we have to face the reality of that. we were too slow with a number of things. but we can make sure that in the second wave we're not this is bbc news with the latest headlines for viewers in the uk too slow. and around the the health secretary, world. the boss of a uk nhs trust warns his staff could run out matt hancock, has responded of protective gowns this weekend, despite assurances from ministers to concerns that there are enough to go round. about a shortage of protective gowns — by saying that 55,000 gowns with a number of countries will be arriving today. changing their advice on facemasks — i would love to wave a the mayor of london calls for people to wear them, whenever magic wand and have large quantities of ppe they fall from the sky and be able to leave answer your questions about when it home. will be british government ministers set out five key tests before lockdown restrictions might be eased, resolved. including a sustained fall in daily death rates. and there are calls for the public chinese officials revise to be urged to wear face masks upwards — by 50 per cent — to halt the spread of the virus. the number of people who've died, after testing positive also this lunchtime: for covid—19 in wuhan — as china's economy slumps, the city where the pandemic started. the international monetary fund warns the outlook for other economies around the world could be president trump outlines proposals far worse than originally predicted. for a phased lifting the duke and duchess of cambridge

of coronavirus restrictions speak to the bbc about the need to protect mental health across the united states. during lockdown — and their feelings when prince charles and the duke and duchess was diagnosed with coronavirus. i thought to of cambridge on life in lockdown, and prince charles being myself, diagnosed with coronavirus. "if anybody's going to at first i was be able to beat this it will quite concerned. he fits the profile be him," and actually he was of somebody at the age he's at, which is very risky very lucky. and so i was a little bit worried he had mild symptoms. and actually he was very lucky. and also speaking to him made me but i thought to myself, if anybody feel more reassured that he was ok is going to be able to beat this, and he was through the worst of it. it's going to be him. and the leeds united legend norman hunter has died, after contracting coronaviras. he was 76. and coming up on bbc news, as premier league clubs meet hello and welcome to audiences in the uk and around the world. we're covering all the latest coronavirus developments, both here and globally. as the uk enters another three weeks of lockdown, the head of one nhs hospital trust has asked for help finding more protective clothing and equipment, despite uk government assurances that there's enough

to go round. the nhs boss said his trust has "less than 2a hours supply" of protective gowns. as governments around the world consider lifting lockdown, ministers in the uk have set out five key tests before restrictions might be eased, including a reduction in deaths and confidence that any adjustments won't risk a second peak. chinese officials in wuhan — where the coronavirus outbreak began — say the number of deaths was 50% higher than previously reported. they deny a cover up. china has seen a 7% shrinking of its economic output, reflecting the impact of the pandemic. it's a first in china for at least three decades. president trump has set out plans for a phased lifting of the us lockdown. and, the duke and duchess of cambridge have said nhs staff treating critically ill coronavirus patients are taking home the pain they witness every day. our first report is from charlotte gallagher.

cheering and applause. for the fourth week in a row, millions of us, young and old, clapped for our carers, coming out to make a noise on our doorsteps, in bradford... applause. ..in stoke... pots and pans clang. bagpipes skirl. ..and a hilltop in the north—east of scotland — a national show of appreciation for the people risking their lives to save others‘. and for these nurses, doctors and carers to do theirjob properly, they need more than applause. cheering and applause. they need personal protective equipment — the gowns, masks and goggles that keep them safe. but a major nhs trust has contacted the bbc, requesting phone numbers for barbour and burberry to ask them for gowns. it fears it does not have enough stock to even get through today. it said other trusts were resorting to washing and reusing single—use gowns and masks. the department of health says

it is working around the clock to provide protective equipment where needed. the figures remain grim — a further 861 people have died from coronavirus in uk hospitals and there are 4,618 new cases. the infection rate and fears of overwhelming the nhs has led the british government to extend the lockdown for at least another three weeks. if we rush to relax the measures we that have in place, we would risk wasting all the sacrifices and all the progress that has been made. and that would risk a quick return to another lockdown with all the threat to life that a second peak of the virus would bring and all the economic damage that a second lockdown would carry. the uk government will not be drawn on when the restrictions might end but opposition politicians say a plan is needed. now, an expert panel at the royal society is looking

at how and when the uk can ease restrictions, while scotland's first minister nicola sturgeon says she will set out a possible exit strategy within the coming days. but for the next few weeks at least, lockdown life continues. charlotte gallagher, bbc news. our political correspondent, leila nathoo is at westminster. very shortly we are expecting the health secretary matt hancock to appear before the health select committee. they are going to have a lot of questions to put to him today? absolutely. select committee hearings are still continuing gradually although parliament is officially in recess and we had the health secretary matt hancock being questioned by his predecessorjeremy hunt, in the role, now the chair of the health select committee. jeremy hunt has been quite a vocal critic of government strategy in parts, especially on testing and there are a huge number of issues that i think he is going to be pressed

on. the admission yesterday that transmission within the community was going down, but actually within hospital settings, certain hospital settings and social care settings, transmission rate of coronavirus is increasing, i think that's a huge point and that draws attention back to testing, draws attention back to ppe and why nhs staff had taken so long to be equipped with the releva nt long to be equipped with the relevant ppe, are there still bottlenecks? we heard the transport secretary grant shapps talking about that this morning saying it had been a huge challenge to get ppe to the front line. i know this has been an unbelievably difficult logistical task. the army, who i'd like to thank for their work, have been helping with the logistics of distributing nearly a billion pieces of ppe, i'm not going to pretend it's straightforward or had lots of difficulties along the line. it clearly has been. that is the nature of this global pandemic that we face and the work that's

gone into trying to ensure everyone, including care homes, are getting the right pieces of ppe has been tremendous. grant shapps. thank you very much for now. let's take you to the uk parliament, the health select committee, hearing evidence, it's been done remotely in the uk government handling of the coronavirus pandemic. you see in front of you former health secretary jeremy hunt, now the chair of this committee, later this hour, jeremy hunt, now the chair of this committee, laterthis hour, in jeremy hunt, now the chair of this committee, later this hour, in about 20 minutes or so, we are expecting that hancock the health secretary to appear in front of this committee by remote hearing, it has to be said. let's listen in. the courage they are showing, risking life and limb to keep us all safe. lots of issues with ppe testing and so on but could you give us an update as to how things are at the moment on the front line? everyone has worked

together to try and meet this demand. everyone has worked incredibly hard, obviously critical ca re incredibly hard, obviously critical care is at the front line of this. but it's notjust in critical care, it's everywhere else as well. the only way that we've been able to get anywhere near being able to meet this demand is by working in very different ways. so we've had to look at expanding capacity in areas of the hospital, we've got the nightingale hospitals as well. and everyone is working incredibly hard together as a team. but i think what staff at the front line are concerned about is the way we've had to change the way we work so we have non—critical care staff helping us, they've been incredible in using their skills to be able to help us as part of a team. but we are working differently, working in different environments, different ways. so that for instance,

the normal standard of care for a critically ill patient would be one highly trained critical care nurse per patient and in order to be able to meet the increase in demand we've had to change those ratios. so although we do have spare capacity, thatis although we do have spare capacity, that is capacity that isn't at the normal standard so we've had to spread ourselves more thinly. and we have developed guidance to try and make sure that continues to be safe. but if we had to expand even more and spread ourselves even more thinly, there would be concern that safety could be compromised. so everyone is working really well. we are doing everything that we can't but staff are genuinely concerned. and then, that on top of concerns about availability of ppe, testing issues and everything

else, means that staff are under increased stress and we need to make sure that notjust stress and we need to make sure that not just doctors but mercer's and all the allied health professions that work with us to provide critical care, they remain resilient so we can see critical care, they remain resilient so we can see this pandemic through to care for patients and also to be able to continue to provide that ca re able to continue to provide that care afterwards when we start to get back to normal. thank you very much. we will come back to you, if we may but i'd like to go now to another contributor, dame donna, thank you for the incredible courage being shown by nurses. their work is a lwa ys shown by nurses. their work is always up close and personal. at high risk to themselves. perhaps you can tell us what the situation is like in the front line but both are nurses in hospitals and the communities. if i start with hospitals, i note this week i have worked as one of those nurses that isn't a critical care nurse

but helping critical nurses on the front line in the nightingale hospital in london. what you see there is that nurses are working incredibly hard, so are nurses are working incredibly hard, so are others and i worked with a clinical scientist this week who is taking on the role as a health professional. there is an issue with capacity but there is also an issue that actually, when people are volunteering, you don't get the same staff all the time and therefore, that's where you sometimes are compromising safety standards. because although we are all fit to do the work, you are only one critical nurse to a range of other people, trying to deliver the care to those under and in an intensive ca re to those under and in an intensive care environment. 50 to those under and in an intensive care environment. sol to those under and in an intensive care environment. so i think on the front line, people are working and changing and adapting the way they work. but they are concerned. so even in some of our environments, such as the nightingale hospital, people have become ill, there is an issue about how we get nurses and

others to be able to be tested. because actually, it's not quite clear. you would expect an employer, if you started to become ill, you would be able to have a defined place to go to and your employer, occupational health would instruct you where to go. i'm hearing from the front line, nurseries are sometimes driving two hours, feeling very u nwell sometimes driving two hours, feeling very unwell with possible symptoms of coronavirus. and driving to testing stations. sometimes if you haven't got an appointment you are turned away. only to be told to come back another time. we need some really clear direction of how we can access testing, both in the nhs but more so access testing, both in the nhs but more so for social care. because they don't have the same infrastructure as the nhs. so for me, there is something about the stp, giving clear instructions to the hospitals, social care outlets, in theirenvironment,

the hospitals, social care outlets, in their environment, about how to get tested so that people aren't turned away, we can make appointments and that people who are feeling very unwell with those symptoms can get access to this. thank you very much. we will come back to you as well if we may but that was very helpful. i'd like to turn now to professor costello. you've been a very prominent critic of the government approach to testing so far. and on april the 4th, the health secretary announced this big target of 100,000 tests every day, i'd like to ask you to what extent that has assuaged your concerns about the overall approach the government is taking. yes, i mean look, we are going to suppress the chain of transmission of this virus in the next stage, we all heard that the national lockdown and social distancing will bring about a large suppression of the epidemic so far but we are going to face further waves and so we need to make sure

that we have a system in place that cannotjust do that we have a system in place that cannot just do a that we have a system in place that cannotjust do a certain number of tests in the laboratory. but has a syste m tests in the laboratory. but has a system at district and community level and listen, i pay a huge tribute to the people on the front line, intensive care nurses, doctors and the like but there is also a massive transformation going on right now with general practices, with the public health local authority and reach management teams and it will fall on them to put into place a system that enables you to test people rapidly in the community, in care homes, and to make sure that the results have got back to them very quickly. and that we also maintain social distancing ofa we also maintain social distancing of a kind after we left the national lockdown. and if we can do that, then we are going to be focusing on then we are going to be focusing on the people we really want to lockdown which our cases and contacts. as the who said all along

you need to find cases, you need to test them if you can, you trace their contacts, you isolate them, do social distancing but most important of all, you do it all at speed. and the harsh reality and one of the reasons, i hope i've been constructively critical, also i believe we should not have any blame at this stage, we should have a no blame audit, where there are system errors that led us to have probably the highest death rates in europe, we have to face the reality of that, we have to face the reality of that, we we re we have to face the reality of that, we were too slow with a number of things that we can make sure in the second wave we things that we can make sure in the second wave we are not things that we can make sure in the second wave we are not too slow. actually, i'm not sure we need 100,000 tests per day. in reality. if we can get this epidemic damped down. more important is to have the systems in place and i'd like to know much more from matt hancock, how are they restructuring the public health teams, have they got plans in place? will they need

additional volunteers for example, we've got 750,000 people queueing up. i bet there's a lot of retired doctors and nurses that could maybe come in and help with some of the contact tracing, being online, giving that personal service because just asking people to self isolate is not going to achieve the quarantine you want to. korea did it with testing and perhaps we need to hear about apps, china and a lot of the asian states did it by symptomatic identification and careful quarantining, some in hospitals, people with milder symptoms in a special places where they could rest and others in hotels, actually, so we need to think this all through because all of them right now, nature, are facing little flare—ups. and we will face the same and we need to damp that down. it's the number of tests andl that down. it's the number of tests and i think we will get there now, why didn't the reach of who is helping with the testing. but we have to have the systems and

the logistics in place so that we can suppress this and maintain it for a long time and that way we will get the economy going again. my my colleague tom tugendhat has got a question for you and then i will come to luke evans. professor, thank you very much and thank you for what you very much and thank you for what you have done in publishing your thoughts as well, i've been reading them with great interest. may i ask what are the implications for the spread of covid—19 in the developing world and what action should the uk be taking alongside international partners? i have spoken this morning with the heads of un agencies who are deeply concerned, notjust with the heads of un agencies who are deeply concerned, not just at the spread of the disease but also the spread of the disease but also the implications of the lockdown in terms of social and civil unrest. you are absolutely right. most of the poorer countries will find social distancing extremely difficult because of many people living in shanty towns, you know,

one room accommodation. you are seeing this mass migration of labourers in india, for example. india actually does have testing capacity but they have got a massive population. but most countries in africa will struggle to test. they won't have... some countries have no more than a couple of ventilators. they probably don't have intensive ca re they probably don't have intensive care units sufficient to deal with it. so on... and personal protective equipment, of course, is going to be a massive issue. there were none of those counts, there is going to be a crisis, and we're onlyjust starting that because they are a couple of months behind us. i know a lot of the agencies, the usual aid agencies, and of course, the department for international develop and hasa department for international develop and has a great reputation in many countries for giving aid and making sure it gets to the right places, but i think there to be a coordinated effort. we do face potentially incredibly high death rates if the epidemic behaves

in southern countries the way it has behaved in northern countries. it is possible there will be some seasonal issues, there, and the southern hemisphere might be relatively protected for a few months. but we don't know about that. but clearly, the aid issues, the support to the countries we usually support, the agencies that are doing work like the who and unicef and a number of the who and unicef and a number of the others, all of these are big issues and i hope that the uk can play its part, notjust issues and i hope that the uk can play its part, not just to obviously get it right for our country, but also to make sure that we are very generous to the southern... the other is, you are right to mention food security, and also the economic impact because the real risk is that they are going to see big unemployment rates, without social security, bankruptcies, and a huge new debt crisis because they will have loans in, you know, dollars and stuff that they won't

be able to repay. all of these things require notjust repay. all of these things require not just doctors and nurses, repay. all of these things require notjust doctors and nurses, this is for economists and a specialists. cani for economists and a specialists. can i follow up briefly and just get you to touch on why this is important for us? forgive me, we are responsible for the money and the welfare of the british people as memos of this parliament, and ijust wondered if you could touch on why it is so important that we do not allow ponds of disease, as it were, in other parts of the world, and the potential implications for that coming back to the uk and why this is so important for the uk. there is that but we also a trading nation. clearly, if we get the economy going... i mean, africa has been the fastest—growing region of the world in the last decade. if they collapse, that is going to be both a burden on aid for everyone, and there is going to be migration, there is going

to be migration, there is going to be slight, and the economy “— there is going to be slight, and the economy —— flight, and the economy that we deal with that particular you have we are looking for new markets, will be very important. the other thing from foreign policy point of view, we have seen that president trump has cut budgets to the who, which i think diminishes the who, which i think diminishes the status of america. china is actually delivering an awful lot of personal protective equipment and testing capacity to many countries in africa. i think the long—term impact of that may be that people will start to turn to the east rather than to the west. i would hope that we would preserve our strong reputation, really strong reputation, for aid. we have always ke pt reputation, for aid. we have always kept ouraid reputation, for aid. we have always kept our aid budgets up, under whichever colour of government, so i do hope that will be maintained. and to rememberthat, do hope that will be maintained. and to remember that, you know, with open borders, that you need for trade, you are going to have the risk of people bringing

imported infections in if we don't get control over the world. thank you very much,. i'd like to bring in luke very much,. i'd like to bring in lu ke eva ns. very much,. i'd like to bring in luke evans. thank you so much for all the front—line staff and you are right, your allied professions who are coming in and stepping up for vascular surgeons doing a bgs and things like that, i hear it from my clinical friends. i'm intrigued, from the faculty of... from the itu perspective, were you guys consulted about the nightingale hospitals and they set up? how much influence have you had in that process? the faculty of intensive care medicine has not had direct input in the development of the nightingale hospitals. but i do know that clinicians have been involved in looking at sites, looking at how they would run. there area number of looking at how they would run. there are a number of different clinical models being used. that really depends on the geography, the population density,

etc. for instance, in london, they were aware that their critical care capacity in london wouldn't be enough to deal with every critical care patient, so the nightingale at the excel centre would be used to manage critically ill patients. whereas some of the other nightingale hospitals, if within that geographical area, the critical care facilities, including the surgical capacity within the normal hospital footprint, the surgical capacity within the normal hospitalfootprint, could manage with the critically ill, then those nightingale centres would probably be used for either the left stick or —— less sick or those patients who are recovering, rather than staying in hospital could be moved out to the nightingale hospital, to free up capacity within the normal hospital footprint for those who were sicker. that is the kind of model that i think we'll need to be looked at as we

start to get back to normal. —— will need to be looked at. we know after being critically, it takes a long time to recover in respect of what takes you into the intensive care unit. it can ta ke into the intensive care unit. it can take 12—18 months to get back to the sort of place you were at before you became critically ill. that is an area, life after critical illness, which is actually a work stream that the faculty is currently engaged in, and is something that we will need to look at because if patients are staying in hospital when they don't necessarily need it, but they need that increased support and that rehabilitation, then that is going to hinder the speed with which we can get back to normal health care practice afterwards. thank you and ifi practice afterwards. thank you and if i could just follow up on that because you partly touched on where i was going with this, and so i am aware of the criteria for example, the amount of neuro adrenaline that patients should be on when they are transferred, i wondered on the first

point, do you think coronavirus patients are stable enough to be able to make a judgment call whether or not come if they are going to be effectively a step down from itu at the nightingale, is that something you think it's clinically possible? in terms of the rehab, the slow to wean patients, have you got any ability to predict that so that if they are in the nightingale and as you point out, take a long time to re cover you point out, take a long time to recover both from the intensive care unit and longer term, who should be picking that up? does the itu have the capacity to be able to deal with that? to deal with your first question about transferring patients, we transfer critically ill patients, we transfer critically ill patients all the time, based on their clinical need. so if a patient presents to hospital x, where those clinical services are not available, and a classic one would be neurosurgery, so if a patient has a subarachnoid haemorrhage, a brain haemorrhage, and they present to a smaller hospital, they will get transferred to a larger hospital

with a neurosurgical centre. we tra nsfer with a neurosurgical centre. we transfer patients all the time and we do it in transfer patients all the time and we do itina transfer patients all the time and we do it in a safe way. therefore, we do it in a safe way. therefore, we would not transfer a patient who we would not transfer a patient who we thought it was unsafe to do so. myself, my clinical colleagues in critical care are highly trained to be able to say which patients are suitable to transfer and what isn't. it won't be undertaken if it is not safe. they come to your second question, there are two issues about recovery from critical care. there is the issue when you are still in the acute phase, so when you are not too concerned as a clinician about whether the patient is going to survive or not, it is about when they will build up the strength to be able to get off a ventilator. that might be something that could be undertaken in a nightingale hospital, to take off the pressure at the acute, main hospitals.

and again, that is the sort of thing that critical care is used to doing all the time. but even when those patients are well enough to come off the ventilator, they then have a long journey in front of them in terms of not just long journey in front of them in terms of notjust getting home, but getting back to the quality—of—life they had before. so something simple like getting back to work is a major indicator of when somebody is starting to make a good recovery. it can take 12—18 months to get to that point. of course, if you can get back to working, you are then contributing to the economy. that is a major area that we in critical ca re aware a major area that we in critical care aware is not actually adequately resourced at the moment. the faculty is engaged with a group of experts to try to produce some guidance as to what would need to happen. obviously, if we can get patients out of hospital, adequately supported by the right

people, and we currently have follow—up clinics and we manage patients but we don't have the resource to do that and if we can get people back to work and back to contributing to the economy, in the longer term, then that will be really beneficial for everybody. thank you. i think we have got time for a couple of brief questions before we bring in the health secretary but paul bristow and then clive betts. thank you, jeremy, i wanted to follow up with the professor, some of the points that tom made in relation to the impact on the uk from infection in the developing world. i am thinking particularly india, pakistan, bangladesh. there are of course many british nationals living over there and you will nationals living over there, if they are likely to seek in suitable outbreaks there, they are understandably going to want to come back home. what could be the impact on the uk of that type of migration back to the uk and how and can we

manage this? yeah, i mean firstly, in the uk, this is not a single epidemic. this is... it moves into cities like it did in wuhan and then it went out to four cities in china, which they suppressed very quickly in about two weeks with partial lockdowns, the same in south korea. in this country, it has been london, wolverhampton and they be bits in liverpool and glasgow. but the rest of the country is largely, or was untouched until march the 12th, there were 50 local health authorities that had fewer than ten cases. i was against the idea that you should stop contact tracing in those communities. it was right to stop it in london because it was too difficult. and the recent estimates, even from the chief scientific officer, is that after this wave, which could kill, you know, we could see 40,000 deaths by the time it is over, we could only have maybe

10-15% of the over, we could only have maybe 10—15% of the population infected or covered and so the idea of herd immunity would mean another five or six waves, may become in order to get to 60% and i think we should not be using phrases like flatten the curve because that implies continuing. we have got to suppress this write—down. then you run the risk of both community transmission within the country and if you open the borders, to people coming in, not just from the the borders, to people coming in, notjust from the developing world but from europe, from anywhere, so you are going to have imported cases. in china, they have been watching it incredibly carefully. they have picked up mainly imported cases but now they are seeing some transmission, the same in singapore and hong kong and the like. that is the challenge. we are all playing for time, we need to damp it write—down, we need to have a community protective shield to try and keep it that way and then we have got to ray that the vaccine is created. and professor sarah gilbert

from oxford is saying, she is 80% confident she will have a vaccine by september. we have got to be positive, here, keep everything down, stop the deaths, keep the economy open as much as you can with that, without a national lockdown. and then hope that we get a vaccine. thank you. i think we've got a brief question from laura to the professor. we had professor doyle from public health england giving us evidence a couple of weeks ago and she told the committee intensive contact tracing was not effective when there is community transmission. do you agree with that, professor? no, i don't. i agree with it in areas of hot spots, intense transmission, obviously then it becomes much more difficult and your focus on london and other hotspot areas would shift to protecting health workers. but

you know, i am in yorkshire protecting health workers. but you know, lam in yorkshire right protecting health workers. but you know, i am in yorkshire right now, they have less than ten cases identified, confirmed cases in a population of three or 400,000. around the time we stopped all out community testing or contact tracing, i would community testing or contact tracing, iwould have had community testing or contact tracing, i would have had a community testing or contact tracing, iwould have had a more nuanced view, whereby quieter areas, you maintain that and now we have national lockdown and we are suppressing the epidemic, the aim must beat now to get all the logistics set up with digital apps, public health teams, maybe with volunteers and with primary care who fall been doing this, i think, to then have an absolute plan to protect the community as soon as we left the lockdown and then focus on the people we really want to lockdown which is contacts and cases, sorry cases and contacts, and this has been backed up by the nobel prize—winning economist who showed

very elegantly if you focus on that, it's much more disruptive to the economy. professor chris whitty has talked a lot about the indirect effects on mortality, he's absolutely right, from economic damage, bankruptcy, unemployment, we have to get the economy going and if it means locking down 10% of the population, even giving them incentives to stay in quarantine, and with digital apps to help monitor their symptoms and give them support, that's the way to really keep this going until we get a vaccine and save herd immunity. thank you. thank you. a brief one in this part of the hearing, from sarah, and that is fort dame donna. thank you. we heard changing guidance this week from the secretary of state around visitors, particularly around end—of—life care. do you think hospitals have the resources and the correct ppe in order to facilitate this and to do

it safely? well, we are currently worried, very worried about the shortage of ppe, particularly gowns, in hospitals, as we've heard on the bbc this morning. sol in hospitals, as we've heard on the bbc this morning. so i think if we can actually get more ppe into the country then we will be able to do that but as at this moment, i am very worried that we don't have enough ppe fought staff to protect let alone facilitate reading it to relatives, to be able to see their loved ones during end—of—life care. thank you. that concludes this first pa rt thank you. that concludes this first part of the session, i would like to see a very part of the session, i would like to see a very big thank you to dame donna, to doctor, to the professor for your informative answers to our questions. and i want to move on to the main part of the proceedings this morning. with the health secretary matt hancock. i would like to welcome you to this session. congratulate you on your own

recovery from coronavirus. you for your own huge efforts during this crisis but also ask you to pass on through yourself, are thanks first of all to your team at the department of health and social care who are working extremely hard. but also to nhs staff more broadly, who we all know are doing an absolutely superhuman job at the moment. thank you forjoining us this morning. you asked yesterday if you could have a few moments at the start of the sessionjust to few moments at the start of the session just to set out what you think the state of play is and your battle plan, so please do go ahead with that. thank you, jeremy and thank you very much for having me. and i think it's very important that we had the sessions and i'm delighted that parliament is operating in this virtual format. i thought it was just worth starting by setting out the way we approach the things that we need to do to

protect the health of the nation. and we think about this through our battle plan which has six elements and some of these we had them put more detail on already in the public domain. the first of course the social distancing. and everybody knows where we are up to that after the decision yesterday to extend the social distancing measures. that, of course, is mission—criticalfor bending the curve down and that is working. the second part of the battle plan is building up nhs capacity. because making sure that the nhs always has the capacity to treat patients is also mission—critical. and thus far, that has always been the case. as of this morning, we have the highest figure again of the spirit uk wide critical ca re

again of the spirit uk wide critical care beds of 2769, and of course the nhs nightingale project which has been an unbelievable roll—out is a critical part of making sure we a lwa ys critical part of making sure we always have nhs capacity and the ventilator project plays into that, there's a whole load of parts to that. the third element is supply which we have as a separate strand in our battle plan, because it is so challenging. if you think about it, what has happened is that suddenly, the world has needed a huge amount more of a quite small but very important list of kit. that includes ppe, the keep medicines, the ventilators. the medicines, the standard icy medicines. that are needed. and the potential treatments as they are coming down the

track. everyone is buying the anti—malaria drug, in case the clinical trials demonstrate it is a very effective treatment because that is what the early signs say. the ramp up of testing is very important, we track, test and case, it's important for staff in treating patients but for controlling the spread of the disease, you need the testing, the tracking and the large—scale contact tracing and it's the combination of these three that we have, that is the fourth part of the battle plan. and the fifth as vaccines and treatments. and clearly the more that we can have treatments

that mean the morbidity and mortality from catching coronavirus are mortality from catching coronavirus a re less mortality from catching coronavirus are less severe, that obviously changes the impact of the disease in society. so the more we can do on treatments, the less dangerous the disease is and obviously on vaccines, we have and the uk is playing an absolutely world leading role but there is still some time to go. and the reason there is some time to go is the mortality and morbidity is relatively low from this disease. terrible as the death toll is, the relative proportion of people who sadly die is relatively low and you have to test the vaccines because of the risks of putting the vaccine into the general population which itself does damage.

the sixth part of the battle plan is shielding. because the more we can protect those who are most vulnerable, the safer society is from the disease. so they are the six parts of the battle plan and you can see, i hope, that all the different things that we have put into those six parts, overall, the goal is clearly to bend the curve down. and to make sure the nhs capacity is there. and at the same time, to do the work to try to improve the ability of us as a society to cope with this disease and therefore, with the goal that we can lift some of the incredibly restrictive measures that we had to place on the population

in order to get the disease under control. which, i would just end my opening, by thanking the nhs staff and social ca re by thanking the nhs staff and social care staff who are doing amazing work and i'm very grateful for you for opening that and to thank the public also because it's only because of the public, the vast majority, following the rules that we are now seeing majority, following the rules that we are now seeing the flattening of the curve. thank you very much indeed for that. i want to start with the reporting of data. because that's something where i think people had been puzzled and could you just explain why it is that we are only reporting hospital deaths ona are only reporting hospital deaths on a daily basis? the overall goal here is to be as transparent as possible. and the quality of the data is the critical part to the a nswer to data is the critical part to the answer to this question. we have

daily reports of deaths from covid 19, or people with covid19, whether it's deemed by the clinicians as the direct cause or somebody dying with covid 19. we direct cause or somebody dying with covid19. we have that in daily reports that come in through the four nhs, in the four nations and coming toa four nhs, in the four nations and coming to a central point. and i then published. the data of deaths of people who had covid 19 and die outside of hospitals takes longer to collect and that's because it is recorded on death certificates and death certificates are often written a couple of days after a death, they are not always written at the same time as the death and then they are registered and go into the registry and then the data can't be published so the reason that the ons publishes with a lag, the overall number of

deaths, as opposed to deaths in hospital, it is a data collection issue, every death in any setting matters. and is an important part of our analysis. of course it is. and we have managed to work with the ons to bring forward the publication of overall deaths of people with covid 19 to overall deaths of people with covid 19to| overall deaths of people with covid 19 to i think, the lag is now five days, whereas when it started it was two weeks. the ons has done good work to bring that date or more up to speed. but naturally, because everybody is looking at this data, not only to understand what has happened but also to try to understand where we are with the transmission of the disease. i understand why people want that up—to—date stopped rather than holding the hospital stayed it back until we have the whole data, we think it's better to publish the hospital tied up when we have it and

then publish the overall data when we had that. 0k. we've got a lot of questions to get through so if i could ask you to be fairly brief on the answers. you talked about the ons. they say there have been 217 covid 19 deaths in care homes to date. scotland thinks it's a quarter of all its covid 19 deaths come in ca re of all its covid 19 deaths come in care homes, france and spain think it's about half their covid 19 deaths in care homes. does it seem likely to you that less than 2% of our covid 19 deaths are in care homes? no. and the figure that you mention is a figure from a couple of weeks back. and so, i'm absolutely sure that both the number and the proportion are, i can say with a high degree of confidence, the numberand high degree of confidence, the number and proportion are higher than what you say. and i will wait for the official statistics

to understand. ijust wonder for the official statistics to understand. i just wonder why we cannot do what france does, collect that information on a daily basis and publish it on a daily basis so we all know exactly what the situation is? my understanding is that isn't what the french do, i know there's been a lot of attention on the way france publishes this data but they do publish it a couple of times a week. but and as i say, we work with the ons to try and reduce this lag. and we are also now, because i'm concerned about this as well, we and i have asked the care quality commission to make sure we record the data in care homes specifically of those who are residents of care homes, whether they die in hospital or in the care home, they started collecting that data yesterday. and it will be published very shortly. so i have introduced a new measure that will

directly address this question. i want to bring into their own but i wa nt to i want to bring into their own but i want to ask you finally about some thing very sensitive, that 27 nhs staff have sadly lost their lives in the process of this terrible crisis. do you have an update on that number? is it still 27, to your knowledge? the official, verified figure remains 27. it gets updated three times a week. i 00:46:33,1000 --> 00:46:35,448 will let you know as soon i get an update. sadly, i have seen, and we have all seen reports of mary, the nurse who was pregnant and reports of mary, the nurse who was pregnantand in reports of mary, the nurse who was pregnant and in the late stages of pregnancy, an nhs nurse, who died since the publication of the previous figures, so we know that the figure is higher. and will you

commit to publishing that number three times a week when you have it? yes, i would quite like to get it to daily. thank you much. sarah owen. thank you, and thank you, secretary of state, at the last meeting of the health select committee, i asked three times about guidance for pregnant health care workers stop as you have just said, we have now tragically seen the death of a 28—year—old pregnant nhs worker at luton and dunstable health trust, my constituency, the guidance on health ca re constituency, the guidance on health care workers from this pandemic comes not from the nhs but from the royal college of midwives and the royal college of midwives and the royal college of obstetricians and gynaecologists, and if i make it states, "it may not be possible to completely avoid caring for all patients with covid—19. as for oil health care workers, use of personal protective equipment and risk assessments according to current guidance will provide pregnant workers with protection from infection. the arrival of rapid covid—19 testing will significantly assist in organising

care provision." the assist in organising care provision. " the guidance assist in organising care provision." the guidance will be updated appropriately when tests are commonly available, it says. despite continual promises to ramp up the distribution of ppe and testing, workers on the front line has been left wanting. will you commit to ensuring that there is a review of the guidance for pregnant health ca re the guidance for pregnant health care workers in light of the in pp distribution and testing being a long way off being commonly available? long way off being commonly available ? will you long way off being commonly available? will you commit to think that revised guidance coming straight from the nhs and government? well, there are several things to answer in that question, sarah. the first thing is to say is that we worked very closely with the royal colleges and whether the guidance comes from them, public health england, all the nhs but we try to ensure that the guidance comes from the most appropriate body for that particular group and we worked very closely together. where the guidance comes from the royal colleges or the nhs is much less important than what it says and what

the situation is on the ground. with respect to your constituent, mary, her death was incredibly moving, i think for so many people, not only in the nhs but across the country. as was made public at the time that her death was announced, she had not beenin her death was announced, she had not been in work for a month. but... we look into every single death of somebody who works in the nhs to make sure that we fully understand it. so making sure we get to the bottom of each and every one of these cases is incredibly important. and that also includes, you know, access to protective equipment, of course, and testing. finally, on testing, we have now made testing available to everybody who needs it

across the nhs. so all staff who are symptomatic now are able to get a test. i can tell you that over 50,000 people who work in the nhs have now had tests. the good news is, that we are able to expand, because we are expanding capacity to test, therefore, we are able to expand the number of tests that are done, not only on for instance patients going into care homes, as i announced earlier this week, but also on... for nhs staff, and members of their households, if a members of their households, if a member of nhs staff is isolating because of self isolation. thank you and we will come back to testing and pp later but yvette cooper had a question on this point. thank you very much, health secretary, a quick factual question, do you have an estimate for the number or the proportion of nhs staff

or social ca re staff proportion of nhs staff or social care staff who has been infected with covid—19? care staff who has been infected with covid-19? no, i don't. whatl haveis with covid-19? no, i don't. whatl have is an estimate of the proportion who are off work because they either have suspected covid—19 ora they either have suspected covid—19 or a household member does. that is a little over 8%. obviously, with the expansion of testing, we hope to be able to get that figure down. thank you, tom tugendhat and then tyler. thank you, matt, please pass on as well our thanks to everybody in the nhs who is doing an amazing job, notjust for in the nhs who is doing an amazing job, not just for british citizens here but of course, many others from around the world who are in the uk. and on that basis, could i ask what agreements have you been able to come to on reciprocal arrangements for british citizens abroad and other citizens here so that british citizens overseas can also access

ca re citizens overseas can also access care wherever they happen to be? well, it is a very important question, tom. one that we went through in the debate around brexit and we have also reciprocal health ca re and we have also reciprocal health care arrangements with a small number of other countries in the world like australia. i would like to expand that. we had to drop the legal changes to do that during the brexit parliamentary process. but it is something that i would like to see us expand, those formal reciprocal arrangements around the world. now of course, first and foremost, one of the principles of the management of epidemics is that people should be treated by the health system in which they find themselves ill so you will remember themselves ill so you will remember the very first covid—19 patient here in the uk was a chinese citizen who

had come to visit. we treated him and one of his parents in newcastle. so that is the overriding visible. however, we are also highly pragmatic and we have run a huge effort that no doubt he will be aware of, that dominic raab has led, in order to ensure people can come back to the uk because of the colla pse back to the uk because of the collapse of the international travel system as it was before the crisis hit. that repatriations has been for people who are ill and people who are not ill. it has been particularly challenging and acute for people on cruise ships because they do not have a nation of residency. but the time taken to get a cruise ship back that is on the high seas would have been in many

cases too long, given that there was an outbreak on board. so there has been a huge operational side to this, that you are better asking dominic raab about than me. but also, there is that overriding principle that we treat the people who are here. thank you. did you have a quick question? we will of course asked dominic raab about the patch cavities come as you rightly say, the second thing i wanted was very briefly on the international aspect is, clearly, in a pandemic, learning from others is absolutely essential. how are you finding transparency and openness from other countries is affecting our ability to respond and keep our people safe, and what conversations have you had with countries that are successful, like for example taiwan? well, we have conversations with colleagues right around the world all the time. especially the regular g7 discussions, there's a g20, set

of g20 discussions coming up this weekend. and with countries outside of those sorts of formal settings. especially early in the crisis, there were issues around quality of data but i think everybody is doing their level best to get the best data that they can. right from the opening of the question —— the opening of the question —— the opening question of this committee, there are challenges in getting the right data and getting the data out. my right data and getting the data out. my task is to use the very best data and try to understand the countries where certain things are going well, and also try to understand countries where things are not going so well and to learn, you know, what has gone wrong as well as what has gone right. so we do talk to countries right. so we do talk to countries right around the world and we are co nsta ntly right around the world and we are constantly trying to learn. thank

you, i want to make sure we have plenty of time to ask about testing and pp so a final three brief questions on this section on data from tay wo, and thenjames murray and then rosie. do we have t20 custom machenaud. hello, good morning, secretary of state, and thank you for coming out. this is regarding pp. just yesterday, a nurse at my local hospital spoke about her experience on the front line. she described the low morale among staff due to lack of support and she comes home every night crying after her 12 hour shift. she said, andl crying after her 12 hour shift. she said, and i quote, that she is scared and terrified given the lack of ppe. due to the nursing shortage, those on the front line are scared and afraid about the virus. what i wa nt and afraid about the virus. what i want to know is what support are you giving to ensure that nurses and other professionals feel safe

and that you are addressing the lack of morale amongst these teams? well, this is an incredibly important question and can ijust ask this is an incredibly important question and can i just ask which this is an incredibly important question and can ijust ask which is your local trust? university hospital coventry and warwickshire. this is incredibly important because the morale of those who are on the front is so important. people talk about... you know, some of the things that the public do to show their value, and i know from talking to people in the nhs, and in social care, that they really matter, things like the badge has gone down really well among people in social ca re really well among people in social care andi really well among people in social care and i am really proud of it. but these things are only a part of the story because making sure that people have the support that they need exactly as you say, when they are in work is so important. this is why. .. we will are in work is so important. this is why... we will come onto pp detail no doubt but this is

why pp is absolutely critical —— ppe in detail no doubt but this is why ppe is absolutely critical and also testing for nhs staff when they need it is essential and i'm pleased we've been able to do it because we have been able to do it because we have been able to do it because we have been able to ramp up the amount of testing so fast. and the final thing i would say is that, you know, we pay tribute regularly to the staff in the nhs. the fact that we have the staff and the physical capacity, for instance through the nightingale hospitals and with the ventilators to be able to treat everyone who needsit to be able to treat everyone who needs it i think is a really big positive thing that we have been able to achieve during this crisis. it means that nhs staff are not having to make decisions about who gets the treatment. of course, we have got to resolve the issues around ppe and continue to expand testing but making sure that we have that capacity, not only the physical

capacity but also the staff, is a very good thing. we have had staff returning to the nhs, almost 10,000 nurses, and i will try to get an overall figure and that has been something that i think people have seen people really value, the things people have done there as well. taiwo if it is pp, can we come back to it later? i was actually talking about morale. go on, then. i have spoken to lots of pharmacies over the past weeks and a lot of them have expressed their concerns about the fact that a lot of frustrated customers have been attacking them and some pharmacies have resorted to hiring security staff. what i want to know is what is the covenant going to do to ensure that these front line workers feel safe and they are not subject to abuse while they are not subject to abuse while they are not subject to abuse while they are doing theirjobs? yes,

well, i really am glad you have picked up pharmacists because you know, they are a critical part of the nhs family and because they work in the community, they are often closer to the communities they serve and they are part of the nhs. we have put extra funding into pharmacy, an extra £300 million, because of the challenges that they face and in particular, high demand for medicines, to help them with their cash flow. we are also working with them on ppe and not only having the equipment but also making semipermanent changes, for instance, putting glass screens up so that there is a lower amount of transmission, a lower risk within pharmacies, and supporting them to do that. and so, pharmacies are absolutely critical part of our nhs team.

we arejust going we are just going to have two final brief funds on data... my question is to understand how we are using data to make sure the strategy is right in different regions? in my case, in london. on the 2nd of march she wrote in the evening standard, secretary of state, your actions will always be guided by the expert scientific advice and on the 17th of march the government chief scientific officer told this committee that london is ahead of the rest of the country where it is on the outbreak at the moment. putting to one side a question of whether the government was too late in waiting till march the 23rd to introduce lockdown measures nationwide, why did you not at the very least apply them sooner in london? it is an important question. i think we took the right measures at the right time. we did consider having a london specific lockdown and decided that it was better to do it across the country

as a whole. that is for two reasons, the first is, if you put a lockdown in one pa rt is, if you put a lockdown in one part of the country then there is still travel from their to the rest of the country. so it isn't as easy as that. the second reason is that actually one of the really strong things that has come through this crisis is that the country is acting in lockstep and if you look at the response to the social distancing measures, they have been very similar across the whole uk and, really, the country has come together. two separate of one part of the country from the rest actually has downsides in terms of the national unity we have seen in the national unity we have seen in the support for the overall response. these are incredibly

difficult measures and the national unity that has been shown in response has been extraordinary. these are difficultjudgments. as you say, based on the science. we did consider a separate london policy but decided it was better of the whole nation should together. final question on this. from rosie cooper. thank you. can you hear me? yes. thank you, secretary of state. acknowledging that everybody is working tremendously hard on the health service top to bottom and i accept all the statements that have been made to be made in good faith, but i would like to address the elephant in the room, and that is the question of trust and confidence, both of the public and clinicians and people working in the health service.

ignoring the world health organization's test, test, test, without giving any real public health reasoning, so for a lot of people feel they have had statement after statement after statement... within days and weeks the statements fall apart, that some ppe, on testing, testing not be needed in ca re testing, testing not be needed in care homes and things like that. the testing centres that have been set up testing centres that have been set up in out—of—town areas, it could only have come from the centre, someone who has no idea locally how people are supposed to travel miles and miles and miles to get tested. they might as well be on the moon, frankly. so we've got a whole list of statements which are aspirational, we can regard as aspirational, we can regard as aspirational, rather than factual. so hope isn't a strategy. out there, what is your message to the people who go out to the front

line expecting their ppeexpecting the rules to be applied to everybody and for them to make sense and for them to be supported ? for them to make sense and for them to be supported? what assurance, not reassurance, can you give to people that the basis of the decisions you're making and taking our real? for example, we could... ramp up testing and hospital labs, we don't do that and, yes, we are still talking about 100,000 test. overall, how can you go and tell people to risk their lives without giving them the evidence that? there's quite a lot to unpack there. i'm not i agree with your assessment at all. the first thing is, we have had a principle throughout this whole crisis of transparency being at the heart of what we do,

and we've publish an enormous amount of data and information. it is true that if you want to make something happen, you want to make something happen, you have to say what you plan to happen and then follow through. the 100,000 test per day by the end of the month is a clear goal and commitment and i set it out in public to galvanise the life sciences industry and that is exactly what has happened in response to it. i can go through a couple of the other things that you put in there. the morale on the front line is absolutely vital. i've now got the figure. the current cupboard related absences are 7.1% —— covid—19 related as absences. which is lower than the previously reported figure of 8%. that shows it is coming down, partly because we have expanding testing to nhs staff. —— expanded testing. we now have

22, we re —— expanded testing. we now have 22, were going to have 50 right across the country, precisely to get the testing capabilities out into the community and then once we have got those established, we are going to have mobile units and then when the technology is good enough, we will have home testing kits as well. i say that not to set out hope, i say that because i'm setting out our plan for what we are going to deliver. as for the overall public confidence, i am deliver. as for the overall public confidence, iam really deliver. as for the overall public confidence, i am really pleased that the public have followed the advice that we've given and very, very high proportion, and that this had the consequence of overall doing the most important thing in this crisis, which is to flatten the curve, so that we can see that over the last ten days or so, the number of new cases and the number of new cases arriving in hospital are

both flat, which is very good. secretary of state, i would just ask you to think about the actual implementation locally. doing all the centrally and not doing it don't make these out—of—town testing centres, really difficult. you're not getting the three point you should have. —— the three point you should have. —— the three point. will come onto that testing, but there is spare capacity there that we need to use, yes. there was a good bridge into our next topic, which is testing. the first thing i would say is, you announce, secretary of state, very ambitious target of 100,000 times a day on april two. that has been widely welcomed. could we just start with an update, not on capacity, but on how many times were actually conducted under each of the pillars of that programme yesterday so we can have some sense as to how we are doing? yes, i can

give you that data. i'lljust get hold of them. the overall number which is over 18,000 yesterday, saw a rise of 4000. the vast majority of that was impeller one, the number impeller two was around 4000. we haven't got any ties good enough to work in impeller three yet, and the number in impellerfor... samak will be possible, because it is so central to what the government is doing, to publish these on a daily basis? we do publish number. you mean broken down by each pillar smack by all means. the countries

that have the lowest death rates, one thing that puzzles people is why we stopped community testing on the 12th of march. you could, for example, have announced the 100,000 daily test target on the 12th of march, and if we had done that, we would be ahead in the global race for the re—age of chemicals, testing everyone who leaves hospital now, more people in ca re leaves hospital now, more people in care homes. so why the three—week gap between stopping community testing and the announcement of the 100,000 target? i don't think if we had announced the 100,000 target a couple of weeks earlier, as you suggest, we would be in any different position now, because we we re different position now, because we were continuing the drive to increase testing all along. the challenge is, the increase, the radical increase in the amount of testing over the last two months, from 2000 tests a day at the

start of march, to 2000 ——10,000 at the end. and now the ambitious goal of 100,000 by the end of this month. that ramp up has been ongoing throughout. i set a public target, in part because people were asking how fast we are going to get there, and because it also managed to galvanise the non—diagnostics pharmaceutical industry here. the diagnostics part of the pharmaceutical industry, which is brilliant but relatively small here, had been heavily engaged throughout. the overall project to ramp up testing has been going since day one. the challenge is, as the epidemic increased exponentially at that point in the middle of march, it meant that the incidents of

the outbreak was broad and it meant that we weren't able to test everybody with symptoms, but i want to get back to the position, now that we have got the curve under control, i wa nt have got the curve under control, i want bill to get back to the position that we can test everybody we re position that we can test everybody were symptoms, and i anticipate being able to do that relatively soon, because we are increasing capacity, as i say. i can now give you the full figures for yesterday, at midday yesterday we had done 18,665 times in the previous 24 hours, 16,166 from pillar one, 300 in pillarto, and hundreds hours, 16,166 from pillar one, 300 in pillar to, and hundreds of the six from pillarfour. the history of the testing is going to be a long debated subject. what really matters is what we're going to do from on n. what i can tell you is that today we are able to expand the

eligibility for testing, which is currently part patients, for surveys amber nhs and social care staff, and some that go to lrf spa people, people for local urgent need. i today can expand eligibility to police, fire service, prison staff, local authority, critical local authority, the judiciary and dwp staff who need it and we are able to do that because of the scale up of testing.“ and we are able to do that because of the scale up of testing. if we just look at a country like germany, they have a population 25% bigger than us. but on the of deaths. they never than us. but on the of deaths. they never stop testing in the community,

they. clear this up, is that your deputy chief medical officer said that community testing was not an appropriate intervention. another said that the ship had sailed the community testing for is the view that mass community testing is part of the strategy or do you think the ship has sailed? it is part of the strategy. we will be introducing it when we can. it wasn't possible when we had smaller numbers of tests but as we have expanding numbers of tests it will be possible. the way it will be delivered is under both colette two, as we expand the commercial swap testing capabilities -- pillar commercial swap testing capabilities —— pillar two and when we get a mass antibody test which has a high enough specificity for us to be co mforta ble enough specificity for us to be comfortable putting it into

the community. ok, so, as you said, it is not just community. ok, so, as you said, it is notjust the testing, it is the tracking and tracing and quarantining. one doctor told the science and technology committee last week that they were up to 1000 people doing contact tracing in korea, alongside all the digital apps. phe had 290 people doing this at the peak but they now say that has been wound down. are we going to be building up those teams again? yes. winter will that involve local government or central government? we plan to do it through central government. it will be part of the track and trace strategy which is one of the pillars of the overall battle plan. that brings together teams from nhs ex who are leading on the design of

the app with a huge array of partners under the are working within that. public health england who are the experts in what we refer to as external contact tracing, this is where you get somebody else coming in and helping to work out the contacts that you need to get into contact with and then goes and helps you contact them. there is also, when this, the app is itself a contact tracing app. that is the point of it. it is to be able to assist individuals to do contact tracing themselves by notifying people who they have been in close contact with when they have downloaded the app. and then of course, link that to testing so people could get the tests. the test, track and trace is one piece of work. with those three track critical strap strands then you have

to have a wanting policy to back it up. cathy hall is in charge of testing, has she got someone working directly for her who is full time on the contact tracing side of this? the way that is organised inside the department is david williams is responsible for test, track and trace overall. matthew gold runs the app, cathy hall runs the testing part, and someone else runs the contact racing point. finally from you, yesterday, dam and nick rab announced the five tests that would need to be —— dominic raab, the tests that would need to be passed before we exit lockdown. the who has six criteria countries are advised to follow and the second of those sects is that there must be capacities in place to detect,

isolate, test and treat every case and trace every contact. so if we're going to be able to end the lockdown in three weeks if that is a theoretical possibility for the cabinet to consider, do you accept that we will need to get comprehensive contact tracing in place by then if we're going to be following who guidelines? we do need to comprehensive test, track and trace in place, as soon as possible. and we need to get the technology right. we need to have the people and we building that resource and obviously we need to have the testing and we're ramping that up as well. so we do need to have all three of those in place and we're working incredibly hard to make sure that they are. but you accept we could not left the lockdown if we we re could not left the lockdown if we were going to comply with the who advice until we have got that contact tracing, mass contact tracing in the community, in place? the answer is that

it it depends on scale. the scale of contact tracing that you need depends on the incidence of transmission. not on the r, which we have fed a lot about. which is the rate of transmission determines how fast the incidence goes up or down. so what matters for the skill of contract tracing that you need is essentially a number of people who are catching the disease. it is the incidence of transmission. if you start with a high incidence of transmission then you need a massive contact tracing capability. whether that is the contact tracing or external contact tracing and then as you bring the incidents down which we plan to do once we have seen the flattening of the curve, we now need to

drive that curve down, then of course the amount of contact tracing that you need reduces over time. thank you. i would like to bring in greg clark, followed by clive betts. thank you. secretary of state, my committee, the science and technology select committee has heard international evidence that a very high proportion of people with covid—19, over 50%, are asymptomatic themselves. but can infect others. have you received expert representations that asymptomatic nhs and care workers should be routinely and regularly tested? this is something that we are looking at. the asymptomatic transmission of covid—19 is one of the novel features of it. it is not typical amongst coronaviruss and is

one of the single most difficult things that has caused this pandemic to be so severe across the world. and the answer to 01:21:10,1000 --> 01:21:12,574 your question very precisely is yes that is something we are looking at and i am talking to hospital chief executives about. wendy you think you might feel to make a response with actions on that? -- make a response with actions on that? —— when do you think. make a response with actions on that? -- when do you think. in the coming weeks. this plays, it is all determined by capacity within testing and the gap between the testing and the gap between the testing we are doing at the moment, i read out the figure and the current capacity as of today which is 30,000 across pillars one and two. that means we have capacity for 10,000 more tests a day than we did yesterday which i find, given the pressures on

testing, is frustrating. we want nhs staff to come forward and i have also expanded testing to social care staff and two more residents in social care and now today to other public services, like police, fire and present staff and others. and one of the further things that we are considering but have not yet unable to take forward is the mass testing of asymptomatic staff within the nhs. thank you. it is obvious that if we're going to test asymptomatic people within our care settings, as well as expanding to ca re settings, as well as expanding to care workers and others, we're going to need much more testing. you talked about ramping up testing capability. but it is important that we should learn the lessons as we go. that is the basis by which science proceeds. the approach that

was taken from the beginning by public health england was a centralised and ac quench approach. first of all, we started with the central lab and then the other 12 i think public health england labs then expanded it to the nhs. it was done sequentially. other countries, we know, including south korea, did everything at once. we had a decentralised approach. and they did everything from the outset and that meant that rather than having to mmp meant that rather than having to ramp up capacity, more was available. a decision was made to reject that model. sharon peacock in evidence to my committee said that had been considered and rejected. the first thing is will the evidence that has informed the choice to reject that model be published? nearly four weeks ago when sharon peacock committed that she would do

it, in accordance that we should be able to see it. and learning the lessons going forward is important to do this when it comes to the wider deployment of antigenic tests and subsequently of antibody tests and subsequently of antibody tests and we hope vaccines, will this approach of being centralised and sequential be revised in the light of the evidence? ramping up on all of the evidence? ramping up on all of the evidence? ramping up on all of the pillars and as you know some of the pillars and as you know some of the pillars and as you know some of the delivery of the in—house capability, like especially pillar one, nhs and public health england la bs one, nhs and public health england labs and other labs that can contribute. and then pillar two and three and very much commercial based in parallel. bringing the commercial capabilities we can get our hands on to bear. and that is happening absolutely in parallel. i did not know about the

commitment to publish any dents behind the original decision but i will certainly look into it. —— any evidence. decision but i will certainly look into it. -- any evidence. clive betts. thank you, jeremy. secretary of state, we would like to give our thanks to the nhs staff doing a wonderfuljob but i am sure you want tojoin nbn wonderfuljob but i am sure you want to join nbn also wonderfuljob but i am sure you want tojoin nbn also thanking everyone in local government, whether those in such local care, volunteer organisers or those in environmental and public health, contributing enormously to the battle against this virus. it is that issue about environmental and public health capacity i want to ask. you rightly highlighted the need for testing and then contact tracing and tracking. local government, public health and environmental health, will play a very important part in that. but we know in the last ten years that

austerity has meant massive cuts to those services in terms of the numberof those services in terms of the number of resources they have. are you confident talking to your colleague secretary of state for housing, there is now the capacity and the ability to really ramp up and the ability to really ramp up and deal with that programme in a way that we need. i think it is incredibly important that we do and i agree with you about the thanks we should give to everybody working in local government, especially the public health departments and across—the—board. and public health departments and across—the—boa rd. and of public health departments and across—the—board. and of course in care, and social care, one of the things i am really proud of in this crisis is that the country recognised the commitment and thank those working in social care, just as much as the nhs. i have said before it is clap for carers, not cla p before it is clap for carers, not clap for the nhs. both are wonderful and making an amazing contribution ina very

and making an amazing contribution in a very difficult circumstances and that is true also for wider local government and i am glad today we have been able to local government staff who need it. on the financial point, i also agree with you that we need to make sure that obviously the public health capabilities as well as a social ca re capabilities as well as a social care responsibilities of local government are properly funded and we put in a total of 2.9 billion extra since the budget. in order to support and the chancellor has said he will do whatever it takes. does that therefore mean that if we're going to move significantly to the contact tracing tracker which he mentioned that local authorities will have a major role to play in that? it is notjust want to be about apps but there will be physical hands—on work. local councils will be fully compensated for that? to the extent

to which local authorities are needed to do that then of course they will be compensated for it. you said the extent to which they are, surely public and environmental health office rs public and environmental health officers will be absolutely key to getting that done and it will be done at a local level to get it right? know we have not made that decision. not least because the interaction —— no, we have not. the interaction —— no, we have not. the interaction with the app contact tracing is critical and whether it is done locally or whether it is done through phone banks at a national level, that decision is not yet made. but if it is done, through local authorities, then of course there would be payment to do the job. do you accept that an important pa rt of job. do you accept that an important part of this in the way forward for for many people was perhaps as vulnerable, the elderly for example,

not always really comfortable using new technology. for them, they are actually physical contact tracing, done at a local level may be in the end the only way you will get a comprehensive approach to it? there is absolutely a role of people in contact tracing, it is very important. these things are complementary. but what i can't prejudge and i'm sure you will understand this, is a decision about exactly how organise that. when will be no that? is there a date for that? we don't have a date but we will publish more details on this soon. the point i would make is that soon. the point i would make is that so much of this is done over the phone. going round to somebody‘s houseis phone. going round to somebody‘s house is not always necessary. it may be necessary and i can see a point about having a local angle

to it, but given the scale of contact tracing, that is likely to be needed, doing this nationally, over the phone, has a lot of advantages. i would like to bring in laura trott. i would like to bring in i want to ask a question about managing the supply and demand of testing. you mentioned earlier that we have capacity for 30,000 tests. we are carrying out 18,000 has. i know my local ccg has said to me they have got a capacity for huge amounts more tests than being carried out. i know from today, from the expansion that is very welcome to fire fighters etc, that will take up to fire fighters etc, that will take up some of that excess capacity but what is being done essentially to make sure we are using resources where they are

needed and you want to match demand to supply, i don't want massive queues and inability, but i do want the drive—through centres to be fully used, of course i do, everybody wa nts used, of course i do, everybody wants that. this is a problem that has come up over the last week as capacity is increased and at first it looked like a problem due to the easter weekend because the number of people wanted to come forward for testing over the weekend was lower than expected, but we have also found that within the nhs the number of staff coming forward for testing was lower than anticipated and you will understand why we had a priority orderfor the will understand why we had a priority order for the use of the tests where it was patients first, then nhs staff.

use of the test where it was patients first, then nhs staff. frankly, the number of nhs staff coming forward wasn't as high as expected. therefore, we extended it very quickly to social care and both to residents and staff and social care, but because capacity is going up care, but because capacity is going up sharply, i am therefore able to expand it further and we will expand it again as soon as the capacity is there to use it to make sure that capacity is used up. so, we have a priority order and we are running through it and it includes the suggestion that was made, i think it was from you, jeremy, that we should also test asymptomatic people in hospitals and in care homes as part of the survey strand which goes alongside all of this so that we can see and find

people who are asymptomatic but carriers of the disease and may also transmit it and also so that we can understand the prevalence of the disease, especially in hospitals and care homes. thank you. two quick follow—ups. if there is excess demand in one area and excess capacity in another, is there someone who is matching that up and helping the nhs? yes. brilliant, secondly, in terms of nhs staff accessing test, is there a way to increase communication as to how they do that? we had some evidence earlier that in many places it is slightly unclear, obviously it is very welcome that numbers are going up very welcome that numbers are going up overall. from a policy level, it is very clear, but i understand that this is policy that changes relatively rapidly and so cascading that to the front line is a challenge. in policy terms, if you are in the nhs, go to your line manager. if you are

in social care, again you go to your line manager and the social care organisation should go through the cqc. they are playing a very important role in this. it is really clear of how to get hold of the tests and that is written on the website. the question is, and there is an operational question of cascading that information to those who are symptomatic right through the system. yvette cooper. thank you, germany, new zealand, australia, iceland, singapore, all ask people who are arriving in the country to self—isolate or quarantine for 14 days. in the uk, we don't have any of that and on the 13th of march, around the same time that we stopped the community testing and tracing, we also got rid of the guidance

which is said that people arriving from high prevalence countries like wuhan and italy at that time should a self—isolate for 14 days. why did we have any guidance like that on self isolation for people coming into the country while we are taking a precautionary approach? we have the same guidance for people to self—isolate when they arrive as if you have symptoms here and we have facilities to ensure that people who arrive and are symptomatic can self—isolate, even if they don't have anywhere to go to. the nhs has a contract with hotels to put people in those hotels if they arrive and displayed symptoms. so, we do have that capability and it is true

that when the current incidence of the disease in the uk is high, and given that there has been a collapse in the number of people travelling internationally, it is not, i am advised by the epidemiologist, it is not epidemiologically significant route of transmission in the uk because the current incidence is high. of course, if we succeed in getting the incidence of transmission lower, and much lower, which i hope that we will, then you have to ask the question of how to protect the uk from people who have beenin protect the uk from people who have been ina protect the uk from people who have been in a place where that incidence of transmission is much higher.m is very difficult to understand the nature behind this decision because,

reported that 130 countries have some kind of requirement or restriction at the border of isolation or testing or other forms of restrictions and we don't. so it is hard to see why our advice, the advice to us, the science you are talking about, is somehow different to the science that every other government is looking out across the world, especially given that you haven't published any of this analysis and science. i understand that obviously, if staff on the aeroplanes caught someone who was coughing heavily then there may be measures but it is hard to understand what you do have some kind of precautionary approach to self isolation or quarantine because you did have, at the time before, when you had community testing and tracing in place, and even if these are a small proportion of

the overall numbers of transmission taking place at the moment, a small proportion of a very large number is still an awful lot of people. so will you at least publish the analysis behind this decision and will you look at it again in the light of what other countries are doing? yes, i disagree that we are not doing anything. i set out what we are doing and it is similar to many other countries who are following the science. but of course, i can absolutely commit to keeping this under review because you have understood precisely the reasoning behind the current policy but that policy is dependent on the current situation and many things change fast in this epidemic. current situation and many things change fast in this epidemicm current situation and many things change fast in this epidemic. if you are actually trying to minimise the numberof

are actually trying to minimise the number of transmissions completely, you would still be trying to minimise the numberof you would still be trying to minimise the number of transmission is coming from abroad, even if there are a higher number of transmissions happening elsewhere. what this looks as though you are doing is that you are not actually trying to stop any transmissions that you can and you're just looking at broadbrush policies. why would you not to try and prevent every possible transmission, including the people arriving from abroad who may be very easily able to self—isolate, you're not actually asking them to do anything very hard? that what we are doing, in the way you characterise it and we followed the science on this, as we do on the decisions that we take. you publish the science? when you publish it on this?” we take. you publish the science? when you publish it on this? i am very happy to ask the chief medical officer to publish the explanation behind the decision that we are taking, absolutely. and the analysis behind it as well? yes. thank

you very much. i now want to move on to theissue very much. i now want to move on to the issue of protective equipment for health and care staff. if i could, ijust for health and care staff. if i could, i just want to ask you about an issue that has been in the media this morning. are you confident, health secretary, that all our hospitals will have enough gowns to see them through the weekend? well, the challenge of getting protective equipment out to everybody who needs it is an incredibly difficult one. firstly, it is a challenge of logistics because suddenly, over a short period of time, we have gone from needing a small amount of protective equipment to leading a very large amount. —— needing a very large amount. to answer the question directly, as of this weekend, we will have shipped 1 billion items of personal protective equipment across the uk, so, i've had this a

herculean effort before, it is a massive undertaking and it is understandable, in a massive undertaking like that, that there are complications and that there are challenges and i take responsibility for getting ppe out to everyone. this isn't a responsibility, of course there are many players in it, and a hospital chief executive has to make sure the people you get from write a rise in the hospital to the right part of the hospital we take responsibility for the delivery. —— from when they arrive in the hospital. we have another 55,000 gowns arriving today and we are working on the acquisition internationally of more gowns but it isa internationally of more gowns but it is a challenge. this follows changing the guidance ten days ago

which increased the advice on the use of gowns but also said that they should be used for a sessional use rather than the individual patient use and it is a big challenge delivering against that, against that new guidance, and we are doing everything we possibly can, my team are up all night, we have a 24—hour operation, because the team in beijing, and some of the other embassies around the world, are working through the night on that acquisition. so the public understand, based on the information you have in front of you now, are we going to be able to get gowns to everywhere that needs them over the course of this weekend? well, that is exactly what we are aiming to do and then there is a question of exactly what type of gown, which is a technical question, where of course that has to be

signed off by the health and safety executive. that is how we define what type of gown is the right type, so we work closely with a health and safety executive to make sure that we use all of the different types of gowns that are safe to be used. thank you. cani that are safe to be used. thank you. can ijust that are safe to be used. thank you. can i just ask you about that are safe to be used. thank you. can ijust ask you about ppe in social care? at the moment, the guidance doesn't require ppe to be worn in care homes for non—covid—19 patients. this puzzles a lot of people because if those same patients, about 400,000 people across the uk, were living at home, they would be in the shielding category and all the home care workers that came to look after them, to watch them, get them up in them, to watch them, get them up in the mornings and so on, it would be required to wear masks. —— to wash them. why does the guidance not require that? why are we taking that risks with residents in care homes?

ido risks with residents in care homes? i do not think we are taking a risk in that way with residents in care homes. i'm very happy to look at that particular point in the guidance. i can see why people might read that as an inconsistency and i'm very happy to take that away. could you write to us? very happy to. thank you. one social care provider, which actually has a home in my patch, they look after about 3000 residents across the country, they say that it has been a battle but they have got basic ppe now for all their staff but what they can't get is any of the higher level ppe and so they have nurses, for example, who are doing what are called aerosol generating procedures, which means their staff could be getting infected if they get sprayed by patient and i could indeed pass that on the other residents. many in the social care system feel that they have not

had equal access to ppe as the nhs has had. what would you say to them? what i would say is that it is vital that everybody gets the ppe that they need according to the guidance that has been agreed by the clinicians and set out and that is what we are working incredibly hard to do. what i would also say is the challenge is that many social care settings have normally bought ppe through their normal commercial suppliers and because of the scale of the increase in ppe needs, those commercial suppliers have found it to difficult to restock and ultimately we have a global shortage or ppe. there is more ppe being demanded and used across the world than there are supplies, so that is why ramping up the domestic supply is also incredible important.

we have thought carefully about the different use of ppe in different settings. for me it is just important to get the right ppe to the right people no matter what their setting. so, would you allow social care providers for the high—level ppe to access nhs supply chain if they cannot secure it on the open market? absolutely. that is one of the big changes we have made. we are rolling out what is called the clipper service because the nhs supply chain has brought in an online if you think about it the nhs are biting traditionally has been an organisation that gets kicked to about 230 hospitals. we now have a responsibility to deliver ppe to 58,000 settings, so nhs supply chain has gone from what is essentially a

wholesale distribution, to a retail distribution in a very short amount of time, under intense pressure, i think they have done an amazing job. we have then brought in clipper and the army in order to bolster their logistical capabilities, it has been incredibly difficult, of course i don't deny that, the team have been working incredibly hard on it and i pay tribute to them and i think that they deserve our thanks. because in getting ppe out to everyone, i understand the pressures in the system and i understand why people feel so strongly about it, but the one thing i can be absolutely sure of, hand on heart, is that everyone in the system is doing all they possibly can to get the right ppe to the right places. thank you. a final one for me. i want to ask about a group of people who are not talked about as much as they should be and thatis about as much as they should be and that is the home care workers. people who go to people's homes. about half a million across the

country, between about five and 15 people they see everyday. a back of the envelope calculation suggests that that group alone will need about 150 million pieces of ppe between now and the end of may. are you going to make absolutely sure they get it? yes, they are part of they get it? yes, they are part of the team across health and that i worry about. there are around 10,000 locations from which the people who you are talking about, those working in domiciliary social care, there are about 10,000 locations they work from and they are part of the 58,000 which includes them, care homes, pharmacists, primary care, all of the different touch points of the nhs and social care system who all need and deserve to get ppe.

thank you. i have got lots of questions from committee members, if i could start with dean and then i will go to amy, james paul and clive. first of all, secretary of state, can i thank you and your team for being so reactive over the past few weeks when ever i have asked a question i have got a response quickly. i have two questions which i will try and be as brief as i can. for some ppe, from chatting to front—line workers, what i am hearing is that some of the anxiety that is happening is because of the change in the rules around ppe. public health england with their guidelines are different from the who guidelines and then more recently that shifted to who guidelines as i understand it. i think that has caused some concern around why did we not do that from the start. if you can answer that. the second question is not ppe related but it is a critical one. for my constituents and elsewhere in other hospitals. we will be aware we

had a critical incident in watford a few weeks ago around oxygen. i would be interested to know what is being done to ensure that the are not any more of this issues either in watford but also other hospitals across the uk. both important questions. on the first, of course on exactly what ppe is required in what settings, you will understand i have to take clinical advice on that. however, i was have to take clinical advice on that. however, iwas not have to take clinical advice on that. however, i was not comfortable with clinical advice that even though it is what our clinicians had concluded was the best outcome, was the best advice, was not at the level set by the who. and if you think about it, in part, this is about the ppe stocks that had been built up. and fitting the proposals

of what people should wear, when, to what the stocks are, i think that instead, i said we have got to be at who standards or higher. and the clinicians came forward with that upgrade. and i am very glad that they did. now, of course, also, ppe must be used according to those standards and not higher. that is why we set them out in such a clear way. and we have got to make sure that people know what to do in the circumstances where ppe supplies are tight. but this is something that we are constantly working on and critical, or answer to your question is that it is, i am guided by the clinicians in terms of what ppe is right in what circumstances. on the second point, the supply part of the battle plan has ppe as one

of the most high—profile elements but it has a huge amount in it and making sure that the oxygen supplies work is very important. and i think it was almost two weeks ago that we had a problem because one of the oxygen machines, one of the pumps, broke at watford which meant that we had to divert patients coming in by ambulance to other local hospitals. iam glad ambulance to other local hospitals. i am glad to see that no patients had a problem and there was not a risk to patient safety. the situation was managed extremely effectively. and we have brought him a technical experts to sort the engineering problem that there was. and this applies throughout the nhs we are looking at strengthening where they are old or out of date, those oxygen supply, the

physical equipment. it is an important technical problem. can i follow-up very quickly on the question around access to that. can you confirm that no nurse or doctor who wants to perhaps use additional ppe because of concerns, are going to be police and told that they cannot if they are concerned about what they have been asked to wear? exactly. but what i would say is the clinical guidelines have been thought about very carefully and we have to make sure that the ppe that gets to where it needs to be. it is as i have said before a precious resource and the reason it is precious is because globally there is very, very high demand. so getting hold of it is a huge challenge. and it is one of the reasons we are ramping up the domestic manufacture to make sure that we have more that is made here

and can go straight into the front line, whether in the nhs or social care. so ppe is a precious resource and we need to make sure that it is used carefully. thank you. amy callaghan. do we have amy? thank you. secretary of state, i understand there is widespread concerns regarding the availability of ppe. i rep is in the constituency in scotland where concern around ppe concern is high. given conflicting media reports over the past couple of days, can you confirm the procurement ppe rules in scotland and wales. although the nhs and social care are of course devolve, i have an overarching responsibility to the response of a public health crisis right across the uk. i work very closely with my counterparts in

all four nations. we have seen for insta nce all four nations. we have seen for instance in northern ireland, we sent a shipment of ppe to northern ireland and they sent gowns to england because they had more downs than they needed and we were short of gowns. so this team effort across the uk is an incredibly important. i speak to my opposite number in the scottish government and we make sure that we work as best as we can. we have shipped a total of 11 million items of ppe from england to scotla nd items of ppe from england to scotland so i suppose that is the, that demonstrates what a team effort it is. thank you very much. james murray. thank you. iwould it is. thank you very much. james murray. thank you. i would like to ask the secretary of state

for his comments on the reuse of particular equipment that was reportedly under consideration by public health england as a last resort. i want to ask, by what date can the secretary of state tell us the supply and distribution issues ppe will finally be resolved so this last resort measure can be ruled out? where there is a shortage in an individual setting, then of course it is reasonable to follow world health organization guidelines on what to do in the circumstances and in some cases, the reuse of ppe is advised by clinicians. so again, i come back to the point that this has to be a clinical decision. i would love to be able to wave a magic wand and have ppe fall from the sky in large quantities, and be able to answer questions about when shortages will

be resolved, but given we have a global situation in which there is less ppe in the world than the world needs, obviously it is going to be a huge pressure point. there is nothing that you can, there is nothing that you can, there is nothing that you can, there is nothing that i can say at the select committee which will take away the fa ct committee which will take away the fact that we have a global challenge and we're doing everything that we can to resolve it to get that to front line. you say there is a global challenge here and everyone is facing the same issues but if you look at the example in ealing, the borough where my constituency is located, they have gone in with other neighbouring boroughs to procure their own ppe equipment for ca re procure their own ppe equipment for care homes because they don't rely on the national system to be able to liberate for them. —— on the national system to be able to liberate forthem. —— deliver on the national system to be able to liberate for them. —— deliver it. itv are reporting in a survey that 54% of carers do not have ppe to do

the job safely. i would like to ask you, how can we trust the figures you, how can we trust the figures you are giving out about what is going on in care homes when what is being reported from the front line is so different to what you are saying. that survey i refer to took said that 42% of carers said they we re said that 42% of carers said they were looking after patients with covid—19 symptoms. i appreciate the lack of testing means you may not know the true numbers but want to admit that your 15% looks like a substantial underreporting? there are so many things i need to correct and that question. if i go through it. the first thing is that i think it. the first thing is that i think it is terrific when a local organisation is able to get hold of their own ppe. after all, other than in these extraordinary and unusual circumstances, the whole social care sector gets its ppe that it uses are

standard from normal commercial sources. likewise, many hospitals get their ppe from all sorts of different routes, notjust the nhs supply chain which is the national system, but get it from abroad, get it from local manufacturers. that is terrific. this is part of the system working. so i pay tribute to the way ealing are working and i hope you would to. on the point about numbers of cases in care homes, i would expect that figure, the latest public figure is have an outbreak, i would expect that figure to rise. the figure is in fact robust. in terms of its measurement because we do test residents in care

homes when they are symptomatically and we have so far tested over 10,000 residents in care homes when they are symptomatically wet is not true to say that we have not hitherto been testing residents in care homes. so this is a really, really important area to get right but it is important to base it on the facts. there have been reports that state manufacturers in the uk, who are now making fantastic efforts to produce ppe, finding it takes weeks to get their kit certified. ijust want to ask, is that the case? and if so, can this process be speeded up? yes. well, this is really important and it is true that ppe should be certified by health and safety executive according to the

existing rules. we have worked hard with the health and safety executive to speed up health and safety executive to speed up that certification programme and, in some cases, especially of relatively large consignments coming from abroad, the health and safety executive have worked rapidly to certify, but if there are individual cases where that has gone slowly, i would be very happy to look into it and to work with the health and safety executive to make sure that it works properly. and rapidly. you raise another really important point, paul, which is the domestic manufacture of ppe is a critical pa rt manufacture of ppe is a critical part of us building up our capacity andi part of us building up our capacity and i pay tribute to the companies that have already moved over some of their domestic manufacture to ppe, not just those

that we hear about but others who are turning alcohol production and hand gel. although it is less than a problem now, we did have a big shortage of hand gel a couple of weeks ago and diageo came to our rescue, because hand gel is largely based on alcohol. so, there is this domestic effort, this national effort, to make ppe which is really important and when you have a global shortage, and what we started without massive stockpile, we have run through that stockpile, not entirely, but a large part of it and we need to be buying from abroad and we need to be buying from abroad and making it at home. so, we need lots more companies to come forward and help us to make the ppe that people need. thank you, clive betts. secretary of state, you got a fairly

strongly worded letter last week from the directors of adult social ca re from the directors of adult social care where they described the department's approach to social care as an afterthought and in particular they described the national ppe supply chain as shambolic. that is notjust supply chain as shambolic. that is not just about the amount of ppe around but how it was being distributed, shambolic foot up do you accept that criticism and what you accept that criticism and what you doing to put it right?|j you accept that criticism and what you doing to put it right? i don't, i think it was a bit unfair on the people who work in my team who are doing everything in their power to get to ppe to the front line and as isaid get to ppe to the front line and as i said before, with the support of the army logistics corps who are amazing and changing a distribution model from distributing to just over 200, 230 hospitals, to delivering it to 58,000 different locations, is

a mammoth huge task and the truth is that a very high proportion of local authorities have played a big role in that. also, since that was published, we published the social ca re published, we published the social care action plan which we were working on and addresses many of the points that were made in the letter. you think the supply chain is working well now? i would say that the supply chain is working very ha rd to the supply chain is working very hard to get all the ppe to the front line where it is needed. and when will all care workers, including those going into peoples homes, which was rightly mentioned, it is notjust care which was rightly mentioned, it is not just care workers in which was rightly mentioned, it is notjust care workers in residential homes, when will they all have the ppe they need? the answer to that is as soon as possible. i wished i could wave a magic wand but i can't. you mentioned stockpile, a few minutes ago, but the figures from

your own department show that the amount of ppe available in the stockpile was reduced by 40% in the la st stockpile was reduced by 40% in the last six years. hasn't that contributed to the problems we have got now? well, no, i think that was unfair but it is a tricky question for me to answer. it is the first time this had happened on this select committee because that was before i was secretary of state and i know i may have to defer to the chair but i did as the officials to look into this and they found that accusation not to be fair and not to bea accusation not to be fair and not to be a reasonable accusation to level either me or my predecessor. ok, so you say the figures are wrong? i'm saying that that particular accusation, which i am aware of, we have looked into and it is not right. ok, thank you. thank you very much. just two final areas we want

to ask you about. one of them as treatments for coronavirus and the other is the impact of coronavirus on other treatments like cancer that might be interrupted. if we can just go onto treatments first secretary of state. you talked earlier about one treatment which has been used in france and some people think there is great potential in plasma treatments. the who seems to think that the ebola drug is very promising. if we were to conclude a drug is safe, what we shall cut the normal processes including randomised controlled trials and so on, put the orders in and get the drug out quickly? well, i'm going to bring a professor in he was electronically sitting beside me —— who is sitting beside me. but first it is worth me setting out the principles. the principles are that we wa nt

principles. the principles are that we want to get the very best treatment to those who need it and we will follow the science and the science is best supported by having rigorous analysis of which drugs work and thus far there have not been any clinical trials that i am aware of around the world that have conclusively proved the value of these different drugs. however, we have started to use them on patients here in the uk because the early evidence, which is not verified evidence, which is not verified evidence, shows that they have some value. but all that drugs also have downsides. so the approach we have taken here is that yes, to get people access to these drugs, but to do it within the structure of trials to make sure we also get the evidence of what works. for instance, you mentioned one drug, i saw some evidencejust instance, you mentioned one drug, i saw some evidence just this week

about the value of that drug but when interrogated they found there wasn't a base against which it was compared and therefore the full science has not yet been concluded on drugs like that. so, yes get the drugs to the people who need it but also make sure it is done in a way thatis also make sure it is done in a way that is structured and we can get the proper scientific verification out of it. that is the approach that we have taken but the professor will be able to add more information than ican and be able to add more information than i can and he is one of the top experts on this. thank you. i will come in at this point and say that for the committee, we absolutely don't know what works at the moment. we have limited reports from china and other parts of the world that certain things might work but

what we don't have is proper comparisons between treatment and not. one of the problems you get into is if you just use a drug and you give it a go, so to speak, is that the population of patients in whom you give it a go are very often sicker and quite often different to the ones in whom you don't need to reach for the treatment and we know with covid—19 the range of disease severity is very broad, from very mild to very severe. and so, if we don't hold our discipline and to do the randomised trials where we can actually compare these treatments against each other and against supportive care, we will never know definitively what really works and what doesn't work. can i be very specific because i did ask a very specific because i did ask a very specific question? i asked, once we

knew a drug was safe, would we short—circuit the normal requirement for randomised controlled trials and you are saying no, it is very important we do them, is that correct? i'm saying we need to know that a drug is both safe and effective and we need to know, from the clinical trials, who are the best patients to use that drug in. it may not be the whole population. there may be unexpected or intolerable side effects in a certain age groups, types of patient and also we need to understand at what stage in the illness the drug will work. that is why we have got a clinical trial, a very large one, very fa st clinical trial, a very large one, very fast recruiting foot on a 200 to 300 patients a day going into this trial that begins at the doors of the hospital when someone is admitted with covid—19 but we have another trial in the intensive care

unit. ok, thank you. just so i understand, so what we are saying is that we are going to carry on following the normal processes? because obviously you wouldn't want to give a drug to someone if there we re to give a drug to someone if there were side—effects but once you know there aren't side effects and you know it is safe, some people are saying that we should carry on try these drugs for you know it is effective, just because time is of the essence. but if i may, i will go back to the health secretary because ijust back to the health secretary because i just have one back to the health secretary because ijust have one more follow—up, if i may,... mayl ijust have one more follow—up, if i may,... may ijust come back at one point? you are talking about safety in terms of side effects, but it is also possible that some of these drugs may worsen the outcomes of covid—19 itself and if we don't do the trials, we won't get on top of the trials, we won't get on top of the side effects which, for the common drugs, frankly we already know, but we won't get on top of

whether the effects are zero, positive or negative, and whilst it is highly unlikely that we are going to get negative findings, one can't actually rule it out with a totally new illness until we do the science and understand what works, what harm is, what doesn't. thank you. so i have got the message. it is a belt and braces approach. could i go back... and braces approach. could i go back. . . just and braces approach. could i go back... just a minute, it is not a belt and braces approach because we are allowing the people to have access to these drugs. we are doing it within a rigorous scientific structure. that is the correct approach. it is not belt and braces because we are accelerating the clinical trials much faster than usual and allowing people access, but doing it within a structured approach is undoubtably the best way forward. ok. ijust had a brief

question, as a letter that was written to me which was also copied to you. this is about the concerns of doctors effectively having to play god if they had to make a choice between two patients and there was only one intensive care bed or one ventilator available and luckily at the moment the capacity seems to be holding up and long may that last but his concern was that there isn't a nationalframework which allows doctors to make those choices so they could be subject to criminal action at a later date for not giving someone the care that they clinically needed. professor powers told the select committee that that national guidance would be issued. as i understand, it hasn't been issued can you give us an update on that? the good news is that we don't need to issue the guidance. the

horrific nature of the choices that were outlined in that letter from choices that were outlined in that letterfrom sir robert, and the deeply unpleasant situation that it puts doctors and clinicians in it, is yet another reason why it has been so important to ensure nhs capacity is it so much greater than a demand for top it is one of things that, in this crisis, of course i'm very happy to answer questions on pb and testing but the really big thing -- ppe and testing but the really big thing —— ppe and testing, the overwhelming of our nhs, which was expected by many people at the start of this crisis, we have avoided from a huge amount of effort by huge amount of people and that means that we don't have to put out guidance like that which was called for in the letter. thank you. so taiwo and yvette wa nted thank you. so taiwo and yvette wanted to come in on this issue of treatments. thank you. there has

beena treatments. thank you. there has been a shortage of vital medicines across the country for stop this is specifically affecting patients with bowel, gated diseases. —— rare and complicated diseases for top will you use your emergency power to help these vulnerable people and provide these vulnerable people and provide the funds needed for drugs such as medicinal cannabis in this crisis? there are always challenges to some medicines. for instance, overthe summer we had a problem of access to some medicines which was a very significant for the women affected because of a problem of supply and a factory in germany and we worked very ha rd to factory in germany and we worked very hard to address that. so there are shortages that, from time to time, amongst the 12 and a half thousand medicines that are used in the uk. now,

on medicinal cannabis, the uk. now, on medicinal cannabis, the position has not changed since we last approved it and allowed for the importation and changed the border rules around importing medicinal cannabis products and so it is an important question but it is separate to the covid—19 response and we have made progress over the last year on that. again, it comes down to having the right evidence for both the effectiveness and safety of the drugs. there is a covid—19 specific challenge which is that clearly the drug is needed around the ventilation of a patient have been much in demand across the world over the past few couple of months and we have, in the uk, we did put out one alert to recommend the switching from one particular intensive care drug to another

one that had exactly the same clinical effects and so it didn't have any impact on patient safety at all thatis impact on patient safety at all that is exactly the sort of thing you do when there is a similar drug available but under a different branding for instance when there was a shortage. so far we have been able to keep the supply chain going. there have been moments where it was difficult and i have been involved in talking with my opposite numbers across the world to make sure the supply chain has a lwa ys to make sure the supply chain has always made sure, coming back to my previous answer, that the capacity for the nhs to treat people with covid—19 has always been there and that was my absolute top priority. finally on covid treatment, yvette cooper. while you have some additional critical care capacity, have you looked at using it to intervene earlier and to treat more

patients with oxygen at an early stage, given that there have been concerns about people being sent home again after being looked at at an earlier stage and then deteriorating or alternatively not coming to hospital until it is too late? this is a decision that always has to be a clinical decision for each individual. this is exactly the sort of thing jvt provides advice to me on so he can do that for you. we understand this is an eleanor switch is, generally lasts 5—7 days. —— this is an illness. for patients who end up being hospitalised, the deterioration is later on at the kind of 5—70 point in the illness

and from that perspective, one can understand the reports of people being seen initially and potentially having to re— present being seen initially and potentially having to re—present on some occasions. but to your specific question about ventilatory capacity and space on the use of earlier oxygenation, these two are completely clinically disconnected in the sense that the primary reason for admitting a patient to the hospital ward at all with covid—19 is for the provision of oxygen therapy. which does not require a ventilator or the intensive care to give. there is in fact a stage beyond oxygen on the world that we call noninvasive ventilation and beyond that again, there is the intensive care where we would formally incubate a patient, put them off to sleep and breathe for them off to sleep and breathe for them for a period of time using a ventilation machine. they are three very separate stages but they are disconnected from each other in

terms of when oxygen is administered. thank you. that brings us onto final section. we are going to discuss now the impact of coronavirus on cancer and other health conditions. i wanted to start, if i may, secretary of state, with something that simon stephens told this committee on the 17th of march. peace said there would be no impact on cancer treatments but cancer expert is worried about access to proton beam therapy and there have been other stories. i wa nt to there have been other stories. i want to check that you are absolutely certain that no urgent cancer treatment is being delayed? that is absolutely our policy. there was a question around proton beam therapy a couple of weeks ago which we addressed and as far as i understand it that is now back up and running and that was to do with staffing rather than to do with

patients being told they should not have access and that has successfully been resolved. however, thatis successfully been resolved. however, that is just on proton beam therapy in manchester. there is a much broader point here. it is important not to do whilst, because it requires a reduction in your immune system and no matter how well shielded somebody is to take somebody‘s immune system down to close to zero which is what some cancer treatments require and in the current circumstances when a deadly virus is prevalent amongst the population, that is, that would be a mistake and the wrong even if we had all the capacity in the

world, it is not a capacity question. it is disconnected from capacity, it is a clinicaljudgment. then there is some cancer treatment which is non—urgent because some cancers grow extremely slowly over a period of yea rs. extremely slowly over a period of years. and where surgery would be better done at a later date. so those are both i think correct policy decisions, obviously where the individual clinical decision is taken by the clinicians of the patient, but a policy in those two cases is to try and avoid, at this moment, taking forward the treatment. there's one area where i am really concerned. because we have also seen a drop of first presentations and this is a really big worry of mine. which is that even though cancer treatment is ongoing now, and if you want

to, if you need chemotherapy that is ongoing, if you need radiotherapy thatis ongoing, if you need radiotherapy that is ongoing, but far fewer people are coming forward and this worries me because we had spent an awful lot of time over several yea rs, awful lot of time over several years, time when your health secretary and time i have been, driving up those coming forward for cancer treatment. and that has been brought to a juddering halt by this virus. and we should all send a message to everybody who thinks they may have found a lump, phone your gp and you will get treatment. and you will get safe treatment, even during this virus and i think that is something we plan to do much more work on over the coming weeks. use the phrase come to a juddering halt. in some parts of the country, the referrals for the two—week cancer

targets a re referrals for the two—week cancer targets are down 75%. which will potentially mean we're missing three quarters of the cancers that would normally be picking up. professor richard sullivan at king's college said there may be more deaths from disruption of cancer services than from coronavirus. is that possible? i think that's unlikely. because the ongoing treatment is they are but we all know that early diagnosis is important in cancer and so we have been very clear from the cmo that was out a couple of weeks ago that we look at the mortality impact not just a direct impact of coronavirus where we read out those statistics, sad statistics every day. but also the impact of death because the nhs has been overwhelmed which tha nkfully has been overwhelmed which thankfully has not happened, the

impact of deaths in this case due to other treatments not happening, and ijust want other treatments not happening, and i just want to stress that the other treatments are available. where they are clinically appropriate whilst there is a killer virus about, but we have seen the biggest problem is the drop—off and people presenting and then the set of deaths which come through the socio economic impact of the measures were having to take. we look at all those rather than just direct deaths even though they are the most visible. and it is something i worry about. thank you. amy callaghan. thank you. secretary of state, i have got concerns around how charities like click sergeant will bail to stay afloat and maintain their invaluable support after the crisis and

during this. without these charities there would inevitably be more pressure on the nhs and it is likely young cancer patients would suffer. do you have a plan to help these charities continue supporting patients? yes we do. this is incredibly important, we have a plan for direct government support of charities which the chancellor and i, but also we have seen charitable efforts right across the country. the latest being captain tom, the wonderful 99—year—old gentleman from bedfordshire who has raised no i think £15 million. 18 i am told, someone had shouted from the other side of the office. £18 million which is absolutely fantastic. but obviously with taxpayers supporting as well, i would highlight at the same time hospices which often raise a large proportion of funds through shops in the high street and the

shops in the high street and the shops have not been able to be open so we are supporting the hospice sector as well. and i think charities across the health and care sector have always played a very important part in the provision of health care and we have got to make sure we support them through this time. thank you. luke evans? thank you for all the hard work you and your team are you for all the hard work you and yourteam are doing. you for all the hard work you and your team are doing. i notice you for all the hard work you and yourteam are doing. i notice in yourteam are doing. i notice in your battle plan, one of the things that i think potentially was missing was when we talk about battle in medicine, death is an inevitability and something you have to deal with. ijust wondered, you put in a herculean effort to get to the itu spaces and ventilators, however, a lot of fifa who will suffer from coronavirus and indeed other conditions will never make it onto the intensive care unit. sol wondered what sort of provisions you have for the number of people who may be dying at home and i have a

few questions about that. do you northern number of people who are dying at home currently? have an estimate? we do know the number of people who die outside of hospital, and they very largely diatom. it comes back to the very first exchange —— die at home. they are reported through ons. with that a good death needs three things, equipment, medication and it needs the staff to administer it so in terms of equipment, a few quick questions. do you have enough syringe drivers in the nhs to deliver medication to keep people comfortable when they are passing away? yes, we do. there was a challenge raised about this eight days ago and we resolved it, it was not as big a challenge as was made public and we have resolved that. so, yes, right now,

we do. the second one is medication, particularly things like morphine, do you have any precautions put in place to make sure we have enough of those medications in place? yes, we have a big project to make sure that those medications as well as the itu medications i spoke about earlier, the supply chain, global supply chains for those medicines are clear. in fact, those medicines are made ina clear. in fact, those medicines are made in a relatively small number of factories around the world so it is our delicate supply chain and we are —— a delicate supply chain and we are in contact with it. in line with that, morphine is supplied per patient to stop it being abused. i have to prescribe it for mr hancock but in this situation if you're going to a care home you may not wa nt going to a care home you may not want to waste precious things like morphine. have you considered relaxing the laws around morphine prescription so there isn't not a

waste? we keep that under review. i have looked at that particular point of view and it is something that the supply chain, the supply team, sorry in the department and the clinical tea m in the department and the clinical team talk about all the time. i don't know if that is jvt, he may wa nt to don't know if that is jvt, he may want to see more. i don't know if that is jvt, he may want to see more. thank you, i have nothing really to add on that. thank you, secretary of state, dealing with cancer. am coming through? yes. i echo your comment about people if they think they have got cancer symptoms that should go to the gp and get it dealt with, early detection. but i think, not withstanding the comments he

made about certain types of chemotherapy which reduce your immune system to almost nil, notwithstanding that, there will be cancer patients right around the country who will be aghast at the disconnect between your words and what they are hearing when they see their consultant or oncologist. operations are being delayed, i virtually attended an all— party group on radiotherapy last week, radiologists are being used in other departments and their machines are not being used to capacity, so people are not getting the cancer treatments as quickly as they could. we are not using the capacity we have got. so there is a huge disconnect between what you are being told and what is actually happening on the front line. we should be using all our capacity as best we can. will you please investigate that and make a

statement, because i know, personally, of several people whose treatment is being delayed. and finally, an aside, could you say whether clinical staff who have died working on the nhs, art their deaths being referred to the health and safety executive for investigation? thank you. on the first of those, what it set out in the policy, and there are different reasons why surgery or, as i there are different reasons why surgery or, as i was there are different reasons why surgery or, as i was saying, chemotherapy, might be delayed, in need of individual cases you have got, if you write to me and bring me to —— bring them to my attention, i will have them looked into absolutely. and the broader point you're making that it might notjust be those who have been brought to your attention, of course i will ta ke your attention, of course i will take that and talk to the clinic. secretary of state, we are getting them all over on twitter, my constituents, personal friends of mine, a formermp,

constituents, personal friends of mine, a former mp, it is clear that there is a slowdown on cancer treatment. as i was saying, it is for good clinical reasons. in other cases, we will make sure that we look into them and i will take that up look into them and i will take that up with the nhs leadership. can you remind me of the second point? the investigations are being done by the nhs, by the employers, because they are the ones on the ground to understand the circumstances. no, should they not be sent to the health and safety executive for a different look at it? i'm not sure the hse is the right body to do that because we have bodies inside the nhs who investigate patients safety issues and so we are doing it through hospitals and

in consultation with the employer, but we need to make sure they are done properly. can ijust coming on that point. i think the concern is that, if for example someone had died... rosie, sorry, i didn't realise you wa nted rosie, sorry, i didn't realise you wanted to come in. do come in. sorry, i think we seem to have lost you. secretary of state, can you hear me? yes, i think you are making the same point at the same time.“ someone had died because of a lack of pp, i think it would be investigated by someone independent of the organisation who are responsible for providing that ppe because there would be a conflict of interest otherwise. yes, thanks to your work we have that system in place. i think they are involved in

these investigations but let me go and check that. two final questions. i would like to ask you a question about motor neurone disease. clinicians have noted that there are severe respiratory difficulties that motor neurone disease can cause and believe that their patients ought to believe that their patients ought to be shielded as a result but at the moment it is not on the list of conditions for being extremely vulnerable. patients can self register, i understand that, but many patients may not know this and may miss out on the benefits put up with this something you are looking to review? yes, it is something i have already reviewed and my team have already reviewed and my team have worked with motor neurone disease charities on this to make sure we get it exactly right. it is very important to get it right. and my initial instinct was to say,

of course motor neurone disease should be on the list, but the clinical advice is that there are many stages of motor neurone disease, and whilst those in the later stages are almost a lwa ys those in the later stages are almost always going to need to be shielded because of the impact of the disease on them quite chilly, that isn't a lwa ys on them quite chilly, that isn't always the case. —— the impact of the disease, that isn't a way is the case. not to leave your home for three months is very significant. as you say, people can self refer and then goes the gp and the gp can make then goes the gp and the gp can make the decision based on the advice, based on the clinical needs of each individual patient. so, we talked to the motor neurone disease campaign is about that. as far as i am aware, the advice i got back is that

they understood and could see the point in making the decision that way. i'm com pletely in making the decision that way. i'm completely open to putting all motor neurone disease, people living with motor neurone disease, on the list, but once you dig into why not, you can also see the case at the other way for some of those who live with motor neurone disease. thank you. thank you, chair. i'm going to ask this question with my heart on being a part of the select committee on human rights so this is a question that i been asked on behalf of the committee to share. it is the identified that human rights we re the identified that human rights were being abused for people with autism and mental health

difficulties in hospitals and one of the concerns is that family visits are being restricted which potentially increases the isolation and makes them more vulnerable to abuse of their rights. i wanted to ask on the half of that committee what is being done in response to that situation, please? this is obviously a very difficult situation. many people who are in patients in this circumstances, not in all patients, but some have higher risk and the decision on an individual decision basis to restrict visitors is an understandable one and same circumstances but it has got to be done right and it is something that i worry about in the same way that i worry about not enough people going

forward for cancer treatment. there are many consequences of the decision we have had to make which are difficult. there is an overall programme which remains working and in place to try and reduce the number of people in inpatient settings and that is a very important piece of work that is ongoing. thank you, i appreciate the answer. secretary of state, you have been very answer. secretary of state, you have been very generous answer. secretary of state, you have been very generous with your time this morning for that we appreciate that you are making an incredibly difficult —— incredibly difficult judgments on behalf of the country and you're given us a couple of hours to show your thinking so thank you very much on behalf of the committee forgiving is your time and very best of luck for you and your tea m very best of luck for you and your team in the difficult days lets cross to edinburgh where the scotland's first minister is giving an update on the

coronavirus pandemic. good afternoon everyone, thank you again for everybody watching at home for joining again for everybody watching at home forjoining us for this daily briefing. i will start as i always do with an update on some of the key statistics in relation to kobe 19 in scotland. as of nine o'clock this morning, i can report that there have been 7409 positive cases confirmed, which is an increase of 307 on the numbers reported yesterday was not a total of 1799 patients are currently in hospital across the country with either confirmed or suspected covid—19. that is the same as the number yesterday although i would point out that that is not necessarily the same patient. a total of 189 people last night were in intensive care with confirmed or suspected covid—19 and that is a decrease of seven on it yesterday's figure. however, the last 24 hours i'm afraid that 58 deaths have been registered of

patients who been confirmed as testing positive for covid—19, that ta kes testing positive for covid—19, that takes the total number of deaths in scotla nd takes the total number of deaths in scotland under that measurement to 837. as i have said before, and as i know all of us have in our minds at these moments, it is important that we never, ever lose sight of the human reality behind the statistics. each and every death represents an individual, somebody who is right now being mourned by the people they have left behind. and so, once again, iwant have left behind. and so, once again, i want to extend my deepest condolences to everyone who has lost a loved one and i know we all think about them at these times. i also wa nt to about them at these times. i also want to express my thanks as i a lwa ys want to express my thanks as i always do, because it is important that we always do this to all health and care workers across the country. you are doing a quite extraordinary job and you are doing it in the most difficult circumstances imaginable. i hope that last

night's applause showed he once again, in a small but important way, the deep gratitude that all of us feel for the work you are doing right now. now, there are are doing right now. now, there are a couple of issues that i want to convert today before handing over to the chief medical officer and a cabinet secretary and then taking questions. as you know, cobra met yesterday afternoon, following that meeting, all four of the governments across the uk agreed to extend the current lockdown rules for at least three more weeks. here in scotland, of course that decision is based on the advice of the chief medical officer and our scientific advisory group. they have advised me and the government that the lockdown restrictions have resulted in a slowing down of the rate of community transmission of the virus. that is positive news and while we can't be complacent and should never be complacent when dealing with this virus, that the slowdown seems to be reflected in a stabilisation of the

numbers being admitted to hospital and intensive care and again, i think we can see that in the figures i have reported to you today. in short, we believe that these restrictions are working and therefore again i want to thank every single one of you for complying with these rules. and for the sacrifices you are making in doing so. however, despite these positive signs, and they are positive signs, and they are positive signs, and they are positive signs, we are not yet confident that transmission has slowed sufficiently to allow us to ease up in any way on these restrictions. the advice to it is very clear that lifting the restrictions now could risk an immediate and a potentially exponential resurgence of the virus. that would very quickly, if it happened, resulting our nhs being overwhelmed. it could also lead to many more outbreaks in our care homes and it would almost certainly lead to more loss of life. it could also necessitate the introduction of even stronger restrictions on future, it would

cause substantially more damage the economy as a result. in short, if we were to lift these restrictions now or if we left them at any restrictions now or if we left them atany time restrictions now or if we left them at any time prematurely, all of the progress that we have achieved together in the past few would be lost. we cannot take that risk and i hope you agree that we simply can't ta ke hope you agree that we simply can't take that risk because the price of it in human life and human suffering is not one that any of us should or would be willing to pay. that said, i know and i am acutely aware that people also want an idea of what might lie beyond the next three week period. while the burden of this work falls rightly on government, we do not, and i've said this repeatedly, we do not have a monopoly of wisdom and that is one reason why, as we think through these decisions, i want to be as open and transparent as possible. so, over the next week we will begin to set out the work we're doing to try to a way forward. let me be clear that this won't give

definitive answers yet because no government has those definitive a nswe rs , government has those definitive answers, but it will set out to the fa ct answers, but it will set out to the fact is that we must consider, the process for assessing the different options and the framework through which we will reach these decisions in due course. i want to emphasise one key point that will underpin these considerations and it is not an easy point to make. this virus is not going to simply or magically disappear. well of course we hope that scientific advances ultimately, of course a vaccine, will offer some solutions, we are going to in the meantime, get used to the fact that this virus will be with us for some considerable time to come. the challenge we face is not an easy one but it is an important one, is to find a balance that allows us to control and suppress the violence and minimise absolutely the damage that it can do, while also allowing life to go on, if not completely as normal, leased in as normal way as is possible, because while we know

that the current lockdown measures are essential and they are really essential, we also know that they bring serious consequences of their own and these are consequences that may also be measured in lives lost and life chances pertained, so this is an important balance for us to strike, that work is under way and i will provide as much detail as i can on that in the days ahead and i want to stress again to you today that the government will be as open as we can be. to be blunt, i will treat you, the public, as the grown—ups that you are and try to share on an ongoing basis the very difficult judgments and balances that we are going to have to strike in the weeks and months to come. i want the public at large to be as involved in that as is possible. now, the other issue i want to talk briefly about issue i want to talk briefly about is the response to the economic impact of this virus. this morning, asido impact of this virus. this morning, as i do every friday morning, i chaired the cabinet subcommittee on the economy. one of the topics under

discussion was support for businesses and there are three specific updates that i want to provide on that today. on wednesday, the finance secretary announced an expansion of our business support scheme which means that the total alongside otherforms of scheme which means that the total alongside other forms of assistance we re alongside other forms of assistance were now beat £1.3 billion available to grants and support to businesses. today, i can confirm that from that total package of support, more than 80,000 of these grants have already been awarded, a total of more than £250 million has been paid out so farand £250 million has been paid out so far and will continue to work with authorities to make sure that businesses can access the rest of that support as quickly as possible. the second update is about support for our seafood sector. it is clear that the market for fish and shellfish has effectively collapsed and that is having a very serious and that is having a very serious and immediate impact on many of our coastal and island communities. the government is already providing a range of support for the sea food, agriculture and fishing industries and that includes help for

businesses with smaller vessels. today, i can announce that we are allocating a further £3.5 million of support forfishing allocating a further £3.5 million of support for fishing vessels of over 12 metres and that means a total of more than 1000 businesses will now be eligible for support and it brings the overall package of support for the seafood, fishing and aquaculture sector to nearly £23 million. providing that kind of emergency support is essential because it helps to deal with the immediate impact that this virus is having on the economy. for the government, it is also important as we do with managing the virus, that we do with managing the virus, that we also seek now to take a longer term view. that brings me to the final economic point i want to touch on today, we are already thinking about how we will start to rebuild the economy once the immediate intensity of this crisis starts to recede. none of us should be under any illusions about the scale of that task, this is an unprecedented situation, you have heard me and others say that many times before and as i've said already, no

government anywhere has all of the immediate answers. but, we do want to start the work now to make sure that we are able to navigate the best way possible forward. that is why we are announcing today the establishment of an economic recovery advisory group. its role will be to advise government on actions to support economic recovery and crucially, it will consider how these actions can contribute to rebuilding a fairer, greener and more equal society as well. this group will bring together business leaders, economic experts and the economy secretary will set out more details of it in the next week but i believe it's details of it in the next week but i believe its establishment will be an important step in preparing scotla nd an important step in preparing scotland for some of the challenges that lie ahead. so, to close today, i want to reiterate, once again, the public health rules, i know you've heard me say these words many times before, but they remain as important as ever. you should be staying at home, other

than fur a very specific reasons, stay two metres apart when you do go out, don't meet up with others from other households and if you or anyone in your household show signs of covid—19, you should not go out at all even for essential purposes. as i also always say, i know how difficult these restrictions are and i know that they always get much tougher and i'm sure feel much tougher at weekends, particularly for those of you with children but they are essential. as isaid children but they are essential. as i said earlier, we have a long way to go but we are beginning to see signs that the lockdown is working. the first signs of hope are already there so it is vital that we continue to follow these rules so that we don't go backwards and instead keep moving forwards in the right direction. by all of us doing that, we are helping as we are

already seeing, slow the spread of the virus, helping to protect the nhs, we see that in the stabilisation of numbers in hospital and intensive care and while we are still sadly reporting many deaths every day, complying with these measures is undoubtedly helping to save lives and we bring ourselves by complying with these measures, a little bit closer to the time that we can start to return to some semblance of normality. let me end by thanking you all once again for doing the right things, i hope in these difficult circumstances, you will have the best weekend possible. i'm going to hand over now to doctor greg smith will say a few words and then to the health secretary before opening to questions. your mac thank you first minister. i want to take you first minister. i want to take you through some of the reasons why it is so important that we continue. the decision to extend these measures affect our everyday lives

so the decision has not been taken lightly but i believe it is the right decision for this moment in time. we continue to be guided by the evidence when we take these decisions and i am very grateful to the group of scientists who continue to assist us and provide insights into the data and evidence to allow us to come to these difficult decisions that we have made. this is a nasty little virus and it spreads easily and preys on those who are especially vulnerable within society. we need to remember that at this moment in time, that we have never encountered this virus before and so for that reason, our immune systems a re and so for that reason, our immune systems are vulnerable to it. we don't have any reliable treatment at this point in time and at the moment, we don't have a vaccine, but i'm confident that over time, we will develop these approaches. before we introduce a series of measures to limit the spread and protect the most vulnerable, the reproduction rate of the virus sat at over three. what this means is that for every person who caught the virus, they spread it to at least

three others, so one case became three others, so one case became three cases and each of those three people spread it to another three people, to make nine cases and each of those nine cases, you get the picture. the actions you have taken have managed to reduce the rate of reproduction by two thirds. the reproduction by two thirds. the reproduction rate is now calculator to be under one. what this means is that the virus has not gone away, but it is spreading much less readily than it was before, so one person is likely on average to spread it to less than one more person. that's new case will on average and spread it to again only one more person. it still has the ability to spread, but not in the exponential way that we have all feared and seen in the early stages. we see this already in the number of new cases that we report each day. there has been a slowing in the rate of increase here and also in hospital admissions. the doubling time for new cases has now stretched over 11 days from the situation where it was 45 days only three weeks ago. the nature

of the disease and the way it progresses, it is too early to see this change coming through in the number of deaths we report, but i'm confident that this will happen soon as well. the margins are very will happen soon as well. the margins are very small though, in fa ct margins are very small though, in fact they are tiny. and that is why it is not yet time to replace these restrictions. because even a small drop in the way that we are making these restrictions work, at this stage will see is returned to the exponential growth that will swamp our nhs and potentially lead to many more lives lost. so i ask for your patience and your perseverance in making this continue to work. to stay at home for all but essential reasons, to ensure that you continue to wash your hands regularly, to make sure that you isolate if you develop symptoms and avoid contact with those that are most vulnerable. i was sent a message by a friend yesterday and it summed up the situation we are in quite nicely. they likened it to having jumped out ofa they likened it to having jumped out of a plane with a parachute and experiencing that sense of relief

that the parachute had opened and was slowing you down. but you wouldn't take the parachute off before you had landed safely. that is where we are just now. we should be encouraged that the signs are going in the right direction, we shouldn't yet take our parachute off until we have landed back on firmer ground. we are grateful to everyone for healing art stay at home save lives message but i want to emphasise again that the nhs remains open. one important aspect of this that must continue as a routine vaccination programme. it remains an important way to protect you and your family's health. receiving important way to protect you and yourfamily‘s health. receiving a scheduled vaccination is one of the important medical reasons for which you should leave your house and it will help protect you or your child from other types of serious illness. so, thank you for your continued efforts. just remember that by sticking these restrictions, you are helping my colleagues across health and social care and you are literally saving lives. please stay at home, wash your hands regularly

and isolate yourself if you begin to develop any symptoms. and isolate yourself if you begin to develop any symptomslj and isolate yourself if you begin to develop any symptoms. i will hand over to the cabinet secretary. thank you. i have had said before here and other occasions, people who live in ca re other occasions, people who live in care homes and the staff that work there are as are as important as anyone else. across scotland, our ca re anyone else. across scotland, our care homes and the staff in them provide persistent, compassionate ca re provide persistent, compassionate care for the residents for whom care home is their home. we know from our work with scottish care... we are going to leave the briefing in scotla nd going to leave the briefing in scotland there. the top line, a new sombre line every day, deaths in the past 24 hours, in scotland 58 new deaths of those tested. now, let's catch up with the weather. we have some rain around today. further north it is a drier, some spells of sunshine the

best of which the further west you are. rather cool and cloudy. best of which the further west you are. rather cooland cloudy. he best of which the further west you are. rather cool and cloudy. he is the area of low pressure and the frontal system providing that rain through the rest of the day but that rain band will tend to weaken on its journey northwards through this evening before some heavy, thundery showers at to push up from france across central southern england, through wales, into the midlands but further north it is drier with clearer skies further west you are. once again, a touch of frost was some rural parts of scotland, milder further south with the cloud and showers. we still have those showers around crewe tomorrow morning, slowly strapping their way northwards through the day but probably not getting much further north and southern parts of northern england. try it with sunshine across scotla nd england. try it with sunshine across scotland and northern ireland. spells of sunshine coming through across the challenging islands through the afternoon, generally for much of england and wales, a call and cloudy day, showers around, could be heavy and thundery through the afternoon but drier with the best of the sunshine across the far north of england, northern ireland

and scotland. more sunshine around through the eastern coast is missing today. area of high pressure building from the east and north—east as we go through sunday, initially a fairly cloudy start, particularly for central and western areas of the uk but increasing amounts of sunshine from the east as the day wears on, we mayjust hang on to more cloud across northern ireland and some western parts of wales and south—west england. it should feel warmer on sunday for many, temperatures in the mid to high teens but still fairly call for the east of scotland, the eastern coast of england and the northern isles. by the time we get to monday, it is looking dry with, still a noticeable breeze and it is coming in from noticeable breeze and it is coming infrom a noticeable breeze and it is coming in from a fairly cool direction across that no see, no seacoast will a lwa ys across that no see, no seacoast will always be cooler but warmer away from here, temperatures getting up to 17 to 90 celsius. as we go through tuesday, high pressure is generally the dominant feature but notice a squeeze on the isobars, so still quite breezy if not windy, particularly the eastern coast but for next week, things are looking

mainly dry, there will be some good amounts of sunshine, for many it will feel quite worn away from those colour eastern coast is generally the dominant feature but notice of squeezing the isobars, so still quite breezy if not windy, particularly the eastern coast but the next week, things are looking mainly dry, there will be some good amounts of sunshine, for many it will feel quite worn away from those 02:59:16,425 --> 1073741528:02:49,676 cooler 1073741528:02:49,676 --> 2147483053:06:22,927 eastern 2147483053:06:22,927 --> 3221224578:09:56,178 coasts 3221224578:09:56,178 --> 4294966103:13:29,430 goodbye.