United Kingdom COVID-19 Briefing Transcript April 3

Matt Hancock: (01:50) Good afternoon and welcome back to Downing Street for today's coronavirus press briefing. I'm joined by our deputy chief medical officer, Professor Jonathan van Tam and by the chief nurse Ruth May. Our plan is to save as many lives as possible by protecting the NHS and preventing it from being overwhelmed and we're doing this in two ways. Matt Hancock: (02:17) One, by slowing the spread of the virus. That's why it is so important that people stay at home. And that's true for everyone who's watching, how important it is that we stay at home. And two, by boosting the capacity of NHS to care for those who fall sick. That means more beds, more staff, more life saving equipment, and more effective treatments will come on to that. Coronavirus continues its grim march. I could report that through the government's ongoing monitoring and testing program, according to the latest figures as of this morning, a total of 173,784 people who've been tested, of whom 38,168 tested positive. 3,605 people sadly died. And we're reminded again today that for the NHS, this truly is the front line. Matt Hancock: (03:28) In the last 24 hours, two nurses and two healthcare assistants tragically died fighting Coronavirus. Every life lost to this dreadful disease makes me more determined than ever to push for victory. And today, I want to update you with the latest on what we're doing to boost NHS capacity. So the capacity we have to care is always above the need for that care. First, we're delivering more critical care beds. This morning, I attended the opening of the new Nightingale Hospital in East London, with Ruth and many others. It was planned, constructed, and fully staffed in just nine days. That is an outstanding achievement and I pay tribute to Ruth and all who've been involved in its construction. It shows what's possible when we come together as one team in one national effort, I pay tribute to the extraordinary work of everyone, the NHS, the military, the construction industry who both donated supplies and of course their expertise, the engineers, the electricians, the plumbers, the caterers, and others all playing their part to build a place of hope and a place of healing. Matt Hancock: (04:52) It was really inspiring to go and see the sheer scale of it and the teamwork going on there. And lastly, I want to thank you. I want to thank everyone who is at home because you are giving the NHS the time to expand so that it can save lives. By staying at home, you are saving lives. We have more Nightingale Hospitals planned and on the way in Birmingham and Manchester and Glasgow, and today we've announced that we will begin the work on two further Nightingale Hospitals in Bristol and Harrogate. The Bristol Nightingale will have a capacity of up to a 1,000 beds and in Harrogate the capacity of up to 500. The Nightingale Hospitals are not the only expansion we've seen across the NHS. Matt Hancock: (05:49) Since the start of this crisis, we've boosted the number of critical care beds to care for coronavirus by over 2,500. That's before the addition we'll get from the Nightingale Hospitals. And the result of this extraordinary work is that in every hospital in the country, we have managed to expand capacity. And as we stand today, over 2,000 critical care beds are free and available and they're ready should they be needed. And that's before the Nightingale Hospitals come on stream. And of course, we're working round the clock to deliver essential deliveries of PPE across the whole NHS, across social care, key public services, and in all four nations of the UK. Yesterday, more than 26 million PPE products delivered to 281 different organizations. Matt Hancock: (06:47) And I've agreed with the Northern Ireland executive that we will immediately be providing more PPE to Northern Ireland to meet their needs, over 5 million items, including goggles and aprons and masks. Over 7,000 NHS staff have now been tested. And next alongside testing, we're intensively researching drugs and treatments. Right since the start of this crisis, we've been clear that all our plans are based on the best possible science and that science gets better every day. But there's still a lot that we don't know about how to treat and potentially prevent COVID-19. So research about treatments is absolutely central to our plan. The UK of course has a long tradition that we're very proud of, of being the best in the world in this sort of science. And we are a world leader in clinical trials and we're putting this to use right now, bringing together some of the finest research minds in the country to design new trials and we're delivering them at record pace as well. Matt Hancock: (07:56) We've established three national clinical trials covering each major stage of the disease, primary care, hospital care, and critical care for the most seriously ill. And just like the Nightingale, one of these trials was in fact put together in just nine days, which is breathtaking speed. These trials are looking at the effects of existing drugs and steroids repurposed for treatment of COVID-19. One of the trials which is called recovery, which deals in hospital care is the largest of its kind in the world with 926 patients enrolled. We've also set up an expert therapeutics task force to search for and shortlist other candidate medicines for trials and I'm advised on that work by my brilliant colleague Jonathan van Tam, the deputy chief medical officer who is one of the finest research scientists of his generation. And Jonathan will say a bit more about in a few minutes. Matt Hancock: (08:57) We need more patients to volunteer to be part of these trials because the bigger the trials, the better the data, and the faster we can roll out the treatments, if and only if it's proven to work. These treatments will help us as the science develops. But for now, the only way to protect yourself and your family from this disease is to stay at home. And of course while this is a national effort to find these treatments, it's also an international effort, in the same way that we've donated more money to the global search for a vaccine than any other country. So too, we will lead the world in the science of these treatments. And whatever we learn, we will share because we are all on the same side in this war. Matt Hancock: (09:48) Earlier today I spoke to my counterparts in G7 to coordinate our research efforts over this and other things. And whether it's treatments or equipment or NHS capacity, we will strain every city. We will move whatever mountains need to be moved. We need everyone to keep playing their part and that includes you. The only way to protect yourselves and others now is to stay at home. The one final thing I want to say is this. We're set for a warm weekend in some parts of the country, but the disease is still spreading and we absolutely cannot afford to relax the social distancing measures that we have in place. We cannot relax our discipline now. Matt Hancock: (10:40) If we do, people will die. So I end with the advice that we all know. This advice is not a request. It is an instruction. Stay at home, protect lives, and then you will be doing your part. I'm now going to hand over to Ruth May, the chief nurse to say a little bit about the Nightingale Hospital and then to Jonathan van Tam to talk about the treatments and the data that we've got. Ruth? Ruth May: (11:15) Thank you, Secretary of State. Before I talk about the Nightingale Hospital in London, I want to recognize that today we've had the very sad news of the loss of two of my colleagues. We have lost today, Amy [inaudible 00:11:33] and [inaudible 00:11:34], two registered nurses working to protect our public and they sadly have died. My sincere condolences to their families, their friends, and their colleagues because they were one of us. They one of my profession, of the NHS family. Ruth May: (11:59) I worry that there's going to be more and I want to honor them today and recognize their service. So as the Secretary of State said, we were with the [inaudible 00:12:20]. And his Royal Highness, the Prince of Wales, he was joining via video cameras as he opened the first NHS Nightingale Hospital in London. It was an extraordinary feat. People have worked so hard from all sorts of walks of life, all sorts of backgrounds, and they've come together as one team to build an NHS hospital. An enormous piece of work, of absolute huge. As the Secretary of State has said, he's announced two further facilities in Harrogate for the people of the Northeast and in Bristol for the people of the Southwest. And of course that's long side, Birmingham and Manchester. So thank you to all of our NHS staff, all of our staff across into social care, whether that's nurses, midwives, doctors, all of them pulling together to make sure that we continue to prepare for COVID-19 surge. I'm grateful for all of our frontline staff and all of our support staff who are caring as a team for sick patients. Ruth May: (13:26) I'm very grateful to you, the British public, for your patience and in helping our NHS. As the Secretary of State said, this weekend is going to be very warm and it's very tempting to go out and enjoy those summer rays. But please, I ask you to remember Amy and [inaudible 00:13:48]. Please stay at home for them. Matt Hancock: (13:53) Thank you, Ruth. And Jonathan van Tam, if you could bring us up to speed on the treatments and on the latest data that we have. Jonathan Van-Tam: (14:01) Thank you, Secretary of State. I'll begin with the data- Jonathan Van-Tam: (14:03) and the first slide I want to show you is a survey which shows the behavioral change as of 29th of March in relation to the social-distancing advice that the government has given. Jonathan Van-Tam: (14:18) As you can see on the slide, if you begin on the left, there is a small increase in mobility within residential settings. This actually is good because it shows people are staying at home. If you then contrast that with the bars further to the right which move progressively through grocery and pharmacy, through public parks, through workplaces, through transit stations and finally to retail and recreation, you can see progressively larger declines in mobility across the UK. This is really very encouraging indeed and shows that the British public are following the advice that was given, to them but it needs to continue. Next slide, please. Jonathan Van-Tam: (15:04) If you then move on and you look at the change in transport use between the 5th of March and just a few days ago, you can see dramatic declines across the piece in total motor vehicles and in use of national rail, buses, and tubes in London. This again is very encouraging. Next slide, please. However, as we have always said, we do not expect these changes to turn the curve on this awful disease immediately. It will take time. As you can see, this slide shows the number of UK cases by day and you can see the numbers are increasing. This remains a dangerous time. It remains vitally important that people continue to stay at home and practice the social distancing that we've asked of them, even this weekend as the weather turns warmer. Next slide, please. Jonathan Van-Tam: (16:09) You will see a similar picture for hospital admissions, that they are increasing and again, this reinforces the advice we give. The final slide, please. Jonathan Van-Tam: (16:22) Shows the comparison of the UK in relation to various other countries. The index is set at the first day in each country when 50 deaths were reported. You can see from this slide that it is a global battle and that the UK is in the same situation in terms of the curve and the shape of the curve as many, many other countries around the world. This is a serious battle. We need to keep fighting it. Jonathan Van-Tam: (16:57) I'd now like to talk about clinical trials, if you could take the slide down. Thank you. The first thing I want to say is that this is a new disease where at the moment we do not have any proven treatments. The UK is absolutely determined, however, to find effective treatments for this virus disease. Weeks ago we began to look at clinical trials. We may not have publicized it at that point, but a lot of work has been going on for weeks behind the scenes. Jonathan Van-Tam: (17:37) Clinical trials are a gold standard way to discover if a treatment works or not, but saying whether it works or not is rather too simplistic. The treatment has to be effective. It also has to be safe and we also have to understand the right dosage to use, the right patients to give the treatment to, and the right time in the illness to give that treatment. This is complicated stuff and the only way to unpick the signal and make sure we get it right is through clinical trials. Jonathan Van-Tam: (18:18) And as my colleague, the secretary of state, has said, there are three trials already up and running in the UK that target different places in the patient pathway from primary care through to critical care. The recruitment rate has been absolutely astonishing, particularly in the recovery trial where we are at 926 patients some three weeks after the trial began. It's astonishing. It really is a fantastic tribute to the fact that the NHS is getting on with delivering care, but at the same time is committed to finding the right effective treatments. Jonathan Van-Tam: (19:02) Now, again, as the secretary of state has said, our initial focus has been on what we call "repurposed medicines," medicines that are already licensed for some other use or indication. An example would be hydroxychloroquine, which is a malaria drug. Another example in our clinical trials would be a combination of lopinavir and ritonavir, which is an HIV treatment. We are going for the foreground targets in the first instance, where we already have a drug that is licensed. But we're just not stopping there. Jonathan Van-Tam: (19:39) We are determined in the next round of clinical trials to move on to new medicines, ones that are in what we call Phase Two or Phase Three development now possibly for something else but which might have a role to play. We're going to explore all of those technologies. To do this, we are going to need this therapeutics task force that we have set up to keep an oversight and to coordinate this. Jonathan Van-Tam: (20:07) Now, I know that there'll be a question about when are we going to get some results from these clinical trials. My straight answer to you is, I don't know. I think it's going to be a few months, but it will all depend upon how quickly patients are recruited into the trials across the NHS. The faster we go in getting bigger numbers in the trials, the clearer and more emphatic and more granular signals we will get about what works and who it works for. Jonathan Van-Tam: (20:42) Thank you, Secretary. Matt Hancock: (20:43) Thank you very much. If we now go to questions, the first question is going to be from Hugh Pym of the BBC. Hugh Pym: (20:54) Thank you very much. It's a question actually for Jonathan Van Tam, if I may. When do you expect the peak of the epidemic to be? At that point, will the NHS have enough ventilators to give those who need critical care that care at a time when some patients might fear they won't be able to get it? Jonathan Van-Tam: (21:14) Thank you for the two questions. The first one is about when we will turn this curve round, when we are going to peak, and when we're going to come down. Jonathan Van-Tam: (21:24) We don't know the answer to that yet. We have always said that we will know if our social- distancing measures are working a few weeks after we have put them in place. By my quick calculation, we're at kind of 10 or 11 days at the moment. It's too soon to say. It will partly depend upon how well those social-distancing measures are adhered to by every one of us, but I hope it will be soon. We are going to watch very carefully to see when we've hit the peak and when we're starting to turn it, but we will not take any premature actions. We're going to stick with the science and see where it takes us. Jonathan Van-Tam: (22:07) Your second question, is kind of related and about how tall the peak will be and whether there will be enough ventilator capacity across the NHS. Jonathan Van-Tam: (22:19) I can tell you that I don't think we're anywhere close to that kind of scenario at the moment. We will watch it extremely closely and we will make decisions as we need to on a day-by-day basis. But I repeat, we are not anywhere close to the scenario you describe at the moment. Matt Hancock: (22:40) Thanks very much. If we go to Robert Peston of ITV. Hi, Robert. Robert Peston: (22:46) Afternoon, gentlemen. Firstly, on the clinical trials, Jonathan Van Tam said the success depends to a certain extent on the numbers enrolled in those trials. Was that actually a call to individuals with symptoms to enroll in those trials? Are you looking for volunteers? Robert Peston: (23:03) Secondly, very recently, Patrick Vallance told the health select committee that on the basis of the lag between infections and deaths, he thought there were probably a thousand people in the community with this virus for every death. Does that mean we think that we're not far off four-million people infected, or have you've got a new rule of thumb now that we're slightly further on? Robert Peston: (23:28) Then, finally, Secretary of State, you're well aware, because of ministers and people you know, that the range of symptoms you can get with this is very broad indeed. For example, there's a lot of evidence that losing sense of smell and taste is a symptom. Are you looking at changing the guidelines to people for when they quarantine, because at the moment you're saying self-isolate if it's a high fever and a cough, but are you going to add to the list of symptoms where people should start self isolating? Matt Hancock: (24:01) Well, thank you. If I answer some of that and then I'll cast over to JVT. On the last one, which you addressed directly to me, Robert, it's a complimentary of you to ask me a scientific medical question, but I'm going to resist the temptation to answer it because we've got a proper medical scientist in the room and we are following the science. For me, personally, I did lose my sense of taste and that actually has begin to come back though. I can assure people who have lost their sense of taste that the good news is that that, in my case, wasn't permanent. Matt Hancock: (24:42) On the first point about the clinical trials, the answer is that we are looking for people to sign up to the clinical trials where that's possible within that hospital and where that is clinically advised. The call really is to the NHS, who are the ones who would make recommendations that somebody would be on a clinical trial. Matt Hancock: (25:07) JVC, do you want to add to those two questions and also answer Robert's middle question on the rate of infection. Jonathan Van-Tam: (25:13) Yes. Yes. Thank you very much. I will answer those questions. Jonathan Van-Tam: (25:16) On the point about loss of taste and smell and nausea, we have actually asked our expert advisory committee NERVTAG to look at this, and there are some anecdotal data that are now in the published domain that suggests that a proportion of people do indeed lose their sense of taste and smell. However, we have looked at the data that there are in relation to whether that on its own is a symptom that would be important to add to the case definition. The answer to from our experts is absolutely not; that, yes, this is true. Well, as far as we can tell on limited data, it appears to be true; but It doesn't contribute anything on its own to the overall affinity of the diagnosis. Jonathan Van-Tam: (26:11) On the second point about volunteers for clinical trials, people will have read in the newspapers sometimes when a new drug is being tried that there's an advert and you ring up and you volunteer for the clinical trial. This is a very different scenario. Here, these are about patients who are undergoing treatment at some stage for COVID-19. Jonathan Van-Tam: (26:35) First of all, we need the physicians in charge of their care to sign up for the clinical trial and then it is up to the physicians to approach the patient and ask them if they would like to take apart. It's a process of very careful, written, informed consent for that to happen. But the straight answer is, yes, we do need people to take part in the clinical trials and they are doing. For the recovery trial, yesterday's figure reported to me was a little over 700 patients into the trial. Today, I'm walking on my way to 10 Downing street and the number comes through of 926. This is really fantastic work by both clinicians and by patients. Jonathan Van-Tam: (27:26) On your final point about are there more people out there than we are counting through the case numbers, our testing is based primarily at the moment in hospitals where it is needed most, and there will be further cases out there, people who are isolating in accordance with the guidelines, who have COVID-19 who we have not counted in the official statistics. How large that is, I wouldn't like to speculate. Matt Hancock: (28:00) Any follow-ups to that, Robert? Robert Peston: (28:03) Well, it was simply that- Robert Peston: (28:03) [inaudible 00:28:04] did use a ratio of one to a thousand. I mean, it was a rule of thumb that he thought was useful. Do you have a rule of thumb at the moment? Or do you personally, Jonathan, think that's not terribly helpful. Jonathan Van-Tam: (28:18) It's not that I don't think it's terribly helpful. That's the official advice we've had through the Scientific Advisory Group for Emergencies, but obviously there's a lot of imprecision associated with those kinds of estimates. And I think it's probably unhelpful at this point to try and nail it down, as it were. Matt Hancock: (28:33) I think that another way to add to that is that pillar four of the testing strategy is having survey tests to try to find the answer to that question as scientifically as possible. And there's a huge amount of work under way under pillar four. If we go to Sam Coates, from Sky, please. Sam Coates: (28:58) Thank you. To Matt Hancock, earlier today, you seem to indicate that you did think that Easter Sunday, April the 12th would be the projected peak for coronavirus deaths, but Jonathan Van-Tam doesn't seem to quite endorse that when speaking just now. Why is that? What's going on there? Sam Coates: (29:16) And secondly, to all of you, there are people, some elderly, some disabled, being told by GP's today that they fit into the category of do not resuscitate. That they wouldn't be taken to hospital, that they won't be treated. What do you say to them, to their families? Should they fight those do not resuscitate messages and notices? Or should they just accept what they're told? Matt Hancock: (29:38) Thank you. On the first one of those, the truth is that we don't know. I think you've over interpreted my comment. I was asked about a suggestion earlier. And I answered the same, which is that we don't know. And actually, there's a reason we don't know. And that was because it depends on how people act. And this is why the absolute central message, the most important message that anybody can take away from this press conference or the entirety of the government's messaging and how we feel is that you've got to stay at home. And I know we repeat this, but it is really important. Because the more people stay at home, the faster that we will get through this. Matt Hancock: (30:28) On the question of DNRs, I'll hand over to Ruth. Ruth: (30:35) Yep. Absolutely. So, clinicians, my clinical colleagues have these discussions all of the time with patients and their families thinking about their wishes, thinking about what their care being planned. And that's right and proper. COVID-19 is no excuse to have those discussions. And in an insensitive way. But these discussions need to happen all of the time with families and with patients themselves. But it needs to be done sensitively. And COVID-19 should not be used as an excuse to do that quite separately. Matt Hancock: (31:12) Thanks very much. If we go to Liz Bates of Channel 4. Hi, Liz. Liz Bates: (31:17) Hi. If I could direct my questions primarily at Matt Hancock. First of all, you hugely based expectations when you said 3.5 million antibody tests had been ordered and would be widely available. Now you're saying they don't work? Are these tests ever going to materialize. Liz Bates: (31:37) And secondly, if I may, countries which have carried out more tests and the U.K. Have had fewer deaths per million. Has the decision to carry out fewer tests than places like Germany and South Korea cost lives here? Matt Hancock: (31:52) Thanks. I can take both those questions. We have provisionally ordered 17 and a half million, not three and a half million antibody tests. But, as I've been absolutely clear all along, we'll only use them if they work. And, in fact, on the G7 call earlier, it's clear that no G7 country has yet found a home antibody test, which is pillar three of the testing strategy, that works. But we continue to search for one. Again, this is an area where the science is constantly developing. And there's a huge amount of global effort going into finding one of these tests that does work. But I've also been clear that we're putting the orders in place so that, should they work, then we can get them here in the U.K. Matt Hancock: (32:41) And on the second point, can you remind me of the second question? Liz Bates: (32:50) That we haven't tested. Matt Hancock: (32:52) It was about the numbers testing. Yeah. The truth is, we've had a clear ramp up in testing as part of the strategy from the start. We had just under 2,000 tests a day a month ago. I set the goal of reaching 10,000 a day. And we have reached that. And we hit that on target at the end of March. And now, we've got the clear goal of 100,000 tests a day by the end of April. Matt Hancock: (33:24) There are countries that have tested more than us, like Germany as you mentioned. But there's others, like France, that haven't tested as much as us. The question of the correlations is a very complicated one with lots of factors in it. I don't know if you want to add anything, JVT. Jonathan Van-Tam: (33:43) Yeah. So, I would add just something, Secretary of State, on the quality of tests. It's absolutely vitally important. Any test in medicine, any test is never a hundred percent accurate. That is a truism. And the wrong antibody test that isn't accurate is going to say to some people you have antibodies when you don't. It is also going to say to another selection of the population. You are not immune when you are. And so, it's really important that these are rigorously evaluated so that the tolerances on those error rates are very low, indeed. And we have to get that right before we can even think about how we can use these antibody tests in the most advantageous and informative way for everyone. Matt Hancock: (34:40) Thanks very much. Andy Bell, Channel 5. Andy Bell: (34:44) Thank you very much. A quick follow up to you, Mr. Hancock, a follow up to Liz's question. Have we spent any money on those 17 million tests we've ordered? And then, a question for professor Van-Tam, twice this week. One of your colleagues, Steven Powers from NHS England, has talked about seeing green shoots. Is that the way you would characterize what you're seeing at the moment in the data? Matt Hancock: (35:09) Well, on the first question, of course. The samples that we've got in, we've needed to pay for those samples because they're being tested. But what matters here really is these tests. If we can get them, if they're accurate, if they can work, if we've got the confidence in them that we can use them, then the positive impact that will have on people, knowing with confidence that they can get back to normal life more quickly, will vastly outweigh any cost. So, of course, cost is a consideration, but frankly getting a test that works, it is worth more than just more than just money. JVT. Jonathan Van-Tam: (35:56) Thank you. On the green shoots, the answer to your question is, where you look for them. I absolutely see green shoots. I really do in terms of the massive change in public behavior that's already taken place. If that continues, for as long as the government asks for it to continue, then they really will be quite big green shoots in the end. Jonathan Van-Tam: (36:24) However, if you're asking me about the health care hospital admission data, then I think it is too early to make any kind of interpretation such as that. There will be day to day variations in the number of hospital admissions that occur as a feature of near random chance. And so, one mustn't interpret the data. One needs to be patient and look for a long term trend. Matt Hancock: (36:53) Thanks very much. We're going to go to Martin Brown of The Express. Hi, Martin. Martin Brown: (36:59) Hi there. Thank you. Mr. Hancock, can I ask what measures, what help is being given to the mental wellbeing of thousands of patients who are in hospital on their own, many of whom are sadly dying without their loved ones by their side? And the same goes also for pregnant women, as well, women giving birth. What help is being given to their mental wellbeing? Martin Brown: (37:23) And for the medical experts, can I just ask, is there any benefit in wearing a face mask, the public wearing face masks when they go outside? Countries such as Japan, South Korea, Singapore where the use of face masks is more prevalent in the public, they seem to have lower levels of infections and deaths from coronavirus. Matt Hancock: (37:45) Thanks, Martin. I really worry about the impact of coronavirus on the mental health of those who are badly affected. And I really feel for those who have seen their loved ones die and not been able to be with them at the end. And I think it's a really difficult issue that we have to make sure that we support people with compassion and understanding for what they're going through. Matt Hancock: (38:17) We have put five million pounds into Support Mind to help people with the impact of coronavirus on their mental health. But this is going to be, I think, an issue of increasing importance as the crisis goes on. I'm going to ask Ruth to say something about that, and also about the maternity question. And then, if JVT answers the second question. Ruth. Ruth: (38:43) Thank you very much. I was only on a phone call this morning to Sebastian, who is a doctor, a medical colleague of mine. And he had lost his father from COVID-19. And hearing his story about the extraordinary lengths that the nurses, the matron on that night shift had gone to to make sure that they were able to connect a conversation with his brother in Singapore, to be able to connect, to make sure the battery was fully charged for his dad to be able to have numerous phone calls. Ruth: (39:15) I am seeing, across the United Kingdom, nurses, midwives, the whole of our clinical teams going to extraordinary lengths to make sure we absolutely do that. And whilst we know that visiting has been reduced to the absolute limit, it is also... we are saying that visitors are able to go, of course, for people end of life care. But technology is really important. But looking on the wellbeing of our patients is really important, but also wellbeing of our staff. We need to make sure that we're assessing out measures to look after our staff as well. Ruth: (39:48) I didn't get quite the maternity question, Secretary of State. So, would you mind repeating that one? Martin Brown: (39:55) It was just the same really. What help is being given to the women who are alone in hospital without their loved ones giving birth. Ruth: (40:06) Well, I'm very fortunate to work with professor Jackie Dunkley-Bent, our chief midwifery officer who provides enormous, fantastic midwifery leadership across England. What she's been telling me is that midwives, yes, again, are doing exactly the same. They're going to extraordinary lengths to make sure they're using technology, using Zoom, using all of the technology to make sure people are connected. There's been plenty of people that are doing just that to make sure that families can get together, when they can, safely to connect with their new members of their families. Matt Hancock: (40:39) Thanks, Ruth. On the second question, JVT. Jonathan Van-Tam: (40:41) Yeah. I'll just begin on the first, actually, to say, I realize this is an awful and distressing illness. And I'm very distressed personally when I hear these stories of families separated, when I hear everything that's going on in that space. It's really terrible. Jonathan Van-Tam: (41:01) But to your evidence point about face masks and wearing of face masks by the general public, this has been a controversial area in pandemic preparedness and planning for the 15 years that I've been involved in it. And, indeed, I was on the phone this morning to a colleague in Hong Kong who is a professor there who has done the evidence review for the World Health Organization on face masks. And we're of the same mind that there is no evidence that general wearing of face masks by the public who are well affects the spread of the disease in our society. What matters right now, of course, is social distancing. And yes, it is true that we do see very large amounts of mask wearing, particularly in Southeast Asia. But we have always seen that for many decades- Jonathan Van-Tam: (42:03) ...and it is entirely wired into some cultures that masks are worn quite frequently in open spaces. So it's very different, but in terms of the hard evidence and what the UK government recommends, we do not recommend face masks for general wearing by the public. Matt Hancock: (42:24) Thanks very much. I hope that answers the question, Martin. Pretty clear. Dan Martin from The Mail. Dan Martin: (42:32) Mr. Hancock, you said that if people don't obey the rules, you would consider toughening the lockdown that's in place at the moment. In France, they're stationing police in railway stations and installing multiple checkpoints to check where people are going. Is that the sort of thing we might see happening here? To the scientists, the Institute of Biomedical Science has come out today to say that the April target is practically impossible because they don't have the equipment and chemicals they need. Are you concerned about that? Matt Hancock: (42:59) Thank you very much. We rule nothing out in terms of further social distancing if that is needed or further enforcement of social distancing. However, the British public are, in a very large part, following the new rules, and the police are policing them largely with their normal consent-based attitude and approach. I pay tribute to the police because bringing in a new set of rules like this in short order does, of course, provide a challenge to the police, and I think that they have risen to that challenge. Matt Hancock: (43:41) On the second question of the testing, we're absolutely determined to hit the new goal of 100,000 a tests a day under all five pillars of the testing strategy that I set out. Yes, that will involve some challenges. There's no doubt, including making sure we get hold of all of the parts, for instance, and all of the reagents. Matt Hancock: (44:06) Everybody can see that there are challenges around the world in terms of increasing testing, but we're determined that we're going to get there, and this is going to have to be a national effort in which not only my team and the people at Public Health England and across the NHS, but the whole life sciences industry is going to have to play a part. Matt Hancock: (44:27) I've been really delighted by the response since I set that challenge down at this press conference yesterday, and more people have come forward saying that they can turn their capabilities to increasing testing. We're going to have to hit that target. JVT, I don't know whether you want to add. Jonathan Van-Tam: (44:47) No, Secretary of State. I think you've answered the question. Matt Hancock: (44:50) Have you got any follow-up, Dan? Is that okay? Dan Martin: (44:53) That's fine. Thanks. Matt Hancock: (44:54) Okay, good stuff. Martin Bagot from The Mirror. Hello. Martin Bagot: (44:59) Hi, good afternoon. Secretary of State, at yesterday's briefing when you promised 100,000 daily tests by the end of the month, you seemed to acknowledge only 25,000 of these were likely to be the more urgent in need antigen test, which can tell if a patient currently has the virus. The Prime Minister promised 25,000 daily antigen tests last month, and now delivering on this appears to have been delayed until the end of April. Can you acknowledge today that we expect the peak to come in the next fortnight and Germany is increasing the antigen tests from 70,000 a day? Do you think this could come too little, too late? Martin Bagot: (45:33) Secondly, could we have some clarification on the national lockdown guidance on the eve of what looks like being a sunny weekend? Given many families don't have access to a garden, can people spend time in green spaces, for example, having a picnic for an hour, so long as they are in household groups? Or is it just a case of jog or walk for an hour and then go home? Matt Hancock: (45:52) All right. Thanks very much, Martin. Just on the first one, I want to be crystal clear that the goal that I set yesterday was 100,000 tests per day over all five pillars of the testing strategy. Pillar one, which has brought us to 10,000 tests per day, that is set and was always set to get to 25,000 by the end of April. But pillar two, which is bringing in the private companies to also deliver, that is part of the goal, as is pillar three, which is the antigen test to see whether you have the virus, pillar four, which is the research, and pillar five, which is the national effort to bring companies that haven't hitherto been involved in testing into this great challenge. Matt Hancock: (46:42) So we, in fact, increased the goal for the end of April from about 25,000 to 100,000. Then we will go on to meet the target that the Prime Minister has previously set out of eventually 250,000 tests a day. It was all, as I set out yesterday, answering that specific question. Matt Hancock: (47:10) On the question about what people should do over the weekend, it is incredibly important that people follow the guidelines. I know that it's going to be sunny, and it may be tempting, but it's staying at home that saves lives, and I think we should just be absolutely crystal clear about that. The guidelines have been set out in terms of people going out for exercise reasons either on their own or with people in their household. People need to stick to the guidelines, and we're going to stick with those guidelines. Thanks very much, Martin. Jen Williams from the Manchester Evening News. Hi, Jen. Jen Williams: (47:50) All right. Thank you. A couple of questions for the Health Secretary from me. We're getting reports here and there've been reports elsewhere as well of care homes being told that their residents may not be admitted to hospital if they have suspected coronavirus. There have already been cases where a significant number of people in a single care home have died including [inaudible 00:00:48:08]. Is there a blanket policy across the system not to admit care home residents into hospital? Jen Williams: (48:14) Secondly, also on social care, there are growing concerns with insufficient PPE and testing for infection as a whole. Counselors are now having to source their own, but are finding that they're facing escalating prices. There are fears more broadly that sufficient care has not been prioritized at the national level. So is social care an afterthought in this? Jen Williams: (48:33) Just finally, on PPE as a whole, how many units do we have in the national stockpile, and how many are we expected to need during the course of the outbreak? Matt Hancock: (48:43) Okay. Thank you very much indeed for those three questions. The first one on care homes, it is absolutely not a blanket rule that people shouldn't go to hospital from care homes. Hospital is there for people when they need it and when the doctors advise that they go. We have 2,029 spare critical care beds in the NHS right now, 2,029. That is before we bring on stream the Nightingale hospitals, and that is testament to the NHS who have done amazing work. They've already expanded the number of critical care beds by two and a half thousand for COVID-19 patients. Matt Hancock: (49:31) So there is capacity in the hospitals right now to deal with COVID-19, and there is no blanket rule. It is a clinical judgment about when somebody goes to hospital. I don't know if Ruth might want to add something on that. Matt Hancock: (49:47) On the PPE question we have millions of pieces of PPE in the stockpile, and I can make sure that we get the exact figure to you. I haven't got it on me, but we are also replenishing it all the time. Because whilst we have a very large stockpile, we are also using it. So we've got to make sure that we replenish it, and we're replenishing it both from buying internationally, where much of it traditionally, has been made and also making it domestically. Matt Hancock: (50:23) I'll give a shout out to Burberry who've turned over their production to the production of gowns to add to the stockpile and to get PPE to people who need it, which is another part of the national effort. I think Burberry deserve the credit for what they've done so far for the nation and hopefully lots more Burberry gowns to come. Ruth, I don't know if you want to add. Ruth May: (50:48) Two points. Thank you very much, Secretary of State. So about the care homes, my mother-in-law, Millie, lives in a care home, and that is her home. So clinicians from whatever background will make a decision based on the clinical need of that person as to whether they need hospital care because that's the important part. With regard to social care, I know that out of the 6,000 nurses that are coming back onto our emergency register, some of those are opting to go into social care. I am delighted to see that we're offering people the option of coming into our hospitals, coming into our primary care setting but also into social care, and I'm going to be woefully sure that we continue to do that over the next few weeks too. Matt Hancock: (51:35) Okay. Does that answer the question, Jen? Jen Williams: (51:35) Yeah, it does. But on the PPE, I mean, obviously you said you'd come back on the numbers in terms of how many you've got in the stockpile. But do you know how many you're going to need over the course of the pandemic? Matt Hancock: (51:45) Well, it depends how long the pandemic lasts. But at the moment we are distributing many millions of pieces every day. In the last 24 hours it was 26 million. Over the last couple of weeks it's around 400 million. So you can see that we're getting through it fast, and so we're replenishing it at the other end as fast as we can. But the challenge in PPE is a challenge of distribution rather than a challenge of having the stock. Matt Hancock: (52:15) I also didn't answer your question about social care with PPE because it's incredibly important to me that we get the protective equipment that we need to people working in social care as well as in the NHS and all parts of the NHS. The new PPE guidance that we set out yesterday, which has got very broad support, that sets out what sort of PPE is appropriate in what sort of setting, and we will deliver that PPE into social care. Matt Hancock: (52:49) I know that it's a challenge not least because there's around 26,000 social care settings, a combination of care homes and organizations that provide care in people's homes, and so it is more complicated than delivering to the NHS. But the priority of getting the right PPE to social care is exactly the same as the priority of getting the right PPE to the NHS, and that's what the system, with the support of the military, is doing. Matt Hancock: (53:16) Thank you very much indeed. I think that's all we've got time for today, but no doubt there'll be more to come in these daily press conferences. I am very grateful to all of the questions, and I'm very grateful to both Jonathan Van-Tam and Ruth May for answering the questions with me. Thanks very much indeed.