 Brunhau'n dda, wrth gwrs. I'm Andrew Goodall, chief executive of NHS Wales. And I'm Dr Frank Atherton, I'm the chief medical officer for Wales. And today we wanted to update you on the latest public health situation in Wales and also to provide more information about phase two of our vaccination programme. But first Andrew's going to start by updating us on how coronavirus is affecting the NHS here in Wales. OK, thank you Frank, erdiwch. Er, this continues to be a challenging time for our health service as we balance the ongoing pandemic, winter pressures and all the other demands on our NHS. As you know, the NHS has been under intense and sustained pressure over the last few months. It's been the most challenging time that I have known and that our incredible NHS staff will ever have experienced. However, as you can see from this slide, the picture is slowly improving. Our community prevalence rate is now down to around 75 cases per 100,000 people and gradually reducing. Lower levels of coronavirus in our communities is starting to translate into lower demand and fewer people being admitted to our hospitals. The main reason for the recent improvement is the action the people of Wales have taken to stay at home. You have made a big difference in reducing the virus in our communities over recent weeks. We have seen a drop in the proportion of GP consultations identified as coronavirus incidents reported by Public Health Wales. This represents around a 70% reduction since January. The Welsh ambulance service has confirmed that the percentage of ambulance demand related to COVID has reduced to around 9% from a high of 20%. Whilst improving, this still means that one in ten ambulance calls are to help someone with coronavirus. The number of people admitted daily to hospital with coronavirus symptoms has been reducing over the last month. There are now on average around 70 coronavirus hospital admissions a day down from a peak of around 130 a day in January. There are almost 1,650 COVID-related patients in Welsh hospitals. This is 7% lower than the same point last week and around 1,200 less than the peak in January. This is the lowest number since the 19th of November. However, despite these improvements, this means that we still have a higher number of patients in hospital beds than at the peak of the first wave we experienced in April last year. I remain concerned about this sustained pressure on our critical care facilities and hard-working staff. Today, there are 60 COVID-related patients in critical care beds. It's a quarter lower than last week and two-thirds lower than at its peak. However, despite falling numbers, our staff are supporting the equivalent of a 110% occupancy in critical care. It is really positive to see recent improvements in the trends that show our collective response against coronavirus is working and we hope and expect that this good progress will continue. However, I need to emphasise that our overall numbers in hospitals remain high. This is serious and affects the ability of the NHS to undertake other activities. It would not take much to see these numbers go up very quickly if the virus once again spreads through our communities. The NHS remains very concerned that the good progress we are now seeing could be reversed if we do not retain the right balance between NHS pressures and the gradual release of restrictions. Although the NHS is under immense pressure, people still receive, of course, life-saving treatment each and every day. It is absolutely critical that people still come forward for emergency or urgent care and if you require non-urgent medical attention, please contact your GP or call NHS 111. I would like to acknowledge the incredible commitment of the NHS and care workforce in continuing to protect the people of Wales throughout this crisis. I also want to pass on my personal thanks to NHS staff supported by partners, volunteers and military colleagues who are working tirelessly to deliver vaccinations at pace. Thank you very much, Diolch yn fawr. I will now pass over to Frank. Yes, thanks very much, Andrew. I would like to add my sincere thanks to all of those people, many, many people who have been involved in our world-leading vaccination programmes thanks to them doing a fantastic job. I just published some figures this morning which show that over 902,000 people in Wales have had their first dose of vaccine and that is fantastic news. As you can see from this slide, we are now giving the second dose of vaccines and over 80,000 people are also reported to have had their second dose. That is about 2.7% of the adult population in Wales and that is the highest level across the UK. So all good news. By tomorrow, we expect that our remarkable vaccination teams in all of our health boards and areas will have administered over 1 million vaccines, a really phenomenal performance and a key milestone. So that is a great success story which brings us hope and it brings us a potential way out of the coronavirus crisis that we have faced over the last year and more. So we are working very hard as our vaccination strategy suggested to reach all of those priority groups, groups 1-9, by mid-April and to reach all of eligible adults here in Wales by the end of July. That is always, of course, subject to vaccine supply issues. But it is time to look beyond July now and to think about the future and today the JCVI, that is the independent group, the Joint Committee on Vaccination and Immunisation has issued further advice on the prioritisation of people in the phase 2, the next phase of the COVID-19 vaccine programme. And JCVI has said that the most important thing is to continue the vaccine rollout at pace to really get as much of the population vaccinated as quickly as we possibly can and it is therefore recommending the continuation of an age-based approach to prioritisation because this is the single factor which has the strongest link to deaths and hospitalisations. So if we put it simply, people in their 50s benefit more than those in their 40s who benefit more than those in their 30s who benefit more than those in their 20s. So alongside the other three chief medical officers in the UK, we have all agreed that we support this JCVI guidance and the four UK governments have agreed to implement it and that's great news because it means that the UK's vaccination programme remains aligned as we move forward with a shared goal of getting the population vaccinated. And I want to stress that this is seen as the simplest, the quickest and the fairest approach to the next phase of the vaccination. It means we can stay on track to meet our ambitious targets. As I'm sure everybody will have seen, there's been lots of calls from different groups and specific occupations to be vaccinated, to be prioritised. JCVI did look at that, it looked very carefully at that and it found that there wasn't sufficient evidence to support any specific occupational group. It also advised that adding complexity by going down an occupational route would slow down the pace of vaccination and was very clear that we need to vaccinate as quickly as we can. So today we've published an update to our national vaccination strategy that confirms our intention to follow the advice that we've been given by JCVI and also to continue with the fantastic pace and progress of the programme. We know that vaccination is safe, effective and it's essential as part of our route out of lockdown and to a brighter future. So we encourage everybody who is eligible to take up the offer when it becomes their turn to receive the vaccine. So to finish, we are at a critical juncture now. We need to ensure that we maintain the progress that we've made here in Wales. We can't afford to lose that and we do that by everybody, whether you're vaccinated or not, following the guidance and the rules that have been in place that we've all become so familiar with. It's really important still to maintain social distance from each other, I'm afraid. It's really important that we still practice good and hygiene, that we work from home wherever possible and that we wear a face mask where it's required in public places. So all of these actions will continue to help to protect our population, our people, our friends, our neighbours, our loved ones and will protect the NHS. This is still a very challenging time but there is good news ahead, we hope. So thank you very much and we'll now take questions from the journalists and as usual, everything will be broadcast on Welsh Government social media channels. Thank you. So we'll start with questions and the first question this afternoon is from BBC Wales. Good afternoon here. You've come under huge pressure from different professions, teachers and police most notably for them to be prioritised during Phase 2. Was the Welsh Government, were you considering that at any point or have you just decided to delegate that decision to JCVI and when it comes to reaching those groups who you know to be more at risk because of their ethnicity or because they're poorer, to ensure that they have a bigger uptake in terms of the people who can move forward for a vaccine when they're offered it? Yes, thanks very much. Certainly we asked JCVI to look carefully at the occupational issue. That was really important that they did that. And when they did that they came to two conclusions really. First of all, in fact taking an age-based process covers most of those professions. So for example, 45% of front line police staff aged over 40, 60% of people in education and childcare are aged over 40. So that was the easiest way and the safest way to get to those populations really. So the other point was that if the JCVI had really looked at it carefully and came to the conclusion that if we were to make a decision to go round down an occupational line it would be a much more complex process. It would slow down the whole process. So in the interest of everybody's health of speed, efficiency, safety and effectiveness it was deemed that it's the right thing to go down an age criteria and we fully endorse that here in Wales. Can I ask you about the supply issues because the updated vaccination strategy today talks about how that is still in play and it will be due in the course of the next phase as well. Are you confident that the supplies can keep up with this strategy given that you don't seem to know perhaps beyond mid-march the amount of volumes you're going to get into Wales? How can you be so confident about reaching those targets to vaccinate everyone by the end of July? It's a really important question to you and we've always been clear that our progress is absolutely dependent on supply chain, of course it is and there's no guarantees in any of that. Factories can go down there can be problems in the supply chain. We're not expecting anything, it's not entirely within our hands here in Wales we are procurement and supply is through the UK Government we receive our share here in Wales but we've had nothing in the pipeline that suggests that we are going to experience a shortfall and in fact some of the supplies that we expected later in the year are coming through earlier but obviously this is a complex area and it's one that we have to keep constantly under review which we do with UK colleagues. I think to give some reassurance to you as you would imagine given the complexity of this across the UK we are in regular contact and that may sometimes mean even on an hourly basis on days when we're just judging those areas but as Frank says we do have confidence and will be given the assurances about what our expectations should be for Wales over the forthcoming weeks Thank you very much Diolch yn fawr iawn moving next to James Crichton-Smith from ITV Wales. Good afternoon James. What impacts are you seeing if any in those groups that have had the most vaccinations so are you seeing the impact of the vaccine on hospitalisations on serious illness in various demographics and what can you tell us about that? I'll kick off. Thanks James. We're a small nation in Wales and we will start to see we believe impact in our own figures but we have to look at the UK as a whole and so we've had good news this week out of Scotland for example Public Health Scotland produced figures showing that four weeks after the first dose of vaccine there was a reduction in hospital admissions of 85% with Pfizer vaccine and 94% with AstraZeneca so that does show that the vaccine is doing what we expected which is to reduce significant serious disease and harm and people are ending up in hospital so that's a good news story and that evidence continues of course to build. Just looking at the general data James obviously we're tracking this daily we report it through mechanisms like this press conference at this stage at the moment the trend of reduction is probably quite similar to recent weeks the good news is that we continue to see drops there's about a 7% difference in the number of patients in hospital what has been really pleasing over the last couple of weeks is to see critical care patients and critical care beds reduce more significantly around a quarter of a week at this stage but I think probably as Frank says the data that will really tell us about the impact of the vaccinations will probably come through in the next two to four weeks Thank you very much The vaccination strategy being aligned across the four UK nations clearly you believe that is a sensible approach now lifting of lockdown isn't necessarily as aligned how worried are you that there isn't that alignment and what impact might there be on the virus? Well to kick off I think better alignment is in everybody's interest in as much as it makes messaging simpler but we're all following the same approach really some of the timings are slightly different but everybody is all the four nations are faced with the question of how do we ease the lockdown we cannot remain in lockdown permanently so the question is how we can do it how we can do it safely and there may be some marginal differences between the approaches taken in different nations but the general note that all chief medical officers have sounded is one of caution that as we release we should release cautiously measure the impact of that make sure that things are remaining on track before we move to further measures so we align as much as we can but the end goal is the same James we obviously have the routine in place that every three weeks that cycle allows us to review the data and the impact and obviously that process is led by the first minister with the cabinet in terms of making the government decisions around these areas but as I said in my introduction certainly my conversation very formally with NHS on Tuesday was still a worry that we just need to ensure that there is an ongoing balance between a recognition of the NHS pressures which are still there our numbers in hospital beds are still higher than the peak in the first wave back in April and just to make sure that as of course gradual restrictions are required we continue to keep that under review what we don't want to happen is to see an emergence which would lead to a third wave in Wales of significance and some of the modelling work that obviously we have to review is to demonstrate that if we don't take a gradual approach there is absolutely the chance in which we could see the new variant in particular take an additional perspective in Wales and we would have some difficulties in managing some of those demands as well so we will keep it under a very regular review from a system perspective but of course government will keep it under review on the 21 day cycle process as well okay thank you very much James Sir Diolch yn fawr moving to Mark Smith next from Wales online good afternoon Mark pronounce our welcome to you both Swansea Bay University Health Board confirmed yesterday that people can now access a COVID test if they display a wider range of symptoms including excessive tiredness a persistent headache and a runny nose or blot nose do you believe their decision to widen the testing criteria beyond the three classic symptoms should be consistent across Wales and in addition would you be able to explain whether people with the Kent variant have typically displayed any different symptoms to the original strain yeah I'll take that one thanks very much Mark it's true that particularly with the new variant and the Kent variant as you mentioned some of the symptomatology the symptom clusters do appear to be a bit different to the the virus that we originally saw here in Wales and in the UK so there are other symptoms that people have I mean the classic three symptoms remain the case definition that's continually reviewed by chief medical officers so we keep that under review but the widening of the testing criteria does make sense in the current circumstance and that's something that we're thinking about not just in Swansea Bay but in other areas as well as the rates go down as our community rates go down it gives us more ability to castanet wider and to find residual cases so widening the testing criteria not changing the case definition but widening the testing criteria can make sense and can be helpful in bringing rates down even lower that's great thank you very much and secondly according to the latest figures from public health Wales around 7% of all positive cases reported in the last week were either probably or definitely contracted in hospital that's the highest percentage we've seen since August with the confirmed outbreak at a Sputty Gwynedd in the past few days do you believe Welsh hospitals are still struggling to separate Covid and non Covid patients and what reassurance can you give patients that hospital environments are indeed safe Mark I think the reality for our hospitals but also all of our healthcare facilities is that even with a lower community prevalence they have to still operate as if any patient coming into the system has got coronavirus so we still need to have all of the same protections in place streaming physical changes to environments of course the use of PPE and that's because we want to keep both patients and staff safe in respect of the percentage that you referred on the latest figures it's 7% of all the positive cases of course one of the factors influencing that percentage is the fact that the overall community levels have reduced so we have lower numbers of positive cases reported in our communities therefore hospital levels will have moved to be higher nevertheless I think North Wales' experience at the moment does show that whilst in overall terms outbreaks are reducing and the surveillance data is telling us that generally across Wales this virus can have traction very quickly and it is able to transmit and cause problems in a range of environments so we have to continue to be cautious about that we have, as we've set out in previous press conferences set a whole range of expectations for the system exchange good practice set standards as well and I do think that they have made a difference particularly as we've come through this second wave but really North Wales just demonstrates how quickly things can change so just need to keep an ongoing eye on these things so that the NHS is able to respond Thank you very much Mark Joachan Vow, moving next to David Evans from Nwydhion Pryranhawn Dar, David We heard this week that 90 staff at care homes in the county of Conwy tested positive in January How much of a reminder is that a figure like that that getting the vaccine doesn't give total immunity and are you worried that that message isn't hitting home? Well if I just start and Frank you may want to come in firstly for the care home targets and moving through those very quickly through January and February of course we met the target to get to the cohorts for which care home residents and care home workers were included by mid-Febru so even in January the efficacy, the effectiveness of any vaccines that have been administered may not have worked their way through In overall terms in care homes at the moment on the testing that we're doing the positivity rate is down to around 1% it's actually reduced by about a half since last week so they're just on the very latest available figures for February and I think that is demonstrating that actually there is a lower prevalence that we're now starting to see in care homes but inevitably it takes time for all of those individuals to be worked through but as we go into March Frank a much more visible impact of the vaccination programme in care homes The only thing to add to that is that it reminds us that vaccination is really important but all those other things that are in place testing and PPE and infection control arrangements are really really important still so your question is absolutely right we can't lose sight of those things Thanks Daphys Do you have any indication or figures as to how that 90 figure of 90 might compare with what you're hearing seeing in other parts of Wales? Well in terms of care homes generally we are seeing the numbers of care homes who are reporting having had active cases over the last 28 days and over the last 7 days reduce so through February I think we have seen a change from what was the most difficult and most challenging month in January at this stage but inevitably wherever there is any contact and as Frank has said we just need to make sure that the underlying and protection arrangements are in place at this stage but if you're asking about the general picture for Wales the general picture is it is at least improving through February and we are seeing a reduction in the cases that are reported to care in Spectra at Wales David Jochenvaryan thank you very much moving next to Dan Wilson in LBC Good afternoon Dan Good afternoon Mr Mark Drakeford said on Tuesday in Plenary that returning all children to schools on one day in Wales would not be safe that it could increase the R rate by up to 50% the following day during Prime Minister's questions Boris Johnson defended his decision to reopen all schools in England on the 8th of March by saying that his scientific advisers said it was safe who's right and who's wrong because I don't think many people would believe that the science could be that different on one side of the border to the other I don't think safety is an absolute issue it's not an absolute construct is it really it's safer it's not absolutely safe so I think there's an issue there that we need to unpick really but the policy here in Wales has been very clear that we want to get kids back to school back to face-to-face learning they've been too long in the distance learning and we need to change that so that's why we've taken a more gradual approach but we are being cautious because we know that when schools do restart that that can drive community infections so we want to get community infections as low as we possibly can here in Wales there's no absolute right answer to this but we are being slightly more cautious I would say in Wales because we we believe that we don't want to we absolutely don't want to create a third wave as Andrew has said really so that explains some of that difference it's a policy choice rather than a question based on science really and we've wanted to make sure that the evidence and the data and the information that obviously is allowing ministers to make decisions is made available you'll be aware that the technical advisory cell produces its reports on a weekly basis in overall terms that demonstrates some of the underlying modelling and they will continue to produce some of the individual reports that probably help to to demonstrate why some of these decisions are being made and it's why I shared earlier that certainly as we look at the modelling work and depending on the order of restrictions there is still the potential of seeing a growth in other cases of coronavirus and seeing very visible pressures re-emerge again so it is a bit of a mathematical equation to get the order of this right but as ministers of articulated schools remains an absolute priority thank you just a follow up to that sort of really again Mark Drayford said in his press conference last Friday that he hinted that perhaps stay at home restrictions could be eased from the next review in two weeks time given the latest figures showing that the pressure on the AHS and hospital admissions are going down but in two weeks time we could still be at a point where the figures are around about where we were during the peak of the first wave is it unlikely then do you think Dr Atherton that we will be in a position to ease those stay at home restrictions at least in the next two weeks I think it's just too early to tell really we're just at the start of this three week cycle and so the first minister has been very clear he wants to see how things pan out over the next two or three weeks before he makes that decision and I think that's the right thing to do my advice to him has been to open up and open up cautiously so it's entirely in line with the advice we've been giving Dan thank you very much moving next to Harry Evans from The Daily Post good afternoon Harry do you have any updates on the coronavirus outbreak in the specific winners so you will have seen the reports from Betsi Cadwaladr University Health Board of their need to adjust some of their local activities as I was describing earlier Harry I think it does show first of all that this virus can take hold very quickly obviously when we look at the position across Wales and we've described the overall position for Wales at 75 cases per 100,000 population we are aware that there are some individual local authority areas up in north Wales that are currently higher where there is high community prevalence inevitably it finds a way into healthcare settings and I just think it just demonstrates how quickly that can translate I do think that the health board has taken the appropriate steps from a safety and protection approach there is a need for them to adjust some of their activities to make sure that they are ensuring that the environment is as safe as possible and that they can contain these outbreaks they have also managed to demonstrate success in those areas in other areas across north Wales and I think one of the opportunities that they have is to be able to balance how they can switch some of the services across some of the other main hospital sites in north Wales and just as a reminder of course that was something that was actually happening earlier in this second wave when Rex and Myla had particular problems and issues and Betsi Gwydwaladau were able to use the hospital facilities in Aspati Gwynedd and Aspati Glan Clwyd as well so we are obviously receiving reports on that at this stage and we will continue to keep an eye on those outbreaks over the course of the next 7-10 days in particular Yes, hello and with the UK level being lower to level 4 the NHS has had to be no longer at risk of being overwhelmed what the fact if any will this happen hospital waiting times in Wales so our waiting times in Wales inevitably because we have had to step away from some of our routine activities have been deteriorating on a monthly basis we wanted to ensure however that there is a way of accessing services particularly for emergency and urgent care needs I think that the signal from the UK about that level for description does not mean that the NHS however is not under significant pressure it just means as I've been describing on our own figures that we are at least on an improving trajectory at the moment if you remember our general approach in Wales we have tried to focus of course on the immediate pressures that coronavirus brings but we are continuing to be concerned about the broader harms that are created so I know that the health and social services minister's intentions is to be able to give further detail about a plan and a framework for resetting and recovering the NHS and the care system of course of the next number of months and indeed years and we'll be hoping to do that at some point in March at this stage what I'm doing is actually working with the NHS to make sure that we do have plans ready and available and that we're able to take the opportunities as pressures are easing so that local organisations can start to increase their level of activity but a couple of final thoughts firstly I think we need to ensure that we retain many of the different approaches that have been put in place for our services in Wales there have been lots of changes that have been positive for both patient experience and also for staff but equally I think we have to be very realistic about the pressures I do worry sometimes when we're looking to return our activities that it feels as though we just need to press a switch and as I've said before even with very low levels of community prevalence for coronavirus and an improving position we still have to act as if coronavirus is still out and around one in ten of our ambulance calls one in five of our beds across Wales and we've tried with people with coronavirus so all of the normal safety precautions that slow activity down because we are taking a safe approach have an impact on those waiting times as well there was just to finish a small improvement in some of the longest waiting times at least on the latest reported figures in December but this is going to be quite a long term effort I think to return the list to where we think it would be acceptable Harry Diolch yn fawr iawn thank you very much moving next to Tom Magner from Carersworld Live good afternoon Tom good afternoon to both of you and thank you for your time can I say that obviously I'm expecting answers from an operational perspective I'm not expecting you or tempting you to tread in the political arena however you do appreciate the work you're doing that it's difficult but there is considerable frustration I'm duty bound to put these points to you and the first question if you calculate the rate of vaccination on the figures and use the census 2011 figures for the number of unpaid carers you could vaccinate them on Anglesey in a day and card it in three days if you know who the unpaid carers are in the published guidance from the Welsh Government and I imagine both of you had a contribution to make on this it says and I quote due to the large number of unpaid carers across Wales and the importance of vaccinating those at the highest risk we cannot vaccinate everyone who provides care for a friend or family member now this isn't at odds with the audience's expectation which they drew from the First Minister's reference to unpaid carers going into Band 6 you have the cohort list of numbers on 3 January so you already knew the numbers please could you both explain given that we understand your earlier reference the supply is precautionary what in detail is the operational problem that holds you back from vaccinating all unpaid carers ahead of rushing on to Phase 2 thank you very much Tom and as you rightly say we did put out some guidance on Wednesday this week actually so it's good to see that you've received that and you're pouring your way through that the issue of unpaid carers is obviously a complex one and we're very grateful to the carer organisations who've worked with us to try to find a way through this it is a large group a potentially very large group one of the issues that we've faced of course is it's around the definitions knowing who is and is not a carer at one level there are places around the world where people are saying I'm a carer because they do a little bit of shopping for an elderly relative it's not that level of carer that the JCVI is looking to actually it's people who provide substantial care to people who are frail or very frail and those groups who've required vaccination because they're clinically extremely vulnerable so what we've done in Wales here because we want to be as inclusive as we can but we don't want to overload the system what we've done in Wales as you probably know now is to set up a process where people can do a self-assessment to understand and to declare themselves as carers so that they can then be prioritised for vaccination there's never going to be a perfect solution and we're going to have to find a way through this but we have to use the JCVI as the benchmark and then try to find ways of identifying safely people and getting them vaccinated as quickly as we can the other thing to point out of course, Tom, as you well know is that many carers are actually in the over 50 group so we'll be eligible for vaccination very very soon because of that as well we'll be exploring these issues with the JCVI at another time the Welsh Government strategy says that 4 out of 5 unpaid carers identify on first contact with medical professionals given that GPs know their patients through family history they target people with flu jabs and that the hospitals are supposed to work with unpaid carers on discharge needs and arrangements isn't this a simple matter in relation to unknown unpaid carers of medical professionals asking one question are you an unpaid carer or not do you think this would work and if you don't why not personally I think that's just too well there's two problems with that Tom one is that we have to avoid GPs becoming overloaded with questions of that nature because they really have struggled to keep up with the provision of general medical services as well as the vaccine programme so it would add a complexity to their workload but the other dynamic of course is that just self-liquidation on that simple one question is perhaps too simplistic for the reason I mentioned before really which is that we are trying to identify people who really are essential to the well-being of the person they are caring for not just people who self-declare as doing shopping for a relative so I acknowledge this frustration and difficulties in all of that but we will work through that and hopefully working with the carers organisations we can make the process as effective and as fair as possible and as always Tom we will consider your questions in the operational context that you asked them as well so they are useful for us to take away and just think about so thank you very much for that moving next to Nathan Shusmith from the speaker good afternoon Nathan thank you good afternoon to you both it was said last weekend that cases of the South African and Brazil mutations of the virus fell in in the UK there has also been the B1-525 variant identified recently how concerned are you about variants of the virus and are you as concerned as when variants were first recognised last year well yes thanks Nathan we are concerned about variants and we are concerned about them because they represent an unknown and potentially variants arise they can bypass the vaccines that's really why we worry about them but also that they can be more cause more severe disease and we saw that and be more transmissible and we've seen that with the Kent variety so we do want to avoid new variants if at all possible we have developed in Wales an approach to that and it starts with prevention if we get the community rates as low as we possibly can that will stop new variants emerging within our own communities there's a lot of work going on around border controls with the UK government some of that is beyond our responsibility and ability to manage directly here in Wales but that's an important dynamic as well and when we find these variants here in Wales through our genomic testing when we do identify them there is a process of epidemiologically looking very carefully at where they've been their travel history if they don't have a travel history we do a very detailed investigation to look both forwards and backwards in terms of contact tracing to make sure that those variants are not spreading so that's our approach here and I think it's the proportion on the right one for the reason I say because these viruses do mutate we know that coronavirus in particular can mutate and as there is a selection pressure on them because of the vaccine it's likely that other variants will start to emerge but keeping community transmission as low as possible and identifying and dealing with variants as they arise is absolutely the right approach Thank you and another question on schools with some of the youngest pupils in Wales returning this week what are you expecting that to the impact that we'll have on community transmission given the role I have of the vaccine to more people obviously not to young people but do you expect there to be a significant impact and how long do you think it will take for that to shut up in data? Well it's back to the earlier question about the the impact of opening schools which we know from the sage advice does have an effect on the R number it does lead to increase transmission not necessarily because of the transmission within the schools but because of everything that goes on around the schools dropping kids off and more parents back at work etc so there is likely to be some impact in terms of the community transmission we may well see a signal that signal becomes less as community transmission again is low another reason why we need to keep it as low as we possibly can and generally speaking it's the three to five week period that we see a signal from any intervention which is why we have a three week process here in Wales of reviewing what we do in terms of releasing the lockdown Nathan thank you very much and moving to our last question this afternoon over to Rhys Nelson from Cardiff University News Good afternoon Rhys I've been speaking to Asma Wales who have issued a report that shows that people with even mild levels of Asma are twice as likely of developing long Covid than those without we understand that those with severe Asma have been vaccinated from Covid but those with moderate Asma still haven't are you able to clarify when people with moderate Asma will receive the vaccine? Again this is an issue that JCVI has looked at he's looked at a number of health conditions and severe Asma people who have been needed to take oral steroids regularly or people who have been admitted to hospital with Asma clearly have a strong signal of higher mortality and morbidity and so they were prioritised earlier in the process for vaccination Mild Asma doesn't have that signal that strong signal and so essentially people who have mild Asma or who use an inhaler occasionally will be managed according to the age profile they will be vaccinated and that's the JCVI advice and that's the advice that we have picked up here in Wales Thank you I have been reading reports that say that people with Asma on any level are more likely to end up in hospital than those without though and those people were called vulnerable and many of them spent the year shielding they have now been told that they won't receive the vaccine till the end of the rollout can you give them reassurance that they will be vaccinated shortly Our aim of course is to get everybody in Wales all adults vaccinated by the end of July that's really where we're heading people who have mild Asma have never been advised by me to go into the shielding group Mild Asma on its own does not constitute a necessary reason for shielding but we will get through the Asma group as the rest of society as quickly as possible Rhys, thank you very much that's the end of this afternoon's sessions thank you for the questions and thank you for listening Diolch yn franddw