Coronavirus Expert： ＂The NHS will be OVERWHELMED＂
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Summary
Dr. Michael Head is a global health researcher and epidemiologist, and a word that we find impossible to say: epidemiologist. In this episode, he tells us about the coronavirus outbreak that has swept across the globe in recent months, and why we should all be worried about it.
Transcript
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hello and welcome to trigonometry i'm francis foster i'm constant tim kissin and this is a
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show for you if you want honest conversations with fascinating people our guest this week
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unsurprisingly is a medical expert he's a global health researcher and an epidemiologist a word
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that i find impossible to say dr michael head welcome to trigonometry thank you thank you
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having me on thank you for coming to my home thanks for letting us in to spread our corona
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if we have it um but uh epidemiologists i i managed to say it it's it's a profession that's
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become a lot sexier these days isn't it yes no one had heard of us until about two or three
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months ago and then suddenly we're in the news everywhere so our sexiness rating has gone from
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zero to well maybe a little bit but it is there now absolutely nailing it on tinder well done
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tell us what an epidemiologist is first of all because i assumed it was someone who studies
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epidemics but actually it's just someone who studies disease yeah so the word epidemiology
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epidemiology hard to say literally means the study of disease so you do have epidemiologists who study
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non-infectious disease stuff so there's epidemiologists who do cancer and heart disease
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stroke and all that sort of thing and then there's those of us like me who do infectious diseases
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and suddenly we are sexy oh wow so you've become a celebrity now yes i mean in the last couple of
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months, coronavirus has kicked off big time. Rarely in the past have I been in demand like
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this. I've done the occasional bit in the media in the past. But when my press office first asked
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me about this outbreak that's kicking off in China, they said, if the press come along,
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do you want to comment? I said, yeah, fine, no worries. And then the press did come along and
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actually asked me to comment. I thought, well, hang on, let's get Googling now, I guess, really,
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hadn't I? Because no one knew anything about it. The people were asking us questions that we didn't
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know the answers to so i think certainly initially our kind of collective responses to the media was
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basically don't know really um let's try and find out things as we go along um but so yeah so we've
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been in a large amount of demand over the last couple of months all right well let's get into
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the reason why obviously this situation has come to the fore in a way that people didn't many people
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didn't expect myself included francis has been banging on about it for months now i've been
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banging on about it and in constantine's words don't worry about it it's just a bit of flu
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that's what i thought i readily admit to but what i started to notice is all the people that i
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follow on twitter scientists that we've had on the show in the past all of them were taking it
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seriously and it was dickheads like me going oh it's just the flu so on balance i thought maybe
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this is serious and obviously now it really is we're recording this on thursday probably go out
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in a few days from now uh things that seem to be picking up so uh one of the things i wanted to
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start with is how serious is it now and how serious is it likely to get? So where are we at
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the moment? So it is proper serious. Often you see people like me being a bit more pragmatic,
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sort of saying, well, it's not serious yet, that sort of thing. We are at the stage where
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globally and the UK, it is serious. It's bad and it is quite scary. We now have at least 200,000
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diagnosed cases around the world. There'll be many, many more times than that undiagnosed.
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Focusing on the UK, you've seen all the graphs with various peaks on them that are constantly in the news.
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We are basically at the start of that peak, or sorry, at the start of that graph, at the bottom end of it.
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The peak is yet to come. That will be over the coming weeks or months.
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And then hopefully, in a few months' time, at least the numbers will subside, if not the problem.
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But even to get to the point where we've reached the top and it's starting to come down again, that's still a long way off.
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Do you think that the government were reckless in their pursuit of herd immunity and saying,
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well, the majority of people will get it and then they will create essentially a group of people who are immune to it
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I think that was slightly poorly explained, but there's a theory behind it.
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And the theory works, whether the practice does or not is another matter.
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That when you get an infection, after most infections, you do have a bit of immunity left to it.
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so if you have the flu you won't normally get that strain of flu again quickly if at all if you get
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the common cold you almost never will get that strain again there's lots of different types of
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common cold which is why we always get colds um so the theory here and there's a little bit of
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evidence to back it up but we don't really know properly yet is that people will have some level
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immunity we don't know how long for so if enough people do get it we don't want that to happen
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clearly because that's a problem but if enough people do get it then that might have some
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protective effect upon those who haven't got it yet but we don't know the answer to that and what
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we do need is a test which is coming in probably a few weeks but not yet that will tell us if people
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have had the disease so the tests at the moment are testing for the kind of the virus as you've
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got it it tests for their for rna which is a bit like dna but their genetic code basically
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so we can test accurately for that whether you've already had it you need to test for antibodies
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essentially so various diagnostic firms in the uk and around the world are sort of frantically
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racing each other to produce some really good quality tests to look at the people who have
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already had the disease and then that can inform our sort of our strategies going forward if we
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know that everyone's had it you can then send them back to work for example and things like that
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so it would be a bit of a game changer if if and as well we do have it we will have it at some
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point but that's a few weeks away and a few weeks in a pandemic is a very very long time indeed
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Yeah. Well, actually, this is one of the things, one of the reasons I wanted to get into how serious it is, because, you know, my wife went into town to do some shopping yesterday and she was saying, I don't think people are getting the message because particularly older people, they're still out and about.
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they think like a comedian friend of us posted saying they think it's a bank holiday for old
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people this thing that's happening i don't think people are taking it seriously but going off the
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government's figures if they're estimating up to 80 percent of the public are going to get this
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disease and one percent which is seems to be pretty reasonable estimate will die from it
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well if you do the math it's like half a million people minimum half a million people will die from
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this and a lot of people you know we saw these videos from you know english fans football fans
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or whatever in tenerife or whatever uh you know just go oh it's just a bit of flu mate just like
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me just have a beer it's gonna be fine you know behaving like legends basically i'm not even sure
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they were football fans they just looked like football fans anyway so my point is there are
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people who are not taking it seriously when when we talk about it being serious how many people
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are going to die from this well we don't know i think we can probably safely say it's going to be
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thousands maybe tens of thousands that half a million figure and the 80 figure um that's the
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kind of upper level estimates that's the worst case scenario so when we get modelers to calculate
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to kind of try to predict the future which is obviously so uncertain something like this
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they do have to calculate basically kind of the worst level scenarios so that people can
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plan for that scenario if you put measures in place like all this social distancing and
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shutting things down we should not get anywhere near that worst case scenario but it is still a
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possibility there's just no guarantees people often say right how many people are going to die
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how bad is it going to be don't know is the short answer but i don't think we will get that 80 and
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half a million people dying but obviously there still will be plenty of excess deaths that was
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not good and who are the people most at risk of this is it particularly the elderly is it the
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people who are, for instance, having cancer treatments, chemotherapy? Are there a particular
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set of people who are at risk? I mean, it is the most vulnerable people in society,
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which includes the elderly. So the kind of the rough cutoff is 70 or above. And the older you
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get, the bigger the risks are. I think if you're over 90, the death rates are about 20 or 25%.
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It's pretty big. If you're between 70 and 90, again, it kind of goes up from 70 to 80
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um and beyond um but it's many percent of people would die in that particular demographic
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in terms of children and young adults the death rate is actually pretty low there still are some
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complications people are still being admitted to hospital children and so on but overwhelming big
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burden of disease the serious burden of disease is in the elderly it's in people like say who are
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having cancer treatments um people with cystic fibrosis um and if you've got other comorbidities
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as we call it. Basically, they've got other things already wrong with you, like hypertension,
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diabetes, if you've had a stroke. To a certain extent, respiratory conditions like asthma or
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chronic obstructive pulmonary disorder, COPD, they're all risk factors that increase the chances
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of if you get COVID, if you get the coronavirus, then you're likely to be a bit more ill than
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people who are younger and haven't got comorbidities. What about lifestyle stuff like
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being overweight smoking uh you know stuff like that yeah so smoking is certainly linked to um
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increased risk of being hospitalized that's the kind of often metric we use as to how serious it
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is do you need to go to hospital that's the kind of kind of benchmark for a serious case often
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definitely very little bit but you can kind of use that as a benchmark so you're more likely to
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be hospitalized if you're a smoker i mean if you are obese and overweight you're more likely to
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have things like diabetes and so on so that would then contribute to a risk factor that would
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elevates the likelihood of seriousness in your particular case. It's all risk factors. It doesn't
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mean it's going to happen, but it increases the chances of a worse case. I'm going to use a lot
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of this interview to explode some myths, because as we're all on social media, we've seen a lot
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of people saying certain things and people getting quite worried about it. They were saying
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there was a link between anti-inflammatories and exacerbating the condition. Is this true? Is this
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not true or do we simply not know just for people who may not know anti-inflammatories being things
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like ibuprofen and so right so that probably is true that one we don't know um so the link first
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came from i think it's the french health minister who first stated it and then a few doctors have
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um given a few sort of pragmatic viewpoints that it probably is the case that paracetamol is a
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better painkiller i think that the latest guidance as i say this right now um is that if you are
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have been told by your doctor to take things like ibuprofen then carry on doing so but maybe have a
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word with them just to see what the latest score is and if you do have symptoms of the coronavirus
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try and take paracetamol rather than ibuprofen i'm on quite strong ibuprofen myself at the
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minute i've got a slightly dodgy hip so i'm on these anti-inflammatories so i'm watching that
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one with great interest and it's interesting you said that and also as well i really want to focus
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on this because I find it deeply worrying. You know, people just going, oh, I'm just living my
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life normally, blah, blah, blah. Like, for instance, if I'm young, I'll be fine. What effect
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does that actually have? And are you putting people at serious risk if you essentially go
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and live your life like you used to last month or three weeks ago? You are putting people at risk
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because you might be fine, but that they're in is not the problem here. The population at large,
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and if you want to personalise it, your elderly relatives might be fine. So if you live your life
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as normal and mix a lot and have lots of contact with other people, if you then take a coronavirus
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into your grandmother's house, for example, then there might be problems afoot because that's a
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vulnerable person you're affecting right there. So we do all have a big responsibility to actually
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just behave a little bit and follow the public health guidance. The kind of measures have been
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put in place to reduce the amount that we mix with each other and large gatherings and things
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like that there is a point to it um and it is to kind of reduce those big peaks and just to make
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the whole country a bit more a slightly easier place to live in and we all have a responsibility
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to contribute to that so there you go trigonometry we're being irresponsible by having this face to
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face so you don't have to and also i don't get to see my mother excellent thank you for that
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actually i would say that i think the current guidance suggests that gatherings of more than
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10 are early advised and there's currently three of us in front of the camera there's somebody
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behind the camera four we're fine we're fine we don't have symptoms do we i don't think anybody
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no i actually have a feeling i might have had it already because like three or four weeks ago i had
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a dry cough and a bit of a fever i mean that could easily have been the coronavirus and again
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in many people you may be superhuman no in a very precise way thank you very much shut up
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I remember it because it was Valentine's weekend
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How likely is it that people have already had this
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or did it only really appear in March and so on?
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so it's actually less likely that you have had coronavirus the thing is january february march
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it's flu season northern hemisphere there's flu and coughs and colds everywhere so that's also
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been a bit of a problem because hospitals and doctor surgeries are handling flu cases and
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slightly more and other respiratory infections as well along with this brand new thing that's
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been thrown into the mix one of the reasons why it's better to try to deal with these things over
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the summer is that there's fewer things like that out there's fewer cases of flu out there
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so if people are getting these symptoms now from now on it's more likely to be coronavirus because
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there's less flu around so that makes the kind of diagnosis and case management that bit easier
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And another question I really want clarified is,
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if somebody who is young, fit and healthy gets it,
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what are they likely to experience in terms of symptoms
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Because again, people have been sharing all sorts of nonsense articles
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I mean, most people, I mean, roughly 80% of people who get it
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are not fine, but it's very low-level symptoms.
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it's the equivalent you feel about as grotty as you do when you get a normal cold for example
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but obviously the key as has been emphasized repeatedly by the chief medical officer is
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it's kind of it's not about you as a relatively young healthy person who's kind of all right
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it's about protecting the people around you who are potentially not going to be right if they get
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it um and it's also about protecting the health system from a large swamping of cases where
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people who need access to icu beds or ventilators whatever don't there's not enough of those things
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to go around if everyone gets the disease at the same time yeah so I mean if there's gonna be a lot
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of people with a fever and a cough at the minute as we go forward even more they need to hang
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around at home and self-isolate so that the health facilities gps and hospitals are freer than they
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otherwise would have been so they can concentrate on the proper serious stuff and you were saying
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that we're at the start of the process what does that mean can you guide us through what you think
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the government are going to do and the modelers are going to advise the government to do well i
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think we've probably got a clear strategy in place for the next few weeks which will be schools
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closed to kind of keep your distance from everyone to protect the elderly so there's kind of fewer
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visits to granny and that sort of thing the kind of advice that's out there as i speak right now
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is probably the sort of advice we're going to have with us for at least a few weeks i suspect that
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will probably probably look at that again i mean we looked at again all the time but then we might
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see significant changes maybe around may or so as we start to hit the peak yeah hopefully by then
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we'll be somewhere nearer the peak um and things like we might see for example schools opening up
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again for a short period of time um because closing schools is a big step yeah it's got
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such an impact upon everyone else it has the potential to take frontline health workers out
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the way it means parents can't go to work and can't earn money so there's all these kind of
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secondary consequences from the relatively simple act of closing schools but it then gets complicated
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and obviously we to some extent need to live our lives at least a little bit and also compliance
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with these public health guidelines we've talked a little bit about lack of compliance that we've
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seen it is likely very likely that compliance will get less as we go through as people get a
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little bit fed up with it and get a bit of if you'll excuse the phrase cabin fever from being
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at home the whole time so i think it's been mentioned that we'll might have this course
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so-called switching on and off of these big interventions so we might switch off school
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closures and open them up again for a bit a few weeks maybe so we might just to give parents a
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bit of a relief basically i mean i have two kids myself so i'll be delighted when schools
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back up again um but so for example i've no idea if this will happen but a guess on my part might
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be that around the may half term with that kind of second half of that term we might see the schools
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open up until july um and then you've got the six week summer holiday break there's kind of a natural
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time when schools are closed anyway. So that sort of switch on and off. That's the sort of thing we
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might see going forward. So you don't think that actually things are going to get stricter and
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harsher in the weeks to come? You don't expect a lockdown where everyone just has to stay at home
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and you get to go out for an hour a day to walk the dog and buy some food? I mean, that might
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happen. My sense is it won't, but it does depend a little bit on whether, again, whether the
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population are applying at the moment in the uk we've kind of done this guidance for the public
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rather than in other scenarios in other countries where it has been locked down you are staying at
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home like we've seen for example in china and some other countries they're big on human rights
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anyway china's quite big on telling its population what to do yeah so i think on the whole the
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slightly more if you want to call it softly approach of guiding people rather than telling
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people is certainly in the short term better so i actually i do hope we don't need to have these
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kind of legally enforced lockdowns they could happen but we shall see so from what you're saying
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basically what i'm hearing is this is going to be with us until autumn at the very least right is
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that fair to say i think it's fair to say yeah and what about the second peak idea where uh
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essentially what like with the spanish flu there was the first peak and then actually there was a
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lull and then it came back do you think we may see that with this is it too early to tell
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well it's too early to tell but we might do so with flu most seasons actually even with seasonal
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flu you normally get peaks that vary according to in the case of flu according to when schools
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shut for school holidays and so on so when they shut over christmas a couple of weeks flu cases
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drop because normally children that are spreading it on the whole little fuckers that word yes
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and as a former teacher i hardly concur with constantine the only time that's happened on
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our show sorry carry on no worries my wife is a teacher if she was here she may well contribute
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to this particular conversation in a similar fashion i expect but i won't speak for her
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yeah but so in flu they often they are the key transmitters um with coronavirus although children
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do seem to be getting it they don't they're not obviously the kind of the the center of it they're
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not the kind of conduits that really spread but so we do see those peaks though in flu seasons
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anyway and like you say with spanish flu there was clear peaks with coronavirus could easily
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see a peak we might find the peak that's coming in a few weeks if we can get out the other side
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of that and have much lower cases the problem might then come in the winter when everything's
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back flu's back common colds are back and coronavirus might increase as well and so we
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might have to see a fair amount of again switching on of those interventions switching on of the
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social distancing and so on in the winter um it's a trickier time to live in the winter
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um particularly for the vulnerable people even more so at that point so comedians
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are you a vulnerable are you kind of a dangerous species or vulnerable these days oh there's no
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comedy shows anymore no right now so we are vulnerable just through the hunger that we
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experience uh but to be fair i need to lose weight so yes you do mate uh absolutely but um so this
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is going to be with us for quite some time and in terms of this the potential for it to make a
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comeback on an immune level are we going to be better prepared for it coming back to be confirmed
00:21:00.260
again we don't know yeah if this herd immunity theory takes hold might not be too bad if a
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vaccine rocks up in 12 months will it don't know there's lots and lots of vaccine candidates being
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looked at but because we are pretty much starting from the beginning there's been a bit of research
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looking at other coronaviruses down the years now the common cold one of the causes of that is a
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coronavirus oh really yeah yeah there's several different types of coronaviruses some of which
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are seen in animals and not not so far been seen in humans the common cold is a coronavirus you've
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heard of SARS of course from years back MERS Middle Eastern Respiratory Syndrome um camels
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right camels exactly yeah a bit racist at times anyway you know when I went to Egypt someone
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offered me 130 camels for my wife did they yeah did they have a virus i don't know 130 camels mate
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you'd be richer and happier anyway with the camels uh but yeah so there's lots of different
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coronaviruses of which the common cold is one of the causes one of the main causes of common
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i just like the word it's the rhino virus oh really yeah um so so the coronavirus causes
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the common cold i've actually lost the point of what the question originally the question was are
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we going to get a vaccine anytime soon so yeah so there has been lots of research on the common
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cold including vaccine stuff fairly recently and back in the day and with SARS and MERS and just
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coronavirus generally there's been a bit of laboratory stuff going on to kind of prod and
00:22:24.040
poke the virus and look at the immune response in a in a laboratory setting um we've but it's
00:22:29.120
not really got anywhere and it's not really been a focus and actually I would argue going forward
00:22:34.920
and it should have been already that viruses with pandemic potential I mean new we've had warning
00:22:40.300
shots with SARS and things like that, that coronavirus is potentially that, we should
00:22:43.800
have done tons more in the what we call inter-pandemic period, between scary times, with research
00:22:50.180
and development, looking at things like vaccines and therapeutics and diagnostics and all those
00:22:55.120
other sorts of things. But we haven't done. So we've been playing catch-ups with Ebola
00:23:00.620
when that was a big outbreak of West Africa. A lot of work's been done since. But one of
00:23:05.280
the other things I do actually for research is looking at how research money is spent.
00:23:09.160
So we've got this big global database of how about $100 billion of research money
00:23:14.640
has been spent around the world over the last 20 years on infectious diseases.
00:23:17.700
And we've looked at things like coronavirus and Ebola and flu.
00:23:21.400
And if you want to, look at mad cow's disease. Remember that from years back?
00:23:24.800
But that's not a virus. That's a prion, isn't it?
00:23:26.660
That's a prion. It's a protein. Very good knowledge there. I'm impressed.
00:23:32.540
But funding follows the kind of public health emergencies
00:24:06.880
in a similar fashion, but we are way behind the curve.
00:24:15.260
The first vaccines you see are often not necessarily the best ones.
00:24:19.140
Because it's a process of refinement, I imagine.
00:24:22.040
So it might help that there's lots and lots of competing vaccines
00:24:28.580
so you can kind of just process all that information
00:24:32.420
in a bit more real-time than you would normally.
00:24:43.200
but it might not be the kind of holy grail that cures everything.
00:24:50.080
Michael, what is the chance that this could mutate
00:25:01.160
and they very rarely mutate into a more serious strain and generally speaking what you see
00:25:06.900
actually is when a virus hangs around a human long enough it kind of adapts to its host it's
00:25:11.980
not good for the virus if it kills everyone it sees instantly because then it can't be spread
00:25:16.660
the chain stops so something like flu is quite good it doesn't kill that many people but it's
00:25:22.860
it kind of is easy to spread measles as well um that's the kind of most successful kind of virus
00:25:29.140
is one that makes you ill enough to spread it but doesn't kind of knock you out altogether
00:25:33.740
so mutations of viruses don't necessarily mean bad they mutate all the time anyway most mutations
00:25:38.640
mean nothing um and whilst it theoretically could get worse and be more difficult to treat or so on
00:25:44.820
actually it's more likely to get slightly more mild if anything but we don't know what will
00:25:51.200
happen that that's all to be confirmed it's such a new virus it's only jumped into human three
00:25:54.600
months ago. Whereas measles and flu, we've had for hundreds and thousands of years. So we know a bit
00:26:00.240
more about how they evolve and so on. But you can expect probably the coronavirus to behave in a
00:26:04.820
similar fashion. And what do you say to those people who go, this is a man-made virus, it was
00:26:10.520
made in the laboratories of Wuhan, how convenient, they have this massive laboratory, and all of a
00:26:16.520
sudden it started there, and the Chinese are using it to dominate the world?
1.00
00:26:22.000
See, there was a paper published, as I speak, just yesterday in, I think it was in Nature,
00:26:26.980
one of the big scientific journals, that pointed out that this is, I'm going to swear, actually,
00:26:31.640
this is bollocks, this kind of man-made theory. And they pretty much, they don't use that swear
00:26:36.300
word, but they pretty much say exactly that. Basically, dear conspiracy theorists, please
00:26:39.460
stop it. So they can show the genetic lineage of it and exactly how it's evolved and show
00:26:44.760
that it's not a man-made virus. It's probably almost only come from bats as the first originator.
00:26:49.860
bats host viruses so well and they don't have symptoms many of our sort of potential future
00:26:54.620
threats are hanging around the bats right now there was probably an intermediate you've got
00:26:58.460
to be careful this could initiate a whole swathe of racist attacks against bats i think i think
00:27:05.060
people um i think i can say people should steer clear of bats including eating them which has
00:27:10.940
been the problem in china the fact that bats are on the menu and in these weirdly kind of big
00:27:16.240
markets with you've seen the sort of the menus in chinese of everything they've got on the menu
00:27:19.880
and people translated it and there's pangolins this kind of cute little animal that's on the
00:27:24.760
menu there um they basically chuck all these animals in a in this market together um and then
00:27:30.480
they um they eat them all so there's kind of the potential for transfer of genetic material
00:27:36.720
viruses on between the animals and then the humans are eating it and also humans are preparing it so
00:27:40.520
they're kind of slaughtering and getting covered in blood and so on so that's probably where the
00:27:44.900
virus started in bats probably by an intermediate host and a pangolin is one of the theories we
00:27:50.160
don't quite know that yet but this paper kind of refutes the man-made theory and also that point
00:27:54.900
about there's a lab in wuhan that's the only level four lab in china level four is the kind
00:28:01.380
of highest level of pathogen ebola and things like that that's how it's kind of level one to
00:28:05.060
four so common cold level one ebola is level four everything else is in the middle i don't know if
00:28:10.120
it's still the only level four one in China, but there is one in Wuhan. The way that conspiracy
00:28:15.300
theory falls down, in my view, is that coronavirus is not a level four pathogen. It's in level
00:28:20.740
two labs or level three labs at best. So the level four thing is completely irrelevant
00:28:24.380
because you don't need a level four lab to deal with it or research it. So again, I'm
00:28:31.140
But also, I mean, our regular viewers will find this funny, but a relative of mine used
00:28:37.100
to work on the soviet bioweapons program because i'm from russia originally okay and i spoke to him
00:28:41.880
edging slowly away well we did have to drive past salisbury to get there actually brought back great
00:28:48.260
memories for constantin yes that spire is still looking good but um he was saying look if you
00:28:53.960
were developing a biological weapon this is like the worst biological weapon in history because
00:28:59.020
what you want with a biological weapon is you want to kill healthy young men uh who are the enemy army
0.97
00:29:05.840
and you want to do it quickly you don't want to have a week-long incubation period when they
00:29:10.220
don't even have any symptoms and you want to have a lethality rate over one percent
00:29:14.520
significantly over one percent so it certainly wasn't you know the idea that it's designed as
00:29:19.700
a biological it's much like the virus was made in china no quality yeah and breaks down after six
0.91
00:29:25.840
months yeah um yeah so i i do agree i think it's ridiculous uh but people do like the the
00:30:04.980
He's the perfect man for this situation right now.
00:30:08.420
But in the press conference, you kind of see Boris answering questions on a subject he knows nothing about, nor should he.
00:30:14.380
He's a politician who's kind of used to handling questions about whether Priti Patel bullied people in the ministry or whatever.
00:30:23.380
To answer questions on public health and epidemiology, you can see him panicking slightly whenever he's speaking about it.
00:30:29.540
But he does at least refer to the people either side of him, which is good.
00:30:35.240
But obviously, when it's still framed as the government is telling us to stay indoors and not go to the pub,
00:30:49.760
I've had so many inquiries from people I've not spoken to in years.
00:30:54.320
They're saying, remember me, I've got a question for you.
00:30:56.320
And one of the questions I had was, there's a conspiracy theory going around that if you blast yourself in the face with a hair dryer,
00:31:00.940
the heat would kill the virus um that sounds brilliant yeah look hold on can i just as a
00:31:06.980
as a layman can i have a theory that the temperature you would need to do that would
00:31:11.620
be so hot you would burn your face off i suspect there might be secondary consequences before you
00:31:15.940
got as far as a virus yeah the thing is that's we haven't researched we haven't done a clinical
00:31:20.180
trial on blasting yourself in the face with a hairdryer so we haven't tested this we can't
00:31:24.720
sort of say we can say no that's nonsense but then if somebody says prove it we can't prove
00:31:29.900
we can say look it's nonsense you'll also have to go and take that theory further and say right
00:31:34.760
all the world's infectious disease experts all of them none of them reckon you can cure it by
0.84
00:31:41.260
blasting yourself in the face with a hairdryer but you like crackpot conspiracy theorist person
00:31:47.100
over there you reckon you can so that the video i got sent of it was by someone who just happened
00:31:51.500
to have a few books to sell by someone who is i can't remember their name otherwise i would have
00:31:55.200
said it um but they wrote a book called something like cure the common cold it's quite an old book
00:32:00.220
so whoever that person is they're not a doctor they're not a medical researcher they have no
00:32:04.380
background effects diseases but they do think you can cure coronavirus blasting yourself in the face
00:32:07.900
of the hairdryer um and by the way here's a few books i've written in the past um so again the
00:32:12.860
conspiracy theorists rock up with their things to sell and a theory that it doesn't have to be
00:32:17.900
accurate and that's clearly so silly it doesn't have to be an accurate theory it just has to catch
00:32:22.360
people's attention and be circulated for it to kind of achieve its goal and there's just so much
00:32:27.840
of that out there there's a lot of scam potential in times of scariness some of the one thing i'm
00:32:35.720
concerned about with this kind of community spirit that's building which is great there'll be a lot
00:32:40.440
of very well-meaning actions that will have consequences that no one had really thought of
00:32:44.460
and that probably will include a few um unscrupulous types doing kind of you know
00:32:50.620
supermarket runs for old people whilst nicking a few of their valuables while they're back to
1.00
00:32:54.840
turn. There will be a bit of that happening. You can just guarantee it. So those secondary
00:33:00.260
consequences of it are also important. We have to work it out as we go along, how much
00:33:06.580
community action groups, how much good will come out of them compared to how much negative
00:33:12.440
will come out of them. Hopefully, it'll be a net positive. But we do need to think a
00:33:15.520
little bit about, again, the vulnerable people in the society who we are trying to help and
00:33:19.200
So a few, a very small number of unscrupulous types will try to very much not help.
00:33:24.140
Well, the law of unintended consequences is so important here because you were talking earlier about shutting schools.
00:33:29.280
You get these people, you know, P.S. Morgan and others screaming on Twitter, oh, you've got to do this, you've got to do that.
00:33:35.500
And, you know, there's so many unintended consequences to many of these issues.
00:33:40.620
I mean, you know, shutting down schools, the point you made is nurses, doctors have children.
00:33:45.560
If they have to stay at home with the children, they can't work.
00:33:47.920
also children then end up with grandparents potentially spreading the virus to vulnerable
00:33:52.980
people so although teachers mental health will skyrocket not being around children so no one
00:33:58.020
cares about so we it's i mean we've got to be sensible about this and the other point of course
00:34:05.440
is you start shutting things down that has a huge economic impact the economy tanks that kills
00:34:10.100
people too you know so there's got to be a balanced response to this we can't just shut
00:34:14.680
everything down and and just focus on that alone can we no so the economic consequences will be
00:34:19.580
huge of this um and the social consequences some of which we just touched on but again
00:34:25.280
elderly people not being visited by the relatives anymore or not as much as they were that's a
00:34:29.580
problem for them because they rely on that kind of social contact um to kind of enjoy their day
00:34:34.860
go get a respirator and go and see your mother that's ironically what a friend of mine has done
0.97
00:34:41.500
he's actually taking a respirator to go and see his parents.
00:34:48.380
But can you console these people who are looking at their elderly relatives
00:34:53.580
and think, oh, they're going to die and all the rest of it?
00:34:56.540
Is that hyperbole or should we prepare ourselves for the fact that actually
00:35:00.540
these people we've had in our lives for so long, our grandparents, our great-uncles,
00:35:08.300
We're going to see excess death in the elderly from this.
00:35:25.340
the kind of various kind of 5, 10, 20% sort of number.
00:35:33.660
so I look at numbers on the spreadsheet quite a lot.
00:35:37.500
but then if I kind of think back to my own family and think about my elderly relatives I've got one
00:35:43.200
relative who's over 90 and I'm sort of thinking if she gets it big problems potentially in terms
00:35:47.900
of her health and she's in relatively good health for someone in their 90s very stubborn and very
00:35:53.060
cheerful so the kind of withdrawal of social contact for her in particular because she is a
00:35:56.560
very sociable person still is a tricky thing and I don't quite know how to handle that for the best
00:36:01.740
to be honest. In the same way that I do worry if she and other older relatives, particularly those
00:36:07.780
who've got existing K-morbidities, as we've discussed, if they get it, again, it's more
00:36:11.720
likely to be serious. So I can number crunch during the day and then at home I come at night
00:36:16.320
and I do worry. I think about these things. And I don't know what the answer is on that particular
00:36:21.440
point. And touching and going to the situation in Italy, is that why the situation in Italy is so
00:36:26.620
bad because they have a very high percentage, I think something like 23% of people aged 60 or
00:36:32.140
over, or is there something very specific happening in Italy? Because at the moment,
00:36:36.960
people are going, look what's happening in Italy, this is going to be happening here.
00:36:40.980
So we probably think that our, at least numbers of cases, those kind of peaks and curves on the
00:36:45.640
graphs will follow something similar to Italy. We are a few weeks behind, so that's an advantage,
0.90
00:36:49.960
that we can kind of watch what other countries are doing and plan a little bit accordingly.
00:36:53.560
So I think our early case detection and contact tracing, which is basically when you find out a
00:36:59.180
case, you kind of ask who have you met, who have you been in a room with, that sort of thing.
00:37:02.060
That did slow the progress of the virus in this country, which has been very helpful to buy us
1.00
00:37:06.320
time just to work out a bit better what to do. The high mortality rate in Italy, I don't actually
00:37:12.200
quite know precisely why it's much higher there or a lot higher than in the main countries.
00:37:17.200
i think that demographic profile of italy and england is not too different i think they do have
00:37:23.340
more older people as a proportion of their population than we do but i don't quite know
00:37:28.760
precisely why it's either probably as a range of factors that each contribute a bit it might be
00:37:32.540
that there's more older people it might be that the health services weren't quite so prepared
00:37:36.860
as us in the uk i don't know if that's true i'm just hypothesizing it might be true there's also
00:37:40.660
more kissing yeah they're a bit more they're more tactile more affectionate people and families are
00:37:45.720
closing it together in different generations yeah so i mean those are all really valid points and
00:37:49.760
actually the behavioral science of this is firstly tricky secondly i think massively underrated
00:37:57.160
people like me who are number crunchers we kind of look at the numbers and then there's a model
00:38:01.140
who come along to predict numbers throwing in the behavioral side of things is so important
00:38:06.220
it's why you can't obviously say italy or somewhere else is doing lockdowns why aren't
00:38:11.700
be doing that here. It might be we should be doing that here. But we know from previous studies
00:38:17.340
in times of, for example, during the 2009 swine flu pandemic, that there were analyses done looking
00:38:23.160
at the behavioural factors across different countries. And we know that people in different
00:38:27.820
countries respond in different ways. There's different levels of compliance. When it comes
00:38:32.040
to washing your hands, people wash their hands in a sentimental way. But when it came to
00:38:35.300
restricting your contact patterns, your social distancing, that was massively variable across
00:38:41.520
countries so again a country like italy which is very very like you said lots of kissing lots of
00:38:46.340
hugging lots of intergenerational living if that's the right phrase those are different factors that
00:38:51.960
will apply into modeling in italy that isn't so relevant here the weighting should be a bit
00:38:58.220
different so i'm always a little bit cautious of saying the government's doing the wrong thing
00:39:01.400
particularly when it is clearly backed by some of the leading scientists they're seeing data
00:39:06.260
that we haven't seen i think we should see it there should be more transparency about what
00:39:10.480
evidence they're using to make decisions. But as I speak, we haven't seen it. They have.
00:39:16.520
They've got an idea of what the evidence says and of the local context. So we can learn lessons
00:39:21.240
from Italy, but we shouldn't necessarily replicate Italy because it's not the same situation here.
00:39:25.120
We're all at different stages of the outbreak as well. So there will be different interventions
00:39:28.400
at different times. That's fair enough, I think. And London is fair to say that it seems to be
00:39:34.240
ahead of the kerb, if you will. Why is that? Just if you could break that down as to why. Is it the
00:39:39.560
fact that people are going on the tube a lot? Is it buses? What is it about being in London?
00:39:44.740
Or is it the fact that a lot of people rent and live together?
00:39:47.200
It's a high density of population, which is one key factor. In rural areas, population
00:39:53.200
density is much lower. And the fact that in London, you are often cramming more people
00:39:58.900
into a small space, for example, on public transport. Public transport is an interesting
00:40:02.720
one. We know that international travel is a big conduit for spread of effects, diseases.
00:40:07.160
That's kind of fairly obvious in a way, but we also have the evidence to prove it because we can track people.
00:40:16.160
And if they become a case in a new country, then you see exactly where it's come from.
00:40:20.460
With buses and trains, you've no idea who's on the train.
00:40:26.720
You can say, well, I was on the Piccadilly live for 20 minutes this morning.
00:40:29.480
But you're in a cram space for a fairly short period of time.
00:40:33.020
and you also don't quite know if you pick up a virus you've done lots of there's been lots of
00:40:42.280
other contacts during the day as well so there's lots of opportunities for contacts in london that
00:40:47.420
you don't have in a rural area for example but it's also hard to pin down where you picked up
00:40:52.940
your infection from it could be any one of those contacts it could be the door handle as you left
00:40:56.700
the train it could be on the train it could be in the office it could have been in the pub in the
00:41:00.440
evening. It could have been on the pint glass you touched that someone else had used beforehand that
00:41:04.300
hadn't been properly cleaned, all those sorts of things. So it makes the epidemiology of things
00:41:09.660
so fascinating, but often hard to disentangle. But the higher population density is the big one,
00:41:14.980
and that makes a lot of sense. And that kind of leads me into the question that I wanted to ask
00:41:19.080
you is, in the world that we live in now, the globalized, interconnected, everyone traveling
00:41:24.720
everywhere world, is this going to keep happening with all kinds of different things? Because we've
00:41:30.040
seen it you know you mentioned SARS and MERS those those didn't explode to the level that this is
00:41:36.100
likely to to go to but are we gonna you know continue to see this kind of thing happening
00:41:40.680
it's easier now for outbreaks to happen for easier for pandemics happen pandemics just don't happen
00:41:47.960
very often but we know that always will be a next time so certainly when this is said and done
00:41:53.300
whenever that be, we need to learn lessons and properly prepare globally. There's health
00:42:01.240
systems in the poorer parts of the world that if they do get a lot of pandemic cases in their
00:42:06.300
country, they're not going to be able to cope. The Ebola decimated parts of West Africa that
00:42:10.700
they've not recovered from now. So globalisation includes the spread of infectious diseases, but
00:42:18.340
also in sub-Saharan Africa, wherever you go, there's a can of Coke. These things, which then
00:42:25.700
leads to things like tooth decay and obesity and cardiovascular disease. So even non-infectious
00:42:31.040
diseases do spread because of globalisation and increased connectivity. Obviously, it's great
00:42:37.560
that we can travel to all parts of the world and we've got the internet that can connect everyone.
00:42:41.680
the downsides is that as sometimes as infectious diseases generally decline clearly not right now
00:42:49.120
with this one but on the whole infectious diseases in most parts of the world are going down
00:42:52.400
we're seeing non-communicable diseases like diabetes hypertension cancer go up and i see in
00:42:59.540
part also because there's increasingly aging populations so whereas in the poorer parts of
00:43:04.180
africa let's say the life expectancy even 10 20 years ago might have been 40 now it might be 60 or
00:43:09.240
so. So those age-related conditions kick in, plus also the fact that you might see a fast food
00:43:14.620
brunch or a can of Coke almost anywhere in different parts of the world. So it brings new
00:43:20.420
health challenges to everyone, including infectious diseases and including things that have pandemic
00:43:26.200
potential. Well, one of the things also shows, isn't it, that we are as weak as our weakest link
00:43:31.820
in a sense as a global society of people. So if there's a wet market in China where you've got
00:43:38.160
these different animals all you know bleeding all over each other as they're being slaughtered
00:43:42.380
and whatever even close interaction with humans we can't just like be okay that's no nothing to
00:43:48.180
do with us because that then leads to what we're having now which is thousands of people dying all
00:43:53.920
over the world yeah so occasionally there'll be that perfect storm where the animal is slaughtered
00:43:58.960
that happens to be infectious in the context of another animal which then absorbs the infection
00:44:02.200
and it sort of it then meets the human meets the human and the human is able to spread it and
00:44:08.660
It kind of needs a lot of factors to come together,
00:44:17.020
I did see one newspaper article a few weeks back
00:44:28.240
will need to look very closely at those food markets
00:44:32.020
do they need to be eating all these random animals?
00:44:39.520
Well, yes, they have a very dangerous life in China.
1.00
00:44:43.680
so whether that kind of importation of sort of fun and funky animals
00:44:49.960
But, I mean, food markets are kind of embedded in Chinese culture,
00:44:52.920
so it's hard just to say to someone, you're not doing that anymore.
00:44:56.040
But also they have a huge population and lots of mouse to feed.
00:44:59.000
They're doing everything they can to try and feed them.
00:45:02.060
I don't know to what extent pangolins might be feeding many people
00:45:04.740
under the food crisis but i'll tell you the point obviously they need to feed their populations
00:45:09.300
and they have different diets to us and that's obviously fair enough but we saw again it's
00:45:14.880
back to the behavioral side of things can you shut down these these food markets without much
00:45:19.740
of consequence if the chinese government says to the population we're doing it actually well
00:45:23.580
you probably can in other cultures it's harder so with here's an example from bird flu 2005 or
00:45:30.060
thereabouts there was a lot of concern that it would get into africa and spread there with such
00:45:35.940
poor health systems that's a really big problem in i think it was nigeria there were some cases
00:45:42.700
in chickens which was the kind of the host of bird flu as your bird flu is around today affects a few
00:45:48.740
people in southeast asia affects birds a lot some birds are fine and can fly around and therein
00:45:53.040
there's a problem they then infect other birds who who suffer so it still happens but your full
00:45:57.920
great outdoors comedy festival lineup is here on september 11th through 13th at arendale park
00:46:03.920
three nights five shows huge laughs september 11th through 13th buy tickets now at great
00:46:10.600
outdoors comedy festival.com a few chickens in a nigerian village got infected and the kind of
00:46:17.740
the ministry came along and said right we'll take those thank you very much and on the way out they
00:46:21.160
said well we'll give you compensation but that's no good to the village because that's their food
00:46:24.940
in the next few days right there so the village followed them at a discrete distance the ministry
00:46:29.780
people basically went a few miles up the road and buried them the village waited till they'd gone
00:46:33.960
and then dug them up and ate them so clearly public health wise you shouldn't be doing that
00:46:40.380
but these are people who have one source of food and that's their chickens and they've been promised
00:46:45.120
money but they don't trust the government and they may well not get it therefore you see why
00:46:49.440
they've done it but and we saw with the bowler as well that a lot of the problems are kind of with
00:46:54.120
bodily fluids. So if you're touching a dead body, which happens a lot in Africa, there's
00:46:57.700
some kind of part of their burial process. It's very intimate. It's not like in the UK
00:47:01.300
where they're in a box and you don't see them. You do have the bodies open, you touch them
00:47:04.240
a lot. And there was spread of Ebola quite significantly from touching dead bodies. And
00:47:10.820
with Ebola around, there were more dead bodies to touch. So it was a problem. And we in the
00:47:17.080
kind of Western world, the global North, as is often the phrase now, handle it quite
00:47:20.940
badly by basically running into Africa saying, stop that. And the population said, no, these are
0.77
00:47:26.380
our embedded cultures. What do you know about us? My dad's just died. Leave me alone. Again,
00:47:32.260
you understand that kind of response. So again, I'll come back to the point, I think social science
00:47:37.600
and anthropology and behavioural sciences, it's so underrated. We do take the mickey out of them
00:47:42.780
a little bit, particularly us number crunchers. We look down on the social sciences and we so
00:47:45.960
shouldn't, because they are probably more valuable than us, I think, in these kind of
00:47:49.800
average situations. And do you think if it gets into, for instance, South America, like you said,
00:47:54.780
or parts of Africa, where the health system isn't what it should be, and the networks aren't strong
00:48:01.860
enough, that it could decimate a population? No, I mean, there are already some cases,
00:48:07.080
for example, in Africa. There's quite a few in Egypt. But other countries are reporting, anyway,
00:48:12.580
a few very low numbers of cases. There will probably be a lot more than what they've got.
00:48:16.200
And the problem is, I do research in Ghana and West Africa,
00:48:19.360
and also started links with colleagues in Togo, which borders Ghana.
00:48:22.820
And I was in both countries just a few weeks ago.
00:48:25.620
And you see the health services and health systems, and there's no spare capacity.
00:48:30.200
The NHS has a limited amount of capacity that will be overwhelmed at some point in the coming months.
00:48:37.320
In Africa, most countries have no capacity at all.
00:48:40.840
So there is the potential that it could get very, very scary for their populations.
00:48:49.380
Hold on, you say the NHS will be overwhelmed, we know that.
00:48:53.180
Isn't the whole part of the government's strategy
00:48:55.640
to flatten the peak so that we never get to that point?
00:49:00.180
Are you saying it's inevitable they will be overwhelmed?
00:49:03.600
including the recent modelling papers that came out of Imperial College,
00:49:05.600
says that yes, the NHS will be overwhelmed at some point.
00:49:08.080
And the chief medical officer has said that in his press conferences as well.
00:49:11.140
So the kind of these interventions to try to reduce these big peaks
00:49:13.980
The peak is still going to go above NHS capacity.
00:49:17.580
So what you're saying is within weeks or maybe months,
00:49:21.300
we will be in the position where Italian doctors are now,
00:49:24.380
where they're having to basically triage who they give life-saving support to.
00:49:31.600
And that's pretty clear that we can expect that.
00:49:35.860
But that is what we expect to happen in two or three months' time.
00:49:41.980
because when we talk about people not complying with the government's advice and all this kind
00:49:46.100
of thing, that's what we're talking about, right? That's the end product of that behaviour.
00:49:51.580
Yeah. So social distancing is a key part of this. And it's something that we all have to do. We all
00:49:57.300
contribute to. So if there is low compliance with these kind of measures that we put in place,
00:50:04.340
and then the NHS is even more overwhelmed than it could have been, actually, that's our fault
00:50:08.640
to some extent so before we wrap up the interview then just tell us uh wash our hands right but
00:50:14.080
this virus is is mainly spread through just breathing the same air as other people isn't it
00:50:18.480
so it's a respiratory one so it kind of goes out in aerosols but you touch surfaces and so on where
00:50:23.980
the virus is so washing your hands it's so unsexy and dull but it's so important anyway or we should
00:50:31.020
be washing our hands thoroughly many times a day let me ask the question a different way
00:50:35.460
if you had it now would we get it potentially you would be defined you two and behind the camera
00:50:43.940
there you'd be defined as contacts of mine so a contact was defined as something like
00:50:48.300
within two meters for 15 minutes or more so if you sat at a restaurant next to someone who's
00:50:53.440
two meters away then that's a contact we've been sat in that kind of proximity so there would
00:50:58.300
certainly there'd be a reasonable chance that you would have it so actually if i have got it
00:51:31.980
It's a slightly different definition. That's probably one to two days.
00:51:35.460
Can I just say I'm offended I am that you've referred to him as my contact. Anyway,
00:51:39.700
but there we go. But there's one question I really want to dig down on, which was that you
00:51:45.400
said the NHS would be overwhelmed. And I think people are not really taking on board what that
00:51:51.420
means. Can you explain in clear detail what does it mean when the NHS or health system is
00:51:57.500
overwhelmed what does that look like in real world figures data situations i can't provide the figures
00:52:04.920
or the data on it because it's kind of a hypothetical probably will happen scenario but
00:52:08.300
what it means is there won't be enough beds in hospital there won't be enough doctors and nurses
00:52:12.680
and someone to treat you there won't be enough bits of equipment like respirators and ventilators
00:52:17.200
we've heard a lot about that over the last few weeks um so i mean like you say with doctors in
00:52:23.060
they're having to triage their patients to try to work out who to treat who to give the ventilators
00:52:28.740
to at the moment if someone needs a ventilator they can have it on the whole because there's
00:52:35.140
enough capacity in the health service when we get overwhelmed there won't be enough ventilators
00:52:38.960
so it could get very very tricky at that point so again it's down to all of us to lessen the
00:52:44.600
impact of that because that could be our grandmother or mother or relative or someone
00:53:05.280
this one stands a 20% chance more of making it,
00:53:16.980
But if you've not got enough bits of equipment to go around, then you do have to work out
00:53:21.300
And again, to kind of get back to Ghana, I want to speak to people in the hospitals there
00:53:24.480
and they say, we've got loads of children with pneumonia here.
00:53:28.360
I've got a very limited amount of capacity to test what bug they've got.
00:53:32.580
I've got maybe two tubes a day, two blood tests I can take a day to kind of work out
00:53:41.780
That's what happens in Ghana and country of the other every single day.
1.00
00:53:44.420
to a lesser extent but still important extent here our medics are going to be facing those
00:53:49.980
sorts of questions it's not going to be fun it doesn't sound like fun at all which is why we
00:53:55.360
wanted to talk to you because i think it's important that this information gets out there
00:53:58.720
as much as we can help with that but thank you very much for taking the time and having us in
00:54:04.160
your home and not infecting us hopefully we'll reserve judgment on that let's come back to me
00:54:10.080
in a few days time we'll kind of compare notes we'll find out if we're still alive in a few days
00:54:13.600
but um the last we only have one more question for you and the last question we always ask is
00:54:18.720
and and in this case in this particular context what is the one thing that no one is talking
00:54:23.680
about that we ought to be talking about do you know i'm going to say the word scabies
00:54:29.680
you weren't expecting that were you no no now scabies is one of my most fascinating bugs i
00:54:35.580
do research on including in ghana um it's a mite so it's a bit like a head lice um that is literally
00:54:42.180
everywhere it causes itchness rashes it's really unpleasant it doesn't kill many people um she
00:54:47.740
certainly won't have heard much about scabies in the last few weeks because everyone's talking
00:54:50.080
about the stuff that does kill people which is fair enough but scabies is kind of these one of
00:54:53.400
under thought about conditions that is rife around the world we have it we did a study in the uk
00:54:59.360
looking at scabies in care homes um where there's plenty of it and it infects people with dementia
00:55:04.580
more than people without dementia so it infects the most vulnerable people and so on so forth
00:55:08.100
there's about 400 million cases or so of scabies every single year around the world it's vast it's
00:55:14.660
unpleasant it's hard to get rid of it's badly diagnosed there's a lot of stigma attached to it
00:55:19.180
we should talk more about scabies when we start talking about coronavirus do that first but then
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00:55:23.180
secondary scabies and who thought epidermis just weren't sexy there you go well michael thank you
00:55:30.200
so much for taking the time it's great chatting with you and uh are you on social media by the
00:55:34.880
Where are you sharing information, putting anything out there for people to follow?
00:55:44.700
I'm not really on many other social medias, so Twitter's probably the key.
00:55:49.820
Maybe if I've got more time in any kind of lockdown situation,
00:55:54.880
So go follow Michael, and we'll see you very soon
00:55:58.020
if we're all still here with another brilliant episode.