January 1, 1970
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The key thing for us when it comes to relaxing lockdown is the need to do it gradually. We do know that any kind of relaxation is going to impact the R number. But we do have some good news, you know, the vaccination campaigns going really well. And far better actually, than I thought it would have done at the start of January. And if we can keep that trajectory going, and these vaccines work, and they have a high level of protection, not just from severe symptoms, but also in terms of blocking transmission, we could be in a position that by the summer, we have dramatically eased lockdown, but it’s really dependent upon getting a high level of uptake of vaccine even in the non-vulnerable groups.


So with the vaccines, they have a high level of protection, possibly about let’s say, 90%, just to make it easy 90% for severe symptoms, that’s then 10% of the population vaccinated that are not immune. And now if we have an R number of about one, then we will see the deaths and the hospitalisations go down dramatically. But of course, as we start easing things, and the R number goes up, those people that are not protected are exposed to much more risk. And so that’s where the concern comes in terms of significant relaxation, that we really need to wait until we have pretty high levels of protection across the population before we totally drop restrictions.


Let’s say we have a situation where the vaccine is really, really protective, and no one’s dying. And there’s no there’s no one with Covid in hospital or even if the numbers are very, very low, then actually, you know, if the R number is greater than one, you probably don’t care. You know, if the virus is sweeping through the healthy population, and no one’s getting badly sick, that’s acceptable. And you know, even if you know there’s a low level of hospitalisations, then maybe that’s also acceptable. So it’s not just the R number. It’s really the R number coupled with any kind of local prevalence, you know, if there are particular communities with high numbers of cases, or if there is evidence of hospitals starting to come under pressure, then all of these things need to be taken into account. If the vaccines are really good at protecting the vulnerable, and then actually, as I said, the R number becomes almost irrelevant. And actually we’re really focusing on what’s going on in the community what’s going on in our hospitals. And if, if that’s okay, then we could potentially relax controls further.


We need to remember that this happens with viruses all the time, you know, we have this with influenza every year, and sadly, very many people die every winter from influenza, and, and we don’t lock down and to manage influenza. So it comes down to and this is a, you know, this is a very controversial topic for us to discuss. But actually, at some point, it needs to be discussed, if we are not going to eliminate COVID, and, you know, I would argue that that’s probably extremely unlikely, certainly in the near future, then we do need to have that discussion. What are we as a society prepared to accept and in terms of the numbers of people in hospital and the number of people sadly dying? People die from all causes every day, you know, we have people dying from cancer, we have people dying from heart disease And actually, you know, the cancer figures, 400/450 people a day, you know, they’re horrifying, if they were reported every single day, the number of people dying from cancer, those figures would be really, really scary. But we don’t put them so you know, at what level? Are we as a society prepared to accept it? And I can’t give you an answer to that. But I think it’s something we need to talk about if we aren’t going to eliminate it, at what point are we prepared to go back to normal and accept that COVID is going to be endemic and every winter, some people may die from itAnd we can do things to try to mitigate that with booster vaccines for the vulnerable. But at some point, we need to get back to normality.


In a way, yes, you could achieve zero COVID. But the only way you can really achieve zero COVID and stay with zero COVID is to achieve zero COVID internationally, because you are always going to be under that risk of reintroduction. And I think this is the problem. So yes, theoretically, we probably could, you know, if we went into severe lockdown for the next year, banned anyone coming into the country, we could probably get to zero COVID levels. But this is just not practical. And if we go into these kinds of severe restrictions, there is long term harm and not just economic harm, you know, if we, if we stay in lockdown for another 12 months, there’s the potential for more people going into poverty, and that has negative health implications as well. So I think, you know, this is, these are the things that, you know, it’s a pipe dream, in my opinion, to think about achieving that. And unless we focus on an international stage.


I mean, I’ve been reading these quite worrying reports of some scientists coming out and saying, there’ll be certain measures that we will have in place forever. And I feel that’s actually I find that very, very scary. You know, I think that I mean, even things like you know, and if we think about, you know, some people have been suggesting we will have masks in public places forever. You know, I worry actually about the long term mental health harm and developmental harm for our children. You know, there’ll be some really young children that won’t be used to actually interacting with with strangers with people not in their family, because they never see their faces, you know, I can understand the need for these restrictions now. But I would hope we would be trying to achieve a society where in the long term, we can get back to some semblance of normality. You know, there may be certain things that actually we take forward, better hygiene, making sure we wash our hands, maybe using hand gel, when we go in and out of places. These are things that actually a pretty good practice, and we continue to observe, but I think we are a sociable society. And I think we should try to achieve at least getting back to some level of being able to interact with people that are not in our immediate family. And I do worry about a lot of the rhetoric that suggests that there’s going to be some level of controls that we’re just going to keep forever.

On our ability

You could take a very, very cautious approach, and you stay in lockdown until you’ve eliminated it, but it’s about balancing harms. And I think this is the thing. And again, to go back to the cancer argument: you know, if we look at 400 people dying every day from cancer, we could ban smoking, we could ban alcohol, we could force people to take an hour of exercise every day, that would reduce the cancer figures dramatically. But we’re not as society going to do that. And maybe I maybe I shouldn’t be suggesting this, because this might be something that, but you know, it’s one of these things, it sounds flippant, but it’s true, you know, we could do all of these things to try to reduce people dying from other causes, but we don’t. And we, we accept a level of risk as a society to have some semblance of a normal life. And I do think sometimes that we’ve lost the ability to balance risk. And I’ll give you an example. I have young children at primary school. And I remember discussions going around about the potential for children to go back to primary school in April. And I remember so many parents coming out and saying, Well, I’m not going to send my children back, I’m not exposing them to risk. And of course, as an epidemiologist, I was telling them at the time, well look at the data, you’re actually more likely that your child will die in an accident on the way to school, than they will die from COVID in school, but by getting an infection in school, and I think this is one of the things I find really frustrating that we should not ignore the risks, we should never ignore the risks, but we’d seem to have lost the ability with COVID to actually balance risks, or even understand what the risks are, you know, people go on aeroplanes, people go skydiving, you know, there are risks associated with those things. And the risk of children being in school is extremely low to the children.


And I think actually, this, I remember having a conversation with my brother about six months ago, and about the new normal, and we were saying the whole idea of the word new normal sounds a bit 1984. You know, I think it does sound dystopian, you know, I, in a sense, I’m not arguing with measures that have been introduced in terms of the need to reduce risk. But actually, I would want pretty much mostly the old normal, you know, with the caveat of, as I said, making surewe continue to observe these good hygiene practices and all these things that, you know, I’m much better about washing my hands now. And actually, you know, that is something that I have no problem continuing to do in future to be really careful about, you know, washing my hands, when I come into the house, never been in the garden coming back in and washing my hands, you know, these are all the sorts of things that we should have been doing anyway. But I think as much as possible, I think, I think we shouldn’t be striving for a really a new normal, we should really want as much as possible, the old normal back. So actually, we can see our loved ones, we can have that level of social interaction where we’re social species. And I think, you know, a lot of the dystopian discussion of a new normal actually really scares me, because I think we lose that level of social interaction that actually keeps us going. We don’t talk enough about mental health. And actually, one of the big challenges in the last 12 months, I think, has been to mental health of you know, everybody, actually, you know, not even people who may be you know, suffered more from mental health challenges before the pandemic, but actually an awful lot of people who probably because of the pandemic have really struggled with their mental health.


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