 Er fyddion, yw'n cael ei gweithio'r新iol yn ymddag wahanol ar gyfer gyntaf y dyfodol coronaeth mixesio-rhyw gweithio. Fyonwch rydym ni wedi'w hi, fel fyddai'r digon o'r coronaeth yn gwaith a ymddangos ni wedi bod yn ymgyrch ar gweithio'n amser, ychydig i ddim yn gwych gyda'r gwybod a'u dweud hynny yn ymgyrchu rhai. On Friday I said we're starting to see some early very positive signs that cases of coronavirus are beginning to fall. This downward trend is continuing. The seven day incidence rate for Wales is now around 160 cases per 100,000 people. A reduction of 70 from this time last week. In Berthyr Tydfil, which had the highest rates in the UK just over a week ago, the rate is more than half to around 330 cases per 100,000 people. And in other parts of the South Wales Valleys in Rhondda Cynllun Taf, and Brannag Gwent, where we also saw very high rates, the incidence rate is now less than 300 cases per 100,000 people. Now the top graph of this slide shows the two ways of coronavirus we've experienced this year in Wales in the spring and now. This ongoing autumn wave of cases has been rising sharply since the end of August. This wave is so much bigger in the graph than the spring because mass testing has only been available from the summer and we have been able to take cases in the community for this second wave. In the spring of course we are only able to test people in hospitals and care homes. The second graph on the slide shows deaths involving coronavirus. There was a large peak in the first wave and it would appear when now heading towards another large peak this winter. And this underlines why we introduced the firebreak. In the first two weeks of November, Public Health Wales have recorded more than 250 deaths from coronavirus. That is a very sobering number. But of course these are not just numbers. These are people who leave behind lives and loved ones. There will be more than 250 families across Wales who are mourning their loss. I do hope that these figures help to explain why we're taking coronavirus so seriously and why we, like other governments around the world, are taking action to protect people's health. But some people believe the risks from coronavirus have been exaggerated and others believe that the action we're taking is wrong. About six weeks ago I addressed some of the common misconceptions about coronavirus. I'd like to do something similar again today by explaining why coronavirus is different to winter flu and why we're asking everyone to make some changes to their lives to keep themselves and their families safe. There are some similarities between coronavirus and flu. Both are highly infectious diseases which can cause serious or even fatal respiratory illnesses. But we are more familiar with flu. We have a flu season every winter and we have almost a century of experience where it comes to treating and managing the virus. Every year we have a flu vaccine which is free for everyone at greatest risk. Every year some of us will fall ill with flu. It's a nasty virus which causes a nasty illness, very different to man flu. Flu kills the young and old alike. So we try to prevent it with vaccines and by changing some of our behaviour in the winter. Most of us will naturally adjust our behaviour to try not to catch flu if we can. We'll avoid people who are coughing or sneezing, for example. And many of us will have the flu jab, either the NHS vaccine or we'll pay for one ourselves. Fortunately we also have some immunity to flu viruses, which are circulating because we've seen them before over many winter seasons. We are not though familiar with coronavirus. Our bodies don't yet know how to fight it. It's a new virus which emerged at the end of 2019 and has spread rapidly across the world. More than 53.5 million people worldwide have been affected and at least 1.3 million people have died in just over 11 months from coronavirus. Unlike flu, we do not have a vaccine for coronavirus, although there are many in development. And we do not have almost a century of experience in treating and managing coronavirus. There are no treatments that can prevent coronavirus, but we have learned a lot over the last 11 months. There's a lot of research on going into the virus itself and new treatments. We don't know if any people have immunity to coronavirus once they've had it or how long that immunity could last. There's evidence that some people have caught coronavirus twice. Many people who have recovered from coronavirus are continuing to experience a range of health problems, sometimes known as long COVID. The World Health Organization figures suggest that 15% of people who are infected with coronavirus will develop a severe illness, which requires oxygen therapy and 5% of people will become critically ill. That is higher than that seen for flu. Sadly, the death rate from coronavirus appears to be much higher than flu. Research by Imperial College London suggests that overall infection fatality ratio for coronavirus is 1.15%. Mortality per season of flu is usually around 0.1% according to the World Health Organization. We have a new set of national measures in Wales to help us to maximise the impact of the firebreak and all of your hard work during those 17 days. But government rules won't keep Wales safe on their own and we cannot go back to normal. How we act and the choices we make over the coming days and weeks will define the course of this virus. We should remember that coronavirus thrives on human content. In the same way, we naturally make changes to protect ourselves from winter flu. We're asking everyone to make changes to our daily routines and to protect ourselves from coronavirus. That means reducing the number of people we're in contact with. Working from home if we can and going out less. It means keeping our distance, washing our hands and wearing a face mask wear required. If we all make these changes, we have a better chance of keeping coronavirus under control. If we all do this together, then we can keep Wales safe. Thank you all now to questions from journalists, but as usual, we'll broadcast the answers to all questions live on our social media channels. The first question today is from James Williams on BBC Wales. Thank you very much Health Minister. Public Health Wales has said that they are concerned about the cues that we've seen, particularly over the weekend. From the data and intelligence that you have as a Welsh Government, do you think what's happened in the first week of the new set of rules is going to have an effect on how tough the restrictions are around Christmas? And can you just give us the latest on those discussions around Christmas and the kind of things that are being discussed at the moment? Well, it's too early to tell at this point, James, is the honest answer. I've seen pictures of people out and about. I've seen cues where people have been socially distancing and those cues reflect the fact that people both want to go in. That's a bit of pent-up demand after the firebreak, but it's also because retailers are operating limits on the number of people that can go in, so fewer people can go in than you would have expected to have last festive season, for example. My concern, though, is that if we don't all try to do the right thing, that's both businesses doing their part in running COVID-secure environments as far as possible, but also us as customers for those businesses, we all need to play our part. And I have seen some images that are more concerning, where people have forgotten about social distancing and are returning to a more normal way of behaving. Now, if that continues and we really will face difficult choices, and we're likely to see the trend that we've already seen with reducing cases that can easily reverse, because as we keep on rehearsing, this is a highly infectious virus that thrives on human contact. That's also why we can't have a definitive view at this point about what Christmas might look like. Now, it's a major festive season for Hindus, Sikhs and Jains with the Diwali weekend that we've just gone through, and that's been a very different experience. That's in many ways like Christmas and New Year rolled into one for the rest of us. So it's already having a major impact on communal festivals and events where people naturally gather together. Whatever happens with Christmas and the festive season this year, it won't be like normal. We're still discussing issues about where we can get to with other gums across the UK on travel, and we're still looking at the evidence about what we might be able to do around contact, but it does rely on the picture that we'll see in the developing evidence over the coming weeks. So you shouldn't expect there to be a definitive statement in the next few days or weeks, James. We have quite a long way to go, actually, in the course of the pandemic we've been dealing with before we get to the Christmas period. And you referenced Rhondda Cynon Tavenworth in your opening statement. There have been a big drop in the seven-day case rate there, but they're still high compared to many other places in Wales. Are you seeing enough progress in those areas to not perhaps look at local restrictions being imposed? And what's your assessment of why, not just now, but since the start of the pandemic relief, those areas in particular have been hit really hard? Well, as you can see from the first graph that we had, seeing the sharp reduction in cases that are taking place, and that is good news, that isn't complete yet though. And we did say it would take two to three weeks to the full impact of the firebreak. So we can't have a definitive view at this point in time. We'll need to see how much further those infection rates fall before we make choices about whether we need to do anything differently, whether that's locally or nationally. But our preference is to have a common set of national measures, a common set of an agreed way of behaving differently to reduce our contact with people, because that's the best way to suppress coronavirus. Now, we've also seen in terms of some of the evidence about travel patterns, for example. We know that more people are travelling. Now, it's still about what people do when they get to where they're travelling, and we'll need to see how much of that is a reaction to the firebreak ending and how much becomes more normalised. And this is an unusual period of year, of course, where we expect people to gradually get busier going into that festive season. So it's still too early to tell what we'll do. We'll need to see the evidence of what's happened post the firebreak, and we'll need to see if the way that people have normally celebrated living their lives in communities, especially so in Valleys communities, where there are extended friendship and families, groups of people who are used to being in each other's houses, whether actually we're seeing that behaviour change, not just in the Valleys, but in every part of Wales, where we can reduce our contact, and especially the contact we have with people in our own homes, that is still the biggest factor that has been driving coronavirus and its resurgence into this second wave. Thank you, James. We've now got ITV Wales's James. James, Crichton Smith. Minister, thank you. Should primary carers be regarded as key workers and therefore be able to access the same level of testing that means they could go into care homes knowing they're safe? And if so, how would you make that happen? Well, we're actively considering what to do with testing policy, not just on testing for carers and for care homes, but more broadly as well. So over the coming days, we're going to need to consider what we're doing with not just a capacity that gets in all parts of our system. You'll recall we've invested in the public health Wales. You'll recall that there's further capacity from lighthouse labs and there's now an improving picture on their turnaround. And we have lateral flow devices, which can give us much quicker tests, but we need to understand the accuracy of those tests as well. And so what I've said previously is still where we are and to want to understand how we may be able to use those tests that may mean we can have a different approach to testing in care homes. But as I say, I think it'll be wrong to see this just in terms of one particular issue in one area without seeing the broader picture on how we utilise all of the tests that are available to us. And that's where I want to get to to have that broader settled picture, which will definitely include the potential for a different deal on visiting in care homes. But the work isn't finished just yet. When it is, I'll make that clear in public. And I'm sure there'll be lots of people who will be looking forwards to any decision that we make there. But I think the clarity and the whole picture is really important. In the meantime then, what are you doing to make the situation easier for dementia sufferers and dementia carers? Well, people living with dementia, whether the person who has dementia or their family, their carers and their loved ones, this has been a particularly difficult period of time because you have these competing difficulties of both wanting those people to be kept well and safe. And at the same time understanding that the value in that person's life is even more tied into seeing regular, trusted, loved people. Now, that's really difficult. So that's why we haven't had a blanket policy on care home visiting because we need to take account of the fact that people are different and where visiting takes place, it's about how safe is that environment. So we're working with the care home sector in particular on looking if there are other things we can do to facilitate safe visiting and that isn't just the points about testing. Even with a test, it's still then about the environment in which a visit takes place. So again, there's more work we're doing on infection prevention and control on both health and social care, social care especially when it comes to residential care where lots of people with dementia are living, but it's also about people living in their own home with dementia and what that means in terms of the household contact too. So there's quite a number of things to work through and I want to get to a position where we can understand what we're going to be able to do to make visiting not just accessible but as safe as possible to make sure that people don't come to even greater harm. But this is one of the more difficult questions that we'll continue to face in this unfinished pandemic. Thank you, James. We've now got Will Hayward from Wales Online. Thank you, Health Minister. I also want to ask you about care homes and the issues around testing. It's clear that people have been dying in Welsh care homes because tests are taking too long to come back. Can you outline who is responsible for testing in Welsh care homes, what the split is between the UK and Welsh Government in terms of testing, and can you give people a date when these issues are going to be resolved? Well, when your first assertion isn't one that is borne out by all of the facts, we know that there are challenges in the turnaround times for testing in care homes. We've been clear and upfront about that. We're now starting to see an improving picture when it comes to Lighthouse Lab turnaround tests. The test itself isn't what keeps people safe on its own, of course. Because when you have a test, that tells you about your position at the time you've had the test, it doesn't tell you the position you're in another two to three days' time. So, actually, that's why there's so much importance placed on infection prevention and control measures as well. And it's also a reality of the high level of community transmission. It's one of the consequences of losing control of coronavirus and the significant peak that you saw in the first graph that we saw. And that rise through the autumn has real consequences for people, especially in these closed environments. So, Lighthouse Labs are, as you know, a responsibility for the UK government. As we're seeing an improvement there, there's still a regular programme, and local partners will determine whether to have fortnightly or weekly testing. I expect most local partners will opt for weekly testing, but the testing goes alongside and it doesn't replace effective infection prevention and control measures. And, of course, as you know, we've been helping with that throughout this pandemic by making available free PPE and we've got a commitment to do that, to help care homes, not to take away the cost, but to take away the concern over whether effective and appropriate PPE is going to be available. And we've guaranteed that through the course of this pandemic. We'll have more to say on nosocomial transmission within healthcare settings and infection prevention control, with a review that I've already asked for. We should be reporting within the next few days and we'll be clear in public if there is any further action to be taken to help provide people with the assurance that I know they'll be looking for. Sorry to contradict you, Health Minister, but that is borne out by the evidence of people who have been speaking to us who have said that they worked for a week unknowingly with coronavirus within a care home because they didn't have their tests come back. I'm going to stay on care homes if I may, despite repeated assurances from the Welsh Government that you would publish weekly data for outbreaks in care homes. It still hasn't happened. It doesn't seem unreasonable for you to commit to a deadline for when this will be done. Can you please give us a date for when this information will start being made available to the public? With respect, we don't agree on your first point. It's your view. It's not a factual assertion, though. We do know that there are challenges and turnaround times, but as I say, it isn't just about the test itself. It is about the effective infection prevention and control methods, so it's about dealing with both those, not pretending that there's only one, not the other, that matters. When it comes to the publication of information about care homes, so the regulator, Care Inspectorate, they receive some of the information, they receive notifications. Public Health Wales also have data. We're looking to see what's already published to then come to a way to either directly to what's already in the public domain to make sure there's a regular provision of information. And I'm not going to try to get into having a definitive date because, as I told you on Friday, of course, and you're aware of this will, if we're going to have things that are official statistics, we need our colleagues here in our independent statistics group here to be clear about that, or whether, actually, if you can have information published, whether it's by Care Inspectorate or Public Health Wales, to give that. And I accept this is an entirely reasonable thing for people to want to see, to see the pattern of infection rates, whether there are new infections in care homes and to be able to provide that in a way that is entirely transparent. So following on from Friday, we're now on Monday, I'm expecting the issue to be resolved, and then to have that provided clearly and transparently as soon as possible. Thank you. We've now got Dan Bevan from LBC. Thank you, Health Minister. Good afternoon. I want to start by asking about vaccines and vaccination. According to a survey that was proportionate to the population, around one in four people in the UK say they wouldn't take a vaccine in its first instance when it's first available. Your comments previously that you wouldn't rule out mandatory vaccination, although saying it would be unlikely, could be a cause of concern to some people who are concerned about vaccinations. I wondered if you would rescind those comments and rule out mandatory vaccinations. Well, it's the most extreme and the most unlikely outcome possible. You'd need to change the private legislation to do this, and it's certainly not any part of our working assumption. I've never tried to mandate vaccine provision in the several years that I've been a Minister in the Health Department as Deputy or as a Cabinet Minister, and I don't think we're going to get anywhere close to that this time around. This is really about wanting to have safe and effective vaccines that are available for the public. I do not expect and I do not plan to try to mandate those who want to make them available for the public. And actually, we've seen different figures about the numbers of people who would and wouldn't take a vaccine. Those concerns about the safety of it are really important. There is also, then, the potential that if we have an effective vaccination programme, giving a significant population coverage, it could make a really big difference to the choices we can make about how we live our lives. And now I don't expect any form of bandation. I've always been deeply skeptical about the benefits of it in any event, and I'm not particularly keen to try to change the law for that to happen. I'm interested and people understand the evidence about the safety of the vaccine and then making the right choice to protect them, their family and their community. Thank you, Minister. And you've already mentioned about your concerns about the numbers of people we've seen on our high streets this weekend. Of course, Cardiff City Centre in particular is somewhere that many people will do their Christmas shopping. So in the lead-up to Christmas, are you concerned that those crowds will only begin to grow as people from outside of Cardiff travel in? Well, this is one of the questions, the challenge we have about opening up different areas of activity. And as I said earlier, there's a bargain here to be struck in terms of the business that wants to provide as COVID secure an environment as possible, and also how we behave as customers for those businesses, whether it's retail, whether it's hospitality or any other particularly form of business. So, like I said, we've seen examples of where people are trying to do the right thing. They're making sure there's so few distance in queues where businesses are limiting the number of people who go in there and the additional cleaning regimes in a range of different business settings too. And it's still the point about us making different choices as well about where we go and when we go and how many times we want to go out in the content we have with people. This is part of the really difficult balance because if we try to turn people away from retail sectors, we don't have a real impact not only on the economy and people's jobs, there's health harm that comes from that too. And so we're not looking to control parts of people's lives. We're really trying to say, this is about each of us making choices. How frequently we go out, how many people we see, how much content we have and for what time. So what to say, it's about us doing the right thing. And I'm confident that most people will do that. We'll need to look at the evidence for the impact of post-firebreak and how people are making choices. But this is about all of us playing our part, not just the government, not just the health service, not just businesses, but all of us playing our part to help keep well safe. Thanks, Daniel. I've got Rob Taylor from rexham.com. Good afternoon. Have you had any recent updates on the outbreak at the hospital in Rexham perhaps over the weekend or even this morning? And if so, what is the latest? No, I don't have specifics for you on the Rexham outbreak. If you still don't have information, I'll happily talk with the health board after this to make sure we get a particular briefing direct for you, Rob. Thanks for having an update on Friday. I was just wondering if there was anything that developed over the weekend or this morning. Looking at the latest public health Wales figures, there appears to be an uptick on inpatient confirmed cases for the north Wales health board area, and that now shows the highest figure since mid-June. With that data covering the whole of north Wales, is there any detail if that's west, central or east? And what's your understanding for that increase? I can't give you the split between west, central or east, but we know we've got a mixed picture of both challenges with transmission within healthcare settings, which is, in many ways, a feature of community transmission. And we've also got the lag in terms of admissions from the high number of cases that we have seen. It's good news that we've seen cases falling back, and you'll see from the graph that we showed, that first graph on that slide. But actually, when it comes to admissions, there's a lag between the cases and the infections being confirmed. You then see a lag in hospital admissions, and have you seen from the graph with a number of deaths, sadly? We expect those to go up, although this is positive news. We're starting to see a bit of a plateau in hospital admissions across the country. So that's good news. But as we've seen before, the pattern of the pandemic can vary locally and regionally, and you'll recall because you asked me many questions about it, about the fact that we had a slightly later peak in north Wales done in most of south Wales. So there are a range of possible reasons, but we'll need to understand more about what that looks like. And again, community prevalence in terms of testing, and no in terms of infection rates, but also community prevalence in terms of how people are then choosing to behave as well. And we did see particularly high rates in Flintshire and Wrexham compared to other counties within north Wales when we went into the firebreak, and indeed in the first week or so of it as well. Thanks, Rob, and I've got Steve Bagnell from The Daily Post. Thank you, Minister. With a large-scale rollout of a vaccine, it's still possibly months away. If the two-week firebreak is deemed to be a success, will it become a standard tactic to halt the virus? So if cases rise to a certain point, it is reintroduced as a matter of course? No, it's not something they're looking at as a matter of a standard tactic and having, if you like, a set of figures to then push the button. We always need to look at what we think is happening, the data we get from the numbers of new cases that have been confirmed by our testing regime, what's happening with our NHS and the hospital capacity, the death rate, and not just the number of hospital beds being used, of course, but about where they are as well. We need to take real attention to our critical care capacity too. Now, the modest levelling off in that that we've seen over the last few days is good news. That's not just good news for COVID care, but it's also good news for maintaining other parts of our national health service too that don't treat people with COVID because if we see COVID taking off, we won't just see more people coming to our hospital because it will affect what we're able to do in terms of treating people who don't have coronavirus. We know, because again, you've asked questions on this in the past, that can have a real impact on the harm that comes outside of that. If we were to have to pause or cancel other forms of treatment, that's a different form of harm being created. So, at this point in time, there are some optimistic signs, but it still matters that we make different choices together into how we're choosing to live our lives. That will mean the NHS can go on being there for all of us when we need it. Thank you, Minister. Just to return to the comparison between flu and coronavirus. With flu having a mortality rate of 0.1% in COVID, 1.15%, sorry, 1.15%, essentially what the evidence is saying at the moment is that the coronavirus is around 11 times as deadly as flu. Is that a fair reflection of what the current figures are saying? Well, that's what the figures show, and that's why we're treating coronavirus in an entirely different way. Some people have said at various points that COVID is just another form of flu, and it's no worse, no better. Actually, the figures are really, really stark. It is much worse because we don't have immunity built up over a single period of time. We don't have effective antiviral treatments for the whole population and we don't have a vaccine. Now, we may get a vaccine in the months to come, but we're still a long way from that happening and being available to us to protect the population, so it's really important we all continue to make choices. Who we see, how many people we see, how long we spend with them, and in particular, how many people we allow into our own homes. The rules aren't there to try to make every single choice for people. It really is about us making choices for ourselves to keep our loved ones safe and to help keep Wales safe. Thank you, Steve. I look forward to seeing you again answering more questions in the future.