＂Lockdown Was an Overreaction＂ - Professor Karol Sikora
Episode Stats
Length
1 hour and 3 minutes
Words per Minute
174.88066
Summary
In this episode of Trigonometry, we talk to Professor Carl Sakura, a Consultant oncologist and Professor of Medicine at the University of Buckingham, about the impact of the coronavirus lockdown, and how the lockdown is affecting the economy.
Transcript
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Broadway's smash hit, The Neil Diamond Musical, A Beautiful Noise, is coming to Toronto.
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The true story of a kid from Brooklyn destined for something more, featuring all the songs you love,
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including America, Forever in Blue Jeans, and Sweet Caroline.
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Like Jersey Boys and Beautiful, the next musical mega hit is here, The Neil Diamond Musical, A Beautiful Noise.
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April 28th through June 7th, 2026, The Princess of Wales Theatre.
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hello and welcome to trigonometry i'm francis foster i'm constantin kissy and this is a show
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for you if you want honest conversations with fascinating people our fantastic guest today
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is a consultant oncologist and a professor of medicine at the university of buckingham
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professor carl sakura welcome to trigonometry thank you very much it's a great pleasure to
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have you here. COVID-19 has obviously been a huge factor in the life of this country and in fact
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the world in the last few months. Before we get into that, tell everybody a little bit about who
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are you, what's been your background, how are you here today? So I'm an oncologist, someone that
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treats cancer with chemotherapy and radiotherapy and did medicine, went straight into academic
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medicine, oncology, and went to the States for a couple of years at Stanford. Fantastic experience
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in the States. Came back here and have been a consultant in the NHS for 40 years. I started
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young as a consultant. Now I'm very old. So I've been through the whole thing. And then of course
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COVID came out of nowhere. I'm really out of nowhere. In February you can see it building up.
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I said it's not going to happen. Nothing's going to happen. It's all back to normal by Easter.
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And of course, we know it wasn't back in the room. It's continuing now. Here we are in the autumn.
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The leaves are turning brown and we're still dealing with COVID daily.
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I said myself, it's just the flu. So I know how you feel.
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But the thing we really wanted to ask you about, there's a thing that's been bothering us.
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And we exchanged some emails and we talked about this, which is that it seems like the consequences of the lockdown
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are not being given as much weight and attention as the consequences of the coronavirus itself.
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So people don't seem to be thinking about the fact that the lockdown leads to economic problems
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and economic problems lead to social problems, to medical problems, to health issues.
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And are we right to feel that those consequences are not being properly looked at
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when we consider the balance of the actions that are being taken?
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I mean, when I look at it, it looks to me constantly as though the politicians are making it up as they go.
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They don't have a long-term strategy, and nor do their advisors.
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These SAGE committees would hear about 40 or 50 people.
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If you have a committee who wants to get consensus, I've seen it in the NHS over the years,
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You just get a sort of democracy of votes, and then people discuss,
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and then you all go down one route and it changes.
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It's like watching birds flying around in groups and swarms of birds
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and they suddenly change direction and they all go the other way.
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Whether the decisions at different time points are going to prove the correct ones,
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There's the health, there's the economy, but there's also COVID versus other health.
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And that was the reason that I joined Twitter, to point out, hey, we can't stop everything.
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And not only that, we can't stop the diagnostic process for cancer.
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And if you spend a lot of time on COVID, you won't have the other box for other specialties.
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And not just cancer, but heart disease, mental health, all these things.
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And then at the other end, you've got the economy, which loops around back into health because social destruction, the fabric, unemployment, mental health, poverty, deprivation, child abuse.
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They're all connected in that. It's not they're not isolated.
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And so ruin the economy and you get different health problems.
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And at the start, there was the stat of half a million people are going to die if we don't do something.
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Is it, as some people say, that for most people, it's absolutely fine?
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Do you risk long-term complications if you get it?
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So if you take the cruise ships, they were the best studied.
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the cruise ship, and there was an aircraft carrier, a French aircraft carrier, and an American
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battleship all got infected. Roughly the same statistics. High levels of infection,
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thousands of people on the ships got infected. Very few people died. And the cruise ship that
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was stuck in Yokohama Harbor, if you remember in April of this year, it was a luxury cruise ship,
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And yet there were very few deaths, something like 10 deaths altogether out of 700 people infected.
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Not only that, you've got people that get infected, clearly,
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when they have a PCR test or the virus is present, the virus genomic material is present.
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No loss of smell and taste, which are the key features of COVID.
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And the real problem for public health, normally you go chasing the disease.
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So if you take cholera, you look for people with diarrhea, you isolate them,
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make the family wash their hands, you go to the source of where they're eating from,
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they're drinking from, and try and see where the cholera was coming from.
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They're ill before they get the infection, and then they become ill.
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With this, you get infected and you don't become ill in many cases, so it's very difficult to go tracing it.
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And so you do have to have, in fact, a good test for the disease.
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What we've seen just this morning, Matt Hancock has announced that he's going to enlarge the testing program.
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You know, this should have been done three months ago.
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They've definitely changed since we started in April.
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the peak was obviously March then peaked in April in terms of severity of disease now people are not
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going to hospital and it's a slightly younger age group is being infected but we're testing
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everybody the more you test the more you find so especially if you target your testing so if you
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go to hospitals you go to Leicester you go to Oldham Rotherham places like that knock on doors
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shall sticks up people's noses are much more likely to be positive yeah now and also if we
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convert to saliva testing we just tested all our staff with saliva testing just yesterday for the
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first time that is a such an easy way of doing it because it's not at all intrusive it doesn't have
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any ethical issues you know people don't like having a stick up their nose and it requires
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someone you don't have so much skill to do it but you have to be able to do it and the other risks
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of sticking sticks up people's noses, they splutter at you.
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If they're infected and they're spluttering, this is not good for you.
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So you have to wear some sort of protective clothing,
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and that looks frightening, especially for children.
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So collecting a sample of spit into a tube is a lot less invasive, basically.
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And one of the questions that I wanted to ask is,
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obviously as we ramp up the testing, one of the things we are doing
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is uncovering lots of people, as you say, who have been infected,
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Is one of the consequences of that not an indication
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that this disease is a lot less lethal than we thought?
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And the fact, you know, hospitalisation is a key to death
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because if you don't get admitted to hospital, you're unlikely to die.
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Sure, there have been deaths at home and care homes and so on,
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the ones that are going to die go to intensive care and then they die.
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So if no one's going into hospital, that means something's different.
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The nice explanation, which I like, is that the virus wants to be kind to us.
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On the end of those little spikes that you can see in the kids' diagrams,
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you've got a little white flag saying, I want to be friends.
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But evolutionary-wise, that's not a bad strategy for the virus.
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Now, we may not like the sound of that, but, you know, the common cold virus is staying with us forever, and we've adapted to it.
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The flu virus is staying with us, and we've adapted.
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Coronavirus 1, which is the SARS virus way back from 2003, 17 years ago, it's still around, even though it doesn't trouble society.
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And that's the great puzzle, how these viruses can insert themselves into us.
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You know, I tried to involve a philosopher at Oxford on the philosophy of why does the virus exist.
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Can it tell between good and evil and all this sort of stuff?
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Well, and even whether it's alive or dead is contentious.
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Once it gets into a cell, it hijacks living processes that we have to become alive, basically.
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And then it comes out again and reverts to being dead.
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But, Carol, just for people watching at home who are not medical experts,
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compared to, let's say, the common, the flu, which kills a lot of people,
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as as we now discover most medical professionals of course would have known that anyway but
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ordinary people don't think of the flu as this great killer but it does kill a lot particularly
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old and vulnerable people every winter especially compared to the flu the coronavirus as it is now
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is it more lethal less lethal about the same do we have any sort of idea about that it's about
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the same and that's the problem with it all you know and the other thing we haven't come to yet
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is vaccination. We have a vaccine for the flu, but it's never very good. It's 50% effective.
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And we make a lot of fuss. Some people have it, some people don't. And if you're over 60,
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you get it free. For a healthcare professional, you get it free. And if you're vulnerable as a
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young person at your young age, you'd also get it free. But we forget that the flu kills more
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people and this has killed this year and we don't but it doesn't happen in quite the same way the
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other similarity is the age difference that you know flu like Covid too is an age related that
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the average age of someone that's died this year with Covid is 82 that's the average 82 exactly
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it's the same with flu younger people 70 year olds um they get over it it's people with bad
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lungs, previous infections that die from flu in hospital, that don't respond to the antibiotics
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basically, happens every winter. And we accept that. Flu is winter related. That's one of the
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big differences. COVID is not. It seems to go just even throughout the year. So as we go into winter
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now, the biggest worry is that we get a second wave. I don't believe there will be, but just
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imagine you get a big spike of infection around the country at the same time you get the flu and
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so you get people with chest infections you can't tell the difference you've got older people some
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with covid some with pneumonia because of the flu and you'll start with a whole lot of patients and
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the nhs shuts down and that's the disaster and there was a very gloomy prediction report from
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say, two weeks ago, predicting 85,000 deaths in the second wave and moving into winter
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And, you know, the top echelons of the NHS, they have to plan for that sort of scenario.
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You have to plan for it, which would involve closing down cancer and everything again.
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It would also mean, for society, closing down a lot of other things, schools, shops, pubs,
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And of course, that would have huge economic disaster if we had to shut down again.
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So I think, you know, that's the disaster scenario, which epidemiologists like, by the way, from Ferguson downwards.
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Ferguson was the half a million deaths predictor at the beginning.
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He was slightly distracted when he was working on, as we now know.
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Their importance depends on how gloomy they can be.
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Right. If a politician hears, he's going to have half a million deaths to answer for, he's going to wake up and say, OK, come in here.
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Tell me what I have to do. If he says, no, it'll blow over.
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It'll only be 40,000. It'll all blow over and it'll all be 82 and above anyway.
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And, you know, all this sort of thing. Well, that's not too bad.
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We'll just ride with it. So it's it's it's very difficult.
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They they they phrase the whole thing. This is not a prediction.
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And I remember seeing a very funny cartoon where, you know,
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it's got four boxes, and the first box is, you know, predict gloom.
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They say, I saved you from the gloomy prognosis.
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If you predict no gloom, it's all going to be okay, and it goes bad,
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they're just body counters basically so it's it's a very strange scenario so the doctors the
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actual treatment doctors like me say come on you can't do that you've got to be more realistic and
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otherwise the implication of gloomy epidemiology is you shut things down you build nightingale
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hospitals completely wasteful in terms of money and not thought so obviously we'll talk about the
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second wave potentially and the second lockdown but let me just get something clear in my head
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because I have a confusion that I know from listening to our viewers
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We were told that the first lockdown, the purpose of the first lockdown,
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was protect the NHS, crush the sombrero, whatever Boris Johnson said, right?
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And it's about preventing the NHS from being overwhelmed.
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The Nightingale Hospitals, which you just mentioned,
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were essentially unused, saw almost no patients.
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At the moment, the numbers of people in hospital, as you say, are very, very low.
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And yet we continue to have what you might describe as quite restrictive measures,
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people wearing masks indoors, social distancing.
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There's certain things that you can't do, et cetera, et cetera.
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If the rationale for all of these measures was to protect NHS,
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There's no doubt. Before Easter, Easter was about the 8th of April, and as we came up, the worry was, what happened in Italy, the health service nearly got overwhelmed.
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It was overwhelmed. There was prioritization of younger versus older people in intensive care and so on.
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We never got overwhelmed here. There was one hospital declared an emergency in northwest London, Northwick Park Hospital, and that's just a redistribution.
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Too many people pitched up in the emergency room at the same time.
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The problem we've got is that the problem then was you couldn't predict what was going to happen.
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And so the logo, the strap line of, you know, protect the NHS, save lives, stay home, was the line that frightened everybody.
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And, you know, older people especially were doing it because they thought they were protecting other people, protect the NHS, which implies protect them.
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And, of course, cancer patients didn't come forward.
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During that period of April and May, 45% reduction in the number of people having heart attacks.
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It's just that no one came because they suffered chest pain and didn't do anything about it.
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The attendance, the emergency rate, if anything, has dropped to 50% of what it normally is.
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That's because people won't get out on Saturday night.
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They didn't want to go have knife fights, drug deals.
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But as you move forward, now it's about trying to protect the whole system
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Because the same measures of social distancing, hand washing,
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mask wearing, protect you from other infections like flu.
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The real truth, constantly, is nobody knows what's going to happen.
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Neither me as an oncologist and not the epidemiologist, nor my infectious disease colleague.
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And to me, there are really three options now the virus has got.
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We want it just to go weak and learn to live with us, and we'll just cope with it, and that's fine.
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And that's what we're seeing, which are politically quite damaging, because, you know, you get this rivalry in Scotland, Wales, Northern Ireland, and trying to show that they're coping better and so on.
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And, you know, when you do see a local outbreak, it's not like we're really doing that drastic measures.
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You can't socially go and visit grandma, but you can go to a pub with grandma and have a meal in the pub.
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and what you really have to do if you really believe in in public health strategy you have
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to shut the town down you have to cut off the roads put roadblocks around it close the railway
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station so that's it that's what we did i'm from russia that's that way yeah exactly that's what
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and what they did in italy it's one of the police roadblocks everywhere you couldn't go from north
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to southern italy so no you go back uh and we haven't done that anywhere in old and all these
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other places, all the Manchester suburbs that are hot. So the third thing for the virus is
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the full-blown second wave. When it really comes back, the higher peak that you can't squash with
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hospital admissions and intensive care flooding the system. Now, it's clear that nobody really
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believes that third option is going to happen. And it probably is between the two, fizzling out
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with a few local spikes, and we can cope with that.
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The difficulty is how serious you have to take things.
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and the Chewy flight that came from Zanchi to Coventure to Cardiff,
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and 11 people were infected on it, testing positive.
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it's it's very difficult there's no right or wrong answer my own feeling is you just ignore it and
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you just leave it carol what i'm getting at and i think this is a question a lot of people's minds
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is you've said that the average age of death for a patient a covid patient in this country is 82
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we had a period which was the summer and late spring yeah when the nhs was not overwhelmed
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are we not overreacting with everything that that we're being forced to do particularly given that
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there's a cost to the reaction yeah the cancer people who are not coming in to get a diagnosis
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the heart attacks that are going and treated mental health alcohol abuse drug abuse child
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abuse all of these things are exacerbated by people being forced to isolate there's a lack
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of communication between different generations all of these things cause a problem have we not
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overreacted i think we have and i think if you're taking it as a doctor we've certainly overreacted
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putting too much emphasis in healthcare on COVID and removing it from the other things.
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In terms of the economy, I think we've already discussed the fact that economy and health are intertwined.
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And if the economy goes down the tubes, then even people that are currently in deprivation areas,
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Carol, there's a question that I really wanted to ask you.
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So you're an oncologist, you're a cancer specialist.
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what effect has this had on people having cancer treatments people being diagnosed with cancer
00:21:45.040
what are the real world implications of this so for people with cancer that we've known at the
00:21:50.480
beginning say you had cancer in April has it really impacted we've tried to minimize the
00:21:56.200
impact so if you're on chemotherapy or radiotherapy you got it if you're about to have surgery
00:22:01.080
except in the period in March and early April most people got it the biggest impact
00:22:07.700
which is still ongoing is on people that have got symptoms they've gone to the doctor and they
00:22:13.700
haven't really been got into a diagnostic pathway so that you only diagnose cancer by taking a
00:22:20.160
little bit of tissue called biopsy from wherever the cancer is in four common areas breast lung
00:22:25.600
prostate and colon so you've got to get in that which means doing some technique some image
00:22:32.060
ultrasound, CT scan, MR scan. And there's been a complete shutdown of all the diagnostic pathways
00:22:40.200
for far too long now. The first three months you could perhaps excuse, but some of them are still
00:22:46.280
not operating as normal. One estimate last week suggested 15 million people were actually waiting
00:22:52.600
for a diagnostic test. The problem is a lot of people have diagnostic tests and only a small
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proportion thank goodness have cancer but we don't know which they are in there so um if you
00:23:03.520
take ct scans you screen maybe 100 people and only 12 or 13 will actually have cancer in there but
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there's no way of prioritizing them that's so we've tried to fast track people with cancer
00:23:14.980
like symptoms but it's not like that the other problem for the nhs which is peculiar to this
00:23:20.320
country is that it's undercapacitized anyway for diagnostic tests so in france if you need a ct
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scan because you've got a cough or coughed up a bit of blood, you'll get it by next week. It'll
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all be sorted out by next week. Here, you may take three months. And that's normally, that was 2019
00:23:36.460
before all this happened. And so now, because of the huge backlog, if you have cancer but don't
00:23:42.940
know it, it's going to take longer to diagnose. And the danger in that is it gives cancer the
00:23:48.080
opportunity to spread. And whilst we're very good at treating localized cancer in the four main
00:23:53.340
organs, but anywhere else you have it, we're not so good if the disease starts spreading. The
00:23:58.860
outcome, the prognosis, goes down, and the treatment gets more difficult, more arduous for
00:24:05.600
the patient. So chemotherapy, radiotherapy, immunotherapy, all these things which we can do,
00:24:11.400
but the prognosis is much worse if the cancer spreads out of the primary organ. And so that's
00:24:17.480
the impact of this five published papers in the uk looking at trying to quantitate that impact
00:24:23.800
and they vary from 20 000 excess deaths because of the delay to 50 000 excess deaths already and
00:24:30.460
that's the the worrying feature and we're still not back to normal uh again that our health
00:24:37.160
minister said we were nearly back to normal i would dispute that if there are 15 million people
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waiting, but this is not normal, even in the NHS. You know, there aren't 15 million people in France
00:24:48.880
waiting for a diagnostic. We've really got to speed that whole thing up. And the other thing,
00:24:54.840
of course, it's not just the big diseases. There's all sorts of other diseases that we need to look
00:25:00.040
at. I mean, children with deafness, they've just been ignored. People with, you know, things that
00:25:05.800
we say, well, they can just wait, just put it on hold. Deaf children, for example, that need
00:25:11.600
hearing assessment, people with painful hips, painful knees, not urgent because they've had
00:25:17.640
pain for years, they need a hip replacement, just they'll just have to wait. The waiting list
00:25:22.080
at the best of times is often more than a year anyway. Now it's going to be two or three years
00:25:28.940
before they get the NHS to get them the operations. A lot of pain and suffering is caused by the
00:25:34.740
virus, not directly, but the indirect effects on our health service.
00:25:39.960
broadway's smash hit the neil diamond musical a beautiful noise is coming to toronto the true
00:25:47.000
story of a kid from brooklyn destined for something more featuring all the songs you love
00:25:51.760
including america forever in blue jeans and sweet caroline like jersey boys and beautiful the next
00:25:58.160
musical mega hit is here the neil diamond musical a beautiful noise now through june 7th 2026 at
00:26:05.260
the princess of wells theater get tickets at murbush.com but the number that i found staggering
00:26:12.860
there is you said that between 20 to 50 000 excess deaths as a result of the virus purely from cancer
00:26:19.980
is that correct that's correct why is this not a bigger scandal i know i keep saying everybody
00:26:25.980
it is a scandal and you know the the reason it's such a variance that 20 how can you not know
00:26:35.960
And the reason is the only way to know will be next year.
00:26:41.100
you'll be able to look and see how the cancers behave.
00:26:46.580
And all these things are predictions for delay.
00:26:59.940
Altogether, the mass of cancer in this country is very simple.
00:27:04.240
There are 360,000 new patients a year, about 30,000 a month, and that means 1,000 a day.
00:27:11.420
At the moment, the cancer diagnostic rate is running at about half of that.
00:27:17.460
So it's not that the other 500 aren't getting cancer.
00:27:21.220
COVID has suddenly prevented cancer and everyone's not getting it.
00:27:25.680
But it's just hiding the fact that these people haven't been able to get the diagnostic necessary to work on it.
00:27:32.620
So half the people who need to be tested for cancer are not getting tested.
00:27:45.860
So mammography, which are breasts, that's really picked up.
00:27:50.400
And because it's simple, it doesn't generate any aerosol.
00:27:53.860
aerosol. There's no touching involved necessarily, so it can be done. Your flow of patients isn't
00:28:00.380
affected by it. At the other end, you've got endoscopy, which involves putting a tube down
00:28:05.540
in the mouth or into the back passage. Down into the mouth, people are going to cough and splutter.
00:28:10.700
It generates aerosol. You've got to wear full protective clothing for the operator. You've got
00:28:16.160
to clean everything between each patient, disinfect the whole place. So instead of doing 10 endoscopies
00:28:22.940
a morning for example would be the average endoscopy list you're down to three or four a
00:28:27.420
morning so and yet you've got a backlog for for four or five months backlog so it's very difficult
00:28:33.580
at a slow pace what's the solution right you just have to work harder work longer and do what it
00:28:38.940
takes and and change the processes you know industry a pub just change the way it works
00:28:45.120
they want the revenue um you know i'm a little bit uh and a public private private sector is much
00:28:51.880
more efficient going to change public sector has the luxury of time and luxury well there's no
00:28:58.860
incentive to do anything we can discuss the problem set up a committee do a working party
00:29:04.120
write a few papers a piece of work is a paper in the nhs it's not actually doing anything
00:29:09.480
and once you've got that you know what you need it's difficult to get rid of the backlog plus
00:29:16.420
the fact the staff feel uh you know during the whole covid thing there's a lot of effort and it
00:29:22.860
was sort of i hate to say it but it was it was fun it was different from normal people pulled
00:29:27.600
together it's a great spirit and they were recognized by the public and all the heroes
00:29:32.960
the banging of spoons all that stuff great that's all gone and so now people are beginning to
00:29:40.140
complain they've been on a list they've been told to come back next month and nothing's happening
00:29:45.680
GPs, you know, the problem there is a lot of GPs just shut up shop.
00:29:50.080
They don't like me when I say this, but it's true.
00:29:54.600
But when you look, we have a health service at primary care base.
00:29:57.840
Why didn't they take control of the whole pandemic in reality?
00:30:01.840
All the testing should be done in GP surgeries.
00:30:04.480
It should be done in the car parks of GP surgeries.
00:30:07.220
I mean, why should people go up to Aberdeen if you live in Sussex for a test
00:30:11.720
and have a swab put in your nose when there's a perfect network
00:30:14.680
of primary care doctors, nurses, healthcare technicians in these places.
00:30:19.900
So I think that's probably what we have to get back to.
00:30:22.560
And why is it that it's now taboo to criticise lockdown,
00:30:30.680
to even say that maybe our reaction was overblown,
00:30:33.840
especially when there's numbers of the excess deaths that you've just quoted?
00:30:38.960
I mean, if we were in a dictatorial state, we'd all be arrested.
00:31:00.140
On the whole, in Britain, we've handled it very...
00:31:23.740
there was one, I saw something right at the beginning
00:31:28.180
some little old lady was made to open a shopping bag
00:31:30.800
at a police checkpoint to see if she'd really been shopping.
00:31:38.900
their own responsibility where they've really been shopping
00:31:51.540
that broke up a child's birthday party somewhere,
00:31:56.700
You imagine, you're hands up, you're surrounded.
00:32:09.920
And on the whole, it's been handled really well, I think.
00:32:12.700
The difficulty is that the politicians maybe get a kick out of power,
00:32:17.220
and it's the taste of power you don't normally have.
00:32:20.360
Emergency regulations always give people more power than they.
00:32:25.440
Imagine some overzealous public health inspector in a council.
00:32:31.100
His moment of glory, you can come and put a black cross on your door,
00:32:35.540
You know, even yesterday at the hospital, I was going around the straight mandible hospital and I was not wearing my mask properly.
00:32:48.540
This is a confession. I don't normally make confessions on TV, but I'm telling you.
00:32:52.540
And it was just after my nose was visible. And this very nice lady, a nurse in a sister's uniform came and showed me her card.
00:33:12.100
Imagine if she could get, you know, you are surrounded.
00:33:18.700
Well, we joke about it, but sometimes in my more paranoid moments,
00:33:26.360
No, I think we're going to get out of it before we get there.
00:33:28.980
Well, let's talk about that, Kurt, because you've said repeatedly
00:33:31.780
that you don't think there's going to be a second wave.
00:33:35.600
Isn't there some evidence that this is a sort of seasonal disease
00:33:40.440
Or have all the people who are going to sort of get it and die from it
00:33:44.940
Well, the two things are the main bulk of vulnerable people
00:33:51.080
already suffered and gone, and that's one thing.
00:33:54.880
And the second thing is the virus changing to be more amenable
00:33:58.980
to live with us and not to cause severe infection and cause the lung damage that results in death
00:34:05.520
via intensive care units and so on. So we really just don't know. And time will tell. The next few
00:34:13.120
weeks are critical. As we increase testing and as we increase risk, schools going back does increase
00:34:20.700
the risk. But, you know, it's the first week's too early to tell. We'll know by the end of next week
00:34:26.440
how many schools have to shut because of it hopefully none and then as we go forward as
00:34:32.300
more and more offices open especially in london we'll see if you look at the last few weeks
00:34:36.840
london's become we just take london because that's where we are now but i'm sure it's the
00:34:41.920
same for all major cities um it's opened up and we've not seen any change i mean nothing's happened
00:34:48.940
basically certainly the emergency rooms are empty which is the best indicator of severe disease so
00:34:57.920
Now, we've kept mentioning, we may as well talk about it now, I guess, the second wave concept.
00:35:02.800
The second wave comes from influenza, where we talk about Spanish flu.
00:35:10.640
It was in France and Germany and Britain, but it's called Spanish because Spain was a neutral country in the First World War.
00:35:17.000
And therefore, the military and the censorship in the countries at war meant they couldn't talk about their military strength being wiped out by flu.
00:35:28.080
More people died of flu in the First World War.
00:35:31.060
More servicemen died of flu in the First World War than by enemy action, which is amazing.
00:35:38.060
So when we move forward with the Spanish flu, the first wave killed about 5 million people,
00:35:48.060
So that was just massive, which, if you remember, well, you don't remember, nor do I.
00:35:53.420
The population of the world is a fraction of what it is now.
00:35:57.620
50 million people in 1918, in a massive percentage of the total population.
00:36:33.140
on the whole. It's constant throughout. So we're not so worried about it in winter. We are worried
00:36:39.220
about, of course, getting overwhelmed by winter pressures, which is due to flu, coming at the
00:36:44.900
same time if we can't get rid of the CoV-2. If you look at countries that are a little bit further
00:36:50.580
along, so there are three countries that opened up at mid-April, 14th of April, and that was
00:37:05.280
they opened pubs, restaurants, all of a sudden.
00:37:12.740
it's a slow rise and it's now coming down again.
00:37:15.520
And the predictors is that they've got away with it.
00:37:25.520
especially if the rise is due to better testing and more frequent testing picking up people
00:37:32.160
can i put to your hypothetical and it will take some time to sort of set out but we've said that
00:37:37.960
the initial lockdown that we've had and the other responses were a bit of an overreaction i think
00:37:43.100
that's fair to say if there is contrary to your predictions which we believe but but if you if
00:37:50.280
you're not right and there is a second wave what would be the appropriate response to that given
00:37:56.660
everything that we have talked about with francis where it's hard to say what's done more damage
00:38:01.780
covid or the lockdown what would be the right reaction in that situation as long as the
00:38:06.600
hospitalizations are not going as long as people are not getting out we just carry on just keep
00:38:11.500
everything open keep the schools open keep workplace open obviously pubs shops restaurants
00:38:49.600
You're going to wear a plaster around your mouth for the whole of the match.
00:38:53.840
So we have this ridiculous vision of football where you've got artificial applause.
00:38:59.240
I mean, it's absolutely ridiculous to watch and listen to.
00:39:03.620
And sometimes it gets out of sync with where the ball is.
00:39:08.020
But I think moving forward, what will happen is that society has already got used to it.
00:39:24.660
They frightened them right at the beginning for this protect the NHS, which was unnecessary.
00:39:29.840
And that means they're too frightened still to go back to normal society.
00:39:35.300
But, again, you get the gloom and doom, but it's time you see them everywhere.
00:39:41.080
Good Morning Britain, ITV, morning television, daytime television.
00:39:46.440
I've been on a couple of times now, and their resident doctor, he's always predicting in two weeks there'll be the second wave.
00:39:53.420
He said that a month ago, and luckily it's not.
00:39:56.140
But let's say that there is, and there are more hospitalizations, and we start to see that coming back.
00:40:01.120
What should the government do in that situation?
00:40:07.200
Which if hospitalizations go up, ICU admissions go up, 85,000 deaths happen, just like the gloomy epidemiologist prediction, we would have to take action.
00:40:17.480
Now, can we do it without lockdown? That's the question. Can we just blast away?
00:40:22.180
Sweden did it without any lockdown. Well, it's not true they did it without lockdown.
00:40:26.500
They did it with social distancing and they did it with hand washing and all those.
00:40:30.860
And Sweden is a very, very disciplined country.
00:40:34.880
I mean, the whole of Scandinavia is very disciplined.
00:40:43.820
We're more revolting against the sort of things we've been talking about.
00:40:51.120
And so imagine if you really locked down this part of London
00:41:01.900
So I think what will happen if we do get a lot of hospitalisation,
00:41:07.820
It will never be as bad as it was in April, March, April.
00:41:13.680
Now, the other thing we may see is local, more serious local lockdown.
00:41:18.940
What's curious, the Leicester, which we've well studied now,
00:41:22.380
not a blip in hospital admissions in Leicester.
00:41:25.200
So you can see the classic dome-shaped curve for infection in Leicester
00:41:29.560
going up and going right down again now and look at hospital admission just flat throughout the
00:41:34.600
whole thing so totally different if you look at leicester way back in in march and april when
00:41:40.560
the missions went up and the numbers went up so something different happening so i i think
00:41:46.900
it's a hypothetical question as you say constantly but it's likely uh that it's not going to happen
00:41:53.360
but if it did happen we'd have to reconsider the strategy i mean polishes would have to look
00:41:58.060
and how they could do some sort of local shift in policy.
00:42:02.640
And Carol, I know that you are not a psychiatrist,
00:42:16.160
But we don't seem to be talking about mental health enough
00:42:22.820
and the impact it has had on people and the public as a whole.
00:42:26.420
I read a stat that apparently, according to the National Office of Statistics,
00:42:39.100
and we do ridiculous small amounts when you're a medical student,
00:42:45.020
and you've got a mad patient and you're stuck trying to work out what to do.
00:42:48.940
The problem with mental health is so difficult to measure the severity.
00:42:55.580
someone comes in i'm depressed doctor so what do i do how do i measure how serious this person is
00:43:02.040
or someone says i want to kill myself so you get into the suicide conversation so how can you assess
00:43:08.160
is it serious i remember there was a lady about when i was a young doctor i did general practice
00:43:14.200
for several weekends and i'd go out and the lady about to jump off a build from the the high ledge
00:43:49.540
and you give them a scale, a linear analog scale,
00:43:55.860
So there's the number of smiles, lots of smiles,
00:44:06.240
It's a very crude measurement of the reality of depression.
00:44:10.340
But I think very good indicators of suicide rate going up,
00:44:16.420
because it is a form of mental aberration, if you like,
00:44:19.340
It's not normal family to beat children up or to harm children.
00:44:24.940
And then the other thing is how many people actually got admitted
00:44:28.460
to mental institutions, sectioned, the compulsory, detention, much fewer.
00:44:34.840
And the reason for that, of course, is the whole system is broken.
00:44:38.120
People weren't called. Psychiatrists weren't called.
00:44:42.860
Psychosocial workers weren't, psychiatric social workers weren't called
00:44:48.320
So, again, when this is all over, probably not till September, it may not be over.
00:45:00.440
When I say when it's over, when we can actually collect all the data, just like cancer, you can look at mental health of the nation and look through it.
00:45:08.240
And what will be fascinating is to compare it with other countries, to start looking at the same thing in other countries.
00:45:14.580
who've handled it differently, the timing's been different,
00:45:20.520
And, you know, I have a granddaughter that lives in Peru,
00:45:27.060
You can't go out without a permit and that sort of thing.
00:45:34.680
And that generates its own mental health problems.
00:45:37.600
Essentially, feeling locked up for six months is not a good feeling.
00:45:41.600
But, yeah, so that's the problem with mental health.
00:45:47.080
And there's also a question that we talk about stats and data,
00:45:50.880
we talk about excess deaths, but then it came to the fore
00:45:54.320
that actually the data that has been used by everybody isn't even reliable.
00:46:02.460
Public Health England, which has met its own demise over this whole issue,
00:46:09.240
The death figures were greatly exaggerated, and it was a simple error.
00:46:14.720
What they were doing, if you'd been tested positive,
00:46:17.460
you were flagged up on one register as positive,
00:46:20.880
and then if you died and the computer matched the two,
00:46:24.060
wherever you'd had your test in positive, you were called a COVID death.
00:46:28.600
So if you walked out of the hospital having been tested positive,
00:46:33.320
If you died of terminal cancer, you died with an axe in your head
00:46:49.080
well, let's do it 60 days after testing positive.
00:47:00.820
It doesn't get you up from being run over by a bus,
00:47:04.780
It's more likely to be COVID than other things.
00:47:06.900
but none of it was based and no one understood that even the health minister didn't understand
00:47:12.520
that when he was quoting these deaths they weren't based on the reality and at one point
00:47:17.880
at four weeks ago they had to change the number downwards it was embarrassing it appeared on the
00:47:23.280
WHO website and it said Britain 46,000 a week ago and now only 41,000 deaths so where have the 5,000
00:47:32.840
gone. Well, they're wrongly attributed to COVID. That was a little byline there. So measurement is
00:47:39.160
key because if we are going to make comparisons, France, Germany, Switzerland, Sweden, and us,
00:47:47.360
we need to make sure we're comparing apples with apples and not apples and oranges. So we've got
00:47:52.060
to get these numbers. The same with the infection rate. We've got to make sure we're comparing the
00:47:57.080
same thing. And, you know, if you go and collect people in London where the infection rate is
00:48:08.020
The chance of you finding someone this afternoon
00:48:10.220
down the commercial road that has COVID is almost zelch.
00:48:22.720
There may be one in every 20 people that's got COVID.
00:48:25.540
So put nose swabs up, collect saliva, you'll find it.
00:48:32.660
whichever way you want to so looking at everything that's happened there's been mistakes makes
00:48:40.860
there's been good decisions made what do you think should be the lessons learned that we have so far
00:48:47.200
from this whole episode i think the first lesson is to strengthen public health communication i
00:48:54.500
i had no idea as a as a consultant that this was really going on till about february and i thought
00:49:00.800
would just blow away. I mean, I couldn't believe what happened in the end. And so we've got to
00:49:07.120
prepare for the same thing happening again in exactly the same way. And we've got to prepare
00:49:12.300
for it in a way that doesn't involve lockdown. Can we do it without locking down all services,
00:49:18.120
and including health services? Can we do it in a way that maintains the emergency function for
00:49:23.880
an infection without closing down the system the second thing is is much better public education
00:49:31.700
about what to do and and then the third thing is the politicians probably should stay out of it
00:49:40.120
i mean it was dominated by the boris you know these boris or some other deputy of boris is
00:49:47.220
standing in the centre, flanked by his undertakers,
00:49:57.920
as though they're the executioners of the country.
00:50:05.860
and say this is a spokesman for the medical profession
00:50:10.500
although him and Trump are just bizarre to watch,
00:50:19.280
And, you know, the health service really should have kept going
00:50:24.040
for everything else throughout the whole thing.
00:50:30.560
which were based on the gloomy predictions of the epidemiologists
00:50:37.640
Oh, sure, 40 patients were admitted to the one near here.
00:50:41.500
But that was just tokenism to show it could be done.
00:50:45.120
And even that project wasn't thought through, but the way you're going to get the staff from, you're going to have to take them to the existing hospital. You're not going to recruit staff in the timeframe to suddenly open it. Staff with a limiting factor in healthcare has always been so, always will.
00:51:00.080
so a question that a lot of ordinary people will be asking is when do we get back to normal and i
00:51:09.140
don't mean new normal i mean normal where we meet we shake hands we don't wear you know masks to go
00:51:15.960
to a supermarket and then you walk out of the supermarket go into a pub and you're fine to sit
00:51:19.900
with people like all of these things that don't make any sense no when do we get back to actual
00:52:00.580
But what do you think we need to see in terms of the data to facilitate?
00:52:06.740
Because putting a date on it is sort of a little arbitrary, isn't it?
00:52:09.660
Whereas I think, I guess, a more interesting way of looking at it might be
00:52:13.880
what needs to happen with the virus in order for us to feel comfortable doing it.
00:52:29.580
because first of all, it may take longer than we think.
00:52:31.840
It's got to be completely safe before any of the regulators
00:52:36.740
if it causes some bizarre neurological degenerative syndrome,
00:52:45.200
This is one of the complications of viruses, of vaccines,
00:52:50.860
But more importantly, it's not worked for the flu, really,
00:52:53.620
and it's not worked for SARS, so it may not work for this,
00:53:03.440
The effort to vaccinate millions of people is quite significant.
00:53:08.840
But I think by January, we'll be in a much better place.
00:53:13.020
As long as the hospitalizations stay down, we can experiment.
00:53:25.600
The shaking hands, if you wash your hands, then it's fine, you know.
00:53:29.160
So I think we'll get back to normal quicker than we think,
00:53:49.980
And so, but they haven't a better understanding.
00:53:53.920
Because children are much more adaptable than we are.
00:53:56.520
In wartime, children just went through it with bombs going off and no problem.
00:54:00.860
I mean, some of them had psychological scars, but they tolerated it.
00:54:04.540
And people from war zones, children, adapt to it all.
00:54:09.420
And what do you think about the New Zealand's position
00:54:17.300
The moment they got four cases, I think it was everything shut,
00:54:22.480
France has been wanting to close the borders for a long time.
00:54:34.700
I mean, they're now getting cases because cases are coming
00:54:40.520
I haven't looked at the New Zealand filigons for the last two weeks,
00:54:45.960
because they get people coming, whether they're legal or not legal,
00:54:53.560
The countries that, if you look at the countries of the world,
00:55:06.820
Because returning residents have always been allowed back.
00:55:09.480
So if you're a New Zealander and you come back from somewhere,
00:55:12.640
you're allowed in, and you may have to quarantine,
00:55:19.780
you've got to take people straight off the plane into a camp.
00:55:22.660
Remember the pictures at the very beginning of all this
00:55:32.420
And they were bussed from Bryce Norton to the Milton Keynes
00:55:40.220
And that was before they had any compulsory detention laws.
00:55:43.520
the laws and that was the first we saw of it seemed like years ago yeah it does so how firm
00:55:50.980
your quarantine is how firm your policing of the border and if you allow residents in who knows
00:55:57.420
what's going to happen that's what's probably happened in new zealand because it's also as
00:56:01.460
well is that we don't know that how long the virus has been here so for instance i was still a teacher
00:56:06.440
in in the december time and i remember around about january this there was a thread on twitter
00:56:23.760
There was a case in France in December, wasn't there?
00:56:29.960
at a shooting party in Worcestershire, believe it or not.
00:56:42.440
people that stayed in a big country house and they've proven positive i mean how it all arose
00:56:47.960
and how it spread most likely scenario it rose in wuhan somehow whether it was your full great
00:56:53.740
outdoors comedy festival lineup is here on september 11th through 13th at arendale park
00:56:59.420
three nights five shows huge laughs september 11th through 13th buy tickets now at great
00:57:06.080
outdoors comedy festival.com do you have any unorthodox thoughts on the origins of the virus
00:57:12.100
yeah you mean it was an escape from the laboratory yeah it was a weaponized virus it was a research
00:57:19.240
program to weaponize the virus it escaped probably accidentally the viruses do escape
00:57:24.760
people break the safety rules don't wear gloves or don't wear whatever you need to wear and the
00:57:31.040
virus got out and then you know i like to think it's it's a luxury virus it went straight down
00:57:36.420
the airport road to the first class lounge and then went put me first class around the world
00:57:41.420
All its little friends, all its little viruses, said goodbye with their little suitcases and went off.
00:57:47.100
And they went first class because they could meet fat people, they could meet rich people,
00:57:51.800
they could meet people that were old, because older people can travel because they have more money than young,
00:57:59.000
And before we finish, the one thing I'd really like to say, because it reminds me of that,
00:58:03.800
that one of the economic consequences that the mainstream media don't bring out
00:58:38.040
then you get the next one for £70,000, then you sell that for, you know, so it goes on up.
00:58:46.180
So all my generation, and we've had end scheme pensions, final year pensions,
00:58:53.760
whereas your generation is not going to have that. It's not possible.
00:58:57.680
Now what happens with COVID, of course, it disproportionately affects the younger people
00:59:01.660
whose education has been stopped, younger than you, education has been abruptly stopped,
00:59:07.260
and there are just going to be no jobs to get started.
00:59:16.580
They may get their internship because it's free.
00:59:18.360
They may get the SUNAC scholarships or whatever they call it in government,
00:59:25.640
So with that in mind then, before we ask our last question,
00:59:29.800
should we have done and should we in the future in a similar situation
00:59:37.980
and allow the rest of society to get on it with their lives as normal.
00:59:44.900
I think you've got to give a free choice to people.
00:59:50.160
If you're over 70, consider your health, for example.
00:59:53.620
If you're a fit, active 70-year-old, just carry about your business.
00:59:58.340
But remember, you are at greater risk than if you were 50.
01:00:03.520
not to try and enforce it, not to say every 70-year-old is on the street
01:00:18.580
And that protects them, and so the others can do whatever they want
01:00:24.560
because they're not likely to be seriously damaged.
01:00:26.820
So if a young person's on chemotherapy, for example, for cancer,
01:00:30.020
So then they should be prepared to protect themselves by isolating from the rest.
01:00:35.960
But it's mainly about avoiding crowds where you don't control your meetings.
01:00:40.260
So going to a shop, you have no control on social distance.
01:00:43.960
Whereas in your garden, you have perfect control on social distance.
01:00:55.680
what is the one thing we're not talking about as a society that we really should be?
01:01:07.160
And it's become even more difficult with the demise of organized religion.
01:01:12.300
So organized religion, Church of England, whatever,
01:01:18.880
At the moment, we sort of blank it out of our lives.
01:01:31.300
I've got a Twitter account, as you know, and if I mention death,
01:01:35.820
it's like a whole load of bees suddenly come from it saying you're being unpleasant mentioning death.
01:01:42.900
And I guess doctors are closer to death than most people.
01:01:46.820
If you're a cancer doctor, a lot of your patients are going to die.
01:01:51.120
But I think we don't talk about it in a meaningful way.
01:01:54.500
and we don't accept it and i think it's become a failure it's a failure for the medical establishment
01:02:02.060
if someone dies it's a failure for the politicians the death rate goes up and i think it's really
01:02:08.400
reflected in the conversation we've had if the average age of death is 82 for covid person then
01:02:16.080
that is actually very close to the average age of death in the uk anyway which is 82.3
01:02:22.440
so you're not actually taking life away but look at what we have taken away from
01:02:27.480
people so maybe the balance of death is not too bad a thing and it's now the
01:02:33.940
problem is you get the argument is well I'll carry on being harsh because you
01:02:38.040
know there'll be 40-year-old people in their prime with no comorbidities they've
01:02:41.720
also died well that's the nature of things we cross a road a certain
01:02:45.400
proportion of people get flattened by the bus coming by that's always gonna
01:02:48.780
to happen. You don't close the road because it will stop the buses travelling. So it's getting
01:02:53.620
a balance of risk in there. But death has got to become an acceptable outcome for people. It is in
01:03:00.100
hospices. That's the only place it is. It's not out there in society. That's such a good point.
01:03:06.860
I'm glad you make that point because I feel like on a lot of the response to this virus,
01:03:21.420
But how many lives are now affected by the other things?
01:03:28.440
Professor Sikora, thank you so much for coming on.
01:03:38.560
And two or three a day is about the most I can make.
01:03:41.740
yeah fantastic well thank you very much for coming on and thank you for watching we will
01:03:46.180
see you very soon with another live stream or episode and they all go out at 7 p.m uk time