 Prunhawn da, eich gweithio. I'm Andrew Goodall, chief executive of NHS Wales. I will update you about how coronavirus is affecting the NHS. Yesterday, Public Health Wales reported 705 new cases of coronavirus. Overall, we are continuing to see a fall in the rate of cases across Wales since the end of the firebreak, but we continue to see very high numbers of people dying from coronavirus. Over the last month, sadly, Public Health Wales has reported 532 deaths. These are not just numbers. I would like to pass on my personal condolences to all the families who have lost a loved one to coronavirus. We have four levels of escalation in the NHS, which reflect the pressures in our system. Today, there are 18 hospitals reporting levels three or four, the highest levels of pressure. The NHS is continuing to balance winter and emergency pressures with the demands of looking after people who are seriously ill with coronavirus. Since I last spoke to you, the number of people admitted to hospital with coronavirus symptoms has continued to rise. There are some signs that hospital admissions are stabilising, but this is not sufficient to overcome current pressures. There are currently 1,654 COVID-related patients in Welsh hospitals. This is 8% higher than last week. This is equivalent to more than 50 hospital wards across Wales, full of people with coronavirus. There are 62 people in critical care being treated for coronavirus. This is lower than a week ago, but more than a third of our usual critical care capacity is now being used for coronavirus patients. Our normal critical care capacity of 152 beds is full. We currently have 157 people in critical care. We have plans to expand critical care capacity if required. Nearly half of people admitted to hospital with COVID-19 will be there more than a week. A quarter will be in hospital for at least 21 days or more. Some will need even more time and expert care to recover properly. As you would expect, this has a knock-on effect on available bed capacity. This is why I'm concerned about the impact of the demands and pressures on the NHS. The NHS remains open for essential and emergency services and also for routine care, but with high levels of coronavirus infection in our communities and high levels of people with coronavirus in hospitals, services will find it increasingly difficult to operate normally. Tomorrow we will restart publishing NHS performance and waiting time statistics. These were suspended in March as part of the measures to help the NHS focus on the pandemic. I cannot comment on these statistics until their publication, but I do want to give you some insight into just how much the pandemic has transformed everything we do in the NHS. Coronavirus has affected almost every aspect of healthcare from learning how to treat and care for people who are seriously ill with COVID-19 to making physical changes to clinics, surgeries and operating theatres to protect staff and patients from the risk of contracting this highly infectious virus. I referred earlier to critical care and I want to say something about the immense pressures some of our critical care units are facing and give you a snapshot of what staff working in this highly specialised service are experiencing every day. Working in full PPE for a whole shift is hot and difficult. I don't think many of us can imagine what this must be like. There's an increased need for breaks so staff can take off the equipment. COVID and non-COVID patients need to be kept separate in what are often small departments, increasing the workload and complexity for our staff in their care for patients. There's a higher level of staff sickness as critical care staff are affected by the pandemic and may have to self-isolate. Patients being cared for in critical care are the sickest in the hospital. This inevitably has a personal impact on staff. Staff are often redeployed to critical care from other parts of the hospital, such as theatres. This shows just how flexible the NHS can be when under pressure. Outpatient services where we would normally see 3 million people equivalent to the population of Wales every year have also been affected by the pandemic. Clinics are seeing around two-thirds fewer people to ensure they comply with social distancing requirements. To complete the cleaning regimes needed between each appointment these are scheduled for 30 minutes instead of 15 minutes to manage infection risk. But there are some areas like ear, nose and throat and maxilla facial where the risk is higher and an extended wait between appointments is needed. To improve throughput we are running mixed clinics. Clinicians are seeing someone face-to-face and then someone virtually. There has been a significant increase in the number of remote consultations to avoid the need to physically attend. Around one in three of our patients are now seen virtually. The number of outpatients being seen has increased since the start of the pandemic but outpatient numbers are still around a third lower than normal levels. Despite everything we have been doing, waiting lists are increasing because of the impact of the pandemic and the measures that we have put in place to protect people's safety. Unfortunately we will see further increases to these waiting times as we continue to respond to coronavirus during this public health emergency. It's important we consider different approaches to managing patients so wherever possible we redesign services to maintain the flow of patients through the NHS and support access to services in the most appropriate settings for their care. We also need to track patient experience and outcomes in different ways recognising that the way in which people access services is changing and this means our view of NHS performance will be different. Earlier today we announced changes to monitoring cancer patients which better reflects outcomes through the single cancer pathway and this change has been supported by our clinical teams and stakeholders. I want to emphasise that while we are doing everything we can to increase routine activity in the NHS it is not possible to return all services to normal particularly with high numbers of positive coronavirus cases in our communities. The NHS remains under significant pressure from pandemic and winter demands. I want to acknowledge and thank all our health and care staff for their commitment and for everything they are doing to respond to people's needs in these most challenging of circumstances. They are working in a very stressful environment and have been year round. They remain focused on supporting care and treatment for the people of Wales. We want to ensure with your support that the NHS can continue to deliver its services in a safe and accessible manner. You can help us to help you by following the rules keeping your distance from each other, practicing good hygiene, working from home wherever you can and wearing a face mask in indoor public places. Together we will keep Wales safe. Thank you, Jochran Maureen. I'll just move now to questions from journalists in the usual way and today I'll be starting with Owen Clarke from BBC Wales. Prynhawn da, Owen. Prynhawn da, Dr Goodog. Could I start off with mass testing? A short time ago the Welsh Government announced that the first programme in Wales of mass testing will begin in Murthyr Tiddville over the weekend. Could you tell me what in your view the impact of that will be, not least on the NHS, of course? And we know Prince Charles Hospital in Murthyr Tiddville has been particularly hard hit. And what evidence do you have, let's say, from Liverpool about the effectiveness of mass testing programmes in terms of people taking it up? Thank you, Owen. Yes, first of all, you're right to reflect that within the area that the population of Murthyr are supported, Cwmtaff Morganaig runs the hospital system there. That has been of significant concern that the local health system has been under tremendous pressure over recent weeks with seeing significant numbers of patients with coronavirus accommodated within their beds. At one point it's represented around a third of all of the patients in our hospitals in Wales. And really important that we're able to have mechanisms that rather than just simply respond to the virus, we can anticipate and hopefully contain its transmission. We know that we have had encouraging signs over the last week or so about the impact of the firebreak and that we've actually seen some reduction in the number of positive cases reported for populations. And you'll be aware that that also includes Murthyr. But it's really important that we can find other ways of disrupting the chain of transmission that occurs within our communities. We were really clean as we saw the Liverpool pilots taking place that we wanted to ensure that we were able to pursue that and see whether that was going to be possible for us to develop in Wales. Whilst Murthyr was an obvious choice given some of its recent very high prevalence, it's also offering a template oane for how we may want to introduce other local support and interventions across Wales, whatever our national actions are. And I think this represents a really good example of demonstrating that there are things that we can do to see whether we are able to break that chain of transmission. So obviously we are appealing to the population of Murthyr to support us on this initiative and to take that more repeat testing, whether they have symptoms or not. And hopefully that will allow us to make sure that we can demonstrate for this population that there is a way, again, of having some control and containment of the outbreak and the virus. Thank you very much. Now we know the NHS and many of its staff will, as usual, be working very hard right the way through Christmas. But what data or modelling do you have to suggest the amount of pressure that service or the staff might be under when we get to Christmas? And has there been any discussion perhaps in principle about whether or not a firebreak lockdown shortly after Christmas or early in the new year could help mitigate that? Could you tell us a bit more about what you're projecting about that period? Well, in respect of arrangements for other interventions, that will remain a matter for the First Minister and the Cabinet and obviously there has been a commitment expressed about reviewing, based on the data, the impact that the firebreak has had. And as I said earlier, Owen, there are encouraging signs that the firebreak has had some influence on our system. Certainly the reduction in positive cases in our community, whilst it means that there are some areas of Wales at a very high level, that is reinforcing that we know that we can take actions to actually mitigate and contain issues. As I said in my introduction, there are some emerging signs, maybe of some stabilisation in terms of some of the pressures on the hospital side of the system, and that's going to be important for us to work through. And actually, we currently assess that the reproduction rate is between 0.9 and 1.2, but it's quite possible that we may see that reduce further, again as a reflection of the firebreak, as we look at some of the data that will be coming out later on this week as well. So they will reinforce that we know that things can make a difference. There will be an evaluation of the data, we will see whether that will be sufficient to manage through, but ultimately that will revert to the ministerial reflections and considerations, and that commitment has been given in public to work those things through. In respect of your commentary about the NHS and the pressures that we're under, clearly the NHS is under pressure all year round, we plan for the winter period, we've had to do so even more this year because of the COVID-19 context. One of my worries at this stage is that whatever capacity we have available is simply to reinforce the impact that having currently over 1600 patients in our beds represents, and while I would hope that we may see a reduction in hospital patients as a result of the firebreak, whether these increase significantly or not, 1600 patients being cared for is an enormous ask of the NHS in Wales, we would not normally have those beds taken up by patients in this way, we would be seeing and treating other patients, both as emergencies and also as routine. So it's really important to listen to staff about their reflections, I was with the partnership forum last week with staff representatives considering some of these pressures at this stage, but we hope that there will be an impact of the firebreak to limit the growth, but it's quite possible that we will see some further increases even over the next few weeks or so, Owen. I'm often asked at what point the NHS will need to respond differently. There's not a number of such that helps us with that, but obviously we continue to see increases in the hundreds of patients in our hospital system, it would be under immense pressure, whether it's through a Christmas period or not. Owen, Diolch yn fawr iawn, thank you. Moving next to Adrian Masters from ITV Wales. Afternoon, Adrian. Good afternoon, Dr Goodall, thank you very much. I wonder if you could say a bit more about the arrangements for mass testing in Merthyr. How do you intend to roll the tests out? How do you intend to get people to the tests? How much take-up you would expect? And as a result, what your message is to the people of Merthyr about taking part in them? First of all, I would say that this is a measure to support the local population. It's an opportunity to support themselves, but also to allow us to understand how we can support the population of Wales more broadly. We are, of course, learning from other pilots being developed elsewhere, but the Liverpool City Region pilot is certainly the most significant that we've been able to learn from. I've been very grateful to colleagues who have been working on this from the local authority alongside UK Government and Welsh Government, of course, and particularly working with the health board. And I have to say the extensive military support that we've had in respect of the planning for these proposals, that would be familiar with other experiences elsewhere. What we're looking to deploy here is different technology. The First Minister and Minister have talked about that over recent weeks, and with the ability to use lateral flow devices, it does change the nature and the turnaround in respect of what we can do with this more public mass testing approach. One of the key opportunities here is the ability that, as people arrive for a test, we will be able to give those results usually within a 30-minute to an hour period of time, and that would allow a very rapid understanding of what the local prevalence looks like. I think one of the dangers of it, Adrian, and again I would welcome the support of the population of Merthyr to deliver this, is that the testing is only one part of this. That allows a diagnosis and a statement that somebody has the virus. What has to follow is that people then comply with the guidance and rules that apply, so we will be looking for people and they will need to self-isolate in line with the guidance, but in order to make sure that this is reinforced, they will also have access to a second test just to formalise the fact that this is actually an accurate reading with these quicker devices at this stage. But if we're able to start deploying this kind of approach in technology, this starts to really change the nature of the system to be able to rely on a more routine cycle of testing within our communities, and some of these devices will actually be able to be rolled out in other settings as well, possibly into other healthcare settings, for example, again to allow for rapid turnaround of testing as well. Thank you, and a similar question, really, about the rollout of vaccinations across Wales. Can any details on how you're going to store it? I know that the Pfizer vaccine needs to be stored at incredibly low temperatures. I understand you're talking about using the Welsh blood service facilities, if you could say a bit more about that. How you're recruiting people and what sort of people? Is it GPs or is it pharmacists or somebody else altogether? And where the vaccination would take place? So logistics questions, really, about the rollout of vaccination. Well, it's right to focus on the logistics of this whole exercise. I mean, this is the most significant logistics exercise that we'll have undertaken under any vaccination programme. From a positive perspective, having said that, the NHS, of course, is used to delivering an annual cycle of vaccines, discharging those appropriately from childhood vaccines right through to annual flu cycles as well. So we do have an understanding of the way in which we can discharge that, and that does mean that we have an infrastructure in place across the NHS to be in a position to deliver that. But this will be an enhanced ask of our workforce on top of existing very busy day-to-day activities, and it's important that wherever possible we can actually recruit and enhance our workforce as well. So every health board area across Wales is working on proposals that will allow to support whatever version of vaccines come through the regulatory process, because at the moment none of those have been technically signed off, despite the very encouraging results that we have. Depending on the vaccination itself, you are right that one of the vaccinations being made available does have particular storage issues. Again, we can rely on the fact that we have the Welsh Blood Service to provide some of the specialist support for that as necessary. But it will make some of the logistics for one of them more difficult, because we won't perhaps be able to use it in the same traditional way that we've done with other vaccination programmes. But some of the other vaccines that are emerging now are much more able to be delivered in a traditional primary and community care environment. So rather than simply just disrupt all of our normal activities, we are looking to do it on an enhanced basis. And of course, our particular focus for Wales will be how can we make sure that as many vaccinations are provided to as many individuals as possible, but we also need to make sure that logistically, we ensure that there is a very low wastage rate as well. So again, the opportunity to protect our population, particularly the most vulnerable, allows this to feel that this would really change the nature of our response in Wales. But it will also take us perhaps longer than people want and expect. I think the vaccination programme will be still continuing well into the spring. And therefore, it's really important that we do start with those who are most vulnerable in our society and make sure that they are protected first, Adrian. Thank you. OK, thank you very much. Dan Bevan is next from LBC. Good afternoon, Dan. Good afternoon, Dr Goodall. Thank you very much. If I could go back to the mother mass testing, if that's OK. Time frame is something that we haven't heard about yet. I understand you might not want to put an arbitrary date on the end of this programme. But if you haven't got an end date in mind, could you give us a flavour of whether it's going to be weeks, months or well into next year? For the mass testing programme in Merthyr, we would be looking to start for the first set of members of the community this Saturday. So there will be arrangements that will be in place to at least start off those mechanisms. And that will allow us to grow the individual sites that are in use. I think, Dan, it's going to be really important that we have some flexibility around our approaches so that what we are able to do is to use some of the mobile units in particular and make sure that, as well as having dedicated sites available, to move around to some of the communities, particularly where we think that prevalence is higher. Of course, we'll need to consider about how we move into some of our settings. So one of the areas for consideration will be around how we would approach areas such as education or even workplace settings as well. But we're hoping that the local population will feel supported to want to make sure that they're able to go through this mass testing approach. So those numbers will increase. We will need to think about the success of that and evaluate it. And it may well be that if we have other areas of Wales that still have a high prevalence, that there may be some opportunity to revisit that. But that will be part of ongoing advice that happens for ministers. There will always be some issues of dates, whatever we're doing. So whether these are dates for a mass testing programme or whether they are dates for vaccination programmes, we'll just have to try to keep the people of Wales as updated as we can be, because often these things are happening under quite urgent timescales. And it's important that we're able to be agile, I think, as we learn from the experiences as well. Thank you. I take from that that there isn't an end date in mind for the mass testing programme in Merthyr, which is fair enough. And also that you've mentioned that you've been learning from the Liverpool rollout there as well. What in particular has a picture interest from that? And are we going to be doing it exactly the same as in Merthyr? Or, excuse me, as in Liverpool in Merthyr, or is it going to be different in any way? Well, I think there will inevitably be a difference in respect of the size of the county of Merthyr in contrast to Liverpool as an area. I think that's why this is a useful pilot for us to undertake in Wales, because we can be much more targeted for our population in Merthyr at this stage. We've been able to learn about some issues in respect of the reliability of the testing that comes through. So the use of the lateral flow devices in Liverpool has been really important. And the feedback, of course, is that rather than waiting 24 hours for a test, or up to 48 hours, an ability to actually start the contact tracing process literally within the first hour is a really important mechanism that's here as well. I think the really positive feedback from Liverpool as an area as they continue to go through the cycle of this testing is again an example of how population comes alongside an intervention like this in order to do the right thing. And what Liverpool demonstrates is that many people, a very significant number, are very willing to take up the testing approach, even if this disrupts their life and their activities as well. So it's going to be important to learn from that. The final comment I would make is to just have some understanding of some of the sort of social knock-on effects, particularly where there will be perhaps higher numbers of people self-isolating. And that's one of the reasons why Welsh Government has introduced some support generally to recognise that there will be implications for employment when people have to self-isolate. But my main message would be if people end up with a positive result through this process and they will have another test to confirm that, they must comply with the actions that we have in place, including their need to self-isolate because by doing so they will not expose or be a risk to other patients or other members of their communities. Dan, thank you very much. Moving next to Abby Whitwick from Wales Online. Good afternoon, Abby. Good afternoon, Dr Goodall. I just want to move on to Christmas, if I may. Lots of people are trying to make plans for Christmas. What kind of restrictions at Christmas would most help the NHS run as smoothly as possible? So my main message for Christmas, irrespective of the political review that will be undertaken by Cabinet after the firebreak, and of course there is engagement across the UK about arrangements that may work, is to focus on the need to still limit social interaction and comply with the guidance about social distancing to make sure that hand hygiene is undertaken. Because whilst these are very familiar messages to people, the reason that we speak about them, Abby, is because they are the things that make the difference most and if there is any flexibility that is provided within the system we would still want to ensure that people undertake that with safety in mind because we still need to make sure that the virus is contained at this stage. The NHS, as I've said, is already under enormous pressure. 654 patients who we have in hospital beds for COVID-related reasons at the moment is the highest number that we've had even since the April peak and whilst it's slowing down, it is very disruptive about the nature of the care that we can provide and that's why I know that NHS staff have been very happy to see the way in which the Welsh population has responded right over these recent months to help us by complying and also helping us by supporting with their own behaviour as well. But you'll have heard ministers speak very often about the focus often being on about what people can do, whereas what people just need to pause and reflect on is whether they should do that or not. So if they do need to meet with other people to do so on a limited basis and not, if I can put it this way, to use the regulations to the maximum, really important that they use that flexibility in an appropriate manner. So obviously some people have said publicly that they will break those rules if there are rules at Christmas. So what would the effect on the NHS have of people having almost a Christmas as usual, inviting their friends and family over? What would the effect of a normal Christmas be on the NHS? So one of the worries that we'll have on the NHS side would be seeing the impact of understandable social interaction between people, having an impact on the reproduction rate and leading to an increase in the virus and its development. One of the worries is that our actual experience of the NHS, not modelling experience, is that where there are higher numbers of positive cases in the community, it translates into higher hospital admissions, it translates into higher numbers of patients in our critical care units, and that unfortunately and sadly will lead to more deaths. In my introduction, Abbie, I spoke about the fact that we have had over 530 deaths reported by Public Health Wales just over the last four weeks. As a reminder to all of us, in the first two weeks of September Public Health Wales didn't report any deaths on a daily basis, and that has changed very, very quickly. The more patients there are in hospital beds across Wales, the more deaths that there will be occurring in terms of our community, and that's why we need to take these protective measures. But the decisions on what may happen around the Christmas period and what may need to happen after the review of the post-fire break will be with the First Minister and the Cabinet to review that and to see whether they feel there is a need for further interventions. Some interventions that can happen, though, are about what can be done locally within individual areas, and that's why I've been really pleased to see the Merthyr mass-testing approach be put in place, because I think that does represent something that will be very different in terms of the approach and the experience in Wales. Abbie, thank you very much. Diolch yn fawr. Moving next to Steve Bagnall from The Daily Post. Good afternoon, Steve. Good afternoon, Dr Goodall. Thank you. There was a recent outbreak of 20 cases at the Wrexham Mylar Hospital. Is there any update on the current situation there, please? Steve, I don't have the figures to hand. I'm afraid for Wrexham Mylar. Inevitably, as we see higher levels within our community, we will see higher numbers of patients going into our hospitals. What I would say in our experience this time on the second wave, that it does feel that North Wales has had less impact to date from the virus, and there has been therefore less patients unfortunately within North Wales in both our general hospital beds but also in critical care. There's a danger of that representing that the NHS isn't busy at all, but it's more about the knock-on effects for these patients at the moment. But certainly the pressures have been probably more on the second phase around the south Wales area and moving more along the M4 corridor. We are keeping a close eye though on North Wales, Steve, mainly because of recognising the inevitable links to the higher numbers up there at this stage. But what's pleasing about the preparation in North Wales is I think that they have demonstrated over recent months a range of actions that have been very effective about caring for patients. You may well have noticed that they have decided to open earlier the field hospital arrangements in D-side basically just to give some additional flexibility partly because of some of the emerging pressures that they are seeing for coronavirus. I think that's a very good step that's been taken by the health board and by many patients coming into the system as well. Thank you. Cases do appear to be coming down in North Wales and other areas following the firebreak. But given the picture you've just painted about increasing pressures on the NHS, how confident are you the new national regime of rules is enough to turn the tide in terms of admissions to hospitals across the region on the rest of Wales? We will need to allow the appropriate period of time to carry on for us to understand the full impact of these rules and I know the first minister and the minister have always been very clear that from a hospital perspective it was very unlikely that we would see the full impact probably for a two to three week period afterwards. The positive response so far about seeing at least positive cases in the community reduce, one would expect that that will translate into fewer patients within our hospitals at this stage. I'm afraid as of today I can't report that but I can report that I have certainly seen the growth of cases in hospitals slow a lot over the last week and over recent days and the number of admissions coming into our system has noticeably reduced just over the last few days as well and if that carried on then I would be much more confident about the fact that whilst there will still be a very significant number of patients in our hospitals that actually there would be better support for the NHS with at least some of the more recent pressures when we describe how many patients are in our hospital beds at the moment is actually the number of patients who are there defined as recovering patients and there are over 400 patients now defined as recovering from COVID related patients and if we could see that number reduce it would mean that people would have been able to be discharged safely back to their home environment. I'll be keeping a very close eye on it. You also asked about critical care so critical care numbers in overall terms for COVID related patients have been probably able over the last couple of weeks. I think some of that is about the nature of the treatments that can be applied now to patients which is a good development that we've seen over recent months but I'm still worried that if we see high positive cases within the community ultimately that will mean a higher number of patients in our critical care beds in the future. Steve, thank you very much Joch, moving next to Yolo Jones from Prindhadar Yolo I'm Da Doctor Goodall. I'll be asking my questions in both English and Welsh. Hid yma mwy chwydraeth San Steffan wedi talw'r cyntaf i'r ddebyg gyda chi o wneith i'r wyr brachlen ac wedi sicrhau'n 30, 50 milion ddaws a dros wrth nesaf y dweud yna'n ddweud yn dda i brifrechlyn gyda chi'n nhw'n fwy'r ffeithio'n archaill. So byddai ffynu wneud byddai swyddfa chi wedi'n rhaid i'r lŵr drwyth cymryd i'r llun o'r rithu brachlen panodol ar gyfer grwpiau panodol a wedi'u gyfer gweld i'r llun o'r profiad o'r ffeithio'r dros gweithio am yr enhyng diddwyr i highes cymaintio'r Fyniadol i'n dweud a chympnos i ddechrau i'r ffeithio a picirio'r cymryd a gwaddiwch gymae'r dweud gan rhan fylwyr â'i gweithio'r ddechrau a'u ddweud yn ei wneud yn dweud i'r cynllun ac amser yn iawn i gynrychiol ac yn ei ddechrau i gynrychiol ac yn eu dweud i'r wneud A byddai'r Ysgrifennu Yng ngysyllteb llyfr nhw y byddai'r ffordd yma sy'n blaen yn ddiweddolol. System Hymorth, yn rhywbeth a'r Ysgrifennu'n Siadol yn ffordd farddol, ac mae'r Ysgrifennu Ysgrifennu yma yn ystod o'r llyfrnod. So ymrapod, dystiad yn credu angharthu ar y vaxen. Mae hyn yn ymddangosiodiol iawn oherwydd iawn o'r gennym. ysgrifennu Ysgrifennu kinadol yn yr Ysgrifennu ymெryd o'r rai hwnnw, a that means that for our population on any of these vaccines that we will always have our appropriate share. There have been some advantages of being able to work through some of the underlying criteria. At least the nature of the patients who will be subject to the vaccination. There are UK wide committee arrangements that give that kind of support and advice to us in Wales as well as the other UK countries. We have very clear konwch mewn prifsgrif aer i gael yma yn y blaenau cyflodau. Mae'n rheisio i gael chefnodau sy'n eu Helffbords yw'r llyffaeth yma, ac yn mynd i weld tynod i gael gennymu'r rhai usiadau a'u gael hunain. Yna ni'n gwneud i'r blaenau o'r bledigol Cymru a'r prydau ei wneud yn erbyn i'n mynd i ddweud, on i'n cael eu gofynu am wneud gweld yr maith, ond yn y dysgu'i dyfu, rydyn ni'n gofynu yma fel ffadwer o'r hynny, Mae dwylo'r cychwyn i'w gweithio gweithio'r vaccine sy'n ei ffordd o gyflogio'r sidef۔ Mae'r cyflogio'n braeddon i'r sefydledig o bobl y ddwyll chi arwag y bach sydd oeddio'r vaccine sy'n yn wirgylehnewch. Ynylwyddu chi'n gwybod felly i'r hwn yn gyd態d yw ei ffordd o'r iawn, bydd y cyfrifysgol y gallwn iawn i'r cyhoeddfa'r gwaith, y gallwn i'r cyfrifysgol i'r cyfrifysgol i'r cyfrifysgol gwybod i'r gael gyfer y casgau ddiogelio Covid-19 yn y rhagor, i weithio i ffroedau cyfrifysgol y cwmartd 50, y gallwn cyhoedd yn ei gweithio'r cyfrifysgol i'r cyfrifysgol, ac yn bod yn y gallu hefyd i'r gweithio'r cyfrifysgol. Ond yn fawr, nhw'n hwnnw fel hynny, yn edrych yn gweithio'r problemau yw'r cyntaf ar maes wgledig? Fe wnes i'n sefydlu sy'n tu oedd mynd i adroddedigio. Felly, digwydd, yn byw'r bobl y mor fflingid gweithio, mae ei wneud yw'r cyfrif Coordin ond am gywledigio cael ei bod yn ddigonw gwlad y cyfrifredig sy'n trwy lawer sydd wedi'u gweithio mewn cyfrifredigion ei fabrydau cymreith. Mae wedi cyfrifredigio'r cyfrifredigias yw'r cyfrifredigias hefyd heb mwyn i mi wneud awyr. Wedyn gydigwyd invitedbyn nhw'n ddiwrnod mewn diwrnod i'r am y gwrs i ddigon ynwyd, ei bobl i'r cyfriddio'r gwrs gyda llwyts yng Nghymru, ond mae'n mynd i'w ddaeth yr oeddiweddol yn adroddau'r cyfriddio. Yn oeddiwch i gyd o'r cyfriddio, mae'r rhaid o'ch gwrs yn ochon jei'r cysylltu allan sy'n gweithio'r cwestiadau oherwydd mae'n effeithio'r cysylltu arall i'r agglwysigau ei gael amgylcheddau ar y Pwg Fy sicrwp Rydym. Great. As to my second question, yn siarad y golwg yn dwyedd ar nath Helene Hucklott, sy'n comisiwn idd pobl hwn, rhan i frydder o'n hi am effaith o'r gyfwng ar pobl hwn, mae dydyn ni sylw'r problemau yn gysigdiadau gyda DNA-CPA. Dwi'n dod i bod pobl hwn wedi tymlau pwysig o'r tyno i DNA-CPA a dachryr o'r gyfwng, a bod hynny wedi gwneud dyn nhw'n deimlo bod wedi bwydden nhw'n chai gwerthfawr. Ydych chi'n ymwybod o'r wrthroblemau ac anewch chi gymryd gyflyma i galunogi pobl hi yn cymry. Speaking to Golwg recently, Helene Hucklott, the older people's commissioner, shared her concerns about the effect of the crisis on older people. She specifically mentioned issues surrounding DNA-CPA instructions to not attempt cardiopulmonary resuscitation. She said that early on in the crisis older people felt pressured to agree to the DNA-CPA, but this made them feel that their lives were less valuable. Are you aware of such issues and would you take this chance to assure older people that they are not expendable in this crisis? Well, I would hope, Yolo, that the fact that we've had to focus so much on older people because they are the most affected from an age perspective by this virus, it actually targets age, unfortunately, and it's why we absolutely need to make sure that support is wrapped around here. Clearly, there are clinical guidelines in place for our normal NHS services in terms of choices as well, but particularly through the pandemic we wanted to make sure that any arrangements are very clear. There were a couple of occasions early on where there was some unfortunate communication that happened at a more local level and I was able to respond to that even in earlier press conferences this year because they did not represent national policy for us in Wales and I would absolutely give assurances of whilst there is a normal aspect to what happens in the normal NHS that we have got very clear guidelines in place about what is appropriate for support. Really important that we recognise the need to support older people in their day-to-day lives at home, that we need to support older people who are in care homes and also of course to recognise that we have older people who are receiving care within our hospitals as well. What I'm constantly trying to do with the NHS in Wales is to find the balance to make sure that people don't inappropriately stay too long in a hospital environment where we are likely to see higher levels of prevalence of the virus inevitably because they are emitting emergency patients and what I want to see is that we are able to support older people to be in an appropriate setting as quickly as possible but with the confidence that where needed they will have the negative test results, for example, that are required to make sure that care can be delivered. I still see it as an overall system, it's about the care system working alongside the NHS but I think we also need to recognise the level of support that is needed for older people at home as well. Joch yn fawr iawn, Yolo, moving next to Gabriella Page from Atrium News. Good afternoon, Gabriella. Good afternoon. Thank you, Dr Goodall. We know it's been announced that students studying in Wales could be required to undergo a test before travelling home for Christmas with some universities booking these tests already but others still haven't heard anything yet. How will this testing of students work and how many students are you expecting to test? Thank you, Gabriella. I know the Education Minister was able herself to describe some of the arrangements that have been agreed across the UK to make sure that students can appropriately return to their home settings and I think the good news over these recent weeks is actually some of the changes of the technology that is available for testing has allowed us to think about those things in a very different way from where we were back in March and April. So there are arrangements, of course, that have been described over the border in England but equally there are mechanisms that have been put in place in Wales for the way in which we will have that access. So we have got examples within our university settings, for example in Cardiff where testing arrangements using some of the specialist expertise within Cardiff University itself has been possible and that has provided a level of infrastructure that can be put in place but our hope is that through a combination of some of the community testing approaches as well as the emergence of these new technologies that we may be able to deploy some of these much more quickly and usefully in Wales consistent with the experience elsewhere. I think you're probably aware that some of these are being piloted at the moment across the UK and that's to make sure that all of the university sector can learn from that together but we absolutely want the experience for our students in Wales both those returning to Wales and those leaving to return to their homes elsewhere should be as consistent as possible across the UK and I know that was the intention of the education minister. Thank you. So my second question as well was part of the plan outlined for the students also that they're being asked to minimise social contacts before the end of term but what to be advised for the students from outside of Wales or the university area who have chosen not to move this term and are still commuting how will testing work for these students and will there be a separate plan and guidance for them? I think a lot of what we're trying to work through is wherever we have guidance available what we hope can happen also is that people can use their own understanding and common sense to be able to apply the rules as applied to them. I mean you're absolutely right to recognise that not every student is living on a campus arrangement or away from home and clearly they would need to reflect arrangements that more in line with their experiences. I think the most important message for students at this stage particularly as we get closer to the dates where people want to return to their home environments is to recognise that they will need to reduce their social contacts with others because what we don't want to happen is that students will go back to their home areas and possibly be transmitting the virus to their loved ones and their family so the intention isn't to prevent students from enjoying university life in an unusual way it is absolutely to make sure that what we're doing is protecting those that they love the most and I'd really hope that what we can do is by being practical about some of the arrangements whether that is formal quarantering or just reducing the amount of contacts that people have in that sort of seven to fourteen days beforehand all of these are measures that we know will make a difference to the transmission of the virus. Okay, thank you very much Gabriella. That's the end of today's session. Thank you very much for all of the questions and thank you very much for listening. Diolch yn rhan fydd.