Should We Vaccinate Children Against COVID？ - Prof Karol Sikora
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Summary
Dr. Karasakor is a Consultant oncologist at the University of Buckingham and a Professor of Medicine at the School of Public Health. In this episode, he talks about the impact of COVID and lockdown, and the potential for coronavirus to re-emerge in winter.
Transcript
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Is this normal to vaccinate people who are not at risk of a disease
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to protect other people? Is that normally done?
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No, this is the first time it's been suggested.
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Hello and welcome to Trigonometry. I'm Francis Foster. I'm Constantine Kishin.
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And this is a show for you if you want honest conversations with fascinating people.
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A fascinating guest we have for you today. He is a consultant oncologist. He's a professor
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of medicine at the University of Buckingham and most important of all, a returning guest
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to the show. Dr. Karasakor, welcome back. Thank you very much. It's so good to have
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you back on the show. It's been about a year since we last had you on to talk about lockdown and
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COVID. And we didn't really get into vaccines, I think, much of the time. What have you made of
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the last year and everything that's been going on? Well, it's been fairly fast paced, not what I
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expected. I mean, going into lockdown and when it began was easy. It was easy for the politicians.
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It was easy for those that implemented it. Getting out is much more complex. And that's what we're
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seeing now. We're seeing the tail end of getting out of it. And, you know, the ridiculous business
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of the different four countries having different rules within the UK. And yet anyone can travel
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between them. So the rules are sort of nonsense, basically. But I think now we're in a very good
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position. The number of hospital admissions has fallen, the number of cases has fallen,
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and we seem to be getting out of the third wave.
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If there is anything, it'll just be a little blip.
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Surely there's going to be another peak in winter.
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And I don't say this to someone who's in any way desperate
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It's more that I think it's been a year and a half
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And I think last time we talked, you were hopeful that this would be over by previous January, but that hasn't transpired.
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So the concern for, I think, for everybody is that as winter comes, there will be pressures, whether they're COVID or not.
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There's always pressure on the NHS. And the feeling, I think, is given the public sentiment, which I find difficult to explain, frankly, at this point, we will be in another lockdown.
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Don't you think that that's likely? Well, if it was due to COVID, yes, but it's not likely to be due to COVID.
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It's likely due to other viruses and secondary pneumonia.
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You know, I was a medical student many, many years ago.
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And when I came out of the book work and went to the wards, the first year there was a flu
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The whole wards, no routine operations, everything cancelled because of flu.
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And mainly elderly patients got a bit of an infection with the virus and then they got
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secondary pneumonia and some of them ended up on ventilators.
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And that happens every year. We call it winter pressures in the NHS. It's a euphemism. No other country has winter pressures. It's a failure to have the capacity to deal with it. And therefore, you have to shut down services such as routine non-urgent surgery to make beds, to make facilities available, to make intensive care available for those that need it because of the infection.
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So will we actually get coronavirus causing a problem in the winter?
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Perhaps in a small way, but it's much more likely
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there are a whole row of other things coming along,
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You're positive that this is the tail end of it.
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We can't have this nonsense just this week about travelling.
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I mean, you know, either you go for it and you say,
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that's it, we're opening things up, or you don't.
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You can't suddenly say, oh, this country's just become red on Sunday,
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and so unless you get back by Sunday, you're stuck.
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And this is Mexico, where there's quite a lot of tourists have gone.
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to organise your own trip home on a commercial airliner
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day before yesterday. Wales has different rules. So they're still with masks everywhere, with
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social distancing. No one's enforcing it, but they have that rule. So I went to a little
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restaurant for a curry with a colleague, and you had to wear a mask to go from the door. It's a
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tiny little place, no bigger than the studio here. And you had to wear a mask to go through the door.
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You sat down, you take the mask off. And this has seemed ridiculous that, you know, for 10 yards,
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So it's these sort of rules that are not based on any real science
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that seem to be still lingering and will probably linger way until Christmas
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as people still don't get totally relaxed about the virus, basically.
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Do you sometimes worry, Carol, that with the lockdowns,
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So you say that every winter the NHS comes under pressure
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because of capacity, the government's going to say,
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right, well, the NHS, we need to protect the NHS,
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That certainly is a worry, that you use the experience of the last year,
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anything that comes along, whether it's winter or not,
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you say, oh, let's shut down again, and you do a dramatic shutdown.
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The other way is to say, let's expand the NHS, expand healthcare,
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not necessarily in the same form as we've got it now,
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and develop places that people can go that have chest infections.
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And, you know, when you look at it, the problem we've got,
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£500 a night for a bed in a hospital anywhere in the country
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And you've got care homes which have no medical care,
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but on the whole they have no medical facilities.
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They're commercial. They're all private. And so there's only two choices. What we need is a third choice in the middle. For older people, they can go there and they can get medical care, a light version, not intravenous drips and not ventilators and things, but they can stay there and be looked after whilst they get better well enough to go to the care home with no medical care.
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So it's a matter of, it's called a step-down accommodation, but we just don't really have any in this country.
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Who runs it, the NHS or the private sector, it really doesn't matter.
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I mean, some people get them free, but you have to have very little money.
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If you've got a house, you're going to have to pay for your care home.
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and it seems that the NHS, as long as I've been alive,
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But it does seem to be in crisis at the moment,
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particularly when you look at the effects that COVID has had on the NHS.
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I think the reason COVID's impinged on our healthcare system
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compared to other European systems is simply capacity.
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You know, waiting lists and rationing have been there.
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I've been a consultant 40 years and we've had it all the time.
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And to get an MR scan, a magnetic resonance scan,
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or even if you've got sort of weight loss and abdominal pain,
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it can take six months and everyone accepts it.
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Whereas in France, you'd go within two days, you'd have the scan.
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There's the capacity in the system, which we don't have.
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So building up that capacity is clearly something that we can learn from COVID.
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And, of course, nobody really knows how many people are on the waiting list.
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There's probably more than the government figures, 5.3 million at the moment.
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But there's almost certainly more if you take everything, including scans and blood tests and so on.
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And we sort of accepted a very sluggish system, GP, hospital.
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And to get to see your GP can take six weeks now.
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So just imagine you've got a, you know, you may have cancer
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and you have to wait six weeks before you start.
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that other countries have avoided by having more capacity.
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The people on the right go, you know, the fact that the NHS is bloated,
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It is underfunded for what can be achieved with modern medicine.
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It's also challenged by old people, people older than me.
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And people older than me are big consumers of it,
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And often there's not much health systems can do for old people.
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They have chronic comorbidities and generally body crumble.
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For younger people, it's episodic care, which is what they want.
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You have the defined procedure for doing something,
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such as hernia or, you know, cataracts and so on.
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The problem we've got is that the NHS is also a political tool, and it's very much bloated with middle management that want to be politically correct.
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And, for example, two months ago, I had to do my yearly appraisal.
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To do that, you have to do mandatory training online, and it involves all sorts of things, you know, courses on fire extinguishers.
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Well, I can see the use of the violence in English, of course, just in case.
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But to have to learn about equality and diversity,
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I understand the problems of equality and diversity,
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where people tell you this is what you have to do,
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And ironically, most of these training courses are outsourced to the private sector.
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So it's almost ridiculous that we all have to do this.
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But I think throughout the NHS, there's a sort of a cult of a religion there.
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And, you know, we saw it with the banging of spoons in COVID.
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That's a sort of almost a religious act that you're praising your priests, the high priests of the NHS.
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And, you know, you can say what people are praising, of course,
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They have to dissociate that and try and move forward.
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which I think is actually a very important conversation,
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but there's been another area in which I feel that that's been happening,
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which is this notion that every restriction that has been imposed on the country,
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every decision that's been made, it's all been following the science, which is a phrase that
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irritates me massively because from what I know about the science, both my parents are scientists,
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the science is about discussion and debate and different points of view and testing hypotheses
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and sometimes being wrong and being able to admit it. The idea that the science has one
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particular view is frankly absurd, yet that has been the messaging. What have you made of that?
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I think we've seen the politicians on one side trying to implement the advice they're getting from committees, and SAGE is the main committee, but there are little subcommittees, and it's very difficult.
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I mean, the committee's work, they take the data and maybe 20 people on stage on the committee, obviously just doing it virtually.
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And so you get one or two people that are very negative and want to have, you know, severe lockdown, vaccinate everybody, including babies, all this sort of stuff.
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And so they tend to dominate the thinking of the group.
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So it's called groupthink, and they convert people.
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Everyone wants the committee to come to an end,
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And so the consensus tends to go with the severest option, goes down.
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If you remove two or three people that are doing that,
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The other beef I've got about it is the data is not disclosed.
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So a great example last week, vaccinating 16 and 17-year-olds.
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If the risk of getting COVID would lead to more illness, then vaccination, provided it doesn't cause a lot of side effects, would be justified.
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This was a subcommittee called the Joint Committee of Vaccines and Immunisation.
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And it's been around for years and they've looked at how to do schedules for mumps and for measles and polio and so on.
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And immunising the 16 and 17-year-olds is a valid point.
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So all these GPs are going to have to go out and collect up the 16 to 17 rolls
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and shoot them up with vaccine without really knowing
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if the risks of the vaccine outweigh the risks of getting COVID
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because they're not a group that get ill with COVID on the whole.
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The GPs are going to be vaccinating people without really knowing
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You know, I've asked them to publish the data, but they won't.
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And, you know, one suspects the data are muddy because, you know,
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the vaccine, and it's only the Pfizer vaccine that's going to be allowed.
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So the Pfizer vaccine is probably the best studied of the vaccines
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because it was the trials in the States and in South America
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were right at the very beginning, and they included young people,
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why is it they're only going to give the Pfizer vaccine to the kids and not the AstraZeneca?
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Okay, so the AstraZeneca doesn't go to anybody below 40 at the moment. And the reason is that
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the AstraZeneca has a side effect profile, which is age related. In other words, if you're over 40,
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you don't get the side effects. If you're under 40, the side effects on the heart and on the lungs
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and the consequences of polio are very bad for a child.
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That's all gone for a society because of the vaccine.
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the problem there is that you're going to immunise an age group
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that really is not troubled by the infection if they get it.
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because they say one of the reasons they want to vaccinate kids
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So you're vaccinating, you're putting at risk a young person
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Well, the older person has now been double vaccinated.
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That's why it would be good to see the data on these sort of decisions.
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So the United States, everybody over 12 is being offered the vaccine
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Carol, what do you make of this? Because it's not something that Francis or I know about,
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and these are real questions that I think a lot of people want to hear the answer to.
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Is this normal to vaccinate people who are not at risk of a disease to protect other people?
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No, this is the first time it's been suggested.
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And that's why I'd be very keen to see the data. Forget the protection business.
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See what's the risk-benefit analysis on the patient, on the child, on the 16-year-old.
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I mean, the story is all, well, September's coming up, they're going to go back to school
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or back to college, and the boys and girls at 16 to 17, social distancing is not part
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of their agenda, and they'll go dancing and so on, so they need protection.
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But if the risk is greater than the benefit, we shouldn't be doing it.
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And so that's the sort of analysis you want to see.
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And it's all right saying this is our conclusion, accept it without the data.
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Well, that's wrong. We should be able to see the data.
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It did. Smallpox and polio are the best success stories ever
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is, you know, the story of smallpox vaccination
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Edward Jenner, the founder of vaccinology, really,
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So taking the cowpox and scratching it into the arms of not milkmaids, but everybody.
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In fact, what was fascinating about Jenner, 20 years before, there was a guy called Benjamin
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He was a farmer in Yetminster, which is a small village in Somerset.
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And he did the same thing with his family and others around him.
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He's got a blue plaque on his house because I've been there,
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the farmhouse he had, but he got no credit for it.
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Jenner got the credit because he was a physician.
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His portrait's up in the Royal College of Physicians,
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whereas our friend Benjamin Jesty was just the blue plaque on his farmhouse.
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But, no, the whole business of vaccination is fascinating
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They're the people that are normal, as we are the three of us sitting in the studio.
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that must, by definition, carry risks for their benefit.
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Can you do the same thing for other people's benefit?
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but the ethics of that surely are questionable, aren't they?
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And so that's why the data from JCVI on what benefit,
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what's the risk benefit to the person you're vaccinating,
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I mean, if a 16-year-old could do social distancing
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there's other ways of protecting the grandparents.
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One of the problems of the whole immunisation business,
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a lot of people stopped immunizing their kids. And that has led to an increase in the number of
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children with measles and mumps and rubella and things like that, because parents have just
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avoided getting vaccination. That's sort of disappearing now. With this, it's giving
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vaccination a bad name for the reasons you just suggested. If you can't see the data,
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why are we doing it? And it's a very, very, very good point. And you were saying that,
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you know, we don't coerce people into taking vaccines.
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You know, I think there's some very smart people in Number 10
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that are sitting there looking at how to persuade people
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These are guys that have been to top universities.
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And they've come up with this idea that what we do,
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We don't say vaccine passports are going to be compulsory.
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But because you're dripping it in and the PR comes out,
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You're going to have to have a vaccine passport.
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I mean, how is it really going to be implemented?
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A vaccine passport to go in the pub at the end of the road?
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Who's going to be able to validate that what you're showing is yours
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Crossing international borders is easy because you've got trained people
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that can look at documents, you can insist on various things.
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But going down to the king and queen at the end of the road,
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So I think that the smart guys in number 10 have got a plan
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that you just keep going with it, people then get vaccinated,
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and then you remove the need for any certification
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And, of course, we're already at about 80% immunity
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Jim, because a lot of people have COVID. So you've got the infected and you've got the vaccinated
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people and both of them will have immunity. And so that stops the spread. So it reduces the R
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number of spread. Well, let's go into the whole vaccine passport thing. Francis, sorry, just one
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thing. I know I've been hogging the mic. I just wanted to say one thing on that particular issue,
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which is the counter argument to everything you've said that we keep hearing. And I'd love for you to
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address this, is the idea that if there's a small unvaccinated population, then that will be the
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breeding ground for new variants, which will then reinfect and sabotage the whole programme.
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What do you make of that argument? I think that's unlikely, simply because if you destroy the roots
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of communication, transmission for the virus, you destroy the chances of a mutant getting out
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into the immune people. There's very little evidence that once you're vaccinated, you're
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going to get infected, even with mutants. So if a mutant arises and unvaccinated people,
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it's unlikely that it can transmit back to your immune population.
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Hold on, aren't we seeing people in hospital with COVID having been double-jabbed now?
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A few, but it's mainly people that haven't been double-jabbed that go into hospital.
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That serious illness is prevented by the vaccines, and there's no doubt. What's not
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prevented by the vaccine necessarily is the transmission, especially after just one jab.
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But on the whole, the vaccinated population protects the unvaccinated population. So
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there is again, this sort of, you know, it's a strange business. And if you look at it,
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we've never had it before, because if you look at things like polio, that doesn't,
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the vaccines are perfect compared to SARS vaccine, which is not perfect. It's 80% effective. So 20%
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you're getting no benefit for. So that's the trouble with it all. And people play around
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with those numbers. I mean, you know, I'm not an immunologist, but I know enough to understand that
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it's to say, well, the Pfizer vaccine is 95% effective. Well, what does that really mean?
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And that's the number you really want to do the comparison,
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So going back to the idea of vaccine passports,
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there's a lot of people who will say that those people
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are putting others at risk in an event, in a concert, et cetera, et cetera.
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We've got very good rapid tests now, lateral flow tests,
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which, sure, there's false positives, there's false negatives,
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And I think that should be enough to gain your entrance to Wembley
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I've never been on a cruise, and I never want to go on a cruise, by the way.
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Saga Cruises, and it said everyone has to be vaccinated.
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It said vaccine people only or something like that.
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I know that's an interesting, exactly what you say,
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people feel more secure if everyone's been vaccinated on the boat.
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But it's much better to test everybody as they go onto the boat.
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They'll be really very distraught about the situation.
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But you could test before they leave the house.
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And there are lots of, around the corner from your studio,
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there's a place that says testing, same-day service.
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or the threatened introduction of vaccine passports
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whether you can make mandatory vaccination of staff.
00:29:40.200
And we were all very privileged to be offered vaccination right at the beginning.
00:29:49.660
and eight o'clock in the morning, coffee and a bun and shoot up.
00:29:54.100
And, you know, but there are a group of people that just don't want it.
00:30:01.080
Now, can you insist that they don't work front line with patients?
00:30:05.640
If they're going to insist on that, what use are they to you?
00:30:08.440
because if a nurse can't be on a ward, what are you going to do?
00:30:14.940
I mean, there's not that many roles for people that are, you know,
00:30:19.460
frontline clinical to go behind because they won't be vaccinated.
00:30:24.200
So much better to try and persuade them to be vaccinated or to, you know,
00:30:30.700
It's back to following the science that you mentioned, Constantine.
00:30:34.640
We don't really know if a small percentage, say 10% of your staff are not vaccinated,
00:30:42.060
are there going to be a problem in dealing with patients?
00:30:46.240
Because obviously patient safety is paramount in any healthcare system.
00:30:51.620
And so can you immunise all the staff to prevent them being a route of transmission?
00:30:57.000
And I think you can persuade them to be without making it compulsory.
00:31:01.320
Do you think it's illogical for people to be fearful of this vaccine? I'll give you an example.
00:31:06.000
My girlfriend's 32 years old. She had the AstraZeneca. It's now said that you should
00:31:10.360
be over the age of 40 to have AstraZeneca. There's countries that have said that banned
00:31:14.720
AstraZeneca for a certain period of time. Is it logical for people to be concerned about this
00:31:21.740
vaccine and not want to take it if you're looking at the science and the data?
00:31:26.080
I think the AstraZeneca has a different toxicity profile, side effect profile, than the Pfizer.
00:31:34.100
On the other hand, it's a much more established way of making a vaccine, taking another virus and
00:31:40.600
coupling it up with some proteins that it expresses to make it look as though it's a SARS virus to the
00:31:46.040
immune system. The Pfizer is just a little bit of RNA, which is the message that DNA makes protein
0.60
00:31:53.680
with. And so it's a sort of genetic engineering, if you like. You're putting an artificial gene
00:32:00.180
in the arm, which is going to turn over proteins that, again, convince the immune system you've
00:32:05.760
already been infected and therefore develop a powerful resistance if you do get exposed to the
00:32:11.460
virus. So, you know, the side effect profiles are different. And what's emerged in the clinical
00:32:17.940
trials is that the Pfizer seems to have less side effects in younger people than the AstraZeneca.
00:32:25.300
And that's the reason for the age cut off. Other countries have made it 60 rather than 40. So
00:32:30.480
Scandinavian countries won't give AstraZeneca under 60 to try and avoid this. And the most
00:32:37.200
serious problems are in the heart, the brain, and the lung. And it's inflammation. It's
00:32:42.700
non-specific inflammatory change. Most cases, it's transient. Two or three weeks, it gets better.
00:32:50.260
But in some, it doesn't. And that's the worry. And there have been deaths, but there are deaths
00:32:55.340
with both vaccines. The real trouble with relating anything to a vaccine is people are primed when
00:33:02.980
they get the vaccine. Anything that goes wrong, they blame the vaccine. And it may have happened
00:33:08.080
anyway and you can't separate that then how do you convince these people who are worried of which
00:33:14.500
I'll be honest with you I am one of them yeah because I like you said I saw the way that they
00:33:19.620
changed continually I and I was thinking at one point do I take the AZ oh I can't take the AZ
00:33:26.280
how do you convince people then but also Francis you've had COVID right yeah and I've had but I've
00:33:31.860
had COVID. So I think to myself, should I take it? Should I not take it? I've had COVID. I was
00:33:39.300
fine with it. I felt rough for a week, but then I got over it. Do I need the vaccine?
00:33:45.100
The answer is, Francis, nobody knows what to advise an individual. And that's where we are,
00:33:50.700
that we can't advise an individual. We can look at the whole population and look at the benefit
00:33:56.140
in terms of preventing COVID-related illness and then including long COVID. And then we can look at
00:34:03.260
the risks of having the vaccine. And in someone of your age, they're relatively small, whether
00:34:09.760
it's AstraZeneca or Pfizer. I mean, they're almost trivial. But if you do get bad side effects,
00:34:15.300
they're not going to be trivial. And that's the problem. So the advice for populations is get
00:34:21.520
immunise, how we persuade people. I mean, I think it's crazy persuading people by giving
00:34:27.060
monetary offerings and $100 in the States and so on, or a Big Mac, have a Big Mac. This seems
00:34:33.580
counter-insuitive as a health gift to have, with chips, of course, and a nice fizzy high-calorie
00:34:41.840
drink to go with it. So bribing people doesn't work. They have to understand. And I think the
00:34:48.380
other thing we've not spent enough time on is working out why people are scared, what the
00:34:53.040
reasons for it. But, you know, it's still very sad. There are families that don't, that mothers
00:34:58.280
won't let their kids have polio, for example, vaccination. And that seems a little strange in
00:35:03.900
the modern world, but people have different beliefs. And I guess my training within the
00:35:09.380
NHS for diversity means you have to encompass all beliefs and not force things through. I mean,
00:35:16.640
in a sense lockdown was forced through although our lockdown in the UK was very light compared
00:35:23.700
with a lot of other countries which used police and military in a much more aggressive way to
00:35:29.760
keep people you know that you got shot if you came to the door you know that's and but you know
00:35:36.000
you were certainly accosted to know why you were moving around whereas here it was almost voluntary
00:35:42.140
And you talk about the lockdowns and the sort of various measures. Have you been concerned by the government's willingness to coerce people into doing things, whether that's, you know, taking the vaccine or whatever other measures that they're encouraging?
00:36:04.100
is the willingness of the government in a free society
00:36:10.440
oh, well, if you want to enjoy life, you're going to have to get the...
00:36:13.160
To me, that's quite a forceful way of doing things, isn't it?
00:36:18.900
Civil liberty is really important, and we've seen that go a bit.
00:36:24.000
But as I say, the UK has not been the worst country.
00:36:29.980
non-pharmacological intervention. It's not a vaccine. It's not a drug. It's social distancing.
00:36:36.440
It's mask wearing. And it's lockdown. I mean, avoiding crowds, shutting restaurants, shutting
00:36:43.040
all these things. And, you know, all these rules, these bubbles. I never understood the bubbles and
00:36:48.540
why restaurants wouldn't take more than six people, because otherwise you'd be breaking the
00:36:52.980
rules. I just couldn't get my head around those. And again, they varied in Wales and London and
00:37:28.280
and they were looking in the boot to see if you'd been shopping.
00:37:34.580
I mean, so I think that's been the problem,
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00:37:43.360
that vulnerable people need to be older people,
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00:37:50.100
who if they do get COVID are going to get it bad.
00:37:55.960
But you and me, we can go out because we're healthy.
00:38:02.080
What do you make of the counter argument to that that people make very often?
00:38:05.120
Because, you know, the conversation the three of us are having here is not representative of the public mood of the deposit to be believed.
00:38:11.980
Right. So the counter argument that people often make is, well, you talk about your civil liberties, Carol.
00:38:17.740
But actually, by being in a restaurant, let's say me and Francis, who both had COVID but haven't had the vaccine.
00:38:24.180
I mean, you are denying me my civil liberty to be in a restaurant
00:38:35.460
And, you know, I travel in from the suburbs from where I live
00:38:39.040
and I come on the train and I don't wear a mask,
00:38:43.080
but nearly everyone else is wearing a mask, I've noticed.
00:38:47.680
Some of them probably think they're protecting themselves.
00:38:50.000
So that's a misconception that they want to believe it's protecting them, they feel better with it.
00:38:59.280
And in fact, on the railway sign, it says, please be considerate, wear a mask.
00:39:04.600
It would help if you wear a mask in crowded places.
00:39:10.300
Obviously, London Underground has been crowded throughout this whole thing.
00:39:16.500
And a lot of people have never worn a mask on that.
00:39:39.440
You just can phone up or email Transport for London
00:39:53.040
And there are all these inconsistencies in the whole system.
00:40:04.420
So this is, either you have lockdown or you don't.
00:40:15.660
And the story she tells, well, obviously it's a bit of a military police state there,
00:40:24.680
And there you walked out and police would come and find you and take you back
00:40:29.100
and, you know, go and tell your parents off.
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The civil liberty side always worries me. But what also worries me is the effect that this has had
00:41:58.000
on cancer patients and stopping the system for lockdown. What effect has that had on you and
00:42:07.260
your department and the cancer departments across the country? Huge effect. And that was one of the
00:42:12.800
reasons I got a Twitter account, was to point this out right at the beginning, that cancer
00:42:17.740
patients are going to suffer here. And what happened way back in April 2020, so more than a
00:42:24.920
year ago, was suddenly the whole system's ground to a halt. So you couldn't go and see your GP,
00:42:31.620
the GP couldn't refer you to the hospital, you couldn't get, even a chest x-ray was difficult
00:42:36.980
to a rate, even if you were coughing up blood, you couldn't get a chest X-ray, which would
00:42:43.000
So even if I presented at the GBIT and saying, look, I'm physically coughing up blood, which
00:42:55.060
And there's a good paper in the British Medical Journal pointing that out, that people with
00:42:59.080
haemoptysis, which is coughing up blood in medical terms, were ignored in April and May.
00:43:05.300
And the best evidence that was a serious problem was looking at the number of biopsies for cancer.
00:43:12.040
So biopsy is putting a needle somewhere and taking a sample.
00:43:18.740
I mean, x-rays and scans do help you, but it's not convincing that that really is cancer.
00:43:27.580
So biopsy level, the number of biopsies per day should be around 1,000 every day.
00:43:41.600
And then they gradually came up as the year went on.
00:43:44.580
But even now, access to certain services are limited
00:43:48.200
because if you've got a waiting list of 5 million,
00:43:51.580
probably more, in there, there are cancer patients
00:43:58.700
But once whatever the procedure they're waiting for is done,
00:44:01.940
cancer will be diagnosed. I've got a couple of questions for you on that particular issue. The
00:44:07.480
first one, again, the counter argument to what you're saying is, well, look, if we didn't do a
00:44:12.460
lockdown, if we didn't take all these measures, the NHS would have been overwhelmed. And you still
00:44:17.020
have a massive backlog, but also loads of people are dying of COVID. Didn't we need to do all of
00:44:22.260
that to just stop the system from collapse? I would say no. It was finally balanced,
00:44:28.400
especially with the second wave, but this wave there's no effect. I mean, the number of people
00:44:34.020
going into hospitals, not flooding it at all. The second wave was a bit different, and it was
00:44:40.300
getting close. Now, the other interesting thing is how difficult it is to predict what's going to
00:44:45.520
happen at any point in time with this. So it's very easy to look back and say, oh, we should
00:44:50.760
have done this, we should have done that. But at the time, you couldn't work out where the curves
00:44:54.340
were going. And the government's politicians are easily swayed by extreme views, extremely negative
00:45:00.260
views about where it's going. You know, the one thing that was quite amazing, and what a waste of
00:45:06.640
money it was, were the Nightingale Hospitals. They were building these places, like one close to here
00:45:12.180
in Excel in London. And no one seemed to give any thought to where the staff were coming from. Where
00:45:18.240
are you going to get the people? They're in the hospitals. They're busy. They've got jobs to do.
00:45:22.460
And getting retired doctors, retired nurses, you know, some of my friends signed up for that.
00:45:30.240
My wife signed up, she's a nurse, but they never got used.
00:45:33.500
And quite frankly, they would need to be retrained.
00:45:37.440
If you're doing intensive care in Excel, you'd have to be retrained to do it.
00:45:42.700
You couldn't just take old people, like my wife, she'll hate me for saying that,
0.97
00:45:47.640
and sort of give them a couple of hours and say, there, go on the ventilator unit.
00:45:55.980
They put a few patients to recover in there and then closed it down.
00:46:00.000
But it must have cost a billion pounds at least for the building that system.
00:46:05.000
And, you know, I remember seeing a brigadier in full camouflage kit, you know, with a stick,
00:46:10.660
pointing out how they were building this and doing it.
00:46:13.600
It's so easy to do that as long as you've got money.
00:46:18.280
It's much more difficult to run them because, you know, in healthcare, it's staff, it's always the problem and not really doctors.
00:46:27.760
It's who's going to be there all the time, healthcare assistants, you need people that know how to do things.
0.61
00:46:36.060
So my second question then is the other side, which is, and it's a very sad question,
00:46:40.980
but we obviously understand from what you're saying that there will be a backlog of cancer patients.
00:46:47.780
many of whom have not been diagnosed yet many of whom and we know people like this and we get
00:46:54.120
messages every day as i'm sure you do by god i'm sure you do for people whose cancer went from
00:46:59.880
being a small lump that was easily curable to full stage four incurable inoperable deadly cancer
00:47:07.040
what will be the cost do you think of of all of this in terms of cancer deaths but also of course
00:47:14.460
you then have to heart disease and all of that but just what the thing that i i've never understood
00:47:19.840
and i've said this to people every journalist i know i said why are you not asking the politicians
00:47:24.200
how many people die from lockdown why have we never had that conversation what what is your
00:47:29.540
take on that whole thing i kept trying during the the the height of lockdown to convince people
00:47:35.960
we've got to get the cancer patient out we've got to get the heart attack people and the stroke
00:47:39.980
people fast-tracked into hospital. And if you're waiting for your hip to be replaced, you can wait.
00:47:45.900
But if you've got cancer, you can't. And the story of cancer is very straightforward.
00:47:51.180
You know, the four common cancers are lung, breast, colon, and prostate. And if you've got
00:47:56.360
a stage one cancer, which means the cancer is confined to the organ, it can usually be cured
00:48:01.360
with either surgery or radiotherapy or both. And the chances of the cure are 90% for stage one
00:48:08.220
cancer. Once it starts spreading to the lymph nodes, and then beyond the lymph nodes to stage
00:48:13.800
two, three, and then four, more widespread to the lung, to the liver, and so on, the chances drop to
00:48:19.640
less than 10% chance of cure. So you go from 90% cure to 10% cure. The time it takes to get there
00:48:27.220
is very variable, depending on the speed of growth of the cancer, the type of cancer, and so on. But
00:48:33.160
A rough rule is that three months probably drops you a stage,
00:48:37.200
in other words, and six months drops you two stages.
00:48:40.680
So you go from what the lawyers love to do for litigation cases of delay,
00:48:46.200
from the balance of probability, you would survive your cancer if it's 90%,
00:48:51.420
if it's stage one, to the balance of probability,
00:48:54.000
you're going to die from your cancer if it's stage three or four.
00:49:01.920
Now, we won't really know until another couple of years goes by, so by 2023 and so on,
00:49:08.640
when we look back at the cancer survival and we'll see a blip in the patients that presented
00:49:15.880
during lockdown because they couldn't access care. Just in the same way, we'll see it for
00:49:21.060
people that have heart attacks. And a lot of people, it's not just services weren't there,
00:49:30.360
So they sat at home with chest pain or they sat at home coughing up blood
00:49:33.960
because they were too scared to use the health.
00:49:36.020
Also, they were psychologically sort of corrupted, if you like,
00:49:41.520
by the slogans, protect the NHS, stay home, save lives.
00:49:52.040
Again, these smart guys in number 10 came up with that.
00:49:55.100
And there are always three little slogans in the strap line and very powerful messaging.
00:50:03.400
And what we see now, now we're coming out, is that people are still psychologically brainwashed into the old thinking.
00:50:12.120
Doesn't the government need to take responsibility for that, though?
00:50:14.660
If you've got someone literally at home dying of a heart attack and they're too terrified to come in because they're worried about COVID,
00:50:21.360
because the government has given them a disproportionate fear.
00:50:25.100
it's basic common sense that, you know, that a heart attack is far more dangerous than COVID.
00:50:29.660
It is. But, you know, if you've convinced people to stay home and protect the NHS,
00:50:35.360
the threshold at which they'll call for help is raised considerably. And that's been the problem,
00:50:41.240
whether it's cancer or heart attack or stroke, the threshold has changed. And so we've got to
00:50:46.760
get it back. We've got to get people back into the system. But that's going to take a lot of
00:50:51.300
convincing. If you've essentially given them a diet of fear, a propaganda of fear for 18 months,
00:50:57.880
how do you undo that? People are so fearful. I mean, again, it's back to the mask wearing on the
00:51:02.660
train and people avoiding me because I haven't got a mask and this sort of thing. They're still
00:51:08.780
very scared. And these people are double vaccinated, you know, and yet they're still so
00:51:15.440
scared. We've got to remove that and sort of embrace it like we embrace the flu. We just
00:51:20.880
live with it and you know someone goes off work for the flu that's fine they come back a week
00:51:24.860
later we get back to work uh but we this is different somehow this is a uh you know the
00:51:31.500
fear factor is much greater for covid carol speaking of fear uh you you're obviously an
00:51:37.000
optimistic cheery guy francis and i are not um in you know in your quiet moments when you you're
00:51:43.700
just you've got a minute to yourself do you ever wonder if we're ever going to get back to normal
00:51:49.400
I think the population here and in other countries
00:51:57.420
It's going to take probably two or three years.
00:52:02.860
In other words, will air travel still need PCR tests beforehand
00:52:16.900
They'll want to carry on doing it, just like immigration controls and all the work permits,
0.61
00:52:28.100
And you're right, it'll last at least for two years, maybe even longer.
00:52:33.700
And the fear factor here, I bet even after Christmas, people will be still wearing masks
00:52:40.240
on the train because they're scared and they think the mask is going to help.
00:52:45.040
It's like having a worry beads in the Arabic nations.
1.00
00:52:48.120
They all go with worry beads and they play with them.
00:52:56.500
do you think we need a public inquiry after this to find out?
00:52:59.680
Not least because we need to know what to do next time.
00:53:08.820
Public inquiry, there's no point using it to find fault with the politicians.
0.94
00:53:15.780
I mean, why would a journalist in The Spectator
00:53:19.860
and other journals like that become prime minister?
00:53:33.400
And they've got very smart people that advise them.
00:53:48.720
And of course, we have to broaden it from SARS.
00:54:00.200
and how we can protect against it and implement a plan.
00:54:06.280
It's a very, very good point because I don't know about you.
00:54:15.620
I know it's a ridiculous question almost to ask,
00:54:22.760
Just stop asking your stupid question, Francis.
1.00
00:54:25.080
Do you think we're going to be seeing more pandemics as we go on?
1.00
00:54:28.580
I think the threshold, again, for pandemic fear is lowered.
00:54:36.440
If you remember way back in 2012, we had the MERS.
00:54:42.860
And then in 2003 and 2004, we had the SARS, the first SARS.
00:54:48.020
And it didn't really cause that much disturbance to everybody.
00:54:54.100
Well, that's done now. That's never going to happen again.
00:55:00.160
trying to stop with non-pharmacological interventions,
00:55:05.100
And we're going to have better monitoring systems so you don't suddenly realise that half your population have been infected.
00:55:12.300
In any pandemic, any infectious agent, there are only three types of people.
00:55:17.180
Those that are actually infected, those that are susceptible, and those that are immune, either because they've had it or they've been vaccinated.
00:55:27.020
And what you want to do is reduce the susceptible group to as small as possible and increase the other two.
00:55:33.220
go on. You don't want too many infected, but you want the immunized people or the natural
0.99
00:55:38.620
immunity people to go up and reduce the susceptible. And that's got to be the aim.
00:55:45.300
And a public inquiry, going back to the last question, could help. The public inquiries I've
00:55:52.440
been involved in have just been whitewashed. And lawyers get in and they've produced long texts
00:56:02.120
So I think what we need is a direction of travel
00:56:05.640
for prevention of a further incident like this ever again.
00:56:14.900
because I think we all agree that we need an investigation
00:56:17.600
because we can't allow the mistakes to be repeated.
00:56:22.340
Our final question before we've got a few questions
00:56:29.640
but we really should be. The thing we're not talking about is still death. I said that the
00:56:35.620
last time you interviewed me. And age, you know, what's the value of life? And is the value of
00:56:42.300
someone of your age greater than the value of someone my age? So that is the thing. At the
00:56:48.080
moment, the health service doesn't use age. It's ageless. But why shouldn't we use age? If you're
00:56:54.920
85, do you deserve a very high cost cancer drug if you get cancer? If we can afford it, yes, but
00:57:01.560
the priority has to be for the 40 year old or the 30 year old to get that drug. And that's something
00:57:07.480
that no one likes to talk about. And if I do talk about it, they say, oh, this is a dangerous
00:57:13.240
territory. So why should it be dangerous? We have to make decisions. Carol, thank you so much for
00:57:19.100
coming on. If people want to find you online, where is the best place to do that? The best place is
00:57:52.400
and hit the bell button so that you never miss another fantastic episode and if you believe that
00:57:58.680
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