Your questions about the management of the coronavirus outbreak answered 

"Countries that had an outbreak much worse than ours, such as South Korea, did not stop the testing and contact tracing. So why is our strategy different?"

"What was different about South Korea was that these were clusters of cases where the initial transmission was well understood, because they were in particular communities and actually it was quite regional. South Korea also did something that we have looked at carefully, which is that they used technology to contact trace. They were using people’s personal details, including their bank accounts.

We have looked at that, and SAGE looked at it and felt that it was not appropriate here. However, we are still looking at applications that might be able to give us some information about conveying between people precautionary information.

The other element of breaking transmission isn’t just contact tracing and isn’t contact tracing in this phase; it is about social distancing and shielding. All countries are involved with this, but we have particularly, as you know, taken that as an effective way of breaking transmission, which is the issue about contacts."

"If you have caught the COVID-19 coronavirus and you test positive for the antibodies, what evidence do we have that that actually provides immunity, and how long will that immunity last for? If we don’t know, what purpose are these antibody tests actually providing? "

"On what antibody testing tells us, it will tell us two things. It will tell us who is highly unlikely to transmit infection, which is important because it allows people to get back to some form of normality, including work.

It also tells us about what is going on in the population, in terms of zero prevalence. That is not the sole purpose of doing antibody testing, but a proportion of the testing will look at what is going on in the population so that we understand much better what this epidemic is doing."

"You said that you could pass on the virus when you are asymptomatic, for potentially up to five days. Does that mean that, today, NHS staff are likely to be passing on the virus to their patients? "

"People tend to most infectious at the beginning of this disease, particularly if they are severely unwell, and that does tail off. That is the issue about what happens between seven and 14 days; other important things do happen between seven and 14 days with those who are hospitalised.

So, the answer in theory is yes, and at the beginning, particularly when people are symptomatic at the beginning, they may be at their most infectious, but we are still learning."

"Could you give us your take, from the ADASS perspective, about whether that £1.6 billion will be enough?"

"I do not think it will be enough, but it is a good start.
It is already very clear that the costs involved in providers taking on agency staff and dealing with sickness, PPE and all of that, are likely to be 30% to 40% higher than the usual rate that we would pay. We are going to have to pay our way out of trouble on this issue, and I think we might have to come back for additional funding."

"We have to think about the entirety of the people who need social care, not just those who need to be discharged from hospital.  We know that we need to work with providers to ensure that they can access staff for all those purposes.

It is about not just the rate but the speed of payment—payments up front, payment on plan and so on. We need to take a whole range of measures to support providers. It is absolutely vital, but it is unfortunately not simple. Guidance is coming out very rapidly. There is guidance on discharge, guidance for commissioners, and I think guidance on fees is coming shortly."

"There was a commitment from Ministers to a target that the discharge of people from NHS hospitals into social care settings should make at least 15,000 hospital beds available by tomorrow. Do you get the sense from conversations or feedback that we are on track to get those 15,000 beds freed up, and if not, what more help do you need? "

"Yes, the discharge to assess process is very ambitious and it does talk about 15,000 beds. I can see that authorities up and down the country will be doing the maths and trying to identify where that capacity will come from. I think that the limiting factor on our success will be the PPE and the providers feeling assured that they can take people either into care homes or back home for home care. That is the first limiting factor.

The second, though, will be the workforce and plugging the gap.

Thirdly, the flow arrangements within our hospitals are still not perfect. We have removed all the bureaucracy, we have removed the funding question, and we have removed some of the legislative factors requiring an assessment, a continuing healthcare assessment or a financial assessment, but we still have this flow issue about identifying the people who are safe to discharge."

"I am interested in how we improve the morale of social care staff, because the staff who work in the social care system are at the frontline of the crisis and their morale is a key factor in ensuring the wellbeing of the people they provide for. "

"Absolutely; I could not agree more. Every time someone says, “Our NHS staff are doing an amazing job,” I can hear myself saying, “And social care. And social care.” I say to all of you, who are leaders and do quite a lot of media work, that just hearing that over the airwaves and seeing it in print and online, consistently, about the NHS and social care would make such a difference."