is a fantastic level of take-up. And they're continuing to offer the jab to the 2% who haven't got there yet. Matt Hancock: (31:54) So this is a rollout that is going well, the enthusiasm for taking the jab is increasing, and I hope that we can keep encouraging people and reassuring people who might be wondering whether to have the job or not, that this is the right thing to do for them and for their community. So, it's really encouraging on the vaccine rollout and I'm very grateful to everybody who's helped play their part, including the media, who've been, frankly, absolutely brilliant in supporting the science on this one. And on the first question, I'm going to turn to Dr. Harris and yes, and then Dr. Hopkins to make sure you get a full and rigorous scientific answer. Dr. Harris: (32:44) So I might just add onto some of the comments about people getting the vaccine, because I think certainly Director of Public Health have been working very hard at local level, as have faith leaders as well, and I think have been absolutely instrumental in supporting individuals to understand the vaccine, what it means and how they might have it. And we've seen some of those centers open- Dr. Harris: (33:03) What it means and how they might have it. And we've seen some of those centers open up in churches and mosques and various other places, which will, I think provide assurance to some local communities. And that is important. The point I wanted to raise was if for example we take some of the very high risk areas, so care homes is something, which is particularly at the top of my mind. We know that the elderly residents are taking that up, but perhaps care home staff were slow to start with and perhaps a bit reluctant. We know that with more information they have then been reassured and come back. And that's important because an area like a care home is itself a bit like a mini population. So it's really important that both the residents and the staff are vaccinated as well, but on the data. Dr. Harris: (33:47) So the high level data is already published. I think it's an HSE data. Susan will clarify that. I know director of public health have had a first structure of data. And again, really important that we understand not just that people have been vaccinated, but the ages of those individuals, where they live, the sorts of roles they're doing in the health and care sector. And that information is starting to flow. It's a huge task and Susan might want to add, but I know even today, a large data linkage has gone through NHSE and is promoting that data. The important thing is that local communities have the granularity, the real level of data that allows them to access and support people in their programs. Matt Hancock: (34:31) Thanks very much. Dr. Hopkins: (34:32) I'll just start on, particularly on the dexamethasone. So dexamethasone were the studies that were done in the UK through the largest city in the world recovery. Have really transformed people who were admitted to hospital and who need oxygen and improve survival. Dr. Hopkins: (34:46) We see no signals at the moment that there's increased hospitalization rates with the new variant, and we're not seeing a clear signal at all that that has changed with dexamethasone. So we would expect dexamethasone to work perfectly because this is about reducing your own immune response and calming that down so that your body can get over this virus with its own immune response. So we expect the dexamethasone will still be effective in reducing mortality with this virus. And we expect that the hospitals will continue to give it, which they are doing at a very, very high level to anyone who needs oxygen who's admitted. Matt Hancock: (35:23) So it's very reassuring that our assessment is that the vaccine works against the new variant and that the treatments work against the new variant, but it passes from one person to another so much more easily that we've all got to just be extra careful to stop passing it on because that's how we're going to get this under control. Thank you very much indeed, Hannah. Next question from Dan O'Donoghue from the Press and Journal, Dan. Dan: (35:53) Hello, just two quick questions for you health secretary. Why do you think Scotland has slowest vaccination rates in the UK? And secondly, we've seen another weekend of polls showed majority support for Scottish independence. Do you think your performance and the performance of your Westminster colleagues over the last year has helped or hindered the case for the union? Matt Hancock: (36:13) Well, I think the case for the union is undoubtedly strengthened by the work that we've done and shown how over this pandemic we're stronger as one United Kingdom. I mentioned the work that the NHS does with the mutual aid between different parts of the NHS, but I just pick out one example and that's the vaccine rollout. We both invested in the science of this vaccine and bought the vaccines that we bought from international companies as a UK government for the whole of the UK. We've then rolled it out to all different parts of the UK through the NHS, including in the three devolved nations. And as a result of this, other than Israel and the United Arab Emirates, we have the fastest vaccine rollout in the world and that's a sign of what the UK can do when we pull together. Matt Hancock: (37:09) And I think that for all those in Scotland who are considering this question, what I'd say as secretary of state is that we're so much stronger together. It means an awful lot to me and my English, UK colleagues in the UK government, that we are one union that can pull together when things get difficult. And that's an argument that I think is resoundingly powerful that this UK vaccine delivered by Welsh and Scottish and Northern Irish colleagues in the NHS as well as of course all the way across England, that is a real example of this country firing on all cylinders. And I think that I know that colleagues in the Scottish government are working incredibly hard to roll this out across the whole of Scotland. And the NHS in Scotland I think is doing an absolutely terrific job at getting this rolled out. I think that it is all about how we work together and if this pandemic has taught us anything, it's that we all rely on each other and that's best done as one United Kingdom. Thanks Dan. Next question is Lauren from Lawrence Dunhill from the Health Service Journal, Lawrence. Lawrence: (38:36) Hi, thank you. The National Institute of Health Protection is supposed to launch in two months time and take over Test and Trace. Is that still the plan? And have you found someone to lead that organization yet? The job advert for the chief exec role said an appointment would be made by the end of December. And on vaccinations, the prime minister has said the issue of vaccine wastage is very important and we've been told that it's very low, but we have no information about what that means or how the wastage rates differ between regions' vaccine centers and priority groups. Will you commit to publishing detailed wastage rates? Matt Hancock: (39:20) Well, obviously reducing the wastage rate is incredibly important and we exchange best practice, and part of the standard operating procedure is constantly kept on the review to see how we can reduce the amount of wastage. On the National Institute for Health Protection, absolutely. That is on track to launch in April. And it has a very, very important role at pulling together all the different parts of the health protection response and making sure that we have one institution that is constantly on the lookout for not just the response to this pandemic, but to make sure that we are as prepared as we possibly can be. In fact, in many ways, that pulling together is already happening. Susan is the medical director of both NHS Test and Trace and for Public Health England, and the deputy chief medical officer works across all of those different organizations. So on the ground, this is all as you can imagine being pulled together and we have that rollout plan in hand, unless there's anything either of you want to add. Thanks very much for that question Lawrence. Lawrence: (40:38) My two questions were actually, are you going to publish some detailed wastage rates? And have you appointed the chief exec for the new organization yet? Matt Hancock: (40:48) Yeah. And on the wastage rates, I said out where we're up to in terms of wastage rates. I'm very happy to look into further publications and in terms of the NIHP, there'll be an announcement as soon as the decision's made. Thanks very much indeed.