hello, you're watching afternoon live, i'm simon mccoy. today at 2:00... the uk adapts to sweeping plans to tackle coronavirus — with no clear end date in sight.

usually congested streets quiet — as people are urged to avoid travel and nonessential contact. stay away from restaurants, pubs and clubs — that's the official advice. it's left some businesses in despair. we can't make money to pay the rent and the rates and everything. so it's tough as well. so i have to send two of them home. the foreign secretary, dominic raab, advises uk citizens against all non—essential global travel for an initial period of 30 days. the archbishop of canterbury calls for church of england churches to put public worship on hold and become a "different sort of church" in the coming months. in france, tough new measures require people to stay at home — only those with documents spelling out their reasons are allowed out.

the government's chief medical adviser is giving evidence to the health committee. it is a semantic difference whether you call it suppression, the aim is the same, how do you keep this thing down and keep it below the level at which you wa nt to keep it below the level at which you want to keep it and how do you keep it down long enough to make sure that you have managed to achieve that you have managed to achieve that suppression? i think that is what we do need to do. then there is a second question, what happens when you release all those measures? that is one of the big unknowns in this, which we are going to have to think about very carefully. so one of the things i understand the modelling

saysis things i understand the modelling says is that roughly, and it is very approximate, one can count on there being around 1000 cases for every death that you have, which would mean there is potentially now about 55,000 cases. does that feel right to you? we have tried to get a handle on that in sage and we have put all the modelling information together. that is a reasonable, ballpark way of looking at it. it is not more accurate than that. as i understand it, prior to the measures that were announced today, your assumption was the virus was doubling the number of cases, the number of cases was doubling every five to six days. but because of the very dramatic social distancing measures that have now been announced, it is possible that we could see the number of new cases actually start to reduce in three weeks' time, is that what the

hope is? he would expect to see an effect of any of the measures after about two, 23 weeks. in terms of the sorts of presentations we are picking up. 0bviously, of presentations we are picking up. obviously, the effect will start sooner obviously, the effect will start sooner but you won't be able to see it or measure it for at least two to three macro weeks. judging on the evidence from other parts of the world and other countries that have followed this dramatic suppression and lock downs in different flavours, does that mean there is a possibility, of course we cannot predict anything, the cases could start to full, new cases could start to fall in a couple of weeks? yes, thatis to fall in a couple of weeks? yes, that is what he would like to see. but the interventions we have made, so but the interventions we have made, so these have all been muddled out, and it is modelling, so we need to be aware of that. the first one we introduced, isolation, you would

expect to bring the peak down by 20%. the second one, of whole household quarantine you would expect to bring down by about 25%. the social shielding of the elderly has less of an effect in the peak, but a much bigger effect on the mortality where you might expect it to be between 20 and 30%. in general social distancing measures, which, as you said, are quite extreme ones that have now been introduced, would now be expected to reduce the pic by about 50%. —— peak. it tells you that together, you should expect those to have a very significant effect on the peak and we should start to see the rates come down in 203 weeks' time. and the ambition in any outbreak is to try to get the note of value down below one and thatis note of value down below one and that is a value at which anyone, on

average, what one person would do in terms of infecting others, at the moment are note value is between two and three and the aim is to get that down below one and then things will decrease. just to be clear, that is not two to three weeks, that would ta ke not two to three weeks, that would take longer? that would take longer, yes. what would be the hope? difficult to get an accurate handle on that and that is where monitoring becomes incredibly important. as we entered this next phase, having made these very significant interventions, it's going to be really, really important we get good data to monitor the effects. that is important for two reasons. one, we might need to do more, and i have been very clear from the beginning, there is a whole range of things we need to look at, all of them are on the table. we might need to do more and also, at some point we will have to back off at some point. we need

to back off at some point. we need to monitor what is a consequence of backing off full cop i appreciate there is the upside and there are no certainties on this, but if yesterday's announcement bears the fruit that you are hoping, the total number of deaths, rather than being in the hundreds and thousands could potentially get below 20,000, which isa potentially get below 20,000, which is a huge number of deaths, but nonetheless, a much better picture than many might have feared? that is the hope that we can get it down to that. to put that into perspective, every year in seasonal flu the number of deaths is thought to be about 8000 excess deaths. if we can get this down to numbers 20000 and below, that is a good outcome, in terms of where we would hope to get to with this outbreak. but it is still horrible, it is still an enormous number of deaths and it is enormous number of deaths and it is

enormous pressure on the health service. having spent 20 years as an nhs consultant as well as an academic, i know exactly what that looks and feels like. just before i bring my colleague in, one final question on what we have come to understand about the disease. most people understand the people at risk are people with a long—term condition or older people. but, in the netherlands, we understand half of the covid—19 patients in intensive care are under 50, including 116—year—old. have we had any deaths in the uk from people who are young and without long—term conditions. ——16—year—old.|i are young and without long—term conditions. "16-year-old. i don't have all the clinical information because that is privy to the health department nhs and the chief medical 0fficer. that is a question for them. but it is obviously a very —— very important, the vast majority of

deaths in this country are elderly and have pre—existing conditions. i don't know if there are any exceptions to that. are you aware of any doctors or nurses who are currently in intensive care because they have picked up the virus from patients? again, i am not privy to that sort of information. i know the cmo is being very careful, rightly, about protecting confidentiality of patients. one of the pownce underlying the question, which i think is important, is these viral infections can adapt and change as we go along and we must keep an eye on everything from clinical picture through to outcome, through to different ages to make sure we are a lwa ys different ages to make sure we are always dealing with what we think we are dealing with. just with reference to the questions over the percentages you gave, what is the confidence interval you are using? if it is nice and narrow it doesn't matter... very wide.

can you give us a ballpark? the range from the first measure of case isolation was between 50 to 25, i think. and even that, i think you would take as a sort of model, but not a precise estimate. i think these are all quite wide. in terms of the monitoring side, you have mentioned that. with the change of policy around testing, can you tell us how you expect to monitor if you are not doing as much testing because people are struggling to see that picture? at the moment, the uk has done something like 114,000 tests, which i think is in the top three or four countries in terms of testing. public health england have a capacity of about 4000 or so per day. that is not going to be enough going forward. 0ne

day. that is not going to be enough going forward. one of the recommendations from sage is, we really need to get our testing in the right position to make sure we can monitor this effectively. at the moment, priority fortesting can monitor this effectively. at the moment, priority for testing is, patients in hospital in intensive ca re patients in hospital in intensive care units, those with respiratory illnesses in hospital and pneumonia in particular, isolated, cluster outbreaks to make sure we can understand what is happening and the gp understand what is happening and the g p syste m understand what is happening and the gp system is trying to get a handle on what is going on in the community. as the capacity ramps up and there is a very big effort going on to try and ramp that up, that will be extended to other groups. ideally, you get that very wide. the second form of testing which i think is going to be incredibly important is going to be incredibly important is serology testing. so looking for antibodies of people who have had this infection. the reason that is so important is, all we can do at the moment is due to test

somebody who has an active virus that they are shedding and there is some evidence, if and you are infected, the test isn't sensitive. so we are not, nobody is able to pick up the asymptomatic people very easily. with an antibody test we would have a much better handle on the proportion of people who are asymptomatic. the true number who have had it in the community already andi have had it in the community already and i think we will get a better handle on what happened in other countries, china and italy. it will change a lot, if we could understand that. my colleagues in primary care at the hospital are concerned about having to isolate without any symptoms and then suddenly, three, four, five or six members of staff drop out of the surgery. that argument is, why aren't we drop out of the surgery. that argument is, whyaren't we being tested, i want to get back out and help. what do you say to them,

in answer to that question? is there any other reason around that?|j think any other reason around that?” think the next group of people i know p h think the next group of people i knowp h e think the next group of people i know p h e and think the next group of people i knowp h eandi think the next group of people i know p h e and i have checked with the cmo to make sure this is exactly where they want to go is to try and get two key workers to make sure they are tested and health care workers would be absolutely there. so as the capacity ramps up, that is where you would go next to make sure you can do that. i think that is the plan. most people will recover, let's not forget that this is flu for most people. could you talk us through how quickly they recover, when they could return to work and also that cohort and if you have any ideas, it seems like you have a response phase, you start to improve, your antibodies fire off and you get this cytokine release so your respiratory problems and that is when people crash. is there any indication on how you are spot on,

do those people have a sign and is there a test for that? you are right, very early on i spoke to collea g u es right, very early on i spoke to colleagues i have worked with in singapore and early in their outbreak. it was clear from then there was this two phases of illness, the vast majority of people get a viral illness which gets better, so that by seven days they are feeling better. 0ften better, so that by seven days they are feeling better. often by five days, they are feeling better. some of them go on to get the second phase which is the immune reaction. that immune reaction kicks in at around five days, it is characterised by shortness of breath, failure to get better from the first round and then a deterioration. it is important this isn't, at that stage, due to active viral replication so much as the body's response to it. the idea of antivirals are going to work then is probably wrong. they might work very early on. what are the features that

make people more likely to be in that phase? some evidence that its initial dose of exposure, which is why health care workers, potentially where risk at the beginning if they we re where risk at the beginning if they were being exposed at very large doses. and pre—existing diseases and age, which presumably is a surrogate for pre—existing diseases as well. so that is what we know about this at the moment. it does have quite big implications for how we think about treatment. could you say to the public, for the people getting better, do they develop an immunity and when can they return to work? if they do their five days and they are feeling better, are they able to go back out into the workforce and they are protected, so they can carry on working? the vast majority of peoples stop having significant viral shedding around seven days.

some may go on a bit longer and that is why the seven day isolation period was recommended for individual cases. some may go on a bit longer but for the vast majority of people, the viral shedding decreases quite rapidly after about four or five days. can i just go back to the comments he made about testing? i think there is a lot of confusion about this. first of all, the words of the director—general of the words of the director—general of the world health organization, you cannot fight a virus if you don't know where it is. fine, test and isolate every case to break the chains of transmission. but on friday we stop community testing for people with mild symptoms and chris whitty said people in the community with a fever or a cough don't usually need testing and the gp himself isolate because his daughter has a fever is not now able to get a test. so are we now saying it is

the priority to test as many people as possible and what we did on friday was a temporary measure and we intend to reintroduce community testing as soon as possible?” intend to reintroduce community testing as soon as possible? i think what chris said, or what he meant was that is what we have to do with the capacity we have got. we need to use the testing in the right place at the moment. we simply don't have mass testing available for the population now. there is a big effort going on to try to get that in place as quickly as possible, to be able to manage this. people are producing all sorts of tests which may be much more readily applicable in the wider community. those are being looked at by public health england to decide which ones really work and how they will get them out. at the point i think chris was making, he will obviously speak for himself, but i think the point he is making, in the situation where you

have got a capacity for a certain number of tests, the priority should be the areas that i mentioned. how it came across was, there is a change in approach and we were focusing our testing efforts from now on on hospital cases. but i think what you're saying is, it is not the case and it is the intention, as we ramp up our testing capability, that we will go back to testing in the communities. is that the case? what i can tell you, and i am the government's chief scientific adviser, so i am advising and sage advisors is we need to ramp up testing, for all the reasons you have mentioned. two things are critical, ramping up testing and making sure we have great data. those are very important in how we manage this, for both the interventions and, as i said, for removing the interventions.“ interventions and, as i said, for removing the interventions. if i just look at some other countries

that have taken the suppression model that was published in the imperial paper this morning, which we are now following, the one that most people think has had the greatest success is career and they had a more serious situation than us, because they had a super spread. but if you look at their testing capacity to head of population, they are testing ten times more people. so is that the kind of scale we are looking at, not just so is that the kind of scale we are looking at, notjust increasing it, from 5000 to 10,000 a day, but a massive increase? i think we need a big increase in testing and that is what i am pushing for very hard. everyone is working very hard to try and make that happen. what you don't wa nt and make that happen. what you don't want is everybody coming to the hospital to be tested. that is the worst possible thing. the quicker we can get to something that looks like a true community based test people can do easily, the better. do you have any sense of time scales on

that? i think a lot of people are concerned that when we are not testing in the community, we won't have the data to actually know what the spread of the disease is? first thing to say is, the measures that are being put into place, case isolation and now hold household quarantine are the measures you would take anyway. they are the thing is, if you like, the potential downside of what we are doing at the moment is we are putting people into whole household quarantine who may not have coronavirus so they may have to do it more than once. but we are doing the right thing if you have got coronavirus and for the whole family. in terms of the actions, it doesn't matter. in terms of the speed of test, there are tests now, lots of people claim to have tests and there are obviously laboratory have tests and there are obviously la boratory tests have tests and there are obviously laboratory tests which can be done. there is a lot of work going on at the moment, i know, in public health england, the nhs and

dhs e to select which test to go for and how that can be ramped up, possibly. i think quite rightly, by the private sector so we can get things out fast on the community side, having the other pa rt community side, having the other part of the testing really controlled by public health england for the hospitals and other bits that need to be done. just a couple of pre—final ones from me in this section. if we look at some of the countries that have followed the suppression approach successfully, andi suppression approach successfully, and i think taiwan is another one alongside south korea, one of the things that is very striking is the use of mobile phone technology. they follow someone who turns positive for the virus and then trace over mobile that have been near that person. obviously there are civil liberty implications that need to be worked through, but if that was shown to reduce deaths by increasing

the speed at which you isolate potential cases, as a scientist is that something you would recommend? that would have been a brilliant thing to have injanuary. so at the beginning, that sort of approach makes beginning, that sort of approach ma kes total beginning, that sort of approach makes total sense. it may have utility later on and it may have utility later on and it may have utility as you go to a situation where you get it down and i want to release. so those technologies needs to be looked at carefully and implementing and i know people are working very hard on that sort of approach. i think that was used quite extensively in china through the app that they have. finally, just from me, could i ask you a question in your capacity as a former nhs consultant and notjust chief scientific adviser? obviously, we alluded to staff cannot look

after patients if they are ill. staff are worried about the lack of protective clothing and protective equipment. ijust protective clothing and protective equipment. i just wanted protective clothing and protective equipment. ijust wanted to read a comment from a doctor who is currently treating coronavirus patients in a major uk hospital. he says, one week ago i was wearing full, personal protective equipment. now we have been told not to bother with any of that, contradicting who guidance. i am terrified, i cannot bear the thought of infecting other patients with a disease that could kill them. what is your reaction to that, given our determination to bring down mortality rates?” that, given our determination to bring down mortality rates? i think thatis bring down mortality rates? i think that is a question that really needs to go to the nhs, as they think about how they organise the response to this. i think it is important we get the proportionality right in terms of where protection is needed and where it is not. one of the things that is a risk, if we go to the wrong place with

protective equipment it hampers all sorts of other parts of health care delivery. i don't think it is a question i am ina i don't think it is a question i am in a position to answer. but i think it is one of the nhs can answer. thank you. thank you for being here today. i have two broad areas or questions, one is around data and one is around schools. i have a lot of scientists asking me why we are not releasing open data and everything we possibly can, given the number of brilliant brains, not just in academia but also in business, who are chomping at the bit to try and help and look at the modelling. i am bit to try and help and look at the modelling. iam interested bit to try and help and look at the modelling. i am interested to get your view on why that hasn't happened and what will be happening on that front? there may be two bits to that question. in terms of the data, the data is being released by public health england and the nhs and that is the data everybody is using and that is data collected from around the world. the second

question about the modelling, clearly it has been a fast moving and we have had all different modelling things that have gone along and niall ferguson released his paper yesterday. we are releasing the modelling that has been done and the various other parts of the science input to sage this week, to try to get that in the public domain. but the data, in terms of the multiple brains on it is the data access, which is important and that data access needs to work well, it needs to be open and allow people to crunch the numbers and come up with the answers they come up with. the models and they come up with. the models and the codes will be made public by sage and by the academic groups doing it. it is not a government organisation doing it, it is the academics. one of the other questions i have had and it might be naive, is the modelling we are using in the uk the same as being

used throughout the world, given it is a global pandemic? is everyone using the same approach and in some cases, why are we making slightly different decisions from other countries? as always, they use different models, thinking about the most important and different variables they put in. the models we use have been used by others as well in quite a lot of demand, so other countries will either use the modelling that has been done here or ask the modellers to be involved in things. so i don't think there is any difference in terms of how it is approach, but some countries have fewer modellers and some have more in the uk, which happens to be a country that has extremely strong sides across the board, including modelling. regarding the modelling side of things, we have seen during elections, data is used across both for predicting disease and so on,

but can be used to identify vulnerable areas with vulnerable people, perhaps older people in certain areas. is there a plan to look at this in a different way where we can predict where potential vulnerable people will be so we can show volunteer networks and support is given to them ahead of time?” know, for example, dearjesse are using the data they have got to understand where the most vulnerable people are to make sure they get the specific advice they need. so i think that will happen, i guess within the department and within the nhs. the other question for modelling going forward is to what extent it can help understand where capacity is being reached and were therefore there are more stringent interventions that need to take place in one area or another, in order to manage this. this is going to be an actively managed process to keep on top of it, which means

testing and data flows are going to be critical to get this right. thank you. on the school side of things, this seems to be the biggest topic for many mps, i understand closing schools might mean children then have to be looked after by grandparents and so on, but what i'm hearing is this is already happening ona hearing is this is already happening on a lower level. i was told a story this week where one school is testing the temperature of children as they walk in the door. if the temperature is too high the parent has to find somewhere for them to be looked after, in many cases it is grandparents. give a clear view on why schools are not closing now and why schools are not closing now and why we are doing it differently from other countries, which seems to be closing schools? and if schools are to be close, what the plans are around that? when we looked at all of the interventions, we looked at the ones which had the

biggest impact first, albeit with the variability we have talked about. those that have less effect. closing schools are lower down the list and some of them we have announced. it doesn't mean it doesn't do anything, it would have an effect but it has complicated effects, including the one you mentioned of potentially leading to children being with grandparents and so on. of course, also causing enormous problems, not just for the workforce generally but the workforce in the nhs as well. it isa the workforce in the nhs as well. it is a complicated one and all i can do is give the science advice on that in terms of the effect. i think as you look across the world, singapore has not closed schools it has introduced some different measures in schools. taiwan, i think didn't close schools imagining this. there has been a variability across the world in terms of school closures and whether that has been pa rt closures and whether that has been part of the approach or not. it is

absolutely on the table, as the whole swathe of measures are. the evidence base is there to suggest where it works and where it doesn't. decisions will be made at the time they need to be made around school closures, which is one of the levers to pull to try to get on top of this at the right time. but as i say, it is not without quite complex consequences. just two more brief questions, if that is ok? one is around school children, i have a daughter myself. a lot of kids are talking about this, they are not ignorant of the situation. one of the concerns also is around mental health. how children are being taught about this in schools, the worry they are going to give their grandparents something that could potentially harm them. is there any discussion around mental health around this? physical health is absolutely key, mental health and the concern and repercussions of this over the coming months and years could be

quite high? i think that is one of the big worries. we need to remember that the health service is going to be under pressure during this process and there will be the direct illnesses and tragic outcomes relating to the virus. there will be the indirect due to the fact that other people may not be able to get the care at the time that they need and there will be the consequences on things like loneliness, on people feeling isolated, on people not being able to get enough exercise and the other things they might want to do to keep themselves healthy and mental health is definitely part of that. i don't think, and that is why when we look at the measures that we re when we look at the measures that were announced yesterday, that is a very substantial set of measures with a lot of consequences and it is why also, this is something for all of us. it is our ability as a society to help each other during

this time which is going to be incredibly important and i think thatis incredibly important and i think that is where we will see a lot of people wanting to help in order to try and get through this but it is not an easy situation and it is going to go on for some time. very finally and briefly, in terms of schools, imagine you must have talked at some point about school potentially closing. if that were to advised, do you foresee it being an overnight decision in which case tomorrow morning children won't be going to school? or would it be a staggered thing so teachers, parents and children get the chance to adjust and know what the plans would be so that kids aren't just adjust and know what the plans would be so that kids aren'tjust given adjust and know what the plans would be so that kids aren't just given to grandparents? i think that is a decision for ministers to take as to how they would make a decision about closing schools and at what point they would choose to do it. thank you. hello, just on schools, i've just got a couple of questions from the exchange you had there. i have had a numberof the exchange you had there. i have had a number of enquiries from

teachers who have e—mailed me about the risks that they feel they have, about their exposure to the virus. what would you say to them?” about their exposure to the virus. what would you say to them? i think all of us, and that is one of the reasons we have given the advice on the measures we have, want to try and reduce the transmission and that is the social distancing measures. there will be groups of teachers and others who are particularly at risk potentially and i know this is something that the cmo is looking at ha rd something that the cmo is looking at hard and thinking about the right advice for those people. i think for eve ryo ne advice for those people. i think for everyone in the public sector working and those continuing to work in aspects of the private sector as well, clearly, the more we are going out and about, we do all carry some risk of catching this. to go back to the point that was raised earlier,

for most people this is a mild illness and we just need to remember that the vast majority it is a mild illness. i think advice around specific measures for vulnerable groups, those most at risk, is what nhs and dhsc are producing.” groups, those most at risk, is what nhs and dhsc are producing. i also noted there has been some talk of advice given to those who are pregnant. what would you also say to those, and i declare an interest in the sense that my daughter isjust 12 weeks old, but to mothers and ca re rs 12 weeks old, but to mothers and carers for very young children, babies? i don't want to dodge the question, that is really a question for the chief medical officer. i know i am a doctor but i haven't practised for a long time. i don't wa nt to practised for a long time. i don't want to be giving advice that is really the thing that the cmo and the nhs it should be giving. that is fairenough. is the nhs it should be giving. that is fair enough. is the government engaging with those scientists that disagree with your plans?

completely. absolutely. if you think sage and the way sage works is a cosy consensus then you would be very mistaken. it is a lively, robust discussion with multiple inputs and we don't try to try and get everybody saying exactly the same thing. the idea is to look at the evidence, come up with the a nswe rs the evidence, come up with the answers as best we can, there are subgroups that work and feeding to sage and the membership of sage changes depending on what we are discussing pulled up it is not as though it is the same group of people who always discuss the groups of topics. their members that come for specific topics. you medically your role was to advise. how much do your role was to advise. how much do you believe that the current strategy that is being driven and how much by behavioural science and economic interest? ——

you made it clear. i think the advice we have been given by sage which is based on modelling clinical behavioural science, actually even other areas of science as well, that goes to the government, has been really carefully listened to and has not beenin carefully listened to and has not been in any way from our perspective overlain with economic considerations as a reason to change the advice. we are interested in to things. saving lives and protecting the most vulnerable. that has been the most vulnerable. that has been the driving force that will continue in all of our outfits. just finally, other than what we have seen in terms of the regular conferences and the daily conferences we are going to see from now on, what strategies are in place to effective information is given to the public and other organisations on the essentials of the plan?

again, that is not really a science question in the sense that i'm not in charge of the sense that i'm not in charge of the communications of it but i do think it is critically important for it is very obvious that this is completed, frightening. people don't know what to do sometimes and therefore the clarity and the ability to keep repeating the same thing ina ability to keep repeating the same thing in a way that people can understand i think is crucially important. all of the behavioural science were to suggest that we have got to get the transparency of right. we have got to get the communication right. we have got to trust that people want to know things and want to be able to be empowered to make their own decisions on this. i think those are some of the key things in terms of how we communicate this. thank you. there were some very serious measures that were imposed yesterday. you mentioned earlier that what happens when you release them as the big unknown. you also

said that we have got to look at what is the consequence of... can you talk through when you think the measures might be lifted? we are just starting to implement them so i think we are nowhere near talking about releasing them. there are about releasing them. there are about making sure we doing them properly and as i said yesterday, andi properly and as i said yesterday, and i have said again here, there may be other things that need to be added and we have talked about one of them here. there may be others. when we get to the stage that we have got the outbreak down to the level where we know we can keep it below the nhs capacity which is the aim, and when we are happy that that can really be maintained properly, thatis can really be maintained properly, that is the time to start talking about how you might releases. there are various about how you might releases. there are various ways about how you might releases. there are various ways you could think about that in terms of backing off a bit and seeing what happens. putting things back and that i think is the

sort of approach that might be necessary in due course but we are not there. do you have a figure in terms of the nhs capacity? that will come from the nhs and they will provide the figures and then the models and the data streams that can flow into that to say where we are against that capacity. there is not against that capacity. there is not a number now that you have that you know that that will be the capacity when it you think you've managed that number you will lift the restrictions? there are two bits to this. the infection itself and how common that is and how much that will increase or decrease and then there is the capacity of the nhs that they are working incredibly ha rd to that they are working incredibly hard to try and increase. that number is moving, both numbers are moving. obviously, both of those numbers are the ones we need to keep an eye on when you think about when you might get to a stage where you could think about backing off. some are suggesting that these measures may last 18 months. is that something you think might be credible or not? i

don't know how long these measures are going to be needed for. i think the modelling so far suggests that it is certainly not a couple of weeks. 0ne far suggests that it is certainly not a couple of weeks. one of the things that i think, if you look at some of the approaches that have been taken, the assumption that you might close thing is for two weeks and start up again is not correct. it is going to be months. i don't how many months. it is going to have to be data driven. in other words, as you see things changing, you might need to do more or less. by the way, that might happen quickly. just as it did over the course of the last week. that isn't because there is a sudden change of strategy, it is that you're responding to the information you have got in order to change and that is what we need to be prepared to do. i think we are going to have to be equally nimble as we think about backing off again stop going to have to try it and one thing for sure is

that we haven't got immunity to this virus and as we back off it may come back again and we are going to have to manage that very carefully. we are going to have to hope that we can get through quickly with some of the other interventions as well to try and get on top of this so vaccines and the other approaches that are being taken. i have to say, i think there has been really remarkable efforts and progress in some of those but we are still a long way off. in your conversations internationally about countries that are further ahead than others, do you have an idea of what their plans or approaches are going to be to actually lifting the measures? for example, potentially china ? actually lifting the measures? for example, potentially china? not really is the answer. i think eve ryo ne really is the answer. i think everyone is asking the same question and you look at some of the scientific papers coming out from china and elsewhere. people are looking at what could happen but we don't know yet. i think all

of the evidence from previous epidemics, this type of infection, it would suggest that you can't avoid this bubbling back up again when you left off so that is what we are going to have to be aware of and try and manage. when you say bubbling back up manage. when you say bubbling back up again, do you mean a spike or what this being something that we would understand as seasonal flu? seasonal flu is in would understand as seasonal flu? seasonalflu is in a would understand as seasonal flu? seasonal flu is in a sense a spike every year. this may be ultimately what it becomes and that maybe what we need to plan for. there are two ways that you can think about this. i think if you withdrew all the measures immediately, you would probably have a lag phase and then a peak. if you withdrew some of them, you can begin to see, is itjust creeping up and you're beginning to see an effect and then you might reimpose them? so i think that is why refer to an agility which is going to be important.”

why refer to an agility which is going to be important. ijust got a couple of questions from our colleague who is not able to be here. i wondered colleague who is not able to be here. iwondered if colleague who is not able to be here. i wondered if i could just follow u p here. i wondered if i could just follow up on one of lower‘s questions because i think the thing thatis questions because i think the thing that is puzzling people who look at other countries —— laura. some like south korea think they are past the peak and they seem to think they are past the peak with less than 1% of the population being infected. they are very realistic, they could be second or third waves but they don't seem to be expecting it as much is you do. i wasjust very seem to be expecting it as much is you do. i was just very struck by the phrase that you said, if you look at all the evidence, you can't avoid concluding that it is likely to come back. ijust wondered if you could explain to non—scientists, because i think the china view or the career view is that it could

be something like sars which burns itself out when the reproduction rate gets below one, why is it that you are unfortunately so certain that it will come back?” you are unfortunately so certain that it will come back? i think the transmissibility of this virus is unlikely sars. sars was not transmittable unlikely sars. sars was not tra nsmittable in the unlikely sars. sars was not transmittable in the same way as this and it had very high mortality rate. this has a lower mortality rate. this has a lower mortality rate. it has a very high degree of mild infection and just today there was a paper that i was reading from china suggesting that something like 86% of infections in wuhan were not ever detected at the time so there isa ever detected at the time so there is a very high degree of transmissibility. all of those characteristics from the evidence from everyone we have heard from suggests that when you left, you're going to get something coming up again. i can't tell you how big that

is going to be and we may be lucky. maybe it doesn't. but everything suggests that that is what you would think in the outbreak of this with a virus like this with the sorts of properties, would be what you would expect to see. thanks. ijust have a couple of questions... by the way, i am hope they are right and it doesn't. that would be a perfect outcome and like all scientists i am very happy if i am wrong on that and it doesn't come back. so, these are from james. his first question is, more than other countries, the approach in those countries continues to segment the population with different levels of isolation. can you explain very specifically why you have chosen this route rather than a more blanket approach with reference to scientific reference, behavioural and so on.

everything is the same for case isolation and household quarantine, asking people to stay together in the whole household. we have given the whole household. we have given the same group of social distancing measures for everybody and said, everybody should take those seriously. they are particularly important and you should be very stringent about them if you are over the age of 70 or have an illness was that we taken one group with serious illnesses which could predispose you to viral infections where there is specific advice and i would be surprised if people weren't being given specific advice in other countries if you are particularly susceptible so i think we have gone the pretty similar actually advice across the pretty similar actually advice a cross m ost the pretty similar actually advice across most of the population. ok, and just to be clear, because there isa and just to be clear, because there is a bit of debate about this yesterday, the over 70s who don't get contacted by the nhs as

being someone with a long—term condition that makes them especially vulnerable, could you just explain what sort of changes in their lifestyle you are hoping for? i think perhaps the easiest way to do this is so what are the kind of things they might do now that you are asking them not to do going forward ? are asking them not to do going forward? the are asking them not to do going forward ? the healthy are asking them not to do going forward? the healthy over 70s. avoid crowded spaces and gatherings. don't go to the club that you normally go to where everyone is sitting around together. reduce travel. try to avoid unnecessary travel. don't go out to do your usual things in terms of going to the shops and things u nless of going to the shops and things unless you absolutely have to. if someone can deliver it for you, so much the better. so, there are several things they shouldn't do that they are doing now. what chris whitty has said and i

think it is an important point, you can go for a walk around the garden, avoiding close contact with people, so that we are not asking everybody to be com pletely we are not asking everybody to be completely separated but there is quite a big change that is being asked for in the specific guidance on the dhsc website. specifically, what about going to sunday lunch with theirfamily what about going to sunday lunch with their family and grandchildren, yes or no? they shouldn't. ijust have one more from james... yes or no? they shouldn't. ijust have one more from james. .. just on that, exercise is going to be key so are you saying, when you mention walking in parks and so on, if someone wanted to go and play golf or the sporting exercise they can do on mass but where they are not close together, they could still do?” think the advice is to try and avoid close contact and reduce social contact. i think

realistically, a walk is ok if you are keeping a distance but it is not if you're going to be in close contact with people. so, realistically it is possible that over the coming months, healthy people over 70 could go out to parks as long as they are giving away from each other? so they could do group exercise?” giving away from each other? so they could do group exercise? i don't think group exercise. i think again we are straying into... you'd need to get the nhs and cmo advice but this could go on quite a long time and think it is quite important that we get this right. the danger is in crowded places, gatherings we have people in close environments, those are the sorts of things we are saying not to do. don't go out to be shockedif saying not to do. don't go out to be shocked if you don't have to. make sure you do it when it is only absolutely essential and there are no other alternatives. it is avoiding those such as social interactions which are such a crucial part of everyone's life. we

are asking is all not to do that. final question from james, this is slightly touching on what you said before but i want to ask it because he has ask me to ask it. given that the advice is slightly different for the advice is slightly different for the under 70s and the over 70s, does herd immunity and the concept of herd immunity and the concept of herd immunity and the concept of herd immunity play any role in the thinking with respect to that slightly different advice? know, the advice is the same just saying do it more stringently for the over 70s. the whole point about the over 70s and the vulnerable groups, most of the measures we are talking about are about trying to protect everyone. trying to prevent the spread of the virus in a way that puts people at risk. for the elderly and the vulnerable it is about protecting yourself. it is a different set of messages, it is pa rt different set of messages, it is part of the first message because they're not spending it either but

it is very much protecting themselves. thank you. a couple more questions about evidence if that is 0k? questions about evidence if that is ok? particularly around medication. aweek ago, ok? particularly around medication. a week ago, common blood pressure medications, a lot of people are on them, there was some concern they could be a problem there. yesterday, france announced that they could be a problem with vicoprofen and an article has been produced today —— ibuprofen. could you give some advice? i spent a quarter of my life making drugs so i do know about that. i think there are theoretical reasons around ace inhibitors which are interesting but i don't see strong, compelling data get to know yet. that is

being looked at. the ibuprofen example, again, it may or may not be right, i don't know. the sensible thing to do i think would be don't take it at the moment, take something else. one final question, what surprised you the most about the situation we are in?” what surprised you the most about the situation we are in? i don't think any of us have seen anything like this. this is a first in not just a generation but potentially the first for 100 years so none of us have seen this. it is not like an outbreak of something like ebola where it is a very different type of disease with a very different type of death rate and different set of criteria around it, circumstance around it. this is a daily changing unique situation where

we are learning as we go along. we are going to have to invest heavily in science. we are going to have to research ha rd to science. we are going to have to research hard to find out why some people are getting ill. the real illness. why some people have a particular storm, white people get better quickly in some cases —— why people get better? this is a really big research effort so what surprises me most is, as always in medicine, you find out there is a lot you don't know. thank you. i just wanted to come back on the data question, itjust occurred to me from some of the comments you made about data collection, testing is

one thing but making sure we are doing the right research relies on the right data being collected, i wondered if any conversations have happened with places like facebook and google to enable people to track their own journey and google to enable people to track their ownjourney when and google to enable people to track their own journey when they have got it in terms of the illness? also, whether you are looking from data from hospitals or local areas where they can say that we are nearly full so people can see the capacity that is going on so that there is a shared data and a response billeted to share that data? first, the research community have stepped up really quickly to some of this. we have had meetings which i've called every week or so to try and get money out more quickly and organisations have worked brilliantly. i think the tech companies are all over this for the reasons that you said. they have been talking to the government and other governments about how we can

do this and yes, absolutely. the data flows of what is happening locally are going to be critical. to know where there is an outbreak that has a bit more or a bit less. london is ahead a bit and we will see it at different times in different places but we need to be able to get the right data flows from the nhs who are working incredibly hard on this and public health england have done and public health england have done an amazing job on their activity so far to make sure we get that right. thank you. thank you very much for sparing the time and thank you for your valiant efforts. much appreciated. that is so patrick vallance, the government has echoed chief scientific adviser who 60th birthday it is today but spending it giving evidence to the health select

committee. i will pick up what he had to say in a moment but ijust wa nt to had to say in a moment but ijust want to give you a few other lines that have come in mate has been talking. the latest figures you will have seen on screen are 1950 positive cases at some 50,000 test being taken. that is up 407 in the last 24—hour is. also been hearing from scotland. the nhs at their reporting on the second death as a result of coronavirus in scotland for this is coming from the chief medical officer. reported that an elderly patient with underlying health conditions, who had tested positive the coronavirus, had died. the board is offering their deepest condolences. 0ther the board is offering their deepest condolences. other lines coming in, we are hearing that euro 2020, as predicted, has been is postponed until next year because of

the coronavirus outbreak for the uefa are saying that the 2014 tournament, which was due to be staged in 12 nations across the continent will now take place injuly next nations across the continent will now take place in july next year. we're also hearing from buckingham palace that the queen has changed some of her schedule. they are saying is a sensible precaution and for practical reasons in the current circumstances, a number of changes made. audiences will go ahead, so the audience with the prime minister, the commanding officer of queen elizabeth the level as i could talk to our health corresponded about what we have just heard. . people will have seen that figure of 20,000. the target is to

bring... it would be a good outcome but nonetheless horrible but intensely general death rate, what does that mean? when i took about 20,000 deaths, that is in excess of what you would normally get because of the spread of coronavirus. he was referring to this new modelling, this new evidence that was published yesterday and it prompted the government to change its approach to coronavirus going, mitigating and trying to reduce the spread to suppressing it. there is evidence, this new approach they think could reduce the death rate from 20,000. they feared it could be higher if they continue with the existing policy. jeremy hunt is back and he is now talking to the chief executive of nhs england.

he is also talking to three others about how the nhs will cope with this crisis. i'm going to ask a few questions to start with and then i will hand over to colleagues. if it is a question about capacity, would that be keith or amanda? any of us. let me start with you, keith. ijust wondered, what is the current number of general adults acute beds that we have? shalli maybe general adults acute beds that we have? shall i maybe start and then we can divvy up other things? as of today, we have 98,000 acute hospital beds across the english national health service and the current... the current occupancy? it has been

falling and under 90%. of those, how many critical care or intensive care units? we have 3700 critical care beds for adults in a play at the moment. of italy, as part —— obviously, with the likely influx of patients, we will be taking action across the whole of the nhs to free up across the whole of the nhs to free ”p ”p across the whole of the nhs to free up up to one third of the general acute beds, to noble perhaps 30,000 of those beds to be available for coronavirus patients. —— to enable. today i must be nhs to do three things to get us into that position to be able to receive those extra patients. first all, we are suspending elective, nonurgent surgery with an assumption that that will be suspended everywhere from the 15th of april at the latest. at least three months but with

discretion for hospitals to take action earlier if they need it with the pressure of patients being admitted or in order to adapt their facilities and train their staff. secondly, we are working intensively with community health services and social care using some of the flex abilities that the emergency regulations before parliament and the funding that the chancellor announced in the budget. thirdly, we are working with the community hospitals, the intermediate care providers and the independent hospitals bring that capacity online as well for coronavirus patients. just cutting to the chase, the modelling published this morning by professor ferguson at imperial, which i think the government is working on, there is assumption 30%

will need a critical care bed. if you combine it with the measures that were announced yesterday, which are expected to slow the growth of the virus, are you confident that we will have enough intensive care beds for people who need them? this is an unprecedented health threat. but there is no other health service in there is no other health service in the world if this virus let rip and it is crucially important the measures that were set out by public health england and by the government yesterday, take effect in order to reduce the infection rate such that the peak pressure on the nhs is moderated. in the meantime, what the nhs is doing is pulling out all the stops to make sure we have got as many staff and beds and other facilities available, including critical care for that

peak in demand. i am not trying to ask if you have a crystal ball, but on the basis of the modelling and what would be reasonable to think that happened as a result of yesterday's measures and also the preparations that are being made, do we have some degree of confidence that as things stand at the minute, we will have enough intensive care beds? those measures will make a difference and in ourview were measures will make a difference and in our view were absolutely necessary. but we will have to keep this under review. if it turns out further measures are required in order to reduce the number of people who get this virus then that will be something that policymakers in government will have to consider. in the meantime, what the nhs is doing is making sure that notjust overall hospital beds, but particularly intensive care beds, operating theatres, recovery bay being repurposed, mechanical ventilation, about which there has been

much discussion, otherfacilities about which there has been much discussion, other facilities across the hospital sector, they are expanded to the greatest possible extent they can be said the nhs can do all we possibly can.” extent they can be said the nhs can do all we possibly can. i think the second of the three things you have just announced, i had a message from hospital in surrey about a big problem they were having in terms of discharging palliative care patients to ca re discharging palliative care patients to care homes and hospices, because the care homes and hospices didn't wa nt to ta ke the care homes and hospices didn't want to take patients unless they knew they didn't have covid—19. is this a problem we have planned for, a solution for, what you have announced today, will it help deal with that issue? we are testing patients who are at merge and see —— emergency admissions for covid—19 symptoms, so we have the diagnosis available to us. as we

look to discharge patients through the extra community health services, potentially palliative care services and social care services, we will have to tackle that. steve, has not crossed your radar particularly? no, but simon is right, we are testing those individuals in hospitals who have a wide range of symptoms which may be compatible with covid—19. so our knowledge patients who are positive and have recovered will increase. i think the doctor who wrote in to tell me about that wa nted wrote in to tell me about that wanted to know, do we have a plan to stop hospitals being able to discharge patients in that situation, which is effectively a community plan? i think the answer to that is yes, but not if the implication is we will be testing every patient in hospital regarding

of the symptoms they are displaying. that is not what is currently proposed by public health england. in terms of the additional, financial flexibilities that had been set out in the budget, hospitals will now be able to, with the local authority partners, fund additional discharge support on the emergency legislation before parliament proposes to take out all of the delays associated with eligibility checking or needs assessments, so those transfers can ta ke assessments, so those transfers can take place very, very quickly. we think on the back of that chair, potentially up to 15,000 of our 100,000 hospital beds could be freed up 100,000 hospital beds could be freed upfor 100,000 hospital beds could be freed up for coronavirus admissions. thank you. cani up for coronavirus admissions. thank you. can i move on to ventilators? obviously, lots of people with covid—19 get breathing difficulties and need, what's called a mechanical ventilator to effectively do their breathing for them and that can be a matter of life and death. so what is

the total number of mechanical ventilators that the nhs has access to in england? as of today, we have 6699 mechanical ventilators operational in the nhs, together with 750 paediatric mechanical ventilators, which can be repurposed. 691 in the private sector and 35 and the military of defence so we have 8175 and we have been preparing and procuring are mechanical ventilators and we can see a line of sight over the next several weeks to another 3799, bringing the total to just under 12,000. in addition to that, you may have seen the prime minister hosted a call that the manufacturing sector to seek to bring new supply into the country for mechanical ventilation and we have set an open—ended goal for what that

would be. just so we understand what you are up against, if we are not successful in suppressing the virus and we end up in the reasonable worst case scenario, what does the modelling show you would need in that situation in terms of the number of mechanical ventilators? when you talk about the reasonable worst—case scenario, if what you're talking about is an 81% infection rate across the population with none of the population mitigation is in place that have already been announced, then there is no country in europe that would be able to have a health service that could deal with all of that need. which is why it is so important we don't get to 81% infection and it is so important these additional measures are enacted and succeed. so if you take into account those additional measures, does the modelling show that when we get up to 12,000 mechanical ventilators, we should have enough? that will

partly depend on the clinical protocols for the patient requiring critical care and stephen may want to comment on that. it will also depend on the extent to which we, as the people of this country, respond to the asks that are being made of us. it is very important that collectively we do, because that is what will keep the infection rate down. i amjust trying to get a sense, i understand that you cannot predict these things, but i am trying to get a sense whether this is an issue potentially solvable, we could potentially solvable, we could potentially have enough mechanical ventilators of yesterday's measures, you must have done some detailed modelling? nothing is certain, but particularly in an epidemic with a new virus, when we are understanding the science better and better every day, but absolutely, ouraim the science better and better every day, but absolutely, our aim working with the modellers, working with sage and the various

processes is to make sure we match are expanded capacity with the interventions the government have announced, so we have the best possible chance of having the capacity that will manage the numberof having the capacity that will manage the number of patients who are infected with covid—19, including mechanical ventilation. as simon has said, the measures will only work if the public act on them and the public stick to the various measures that the government have proposed. so, this is important that we all do our bit in society, because the more we do our bit in society the less demand there will be placed on ventilators. yes, i understand you don't want to commit, but you are using phrases like, that will give using phrases like, that will give us the best chance, but i am asking

a straightforward question, does the modelling show what we expect to happen as a result of yesterday's announcements and the suppression of the disease and what we expect to happen in terms of the additional new mechanical ventilators perhaps getting up to 12,000, does the modelling show that in that situation if all goes according to plan, we could have enough? we will be in plan, we could have enough? we will beina plan, we could have enough? we will be in a better position to give you, based on what the group from imperial and sir patrick vallance has been speaking to you, what they are telling us when we see the sort of impact but in practice over the next week, fortnight, three weeks those measures are having as we see the change, hopefully in the new infection rate, the hospital admission rate, that it will then give us more confidence as to what the landing zone he will be. but as we sit here today, less than 24 hours after those measures were announced, i think we all accept that as a degree of uncertainty of how this will play out over the next couple of months

and beyond. ok. just a final area of questioning from me. iwant just a final area of questioning from me. i want to talk about protective equipment for staff. obviously, it is a massive priority to keep staff safe and indeed, we owe them no less and everyone would agree on that. if you look at the key elements of protective equipment like gowns, face masks, goggles, gloves, aprons, hazmat suits, do we have any shortages at the moment? yes, thank you. quite right, from a staff point of view we know this is hugely important and it is something people are rightly anxious about, because they want to keep themselves safe and they want to keep their family say. it has a high degree of focus and on a reassuring point, we have been assured that there is

sufficient supply available nationally. so we have had the benefit of being able to release our influe nza benefit of being able to release our influenza stockpile and also from the eu exit stockpile. so nationally we are currently assured by colleagues that we have the adequate supply we need. however, we are aware there have been some local distribution problem so we haven't necessarily got the kit in the right place. so what we have done today is set upa place. so what we have done today is set up a dedicated helpline so that if people have local issues that they need immediate response to, they need immediate response to, they have got somewhere to go and we can make sure the distribution, the stock is being moved from where it is to where it needs to be. this has got a very high level of continual focus, but as we stand today, we have got the national supply that we require. i might ask you simon to respond, i think staff are want to know this, you are confident you will have enough protective equipment to keep staff safe

and if there are gaps at the moment, they are localised but you will have enough to keep staff safe in the months ahead? i would just underline what amanda said, as we sit here today, nationally, the department of health and social care procurement tea m health and social care procurement team have sufficient for the ppe we are going to need over the coming weeks. but there is additional issue on distribution around the country and we are going to need more of it. this is a challenge facing every country, a lot of the chinese supply for some of them are basic items has been disrupted. we are going to need to ramp up production for gowns, in particular. some of the face masks and given that this is not a flash in the pan, as we know, it's not something that will be resolved in a fortnight or a month, the coronavirus epidemic, pandemic is going to be with us for months to

come and we are going to have to mmp come and we are going to have to ramp up domestic production on those items as well. it is a combination of, have got aggregate supply now? we are being advised yes. do we need to improve the distribution to every pa rt to improve the distribution to every part of the service? we think so. hence the approach that amanda has set out. and will we need more of this stock over the coming months? yes we will. could i read you a couple of comments that have been sentin couple of comments that have been sent in from people on the front line. there is such a lot of concern about this. this is from an a&e doctor in london writing yesterday. this doctor said, it is carnage in a&e, ks and we don't have any proper ppe, paper mass, not the gowns and not the masks we need and not eve ryo ne not the masks we need and not everyone gets those. the doctors are seeing the sickest patients, suspected heart attacks, pe, sepsis and all they have is a bit of paper

across their mouth. i am in shock andi across their mouth. i am in shock and i feel like i am across their mouth. i am in shock and ifeel like i am being thrown to the wolves here, some of us are going to die. how long is it going to ta ke going to die. how long is it going to take to sort out these localised problems? clearly our staff are critical and doing an enormously importantjob and we need to respect what they are saying. in terms of the ppe, as amanda has said, establishing the hotline to do with the immediate issues of distribution to hospitals where there are problems can contact us directly or contact the hotline directly, to ensure that we get immediate supplies out to them. the ppe has changed in the guidance in recent days so i think there is some education as well about what is appropriate, depending on when the cases, —— whether it is a confirmed or suspected case was that we have

to educate our nhs staff as well to ensure that they do feel that what they have is grateful that we are in a unique position in the uk the two reasons. one is that we have always held a pandemic influenza stockpile and that is what the department is now drawing on and pulling that down and into that distribution chain which is now happening. that is something that is an enormous replenishing a stockpile that we have had a long time. as you know, many countries don't have that. also, a silver lining, we inherited the eu exit stockpile which we managed to retain before that was taken down so there is a significant amount there but we do have to listen to the staff and respond and assure them that the personal protection equipment will get to them. so, the one thing that would reassure them most right now is if you gave me a date by when these localised distribution problems will be sorted. can you commit that, for example, within the next week all these localised distribution

problems will be sorted out and staff will have the protective equipment they need? we have had discussions this morning and been insured by the department that those stocks out there and the distribution model is going into place. so, a week? iwould say, they are being sorted out right now but what we have also got in place today is an intention to do a regional distribution so that regions can make sure that they have got some control of additional stock that they can distribute locally. in addition to sorting out, through this dedicated line, we are putting some additional stock into the syste m some additional stock into the system so that regions can distribute it today so that they have a bit more flexibility than i had yesterday. can any doctor be confident that this time next week the problem will be sorted?” confident that this time next week the problem will be sorted? i think what we are saying is, we are not waiting a week. ok, if it can be thatis waiting a week. ok, if it can be that is great. that is what we want to know. i just

that is great. that is what we want to know. ijust have one more, this isa to know. ijust have one more, this is a different doctor who makes a slightly different point. this is another a&e doctor. i'm treating patients who are perhaps presenting for a broken ankle and they suddenly start coughing all over you. your breathing in droplets and not even wearing a mask, just scraps and a plastic apron. should the nhs nationally have a policy that all staff should be wearing ppe equipment in hospitals where there isa equipment in hospitals where there is a reasonable chance they are going to come in contact with a covid—19 patient? going to come in contact with a covid-19 patient? i will defer to our national medical director on that. we are guided by advice issued by which the ppe has been provided but we believe that staff do have the right to expect the protection that would give them confidence and so part of the question, the dialogue with p h

e is, what is reasonable in a&e departments and other parts of the hospital.” reasonable in a&e departments and other parts of the hospital. i would absolutely agree with simon. clearly pare the absolutely agree with simon. clearly p are the experts in this area and haveissued p are the experts in this area and have issued the guidance will stop as keith has said, that guidance has evolved over the last few weeks as we have learnt more about this virus. but equally, i think, we have learnt more about this virus. but equally, ithink, from our staff point of view, providing them with the confidence that they are safe, as amanda said, in all circumstances, it is important, too. there is a continuous dialogue with colleagues at phe is to setting the right approach and am sure that will continue. just to underline the national event ability point. right now, we have got more than 28 million, and advised, of the most intense face masks are available

with many more in production. so, those facemasks are in the country. thank you. just a last question on ppe. this is very gps, pulse magazine had a story about gp surgeries in 20 areas being sent to masks with a best before 2016 and a sticker had been put over those which said best before 2021. a lot of gps have written to us worried about the quality of protective gear thatis about the quality of protective gear that is being sent to them. is there anything you can say to reassure them on that? definitely. we are fully aware of those. they came from one of the stocks that i talked about. they did go through a quality assurance check the health safety. the reason they have been rebadged is because they were tested to make sure they are of current standard. thank you. one last question and then i will hand over to my colleagues. this is just

then i will hand over to my colleagues. this isjust really prompted by the absolutely heartbreaking scenes that people have been seeing in northern italy and the thing that perhaps, the most awful stories you read, when doctors are having to choose which patient gets an intensive care bed and effectively play god because the patient doesn't get that bed is going to die. a lot of people have been writing in saying that they don't have guidance as to how to make those appallingly difficult decisions. is there a plan to send out guidance, particularly to intensivists, but to all doctors so that in that nightmare situation, we have to make those choices, doctors have to make those choices, doctors have actually got some guidance that they can use? the first thing i would say is the reason that we are expanding capacity and the reason that we have been working with government closely on the

policy that they have introduced, and discussing policies which they may introduce which they have laid out, is to ensure that they could do anything they possibly can notch to get into that circumstance was not doctors make clinical decisions every day. what we want to be able to do is to support doctors to make those continued decisions on the base they are currently making them. because we are ahead of italy in terms of the curb of the epidemic, as i'm sure you will have discussed with sir patrick, that gives us the opportunity to do the planning ahead. but of course nothing is certain in medicine. clinical staff have to make difficult decisions and if that becomes the case, we will support them, locally and

nationally in that sort of decision making. if everybody in the population follows the guidance that has been given, we work in the capacity described, our aim is to ensure that medical practice does not have to change.” understand that and i think we would all agree that ijust understand that and i think we would all agree that i just want to very specifically ask you, are you going to be sending out guidance to intensive care doctors that tells them how they should make such impossible decisions if they end up having to make them? is that guidance going out and if so buy when? because that is on people's minds? i would say, we will be working with our relative colleagues in intensive care but notjust intensive care. see may not be sending out that guidance?” intensive care. see may not be sending out that guidance? i think we have to work out the best way of doing that but i absolutely

hear the concern and it is something that we will be working with our professional colleagues in intensive ca re professional colleagues in intensive care and other specialties to address. you can't give any more comfort than that? because this is happening today in lombardy. people are worried it is going to happen here. they just want a very simple set of instructions guidance that's all. i think you are basically saying, we will listen to you and understand this a difficult... i'm not saying, and say we want to work collaboratively with our colleagues. you will come up with some guidance, in may not be you who has written it, but you will come up with some guidance talking to the royal colleges and whoever? it is and if, and is absolutely emphasised, that isa and is absolutely emphasised, that is a point that we'd don't wish to get to. of course, we will work collectively on a guidance. so there would be guidance before such situations arose? if, and

it is a huge f, we will work on that guidance. —— it is a huge f. huge f, we will work on that guidance. -- it is a huge f. my questionsjust about guidance. -- it is a huge f. my questions just about some of the practicalities was that if i could stop the secondary care and just work out to hospital that's ok. you mention ventilators, how many are in use at the moment? a number of them are in use for some of the procedures that we are going to defer so part of the reason for calling a halt to nonurgent operating is that we not only will free up ventilators but critically, the number of the operating theatres and recovery rooms which can then be repurposed for extensions to critical care. so, you don't know if it is 5000 in use at the moment? because once a patient has a ventilator, that is it, they got a ventilator. do you know the number

in play at the moment? a number of these are going to be brought back online rather than being in use right now. we... you know this but it is worth just saying, mechanical ventilation is not just it is worth just saying, mechanical ventilation is notjust a question ofa ventilation is notjust a question of a bit of kit. it is actually a very complex and sophisticated procedure and involves a sedated, paralysed person, perhaps for ten days, carefully being monitored. it is about trained staff as much as it is about trained staff as much as it is about trained staff as much as it is about equipment. leading into my next question. simon gave you the numberof next question. simon gave you the number of itu beds and not everyone in an itu bed is mechanically ventilated and that will be changing literally from hour to hour across the nhs and it changes on clinical need every minute. a proportion of patients on those itu beds absolutely will be on mechanical

ventilators. simon has also said that there are mechanical ventilators used in theatres and that amount used varies from day to day. the key number is that when he gave you earlier. our capacity seems that they will all be used. can i come back on that because with that, you have rightly pointed out, how many staff do you have it to use that? i couldn't use a ventilator. i could probably be trained but it would take a while to get used to it. the other thing that goes with it. the other thing that goes with it is arterial blood gas machines was that they are critical for working out what settings you need. how we got enough of them aligned with the ventilators, the people to use it and the machines to make the adjustments? we have been talking with the intensive care society and the royal college of anaesthetists and many other medical disciplines. as we have a slowdown in nonurgent surgery, the number of anaesthetists with their intense vest colleagues will be available for this type

of work. but, i have sat next to me, a professor of medicine and a trauma surgeon so i will hand over. again, simon is absolute right. there are staff that use ventilators but not in an itu capacity. they will clearly need some further education, some retraining if it is a skill that they had in the intensive care sector and have had before, and we are ensuring that that training is in place and hospitals are doing that already. your other point about other bits of kit, and it is not just kits, it is drugs etc that are required for patients that are ventilated, then we are also looking at supply chains and ensuring that we have the supplies in place for everything else that is required around ventilation. the final point i would make around ventilation. the final point iwould make is around ventilation. the final point i would make is that there are forms of ventilation that don't require

mechanical ventilation connected to a machine, noninvasive ventilation. we think actually, from the experts that we have heard about in other countries, that the clinical cause of this disease is that we want to place an emphasis on mechanical ventilation and that is exactly why you have heard our efforts, our aim, at increasing the supply in a number of mechanical ventilators. that does not mean that other forms of oxygen treatment, noninvasive ventilation with a tight—fitting mask, or for the majority of patients probably who have been hospitalised, regular oxygen, is not an important part of treatment as well. that is why we are working to ensure that we have a supply of those items as well and why we are working hard for example to ensure that the oxygen supply to hospitals is maximised so that we

don't have a constraint in any part of the supply change. —— supply chain. a critical part of this is the anaesthetic nursing staff, practitioners who we know, as they are all occupied in operating theatres are doing planned where a lot of the time, as we wind down that activity then they become available. the ventilation breathing support that is required for patients with coronavirus is a relatively, and i say relatively because it is clearly specialist, a relatively easy end of the complex things in intensive care. it is therefore possible to be able to resource your staff quite differently and support that across a wider number of patients. so, what we are doing in the nhs over

the course of this week, which started today, is we are doing an exercise with all our acute trusts and essentially walking them through an exercise to get them to think and understand, and many have done it already and that is fantastic, and you can imagine that most doctors at most hospitals are way ahead of this, but to make sure everybody is understanding what these pressures may feel like and how the best adapted to ensure that as many patients as possible get exactly the right care we want to give them. we are working them through. today, we are working them through. today, we are giving them a point in time at that curve, week six. tomorrow we give them and inject, new data that says no you are at week seven. thursday you are at week eight on friday week nine. some of them will have their plans in place and can test out their plans, others will realise their plans need to do do

more and will need to think much more and will need to think much more creatively and in the tivoli —— innovatively. tied into that is going to be an education programme, a bit ofa going to be an education programme, a bit of a call to arms as well, call to action so that the nhs is all on the same page in terms of responding to this because we do need all that the nhs to move with us and we need all our supporting partners outside of health to help us on this put up so there will be education packages that will not only ensure that the staff have the education, that they really understand about what a coronavirus is that we take an assumption that eve ryo ne is that we take an assumption that everyone in health does know what a virus is that actually people aren't working in that field. they're not sure on that in some of the anxiety that you alluded to, lack of familiarity with this because they don't see it. the education programme is going through, some of which will be nationally based but many will be locally based

as to how each of the hospital specially is, talking about secondary care, as we walk into this and as we expect it will become more difficult, how we ta ke will become more difficult, how we take down the things that we normally do which would have the least impact, take this thing is it down and then redeploy the staff. for instance, i'm a trauma surgeon but in the emergency department there are many injured miner patients that you may well have sent in who have injured toes, fingers, ankle sprains, whatever, we can lift all of those out of the emergency department and move them into the orthopaedic setting and free up our emergency doctors to do the respiratory cases and the other one is that only they can do. we can do that through each specialty so that we can start to completely restructure the way we deliver care.

people with cancer, can you comment, cancer operations, will they go ahead? yes. thank you, prescribing rooms for gps, will there be any rules for prescribing, reviews to relieve the system lower down? almost certainly, yes. new registration of patients and staff, patients have to come into a gp surgery to register, plenty of people will be thinking, i need to get onto gp health care, normally they have to show identification. but i wonder if there is any thought behind doing something about that or online and also for staff who want to come back in? is there any centralised system for allowing staff to get up to speed very quickly to step back into giving care? i think it is a probable yes and a yes. in terms of the probable yes, perhaps i can put some context around that. what we're doing, not

just for gps, we will do the same with community pharmacists, hospitals and nhs trusts and essentially say, for the next four, six months we will be going flat out at coronavirus so we are suspending the usual rules around contracts and payments and incentives and just paying upfront, the funding that staff and organisations need in order to do the right thing for their patients on coronavirus. and there will be a myriad of aspects of there will be a myriad of aspects of the gp contract works that will conform to that. it is notjust gps, it is all part of the health service asa it is all part of the health service as a whole and in the letter issued to the nhs this afternoon, i lay that out. studio: says simon stevens, of nhs england alongside the medical director at nhs england. if you want to keep watching that session, the health select committee, bbc parliament has continuing coverage of that. i am going to pull away, obviously a lot going to pull away, obviously a lot going on as the country deals with

corona vices. let's talk to my health correspondent who joins me now. it is the nonurgent operations been postponed, is the headline from that one? yes, i think so. we had from three of the most senior officials at nhs england and they said from april the 15th, all routine operations will be cancelled. they believe this will free up about 15,000 beds, another 15,000 beds they believe can be freed up by discharging patients quickly. getting people out of hospital and back into the community. that will free up in total, 30,000 beds out of a capacity of 100,000 across england. and also, the question of ventilators. we have heard a lot about those in the last 48 hours and that was addressed directly? yes, that was the most detail we have had about ventilators and intensive care. by cancelling the routine stuff, that does free up ventilators and operating

theatres. we have in england, 3700 critical ca re we have in england, 3700 critical care beds, nearly 5000 in the rest of the uk. with the combination of private sector ventilators, ministry of defence ventilators, sourcing others, buying new ones, they believe they can get up to 11,000, 12,000 ventilators so 12,000 critical care beds to cope with the large numbers of patients with coronavirus they are expecting. the purpose of us covering events like that, these are the people dealing with this crisis, they are on the front line. the message coming across is the nhs, as it stands can cope? yes, they were quite careful in what they said about that. the medical director of nhs england said nothing is certain. he also urged the public to play our bit. that is following the measures of the government advice issued yesterday

about social distancing. we will reduce the spread of the virus and that will allow the nhs to cope better. plenty more on coronavirus throughout the afternoon on bbc news. we want to go to one of the story breaking in the last hour. the brother of the manchester arena bomber has been found guilty of murdering the 22 people who died in the attack in 2017. detectives say hashem abedi, who's 22, was every bit as responsible for the bombing as his older brother salman, who died in the explosion, and may even have been the senior figure in the plot. our home affairs correspondent dominic casciani is at the old bailey. dominic. yes, simon. prosecutors said it was hashem abedi who refused to attend the final days of this trial and stood shoulder to shoulder with his brother, the suicide bomber, salman abedi, during that attack. he was in libya when the attack. he was in libya when the attack was carried out and was arrested shortly afterwards. it did

ta ke arrested shortly afterwards. it did take until lastjuly to getting back to the uk to face justice. justice was done to in less than five hours. thisjury found was done to in less than five hours. this jury found him guilty of 22 cou nts this jury found him guilty of 22 counts of murder, that is a record in english criminal court history. from john atkinson, 28, a special need support worker, who fought on through the night and lost his life shortly after midnight through to jayne torvill, 51—year—old school receptionist, 22 counts of murder. hashem abedi did not attend court in the final days, to face the music and face the families who had to sit through this awful evidence. the evidence was clear to the jury he was there with his brother, help to buy the bomb parts, help the construction of the bomb, try to persuade and ta ntric construction of the bomb, try to persuade and tantric friends into using their amazon accounts to buy things such as acid and other chemicals. some of those who gave evidence against hashem abedi in court. all the way through he denied any involvement, but when it came to

the crunch, his account of what his brother was up to and why he was not guilty, he did not come to court. thejury guilty, he did not come to court. the jury found that silence absolutely deafening. when the verdicts came in, there were tears in court from some of the families who were present. some of them had pictures of their loved ones here in court and they hugged each other after thejudge said court and they hugged each other after the judge said about the love they have for each other rather than they have for each other rather than the hate that these brothers demonstrated on the night. he will be sentenced at a later date, but he is refusing to have any legal representation so he cannot make any mitigation to the court, given he has now been found guilty of these appalling crimes. he is looking at a very, very long sentence indeed. dominic, thank you very much from the old bailey. we will be joined dominic, thank you very much from the old bailey. we will bejoined by viewers on bbc one for a special programme looking ahead to the chancellor, expecting to unveil financial measures to ease

the burden of coronavirus on uk businesses. that is to come and stay here for that. now it's time for a look at the weather with chris fawkes. hello there. today, many parts of england and wales have had dry and bright conditions, a little bit of sunshine coming through from time to time. for example, here in cromer in norfolk, but further north in scotland and northern ireland, we've had the strap of cloud moving in and that's a weather front. now to the north of our front we have got some colder airjust clipping the very far north of scotland, 0rkney and shetland. further south we are into their milder air but that weather front will be pushing southwards over the next 2041 was so the weather will be getting cooler for many of us. overnight, a band of rain move southwards from scotland and northern ireland into northern england and wales. south of this, southern england, much of the midlands, east anglia largely dry but quite cloudy so a mild night here. for northern ireland and scotland it is colder, there will be patches of frost around and with wintry showers being blown in by brisk winds, we could see a few icy stretches building up where temperatures just dipped down below. wednesday then, we will have

a weather front pushing southwards through the day, outbreaks of rain then eventually working into the midlands, although not particularly heavy here. in south—west england seeing the rain through the afternoon. northern england, scotland, northern ireland brightening up but with a few showers dotted around. the milder air holding on in the south, temperatures 14 degrees in london tomorrow afternoon but for most of the uk, actually it's going to be getting cooler with temperatures around eight or nine celsius also. a little bit cool for the time of year. 0ur weather front is still with us on thursday loitering toward south—west england and not far away from southern wales. away from that south—west quarter though, it's a largely dry day with the best of any sunshine across northern areas. although there will still be a few showers affecting 0rkney and shetland from time to time. temperatures, for many of us seven to 10 celsius, may be an 11 there in london the area. and for friday, our weather front is still on the charts, the rain could be heavy for a time across southern wales, south—west england but as well as the wet weather here, it's also going to get

increasingly windy, particularly around the coasts and headlands of south—west england and also southern wales. but you will notice a brisk, north—easterly wind across central and eastern england. the best of the dry and bright weather across more northern areas of the uk as pressure begins to build a little we should see some sunshine breaking through. 0n into the weekend, cloud varying quite a bit from place to place but the trend is for the weather to be largely dry it with some bright or sunny spells.

you're watching bbc news. i'm simon mccoy. as the number of confirmed cases of coronavirus rises to nearly 2000, the nhs in england is to cancel all routine surgery and sent home as many patients as possible in order to free up beds. the government's chief scientific adviser said it was reasonable to estimate that 20,000 people could

die from catching coronavirus in the uk.