 Prinandar. Good afternoon everybody. I'm Dr Frank Allerton. I'm the Chief Medical Officer for Wales. What I wanted to do today was to give you, as I have in previous times, an overview of the current situation and the developing situation around coronavirus here in Wales, particularly focusing on those areas where we have local restrictions in place. As we start to plan, for what may well be quite a difficult winter, I also want to go back over what we're asking people to do, the simple steps that will help to keep us all safe and healthy through the winter. Finally, I'm going to just talk very briefly about the prospects for vaccination, which of course we all need to keep in mind. In the space of the last few weeks, the last four or five weeks, we've really moved very significantly in Wales, through a position where we had very low levels of coronavirus to a resurgence of viral transmission. If we think back to July, August, we were seeing in the range of 20, 30 cases, new cases of coronavirus every day. Well yesterday, we saw 752. So there's been a step change. Of course we're doing more testing, but there is certainly more viral transmission going on. That matters, it matters because as we know if the virus affects older people, they can run into problems with their health, they may well need hospitalisation and they may well need extra support through intensive care. We are starting to see small increases in all of those things in people being admitted to hospital and people being admitted to intensive care unit, that we wanted to avoid here in Wales. That's really why over the last few weeks we've been introducing local restrictions or local health protection areas in areas of Wales where we see viral transmission particularly increasing. That's happening in 15 local authority areas and in Llanelli. Those restrictions are in place really for two reasons. One is obviously to protect people's health as I've just described, but also to stop the virus from spreading, either spreading within those communities or spreading from areas of higher transmission, higher viral load to areas where the virus is less active. We want to prevent that if we can. Those restrictions have been in place for about four weeks now and there is some evidence to show that they're working and what I'd like to do is to show briefly a slide which shows some of this effect. If we look at this, this shows the local authority areas that have been in local lockdown arrangements. If we look at Caerphilly, for example, that's the grey slide, that was the first area to go into a local health protection area arrangement on September the 8th. You can see how after the arrangements were put in place some of these areas have started to see an improvement in the number a reduction in the number of new cases and that's a good thing to see. The top line Blenau Gwent is the blue line and that showed the steepest and the highest rising cases as did Merthyr Tiddville, that's the dark green line and in both those areas now we're starting to see some improvements. We're still high rates of viral transmission and high rates of new cases but some improvement which is a good thing. Even in Rhondda Cynon Tafth, the red line we're seeing some improvements although of course we've had issues there with an outbreak of coronavirus at the Royal Glamorgan Hospital which is still being managed and being brought under control. Just to say a word about Newport which is the orange line there we have seen a decline in Newport but that's been slowed because we know there's been an increase in cases in Newport related to house parties so those are the sorts of things which can delay the improvement of the patterns that we're seeing. So the good news I suppose is that we do have some evidence that the local restrictions the local health protection areas are having some benefit and that they're starting to improve the picture. And as the First Minister said just last Friday we're working on how we can now remove those areas remove the restrictions in those areas so that people can pick up their lives as usual and we do have a hard and fast metric but we normally look at the number of cases per 100,000 population and when that comes below 50 we start to think about whether we can release some of those some of those measures. What we don't want to do of course is to simply relax the measures in an area and then have to maybe a week or two weeks afterwards to put those back. It may be that we do see a rolling programme of putting restrictions in place and removing them. We don't want to do that but that may be something that we have to think about as we go through the autumn and the winter. So although all of us would like to see the back of coronavirus it's going to be with us for some time and we're going to have to learn to live with it to some degree so having a flexible policy which helps us to move in and out of restrictions is probably going to be quite important. The situation is still very fluid in Wales as it is across the UK and the rest of Europe and the world in fact and we can't rule out further restrictions but at the moment we're looking to the local health protection area arrangements to try to guide us through the current situation. I know that people don't want to hear that further restrictions might be necessary but especially as we've been through a very difficult time we got into summer and things were improving in the summer with very low levels of transmission it's not what people want to hear but I think we need to prepare ourselves for quite a difficult winter and it's really while we wait for and hope for a vaccine to become available that we have to really look after ourselves and keep viral transmission low and every time I speak of course I remind people that there are some very simple ways that we can do that and I'm sure everybody knows those we need to maintain social distancing that's the most important thing maintaining respiratory hygiene regularly washing our hands and face coverings when we're not able to socially distance properly in indoor spaces working from home wherever we can thinking all of us about who and where we meet with people outdoors is safer than indoors but smaller numbers is safer than larger numbers and the final thing of course is that anybody who developed symptoms of coronavirus be it a cough a fever or lots of sense of smell or taste to test very quickly and to self isolate while they wait for the results of that test if we're all diligent about these measures I believe that we can improve our chances of removing those lockdown arrangements those local lockdown arrangements those restrictions and buying ourselves some head room so that we can get through the winter I did say I would very briefly talk about vaccination of course these measures are important while we expect and hope that the vaccine will be coming there's a significant number of candidate vaccines available and there's a lot of work going on both at UK level in terms of procurement forward procurement of potential vaccines and also in terms of planning through all of our local health boards about how we would deliver a vaccine programme there are a number of promising candidates in the early part of next year we may well start to see vaccinations becoming available it certainly won't be available for everybody immediately and so we will need to have some prioritisation to think about how we protect the most vulnerable how we protect our health and care system so we're undertaking a lot of planning through the health boards at the moment to think about how we might deliver that programme so thank you I'll pause there and I will be happy to take some questions I'm sure there will be some so I think Adrian Adrian Masters from ITV is first on the list Adrian Thank you Dr Arthurton can I ask you to say a little bit more about the different age groups are there signs that the virus is moving from younger people into the older population if so how will that affect your decision on restrictions will it lead to more nationwide measures or perhaps more targeted measures Yeah I mean what we saw with the resurgence of the virus is it was largely in younger populations then we saw back in March April so it was the 15 to 24 and into the 30 year olds but we are seeing some movement into older groups so to give one example Adrian in Cardiff in the first week of August about 11% of the positive cases were among the over 60s whereas in the first week of September that was sorry the last week of September that was about 16% so it is moving into the older population and of course that worries us because we know that with age comes increased risk of serious illness and the need for hospitalisation and intensive care and of course the mortality rate goes up so we do worry about that and we watch that very carefully Adrian Thank you and on restrictions whether they are nationwide restrictions or other will there be what some people are calling a half term circuit break in Wales with extra restrictions if so what sort of restrictions will there be closing pubs and restaurants earlier or together As I said we are not ruling out the need for further restrictions at the moment we are not planning on those arrangements but we are keeping that under very close review our hope at the moment is that our local health protection arrangements those local restrictions will continue to lead to an improving situation but certainly we don't rule that out and it may be that we need to think about further restrictions but there are no plans for that at the moment Adrian Thank you and we've got Catherine Haft-Jones from BBC Wales Good afternoon Dr Atherton he's spoken of possible rolling local lockdowns over the autumn and winter but there are calls from opposition parties for more targeted hyperlocal lockdowns there's currently one in place in Llanelli does a hyperlocal approach work and if so why aren't we seeing more of them? Yeah well our arrangements in Wales currently are that we work very much with the local authorities and whenever we see an increase in the number of cases an incident management team is formed that works across all partners including local authorities and they then provide updates to Welsh Government and requests any additional support so that's the mechanism we have in place we don't rule out more local arrangements but local authority feels like the right democratic boundary to use for decision making for making decisions at the moment Llanelli is the only place where we've got a non-local authority place but we certainly don't rule that out in future the issue in Llanelli was that it was very much contained within the town itself as opposed to having broader community transmission so we have to take the circumstances of transmission not just the numbers but actually the detailed information that we get from people on the ground into decision making as to what the right area should be Thank you and the most recent TAC report published yesterday warns that unless our rate is brought back down below 1 it is possible that infection incidents and hospital admissions may exceed scenario planning levels what does exceeding scenario planning levels mean? Doesn't mean running out of hospital beds running out of PPE can you elaborate on that please? Well the R number we think is around 1.4 at the moment so that just means that the virus is still in growth and that does mean that we can expect to see more cases, we can expect to see more increased number of hospital admissions The scenarios we have a number of scenarios that have been developed to really just to guide the planning it's not a prediction in any sense but it gives us a feeling for the number of hospital admissions which are likely and so what the TAC report is saying is that with things as they currently stand there's a possibility that we might go beyond those figures it doesn't mean that NHS will run out of capacity or PPE or anything it just means that we need to change some of the planning assumptions and health boards need to take account of that really but I have to stress that all of those reasonable worst case scenarios as they're described are subject to a lot of variations so any changes can lead to quite big swings in what the model shows it's a helpful tool for planning but it's only that really thank you and we have Andrew Forgre from the Daily Post Good afternoon Dr Aserton just picking up the point you made about local hyperlocal lockdowns there's been a lot of speculation that Banga is set to go into lockdown is that the case or will a rise in cases in the city lead to a county-wide lockdown and Banga is under active watch at the moment generally as the local authority area is being considered and there's an incident management team that's been meeting on a daily basis up there and they're providing reports and suggestions into Welsh Government so we're looking at that quite carefully in Banga itself many of the much of the increased number of cases in Banga has related to specifically to the student population where we have an increase in number of cases which are related to specific outbreaks it's kind of easier to manage that because we have outbreak control teams that can go in and work with the communities affected and can help to bring that under control it's where we have broader community transmission that the local lockdown arrangements are more effective and more likely to be put in place so we work with the local authorities and we wait to see what their request for support from Welsh Government might be whether that would be on a Banga basis or on a broader local authority basis thank you very much you may be aware that the leader of Conway council yesterday a corporal local lockdown and accounting to be lifted and he said it wasn't based on evidence and seemed as completely disproportionate to the reality of the situation there he came to local tourism it's being destroyed and people's well-being is suffering is the Conway lockdown an overreaction? I think in all of the areas where local restrictions have been put in place there's been discussion with the local authorities what we don't do in Wales is just to impose from Welsh Government restrictions on local authority areas I don't think that that the request was to completely do away with all restrictions I think it was specifically around the travel out of the local authority area we don't have a position where every local lockdown area every local restriction area needs to be identical and so that is a discussion that Welsh Government will have with the local authority about whether that is the most appropriate thing to have in place but it brings to start relief the fact that we are dealing with difficult decisions and difficult trade-offs here and those restrictions of course are in place to protect public health we reckon absolutely that there are economic and social consequences for all of those decisions and it's really for the system that we've created with the incident management teams or partners coming together to try to weigh up those different factors and come to the best decision in the interest of the people of those communities so we'll continue to work with Conwy and other local authorities on those areas Dan Bevan from LBC Good afternoon Dr Afton Thank you Head of World Mental Health Day this Saturday Do you feel enough is being done to help mental health and wellbeing of young people and children throughout this crisis and what can the Welsh Government do going forward as we're being told to live with this virus? One of the really important consequences of lockdown and then the stresses we've been through and the issue around examinations for children and university entrance all of this we absolutely acknowledge has led to increased mental health stress for the population in general for older people people in the shielding group but also you're right to say Dan for younger people as well and so we have the government has invested additional resources in terms of providing support into those areas we have to work with the sectors that support children and young people safeguarding has been a very important issue that has needed additional attention through the lockdown so there has been a significant recognition of the problem significant working with the various sectors to try to address it but I'm sure what's behind your question is right that there's more we need to do to think about that so thanks for that Dan Thank you and with regards to what the First Minister mentioned about the potential vaccine not being treated as a silver bullet from your perspective what do you think about the optimism that's around a vaccine and how realistic do we need to be with regards to time frames and the effectiveness of a vaccine once one is available well there's trials going on around the world of course on coronavirus vaccines and in Wales we are participating in those trials as well so I am more optimistic about the prospect of effective vaccines becoming available than I probably was six months ago the time frame is really difficult to judge with these we've seen with the Oxford trial being paused and then restarted that it's not a smooth journey by any means there are different vaccines in development which will have different methods of delivery different timing so it's going to be very complex to deliver a vaccination programme against coronavirus when vaccines do become available although the UK has made some advance purchase arrangements with a number of potential suppliers the demand of course globally is going to be enormous and so getting adequate stocks to deliver it will be very challenging and of course the delivery mechanism through existing health services and through other routes that we've talked about that's what health boards are currently planning for so I am optimistic Dan that vaccines will become available I think that's one of the ways out of the conundrum we find ourselves in around coronavirus and we need to continue to follow up keep a very close watch on that and get ready to use excuse me to use the vaccines when they do become available thanks Dan thank you very much indeed Dr Atherton academics from universities across the UK have signed a declaration which calls for a herd immunity approach to tackling the pandemic while protecting the most vulnerable in society the kindness approach will allow people who are less vulnerable to the effect of the virus to return to normal life what's your response to this approach well we keep all suggestions under consideration and we do need to continually think about our approach at the moment we have an approach of trying to keep the virus transmission as low as possible while we wait the vaccine that I was just talking about the idea of allowing the virus to transmit through the population is a difficult one because it would inevitably lead to more hospital admissions ITU admissions ultimately to deaths so it would come at a very significant cost and the other difficulty with that I don't really have but I mean the other difficulty with that is of course that we just don't know enough yet about the immunity which follows on from somebody having had a case of coronavirus so we do know that there are cases around the world where people have been infected more than once though small numbers but we just don't know how long immunity will last whether it will last for a short time so you know it's something we need to keep under review but at the moment that's not the strategy here in Wales Thank you very much indeed for that response and secondly do you think that US President Donald Trump's recent comments on his experience of coronavirus and telling people not to be afraid is giving people in Wales the right message and do you believe it will make it harder to get across the important guidance about social distancing wearing masks and following the rules Well I would hope that most people in Wales don't take President Trump as their guide to how to deal with coronavirus I think people are perhaps a little more thoughtful than that and I would certainly hope that most of us now in Wales have lived through this for the last nine months have seen friends and family who have run these quite serious cases with coronavirus and many many people in Wales have lost loved ones to it so I think the people of Wales understand that this is a serious public health threat that we face it's not to be fearful of it it's to think about how we manage ourselves how we can keep ourselves and our loved ones safe and that's the message really that I'm trying to emphasise re-emphasise today and if we do all do that together I don't mean all of us all do that together then we have a good prospect of keeping the viral transmission to a low enough level until the vaccine becomes available and we can eventually see the end of coronavirus as a public health threat I hope that helps Okay thank you very much everybody and thank you for those questions really helpful