Older coronavirus patients will be given “scores” to determine whether they are suitable for critical care under new guidelines.

In this case “points” does not “mean prizes”. With 30% of East Devon aged 65+ automatically gaining penalty points, perhaps the Exeter Nightingale won’t be needed after all.

Greg Wilford www.thetimes.co.uk 

Doctors and other health professionals have been issued with a “clinical frailty scale” to identify “who may not benefit from critical care interventions”, the NHS has confirmed.

Infected people aged 65 or over will be given a points tally based on their age, frailty and underlying conditions. According to the system, if someone scores above eight points they should probably not be admitted to intensive care, according to the Financial Times.

Instead, they should be given “ward-based care” and a trial of non-invasive ventilation, the newspaper said. However, official guidance states that clinical discretion could be used to override the scoring system if a situation requires “special consideration”.

A frontline NHS consultant said: “The scoring system is just a guide. We make the judgment taking into account a lot of information about the current ‘nick’ of the patient — oxygenation, kidney function, heart rate, blood pressure — which all adds into the decision-making. If this was a bacterial pneumonia or a bad asthma attack, then that is treatable and you might send that older patient to intensive care.”

The NHS says the scale has not yet been validated for use with people under 65 or those with learning disabilities. It can currently be used by “any appropriately trained healthcare professional”, including doctors, nurses, healthcare assistants and therapists.

Any patient aged 71-75 will automatically score four points for their age and a likely three for their frailty, taking their total to seven, it was reported. Those with conditions such as dementia, high blood pressure or recent heart and lung disease will be given more points.

An NHS website outlining guidance on the scoring system states that it “is a reliable predictor of outcomes in the urgent care context”. It continues: “Like any decision support tool, it is not perfect and should not be used in isolation to direct clinical decision-making.

“It will sensitise you to the likely outcomes in groups of patients, but clinical decision-making with individual patients should be undertaken through a more holistic assessment, using the principles of shared decision-making.”

The scoring system is included in guidelines on critical care for adults with Covid-19 issued by the National Institute for Health and Care Excellence (Nice). It was originally developed at Dalhousie University in Halifax, Canada. The news emerged after NHS England wrote to all GPs asking them to contact vulnerable patients to ensure that plans for end-of-life decisions were in place.

Ruthe Isden, head of health and care at Age UK, said some elderly patients have felt unsettled and pressured to sign “Do not resuscitate” forms. “Clinicians are trying to do the right thing and these are very important conversations to have, but there’s no justification in doing them in a blanket way,” she said. “It is such a personal conversation and it’s being approached in a very impersonal way.”

Some intensive care wards are now approaching capacity, with about 5,000 Covid-19 cases presenting every day. The NHS and Nice declined to comment last night.

Haroon Siddique  www.theguardian.com 

The government has been warned that Britain risks having the highest death toll from coronavirus in Europe as the total number of fatalities from the disease in UK hospitals rose above 10,000.

As Boris Johnson left hospital on Sunday, criticism of the government’s response to the pandemic was mounting from senior medics and politicians, particularly over its failure to get enough personal protective equipment (PPE) and testing to NHS and care home workers.

Prof Sir Jeremy Farrar, an adviser to the government and director of the Wellcome Trust, said the figures of almost 1,000 daily hospital deaths showed the UK was in a similar situation to other European countries that had been badly affected.

“Numbers in the UK have continued to go up. I do hope that we are coming close to the numbers reducing. But yes, the UK is likely to be certainly one of the worst, if not the worst affected country in Europe,” he told the BBC’s Andrew Marr Show.

In a video message in which he stated optimism and gave thanks for his care, the prime minister attempted to reassure the nation that the UK was “making progress in this incredible national battle against coronavirus”.

He said the NHS had “saved my life, no question” and praised two nurses in particular – “Luis from Portugal and Jenny from New Zealand” – for watching over his bedside in intensive care for 48 hours “when things could have gone either way”.

The total number of hospital deaths stood at 10,612 on Sunday, up by 737 from 9,875 the day before. On Friday and Saturday, the death toll rose by more than 900 each day.

Epidemiologists and public health experts are divided over how effective the government’s response has been but criticism has been increasing in recent weeks as the UK death toll rises.

Sue Hill, vice-president of the Royal College of Surgeons, said she believed UK deaths could rise to 30,000. She acknowledged that the government has a difficult job but said it gave the appearance of placing “political spin” over action.

Describing the daily Downing Street briefing as “a bit of a joke”, she said: “He [Boris Johnson or another cabinet minister] is sitting there speaking about subjects he doesn’t really understand and can’t answer questions about it. It’s political spin, isn’t it? They’re not doing themselves any favours.

“The thing that irritates me is cabinet ministers are standing up every day, addressing us as if we’re on a war footing and giving Churchillian quotes when they could be doing a few simple things like getting more bits of plastic and paper [which personal protective equipment is made out of] on to wards.”

Prof John Ashton, a former regional director of public health for north-west England, who has previously criticised the government over the crisis, said its performance had worsened.

He said: “It was the failure to convene [the emergency committee] Cobra at the beginning of February that meant everything else flowed from it, the failure to order equipment etc. Now we are into the cover-up. Any journalist worth their salt should boycott this propaganda [the daily briefing]. They don’t answer any questions.

“The chief nurse deflected the question about the number of nurses and doctors who died because of confidentiality. She wasn’t being asked about individuals, she was being asked about numbers.”

He also said that people were dying in care homes and at home without being tested while some were being sent home to die before they had been tested.

“There are probably large numbers of people who are not being counted,” said Ashton.

Dave Prentis, general secretary of Unison, said “the time for excuses has passed” when it came to PPE failures and the deaths of medical and care staff.

“Ministers have been saying for weeks that the PPE situation is in hand. That there’s enough to go around and it’s just a matter of logistics. But it isn’t good enough,” he said.

“NHS, care and other key workers are falling ill in huge numbers. Some have already died – including nurses, doctors, care workers, healthcare assistants and porters.”

Unison said its PPE alert hotline has been told of care workers being told to wash their face masks for reuse, threatened with the sack for using them, having to buy their own stock and having to use watered down handwash.

Labour has tried to strike a constructive tone when criticising the government, but Sir Keir Starmer warned of a “mismatch” between the complaints of medical and care staff that they lack protective equipment and ministers insisting there is enough to go round. The new Labour leader is also expected to press the government this week on gaps in the UK’s financial support schemes for workers and businesses.

Andy Burnham, Labour’s last health secretary, said: “The issue is not whether mistakes will be made, the question is how quickly do you acknowledge them and correct them. I think on certain issues they have done that but on what’s most material – PPE – they haven’t.”

Meanwhile, Labour backbenchers were breaking rank with the leadership, with Barry Sheerman, the Huddersfield MP, saying the government had “failed abysmally” to protect NHS staff.

He had, he said, tried his “hardest to be fair to the government … but mounting evidence of the sheer incompetence of ministers and the grim fact of 10,000 deaths means now the gloves are off”.

Peter Hain, the Labour peer and former cabinet minister, told the Guardian: “It’s becoming crystal clear the government has shamefully abandoned frontline health and care workers to their Covid-19 fate as they battle to save the desperately ill.”

The opposition has called for immediate talks on the return of a virtual parliament. But with the Commons not due to be recalled until 21 April, Sir Bernard Jenkin, the senior Tory MP and chair of the liaison committee scrutinising the government, called for ministers to agree to a hearing this week.

Writing for the Guardian, he said: “Proper, considered, penetrating, constructive scrutiny does really matter. This is not about hauling ministers before MPs to blame them for the problems they cannot instantly resolve.

“Former cabinet secretary Gus O’Donnell should be commended for his searing honesty when he recently admitted, without prompting, that he should have advised previous governments to commit far more resources to flu pandemic planning.

“This crisis calls for the same candour and transparency – that is what speeds up the learning process, leading to better decisions and more effective action.”

Speaking at No 10’s briefing on Sunday, Matt Hancock, the health secretary, insisted that both more testing and PPE were on their way to the care sector but he could not give a timescale for when either problem would be sorted out, saying it was “impossible” to say when the right kit would be in the right place across 58,000 sites.

Admitting the death figures meant it was a “sombre day” for the UK, he also could not give an update on the number of NHS staff who have died, saying the last previous figure was 19. Statements from hospitals and the families of workers show the figure is more than 30.

The usefulness of figures provided by the government in tracking the spread of the virus have also been called into question, with concerns about the lack of tracking of cases – and deaths – outside hospitals.

Dr Chaand Nagpaul, the British Medical Association’s council chair, said with testing only going on in hospitals, it was difficult to draw any conclusions from the government statistics.

Analysis: Ultimately, it may be that the reason for our death toll is simple. The countries that have done the best, so far, engaged in massive testing and isolation early on. We tried to do that, but did not have the capacity.

Steven Swinford, Deputy Political Editor  www.thetimes.co.uk 

Britain’s coronavirus death toll has passed 10,000 as a government adviser warned that the UK could become the worst affected nation in Europe.

The number of people who died from Covid-19 rose by 737 to 10,612 yesterday and nearly 20,000 people have been admitted to hospital with the illness.

Sir Jeremy Farrar, director of the Wellcome Trust, who sits on the government’s scientific advisory committee, said that the UK could learn lessons from Germany, which introduced mass testing at an early stage.

Matt Hancock, the health secretary, called it a sombre day, and questions mounted over Britain’s strategy and whether enough protective equipment was being supplied to frontline NHS workers.

On a positive note, Yvonne Doyle, the medical director of Public Health England, said there were signs that the number in hospital with coronavirus in London was beginning to stabilise but she added: “On the other hand we start to see other areas increasing, particularly the northwest and Yorkshire. It’s very important that the message about staying home and social distancing is adhered to because we are certainly not past this crisis’s damage yet.”

Sir Jeremy also raised concerns about evidence in South Korea that people were becoming reinfected with the virus, which he said could have “massive ramifications” for the development of a potential vaccine. He added that, although a vaccine may be ready by the summer, it could take months to develop the manufacturing capacity needed to distribute it.

He told The Andrew Marr Show on BBC One: “The numbers in the UK have continued to go up. I do hope we are coming close to the number of new infections reducing. But, yes, the UK is likely to be one of the worst, if not the worst, affected countries in Europe.”

He said that Germany had introduced testing at a remarkable rate, adding that the country’s mass testing regime had given it a “critical six to eight weeks” to prepare its health system for the pandemic.

“It is still early in this epidemic. What is critical for Germany is they continue that testing and isolation,” he said. “Inevitably the UK will learn lessons from how Germany has managed to control the epidemic to date.”

On South Korea, he said that evidence suggested that as many as 100 people had become reinfected. “It is critical to understand whether those are one viral infection that has persisted in one individual and now has reactivated or whether they’ve been infected with a second virus,” he said. “Either way immunity in some people is not complete and that has major ramifications for the ability to make a vaccine and also for the community to be protected against further waves.”

He said that vaccines and treatments for coronavirus “are really our only true exit strategy from this”, but added that “the chances of second and third waves of epidemic are probably inevitable”.

In an interview with The Times published on Saturday, Sarah Gilbert, professor of vaccinology at Oxford University, said that the vaccine being developed by her team could be ready by September.

Sir Jeremy said that a vaccine could begin to become available in September but added that manufacturing capacity had to be created to ensure that there was enough to give to billions of people around the world.

He also said that there was evidence that ethnic minority communities were more at risk from coronavirus. He told the BBC: “There is some evidence growing both in the United States and here in Europe that people from [ethnic minority] backgrounds are more at risk. What is critical to work out is whether that is something specific to that background or is it related to other risk factors we know about: age, other illnesses people have . . . diabetes, people who are obese have been more affected, people with high blood pressure, people with heart disease, lung disease.”

Mr Hancock was asked if the “good outcome” of keeping UK deaths below 20,000, as previously stated by Sir Patrick Vallance, the government’s chief scientific adviser, remained likely. He said: “The future path of this pandemic in this country is determined by how people act and that’s why it’s so important that people follow the social distancing guidelines. Predictions are not possible because they depend on the behaviour of the people and I’m really glad that at the moment the British people this weekend are doing their bit.”

ANALYSIS Deaths are hard to explain away (Tom Whipple writes). Comparing countries on the basis of diagnoses is fraught with difficulty. Are they lower in one because there is less testing? Are they higher in another because their testing focuses on hospitals?

Comparing hospital admissions is hard, too. One country may have different criteria for entry, for example, or a different definition of intensive care.

So statisticians tend to place more — though not complete — trust in deaths. They are, to use the technical term, a clear data point, not especially open to interpretation.

On that basis, Britain’s death toll is tough to defend. Our curve is yet to flatten and our daily figure, which still does not count many care home fatalities, exceeds that of the worst-hit countries in the EU, Italy and Spain, at their peak. That those countries still have more deaths in total is little comfort.

Each day’s deaths represent infections from almost a month ago. Since a revolutionary treatment is not on the short-term horizon, it seems plausible that we will pass Italy and Spain in absolute numbers and possibly pass Italy in proportion, too.

That would not necessarily be proof that we had done the wrong thing. Each country is different. London is a global hub with a large, dense population: it was always going to risk a big outbreak. On the other hand, we are also an island. Germany, which isn’t, has managed to control the disease better than any large country in Europe.

Ultimately, it may be that the reason for our death toll is simple. The countries that have done the best, so far, engaged in massive testing and isolation early on. We tried to do that, but did not have the capacity.

(Owl can find nothing from Neil Parish since the “Stay at home and wash your hands” message of 9 April )

A message to our readers from the East Devon MP, Simon Jupp

Philippa Davies  www.midweekherald.co.uk

My thoughts are with Boris Johnson following his admission to intensive care on Monday.

This is a stark reminder of the foe we face and a wake-up call to everyone to follow the clear instruction to stay at home to protect the NHS and save lives.

We are truly living in tough times. I returned home to Sidmouth at the earliest opportunity and I’ve been working seven days a week to help constituents access government funding and return from far-flung places.

Whether you are a well-established firm employing hundreds of people or a small family business, this virus has caused a great deal of anguish as profits evaporate and income dwindles. The Government has offered a wide range of schemes and I’ve been working with businesses across East Devon who’ve contacted me because they’ve not been able to access the support they need.

I hope everyone recognises the speed in which support for jobs and our economy were put in place by the Government. The situation we face is no easy task for any government and alongside my colleagues in Parliament, I’ve worked hard to highlight areas where further support for individuals and businesses is needed. As a result of examples from East Devon and beyond, we’ve seen significant improvements made to the Job Retention and Business Interruption Loan Scheme.

My small team and I continue to receive hundreds of emails a day and we’re working through them as quickly as we can, prioritising urgent cases, as you’d expect. For example, I have recently intervened in cases where care homes have been abandoned by their usual food supply company, and put them in touch with local providers.

I’m acutely aware of the concerns about the strain on our precious health service and I’m in regular touch with NHS leaders and frontline staff to understand the situation on the ground in our hospitals. The availability of PPE in our hospitals is something I’m monitoring closely to ensure any concerns are addressed quickly.

have published a list of the volunteer community support groups setup in towns and villages across East Devon on http://www.simonjupp.org.uk. I’ve also signed up to help in my community and want to thank everyone for playing their part to defeat this virus.

I’m proud to represent an area which has rallied around its communities, demonstrating the determination we need to get through this, together.

SIMON JUPP, MP

Wellcome Trust director Sir Jeremy Farrar told the BBC’s Andrew Marr Show the UK was likely to be “one of the worst, if not the worst affected country in Europe”.

Andrew Marr Show http://www.bbc.co.uk

Currently Italy has the highest number of deaths of any European country – with more than 19,000 deaths – followed by Spain, France and the UK, according to data compiled by Johns Hopkins University.

Germany has kept deaths below 3,000 so far.

Sir Jeremy, a member of the government’s Scientific Advisory Group for Emergencies (Sage), told the BBC’s Andrew Marr Show the “remarkable” scale of testing in Germany had been key to keeping the number of hospital admissions for coronavirus lower than in the UK.

Sir Jeremy said testing allowed countries to isolate people with Covid-19, preventing them from transmitting the virus to others, as well as buying time for hospitals to prepare.

“Undoubtedly there are lessons to learn from that,” he added.

The UK government has said it wants to do 100,000 coronavirus tests a day by the end of April but has faced criticism for not increasing the number more quickly.

Sir Jeremy said a second or third wave of the virus “was probably inevitable” and treatment and a vaccine was “our only true exit strategy”.

He said a vaccine could be available by autumn but it would take longer to ramp up manufacturing to the scale required to vaccinate many millions of people.

“I would hope we would get [that] done in 12 months but that is in itself an unprecedented ambition,” he said.

Asked whether he agreed with Sir Jeremy’s analysis of the UK’s death rate, Business Secretary Alok Sharma said: “Different countries are at different stages of this cycle.”

“What we have done with the advice that we have now set out to people, to stay at home, is precisely because we want to make sure that we have a flattening of the curve, that infection rates aren’t going up, and ultimately people’s lives are being saved,” he told the programme.

“We are starting to see these measures work,” he added, but said it was too early for them to be lifted yet.

Prof Keith Neal, emeritus professor in the epidemiology of infectious diseases at the University of Nottingham, said it was likely the UK would have one of the largest numbers of coronavirus deaths because it had the second largest population in Western Europe after Germany.

“The important figure is the death rate per million and not the total number of deaths. On this count Belgium seems to be heading for a serious problem like Italy and Spain,” he said.

Covid-19 has found an ally in its pursuit of infecting as many people as possible in the shortest space of time — the older white man.  (Obvious – Owl)

“It won’t be easy to rein in the older white man without some form of martial law. The government has deployed every public relations trick in the book. There has been a carpet bombing of emails, letters, press briefings, adverts and headlines all delivering ever more apocalyptic warnings to the public. The doom cupboard is almost bare.” 

Richard Stokoe lectures at the University of South Wales on planning for disasters and civil contingencies and on strategic leadership www.huffingtonpost.co.uk 

Boris Johnson and his dad, Mike ‘Sports Direct’ Ashley, Matt Hancock, Neil and Stephen Kinnock, Tim ‘Wetherspoons’ Martin, Donald Trump, Michael ‘Ryanair’ O’Leary and Robert ‘I drove to visit my parents’ Jenrick. High-profile individuals that at first glance have very little in common. Yet they have all shown public disregard for either the virility of the virus or the advice to stay at home, self-isolate and socially distance.

They are not alone. A recent UK wide poll by JL Partners found that around 3.6 million people are still ignoring social distancing advice, 2.6 million aren’t washing their hands and 3.1 million people are still content to hug or shake hands.

Politicians, like Michael Gove  have lazily pointed to millennials being the culprits. They cite the photos of groups of young people shopping in markets or lounging in parks as evidence that, true to form with rebellious youth, it is they that are breaking the rules and putting lives at risk. 

This is simply wrong. The group that will disobey warnings in a crisis far more than any other is older white men. It is known as the ’White Male Effect’.  

Not all older white men expose themselves to greater unnecessary risk by failing to trust or act on warnings, and not all women or young people will play ball either. We all remember ‘Chris’, the infamous BBC Radio Solent caller who proclaimed she was happy to risk walking on the beach in return for her life. But a far higher proportion of older white men will expose themselves to risk than any other group, including millennials.   

Research repeatedly demonstrates that white men, especially older ones, consistently ignore warnings. They have a greater distrust of officialdom and experts, believe more in their own instincts to be right over anyone else’s and, have a higher tendency to not do what they are told even if it is for their own good or the good of others. They believe in their own invincibility and immortality.

In tornadoes, older white men, compared to anyone else, are less likely to take shelter. In floods they are far more likely to refuse to leave the area. During Covid-19, it means many won’t stay home to save lives. 

This White Male Effect will also almost certainly have played a part in how slowly the UK and the US responded to the emerging pandemic. Both the Johnson and Trump administrations have also turned to older white male experts for how to manage this crisis — the notable exceptions being Jenny Harries and Yvonne Doyle.

This White Male Effect is caused primarily by the education system and society as a whole, which encourages white men to believe in their own superiority. 

The longer a white man lives in Western society, the longer he is exposed to subtle influences that tell him he knows best. He has a higher opinion of himself, a determination to assert dominance over others and a fear of other groups, such as younger people or women, undermining his authority. 

The ongoing challenge for government is to keep older white men on their side as social distancing measures drag on. 

The lockdown appears to be working in terms of ‘flattening the curve’. For the current measures to continue to be successful it takes the vast majority to obey. This need to continue to alter our behaviour will wear thin on many of those older white men who originally conformed. 

Once the initial news blitz declines, and he hasn’t experienced Covid-19 for himself, older white man will think the government has cried wolf. He will believe it is overhyped and will become desensitised to the crisis far quicker than anyone else. The latest uptick in traffic on the roads shows that he probably already is.

It won’t be easy to rein in the older white man without some form of martial law. The government has deployed every public relations trick in the book. There has been a carpet bombing of emails, letters, press briefings, adverts and headlines all delivering ever more apocalyptic warnings to the public. The doom cupboard is almost bare.

The government has commandeered some of the best and most astute older white male minds to tackle the impact of coronavirus. Now they must reach out to the brightest in disaster management, behavioural economics, nudge theory, marketing and public relations, and ask them to solve the White Male Effect conundrum before it is too late. 

This effort must include women, ethnic minorities and younger people rather than another pale male cohort — otherwise the same mistakes will be repeated and more lives will be lost.   

“Sir Ian Boyd, the chief scientific adviser to Defra between 2012 and 2019 , told the Guardian it was difficult to get ministers to spend money on preparing for high-impact, low-frequency events like pandemics. “Governments over the years have buried their heads, and it is harder to have those conversations with people who have a small-government view of the world,” he said.”

Felicity Lawrence  www.theguardian.com

UK government stockpiles containing protective equipment for healthcare workers in the event of a pandemic fell in value by almost 40% over the past six years, the Guardian has found.

Analysis of official financial data suggests £325m was wiped off the value of the Department of Health and Social Care (DHSC) emergency stockpile, reducing it from £831m in 2013 under the Conservative-led coalition government to £506m by March last year.

The finding is likely to raise further questions for the health secretary, Matt Hancock, who faced criticism over the weekend after urging healthcare workers not to “overuse” personal protective equipment (PPE).

The revelation raises questions about why the value depreciated so quickly and how the fall related to stock-levels.

According to official figures at least 19 UK healthcare workers had died after contracting coronavirus. Frontline medical staff have complained of PPE shortages, which they say are putting lives at risk.

Last week, it emerged that three nurses who had been wearing bin bags due to a lack of PPE had tested positive for coronavirus. It was also confirmed that a consultant at a hospital in east London died from the virus weeks after making a plea to the prime minister for more PPE for NHS staff.

Hospitals have turned to schools for donations of science goggles amid shortages of eye protection, while some NHS staff have made improvised masks out of snorkels and bought kit from hardware stores.

The widespread shortages of equipment, which Hancock has blamed on problems with the distribution system, has raised questions about the UK’s levels of preparedness for a pandemic of this kind.

Accounts suggest funding for “stockpiled goods” that are “held for use in national emergencies” was increased between 2008 and 2011, when pandemic preparedness was identified as a national priority for the NHS. But since 2013 the value of the stockpile has fallen.

The findings are likely to renew questions about whether government stockpiles held sufficient quantities of personal protective equipment (PPE) before the Covid-19 pandemic and whether emergency preparations were affected by almost a decade of cuts and reduced public investment.

On Sunday, it was revealed that one in three UK surgeons say they do not have access to enough masks, gowns and other clothing to keep them safe.

Contacted by the Guardian, DHSC declined to provide a breakdown of its emergency stockpile’s contents, which will also include medicines such as antivirals and flu vaccines. However, NHS plans drawn up in 2017 state that “the bulk of” the pandemic stockpiles available to the health service consisted of PPE, including FFP3 respirator masks, gloves and aprons.

The stockpiled goods have shelf lives and so require frequent replenishment. According to the DHSC’s financial accounts, between 2011 and 2019 depletions of the emergency stockpile significantly outstripped the amount spent on adding new supplies to the reserves.

A spokesman for DHSC said the value of the emergency stockpile “does not relate to the volume of its contents”, adding that “through responsible procurement” officials had been “successful in maintaining its stock”.

The department refused to answer the Guardian’s questions about the volume of the stockpile in 2019 compared with 2011.

The spokesman said the UK was “one of the most prepared countries in the world for pandemics” and the government “continues to work around the clock to give the NHS and the wider social care sector the equipment and support they need”.

The reduction in the stockpile’s value occurred at a time the government considered that a pandemic represented the most serious emergency threat likely to face the UK. The government has in recent years been concerned about the rapid worldwide spread of a novel virus to which people have no immunity.

Since 2007, a series of studies and exercises to prepare the UK for an event of this kind identified the availability of PPE for health and social care workers as a cornerstone to a national response, essential to reducing transmission of a new virus.

Dr Lindsey Davies, a former national director of pandemic influenza preparedness, told the Guardian that PPE shortages were modelled as far back as 2007, during a large cross-government pandemic simulation codenamed Exercise Winter Willow. “It was a live issue at the time,” she said.

Davies explained that following the 2007 exercise “there was an increased momentum after that to develop a business case for stockpiling, and a lot of discussion about the right amounts and how far it was right to have a nationally funded stockpile”.

In the wake of the Winter Willow exercise, and with the emergence of the swine flu pandemic two years later, the Department of Health, as it was then known, embarked on a procurement programme aimed at boosting stockpiles of medicines and PPE, according to departmental accounts and performance reports. By the end of the 2010-11 financial year, the value of the department’s stockpile stood at £830m, an 80% increase from 2008-09.

In 2016, after years of delays, the government staged another nationwide pandemic drill, codenamed Exercise Cygnus. The exercise, which simulated a deadly outbreak of so-called “swan flu”, is believed to have shown that in the event of a deadly pandemic the NHS would be overwhelmed by a shortage of critical care beds and vital equipment.

The government is refusing to release the official conclusions from Exercise Cygnus, which have never been made public, but there are indications in reports by local authorities who participated in the exercise that PPE supplies were an area of concern.

It is not clear whether at a national level the conclusions included recommendations about emergency stockpile funding. But DHSC accounts show that in the three years after the 2016 drill, the value of the stockpile fell by more than £200m.

Sir Ian Boyd, the chief scientific adviser to Defra between 2012 and 2019 , told the Guardian it was difficult to get ministers to spend money on preparing for high-impact, low-frequency events like pandemics. “Governments over the years have buried their heads, and it is harder to have those conversations with people who have a small-government view of the world,” he said.

This year, as the government began to consider the threat posed by the novel coronavirus outbreak in China to the UK, PPE soon found its way on to the agenda of meetings between officials and high-level scientific and clinical advisers.

Minutes of meetings suggest that as early as January the government was involved in discussions with advisers about when emergency PPE stockpiles would need to be released.

During a meeting on 28 January of the government’s new and emerging respiratory virus threats group (Nervtag), attended by senior officials including England’s chief medical officer, Chris Whitty, it was noted that if sustained community transmission of the novel virus in the UK was established, the numbers of infected patients in hospitals would rise. “This would entail deployment and use of the UK’s pandemic influenza PPE stockpiles,” a minute of the meeting states.

According to minutes from early February, Nervtag went on to make a series of recommendations to the government’s emergency committee Cobra about what PPE would be required for different settings and different groups of workers. A month later, in early March, advisers discussed a potential scenario where stocks of respirator masks ran out.

Additional reporting by Rob Evans

We spend just over 2% of gdp on defence to protect our nation against  traditional threats—invasions, terrorist attacks, something created by an enemy (about £50bn/year) but nothing to provide a surge capacity to deal with a future epidemic.

Yet a pandemic was recognised in 2010 as one of the highest risks we face. In fact, at the time, our first ever national security adviser, Peter Ricketts, placed the risk of a pandemic higher and greater than a military invasion.

Austerity, austerity – no money. “Penny wise, pound foolish?”  Osborne economics – Owl

Steve Bloomfield  www.prospectmagazine.co.uk

“The risk of human pandemic disease remains one of the highest we face,” stated the UK government’s 2010 national security strategy. The “possible impacts of a future pandemic,” it continued, “could be that up to one half of the UK population becomes infected, resulting in between 50,000 and 750,000 deaths in the UK, with corresponding disruption to everyday life.”

According to the government’s national risk register, published at the same time, a pandemic would lead to “normal life… likely fac[ing] wide social and economic disruption; significant threats to the continuity of essential services; lower production levels; shortages; and distribution difficulties. Individual organisations may suffer from the pandemic’s impact on staff absenteeism therefore reducing the services available.”

In short, we knew this would happen. Ten years ago, the government’s new national security council, led by its first ever national security adviser, Peter Ricketts, placed the risk of a pandemic higher and greater than a military invasion. Why, then, were we not prepared?

“We put it up in lights,” recalled Ricketts, when I spoke to him over the phone last week. “But it never got the resourcing because there was always an immediate crisis.” And yet, the 2010 strategy was written in the wake of the swine flu pandemic. “That should have been a wake-up call,” said Ricketts. “I don’t know why more wasn’t done. There was always a higher priority than buying more ventilators.”

His successor, Mark Lyall Grant, who authored the follow-up strategy in 2015 that also categorised a pandemic as a “tier one” risk, was even blunter, questioning the role of other government departments. “Getting the Treasury to allocate money for contingencies is extremely difficult,” he told me. Furthermore, “I don’t recall the Department of Health (DoH) arguing that they needed more money to meet this risk.”

One reason the Treasury and the DoH might have been reluctant to spend any extra money on dealing with the possibility of a pandemic is because the government repeatedly insisted there was no extra money for anything. The UK’s realisation that pandemics were a major risk coincided with the longest period of austerity since the Second World War.

“Our ability to meet these current and future threats depends crucially on tackling the budget deficit,” wrote David Cameron and Nick Clegg in the foreword to the 2010 national security strategy. “An economic deficit is also a security deficit.” On budgets, “tough choices” would need to be made, they wrote.

Those choices were still being made seven years later. Just three months after Theresa May dismissed a nurse’s appeal for a pay rise by arguing there was “no magic money tree,” the government published a new national risk register. It noted that the likelihood of “emerging infectious disease” had increased in the two years since the last national security strategy.

Instead of promising more money, the minister for resilience and efficiency, Caroline Nokes, suggested that the UK’s “long experience” with resilience would be enough. “Call it what you will, but whether through the fabled ‘stiff upper lip,’ ‘Blitz spirit’ or just a stubborn determination, our resilience can be seen at the forefront of our handling of emergencies.”

It wasn’t just a lack of money, though. In the 2015 national security strategy—“a much better document” than 2010, Lyall Grant claims—89 specific commitments were made to ensure that every part of the strategy was implemented. A sub-committee was set-up to check on their progress and report back to parliament.

As we were talking by phone, Lyall Grant flicked through the 89 commitments, searching for the ones related to a pandemic. “Cyber, dark web, illegal firearms, biosecurity… I don’t see any specific commitment at that time for any specific contingency plan.” This, he accepts, was an error. “Had there been a specific commitment on the strategy that would have put more spotlight on it at different levels rather than leaving it to the Department of Health.”

It is easy to point at the various government documents—national security strategies, risk registers, strategic defence and security reviews—and find the evidence that proves that we knew this was going to happen. But claiming something is a priority doesn’t really matter if no one believes it really is. And that was the problem. For Whitehall, the risk of a pandemic was too obscure, too hard to imagine. Even when the document was there, in black and white, stating the threat as clearly and as boldly as possible.

Our entire national security infrastructure is set up to prevent traditional threats—invasions, terrorist attacks, something created by an enemy. A virus operates in a different manner. A virus does not hold press conferences threatening death and destruction or release grainy propaganda videos. A virus does not carry out a nuclear weapons test or dismantle democracy. Until it exists, a virus will not be mentioned in ambassadorial cables, or raised by the security services in daily briefings, or be the focus of an in-depth profile in a national newspaper.

When the public inquiry takes place, these documents will be pored over. Questions will be asked about why they weren’t acted upon. But it’s not as simple to argue this was a failure of government; it was also a failure of imagination.

A cabinet minister accused of breaching the lockdown faces fresh questions over his housing portfolio as he has charged taxpayers more than £100,000 for a constituency home that he appears to use only rarely.

Gabriel Pogrund, Tim Shipman and Tom Calver  www.thetimes.co.uk 

Robert Jenrick, the housing, communities and local government secretary, was accused of ignoring government advice last week after leaving his £2.5m London house during the lockdown and moving to a country home that he owns in Herefordshire.

Lockdown rules say families should not travel to second homes. Matt Hancock, the health secretary, said such journeys were not “necessary”.

A spokesman for Jenrick said the minister considered the £1.1m, 17th-century grade I listed country house near Leominster to be his family home — and that his wife and children moved there before the lockdown. However, Jenrick’s official entry on the Conservative Party website says he and his family “live in Southwell near Newark [his constituency], and in London”. Neighbours said he is rarely at the Herefordshire property and builders are a “regular fixture” there. One described the claim that it was his family home as “codswallop”.

MPs’ anti-sleaze guidance says they do not need to declare ownership of “any land or property which is used wholly for their own personal residential purposes, or those of their spouse, partner or dependent children”. Yet Jenrick has chosen to declare the Herefordshire home since 2015. Over the same period, Jenrick, 38, privately educated and married to a corporate lawyer, has charged the taxpayer more than £100,000 in rent and council tax for his constituency home.

Travel expenses suggest that Jenrick rarely spends an entire weekend at the property, which is in one of the top council tax brackets. On five occasions between 2018 and 2019, he drove to the constituency and back on the same day.

A government minister said last night: “It’s a bit odd to make the taxpayer fund your constituency home when you’ve got all that money. It doesn’t look good.”

Steve Reed, Labour’s shadow communities secretary, urged Jenrick to resign, saying he was only still in his post because “there’s no prime minister available to sack him”.

A spokesman for Jenrick did not respond to further requests for comment.

The Tory Cabinet Minister accused of flouting virus lockdown rules is now under fire for claiming he understands what it is like to be ‘cooped up’. 

Brendan Carlin  www.dailymail.co.uk

Communities Secretary Robert Jenrick is under increasing pressure to quit for allegedly defying a ban on travelling to second homes by going 150 miles from London to his mansion in Herefordshire. 

But last night, Mr Jenrick – who insists the country manor house is his main family home – faced new claims of trying to ‘con’ the public over his domestic arrangements. 

Communities Secretary Robert Jenrick is under increasing pressure to quit for allegedly defying a ban on travelling to second homes by going 150 miles from London to his mansion in Herefordshire

The Minister, who with wife Michal Berkner has three small children, told the BBC last week that he understood the plight of families crammed into small flats during the lockdown and the need to keep local parks open. 

He said: ‘I am very aware of how difficult this is already. ‘I am a father of young children. I know what it’s like to have a family cooped up…’ 

But Tory MPs reacted in fury last night to the comments. 

One backbencher said: ‘Jenrick’s position was already pretty dire, to be honest. 

‘But to go on the radio and claim you understand what it’s like to be cooped up is an insult to my constituents who are enduring the lockdown in small flats.

But last night, Mr Jenrick – who insists the country manor house is his main family home – faced new claims of trying to ‘con’ the public over his domestic arrangements

‘Whether his family were already in that country pile of his or still in his London home, he can’t possibly say that. ‘He really has to go.’ 

Another Tory MP said: ‘This really is stretching the definition of cooped up to farcical levels.’ 

In another blow yesterday, one of Mr Jenrick’s neighbours in Herefordshire said the idea that the country manor was his main home was ‘codswallop’. 

Mr Jenrick could not be reached for comment last night. 

Well not quite. There is the backstory, reported by Owl on 19 March.

“The south west looks most vulnerable in terms of ratios (of projected critical care bed needs to current supply). It has the oldest population (so highest expected mortality) and lowest number of critical care beds per head of population. The modelling suggests it needs six times more than currently exists there (600 per cent).”

“On the upside, the south west currently has a relatively low infection rate. Public Health England (PHE) should be doing everything possible to keep it that way through aggressive testing and containment of new cases [If only! – Owl] (how prophetic these comments by Owl look after only three and a half weeks). If the virus gets out of control in the south west it is likely to sweep through the region’s retirement towns and nursing homes, overwhelming local hospitals.”

Howard Lloyd  www.devonlive.com 

It was confirmed today at the UK Government’s daily coronavirus briefing that a new Nightingale hospital would be set up in Exeter.

In a story already broken by DevonLive last week, the Devon and Cornwall NHS Nightingale hospital will be established to help the country’s fight against COVID-19.

It was confirmed by Ruth May, NHS chief nursing officer for England as she spoke alongside health secretary Matt Hancock and deputy chief medical officer professor Jonathan Van-Tam.

So what do we know about this new hospital?

It will be based at Westpoint Arena on the outskirts of the city, near Clyst St Mary. Westpoint – the site for the annual Devon County Show – is the largest exhibition and entertainment venue in the South West with an indoor venue for up to 7,500 people. It is located near Exeter Airport.

The site – along with one in Sunderland which was also confirmed today – is expected to be operational towards the end of April or early May and will add up to 700 beds to be used by local services if needed.

The army are helping with the construction of both.

Beds for 200

NHS Nightingale North East will have up to 450 beds initially, with NHS Nightingale Exeter adding around 200.

The military helped to set up London’s Nightingale hospital, which so far has 500 beds in place with space for another 3,500.

Similar hospitals are also opening at Birmingham’s National Exhibition Centre and Manchester’s Central Complex.

In Bristol, 1,000 beds will be available at the University of the West of England.

Hospital will help ‘beat the virus’

Simon Jupp, MP for East Devon, said: “I warmly welcome plans for the new NHS Nightingale Hospital Exeter based at Westpoint in East Devon.

“The extra 200 beds will ensure our superb local NHS is as prepared as possible to beat the virus.

“Opening in early May, the new Nightingale Hospital Exeter builds on existing plans to increase critical care capacity in hospitals across Devon.

“We must all play our part by staying at home to protect the NHS and save lives.”

Owl must add that this doesn’t seem to apply to the Housing and Communities Secretary  Robert Jenrick, swanning off to his second home in Herefordshire. Not the action of what Owl would call a Leader.

Sir Simon Stevens, NHS chief executive, said: “These hospitals will provide backup and support for NHS hospitals across the South West and the North East, should it be needed.

“Our local health service staff have rightly recommended we go ahead with these additional faciliites. But our ambition as a country has to be to continue to stay at home to cut infections and save lives – so that the need to actually use these Nightingale hospitals is as limited as possible.”

Professor Stephen Powis, national medical director, NHS England, said: “As the NHS faces the greatest health challenge in its history, we’re supporting patients and staff with additional capacity across the soon-to-be seven NHS Nightingale Hospitals.”

“The new sites – including the two announced today in Sunderland and Exeter – will give the NHS the best chance of ensuring coronavirus patients needing specialist care can get it, wherever they live.”

Analysis: The Housing Secretary’s visit to his second home during the lockdown means someone must decide whether he should stay or go.

“Torygraph” fails to back Jenrick. But who is in charge during the power vacuum?

By Gordon Rayner, Political Editor www.telegraph.co.uk 

When Dominic Raab faced questions this week about his authority to order a “change of direction” in Government, he was able to hide behind the fact that the issue was, at that point, largely hypothetical.

Not any more. Robert Jenrick’s decision to drive 150 miles to his second home during the lockdown – and make an 80-mile round trip to his parents’ home – means someone must decide whether he should be fired as Housing Secretary.

Only on Sunday, Scotland’s chief medical officer resigned over an almost identical lapse of judgement after it became clear her position was untenable.

Yet acting prime minister Mr Raab cannot sack the Housing Secretary: he lacks the formal powers vested in the Prime Minister, such as the ability to appoint and sack ministers, creating a power vacuum at the heart of Government as long as Boris Johnson remains in hospital.

Whether Mr Johnson is well enough to be consulted on such matters of State remains unclear.

Despite being moved out of intensive care and onto a general ward, Downing Street appeared to suggest today that he is only communicating using gestures.

It has left the Government facing its first real-life test of how it functions in the absence of its leader.

Mr Raab has not spoken to the Prime Minister for a week. He has said that Mr Johnson left him “very clear instructions” before he was taken into hospital, but those did not, surely, include what to do in the event of a loyal Cabinet minister breaking the Government’s own rules on lockdown, which specifically state that visits to second homes are not acceptable.

Any minister who had ignored the message on staying at home and avoiding non-essential journeys would have been in trouble, but Mr Jenrick’s position is worsened by the fact that he fronted one of the daily Downing Street press conferences to hammer home that very message, before heading to Herefordshire.

For now, at least, No10 says it is backing him. The Prime Minister’s official spokesman said Mr Jenrick had “complied with the social distancing rules” and had not done anything wrong.

Mr Jenrick will, perhaps, be given the maximum possible leeway by Downing Street.

Mr Jenrick, together with Chancellor Rishi Sunak and Culture Secretary Oliver Dowden, were among Mr Johnson’s earliest and most vocal supporters in the Conservative leadership race.

Five days before nominations had even opened last June, they jointly wrote an article in which they said the Tory Party faced an “existential threat” from which only Mr Johnson could save it.

Mr Johnson rewards loyalty – Priti Patel’s unexpected elevation to the post of Home Secretary in his first Cabinet was one of the most overt examples of that – but he can also be ruthless, evidenced by his treatment of Sajid Javid when he effectively forced him out in February.

If Mr Raab had the power to sack people, he would have the unenviable task of trying to weigh up what Mr Johnson would do in such a difficult situation.

The lack of any constitutional role for an acting prime minister means he has no such decision to make, and unless Mr Johnson is well enough to take on such heavy responsibilities right now, the situation could drift on, unresolved, for days.

It comes on top of repeated questions about who will take the eventual decision to ease the current lockdown.

Number 10 has said Mr Johnson is at an “early stage” of his recovery, while his father Stanley said the Prime Minister “must rest up” rather than trying to run the country from his sick bed and that there should be a “period of adjustment” before he returns to work.

According to some medical experts, Mr Johnson may need a full month off work.

There are already signs that the crisis created by Mr Jenrick may be far from over. Downing Street faced enough questions about him in today’s daily lobby briefing to suggest that journalists are not yet satisfied with the answers that have been given, meaning they are still poring over his movements looking for fresh angles to the story.

With the Easter weekend now upon us and Britons impatient to get out and enjoy the sunshine, the dilution of the Government’s “stay home” message could not have come at a worse time.

If the negative headlines continue, the pressure will increase not only on Mr Jenrick, but also on the Government to give Mr Raab a more defined, and more powerful role.

An electronics and engineering firm in Exmouth has spoken of its pride helping with the production of 30,000 medical ventilators to save lives amid the coronavirus crisis.

Becca Gliddon  eastdevonnews.co.uk 

The EuroTech Group, in Salterton Road, was tasked to produce 19,000 printed circuit boards to be used in a ventilator prototype that was specially designed to increase the supply of life-saving equipment in the UK in the coming weeks.

Circuit boards built in Exmouth have been incorporated into a newly-designed ventilator prototype, plus lifesaving equipment destined for use in the temporary Nightingale Hospitals.

The Exmouth firm joins a consortium of ‘significant’ UK industrial, technology and engineering businesses from across the aerospace, automotive and medical sectors, in producing medical ventilators for the UK.

The Ventilator Challenge UK Consortium is led by Dick Elsy, CEO of High Value Manufacturing Catapult, a group of manufacturing research centres in the UK.

Mr Elsy said: “This consortium brings together some of the most innovative companies in the world.

“Every day, their highly-skilled staff collaborate to create solutions that help millions of people, and this project is no different.

“They are working together with incredible determination and energy to scale up production of much-needed ventilators and combat a virus that is affecting people in many countries.

“I am confident this consortium has the skills and tools to make a difference and save lives.”

A spokesperson for EuroTech said: “EuroTech is proud to have the opportunity to assist in the project, having been commissioned to make 19,000 printed circuit boards.

“Despite challenging circumstances, the first batch of boards left the Exmouth factory on Monday 30th March for delivery.

“They are to be incorporated into units of a ventilator prototype, which was designed in about a fortnight.

“The printed circuit boards took less than thirty hours to produce from engineering to completion.

“EuroTech is also urgently manufacturing printed circuit boards for those customers involved in the supply of equipment for the temporary hospitals NHS Nightingale, in London, Birmingham and Manchester.”

The Exmouth-based firm’s circuit boards will be used by the Ventilator Challenge UK Consortium, which includes household names such as Dyson, Airbus and Rolls Royce, who have banded together to produce the rapid manufacture and design of the new ventilators.

Companies in the consortium have now received formal orders from the Government in excess of 10,000 units.

The consortium can now accelerate production of an agreed new design, based on existing technologies, which can be assembled from materials and parts already in production.

The firms involved have taken many of their employees away from key company projects to serve the country in its time of need.

Patients in Exeter with Covid-19 are being recruited to the largest clinical trial in the world to investigate existing medicines which might be effective against the disease.

Philip Bowern  www.devonlive.com 

The trial, known as the Randomised Evaluation of COVid-19 thERapY (RECOVERY) trial, has been rolled out across the UK. Already fifteen patients have been recruited in Exeter. The trial is being run through a partnership between the University of Exeter and the Royal Devon & Exeter NHS Foundation Trust. Exeter is one of the 157 trial centres being coordinated nationally by researchers from the University of Oxford. There are currently no specific treatments for Covid-19.

Some existing drugs usually used for other conditions may have some benefits – but they may not. As they are already approved for other uses, the trial is able to start more swiftly than for new drugs which would need rigorous safety testing first. The new trial will provide doctors and the health service with information they need to determine which treatments should be used.

The treatments initially included in the study have been recommended by an expert panel that advises the Chief Medical Officer in England. These are Lopinavir-Ritonavir, normally used to treat HIV, the steroid dexamethasone, which is used in a wide range of conditions to reduce inflammation, and hydroxychloroquine, which is mainly used as an anti-malarial drug and the commonly-used antibiotic azithromycin.

The trial has seen research teams at the RD&E uniting to form a single workforce to ensure that patients have the best possible access to the ground-breaking Covid-19 studies being undertaken.

Dr Ray Sheridan, Consultant at the Royal Devon & Exeter NHS Foundation Trust and Associate Clinical Professor at the University of Exeter, said: “This trial is an incredibly exciting development in the battle against COVID-19.

“In Exeter, the strong and long-standing relationship between the University and the RD&E health trust means our clinicians and scientists work incredibly well together. We don’t yet know if the drugs will work, but it’s heartening to be part of promising research on this international crisis.”The trial will be open to adult inpatients at the Royal Devon & Exeter Hospital who have tested positive for Covid-19, and who have not been excluded for medical reasons. All patients will receive the usual standard of care.

Patients joining the trial will be allocated at random by computer to receive one of the medicines being studied in addition to the usual care.

This will enable researchers to see whether any of the possible new treatments are more or less effective.

Sarah Gilbert, professor of vaccinology at Oxford University, told The Times she was “80 per cent confident” that the vaccine being developed by her team would work, with human trials due to begin in the next fortnight.

Alice Thomson, Rachel Sylvester, Chris Smyth, Oliver Wright www.thetimes.co.uk 

A vaccine against coronavirus could be ready as soon as September, the British scientist leading one of the world’s most advanced efforts has said.

Sarah Gilbert, professor of vaccinology at Oxford University, told The Times she was “80 per cent confident” that the vaccine being developed by her team would work, with human trials due to begin in the next fortnight.

The government signalled that it would be willing to fund the manufacture of millions of doses in advance if results looked promising. This would allow it to be available immediately to the public if it were proven to work.

With ministers struggling to find a strategy to exit the lockdown, long-term hopes of a return to normality rely on a vaccine.

Even if measures to stop the spread of coronavirus are eased in the coming weeks, officials are expecting that without a vaccine some element of social distancing, such as shielding of the vulnerable or working from home, would remain in place for a long time.

The development came as:

• Downing Street said that Boris Johnson was walking for the first time since leaving intensive care and watching films and doing sudoku puzzles as he continued to recover from Covid-19.
• The number of UK deaths from Covid-19 reached nearly 9,000, with a further 980 reported yesterday, the highest daily total so far.
• Matt Hancock, the health secretary, said that there was enough personal protective equipment for NHS staff if doctors used “no more” than necessary. More than 742 million pieces have been delivered since the outbreak began.
• More than 19,000 coronavirus tests were carried out on Thursday as Mr Hancock said there was capacity for “all key social care staff and NHS staff who need to be tested to get those tests”.
• Downing Street urged police against being “heavy-handed” during the lockdown over the Easter weekend as officers patrolled supermarkets.
• The worldwide death toll reached 100,000, according to Johns Hopkins University in the United States.

Professor Gilbert’s team is one of dozens around the world trying to find a vaccine and is the most advanced in Britain. She has been working seven days a week to rush through the development stages.

“I think there’s a high chance that it will work based on other things that we have done with this type of vaccine,” she said. “It’s not just a hunch and as every week goes by we have more data to look at . . . I would go for 80 per cent, that’s my personal view.”

Initial safety trials are due to begin soon, with further studies following around the world to see if the vaccine reduces the risk of catching coronavirus.

Lockdown makes it harder to test a vaccine when the virus is not spreading, Professor Gilbert said. However, if one of the countries in which it is trialled “turns out to have a high rate of virus transmission then we will get our efficacy results very quickly, so that is the strategy for reducing the time”.

Asked if the most optimistic scenario for a working vaccine was September, she said: “Yes and we have to go for that.” Success by the autumn was “just about possible if everything goes perfectly”.

However, she added: “Nobody can promise it’s going to work.” Manufacturing millions of doses can take months and Professor Gilbert said she was talking to the government about going into production before final results were in.

Winter flu vaccines are typically 40-60 per cent effective, although this varies depending on the annual strain. Ministers think that if a vaccine looks viable it will be worth spending tens of millions of pounds to have it ready for use given the economic cost of lockdown.

The US philanthropist Bill Gates, the co-founder of Microsoft, says that he will “waste” billions of dollars manufacturing vaccines, even though most will fail, in order to avoid a delay for any that prove successful.

 “This isn’t the first time ministers have given NHS and social care staff big promises on PPE. But there has been a mismatch between statements at Downing Street press conferences and the realities facing health and care staff on the ground.

“Staff have been raising the lack of PPE for weeks. We hope the government’s plans today deliver the adequate supplies of PPE our brave healthcare staff deserve.”

Denis Campbell  www.theguardian.com 

The health secretary, Matt Hancock, has urged NHS staff not to overuse personal protective equipment, sparking criticism from doctors’ and nurses’ leaders.

“We need everyone to treat PPE like the precious resource it is,” he said on Friday. “Everyone should use the equipment they clinically need, in line with the guidelines: no more and no less.”

After weeks of criticism over the lack of vital equipment, Hancock told the daily Downing Street briefing a “herculean effort” was under way to ensure every health and social care worker dealing with coronavirus has the equipment they need.

The government does not recommend the general use of protective face masks to slow the spread of disease, and Hancock warned the public against overusing protective equipment.

He reiterated that hand washing, social distancing and staying at home are the best ways to avoid infection. “A front door is better than any face mask”, he said.

Hancock and the chief nursing officer, Ruth May, declined to give a figure for how many healthcare staff have died after contracting the virus.

The health secretary said a nationwide delivery system had been set up, with the help of the armed forces, to distribute masks, aprons and other equipment to 58,000 healthcare providers.

He said: “We’ve had to create a whole new logistics network, essentially from scratch.” Within a week, every NHS hospital would be receiving daily deliveries, he added.

The shadow health secretary, Jon Ashworth, welcomed the promise that more PPE would reach the frontline but pressed Hancock to ensure his target was met.

Ashworth said: “This isn’t the first time ministers have given NHS and social care staff big promises on PPE. But there has been a mismatch between statements at Downing Street press conferences and the realities facing health and care staff on the ground.

“Staff have been raising the lack of PPE for weeks. We hope the government’s plans today deliver the adequate supplies of PPE our brave healthcare staff deserve.”

Doctors’ and nurses’ leaders criticised Hancock’s plan as inadequate, given the growing death toll of NHS staff from coronavirus.

The British Medical Association said PPE shortages could spell “real disaster” for doctors. It also took issue with Hancock’s insistence that the NHS has enough PPE to go round but needs frontline staff to use “no more and no less” than they clinically require.

Dr Chaand Nagpaul, the BMA’s chair, said: “We are dealing with an unknown, highly infectious, and potentially deadly virus that has already claimed the lives of several healthcare workers, including 11 doctors in the UK.

“It is absurd that the people trained to treat this disease are the ones who are not being appropriately protected – and without them, we face real disaster.

“We note the government’s announcement this afternoon … However, PPE should not be a ‘precious resource’ and for NHS staff facing shortages of protection they need today, they don’t want to hear of a plan, but that this vital equipment is made available to the frontline now.”

Susan Masters, director of nursing at the Royal College of Nursing, also voiced scepticism that Hancock’s pledges would end the supply problems that are causing alarm among staff, and denied nurses were misusing PPE.

Masters said: “These figures on deliveries are only impressive when nursing staff stop contacting me to say what they need to use wasn’t available. The calls are still coming through – people are petrified. They have seen colleagues die already.

“Things have improved in recent days and I credit the government with that. But the safety of nurses and care staff must not be compromised. They are pretty clear about what they need to do to stay safe and they will be angered by any suggestion they cause shortages by misusing kit.”

As well as promising to tackle what he acknowledged was the “enormous challenge” of ensuring PPE reaches those who need it, Hancock said lab capacity had been increased sufficiently to allow any health or social care worker who needs it, to be tested.

He visited a newly opened “mega-lab” in Milton Keynes on Thursday and said 15 drive-through testing centres were available.

He stressed the complexities of meeting demand for PPE against the background of rocketing global demand, and without a significant domestic supply sector.

Diplomatic staff around the world have been pressed into service trying to source equipment, Hancock said, with Whitehall officials in London trying to organise transporting it to the UK.

He praised firms, including Burberry and Rolls-Royce, which have turned their facilities to manufacturing PPE – and urged others to do so, based on requirements published by the government. “If you’ve got production facilities, and you can meet our published specifications, we want to hear from you,” he said.

Appearing alongside Hancock, May underlined the toll, both physical and mental, that treating the virus is having on her frontline colleagues. But she said they were heartened by the public’s support. “The rainbows and NHS signs in the windows lift me, and they lift my colleagues,” she said.

She and Hancock emphasised the importance of the public continuing to use the NHS for conditions unrelated to the coronavirus.

The extraordinary willingness of the British public to help out has been considered one of the few bright points of the crisis, but only a few thousand tasks are being carried out around the country so far.

Dan Sabbagh  www.theguardian.com 

NHS officials have said it has taken longer than anticipated to get the coronavirus volunteer programme up and running after many of the 750,000 who signed up complained that they had not yet been given jobs.

The extraordinary willingness of the British public to help out has been considered one of the few bright points of the crisis, but only a few thousand tasks are being carried out around the country so far.

With 2.5 million elderly and vulnerable people in the UK supposed to be receiving help from the scheme, there is concern that people who are self-isolating for at least 12 weeks could be falling through the safety net.

Neil Churchill, an NHS England administrator working on the volunteer team, explained “why it’s taking time for you to get your first asks” in a post on a Facebook group for volunteer helpers on Friday.

He said there were “a lot more [identities] to check” than initially expected, and it was only after that that “we ask people in the NHS to make referrals”. But NHS staff have also been slow to call for the volunteers to assist.

“It just takes time for info to get through to every GP practice, every pharmacist and every discharge team. Referrals are in the thousands right now and we expect they will be in the tens of thousands soon,” Churchill said.

Volunteers are registered on the Good SAM app and, when signed in, wait for an alert indicating that a job needs doing. But Facebook groups for volunteers are full of people expressing disappointment that they have waited hours without being given a task.

Dean Tonna, 57, from Leicester, said he signed up as soon as it was announced last month and was told that they would do DRB (Disclosure and Barring Service) checks and get back to him in a week. It took a bit longer than expected, but he was cleared to help last Thursday.

“I was sent a lot of instructions and have been on call ever since and in nearly 250 hours I have not had a single thing to do. On the app you can see other responders in the area and there are a good 20 people around where I am. I am not sure if they are busy but having looked on Twitter it looks like no one is doing anything.”

 War veteran, 99, receives guard of honour from nurses after surviving coronavirus – video

A total of 750,000 people signed up in less than a week at the end of March, in response to a call by Matt Hancock, the health secretary, for volunteers to help those who have been told to stay indoors for at least 12 weeks. The appeal was so successful that new sign-ups have been halted.

Volunteers have been asked to be on standby to pick up medicines from pharmacies, drive patients to and from appointments, and call to check on people isolating at home, following referrals from doctors, pharmacists and other NHS staff.

Melanie Westell, 41, from Kent, said she had signed up to volunteer two and a half weeks ago and last Friday she was told she had been accepted. “I have been on duty for 87 hours over the last week and have not had anything come through,” she said.

“The only thing I can put it down to is that when doctors or pharmacies, for example, refer vulnerable people to the service they have to fill out a form for all the services they may need.”

Some people have complained they have been rejected without clear explanation, saying they supplied or have had up-to-date criminal record checks. But others say they have been asked to help and found the experience rewarding.

The scheme is being run by the Royal Voluntary Service, with the support of Camilla, Duchess of Cornwall, in conjunction with the NHS.

A spokesman for the RVS said the scheme would expand in numbers over the coming days and weeks: “It will be a gradual and developing process as more healthcare professionals, pharmacists and local authorities refer people who need help in greater numbers.”

The row over the Cabinet minister accused of breaking lockdown rules escalated last night after neighbours rubbished claims that the mansion where he is staying is his main home. 

David Churchill  www.dailymail.co.uk

The row over the Cabinet minister accused of breaking lockdown rules escalated last night after neighbours rubbished claims that the mansion where he is staying is his main home. 

Communities Secretary Robert Jenrick, a key player in the Government’s coronavirus response, claimed he had not flouted his own advice by travelling 150 miles to the Herefordshire property because it was the family home. 

But one of Mr Jenrick’s close neighbours described claims this address was his primary home as ‘codswallop’. 

The Daily Mail has been told the Jenricks spend most of their time at their £2.5million townhouse in London, where the children attend school. 

The Newark MP also states on his website that he lives ‘in Southwell near Newark, and London’ – with no mention of Herefordshire. 

Neighbours at the £1.1million Herefordshire residence insisted they rarely saw him. One said: ‘We might see him on the odd weekend but the family are not even here every weekend, let alone full time. 

‘Mr Jenrick has had builders working on the house for much of the last three years.’ 

Neighbours at the £1.1million Herefordshire (St Peter and St Paul’s in Eye, Herefordshire) residence last night insisted they rarely saw him. One said: ‘We might see him on the odd weekend but the family are not even here every weekend, let alone full time’

Another neighbour confirmed builders had been a regular fixture at Eye Manor, which Mr Jenrick bought in 2009 and is 120 miles from his constituency. 

They said: ‘It’s a fact the family come here occasionally at the weekend, but they do not live here year-round. 

‘The children are at school in London for one thing, and both parents have demanding jobs that they could not do from here ordinarily, one would think. 

‘I suppose you could say this house is more like their holiday home.’ 

A Government source confirmed Mr Jenrick had ‘moved his family to his second home’. 

Another source close to the family in the capital said they lived at their Westminster address during the week. The distinction matters as the Government issued lockdown instructions on March 23 stating people should not visit second homes ‘for isolation purposes or holidays’. 

But Mr Jenrick travelled to his second home from London on March 29 following a press conference he gave in Downing Street. 

He has also faced criticism after it emerged he visited his parents another 40 miles away last weekend in a Shropshire village. 

Mr Jenrick said he was dropping off medicine and food and did not enter their home. But he has previously urged people to rely on the NHS for delivering medicines. 

The Prime Minister’s spokesman said: ‘The Secretary of State set out in two different statements the reasons for the journeys that he made and we are confident he complied with the social-distancing rules.’ 

But Mr Jenrick’s opposite number in the Shadow Cabinet, Labour MP Steve Reed, believed the minister had still not explained why he needed to travel across the country from London. He said: ‘It would appear he could have stayed self-isolating with his family in London to prevent that further travel.’ 

Former defence minister and Tory MP for neighbouring Broxtowe, Anna Soubry, tweeted: ‘He totally ignored his own instruction to #stayhome which he repeatedly said in media interviews and from the No10 podium. 

‘It smacks of arrogance and senior ministers must practise what they preach.’ 

Mr Jenrick is understood to have claimed his family moved to Herefordshire on March 20, before lockdown rules were announced. 

The 38-year-old faced controversy when he ran for his Newark seat in a 2014 by-election after declining to mention his and his City lawyer wife’s £6million property portfolio, which includes a £2.3million flat in Marylebone, central London.

He presented himself as a ‘father, local man, son of a secretary and small businessman and state primary school-educated’ candidate. 

His party CV omitted to say he went to a £13,000-a-year private secondary school. At the time, he promised to move his family to Newark, saying he was ‘almost sure’ he would sell the Herefordshire house. 

Despite also having a rented property in his constituency, which he bills taxpayers £2,000 a month for, locals have told the Mail they do not see him as much as they would like. Last night Mr Jenrick declined requests for further comment. 

On Thursday he told the Mail: ‘My house in Herefordshire is the place I, my wife and my young children consider to be our family home and my family were there before any restrictions on travel were announced. 

‘I have been working in London… putting in place the system to shield the group most vulnerable to coronavirus. 

‘Once I was able to work from home it was right I went home to do so and be with my wife and help care for my three young children. 

‘I will be staying at my family home until Government advice changes or if I am needed in person in Westminster before the parliamentary session resumes after the Easter recess.’ 

Robert Jenrick not the only one living on another planet. Two worlds: “Them and Us”

Kim Willsher  www.theguardian.com 

A group of would-be holidaymakers who flew in a private jet from London to the Côte d’Azur in France has been turned back by police.

Seven men and three women arrived on the chartered aircraft to Marseille-Provence airport, where helicopters were waiting to fly them on to Cannes, where they had rented a luxury villa.

The men, aged 40-50, and women, aged 23-25, were refused permission to enter France and ordered by police to fly back to the UK.

“They were coming for a holiday in Cannes and three helicopters were waiting on the tarmac,” a border police spokesperson told Agence France-Presse. “We notified them they were not allowed to enter the national territory and they left four hours later.”

Once the Embraer Legacy jet had landed at Marseille-Provence, the group, made up of several nationalities including Croatian, German, French, Romanian and Ukrainian, reportedly tried to get help from contacts to continue their journey.

“They tried to make use of their connections and made a few phone calls,” the source said.

The helicopter pilots were told to return to their base and were fined for breaking the French lockdown rules.

The jet, chartered by a Croatian businessman reportedly in “finance and property”, arrived last Saturday, but details were only released on Thursday. French police said they would be carrying out strict checks on private aircraft arriving in France over the Easter period.

All non-essential travel inside France has been banned since 17 March and a recent tightening of the restrictions means anyone entering the country should hold an international travel certificate showing the journey is essential.

The authorities in France and Britain have made it clear that travelling to a second home in either country does not qualify as essential.

“Crossing borders needs a legitimate or urgent reason,” a police spokesperson said.

BFMTV reported that nine of the jet passengers returned to the UK and the 10th chartered a private jet to Berlin.

This post gives a link to the Covid-19 tracker app mentioned earlier.. It shows that there are 3,636 individuals in East Devon sufficiently community spirited and motivated to be providing daily data on any symptoms they might be exhibiting.

Around the UK there are 2m contributors.

As a result, and in the absence of any general NHS or Public Health data on who might be self isolating as well as seriously ill, the current estimate for East Devon infection rate is:

Region
East Devon

• # CONTRIBUTORS
  3636
• % OF PEOPLE WITH SYMPTOMATIC COVID (ESTIMATED)
  3.49%

This is around 4,100 individuals for East Devon, compared to official estimates of confirmed cases in Devon Local Authority of around 290 (Thursday)

The authorities simply aren’t in control.

https://joinzoe.carto.com/me