Nick Triggle
Health Correspondent

There has been a suspicion for some time that patients will be picking up coronavirus in hospital – and that the scale of the numbers in hospital is not necessarily representative of wider community spread.

NHS England medical director Prof Stephen Powis admitted today the scale of the problem is not known, but it is something officials are “actively” looking at.

He said some degree of transmission was “not unexpected” given the health service is dealing with a new virus for which people do not have any immunity.

But he added that good practice was being followed in terms of separating patients with coronavirus from those without.

The death rate from coronavirus in New York state increased with 778 new deaths on Monday - up from 671 on Sunday, Governor Andrew Cuomo said at his daily news conference.

Sunday's figure, however, was the lowest daily total in a week.

Cuomo also offered hope that the "apex" had been reached.

There were 1,600 newly infected patients admitted to hospitals across the state, he said, more than half the figure recorded at the start of April.

Cuomo called the trend evidence that residents were "artificially flattening the curve with all these drastic actions".

Nick Triggle
Health Correspondent

The UK government has been criticised for only reporting hospital deaths in its daily updates, with the care sector angry that the scale of outbreaks is not being monitored in care homes.

But logistically, it would be very difficult to collate those deaths in the same way.

NHS England medical director Prof Stephen Powis and his Public Health England counterpart Yvonne Doyle point out the number of hospitals (around 200) compared to the number of care homes (11,000 plus) makes a big difference.

But it is also true that there is not enough capacity to test care home residents for the virus, so like-for-like figures are simply not possible.

The government press conference saw questions go to Chancellor Rishi Sunak, NHS England's Prof Stephen Powis, and Public Health England's Prof Yvonne Doyle. Here's what they told us:

• The government is not going to "choose between" the economy and public health as this would be "self-defeating"
• It accepts there will be an economic shock but expects the economy will see a "relatively swift bounce back". It thinks the cost of not taking drastic measures would be bigger than the cost of the borrowing it is doing
• There is "no truth" in reports that PPE producers have been told to prioritise NHS England over other nations
• The wage furlough scheme will open for applications around 20 April. There will be a delay of a few days between submitting applications and receiving cash, so the government can do a fraud check and other background work

There "may be very good reasons why people from care homes are not being admitted to hospital," says Yvonne Doyle.

But she added: "At no time has it been said to me anywhere that the NHS would not accept a patient who needed to be admitted."

Prof Stephen Powis said doctors should make decisions about patient care "as they always have done, in the current epidemic".

Image source, Getty Images

• Italy has seen the number of fatalities go up by 602, the second increase in as many days, to a total of 21,067 deaths, external. But the number in intensive care continues to fall (by 74) to 3,186.
• Denmark imposed a lockdown more than a month ago and Prime Minister Mette Frederiksen now plans to relax restrictions even more than planned as the rate of infection and hospital admissions is lower than expected. Schools for younger children were already due to reopen on Wednesday
• Sweden has now seen more than 1,000 deaths since the outbreak began. Critics of the government's relatively light measures point to a fatality rate far higher than those of the country's Nordic neighbours
• Russia has recorded its biggest rise in new infections in 24 hours - 2,774 new cases. Over half were in Moscow, and it has emerged that 34 members of the Bolshoi Theatre have tested positive
• Germany's most populous state of North Rhine-Westphalia says it aims to reopen schools gradually after the Easter holidays. Chancellor Angela Merkel will discuss a federal plan with state leaders on Wednesday on how to ease the lockdown
• Thousands of shops such as DIY stores were allowed to reopen in Austria on Tuesday and the government hopes to relax the lockdown further next week

• Authorities in Germany, Ireland, the Netherlands and the UK have foiled an attempt to cheat health authorities out of millions of euros by selling them non-existent face masks
• In Montenegro, church services will be banned for next weekend's Orthodox Easter

Rishi Sunak is asked how greater borrowing to cope with coronavirus will eventually be paid for.

The chancellor says he is "not able to talk about future tax policy" - but adds that the best policy is to ensure the UK economy can bounce back to normal as soon as possible.

The medical experts are also asked if there is anything they regret in the UK's strategy.

Prof Yvonne Doyle, from Public Health England, says "undoubtedly we perhaps could have done things differently," but officials have been working "tirelessly" to better understand the virus.

Prof Stephen Powis, national medical director at NHS England, says it will take time to be able to "learn the right lessons".

Firms should be able to apply for money to help pay furloughed staff "on or around" 20 April, Chancellor Rishi Sunak says.

"That is the working assumption", he adds, with testing of the new system currently being carried out.

There will be a gap of "several days" between applying for help and getting the cash, he says, to allow for fraud checks and the BACS payment process.

Asked if he really believes the UK economy can quickly get back to normal after the coronavirus emergency, with predicted record levels of debt, Chancellor Rishi Sunak says it is "possible".

The aim is to "keep as much of the productive capacity of our economy as possible," says the chancellor.

He adds that the government's plan to boost regional growth, set out in the Budget, will help it "bounce back".

Amid an economic downturn from lockdown measures, Chancellor Rishi Sunak is asked what his message to young people is.

He dodges a question about whether the UK will continue to increase pensions in line with the so-called "triple lock", saying he doesn't want to write future Budgets.

But he says the government wants to make sure there is "economic opportunity" for everyone on the other side of the crisis.

There's also a question about coronavirus infections in hospital, and Prof Stephen Powis, national medical director at NHS England, says this is "not unexpected".

He adds though that data is "not clear enough" to say what the average infection rate is in hospitals, whilst the total number of hospital infections is being "looked at the moment".

Chancellor Rishi Sunak insists care home residents and workers have not been forgotten.

Work is under way to get accurate data from care homes but there is a "logistical challenge".

Yvonne Roberts, director of health protection for Public Health England, says care homes are a "very dispersed sector".

Mr Sunak says there are far more care homes than hospitals, and that makes it difficult to collect reliable data.

There's a question about claims that suppliers of protective kit for healthcare workers were asked to prioritise England over Scotland.

The claim has been made by the head of Scottish Care, the body representing private care homes in Scotland.

Chancellor Rishi Sunak says there is "no truth in those stories".

He adds that the Scottish government's clinical director has dismissed the claims as "rubbish".

There's also a question about why UK deaths in care homes are not published daily, unlike deaths in hospitals.

Prof Yvonne Doyle, from Public Health England, says recording deaths in the care sector is a “bit more complicated".

But she adds that they are "working towards" getting daily data on all deaths in the UK.

Image source, UK government

But Stephen Powis says not everyone is being tested so it can never provide the full picture.

Prof Stephen Powis, national medical director at NHS England, says there is evidence that hospital admissions in London and the Midlands are "plateauing".

He says the figures show the benefits of social distancing, but adds that it is important for people not to take their "foot off the pedal" and continue to follow advice.

Rishi Sunak adds that the UK's strategy is not about "choosing" between people's health, and the health of the economy.

It would be "self-defeating" from an economic point of view, he adds, not to take action to protect people's health.

He says the latest death figures for the UK are a "powerful reminder" of the need for people to follow social distancing advice.

Chancellor Rishi Sunak begins with a few words on today's economic outlook from the UK Office for Budget Responsibility.

He says "these are tough times" and it will be impossible to protect every household and business.

He adds that the prediction "may not even be the most likely scenario".

He says the OBR has been "clear" that the situation would have been "much worse" without government action announced so far.

Chancellor Rishi Sunak has emerged, and today’s UK government briefing is under way.

Stay with us and we’ll bring you all the latest updates.

Image source, Getty Images

The head of NHS England, Sir Simon Stevens, has revealed he contracted coronavirus and self-isolated at home for seven days.

He has said his condition was at "the milder end of the symptoms".

Sir Simon has appealed to people not to stay away from urgent NHS care.

New figures for England and Wales show an unexplained number of non-coronavirus deaths, some of which may be due to people avoiding hospitals because of coronavirus risks.

Sir Simon said: "These figures underline the seriousness of coronavirus - there are 19,000 coronavirus patients in hospitals in England.

"But we've also got capacity in the NHS to look after patients with urgent and emergency needs that aren't about coronavirus so our message is... our staff are here to look after you."

We're expecting the UK's daily news conference to start at 17:00 BST.

With Boris Johnson still recovering from coronavirus, it's being led by the Chancellor, Rishi Sunak.

He'll be joined by Prof Stephen Powis, NHS England's medical director, and Prof Yvonne Doyle, from Public Health England.

We'll be covering it all here.