 Rwy'n gweithio gydag y bydd ymgyrch yn ysgrifennu i'r ysgol yn ysgrifennu Llywodraeth o'r fath ar ymwiel a'r gweithio ar ymwiel yn yr oed. A dyma'r ysgrifennu hynny'n gwneud yma'r ysgrifennu Llywodraeth yn ymwiel yn ysgrifennu Llywodraeth ymwiel. The virus is now present and spreading in every part of Wales. Now this map on screen now shows the current spread of coronavirus in Wales. The darker the area, the higher the seven day incidence rate. The darkest areas have an incident rate of more than 100 cases per 100,000. These are clustered in parts of south Wales and the four counties in north Wales with whole county restrictions. The lightest areas have an incidence rate of less than 50 cases per 100,000 and these are largely in Wales's most rural areas. The all Wales incidence rate is now more than 100 cases per 100,000 people. We have seen coronavirus move from east to west across the UK and likewise from east to west across Wales. This is why the latest area affected is Bangor as coronavirus has moved swiftly across north Wales. There has been a surge of cases in the city associated largely but not wholly with younger people and the student population. Local restrictions were introduced in the city on Saturday night. We are closely monitoring the wider situation in Gwynedd and in neighbouring authorities. We will meet local leaders to discuss the situation early this week. The measures that we have put in place at both the local and national level to date have helped us to keep the spread of the virus in check. However, there is growing concern that these will not be enough to help see us through the winter because the virus is spreading so quickly. We could see coronavirus infections reach the same level as the spring peak in the next couple of weeks. This week, we expect to see tougher measures introduced by the UK government in the hardest hit areas of England and a new three-tier intervention system to help it control the spread of the virus. This morning, the First Minister and myself discussed these measures at a cobra meeting chaired by the Prime Minister. In Scotland, the very strict firebreak measures, which include the closure of hospitality businesses, came into force over the weekend and throughout the central belt. I do not want to scare people, but I do want people to understand that we potentially face a very difficult few months ahead of us. I want to run through some of the figures and some slides with you, which will explain why we are taking the current situation so seriously. As I said earlier, the latest figures show the seven-day incidence rate for Wales is now more than 100 cases per 100,000 people. The first graph shows very clearly how cases have risen sharply since the end of August in Wales. We have more than 600 new cases of coronavirus confirmed on many days in the last week, a region of 10,000 tests a day. This slide also shows, in the second graph, a clear increase in the number of deaths since the summer, when there were long periods when no people died from just virus. Main with everyone who has lost a loved one during this unfinished pandemic. Very sadly, we know that more people will die from coronavirus this winter. The results in the Office for National Statistics latest infection survey suggests that one person in every 500 has coronavirus in Wales. The R number is now estimated to be at around 1.37. The number of people with coronavirus in hospital is increasing steadily. There are more than 330 people with coronavirus in hospital across Wales. That's up by more than 100 from last week. There is about a two-week delay between cases in the community and hospital admissions. As we see cases rise in the community, we can expect to see a corresponding increase in people admitted to hospital and to intensive care. We're seeing a steady increase in the number of people who are seriously ill and need intensive care treatment, including for coronavirus. The NHS is implementing its plans to increase critical care capacity, transforming theatres and recovery areas into intensive care settings to treat the most seriously ill people. 2020 has been a difficult year. We have all been through so much already, but we must be prepared for a difficult winter ahead of us. Coronavirus is moving quickly through the UK and in Wales. It is a highly infectious virus. For most people, it will cause a mild illness, but we know a significant number of people will need hospital treatment, and sadly some people will die. We also know some people will experience after effects long after they have recovered from the illness, sometimes known as long COVID. Now, more than ever, we need to act together to keep Wales safe. Thank you. I'll now take questions from journalists. As always, we will broadcast all the questions and answers live on our own social media channels. The first question this week is from Owen Clark from BBC Wales. Prinand health minister, good afternoon. Given what you've just told us about the growing concern that the measures we have in place now won't be enough to see us through the winter, is it time for you to perhaps level with people to suggest that we will need to think or move into a national lockdown in Wales sooner rather than later? And what's on the table with that? Well, as I said this morning, we are considering all measures, whether we maintain local restrictions or whether we move to a national picture and what that national picture might be. You will have seen the well advertised conversations and suggestions about having a firebreak or a circuit break as Scotland have introduced, and we're obviously considering all of those options here. We need to understand what might be required and what we might need to do, not just at that period of time or what might come afterwards. Now, we haven't made a decision on that. We're continuing to have those conversations here in Wales with our scientific adviser and the chief medical officer's department, but we know that that is consistent advice that is being given to all governments in the UK to consider. So, in Wales, I think this will be a particularly important week as we look to not just have conversations, but we will then need to make decisions through the rest of this week. Thank you. Given the very worrying pattern of disease spread in communities quite close to our borders, what is the latest thinking in terms of restricting travel of anybody from England into parts of Wales with a lower incident? What's the latest thinking on that? Well, myself and the First Minister were meeting again later today, but we're both deeply disappointed that the Prime Minister is still taking an approach where there is only going to be guidance on whether people should or shouldn't travel out of highly infected areas. Now, this isn't just an issue for Wales, an issue for the whole UK. Lower-province areas in England will be equally affected, as indeed lower-province areas in Wales. We do understand that there has already been an importation of coronavirus cases from contact with some of those high-prevalence areas in England. So, we will meet later today and we will then need to make choices given that there doesn't appear to be a resolution on this with England only matters, which would have been the right choice to make about those very high-prevince areas where we all expect there will be further action taken today and over the next few days. But sadly, the Prime Minister has chosen not to act, so we will be making choices here in Wales. Thank you. Oh, I've now got Aidan Masters from ITV Wales. Thank you, Minister. You mentioned the three-tier system that the Prime Minister is expected to announce for England later. Are you considering a similar system for Wales, and if not, why not? Well, we're considering the three tiers that England are producing, but we're not clear about the metrics, the measures that will be used to understand how people move between the three tiers. So, we'll be watching with interest what the Prime Minister does have to say, because we didn't get clarity on that in this morning's COVID meeting. It's also clear, though, that there will be measures beyond tier three as well. And as I said in the script, we understand that some parts of England will have additional measures put in place that go beyond tier three. But it's also clear that the advice that we are receiving from our own Chief Medical Officer's Department, from our own Chief Scientific Advisor on Health, is that tier three measures, as we understand them in England, won't be enough to bring the R number below one. So, we are going to have to think about additional measures beyond that, just as England are having to consider. And as I say, we expect some of those measures to be announced locally or regionally in England later in the day. Thank you. Many people who were shielding until August the 16th are understandably anxious and uncertain about the situation as it is now. Should they think about shielding again? Are you likely to advise them to shield again? And if so, what support would you offer? I have a further conversation to look at some advice from our own Chief Medical Officer's Department here in Wales. We also know that there have been conversations between the four Chief Medical Officer's departments in the UK. And as I said before, we understand some of the protection that shielding gave to people, but it came at a cost because there were issues about loneliness and isolation for a number of people shielding. We also know that a medical conditions approach has limitations, as I've said previously. If you look like me, you're at higher risk than people who don't look like me, and that isn't covered in a list of medical conditions. The reality also is that for some people overweight, that doesn't necessarily mean that that's covered in a list of medical conditions. And equally, we've seen the virus has had a much, much more significant impact in our least well-off community, so that well-trodden understanding of health inequalities, mapping socioeconomic inequality, and that in itself doesn't map neatly across a map of healthcare conditions. So we're trying to understand how to give advice to the public about how to keep themselves safe and well, and whether we need specific advice for people on that shielded list, or whether actually we need a clearer national message for everyone. But for people who were previously on the shielding list, we'd ask again for people to strictly follow the advice in place on hand hygiene, and on not having indoor contacts beyond your limited, exclusive bubbles of people, and equally, to be very, very clear when going out and about to follow the rules. If all of us did that, then we would expect to see a reduction in the amount of coronavirus circulating, but for people who've been shielded, it's even more important for that guidance and those rules to be followed. Thank you, Adrian. We've now gone. Will Hayward from Wales Online. Thank you, Minister. Exactly how many Welsh care homes currently have cases of Covid, and what parts of Wales are most affected? Welsh I can give you an exact list of all the care homes who have Covid right now, Will, but the latest data that we obtained on the 4th of October showed a total of 127 positive cases across staff and residents here in Wales, and with over 1,000 care homes in Wales, I understand that that gives us a prevalence rate of 0.7%. Okay, so that 127 figure is staff, not some individual care homes, and coronavirus is still rising in almost every part of Wales, and either the current restrictions are not strict enough, or people are not following them. Which one of those is it? I don't think it's as simple as that, Will. We understand there about 22, but I don't be exact about it, because we're thinking about those that are managing confirmed cases. The challenge is whether we have the right balance, not just for care homes, but for the whole public, and about the choices that we make. Unequally, we know that we're seeing a lessening in the numbers of people that are following strictly all of the advice that we're giving. Even during the national lockdown that we had from the 23rd of March onwards, not everyone strictly followed all of the rules, so we don't get 100% compliance with all of our rules, whether enough of us are doing the right thing, whether enough of us are following the rules to help restrict coronavirus circulating more widely, and growing more in each of our communities. So it's a balance between the measures and whether people follow them, and it's also about how we persuade people to follow the rules, to keep themselves, their families and their loved ones safe. So it isn't quite as strict as it's either the rules need to be tighter or people aren't following the rules, it's a combination of all of those things and the time of year that we're in, because more of us expect to spend more time indoors as the weather's changed, and we also know that the fact that it's colder and damper are good conditions for the virus. People are, I know, tired of the restrictions on the way that we are able to live our lives within the rules, but unfortunately, the virus itself doesn't get tired, and it continues to present a real risk to all of us in every community. Thank you. We've now got Rob Taylor from rexon.com. Good afternoon, Minister. You've referred to being in a meeting where you're deeply disappointed over the travel restrictions in England. The First Minister indicated legal preparations had already been explored. Can you detail further on those options that you'll be considering? Could we see individual English counties or cities named in regulations, and if so, how can that be legally enforced on the border? Finally, can you confirm the decision will now be taken by Welsh Ministers and you won't be waiting on Westminster again? Welsh Ministers will be meeting today. As I said in an earlier answer, I'll be meeting with the First Minister to consider the legal advice that has already been prepared. We do have public health powers, and because we can see an increase in rate in particular localities in parts of the UK, we should, if needed, be able to identify those areas where the risk is such that we should have restrictions on travel, and it would not be a reasonable excuse for those people to enter Wales because of the risk that they present because of the area of the country that they come from. We have the same restrictions within Wales already, because this will be at travel to and from Wales as well. So we do have powers, but, like I said, I'm disappointed that there hasn't been a more definitive response from the UK Government to deal with England because they understand that there is an issue in some parts of England and they are considering additional measures to introduce because of that, and we do know that travel in and outside of those areas has been a factor in the spread of coronavirus to other parts of the UK, including some examples here in Wales. Thank you, and at this morning's briefing, the NHS England director has said that nightingale hospitals in Manchester, Harrogate and Sunderland have been mobilised again. What's the situation in Wales, and are there enough staff and resources to mobilise rainbow hospitals for Covid quickly if required? Yes, the arrangements are in place to make sure that we can stand up the field hospitals known as rainbow or envious hospitals in north Wales. The challenge is, as we see an increasing pattern of cases coming into our hospitals here, we need to react to that to make sure we protect non-COVID activity as far as possible. We are seeing our normal critical care capacity would be pretty full by now, but as I said, we're already seeing a range of areas, theatres, for example, and recovery areas being turned into venues for intensive care to be provided. I'm in open college across the border in the north west of England in particular, but they are seeing their hospitals become full and their intensive care capacity filling out as well. So we are already planning to make sure that our own field hospital capacity is ready, should it be required, and that does mean staff need to pay in a different way, and it has an impact on the way the rest of the health service is able to manage the normal conditions and normal healthcare treatments. Thank you Rob, I've now got Dan Bevan from LBC. Thank you Health Minister, good afternoon. On your comments today regarding the next few days being serious on determining whether national measures are needed, I wonder if you could expand on that a little bit. Would a national lockdown look the same as the one that happened in March, or would it look more like the current local lockdowns that we have just on a national scale with hospitality, for example, still opening? Well, if we decided to take national action, we would still have to have the final detail of what that national action might look like. A consistent pattern of the current local restrictions across the whole country is of course an option, and as I've said earlier, there is clear advice and say to suggest that a fire break or circuit break with action that looks a lot more like the March lockdown for a limited period of time is an option as well. Now, we haven't to consider all of those different choices, and over the coming days we will need to make those choices for what we are and aren't prepared to do on the understanding of not just what any restrictions might mean, whether locally or nationally, but what we would then seek to gain from doing so, and what that might then mean after any restrictions come off being enforced, because the circuit break or fire break suggestion is to get ourselves some time to then have a different pattern of behavioural controls and rules in place afterwards. Now, we need to run through that to be able to tell people any choice we make whether locally or nationally what that choice is, there's clear communication about it, what we expect to gain from doing so, when we expect the new rules to be after those measures are no longer enforced. Thank you, and it's been reported this morning that there's another meeting taking place regarding the local lockdown restrictions in Bangor and whether they need to be expanded further across other parts of the Gwynedd council area. Wonder what your take on that was? We had a meeting on Friday and Saturday with colleagues from Gwynedd, not just the local authority, but also members of the local health service and indeed our advice in Public Health Wales of police and others. We're expecting a meeting with leaders from surrounding areas early this week so within the next day or two to understand whether we need to do more, and of course this depends on the picture locally within that part of Wales. It also is dependent on the picture across the whole of Wales so there are a number of difficult choices to make about local, regional and national and obviously when ministers have made choices we'll not just need to decide, having consulted with local partners whether they need to announce those and make clear to the whole country what any of those choices are. So we don't have a definitive decision today because those conversations aren't completed and with a recent conversation just completed in Cobra we will need to follow up more certainty we need to understand but what support may or may not be available to help support choices that the Welsh Government makes to help keep Wales safe. Thank you Darren, I've now got Andrew Forgreif from The Daily Post. Good afternoon Minister. Are you confident that Wales has adequate supplies of PPE for the coming winter? Yes I can be much more confident about the position we're in now in the middle of April where I was deeply concerned about the position we had found ourselves in with a tightening of the international market for PPE and at that point we hadn't got lots of our Welsh manufacturers into position to make and create PPE of the right standard here in Wales. We're now in a different position where we've managed to re-secure supplies from international markets we have a much bigger stock that we're holding here in Wales and we've arranged a Welsh manufacturer so we've really stepped up to the plate to act on behalf of the nation and creating new supplies of PPE manufactured locally so we're in a better position but as ever there's always a risk there's always a risk about a virus where we don't understand exactly what the picture will be through the whole of this winter but we're in a much more secure position than we were in the middle of April. Thank you very much. NHS Wales had a reciprocal agreement with the NHS in England which allows for bed-sharing if the capacity is adequate or sufficient. Given the severity of the Covid situation in places like Manchester and Merthyside what is the likelihood of Covid patients from these areas being transferred into hospitals in say North Wales? I think that's relatively unlikely Andrew as we've heard from a previous question in the north west of England they're getting ready to turn on Nightingale hospitals as they're called in England. Their field hospitals are in North Wales called Rainbow or Envis hospitals so that's what's going to happen. They're going to increase capacity in England to deal with any potential impact if Covid does mean that the NHS might be overwhelmed. That's exactly what the field hospital programme is there for. Within Wales we know that our own admissions are going up we know that we're having to again step up and increase intensive care capacity here so I'm not confident that we have capacity to take an overflow from England hence why each nation has gone about creating that additional capacity. I've now got Dan Barnes from the South Wales Argus. Thank you very much. Parents of children at Newport schools have recently been sent consent forms for online zoom lessons. Does this mean that a circuit breaker lockdown of schools is on the cards possibly for the autumn half term? Well we don't have a definitive plan at present but as I've indicated openly and honestly we're actively considering the choices we may need to make over the coming days. What should happen though is that regardless of that that we know that schools should have in place plans of blended learning which may mean that some people may be in place of the school environment and may be learning from home that means that schools should already be developing plans to make sure that they can actually provide that distance learning where it's required whether it's for individual bubbles for a whole year group depending on what may happen and you've already seen of course within the Gwentair that the Argus reports on that a number of schools about whether there needs to be a whole year group that they haven't managed to isolate from individual class groups and bubbles within that year and that's when some whole year groups have then been required to go home for 14 days. So actually the approach on blended learning and making sure that distance learning can't be in place is the right thing to be preparing for now regardless of any choices we may or may not make on a fire break or a circuit breaker approach to trying to gain some control and by some time to deal with the virus on an actual level. Thank you and on Saturday night there was a mass brawl in Cillian High Street after the pubs emptied at 10 o'clock so will the 10pm alcohol restrictions be subject to any kind of review? Well we regularly review all the measures that we're taking but I don't think people can use for drunken violence whether the licensing regime means that we close at 10 or 11 as I remember when I was a young man it was closing at 11 with drinking up time and even then there wasn't an excuse for people to go out on the street and to have a brawl and even with later licensing hours it's not an excuse for unlawful violent conduct. All of us need to recognise that we all have a part to play. We're trying to keep a range of sectors open including hospitality that means that those businesses need to follow the rules and the way that they behave that means that customers that want to use services to enjoy what they have to offer also need to follow the rules and not look for an excuse to blame somebody else for our choices but what we choose to do whether that's 9 o'clock the point in the day. Thank you Dan, I've now got Gareth Wyn Williams from the local democracy reporting service. Prónda, the latest seven day ruling figures show Anglesey standing at 48.5 cases per 100,000 people just short of the 50 figure which has been previously stated as potentially triggering localised restrictions. So although the figure is lower than neighbouring counties at the moment, what is the current situation for Anglesey and have you discussed any specific measures for the island? Well as I said earlier we're going to be having a meeting with leaders not just from Gwynedd but the wider air including obviously Anglesey earlier this week to understand not just a picture there but to understand whether we do need to take additional measures. So we're seeing a small number of unknown cases. We also understand a couple of clusters that TTP is on top of but we need to understand not just the numbers and the data because as you said 50 is a potential trigger for action but we need to understand the wider picture. When the island had the outbreak at two sisters it had much higher rates per 100,000 but we were able to control and isolate that particular outbreak and it didn't break into community transmission but this is a good example of why we need to have a conversation about local, regional or national action and to then understand how we have a set of measures in place the public can understand and support to help us regain some control over coronavirus to both reduce the reproduction rate but frankly it is also about reducing harm to minimise the number of people that need hospital treatment to minimise the number of people who may otherwise die over this winter. On the banger lockdown it currently excludes part of the city including the Pentia reward which includes much of Penos Garnedd this has been questioned by some local councillors who say it is causing confusion locally. How was the decision made to set the boundaries in the first place and what is the situation regarding walking testing in the city? There are two different things there so on walking testing we are looking to arrange more testing to be available in every part we have a particular hotspot and we will have some plans of banger that the local services will be able to promote and share between them so there will be Public Health Wales the North West Health Board, Betsi Cadwaladr and also the local council to help people understand what is available. On your broader point about how the geographic location is set well it comes from proposals made by the incident management team Wenedd who looked at the pattern of cases and we then had a discussion on Friday and Saturday with the local authority involved directly as well so we had the chief executive and the leader in meetings with the first minister myself and other statutory partners and we went through to try to understand what would be the right sort of ward boundaries to set so people could understand what was included and was and this is part of the challenge for a boundary there was always going to be some concern about which side of that you are and how local community interactions work but we did then check after we concluded our meeting on Friday that these were the appropriate ward boundaries to introduce these local restrictions but as ever this is always under review it's why we're looking again at local regional and national approaches and this week we'll need to make some choices about that so it isn't just Bangor and Gwynedd we're having to think about the whole country as well as I say this is all part of what we have to consider as we act together to keep world safe thank you Gareth I've now got Tom Magner of Carers World thank you very much indeed minister good afternoon the issue that's most worrying our viewers at the moment is about respite services in any form of lockdown it seems that you either shut down day centres and local authority home services which ramps up the mental pressure on unpaid carers or you keep them open and risk higher community transmission rates in more populated areas of Wales where do you stand on this critical issue well as ever Tom it's not a simple choice because as you've neatly encapsulated there are consequences to making either choice consequences for carers need to care for their loved ones if they're not able to access the respite on the activity that a day centre may provide and there are consequences in closing those as well and actually it's a real concern for local authorities as well in a call that I had last week local authority representatives were generally concerned about the picture on day services and what they would be able to do and what they would want to do because again they recognise there is a balance of harm that's why we need to understand what's happening locally and then if we're taking a national choice we need to be clear sighted there will be imperfections in doing so but it's still fundamentally Tom about keeping your viewers and their loved ones as safe as possible and making a choice that drives down the art rate that keeps as many of us with the best prospects of being alive and well at the end of this pandemic Thank you for that This morning England's Deputy Chief Medical Officer Professor Phan Tam spoke of incremental grief of coronavirus from the 16 to 29 year age group towards older, more vulnerable people How does that of expert view influence your thinking? We've had similar views and advice from our Chief Scientific Advisers on health, our technical advisory group that give us that scientific advice and indeed our Chief Medical Officers Department and part of the concern is that whilst we see much of the current rise in coronavirus is driven by contact between younger adults it isn't exclusively younger adults and we know that younger adults have contact with people in different age groups and the concern is here that if we see a larger transmission rate as we have done in some of our local authority areas into groups of people who are above 40, 50 and 60 that we can expect there to be a greater likelihood of harm and when we see hospitalisation rates when we see those who need intensive care we see sadly those people who are more likely to die from coronavirus to further up the age range we go the more likely that is to be the case now that definitely plays into the concerns that we are having to consider and the choices that we may need to make so it's okay I'm only with people who are younger and fitter like myself well perhaps I'm a middle aged man so I may not be in that category anymore but it is then about the consideration the contact people have in age groups are at much higher risk and that definitely plays into our choices so that's why we say it's up to all of us to do our bit