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tv   BBC News Special  BBC News  October 12, 2020 11:00am-11:46am BST

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this is bbc news, i'm joanna gosling. the headlines at 11. borisjohnson is to announce new lockdown restrictions for specific areas of england under a new three—tier system. we're expecting to hear about the latest covid—19 data from the deputy chief medical officer, professor jonathan van—tam in the next few minutes. liverpool is expected to face the toughest restrictions with pubs, gyms and bookies closed. the region's mayor says agreement on it has not yet been reached. the chief executive of british airways alex cruz has stepped down from the role with "immediate effect". the chinese city of qingdao will have its entire population of nine million people tested for covid after a handful of new infections.
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and the premier league criticises a radical plan to shake—up english football. "project big picture" would see the top tier cut to 18 teams, and the league cup and community shield scrapped. we are going straight to that briefing with jonathan we are going straight to that briefing withjonathan van tam. i'm joined today by stephen powis, medical director of nhs england and on my left by professorjane eddleston who is executive medical director of manchester university's foundation trust. may have the first slide, please? iwould like foundation trust. may have the first slide, please? i would like to begin by showing you some data which is
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releva nt to by showing you some data which is relevant to where we are now. if we could please focus on the top side, the sliderfor the could please focus on the top side, the slider for the united could please focus on the top side, the sliderfor the united kingdom, although you will see largely the same curbs and shapes represented for countries of the uk. —— curves and shapes. the number of cases by specimen date in the uk, you will see. that is without any double counting, patients who have had two tests. data on an aid from the 1st of february on the left through to mid—october on the right. you will see very clearly the first peak that corresponded to the first wave of that pandemic, which we experienced in the spring. comparing that with the second beat, please bear in mind that this is an apples and pears comparison based on case numbers. our testing capacity in the spring was very much lower than it is now.
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the key point is that having had a rather flat somewhere with very low amounts of covered bike —positive patients —— flat summer cupboard positive patients. since september there has been a marked pick—up and also be aware that the last three or four points on the graph to the extreme right hand side are figures where the data is incomplete, so those columns are likely to go up and it certainly will not go in any other direction. this is where we are in terms of cases by date. i wa nt to are in terms of cases by date. i want to be very clear with you that as patients become ill with covid—i9, they do not immediately go into hospital. it takes some time
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before they become ill enough to go into hospital. and they do not die in hospital the moment they arrive. some, unfortunately, do die, but not insta ntly. some, unfortunately, do die, but not instantly. the point i'm trying to make here is that there is a between cases and when we see hospital admissions rise and when we see deaths rise. based on the curve that is they are, if i were to say to you, these are the infections we have had no, then actually, the hospital admissions we have right now are related to infections we had about three weeks ago. if you look on the chart, three weeks back, you can see the hospital admissions we have now actually relate to a time when there were fewer cases of covid—i9. what i am trying to say here is that already come up with
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the cases that we know about, we have are baked in additional hospital admissions and, sadly, we have also baked and additional deaths. that are now consequent of infections that have already happened. this is an unfortunate and difficult part of the data where we have to understand that there is at this lag on they were statistics on hospitalisations and deaths. next slide, please. on this next lady, i am showing you rates per 100,000 by local authority. for england. the graph on the left of the screen, the purple graph —— on this next slide. these are rates of cases and the graph on the right hand side are rate changes. the darker colours are
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a lwa ys rate changes. the darker colours are always at the higher figures. and at the figures we are trying to avoid. if you look, first of all, at the purple chat, i think you can see that there are now vetted acadians in the north—west, the north—east of england —— very dark areas. and a dark purple colour across at the northern part of the uk, extending down into the west midlands and east midlands. but turning to the right hand chart, of a rather more concern, the dark brown areas indicate the latest data are the way things are heating up. and dark brown clearly means things are heating up. you can see the reach of the dark brown colours is further south into a greater landmass across england. in fact,
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south into a greater landmass across england. infact, i received south into a greater landmass across england. in fact, i received that these slides this morning. i showed a very similar data to mps and at the house of lords on friday and the prime chart had not extended that far south. so it has changed in a matter of a few days —— in the browner chart. that is clearly of concern to me. next slide, please. one of the things that has been widely and accurately reported in the media is that our resurgence of cases this autumn has been mainly in adults aged 20—29 and that is absolutely true. these graphs are the same representations of case rates and changes in rate, but by people aged 60 and over. you can see, again, that there is the spread from those younger age groups into
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the 60 plus age group in the north—west and the north—east and there are rates of change in the same places, but also extending a little further south. this is, again, of significant concern as my collea g u es again, of significant concern as my colleagues will explain to you in more detail because, of course, the elderly suffer a much worse a course with covid—19. they are admitted to hospitalfor with covid—19. they are admitted to hospital for longer periods and they are more difficult to say. next slide, please. —— more difficult to save. this is my final slide and it isa save. this is my final slide and it is a selection of heat charts. what i will do as i will explain it very carefully to you. piece by piece. what you can see on their are nine separate heat charts for various regions of england. if i can ask you
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to focus on anyone in the middle, the north—west. can you click the slide, please? this will be the best one to help you understand what is happening. on the x axis, that is going from left to right, across that chart, we are moving from september the tent on the left through to sometime in mid—october the right. as you go up that chart, we are moving from the 0—15 age bracket through 16—29, 30—44, a0 5-59, bracket through 16—29, 30—aa, a0 5—59, and the top line in that block is 60 plus. if i can invite you to cut the data vertically by i and you will see the infection rate was initially highest in the 16—29 —year—olds. that, as you move to the right, just gets hotter and hotter.
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as it does so, you can see the incremental creep of the infection into the next age band up 30—aa, followed two or three weeks later by a creep up again into the 59's. —— a5 to 59. the north—west experienced that first. my understanding is that pattern is likely to be followed. you can see it in the north—east and you can see it in yorkshire and humberjust you can see it in yorkshire and humber just beginning, but you can see it in yorkshire and humberjust beginning, but at an earlier stage. next please stop that is the direction of travel in terms of the creeping of the infection up through the age band in a given local or regional area. that brings my slides to a conclusion. i will 110w pass my slides to a conclusion. i will
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now pass to professor paris to prevent some further data on hospitalisations —— professor powis. thank you, jonathan. rising levels infections in the community are now leading to a rising level of hospital admissions. as a country, we can limit the impact of the virus using our three lines of defence — the first of these is the personal measures we all individually take to limit transmission, washing our hands, wearing masks, and keeping an appropriate distance from each other. these come along with other measures introduced by the government, such as the rule of six, have helped slow the transmission of the virus at the summer, as you have seen. the virus at the summer, as you have seen. the test and trace service is at the vital second line of defence. identifying cases and asking people to self—isolate when they have come into co nta ct to self—isolate when they have come into contact with anyone who has tested positive. these measures are designed to stop the growth in infection which will inevitably lead
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to increased hospital admissions and, unfortunately, increased deaths. sadly, asjonathan has shown, we are now seeing renewed growth in infection rates. with some parts of the country, such as the north—west, particularly badly affected. we are now having to make greater use of our third line of defence, hospital care for those who are sickest. of course, the uk is not alone in seeing this increase. in recent days, both the netherlands and france have seen record highs in their daily figures for new infections, with france now seeing an average of 18,000 new cases per day. a respected french institute has recently said that without new restrictions 11,000 patients could need intensive care across france by the middle of next month. last week in paris, health authorities ordered hospitals to activate emergency
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measures to cope with fast rising cases. around a0% of hospital intensive care beds in paris are now occupied by covid patients. the spanish government has declared a state of emergency in madrid. with over 3000 covid patients are currently in the capital's hospitals, around 500 and intensive care. meaning about a0% of the region's i see you beds are occupied by covid patients. —— icu beds. we are seeing similar pressures building in some parts of the united kingdom. in fact, building in some parts of the united kingdom. infact, we building in some parts of the united kingdom. in fact, we now have more patients in hospital with covid—19 than we did before the government announced restrictions of much the 23rd in the spring. the first slide, please. this slide shows that as the infection rate has begun to grow across the country, asjonathan has explained, hospitaladmissions across the country, asjonathan has
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explained, hospital admissions have also started to rise. you will see that this is a time serious from much on the left—hand side of the track moving through to the beginning of october on the right. you can see the peak in the seven day rolling average of average new hospital patients, in april you will see the decline during the late spring and into the summer, but you will see that since the beginning of september, paralleling that rise in infection in the community that jonathan has shown, we are starting to see an increased rise in hospital cases. in the next slide, you can see in more detail that it is clear that hospital admissions are rising fastest in those areas of the country where infection rates are highest, as jonathan has country where infection rates are highest, asjonathan has explained, particularly the north—west, where you can see that hospital cases are exhilaratingly fastest and out at the highest. next slide, please. as
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jonathan has already said, we know that infection rates have been a particularly high amongst young adults. he has also shown rates are now increasing in older people too and this is directly resulting in increased admissions in these age groups, so increased admissions in these age groups, so you increased admissions in these age groups, so you can see increased admissions in these age groups, so you can see in the slide are groups, so you can see in the slide a re newly groups, so you can see in the slide are newly reported hospital cases by age. again, the same time series from left to right, but are split into the same sort of age bands that jonathan showed in terms of infections. you can see that now, in the over 65, particularly in the over 85 is, we are seeing steep rises in the number of people being admitted to hospital. they claim that without taking further action the elderly can somehowjust be fenced off from this, i'm afraid, is proving to be wishful thinking. —— from risk. if we look at more details of the north—west,
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north—east and yorkshire, the numbers of patients being treated with covid is rising rapidly in many other hospitals. as you can see, liverpool university nhs foundation trust right at the heart of where those infection rates are rising the highest is seeing the steepest increase in its seven day rolling average of covid—19 patients in its beds, but you will also see the same is happening in other hospitals in the region. liverpool university hospital has at the highest number of covid—19 patients with currently more than 250 patients with covid in its bed. in the last four weeks hospitals in the north—west and north—east have witnessed a sevenfold increase in covid patients in their intensive care units. if infections continue to rise, in just four more weeks, they could be treating more patients than they we re treating more patients than they were during the peak of the first wave. we will shortly hear more
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about the situation in the north—west from my colleague doctor jane eddleston who works at manchester royal infirmary. we are not just concerned manchester royal infirmary. we are notjust concerned about hospital admissions. sadly, we know that this virus is more dangerous to the old, asi virus is more dangerous to the old, as i have shown, but we are also learning about the long—term side—effects of covid which can also affect the young, so these debilitating symptoms, which include breathlessness and fatigue are collectively known as a long covid and are becoming more apparent. this is not just a and are becoming more apparent. this is notjust a problem for the elderly, it is a potential problem for all age groups. the nhs is prepared well for the second wave and we have learned a lot from the first way. we have a new life—saving treatments such as dexamethasone are trialled and tested here in the nhs. we better understand any type of oxygen therapies patients need and the best ways in which to care for them and aid their recovery. 1a day
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survival rates in intensive care have improved from 72% to 85% since the pandemic began. the government has worked hard to improve the supply of personal protective equipment since march, having learned what is needed from the first week. so the departments of health and social care report that we now have enough ppe stockpiled to last for months. we have extra funding to allow local nhs services to use independent hospitals to ensure we can continue to provide elective and plan to care during any second wave. we have plans in place hospitals can help each other to respond to the demand that they may see for covid and non—covid services. advances in scientific knowledge about asymptomatic transmission are helping with our infection control measures that our staff used to keep themselves and our patients say. more money and resources a re our patients say. more money and resources are going into the nhs111 a phone and online services, with
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more expert clinicians available to a nswer more expert clinicians available to answer enquiries. for the first time this winter, we will also see direct booking into our emergency department, our amd is, booking into our emergency department, ouramd is, to booking into our emergency department, our amd is, to keep people safe and direct them to be seen people safe and direct them to be seenin people safe and direct them to be seen in the right place for their condition. —— a&e. despite all of that, we are announcing no further measures today, specifically targeting those areas of the country —— we are announcing new further measures. we will be introducing, with test provided by test and trace, regular testing for its staff in these high—risk areas where they do not have symptoms. this help keep staff and patients in those hospitals say. we have asked the nightingale hospitals in manchester, sunderland and harrogate to mobilise over the next few weeks to be ready
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to a cce pt over the next few weeks to be ready to accept patients if necessary. the support they provide and how they will use scratch be up to local commissions whether it will be covid—19 patients requiring ventilation, there was a recovering or maintaining elective and diagnostic services with patients other than covid—19. it is a sad truth, that whilst we have done much to improve the care of those infected and while scientific research continues apace, it is still no cure, nor no vaccine for covid—19. that means, sadly, the numbers of those infected increases, so numbers of those infected increases, so will be numbers of those who die. the government is looking at what other measures can be introduced in the areas where infection is raising the areas where infection is raising the most. this is the secretary of state for health and say, if we do not take measures to control the spread of the vedas, the death toll will be too great to bear. —— of the
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virus. and my final slide, any additional measures that are put in place this week will take a number of weeks before we begin to see their benefits in hospital admissions. because of the length it ta kes admissions. because of the length it takes from the point of infection to develop symptoms and then the additional time beyond that before people become sick enough to require hospital treatment. so we should remind ourselves finally that right now and throughout the pandemic, the nhs has continued to treat thousands of patients with and without covid—19. whilst we have cared for more than 110,000 inpatients with the virus, we have also provided cancer treatment for more than 200,000 patients. during the last seven months, there have been 123 million gp appointments. every day, on average 108,000 babies have been born and we have carried out 10
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million urgent tests. at the head of the first wave where nearly 20,000 people in hospital with covid, more than double that were being treated. staff had to be diverted to battle covid—19. where we can, we do not wa nt covid—19. where we can, we do not want this to happen again this time. that depends on all of us doing what needs to be done to contain this virus in the community. we also want you to help us help you stay healthy and get the care you need. please use nhs services if you need them for your health needs. contact your gp if you're worried about cancer symptoms, an unusual number, for example, or blood in your you're in, use the emergency service if you have chest pain on another acute condition ——. seek advice through the 111 services are gps and
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pharmacists. but the key is that we must tackle this increase in covid—19 infections so that do not impact on the services that the nhs provides. the nhs is here to protect you from ill—health. as i have described, one of the area are seeing most increases, must increasing the rate of a cupboard infections is greater manchester —— covid infections. as greater manchester and that is why we have axed doctorjane manchester and that is why we have axed doctor jane eddleston manchester and that is why we have axed doctorjane eddleston to be here, she is here to give us an impression of what is going on on the front line. thank you. i am a consultant in intensive care medicine and have had been for 28 years and also a clinical leader within a greater manchester and the north—west. i am within a greater manchester and the north—west. lam here within a greater manchester and the north—west. i am here to share some of our experiences and identify for you what the challenging areas that we are facing at the moment. as you see from the slides, the northwest
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has about ao% of all covid cases at the moment. this is proving to be very challenging for us. within greater manchester, we have seen a threefold increase in the number of patients admitted to intensive care in the last five weeks and an eightfold increase in the number of patients admitted to hospitals. the situation at the moment is that 30% of our critical care beds are taken up of our critical care beds are taken up with patients with covid. this is starting to impact on the services that we provide for other patients. we are working as a system across notjust we are working as a system across not just greater manchester, but the north—west, to ensure that patients receive care, notjust those north—west, to ensure that patients receive care, not just those with covid, but other conditions. receive ca re covid, but other conditions. receive care in covid secure locations. we are doing ourvery care in covid secure locations. we are doing our very best, but at the moment 30% of our beds are occupied with patients with covid. i stress again the importance of us taking this disease extremely seriously. we are still finding adequate patients
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who had admitted to intensive care still require to go on a mechanical ventilator within 24 hours of admission. this is very serious. the condition produces a very profound inflammation of the lungs, which does have serious consequences for patients. i would ask you all to respect the virus and follow the advice that we are being given. i will pass back now to jonathan. thank you. you have heard from all three of us now and if i may very rapidly summarise, we have clearly shown that the covid situation is building nationally. particularly in the north—west and at the north—east. steve has emphasised that the nhs is there for everyone and not just to that the nhs is there for everyone and notjust to treat covid, but to treat all the health problems we have and to stop us from becoming unwell. there is, nevertheless, a massive collective responsibility on
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every citizen now to play their part in defeating this a virus and getting it back under control. i think we are now going to have some questions, and fergus walsh from the bbc. hello. question first for stephen powis, which is the last time the nhs coped during the first wave by cancelling nonurgent surgery and pausing a lot of cancer screening. how close are you to having to do that, especially in these hotspot areas in the north—west? question for jonathan mann time, we have heard a lot that in liverpool — — mann time, we have heard a lot that in liverpool —— jonathan van tam, we have heard that in liverpool bars and pubs might have to shut, is the scientific evidence that that will slow transmission and if that is,
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can you share it with us questioning thank you, so if i take the first question. in the first wave in april, we took a national approach to create the additional capacity that we needed everywhere to manage those patients i described, 20,000, 100,000 treated in all that we saw with covid—19 and unfortunately that didn't mean that we had to stand down elective services and planned care. we have seen increased waiting times as a result and we are really determined to get back to normal in terms of treating patients who are on those waiting lists. we will do everything we possibly can during the second wave to make sure that we maintain there services. of course, this time that we can see much more granular local pictures of how infection rates are rising, as jonathan has shown you. and therefore, we will be taking a much
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more local approach in order to keep services going. that involves hospitals helping each other, as i said. it includes the use of the independent sector hospitals where we can but it also might involve use of some of the nightingale hospitals. yes, we are beginning as jane has said, to see some impact on our capacity, but we are determined to keep that capacity for non—covid services open for as long as possible. but any key to this is reducing infection rates because it is the increase in infection rates which inevitably leads to an increase in pressure in hospitalisation of covid patients, which will inevitably lead to a pressure, also, on the non—covid services, so the key to this is the control of infection in the community. fergus, your question about pubs and bars, it would not be right of me to pre—empt any thing
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that might be said later on in the day. from that perspective, i think i will answer that question based on first principles. we do know that this virus, unfortunately, thrives on the thing we like most, which is human contact. this the other biological conditions that the spread of the virus are well encapsulated by the japanese advice about the three c is. the first c is close spaces, by that often with poor ventilation. the second c is crowded spaces. and the third c is close contact. i would add my own emphasis on t, the duration with which you're likely to be in spaces —— letter d and finally v, volume because we know, and we have increasingly strong evidence about
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shouting and singing as pressure points on the virus in terms of making the expulsion of virus laden particles that go further and at the transmission, therefore, to become more intense. so all of those settings where the three cs and duration and volume may apply are areas duration and volume may apply are areas where dividers will thrive and spread if we allow it to. —— the virus. thank you, fergus. ithink spread if we allow it to. —— the virus. thank you, fergus. i think we will pass on now to richard palette from itv. good morning. my first question for professor powys, given there are huge increases of cases in there are huge increases of cases in the livable hospital, confident are you that transmission is happening in the community in health care settings such as hospitals and care
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homes? for professor van tam, human contact does notjust homes? for professor van tam, human contact does not just take homes? for professor van tam, human contact does notjust take contact in hospitality was that we have seen restrictions on hospitality and back then, oldham, bolton, itjust has not worked. how about the measures of transmission going on in educational settings? how worried are you about that when there are no restrictions on that currently? thank you, richard. i am very confident and jonathan has shown you the data that infection rates are increasing in the community, particularly in the areas you have mentioned around the north west and merseyside so the data is clear and the difference from the first wave in april is we have that data, this time round we can see it very local level how infection rates are increasing and those heat maps that jonathan showed earlier showed new community transmission and increased rates of infection in the community.
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it is obviously important we also control infection in hospitals, we are doing that with some of the measures i have described and announced today we will introduce regular testing of asymptomatic staff in those high prevalence areas. this is a problem of community infection rates increasing and inevitably causing or resulting in an increased number of admissions into hospitals. i thinkjane could give you some more granular detail of what is happening in men they'd make merseyside and greater manchester. yes, the transmission, it is important the stuff that staff adhere to the three, hands face and space and that is entirely what they have been doing. the last weeks, we have been doing. the last weeks, we have had a real focus in hospital on
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those measures because it is imperative to reduce the rate. thank you. richard, to your question about indoor spaces generally, you are right that closed indoor spaces carry a much greater risk of transmission than outdoor spaces and to your particular question about education, actually if you slice the infection data very carefully across the school age bands, what you actually see is very low rates of increase in infection up to around the age of 16 and then picking up a bit in the 17 to 18—year—olds as we drift into that age bracket which i have already discussed of really quite intense transmission. the evidence there is significant transmission in schools is not
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really borne out by the increased infection rates and we already know that children are not drivers of infection and spread in the community in the same way that we know they are for influenza, for example, hence our child ren's know they are for influenza, for example, hence our children's flu vaccine programme which is so important. and therefore it is a different illness that we are dealing with. thank you. i think we are moving now to nick mcdermott from the sun. a quick question for professor powis. hospitals about 4000 covid patients in bed and admission rates are similar to late march. are we in a better or worse position than you expected us to be ahead of winter and we will see more
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before christmas? and mr van tam, when testing trace was large, it was built as a way out of lockdown but we are expecting more restrictions now, so has the second line of defence failed us? ifi now, so has the second line of defence failed us? if i take the first question. we are in a better position than we were in march and april. clearly, we have learned many things from that first wave, we have learned better treatment for patients and certain drugs, we learned they reduce deaths and reduces the severity of the disease because we were able to do those clinical trials in over 170 nhs hospitals and i think that shows what the nhs is able to do in terms of rapidly setting up clinical trials and learning from them. we know better ways to deliver oxygen, so know better ways to deliver oxygen, so not so many people might need
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mechanical intervention for instance, we can make more use of noninvasive ventilation where we don't need to put people to sleep to ventilate them. we have also been able to prepare in terms of ensuring hospitals are working with each other that we can use independent hospitals and other approaches. we are better prepared and the rate of infections is not at the doubling time that we saw in march so that is good news. but they are number is above one, that means infections will continue to rise and as infections continue to rise then the impact on health services will continue to rise. also as night follows day. so the key to this is to keep community transmission under control and move the r number back towards one and ideally below one
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because it is only by reducing the increased rate of infections that we will reduce the impact on deaths and on hospitals. it is not a question of if rates continue to rise, it is a question of when. my answer to your question about testing trace is probably in three parts. the first is that it is always difficult and challenging to build a system and run it at the same time and that leads to some challenges in the development pathway. also, testing and tracing in any system however you decide to do it is always going to be more challenging as the numbers of infections pick up. and it could well be the case we would be in it could well be the case we would beina it could well be the case we would be in a worse situation by now if we had not had test entries notifying
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people —— test and trace and telling them to self—isolate. please use the system, it remains vitally important. and on the nightingales, we have asked those hospitals in the north to go into a higher state of readiness, we have kept them across the country over the summer, we are asking those nightingales in the high prevalence areas to go on to a higher state of alert and we will do that with the nightingales if the need arises in the rate increases in other parts of the country. thank you very much. we will move to the next question. one question that you, jonathan, and then one for steve. can you tell us about the new evidence that appeared, did new data that you got over the weekend which
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changed the map from when you're parked to the mp5 showing an alarming spread of the dark colour further south. where did that come from and how much it showed that worry us? and then i wanted to ask steve a bit more about the two measures he talked about, particularly expanded testing of nhs staff. i don't cover hospitals in any detail but i assume that sort of testing was happening very extensively anyway. can you tell us please who is being tested, who will be tested that hasn't been tested so far? what sort of staff, doctors, nurses, other hospital people, people in primary care? thank you. i really appreciate the question because you can have kind of worried me that i might have presented a bipolar picture that covid—19 is a
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problem in the north and not a problem in the north and not a problem in the south. on the contrary, the epidemic this time has clearly picked up pace in the north of england earlier than it did in the first wave and that relates to the first wave and that relates to the fact that disease levels in the north never dropped as far as they dropped in the summer as they did in the south. but pretty much all areas of the uk are now seeing growths in the infection rate and that extended brown a map that i showed you that is sourced from the joint bio—security centre absolutely makes that point. there are not absolute rates, they are rates of change. for example, in the city where i am a
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university professor when i am not working for the dhs c, nottingham, there have been the very rapid change in rate over the last couple of weeks, but this is a nationwide phenomenon and now that rates are changing upwards across the uk. i hope that helps. so one testing, the government's first priority is to test people and patients who are displaying symptoms of covid and we have expanded in the nhs our testing in different circumstances including people who are coming in for regular treatment, surgery to ensure they are coming into the hospital is free of covid. that keeps the patients and staff safe and also means they are likely to have better outcomes from their surgical procedures. with staff, we have been testing symptomatic staff for many months
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and where we have seen outbreaks in hospitals or perhaps local communities we have also done increased testing of all staff in those areas. as capacity increases and we are able to see new technology in testing emerging that we are starting to implement in the nhs, we are now at the point where we will be able to more systematically test a symptomatic staff on a regular basis. we will do that first on the advice of the chief medical officer in those areas of the country with high infection rates such as the north west. with staff, we want to test front—line staff, we want to test front—line staff in hospitals but it is not just front line staff. we know from serology studies where we looked at antibodies that it can be parties, receptionists who can catch the virus. it is notjust the doctors and nurses. and we want to extend
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this out of hospital into primary ca re this out of hospital into primary care settings such as general practice. ok. that concludes the briefing for this morning. thank you, people, for listening in, thank you, people, for listening in, thank you to the media for listening on and thank you to these specific journalists of other questions. this briefing is concluded. studio: that was the briefing there from jonathan van—tam, the deputy chief medical officer alongside the national medical director for officer alongside the national medical directorfor nhs officer alongside the national medical director for nhs england stephen powis and doctorjane eddleston who is a medical lead for greater manchester. right now the pm is in greater manchester. right now the pm isina greater manchester. right now the pm is in a cobra meeting fleshing out the final details of the three tier system which will be announced later today and that briefing from the medical experts was very much teeing up medical experts was very much teeing up what we will hear later on the
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political front in terms of measures that will be taken to deal with the uplift in the number of covid—19 cases. we heard on the medicalfront it isa cases. we heard on the medicalfront it is a nationwide phenomenon now that rates are changing across the uk. our deputy political editor vicki young is at westminster. there is a lot of data out there that you have do track it down. there is a lot of data out there that you have do track it downm is interesting the government has decided to come forward with the head of the nhs in england and with the deputy chief medical officer and put this kind of information out there for people with the graphs, with all of the information and i think they do feel they need to explain to people why after that severe lockdown in the spring they
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now feel that they are going to have to be extra restrictions. they are really making the case for it and saying to people reluctantly they will have to bring this in. i think thatis will have to bring this in. i think that is because lots of people in the first wave very much on side with what happened with the restrictions that were brought in by the government that people have been through a very difficult time and to face that again now, i think the government realises they have to try to explain to people and you could see very starkly the particular problems in the north—west, the north—east but then as you could see from the graphs, starting to encroach on the east midlands and other places also. although the worst of it at the moment is in cities such as liverpool and manchester, they feel this is not just an issue for the north of england and so that is why later on at half past three in the house of commons we will hear from the prime
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minister about what those restrictions will be or the

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