TRIGGERnometry - Coronavirus Expert：＂The NHS will be OVERWHELMED＂

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00:00:30.000 hello and welcome to trigonometry i'm francis foster i'm constant tim kissin and this is a

00:00:40.740 show for you if you want honest conversations with fascinating people our guest this week

00:00:46.400 unsurprisingly is a medical expert he's a global health researcher and an epidemiologist a word

00:00:53.040 that i find impossible to say dr michael head welcome to trigonometry thank you thank you

00:00:57.100 having me on thank you for coming to my home thanks for letting us in to spread our corona

00:01:01.380 if we have it um but uh epidemiologists i i managed to say it it's it's a profession that's

00:01:07.200 become a lot sexier these days isn't it yes no one had heard of us until about two or three

00:01:10.760 months ago and then suddenly we're in the news everywhere so our sexiness rating has gone from

00:01:14.720 zero to well maybe a little bit but it is there now absolutely nailing it on tinder well done

00:01:19.780 tell us what an epidemiologist is first of all because i assumed it was someone who studies

00:01:24.360 epidemics but actually it's just someone who studies disease yeah so the word epidemiology

00:01:27.980 epidemiology hard to say literally means the study of disease so you do have epidemiologists who study

00:01:33.680 non-infectious disease stuff so there's epidemiologists who do cancer and heart disease

00:01:38.600 stroke and all that sort of thing and then there's those of us like me who do infectious diseases

00:01:42.120 and suddenly we are sexy oh wow so you've become a celebrity now yes i mean in the last couple of

00:01:48.880 months, coronavirus has kicked off big time. Rarely in the past have I been in demand like

00:01:55.620 this. I've done the occasional bit in the media in the past. But when my press office first asked

00:02:00.580 me about this outbreak that's kicking off in China, they said, if the press come along,

00:02:04.900 do you want to comment? I said, yeah, fine, no worries. And then the press did come along and

00:02:09.160 actually asked me to comment. I thought, well, hang on, let's get Googling now, I guess, really,

00:02:12.380 hadn't I? Because no one knew anything about it. The people were asking us questions that we didn't

00:02:15.880 know the answers to so i think certainly initially our kind of collective responses to the media was

00:02:20.160 basically don't know really um let's try and find out things as we go along um but so yeah so we've

00:02:26.480 been in a large amount of demand over the last couple of months all right well let's get into

00:02:30.000 the reason why obviously this situation has come to the fore in a way that people didn't many people

00:02:35.840 didn't expect myself included francis has been banging on about it for months now i've been

00:02:40.300 banging on about it and in constantine's words don't worry about it it's just a bit of flu

00:02:45.140 that's what i thought i readily admit to but what i started to notice is all the people that i

00:02:50.260 follow on twitter scientists that we've had on the show in the past all of them were taking it

00:02:54.640 seriously and it was dickheads like me going oh it's just the flu so on balance i thought maybe

00:02:59.580 this is serious and obviously now it really is we're recording this on thursday probably go out

00:03:04.640 in a few days from now uh things that seem to be picking up so uh one of the things i wanted to

00:03:09.860 start with is how serious is it now and how serious is it likely to get? So where are we at

00:03:18.700 the moment? So it is proper serious. Often you see people like me being a bit more pragmatic,

00:03:24.500 sort of saying, well, it's not serious yet, that sort of thing. We are at the stage where

00:03:27.480 globally and the UK, it is serious. It's bad and it is quite scary. We now have at least 200,000

00:03:33.820 diagnosed cases around the world. There'll be many, many more times than that undiagnosed.

00:03:39.040 Focusing on the UK, you've seen all the graphs with various peaks on them that are constantly in the news.

00:03:45.180 We are basically at the start of that peak, or sorry, at the start of that graph, at the bottom end of it.

00:03:51.280 The peak is yet to come. That will be over the coming weeks or months.

00:03:54.540 And then hopefully, in a few months' time, at least the numbers will subside, if not the problem.

00:04:00.420 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.

00:04:05.600 So there's a lot of pain yet to come.

00:04:07.580 So we're at the very, very beginning of this.

00:04:09.940 Do you think that the government were reckless in their pursuit of herd immunity and saying,

00:04:15.220 well, the majority of people will get it and then they will create essentially a group of people who are immune to it

00:04:20.760 and then we can carry on as a society?

00:04:23.220 I think that was slightly poorly explained, but there's a theory behind it.

00:04:29.260 And the theory works, whether the practice does or not is another matter.

00:04:32.220 That when you get an infection, after most infections, you do have a bit of immunity left to it.

00:04:36.560 so if you have the flu you won't normally get that strain of flu again quickly if at all if you get

00:04:41.520 the common cold you almost never will get that strain again there's lots of different types of

00:04:45.300 common cold which is why we always get colds um so the theory here and there's a little bit of

00:04:50.840 evidence to back it up but we don't really know properly yet is that people will have some level

00:04:54.380 immunity we don't know how long for so if enough people do get it we don't want that to happen

00:05:00.240 clearly because that's a problem but if enough people do get it then that might have some

00:05:04.640 protective effect upon those who haven't got it yet but we don't know the answer to that and what

00:05:09.400 we do need is a test which is coming in probably a few weeks but not yet that will tell us if people

00:05:16.700 have had the disease so the tests at the moment are testing for the kind of the virus as you've

00:05:21.200 got it it tests for their for rna which is a bit like dna but their genetic code basically

00:05:26.160 so we can test accurately for that whether you've already had it you need to test for antibodies

00:05:32.760 essentially so various diagnostic firms in the uk and around the world are sort of frantically

00:05:37.140 racing each other to produce some really good quality tests to look at the people who have

00:05:42.240 already had the disease and then that can inform our sort of our strategies going forward if we

00:05:48.600 know that everyone's had it you can then send them back to work for example and things like that

00:05:52.220 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

00:05:56.960 point but that's a few weeks away and a few weeks in a pandemic is a very very long time indeed

00:06:01.440 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.

00:06:15.840 they think like a comedian friend of us posted saying they think it's a bank holiday for old

00:06:20.160 people this thing that's happening i don't think people are taking it seriously but going off the

00:06:24.860 government's figures if they're estimating up to 80 percent of the public are going to get this

00:06:29.520 disease and one percent which is seems to be pretty reasonable estimate will die from it

00:06:36.380 well if you do the math it's like half a million people minimum half a million people will die from

00:06:41.500 this and a lot of people you know we saw these videos from you know english fans football fans

00:06:48.560 or whatever in tenerife or whatever uh you know just go oh it's just a bit of flu mate just like

00:06:53.040 me just have a beer it's gonna be fine you know behaving like legends basically i'm not even sure

00:07:01.200 they were football fans they just looked like football fans anyway so my point is there are

00:07:04.900 people who are not taking it seriously when when we talk about it being serious how many people

00:07:08.800 are going to die from this well we don't know i think we can probably safely say it's going to be

00:07:12.740 thousands maybe tens of thousands that half a million figure and the 80 figure um that's the

00:07:18.520 kind of upper level estimates that's the worst case scenario so when we get modelers to calculate

00:07:25.220 to kind of try to predict the future which is obviously so uncertain something like this

00:07:29.460 they do have to calculate basically kind of the worst level scenarios so that people can

00:07:33.140 plan for that scenario if you put measures in place like all this social distancing and

00:07:38.300 shutting things down we should not get anywhere near that worst case scenario but it is still a

00:07:44.020 possibility there's just no guarantees people often say right how many people are going to die

00:07:48.140 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

00:07:55.240 half a million people dying but obviously there still will be plenty of excess deaths that was

00:07:59.460 not good and who are the people most at risk of this is it particularly the elderly is it the

00:08:04.700 people who are, for instance, having cancer treatments, chemotherapy? Are there a particular

00:08:09.360 set of people who are at risk? I mean, it is the most vulnerable people in society,

00:08:13.400 which includes the elderly. So the kind of the rough cutoff is 70 or above. And the older you

00:08:19.840 get, the bigger the risks are. I think if you're over 90, the death rates are about 20 or 25%.

00:08:24.440 It's pretty big. If you're between 70 and 90, again, it kind of goes up from 70 to 80

00:08:29.340 um and beyond um but it's many percent of people would die in that particular demographic

00:08:34.060 in terms of children and young adults the death rate is actually pretty low there still are some

00:08:39.640 complications people are still being admitted to hospital children and so on but overwhelming big

00:08:45.100 burden of disease the serious burden of disease is in the elderly it's in people like say who are

00:08:48.900 having cancer treatments um people with cystic fibrosis um and if you've got other comorbidities

00:08:56.980 as we call it. Basically, they've got other things already wrong with you, like hypertension,

00:09:01.020 diabetes, if you've had a stroke. To a certain extent, respiratory conditions like asthma or

00:09:06.940 chronic obstructive pulmonary disorder, COPD, they're all risk factors that increase the chances

00:09:13.060 of if you get COVID, if you get the coronavirus, then you're likely to be a bit more ill than

00:09:18.800 people who are younger and haven't got comorbidities. What about lifestyle stuff like

00:09:23.620 being overweight smoking uh you know stuff like that yeah so smoking is certainly linked to um

00:09:31.560 increased risk of being hospitalized that's the kind of often metric we use as to how serious it

00:09:37.040 is do you need to go to hospital that's the kind of kind of benchmark for a serious case often

00:09:41.500 definitely very little bit but you can kind of use that as a benchmark so you're more likely to

00:09:45.580 be hospitalized if you're a smoker i mean if you are obese and overweight you're more likely to

00:09:49.080 have things like diabetes and so on so that would then contribute to a risk factor that would

00:09:53.440 elevates the likelihood of seriousness in your particular case. It's all risk factors. It doesn't

00:09:58.120 mean it's going to happen, but it increases the chances of a worse case. I'm going to use a lot

00:10:05.540 of this interview to explode some myths, because as we're all on social media, we've seen a lot

00:10:11.200 of people saying certain things and people getting quite worried about it. They were saying

00:10:16.320 there was a link between anti-inflammatories and exacerbating the condition. Is this true? Is this

00:10:22.120 not true or do we simply not know just for people who may not know anti-inflammatories being things

00:10:27.080 like ibuprofen and so right so that probably is true that one we don't know um so the link first

00:10:34.060 came from i think it's the french health minister who first stated it and then a few doctors have

00:10:38.300 um given a few sort of pragmatic viewpoints that it probably is the case that paracetamol is a

00:10:44.380 better painkiller i think that the latest guidance as i say this right now um is that if you are

00:10:51.000 have been told by your doctor to take things like ibuprofen then carry on doing so but maybe have a

00:10:56.080 word with them just to see what the latest score is and if you do have symptoms of the coronavirus

00:11:00.860 try and take paracetamol rather than ibuprofen i'm on quite strong ibuprofen myself at the

00:11:07.300 minute i've got a slightly dodgy hip so i'm on these anti-inflammatories so i'm watching that

00:11:10.840 one with great interest and it's interesting you said that and also as well i really want to focus

00:11:17.900 on this because I find it deeply worrying. You know, people just going, oh, I'm just living my

00:11:22.600 life normally, blah, blah, blah. Like, for instance, if I'm young, I'll be fine. What effect

00:11:28.120 does that actually have? And are you putting people at serious risk if you essentially go

00:11:33.140 and live your life like you used to last month or three weeks ago? You are putting people at risk

00:11:38.740 because you might be fine, but that they're in is not the problem here. The population at large,

00:11:44.020 and if you want to personalise it, your elderly relatives might be fine. So if you live your life

00:11:49.460 as normal and mix a lot and have lots of contact with other people, if you then take a coronavirus

00:11:55.840 into your grandmother's house, for example, then there might be problems afoot because that's a

00:12:01.000 vulnerable person you're affecting right there. So we do all have a big responsibility to actually

00:12:06.300 just behave a little bit and follow the public health guidance. The kind of measures have been

00:12:11.860 put in place to reduce the amount that we mix with each other and large gatherings and things

00:12:16.100 like that there is a point to it um and it is to kind of reduce those big peaks and just to make

00:12:21.280 the whole country a bit more a slightly easier place to live in and we all have a responsibility

00:12:25.840 to contribute to that so there you go trigonometry we're being irresponsible by having this face to

00:12:30.880 face so you don't have to and also i don't get to see my mother excellent thank you for that

00:12:35.500 actually i would say that i think the current guidance suggests that gatherings of more than

00:12:39.380 10 are early advised and there's currently three of us in front of the camera there's somebody

00:12:42.860 behind the camera four we're fine we're fine we don't have symptoms do we i don't think anybody

00:12:47.200 no i actually have a feeling i might have had it already because like three or four weeks ago i had

00:12:51.980 a dry cough and a bit of a fever i mean that could easily have been the coronavirus and again

00:12:56.800 in many people you may be superhuman no in a very precise way thank you very much shut up

00:13:03.240 I am superhuman.

00:13:05.440 No, I like to say only the good die young.

00:13:08.680 Anyway, so that's the point.

00:13:11.400 So, for instance, in February the 14th,

00:13:13.580 I remember it because it was Valentine's weekend

00:13:15.720 and my girlfriend was very angry,

00:13:17.540 but I had, I developed a fever and a cough.

00:13:20.380 How likely is it that people have already had this

00:13:23.360 like last month in February

00:13:25.120 or did it only really appear in March and so on?

00:13:29.460 I mean, it was around in February.

00:13:30.700 There were far fewer cases.

00:13:31.860 so it's actually less likely that you have had coronavirus the thing is january february march

00:13:37.200 it's flu season northern hemisphere there's flu and coughs and colds everywhere so that's also

00:13:42.080 been a bit of a problem because hospitals and doctor surgeries are handling flu cases and

00:13:46.780 slightly more and other respiratory infections as well along with this brand new thing that's

00:13:50.660 been thrown into the mix one of the reasons why it's better to try to deal with these things over

00:13:57.900 the summer is that there's fewer things like that out there's fewer cases of flu out there

00:14:01.600 so if people are getting these symptoms now from now on it's more likely to be coronavirus because

00:14:06.680 there's less flu around so that makes the kind of diagnosis and case management that bit easier

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00:14:28.560 And another question I really want clarified is,

00:14:32.840 if somebody who is young, fit and healthy gets it,

00:14:35.640 what are they likely to experience in terms of symptoms

00:14:38.160 and what impact is it likely to have on them?

00:14:40.720 Because again, people have been sharing all sorts of nonsense articles

00:14:43.640 on Facebook and Twitter and so on.

00:14:45.780 I mean, most people, I mean, roughly 80% of people who get it

00:14:48.960 are not fine, but it's very low-level symptoms.

00:14:52.520 it's the equivalent you feel about as grotty as you do when you get a normal cold for example

00:14:56.380 but obviously the key as has been emphasized repeatedly by the chief medical officer is

00:15:02.040 it's kind of it's not about you as a relatively young healthy person who's kind of all right

00:15:06.140 it's about protecting the people around you who are potentially not going to be right if they get

00:15:09.380 it um and it's also about protecting the health system from a large swamping of cases where

00:15:15.360 people who need access to icu beds or ventilators whatever don't there's not enough of those things

00:15:21.460 to go around if everyone gets the disease at the same time yeah so I mean if there's gonna be a lot

00:15:25.380 of people with a fever and a cough at the minute as we go forward even more they need to hang

00:15:30.580 around at home and self-isolate so that the health facilities gps and hospitals are freer than they

00:15:36.960 otherwise would have been so they can concentrate on the proper serious stuff and you were saying

00:15:41.000 that we're at the start of the process what does that mean can you guide us through what you think

00:15:48.640 the government are going to do and the modelers are going to advise the government to do well i

00:15:53.440 think we've probably got a clear strategy in place for the next few weeks which will be schools

00:15:57.360 closed to kind of keep your distance from everyone to protect the elderly so there's kind of fewer

00:16:01.720 visits to granny and that sort of thing the kind of advice that's out there as i speak right now

00:16:05.320 is probably the sort of advice we're going to have with us for at least a few weeks i suspect that

00:16:10.280 will probably probably look at that again i mean we looked at again all the time but then we might

00:16:15.600 see significant changes maybe around may or so as we start to hit the peak yeah hopefully by then

00:16:22.840 we'll be somewhere nearer the peak um and things like we might see for example schools opening up

00:16:28.480 again for a short period of time um because closing schools is a big step yeah it's got

00:16:32.900 such an impact upon everyone else it has the potential to take frontline health workers out

00:16:37.840 the way it means parents can't go to work and can't earn money so there's all these kind of

00:16:41.680 secondary consequences from the relatively simple act of closing schools but it then gets complicated

00:16:46.740 and obviously we to some extent need to live our lives at least a little bit and also compliance

00:16:53.040 with these public health guidelines we've talked a little bit about lack of compliance that we've

00:16:56.580 seen it is likely very likely that compliance will get less as we go through as people get a

00:17:02.000 little bit fed up with it and get a bit of if you'll excuse the phrase cabin fever from being

00:17:05.860 at home the whole time so i think it's been mentioned that we'll might have this course

00:17:10.200 so-called switching on and off of these big interventions so we might switch off school

00:17:14.180 closures and open them up again for a bit a few weeks maybe so we might just to give parents a

00:17:20.140 bit of a relief basically i mean i have two kids myself so i'll be delighted when schools

00:17:23.500 back up again um but so for example i've no idea if this will happen but a guess on my part might

00:17:29.860 be that around the may half term with that kind of second half of that term we might see the schools

00:17:33.720 open up until july um and then you've got the six week summer holiday break there's kind of a natural

00:17:39.600 time when schools are closed anyway. So that sort of switch on and off. That's the sort of thing we

00:17:43.840 might see going forward. So you don't think that actually things are going to get stricter and

00:17:49.200 harsher in the weeks to come? You don't expect a lockdown where everyone just has to stay at home

00:17:55.580 and you get to go out for an hour a day to walk the dog and buy some food? I mean, that might

00:17:59.920 happen. My sense is it won't, but it does depend a little bit on whether, again, whether the

00:18:04.280 population are applying at the moment in the uk we've kind of done this guidance for the public

00:18:09.760 rather than in other scenarios in other countries where it has been locked down you are staying at

00:18:13.700 home like we've seen for example in china and some other countries they're big on human rights

00:18:17.960 anyway china's quite big on telling its population what to do yeah so i think on the whole the

00:18:26.180 slightly more if you want to call it softly approach of guiding people rather than telling

00:18:30.940 people is certainly in the short term better so i actually i do hope we don't need to have these

00:18:36.040 kind of legally enforced lockdowns they could happen but we shall see so from what you're saying

00:18:41.620 basically what i'm hearing is this is going to be with us until autumn at the very least right is

00:18:47.260 that fair to say i think it's fair to say yeah and what about the second peak idea where uh

00:18:53.560 essentially what like with the spanish flu there was the first peak and then actually there was a

00:18:59.040 lull and then it came back do you think we may see that with this is it too early to tell

00:19:04.480 well it's too early to tell but we might do so with flu most seasons actually even with seasonal

00:19:09.120 flu you normally get peaks that vary according to in the case of flu according to when schools

00:19:15.720 shut for school holidays and so on so when they shut over christmas a couple of weeks flu cases

00:19:19.280 drop because normally children that are spreading it on the whole little fuckers that word yes

00:19:24.420 and as a former teacher i hardly concur with constantine the only time that's happened on

00:19:31.880 our show sorry carry on no worries my wife is a teacher if she was here she may well contribute

00:19:35.580 to this particular conversation in a similar fashion i expect but i won't speak for her

00:19:38.920 yeah but so in flu they often they are the key transmitters um with coronavirus although children

00:19:43.440 do seem to be getting it they don't they're not obviously the kind of the the center of it they're

00:19:47.700 not the kind of conduits that really spread but so we do see those peaks though in flu seasons

00:19:52.840 anyway and like you say with spanish flu there was clear peaks with coronavirus could easily

00:19:59.000 see a peak we might find the peak that's coming in a few weeks if we can get out the other side

00:20:04.420 of that and have much lower cases the problem might then come in the winter when everything's

00:20:10.800 back flu's back common colds are back and coronavirus might increase as well and so we

00:20:16.860 might have to see a fair amount of again switching on of those interventions switching on of the

00:20:21.780 social distancing and so on in the winter um it's a trickier time to live in the winter

00:20:26.600 um particularly for the vulnerable people even more so at that point so comedians

00:20:31.420 are you a vulnerable are you kind of a dangerous species or vulnerable these days oh there's no

00:20:36.820 comedy shows anymore no right now so we are vulnerable just through the hunger that we

00:20:41.340 experience uh but to be fair i need to lose weight so yes you do mate uh absolutely but um so this

00:20:48.260 is going to be with us for quite some time and in terms of this the potential for it to make a

00:20:52.840 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

00:21:07.000 vaccine rocks up in 12 months will it don't know there's lots and lots of vaccine candidates being

00:21:14.300 looked at but because we are pretty much starting from the beginning there's been a bit of research

00:21:18.660 looking at other coronaviruses down the years now the common cold one of the causes of that is a

00:21:23.460 coronavirus oh really yeah yeah there's several different types of coronaviruses some of which

00:21:27.500 are seen in animals and not not so far been seen in humans the common cold is a coronavirus you've

00:21:32.860 heard of SARS of course from years back MERS Middle Eastern Respiratory Syndrome um camels

00:21:38.120 right camels exactly yeah a bit racist at times anyway you know when I went to Egypt someone

00:21:43.380 offered me 130 camels for my wife did they yeah did they have a virus i don't know 130 camels mate

00:21:51.120 you'd be richer and happier anyway with the camels uh but yeah so there's lots of different

00:21:55.280 coronaviruses of which the common cold is one of the causes one of the main causes of common

00:21:58.760 i just like the word it's the rhino virus oh really yeah um so so the coronavirus causes

00:22:04.420 the common cold i've actually lost the point of what the question originally the question was are

00:22:07.780 we going to get a vaccine anytime soon so yeah so there has been lots of research on the common

00:22:11.400 cold including vaccine stuff fairly recently and back in the day and with SARS and MERS and just

00:22:19.760 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.

00:23:29.560 I'll give you a gold star afterwards.

00:23:32.540 But funding follows the kind of public health emergencies

00:23:37.200 or the public health concerns

00:23:38.640 rather than being in advance.

00:23:39.880 And there's something

00:23:40.160 we've been very bad at

00:23:40.980 in the global health community

00:23:41.700 is looking at problems in advance,

00:23:44.540 doing a better kind of forecasting

00:23:45.720 and trying to work things out more so.

00:23:47.920 We've started to get a bit better,

00:23:49.260 but we've seen here

00:23:49.920 that we're nearly good enough.

00:23:51.840 So I still haven't answered the question.

00:23:53.940 Coronavirus vaccines,

00:23:55.360 the first phase one trial,

00:23:58.880 that's the first time

00:23:59.520 we chuck a vaccine into a human being

00:24:00.860 to see what happens to it.

00:24:01.840 That's just started in America.

00:24:03.920 Over the next few weeks,

00:24:04.820 we'll probably see a few more

00:24:05.720 vaccine candidates trialed

00:24:06.880 in a similar fashion, but we are way behind the curve.

00:24:09.800 So it'll be minimum of 12 months, I reckon,

00:24:12.480 before we have even a half-decent vaccine.

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.

00:24:21.120 Process of refinement.

00:24:22.040 So it might help that there's lots and lots of competing vaccines

00:24:26.100 and who will hopefully all share data,

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.

00:24:34.280 but we'll be exceptionally lucky and fortunate

00:24:37.680 to have a cracking vaccine in 12 months' time.

00:24:39.860 I expect it to probably be longer than that.

00:24:41.540 A vaccine might be better than nothing,

00:24:43.200 but it might not be the kind of holy grail that cures everything.

00:24:45.820 It might give you cancer.

00:24:47.300 Thanks, mate. Keep it light.

00:24:50.080 Michael, what is the chance that this could mutate

00:24:53.300 into an even more serious strain,

00:24:55.980 which proves even more deadly for us?

00:24:58.440 See, viruses mutate all the time anyway,

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?

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

00:28:29.320 going to use this word again. It's bollocks.

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

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

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

00:29:33.940 conspiracy theories,

00:29:34.800 don't they?

00:29:35.560 Especially in times of panic

00:29:36.560 because people are desperate

00:29:37.380 for information.

00:29:38.500 They don't trust

00:29:39.440 a lot of people.

00:29:41.320 They don't trust Boris Johnson

00:29:42.400 and telling them things.

00:29:43.660 And I understand that.

00:29:45.200 I don't like Boris Johnson either.

00:29:47.340 Where I think Boris Johnson

00:29:48.480 has actually done quite well

00:29:49.560 so far in this

00:29:50.400 is he's not said

00:29:51.260 very much at all.

00:29:52.340 He's basically pointed

00:29:53.040 at the scientists

00:29:53.580 either side of him

00:29:54.320 and basically said,

00:29:55.300 right, you answer those questions.

00:29:56.820 So when you have

00:29:57.100 the press conferences

00:29:57.620 with him,

00:29:58.620 the chief scientific advisor,

00:29:59.840 the chief medical officer,

00:30:00.780 who are both brilliant,

00:30:02.040 chief medical officer,

00:30:02.800 Chris Whitty,

00:30:03.200 His background is infectious diseases.

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.

00:30:21.120 He can handle those questions.

00:30:22.160 That's what he's designed to do.

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.

00:30:33.120 We need to hear from those people.

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,

00:30:40.140 there's still a lot of distrust about that.

00:30:42.720 And conspiracy theories crop up.

00:30:45.840 So someone I know emailed me the other day.

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

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

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

00:34:41.500 he's actually taking a respirator to go and see his parents.

00:34:44.220 A full-on respirator? Or just a mask?

00:34:46.300 No, no, no, a full-on respirator.

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,

00:35:04.860 they might not be around for a while?

00:35:08.300 We're going to see excess death in the elderly from this.

00:35:11.940 So some people are going to lose relatives

00:35:14.120 that they otherwise wouldn't have lost

00:35:15.160 if this pandemic hadn't occurred.

00:35:19.200 To make it slightly cheerier,

00:35:21.680 the death rates in the over 70s is kind of,

00:35:23.800 depending on how old they are,

00:35:25.340 the kind of various kind of 5, 10, 20% sort of number.

00:35:27.340 So actually most people aren't dying of it.

00:35:30.040 But obviously many people still are dying.

00:35:32.440 I mean, I'm in epidemiology,

00:35:33.660 so I look at numbers on the spreadsheet quite a lot.

00:35:35.340 It's kind of, it's depersonalised.

00:35:36.500 It's just a mortality rate.

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,

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

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.

00:40:12.080 We know who gets on and off a plane.

00:40:14.760 We can track where they go.

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.

00:40:24.140 So you don't quite know.

00:40:25.520 You can kind of do some content tracing.

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

00:44:06.320 and then it kind of grows exponentially.

00:44:08.660 It kind of needs a lot of factors to come together,

00:44:10.320 but we've seen that it's possible

00:44:12.160 that kind of mechanism does work

00:44:13.540 and sometimes works frighteningly well.

00:44:15.840 With those food markets,

00:44:17.020 I did see one newspaper article a few weeks back

00:44:19.540 saying that China had now banned them.

00:44:21.480 I didn't see any follow-up on that

00:44:23.100 and I didn't see that claim more widely.

00:44:25.560 So I don't know if that's the case,

00:44:27.100 but I think certainly I think Chinese

00:44:28.240 will need to look very closely at those food markets

00:44:30.200 and try and work out,

00:44:32.020 do they need to be eating all these random animals?

00:44:34.920 Some of them are endangered.

00:44:35.740 I think pangolins are probably endangered.

00:44:38.080 Probably high in China anyway.

00:44:39.520 Well, yes, they have a very dangerous life in China.

00:44:42.220 But there's not many of them around the world,

00:44:43.680 so whether that kind of importation of sort of fun and funky animals

00:44:48.120 needs to happen anyway.

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.

00:45:00.940 Yeah, indeed.

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

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.

00:48:35.640 It will be. We just know it will.

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.

00:48:44.300 if there are a vast number of cases there.

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?

00:49:02.540 I mean, all the evidence we have,

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.

00:49:29.620 I mean, almost certainly, yeah.

00:49:31.600 And that's pretty clear that we can expect that.

00:49:34.180 Hopefully it won't happen.

00:49:35.860 But that is what we expect to happen in two or three months' time.

00:49:40.380 Well, I think this is really important

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

00:51:01.980 and I develop symptoms tomorrow.

00:51:03.460 I'm probably infectious now.

00:51:05.500 Oh, yeah.

00:51:05.820 You've been infectious for days

00:51:07.060 if you had symptoms tomorrow, right?

00:51:09.480 I've probably been infectious

00:51:10.440 one or two days, I reckon.

00:51:12.740 The amount that you can spread the virus

00:51:14.220 before you show symptoms,

00:51:15.680 most respiratory infections

00:51:17.140 is a day or two beforehand.

00:51:18.500 It's not usually a long period of time.

00:51:20.360 Right.

00:51:20.980 The incubation period

00:51:22.200 for when you get exposed

00:51:23.400 to when you show symptoms,

00:51:24.880 that's usually most people

00:51:26.100 is about five days.

00:51:27.300 So I think the infectious period,

00:51:29.460 which is the time

00:51:30.060 when you can spread the virus

00:51:30.900 before you show symptoms,

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

00:52:48.100 that's sat in that hospital bed

00:52:49.400 who hasn't got the equipment they need

00:52:50.920 because, in part,

00:52:53.600 we weren't very good

00:52:54.260 with our social distancing compliance.

00:52:56.820 So that effectively means

00:52:58.320 that the doctor looks at two patients,

00:53:01.040 they've got a respirator,

00:53:02.100 and they go,

00:53:02.460 well, this one's over 75,

00:53:03.900 this one's 65,

00:53:05.280 this one stands a 20% chance more of making it,

00:53:08.820 I'm going to give the respirator to them,

00:53:10.680 and unfortunately that patient

00:53:12.720 is left to their own devices almost.

00:53:15.080 I mean, they'll be treated as best they can,

00:53:16.980 But if you've not got enough bits of equipment to go around, then you do have to work out

00:53:20.380 who to give it to.

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

00:53:37.140 what's wrong with the children.

00:53:38.440 There's 50 of them in the hospital.

00:53:40.000 Which two am I picking?

00:53:41.780 That's what happens in Ghana and country of the other every single day.

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

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?

00:55:38.820 Spreading fake news.

00:55:41.000 I'm on Twitter.

00:55:42.220 Michael G Head is my Twitter handle.

00:55:44.700 I'm not really on many other social medias, so Twitter's probably the key.

00:55:46.960 Not TikTok?

00:55:48.980 Not yet.

00:55:49.820 Maybe if I've got more time in any kind of lockdown situation,

00:55:52.460 maybe I'll be on board and do a few videos.

00:55:53.980 But for now, that's where I am.

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.

00:56:01.080 See you next week, guys.

00:56:04.880 We'll be right back.

TRIGGERnometry - March 21, 2020

Coronavirus Expert：＂The NHS will be OVERWHELMED＂

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