COVID-19 Media Briefing – Friday 15th May 2020

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COVID-19 Media Briefing – Friday 15th May 2020

Welcome again. There is a great deal of information to to get through today, so to get plenty of time for questions we will extend this press conference to up to 2:30 if we need to. The Bailiwick is in a very strong position today, with 15 consecutive days with no new positives, and being down to 7 active cases. And thank you to everyone for working so hard, and working together in the spirit of #GuernseyTogether to deliver that fantastic position. As a consequence, the Committee for Health and Social Care have this week decided that we can move into Phase 3, starting from one minute past midnight tonight – a week earlier than originally envisaged in the exit framework. And Deputy Soulsby will provide the detail in a few minutes You will have many, many questions, I’m sure, following today’s announcements; and, as ever, we may not have all the answers either today, or even after today; so please do use all the help lines, but do bear with them as well, as they will be busy over the next few days – and the Chief Executive will talk about how we’re planning to staff that up to cope with those questions – but we will expect them to be busy. If we can maintain our success, there is every reason to believe that we can concertina the phases that follow, which would obviously be a fantastic result for all of us. Now the message elsewhere is clearly changing In England, you are now advised to “stay alert”. In the Isle of Man, you are now advised to “stay safe”. And I will obviously advise, “Please feel free to to do both of those.” But, I want to be very clear, even though we are easing out of lockdown and you will be able to do more, firstly that does not mean that you have to do everything that is permissible, and secondly the central Public Health messages that we’ve heard for several months now have not and will not change. So, wash your hands frequently, don’t touch your face, keep two metres distance from others, go shopping on your own – not with others unless you absolutely have to, and yes, “stay at home”. You can go out to exercise, and/or you can move from your household bubble to your work bubble if you are unable to work at home, but then you return to your household bubble; so “stay at home” remains key for all of us – as much as we possibly can. I said last week that we would say something about education this week. More detail is set out in a dedicated press release today, and much more information will follow from Education next week, but what I can say now is that the Committee for Education, Sport and Culture have decided that, for primary schools, from the 8th of June, students will be able to attend schools on two days each week Approximately half of the students will attend on Monday and Tuesday, with the other half attending on Thursday and Friday. Siblings will be kept together Primary schools will close on Wednesdays for deep cleaning. and for teachers to develop home-home learning for students when they’re not in school Vulnerable students and children of essential workers will continue to be supported on the four days that Primaries are open, if needed by their parents; so, please do discuss that requirement with your schools. Primary schools will contact parents directly during half-term to provide details on how it will operate at at the each individual school. Secondary education will continue to be delivered by distance learning for the time being, as the advice from secondary school leaders is that this is the best option educationally whilst complying with Public Health guidance. And vulnerable students and children of essential workers can still attend as they are now In the last week, there has been much talk about the R-number, the rate of reinfection from the UK to Germany; there’s been lots of speculation about what it currently from Jersey to Japan. We don’t actually have an R-number right now, simply because we’ve not had any new infections to provide the data for Public Services to calculate what that number might be. Now, at the outset, you will recall, the objective of lockdown was to “flatten the curve”, and and you’ve also heard Nikki subsequently say that in fact we’ve managed to “crush the curve”, exceeding all expectations, and that has given rise to talk of the elimination of

the virus from the Bailiwick. And Dr Brink can answer questions about the challenges of defining elimination and what that actually means within the geographic area; but it would be a perfectly reasonable challenge for you now to be asking, “Well, when did the objective change, when did it move from being flattening the curve to eliminating the virus?” And let’s be clear, the strategy is, and remains as it has all along, “test, trace and isolate”; and the consequence of our success in applying that strategy is that we can realistically aim to eliminate the virus in the Bailiwick now. And I want to explain why that may – that now may – make sense for the economic life of the community Our initial economic modeling indicates a reasonable expectation of a contraction of the economy this year (in 2020) of 9 to 10 percent, and that’s a loss of economic output of around 330 million pounds this year. And actually, as an aside, without any intervention by virtue of any recovery strategy and the plans that follow that, we estimate that our economy would not be back to its pre-CoViD size until 2027, which emphasizes the importance of developing a recovery strategy. But by comparison with some other economies, our estimate of economic contraction actually is relatively low, and that I think reflects, as it does, the dominance of our financial services sector in our economy in comparison to others, and its ability to continue largely to trade through the crisis so far – and I think we absolutely should thank them for that However, we estimate that a worst-case case – in other words, a slow exit followed by a second wave and a further lockdown – could see that contraction double; so, the stakes are very high, and we need to get our exit right. And for that reason alone – for the economic reasons alone, quite apart from the Public Health reasons – managing the exit in a series of measured and controlled steps through the remaining phases makes much more sense than a single leap to reopen the economy in one go In short, the the reality is that actually much of the economic output has already been lost and – and much for some of the sectors, including of course particularly the inbound visitor economy – is not going to come back for much of this year anyway, whatever we do. So, the marginal gain of a single step is simply not worth the downside risks of that approach. We’ve had the economic pain, and we must not now squander the very real and visible gains by moving too fast now and risking even more economic damage later. Our approach should, our approach should, enable us to effectively reopen the whole internal economy within a few weeks. I’ve said all along that I will level with you, and I will do so again. I just simply don’t know, and I think no one does, whether we have got the speed of our exit right. Is it too fast, or is it too slow? Should we be allowing more or fewer types of businesses to restart? And everyone is going to have their own personal view on that. And the picture is even more confusing when you start to look outside the Island Every jurisdiction is doing their own thing, doing something a bit different. You can see, you can actually get a haircut in in New Zealand today, bars in New South Wales can have up to ten customers in them, there’s al fresco dining in Jersey, you can drive to a park in England but not in Wales, and so on. And the reality is, it’s only going to be in two to five years from now, when lots of researchers have produced lots of academic work on this, from all around the world, looking at all the different approaches, is it going to be possible to judge whether our decisions today are the right ones or not – and frankly, even then, I suspect those papers probably won’t all agree. So we’re now at the stage of making difficult subjective political decisions. And not everybody will like them, especially if they can’t do what they want to do, but what I can say is that these decisions are being taken on the back of the best currently available – and that is a very important caveat, “currently available” – advice and data. And I asked you to trust us on the way into lockdown, and I ask you to trust us again on the way out. And when our decisions are judged in the future, with the benefit of hindsight, in the big picture, frankly, it won’t really matter whether we decide to allow the nail bars to open next week or next month. What will matter is, did we manage to save lives, did we prevent our health care system from being overwhelmed, did we mitigate the economic damage, and did we enable as swift a recovery as possible. And I hope that the answer to each of those questions will be “yes”; but frankly, those judgments simply cannot

properly be made until this pandemic has passed. I just wanted to say a quick thank you to all those who have contributed to the appeal funds. The CoViD-19 Response Appeal is currently standing at ninety thousand pounds, and the Social Investment Fund appeal stands at one hundred and forty thousand pounds. So, on behalf of both, thank you so much to everybody who’s contributed to those. And finally, before I pass to Dr Brink, I want to pay tribute to the other Islands of the Bailiwick. Herm, Alderney and Sark have all remained, of course, blessedly free of coronavirus And though, of course, they’re separated from us, that you too have been very connected to our shared community commitment, to the Bailiwick’s strategy, and, of course, you too have suffered the same privations and impact as Guernsey – and so I’d like to take this opportunity to thank you for your hard work, sacrifice, and your own Islands community spirit; so, thank you Over to Nikki, and then we’ll pass to Heidi. So, thank you very much Deputy St Pier. So, as Deputy St Pier said, we’re in a really good place. We reached a milestone when our first test run came off this morning – our first run of tests – and that we’ve now done over 4,000 tests in the Bailiwick; so really, really impressive from that point of view. We remain at no new positives on day 15 of no new positives. We have 252 cases, so that remains stable; and we now have only 7 active cases, so everything moving in the right direction for us. So, I think from that point of view it’s really positive. What we’re seeing in the community is, we’re not seeing very many cases of respiratory type illnesses, loss of smell, loss of taste; so, we’ve got very little activity in the community. So what we’ve actually done is moved forward some of our expanded testing programme; so, we’re starting now to test asymptomatic people working in key areas. So, that’s been important as well. So, we’re moving away from testing of symptomatics only to some asymptomatic testing as well, and that of course relates to the direct detection of the virus – so, our PCR based assay. So, we’re very pleased with the progress of that, which brings me into antibody testing – and I’ve had quite a few questions about antibody testing. And I think you all know that I favour the well based assays that are the one that we can do 96 tests at a time. You may have read that the U.K. have procured antibody testing through a certain provider. Guernsey is going to be getting tests from the same provider. It’s been a test that’s been rigorously evaluated by Public Health England, and we’ve put in an order for 10,000 of those tests for the Bailiwick. So, we’ll be looking at using those. As I’ve said to you before, we’re not intending at this stage to do large-scale population-based seroprevalence, because we think the instance of infection in the Ireland is very low. What we’re doing is looking at testing certain targeted groups; so, for example, sometimes – as I’ve said to you before – when someone has CoViD-19, they can get rid of the virus very quickly And indeed, some of the later symptoms can be mediated by the body’s own immune response to the virus; so, they’ve lost the virus but the body’s immune system is causing some of their symptoms In those cases, you might well see the people being antibody positive, so it’ll give us an additional diagnostic. It’s not common – we’ve got a handful of cases who fall into that category – but it would be nice to test such individuals. So, those are the main – that’s the main group The other group that we’re going to look at are the contacts of known positive cases. So, we’re going to offer them testing as well, to see if there was any asymptomatic transmissions in those groups – so very, very targeted groups. So, that’s with regard to the antibody testing; so, the other thing I wanted to comment on is the progress to Phase 3 Now, we always said that the progress and our exit would be driven by evidence – good evidence and bad evidence What we have seen today with our progress and our recommendation from a Public Health perspective that we moved to Phase 3, we’ve seen that we’ve actually exceeded our expectations. So, if you recall progressing from Phase 2 to Phase 3 meant that we had to have stable or decreasing levels of community acquired CoViD-19 infections. Actually, when we look at the data, we have now our last case of unexplained community transmission of SARS-CoV-2 occurred on the 21st of April, and we moved into Phase 2 on the 25th of April. Since then, we’ve had no cases, and no cases of community acquired transmission, so we’ve exceeded our expectations in that way Other parameters for progression were, access to an Island testing. Our on Island

testing is functioning very well. We have enough reagents to not only tests our symptomatic people but to extend into some asymptomatic testing as well. We’ve had high degrees of community compliance with all of our messaging, so that Guernsey Together “brand” (if we want for, want of a better word) has worked so well for us. And Dr Rabey will tell you the hospital is quiet. And linking with our GP colleagues, there’s no untoward activity that we are aware of in the community. So, we’re in a far better place than we thought we’d be, which is why it was only right to recommend – because we’re in a better place – that we actually progress progress sooner. So, we always said we would only keep measures in place for as long as we had evidence – and I think you all know how much I love evidence – as long as we had evidence to keep those measures in place. And we’ve really exceeded those expectations. So, the final thing I wanted to comment on was elimination; and I think you need differentiate between elimination and eradication. So, eradication is when you permanently reduce to zero a particular infectious age – and globally. Okay. So, if you ask me for an example of a infection that we’ve elimi…, we’ve eradicated globally, that of course a smallpox; so, it no longer exists across the whole world Elimination is a more narrow definition; so, elimination is when you reduce to zero an infection in a particular geographical region. So we’re consi…, considering the Bailiwick as our geographical region. An example of a virus that we’ve eliminated locally, but they haven’t eliminated in the UK, is measles. So, those are examples for that So, that took us in the Public Health Department – and we had a wonderful couple of hours trying to define how we would look at elimination, how would we say that we’ve eliminated the virus that causes CoViD-19. So, there isn’t an international definition that we could find, or a reliable one; so, that took us back to first principles. And we could say, “Well, we’ve had no new cases for 15 days. Should that count?” We’d argue not, because – as you would see from our data – we’ve still got seven active cases So, although those seven active cases are still in quarantine, there are still people who are excreting – potentially excreting –the virus on the Island. So, what we’re thinking of doing – and we’ve opened this up for academic debate with various of our colleagues in the UK – is, what if we looked at the last active case disappearing and look at, say, a cycle of 28 days after that. Is that a definition we could work with? So, we’re throwing these ideas up for discussion in the academic communities. How do we actually define elimination of the virus that causes CoViD-19? What is important for us is that we actually do do exit testing. So, when someone is diagnosed as being positive We don’t release them from quarantine until we’ve tested them and showed that they no longer have the virus. Now, that’s different in different jurisdictions; a lot of people aren’t doing that exit testing. So, we’re quite confident we can do the exit testing and then work on some sort of definition of elimination So, that’s going to be an interesting one, and the debate that we want to have both within Guernsey, within the whole Bailiwick, but across various places in the world, as to how do we collectively – here and globally – define local elimination of the virus that causes CoViD-19. So, thank you. Thank you. And Deputy Soulsby Thank you Gavin. As Dr Brink has advised, thanks the amazing efforts by the whole community, we’re in a far better place than we possibly imagined we would be just two weeks ago when we were putting together our exit from lockdown framework. As all of us said repeatedly last week, the framework is not set in stone. It is a living document that will change and be updated based on the evidence we have and the situation we’re in. And Dr Brink has provided the evidence and justification for moving to Phase 3. And so, the Committee for Health and Social Care has decided that we can bring forward that phase effective from tomorrow. Before I set out what that means, I really do think it’s important that, like Deputy St Pier, I remind you what doesn’t change, the key messages that continue and which must not be lost amongst the headlines of what we’re announcing today: Stay home in your bubble as far as possible; continue to work from home wherever possible; maintain social distancing of 2 meters; follow the hygiene guidelines; if you have CoViD-19 symptoms, immediately self isolate at home and seek medical help; and if you’re returning from outside the Bailiwick, isolate for 14 days – that doesn’t mean mixing in your bubble This is a legal requirement and you’ll be committing an offense if you don’t do so. Indeed, as we relax restrictions within the Bailiwick, this will become increasingly important, and we’re going to be stepping up efforts to ensure the Bailiwick bubble is strong. Okay, so what does Phase 3

mean? Well, for those classes of businesses already allowed to operate – such as building and other trades, building wholesale and supply, and vehicle sales, repairs or maintenance – we’re removing restrictions on the number of people can work on a site or premises. Instead numbers will be restricted based on how many people can work on the site and still maintain social distancing and hygiene requirements. Premises may be open to customers, with restrictions on the numbers of people permitted as currently apply in food retail, with 2-meter social distancing to be maintained at all times The above will also apply to offices, although we’re still advising people to work from home if at all possible Now indoor building and allied work within houses is now permitted under strict hygiene guidelines. This will be limited to two people unless a house is unoccupied, or health and safety guidance requires otherwise. This doesn’t currently apply to domestic cleaning, but I can say that considerate consideration is being given to the potential development of further specific guidance. In addition to the above, take away food services – including those provided by restaurants and hotels – can commence taking pre-orders only, and with collections permissible subject to conditions Childminders may now provide a service to essential workers; however, those who work in their own home with several children from more than one household including their own cannot work, as this mixes several households, and unless households are bubbled together. It’s also important that, where any child is showing CoViD-19 symptoms, they shouldn’t go to a child minder and medical advice should be sought. Now, our public venues such as museums libraries and gyms must remain closed. Places of worship can open for private prayer. In addition, a maximum of ten friends and family can now attend weddings and funerals, although I’m afraid receptions and wakes are still unable to be held. Public toilets will also be opened, which I’m sure will be a relief for some. There will be no changes in recreation time as we start Phase 3; however, we are saying that bubbles can now contain four households. So, an existing bubble of two households can join with another bubble of two households, so long as they all agree to it A bubble of two households could join with two other single households, or four single households could bubble up. The important thing here is that households can’t change those that they have already bubbled up with, and the maximum number of households that can bubble up is four Finally, in relation to the changes being made now, we’re going to pilot the opening up of non-essential retail. We want to do this so we can test how things go, see how it works before opening up further. So, from tomorrow, we are allowing garden centres, cycle shops, sports shops and shops selling clothes and shoes for children to open As before, businesses will need to notify the States that they intend to operate, and provide details as to how they will comply with the guidance, all of which can be found on the coronavirus website I think it’s also important that I ask everyone to have patience. It may be a good idea not to rush to order a takeaway, or go to the shops immediately Some businesses may not be in a position to be open, to be able to open straightaway. Unless you really have an urgent need for something, just allow time to let things settle down a bit. Now, those changes will be effective from midnight tonight; however, we also think it’s important that we look ahead, given the position we now find ourselves in. So, on the basis that things continue the way they have been, we’re looking at potentially making further changes in two weeks time. This includes enabling outdoor dining and the opening of beach kiosks, as well as increasing recreational time and a further change to bubbles. In making our decisions, we have balanced the risk of the virus to our community against the wider health, social and economic impacts on Islanders. There is no right answer. We know for some, it may be felt we’re going too slowly, and for others too quickly; however, I would just like to assure you that we have given this an incredible amount of thought, working very closely with Dr Brink and her team, as well as feedback through the new CoViD-19 Recovery Advisory Group. And finally, I can’t emphasize enough how important it is that we don’t get complacent. Just because we aren’t picking up positive cases doesn’t mean that there are no cases out there. The longer we all keep to the Public Health messaging, the more likely that is the case; but there is absolutely no guarantee that is the case now. If we get complacent, that is how the

virus will most easily be spread, and we will end up going backwards not forwards Our planning is contingent on everyone staying strong, as you’ve done for so long now and that’s put us in the position we are today; so, let’s continue to be proud to demonstrate we remain Guernsey Together. Thanks Heidi. Paul Yeah, just following on from that, as already noted, we are moving into the first stages of Phase 3. The details of what this means for us all will be published online during this briefing This will mean that more businesses can start operating again over the coming days and weeks. If, having read the criteria, you think this applies to you, then you will need to notify the Environmental Health Team of your intention, just as those already working have done. If you’ve already notified Environmental Health, you do not need to do so again. Please take into consideration that these measures are put in place to ensure we continue to make this excellent progress. If you’re unsure as to whether you qualify, then please make sure you speak to the Environmental Health Team before doing so. This positive progress is excellent news, but there continues to be a need to support the economy. So far, we have supported 2015 local businesses, where more than 1,000 claiming through the payroll funding scheme and payments now reaching seven million pounds. A further £5.3 million have been paid out in the form of grants, totaling over £12.3m of payments to date This equates to over six thousand employees in Guernsey being assisted with the provisions of pay by the Business Support Scheme. As previously mentioned, we have had the issues with the running and operating of a manually – manual email based application process remotely by individual caseworkers, which has meant payments and claims are taking longer than is satisfactory to be processed. As promised, we have been working on building a digital solution with our partners, Agilisys, and I am really pleased to say that by the end of this afternoon businesses can apply for payroll support through the Business Book Support Scheme, which will be able to submit their claims through a new, online, digital portal. This new IT processing scheme will enable faster processing, and payments of applications, and, importantly, will allow us to track and monitor your applications more effectively. If you’ve already submitted a claim, you do not need to do so again through the new portal. There has also been some changes made to the qualifying criteria, and eligibility for funding has been widened for certain businesses. In particular, small businesses employing up to twenty people will now be entitled to claim a small business grant, and companies that have multiple businesses in different economic sectors can make a separate claim for each of those businesses Details of all the changes to that business guidance is now available online. If, having read this guidance, you can consider your business to now be eligible to claim under these new revised criteria, all details of how to claim are in those guidances. Please remember that some businesses may be more prepared to open than others, and some may not choose to open, or indeed meet the criteria. Equally, some businesses may not be operating then to their normal level of operation. This is going to be a gradual process, and so we would all need to be patient. If you have any questions, or details or queries on the changes to these restrictions, it’s important they’re directed to the right staff that can answer your queries Please avoid sending general queries to, directly to Deputies St Pier and Soulsby, and particularly Dr Brink There will be people online, and we’ll have people online over the weekend, to answer your calls. Thank you very much, Paul. Dr Rabey Thank you. I’m delighted the spotlight isn’t really on the hospital at the moment, but I’m going to give you a brief update on on where we are with things Dr Brink use the “quiet” word. I get told off when I go back and use that word, because doctors are quite superstitious about that word and, and, but I’m not! Just because areas of the hospital have been quiet doesn’t mean that people haven’t been working hard, and I’d just like to mention some of our, some of our wards have been working ever so hard throughout this entire thing. So, our rehabilitation ward, Le Marchant, has been full throughout the entire period, and and I just think, you know, they’ve been having to work ever so hard, with with all the restrictions about CoViD that they have to deal with; so, just a quick mention of that. The Imaging Department and X-ray Department are seeing a lot more people now. We’re seeing a gradually increasing numbers through the Emergency Department, as well Next week, we’re dipping our toe in the water of planned and elective operations. It’ll be a slow start, because we’re still taking full precautions for the for the personal protective

equipment, and we have to do the deep clean between patients still; but we hope soon after that that we can move back towards more normal working in theatres, and, and perhaps in a couple of weeks, start increasing our flow through the operating theatres; and perhaps think about things, like something we’ve had a lot of questions about; when partners can attend with their with their mums to be for a caesarean section, that sort of thing. So we know that’s on your radar, and as soon as we can we’ll be giving you news about that – when it’s safe to do so Things we always talk about, personal protective equipment, we’ve got at least three months supply in every line now, and we’re seeking to increase that further, because, if we get a second wave we will be needing all of that, but, but we’re in a good place for that at the moment. So that’s that’s more or less the hospital position. Moving on to care homes, we we only have one patient left in the hospital now who’s from the care homes who’s still testing positive. It sometimes take a long time, as Dr Brink has said, for um, for especially elderly people to completely eliminate the virus, but but that’s a fabulous position and probably while we’re talking now I think what one patient who’s finally tested negative is going back to to one of the care homes that was previously affected. So good news there and and I know the care homes will want to get their residents back to sort of more normal out of the room activities and things, as soon as they feel it’s safe to do so And so I’m gonna say, you know, only, only positive news at the moment about the care homes, which is great. Primary care continue to work closely with us: you’ll remember that throughout this time I’ve considered their input to have been exemplary in terms of how they’ve helped us in the care homes, how they’ve divided the hot clinics, and, and worked at the chest and our clinic, doing testing with us, and offering support. And we’ve had a lot of help from them, so, so, we continue to work closely with them. I think that’s enough for me. Thank you. [Gavin] Okay, thank you very much Peter. Okay we’ll open up for questions, as say, given that we’ve covered quite a lot already, we will extend if needed, so who’d like to kick off please? Rosie Allsopp, Island FM: Can you tell me where community centers will fit into this moving into phase three: particularly those that do activities that concentrate on the well-being of the population, social prescribing, that kind of thing? [Heidi] At this moment, public venues which, i would say, would include community centers won’t be opening but, again, things are moving at a fast pace. If things go well, we might be able to see that in the next few weeks but, certainly not in this stage. Dr Brink, if we are working towards elimination, what does that mean for them eventually opening up to the rest of the world. [Dr. Brink] yeah, I mean that’s a great question and something that we have spoken about in, in great detail. So, the obvious thing would be the development of a vaccine – so providing some protection to the local population. The second arm that people are looking at is the development of effective treatment for the viral infection. So that would be the other, the other issue that could be considered. So there are various drugs that are being trialed at the moment Remdesivir and various other drugs. And in the third thing is if the infection burns out in neighboring jurisdictions. So we will be looking at what the risk of infection is to islanders and how we can mitigate that risk but actually, other than the external risk, if we manage to get the levels down to eliminations, that we had no known cases on the island, is there would no reason why the Bailiwick couldn’t carry on and function entirely normally, other than external travel, and that would get a lot of sectors moving. It would get people moving, it would get children back to school, it would be all of that. and that would be really positive. The thing is, because this is a new virus, it’s only just hit the human population in the last six months, I think I’ve said that one before as well, is that we just don’t know how quickly we’re going to get an effective vaccine, when we’re going to, or if, when and if we’re going to have effective treatment, and how long it’s going to take take to burnout. So there is a bit of a unknown there, but if we could be virus free within our jurisdiction it would open us up to a lot of activities. [Gavin] I’m just, just wondering whether, on the back of that, you want to say anything about the fact that the rates of infection globally, in terms of the number in the proportion of population that seem to have been affected, it seems to be much lower than than was originally assumed, perhaps three months ago, and what impact that has in terms of future planning the course of this disease? [Dr brink] So we’re all concerned about a second wave, so that has to be a concern because most of us seem to have largely susceptible populations. One of the problems is is no

good large-scale seroprevalence studies have been done. So there’ve been quite small studies: there have been extrapolations from the number of people dying and the number of people in hospitals to predicting how many people in the community have being infected. But it does seem that in most jurisdictions the minority of people have been infected, which really has implications for, for future infection, in all of the jurisdictions. Thank you. Euan Euan Duncan from BBC Guernsey. Just to pick up on a point you said Dr. Brink if you’re – You said we could return to normal if we can say we’ve eliminated the virus. does that mean we will be able to stop socially distancing within the Bailiwick, and would there be a concern if we say we’ve eliminated the virus, there could still be people with symptoms who are asymptomatic, or simply just don’t put themselves forward for testing? [Dr. Brink] Absolutely. So asymptomatic tests, asymptomatic infections does – it will always be a concern. But if asymptomatic infections are transmitting to other people you would expect someone to declare as symptomatic. So that then goes to our test, contact, trace and, and quarantine. So, if you had an asymptomatic affect, and they’ve infected five people, you would expect at least two or three of those to be symptomatic, and you would then test them and then contact trace back. So, I think from that point of view it’s not everyone’s going to be asymptomatic, so you are protected to a degree, by some people becoming symptomatic. So, what our new normal will look like – we’re not sure yet I think this pandemic has fundamentally changed our behaviors. So I think if we can adhere to good standards of Hygiene and so on, not only will it helpful infection with the virus that courses Covid-19 but but also other infectious diseases: so winter vomiting disease, norovirus, and so on. So, I think if we eliminated the virus, and we were confident, over a period of time, and we’d have to monitor, the the longer we had no cases, the longer the hospital had no possible cases admitted, the more confident we’d be to drop some of what we call non-pharmaceutical interventions, which is things like social distancing And, in essence, what you’re doing now is as we ease out of lockdown, you, more people are going to be mixing in the community. So I would see a gradual progression, but I really want to caution against complacency. These are hard fought gains, we’ve done really well, but we’ve done well because the community has enabled us to do well. Public Health and all of us in the hospital and so on have just been vehicles. The community are the people that have actually enabled this to happen and I’d really caution about being too complacent, and let’s move forward positively. [Gavin] So just to be clear, in response to that question then, even when we get to a stage where we have, have that Island bubble, normal life has returned within the island, it is still quite likely that will there will be a requirement for some of those Public Health guidances to be followed for some extended period of time. [Dr. Brink] I would expect, I’d hope that some of them would have become integrated into our daily life, you know so “catch it, bin it, kill it”, good hand hygiene and all that, I’m really hoping that some of our behaviors will be fundamentally changed and I think that would be one of the good things that comes out of what’s happened to us. [gavin]Thank you: Hi, Charlotte Gay from ITV Channel: with the decisions around returning some primary school children back, what was the decision with primary school children versus secondary? Obviously younger children are not going to understand social distancing: we, we’ve seen pictures of different countries putting, you know, children in these sort of like, zones, that they need to stay in How, how do you realistically get your – ask children, to social distance when they’re back? [Gavin] Um, So I think, predominantly why primary not secondary that is an education decision. So what we’ve done from a public health perspective is that we’ve done an analysis of the risk. So, this is where we are: we think the overall risk is decreasing very quickly We’ve had no new cases for 15 days, and so it’s a public health risk, it’s up to the educationists to backtrack on to the public health which I wouldn’t dream of telling teachers how to run the school, just as I’m sure they wouldn’t dream of telling me how to work in public health. So I think that’s important. So we provided a risk assessment as to what, what we think. With regard to social distancing of children in school, of course that’s a challenge But one of the things I always say is the 2 metre social distancing is important, but it’s only one of a suite of interventions, and with every calculation that we do, with these non-pharmaceutical interventions, we don’t calculate them on a hundred percent compliance. So you calculate them on about 60 to 70 percent compliance when you look at the overall efficacy. So in addition to the 2 metres,

you’ve got the hand-washing, you’ve got the no fluffy toys, you know, just toys that you can clean. You’ve got the deep cleaning of the school environment. So, it’s part of a whole suite of, of interventions and you can never say something’s 100 percent safe – you can’t say that in, in in any situation. But what you can do is make it as safe as possible And so the two meters: it’s an attempt to keep um children two meters apart, but with the knowledge that whilst you’ll be successful probably quite a lot at the time, you won’t be successful all of the time. [Paul Whitfield] Yeah, I think what’s important was the Committee for Education, Sports and Culture were very keen to make an announcement this week, as previously mentioned, in terms of the direction for opening schools. And I think, as Deputy St. Pier noted, the date for that is the 8th, which gives some time for Education, sports and Culture have absolute intention of coming forward and providing the absolute detail of how those are going to operate. It is, it is very complicated as you say, and so taking all the health advice, then working with the educationists, the schools and the Committee office, they’ll be providing that and coming forward very shortly with the details of how that’s actually going to operate in practice. [Charlotte] Is it mandatory that children do have to go back to school? There is no option for parents to say “I’m still not comfortable with that”? [Paul Whitfield] well I would I would say there is, by law, there’s there is a responsibility to provide provision of education through, through the Committee office. A parent has also a right on how they choose to school their particular children Some people do home home schooling now So of course, and I think the very sound advice that Deputy Soulsby said: that if anybody’s got any indications of symptoms, whether a child or adults or otherwise, should stay at home. And if they prevent, prevent that risk. [Gavin] Okay, next next question, [Mark, Guernsey press] Deputy Soulsby, I heard that last week, I think it was, eight ventilators have been shipped to Guernsey in addition to what already got. Just wondering if we’re gonna need these? If not are we’re gonna send them back, are they’re going to be sitting there waiting for a possibility of a, a relapse if you like? [Heidi] Well, I think Dr. Rabey will be able to answer about the ventilators and what we’ve got, but it’s all about being prepared and we can’t – and this is again, it’s about not being complacent. Just because we’re in such a fantastic place now, it doesn’t mean – in two weeks time we are. And we’ve got to be prepared for a second wave, which we don’t want, we’re doing everything to avoid that. But it’s silly to take our hand off the tiller right now and say “right well, that’s fine, let’s just get it, you know, life is, life is normal” We’ve got to be prepared, continue to be prepared, and that’s one reason for those extra ventilators, which I’m sure Peter will be able.. [Dr Rabey] Yeah we’re delighted to have received basically four loan ventilators from the UK. We’ve um, we’ve got our own ventilators which we started the crisis with. We obtained, we obtained some more. We’ve got these four on loan from the UK. They initially sent us four that aren’t suitable for intensive care use, and we were really disappointed when we opened the boxes But, but we got in touch with them and they’ve sent us for proper intensive care ventilators, which we can use if we get a second wave, and we will use, and we’re going to keep them here if we need them, until they recalled. They’re owned by the, by the NHS, and they can recall them any time they like, but at the moment they’re with us. We also have six ventilators on on order: proper intensive care ventilators that were largely funded by really generous donations actually. They’ll arrive soon and those will be used, even if not in this crisis, and let’s all hope that we don’t end up using them in this crisis, as part of our Hospital intensive care redesign anyway. So those those are part of our future intensive care and we wanted them anyway, so we’ve got them a bit earlier than we would have done. So we’re content with our position on ventilators. [unidenified media person] Is Public Health – I know it’s hard to tell now, but is Public Health expecting a second wave, if we are preparing? [dr. Brink] I think we absolutely have to prepare for a second wave. I like to be really well prepared for any eventuality, as far as I can be, and I think if we didn’t prepare I think the community could rightly ask questions of us. So it’s, you know, hopefully we will be able to mitigate against the impacts of, of a second wave. So, the type of thing that we’ve developed is our extended, The Bailiwick Expanded Testing Strategy, and that basically will allow us to identify and test very quickly. you might recall the concerns, as we were going into lockdown, where the fact that we didn’t have on-

island testing, and we were limited to 35 tests a day. We now can do as many tests as we want today, and we can test rapidly and we can also turn on those tests really rapidly. So up till now we’ve been doing three test runs a day. So testing from early morning and taking the last run for 10:00, 11:00 in the evening So we, we’ve got that very rapid turnaround time and if we needed to do that again, we could. So we, we’re preparing for a second wave. We think if you look at the modeling of, of these respiratory virus pandemics, is there often is a second wave, so we need to prepare and need to make sure that we’ve not only got the appropriate resources in place from managing the viral aspects, but also things like we’re planning to make, look at our PPE stocks. So all of these things, so that we’re ready if we have another another pandemic. And indeed, the ventilators is another example of that. [Gavin] And even a third wave. [Dr Brink] Yes, absolutely, and sometimes the second wave can be worse than the first wave, so we really need to be well prepared. [Euan] Sorry, I was just going ask you a question about the second wave, you’ve just answered that really. But what could a second wave look like? If we can say we’ve eliminated it, could the second wave not be as bad, or difficult to say. [Dr Brink] it’s, it’s difficult to say, but what we are now, what we have got now is, we’ve got all of our testing in place. We kind of understand the virus now; we know the symptomatology is, so if you think about it, in the, in the early days it was a fever or cough, or shortness of breath, and it soon became apparent to us there were other things going on in the community. So we learned very quickly of the other symptomatology which is why very early, we changed our case definition. So we would be more prepared and that. We understand more about the symptomatology. We understand more about the consequence of the virus We have established testing. We know that our contact tracing has served us well so you with our reports with a contact tracing we went back 24 hours before symptomatic and we think that’s also helped us. It’s that we designed that program we’ve got 35 contact tracers, trained and ready to go, that’s equivalent of 35,000 in the UK The UK are hoping to have 18,000 trained up. So these are people who are trained and competent to go at any time So we are as well prepared as we, as we can be. And what we’re also doing is we’re looking for asymptomatic cases as well: so any seeding that could bubble up into a cluster, we’ll hopefully be able to contain very quickly. [Euan] I was just gonna ask you about that as well – the the modelling that you’re doing, are you looking at the amount of people in the island who might still currently have it with it be asymptomatic, and would you know from that modelling how many people have actually had it, but not presented themselves? [Dr. Brink] So the only way you could actually have a look at how many people who’ve actually had it would be at some stage to do a larger seroprevalence survey. In other words do the antibody test across the island. You could also do a very large-scale test on a sort of point of prevalence to see how many people have the virus on a particular day – 30,000 sample – you know, thousands of people. So there are various ways in which you can, you can do that. What we’re doing at the moment is we’re having a look at key areas and looking for asymptomatic infections in those key areas, and looking at supporting people in those key areas to get tested. But we’re testing for the virus at the moment in those areas, and as I say, you might get an asymptomatic case, but statistically, if you have an asymptomatic case and they’re transmitting, you’re going to bubble up with a symptomatic case at some stage. I shouldn’t use the word “bubble”. You’re going to have symptomatic one’s going to appear. [Mark] Sorry, what’s the situation with people coming into the island and going into self isolation for 14 days. Is that the number in single figures daily? Are we talking about a couple of dozen a week, I mean what’s the rate? [Paul] about 15 to 20 We have some peak arrival times. For example, on a Monday when we have maybe key workers or essential workers that we need to bring into the island. But of course we, we are monitoring that very closely all the time. We are looking at how we might improve how we monitor and safeguard against the travel. We know that was our weak point at the start of this. So we’re very keen to keep a very close eye on that, and we’re looking at ways we can improve upon that all the time. but it’s, that’s why it’s essential that we do keep that 14-day period isolation for arrivals at this moment in time. [Gavin] Okay, next question. Yes: Kit Gilson ITV News: Question for Doctor Brink, just a bit of clarity really, of the 4,000 tests

or over 4,000 tests that we’ve done, is that individual tests or tests of individuals. [dr. Brink] Its individual people. So if we looked at the number of tests we’ve done, and we actually thought we should publish that because it’ll be a lot more So, for example, if someone’s tested positive, we will then test them on day 14. if they’re positive we might test them again. So we might, not we might, we will test them again Also, some people have had more than one set of symptoms, so they might have one set of symptoms and two weeks later have something else So it’s individuals, not test numbers. So these are for 4035 individuals that have been tested. [Gavin] Euan: [Euan] Yeah, a question about the antibody testing: you mentioned you, said you’ve ordered 10,000 kits. What does that actually mean, and who will be prioritised for those tests? [Dr. Brink] So, in the first instance we’re going to prioritised contacts of known cases. So we’ve got our 252 positive cases, so we’ll see, do some, offer some testing around those contacts. So that will be important. The second group we’ll prioritise are people who’ve had symptoms suggestive of Covid-19 who actually have tested virus negative. Now, you might say “well why they’ve, you know, they’re over their symptoms” and so on For a lot of people they’d like to know what their diagnosis was, so we’d be working with those groups of individuals And then what we will do is go and offer testing to some key groups that possibly have had higher, not possibly – would have had high exposure to Covid-19 in the peak of activity here. So it would be – start off with context of known cases: symptomatic people who’ve had a negative diagnosis, go on to key groups who we think are at greater risk of potential exposure, and then possibly later on, doing something on a wider population base. So it’ll be a stepwise progress through there. We wouldn’t go for a broader population base at this time, because the other duty we have is to work cost-effectively as well and we think that the rates of infection are very low, and we’d rather focus our efforts on direct viral detection, rather than a big antibody survey when we think our rates are very low. [Mark] Proabably for Dr Rabey We’ve heard the day patient unit may well be opening in a week or so’s time, is that? [Dr. Rabey] It’s almost anticlimactic, but we’ve been making it back into a day patient unit and moving all the intensive care stuff out. We’re doing that in a way that we can reinstall it as an intense care within two days should we need to. So we know exactly what goes where, which piece of equipment’s being stored where, and, and, and we can do that in a very controlled way. So we’ll be putting people into the day patient unit, I think on Monday actually. [Gavin] okay, thank you.Any more? [unidentified media] Did you see, obviously, if we were originally planning on entering phase three next week, a lot of, you know takeaways, as an example, would have been mentally probably thinking, hopefully that’s the date. Was there a decision behind giving businesses less than 24 hours notice, in that, that might maybe have a slower reopening, or is it just that you kind of, you’ve made the decision now, you, you want to open sooner rather than later. I don’t know whether you know, it’s a smaller scale issue, but you’re not giving people much notice, whether that was intentional or not? [heidi] No, oh it’s purely because of, looking where we are now and saying, I mean, business don’t have to open now if they don’t want to, and if they’re able to that, that’s, that’s fantastic, and we’ve had information about where certain businesses are at the moment anyway. I think some can start. I think it’d be harder for some in terms of their supply chain, and I think a lot of, a lot of businesses have been mentally prepared anyway, that’s think, things will change, and lots of them have put through what we call “method statements”, about how they would operate So I think a lot of them have been chomping at the bit to be able to start, start anyway But no, this is purely because the evidence has shown such a fantastic position. We shouldn’t, in terms of proportionality, keep things locked down where they were, for any longer than they needed to be. [Gavin] And we’ve mentioned the method statements before and it just is again it’s worth putting that message out, that for those businesses that aren’t yet able to trade, that they are encouraged to engage with Public Health, with environmental Health and with with Health and Social Care, to start preparing and thinking what would be required [Heidi] Absolutely there’s been really interesting seeing those businesses being very proactive. I mean we’ve had that same come from hairdressers as well. So they know that it’s not going to be until phase four, but they’re starting to say “this is what we can do” and that, it’s fantastic and that all helps make make things work far, far more smoothly. Absolutely and it’s not all because – all this it’s not just about government saying “this is what you do” I know I sit here and do it from that

point of view, but it is working with businesses and others, to say what will work, and it’s getting that, as I said in a previous press conference, it’s that two-way conversation. You know, it’s something for all of us to make this work, and we really welcome all the help we can get. [Gavin] Right, thank you. Yes Euan: Yeah we just had a quick word about schools, I know you said we’ll have an update a bit later on, but what kind of modeling are you looking at, and is this one of your biggest challenges you’re going to face in terms of how you get the children back and are Head teachers all in agreement of how that’s done? [Gavin] I’m not sure I’m in a position to address and answer that question now I think that’s probably a question that needs to be addressed to Education next week. [Paul] Absolutely. The the sort of reinforcement of my message that a huge amount of work is going on behind the scenes: engagement with the unions, engagement with the teaching staff, working with their Heads, working with the, the staff that work in the central office for Committee Education Sports and Culture and of course the Committee themselves, in what is proportionate again – how can it be done safely. And that’s all being worked out, which is why, I think sensibly, they’ve given themselves just a slight little bit more time, opening on the 8th, which is a week after the the half term, predicted half-term break. And that is principally, and also so that they can work out those procedures. And once that’s all done, obviously communicate those in a calm and effective way, rather than do it in a compressed sort of five or ten minute slot in this in this particular panel session. There will be a dedicated one of how that’s put across to the community [Gavin] And again, I think going back to a previous question it is important that that is done to build confidence that everybody involved. Obviously parents are going to be want to be anxious and concerned that they’re, that they’re sending the children into a safe environment. And teachers want to be sure they’re working in a safe environment, so it does, hence the time and I think it’s also Guermnsey is not unique in addressing that challenge: clearly every every jurisdiction is trying to work out what the appropriate and safest way is, given their own circumstances. Any other questions? Go on: [Euan] Just, just lastly Dr. Brink has said that we are exceeding expectations. You’ve outlined in the last press conference the weeks and the stages until we get to the next one. Obviously you’ve said it’s a living document. We know that things will get moved and updated as we go along. Are we looking at less time for a move to phase four, or too early to say until we’ve been into Phase three and figured out what’s happening? [Dr. Brink] So potentially we’re looking at a less time but we need to be absolutely clear that we will be guided by the evidence: we will continue testing and, bearing in mind we’re starting to test new groups of individuals, we need to see what comes out of that. So we’re in a very good position. If we remain in a good position there is always the potential for that. We always said we could concertina the phases which is why we called it a framework Because we didn’t want this to be tablets of stone, but we felt we needed to give people an idea of where our thoughts were, and that’s been what we’ve done throughout. We’ve said this is what we’re thinking, but it might change, and I think people can understand that you, know. So yes, if it continues going well we could concertina it down, but we’d want to be absolutely sure we continue in a good place. We don’t want to compromise the – we don’t be complacent and we don’t want to compromise what we’ve gained.[Gavin] Heidi? Yes I dont know if the phrase “don’t run before you can walk” is one to use here Yeah, it’s been brilliant, and I mean I just wake up in the morning, I can’t believe we’re here. I feel like like Gavin, just waiting for the daily briefing to come through from Nikki to say how many cases there are, and it’s like you, click on the button and then go Oh phew! and it just some somewhat feels rather surreal at the moment and, we’ll have a test of this by easing the lock down. That’s when we might let, more likely to see any cases come up, so we can’t make any promises Everything’s been fantastic, but we can’t make make promises. Clearly, what we will say is that the evidence shows that we can release lockdown sooer, we will Because it’s all about being proportionate to the risk that that is impacting us But yeah, let’s just take it take it easy – just don’t be complacent, just really follow Nicky’s guidance, listen to Nicky, I mean it’s been right so far.That it’s the best thing to do is to follow the the current messages and just don’t be complacent, and we will be out to go out this sooner rather than later. [Gavin] Under promise, over deliver. [Heidi] Yes. Okay all right so it’s covered and I’ll finish up. I think one

of the plus sides have been, having lock down, and people being at home, is seeing more nature enter our gardens or in the countryside and, and the Pollinator project have been working with Guernsey Mind to build on that and so people get them, a door drop, I think it’ll be from Monday, and just helping people get, and get more knowledge about what’s out there, and so this one’s about, all about learning about the butterflies and the community, which is fantastic That’s a beautiful piece of work actually. Excellent, and I think there’s a butterfly competition as well to create a Guernsey butterfly. So, well done to Pollinate Project and Guernsey Mind for doing that. So I look forward to seeing it, and seeing what we can do with it, and just I hope people can enjoy it and and take on board what they’ve done Thank you. [Gavin] Thank you very much. So that, that concludes this week, we’ll plan to meet again this time next week next, Friday at 1 p.m., and in the meantime, stay at home as much as possible. Thank you very much indeed. Thank you