welcome to the alex salmond sure we give you the opportunity to question while drinking experts on the corporate pandemic with corporate resurgent across the u.k. and in many countries around the world i was 3 wise men answer your questions on what if anything can be done from the world of intensive care professor human debris or cheer to university college london intensive care unit can advise on how treatments are progressing for the deadly condition from the world of reality cambridge university's dr chris messed can tell us how close we are to securing a vaccine to offer an escape route of this nightmare and from the wall to public health professor how to apply the new president of the b m e and former chief medical officer of scotland discusses with alex whether the buy this can be brought back under control through tighter public health measures from your questions we will seek to do all the lessons across the u.k. and internationally but 1st let's look at the reviews of last week's show or 9

slash artist janet and bunged i'm the 1st to hear from the infamous and he says fascinating program what a fantastic are to standard is great to hear about how scottish talent who can make more like this especially independent supporting artists and says i love the interview with jerry brown's he's a great artist alan the card says great show thank you cereal bar this larry says totally enjoyed the program could have watched it longer thank you fig kennedy says nothing more poignant than the flag and a bear that's what we're all a bit and finally when agree or says about your it's paintings i love the soldier now over to alex with your questions to our 3 top experts. so welcome dr chris murphy professor of human governing no fuss segment viewers' questions is on vaccines are picked particularly with the the news of father restrictions in the u.k. the virus for assumption to many countries around the world people are telling their

minds to vaccines and the chief medical officer in the england said 6 months was an estimate and we're going to back questions from family barnes and from maggie checky who say do you think a covered $1000.00 vaccine will be available so over to you christmas. i was speaking this week with one of cambridge university's foremost experts on this gordon doogan who is a vaccine ologist is an award winning vaccine on the just and he has brought to the clinical coalface a number of vaccines over the course of his career and i asked him this very question last week and said with a fair wind behind it what's his most optimistic projection he said to me he's thinking realistically probably 2120 in 2021 june so it might be as long as 9 months to go yet the government themselves have said that we might see some vaccine available before christmas on a small scale basis this might be just part of a trial or whatever but really to scale this up to get it to the number of people

who need it and do it in a safe way is still going to take quite a bit of time so that's why i think the projection of june 2021 is not unreasonable pressure given government a lot of caught in the. valor of the questions a boat vaccine but asking in the case a lot of there are 450 people dying from cancer these day prior to the pandemic quite of the predictions for the power to or the lack of screening and the inability to pursue treatment as you would normally do and valor how long is the process of strain we are in the virus of the scale and and what implications does that have for for a vaccine or how does the the balance for the treatments of normally available there that chess with the concentration on finding a vaccine solution to the fundamental well taken up 1st question will broadly then there is no question at all that we are definitely seeing the health impacts broadly of the lockdown in teaching covert and i was too speaking with my

colleagues only recently we're seeing people presenting it all motions you palms now we disseminated cancers of the past would have been treated will curable if take months ago because they've not been able to see their doctors or they've not been able to get in the hospitals for assessment another colleague entirely is of care says the same thing that they get. overwhelmed with palliation now of people who otherwise might have been treatable so it's a good point we must remember that whilst we are all trying to save the lives of coated patients there really is a genuine big impact going on in the general population would treat diseases such as cancer those are not getting treated that is a balance that we do have to address on the issue of the mutation viruses all mutate in fact all genomes new to it we know that there are vast numbers of minor variations in this virus the ready the one that was most dominant was known as a g d change it's one of my no acid in the spike protein

a protein uses to attach to cells and the one that's now dominant is not the one that came originally out of hand it seems as if this g. variant is a little bit more infectious it gave it just enough of an edge to become the dominant form so my guess is yes it will mutate it will change in an activity possibly in its severity over time it's hard to know at what point if and when that just changes the efficacy of a vaccine and crisper piro. emailing him from the south africa he asked the question what is the rate of covered $1000.00 mutations with other viable strains in the wild we have for example the famous and the one strains should we be watching with patient rate closer than the other protect new viral activity how long therefore with a vaccine remain a factor of push push push it out of the paper actually the biggest fly in the ointment is the fact that we don't make very long term immunity to coronaviruses if

we compare this new coronavirus to the existing coronaviruses that just naturally circulates in humans there are 4 other coronaviruses that discourse cold like symptoms but one of them infects our cells in a very similar way to the new corona virus so we can use that as something like a proxy marker for what's likely to be the case with this new virus what we can do . is knowing that these viruses might not drive a very powerful immune response when you catch them we can make sure our vaccines do and there are various ways to do that by adding chemicals called additive thems to the vaccine that give your immune system a kick up the backside so that you make a more profound response than the natural infection does hopefully conferring longer term protection but at the moment we just don't know where that brings us neatly on to the questions of treatment because poor fernandes writing in for from spin says why are most of the efforts in the mainstream media coverage she says are focused on finding a vaccine where we don't know anything of a little about other treatments and medicines every chance of finding an effect of

. the bin that vance's and interesting this that this virus in the last 6 months or so there is good news on the treatment front and it's a good news story that comes worldwide also particularly in great britain where our national health service is very well integrated has a fantastic leadership in research and it allowed us to do some trials very quickly and very effectively with great power to try to find things that worked the 1st of those actually that really was much more generic around the world is we realized a lot of the severity of or most of the sudden deaths we saw in hospital releasing to blood clots that wasn't something we did a trial or we identified it very quickly and patients now were admitted to hospital will now be given much higher doses of blood thinning agents than they were before and now with the patients we are seeing in hospital or get that routinely and we're picking up lots much much earlier and that in itself is going to make a big difference the 2nd 2 studies out of great britain we have to run recovery in

one called remap cap and they identify the same signal that low doses of steroids which are anti inflammatory drugs and a very very cheap make a very big difference they reduce death rates in intensive care admissions by around 30 percent and in medicine that is a really really big thing. of any drug is cheap very safe to gave it highly effective and finally there was a study out of the united states with a trickle rendez of beer that shortens symptoms volatile over 4 days we don't have a really strong signal for mortality this in the n.h.s. at the moment most patients who are severely ill of getting both steroids x. method and or 100 percent loss rendez if again i think that with the answer calculation will make a difference now those platforms are still running in britain we fortunately had a big drop in admissions and actually though the downsides that it's been we have not had enough patients to be able to start expanding our knowledge of what's afaik

effective numbers are going back up again and those trials are still recruiting and there are other trials ongoing around the world that will produce new treatments so it's a good news story in many ways we've got some big wins already and i think there will be more coming as these other trials particular prove whether or not a case numbers start reporting so down to the big question here then here if you're caught if you are lucky and fortunate enough to catch a covert know. september 2020 as your chances of surviving it if you go into hospital much better than they were in february or march we don't know but i think that would be the case we set a new source signal over time during the 1st wave that's intensive care mortality fell as time progressed now that my part have been organizational because one we were swamped to the beginning and it was very difficult to manage just organizationally but actually we did learn a lot about for instance the use it and try to get a certain did make

a difference so yes i think from the trial data from steroids to there will be a much aggressive chance of surviving if one's admitted to hospital or to an intensive care unit just for clarity that is not what is driving the reportedly quotes mortality rate case the moment this isn't because we're better at treating it this is largely because the page we're testing a lot of people infected are much lower risk groups christmas. regarding the tension between drug treatments and vaccines the other thing to bear in mind here is that prevention is always better than cure and what a vaccine offers us is the ability to defend ourselves not just today not tomorrow not next year but for years to come and as the world health organization of pointed out many times this is this problem is not going away any time soon there's at least 5 years of the present predicament to run there after we fully anticipate

this new coronavirus is going to settle down and become an endemic human infection is going to continue to circulate joining the other car dray of coronaviruses that cause seasonal infections in humans and therefore it's likely we are going to need to prevent this sort of infection or at least the severe manifestations of it in at least a susceptible population all over the world in years to come and that means that having a vaccine that does that does that reliably and does that safely is a huge potential win and will enormously tip the balance in our favor in the future while acute drugs for managing the crisis here now are very important and lots of investments going into trying to find them including cutting edge technologies i'm talking to colleagues who have got very clever ways of using artificial intelligence learning systems to look at how when viruses going to cells they change the spectrum of genes that are turned on and turned off in a cell and they can marry that pattern up with the changes that different drugs

produce and they're using the argument well if a drug produces the mirror image changes in the gene profile in the cell that the virus does perhaps that drug could interact with that virus and stop it growing so people are looking at enormous numbers of drugs that we already have on the shelves to see if they can see these sorts of matches and that will help us here now but one must never take your eye off the longer term because this problem is not going to go away and therefore having a long term. so there that will work well before we get anyone in such extreme health conditions that they're going to need to use help for safety she's trying not trying to do our business you but you know that's going to be the really cool really critical thing here which is why investment in a vaccine is very important joins us after the break alex asks our top experts what the future holds when you will list contagion finally join us at.

mining in the valuation you get a. stock price times current the number of shares outstanding and if you have knowledge on how to buy back your own stock and pump up those stock prices

and executive stock options then you have a higher market cap but you actually didn't create anything for the economy you didn't engage in any capital expense expenditures like cap ex to expand your company in any way and what'll happen is will happen i.b.m. you know they went to the whole stock buyback routine in benchley played out in the companies a shambles or general electric general electric is almost absolutely out of business by trying to push me instead of products. welcome back alex is in conversation with professor human governance chair of the intensive care unit at university college london i'm dr chris smith for all the just i'd cambridge university. but it will have

a lot of questions about immunity and scott want to know how many people have a complete immunity to disease so the complete easy don't know we don't know what community mean the community does exist and to say it does exist i'm quite certain that this where how complete it is how long it lasted i don't know we do know that the grown a virus does mount a significant to the response your body does defend itself and it does that in a couple of ways it makes these chemicals good antibodies which are proteins that jumps to the vowel sound and help your body attack that cell so if you want my guess my guess is that you do get some degree of affected immunity but quite at what level of antibodies you need and how long you see last i don't know the christmas. just the direct question that has been alluded to after contracting covered 19 are we have mutant of the seas lots of people want to go that's of that question if you get it once can we get again you alluded to that earlier but you

also said this disease could be endemic in the population what you mean by that we don't know what proportion of people will have long term immunity having had natural infection with this corona virus and as we are beginning to see alarmingly there are people who were sufficiently ill with it the 1st time around to take them off to hospital they recovered but then they have been confirmed as catching it again and it's not just that the virus looked in their body we can prove genetically that they've been infected with a new strain of the virus or a new variant of the virus proving that the immunity that you make at least in some people is short lived now on the subject of pandemics versus epidemics and so at the moment this is a pandemic came from one corner of china as far as we know it has eclipsed the entire world and now we're dealing with it but will it switch to become an endemic infection we think it. probably will endemic means it's effectively tied up bound

up and circulating relentlessly within a population yes we think that's the case all the good examples of this h.i.v. has caused a pandemic it came from one corner of africa it spread to involve the entire world it's now endemic in the human race so that's a good example of a pandemic virus that was a newly emerging infection that then has become an it in demick infection an end to an endemic relentless problem in the human rights so one last question for you both for a start if you really in this great struggle the mast and between the virus and the one on the science and medicine and the other is going to come out the top. we've got to remember that we've had 3 emerging diseases in only 70 years is partly due to the way we treat our natural environments and animal husbandry and so forth this won't be the last unless we start changing the way ben you behave there will be more of these and we'll go around this circle again so it's

a call to arms echoing what chris said earlier on prevention you know announce a prevention is worth a pound of cure let's not take a rocket ball let's start changing the way we treat our natural environment to try to stop these emergencies at the current quite so frequent and prevalent because 3 in 17 years is quite a lot. less worth really the take home message is if we want to prevent this again we have to look beyond just how we cure the present problem but what the mechanism is of the present problem and the mechanism of fortune is is our fault and it is not a coincidence that these diseases are emerging from areas where there have been big population explosions history keeps repeating itself we saw the same thing happen with a bona boner outbreak of 203040 that occurred in parts of africa where they've been a 500 percent increase in population so our target is to look at sustainability we absolutely have to look at making sure we exist sustainably and we have more respect for the natural world and the animals in it to avoid these kind of jumps in

future because otherwise it's absolutely certain the viruses will win dr chris murphy professor of human government thank you so much for sharing your knowledge announcing of your questions thank you thank you with the search for a vaccine still ongoing and treatment still developing it is public health initiatives which have taken the strain of vitus control alex asked the new president of the british medical association professor heidi buttons whether they knew to plant they can hold the bite is it baby and why some kind to say succeeded and why some are feeling. so are they joined from. glasgow by professor honey buns the newly elected president of the british medical association many congratulations holly thank you very much for coffee our 1st question from lily she says how long can it is some to mattick collier county and spread this virus is

that one of the big challenges for controlling coal that it's simply part of says that pattern of spread of the virus the 14 days limit i think is probably not you know right definition you know when new is if somebody said to magic they're walking about never tested you don't know if they've been spreading the virus but don't know why he's counsel is it if you post a script definitely has this or is it just so for a sleep for 2 weeks and you're a straight face baby not at the time of skull and thinking about scotland and specifically says how can we deal with if we can't control of bottles doesn't that mean continual cross infection. yes that's that's an issue that i've hared a number of debates have had a republican say that we really need to. stop people from coming in and i know of the same that's a relatively minor tribute to the strange we've got enough infectious people within

our borders just to be and the way in which they're behaving in terms of not socially distance saying you know goods that pop in a lamp in the same that's what's driving the increase in cases at the moment so yes it is an issue but it's probably not be crime issue that driving the crease in the number of cases system is strained within the show as it takes a look at a chi's says that she's very suspicious she says considering the history of mankind must have always been the controlling the man of vishnu well be this as a possible the history is repeating in a sophisticated modern way to stop more control over all mankind the lowliest suspicions justify how to i don't think so not unless of course. pangolin is as being agent since authority government or whatever one of the things it needs to

come out of this is rolling back the destruction of natural habitats they claim an emergency is a really serious public health issue for 7 my children and my grandchildren situation so this isn't a fiendish lot by evil foreign governments not even the westminster government and but it has been a natural occurrence that you would expect when you are beginning to see and change in the way nature or the human interaction with nature is occurring one of us questions a very poignant one from louise hawke she says must contact us and. hand-washing could continue but for now if it's nothing homestay come a lasting 2 years why would the elderly choose existence of a helmet for the final years put that aside trade off between the quality of life and the risk of catching this virus from the elderly i have

a huge amount of sympathy with that question but the fact is there were people we have it in and out of nursing homes in the rightly everyone has to be infected and the deaths of patients in nursing homes it was a originally suggested that in the scottish parliament that there salute these these deaths were due to people with coronavirus being sent to those nursing homes from acute hospitals right the data i seen would suggest that it was mainly infected stock that were responsible for the transmission of nursing homes so the fact is that anyone going in or out of the snuffly which is likely to be a carrier and then it will spread like wildfire and lots of people some who are not seen their relatives are going to die so we've got to be very careful about who said we need to continue to be that hardy bums of the us nobody more experienced in public health and the what will the new yourself is that really

possible to control a highly infectious virus with the pubs open the government's been giving us by suggesting that was possible when we went no to 2 metres distance into one gas meter distance same i have a behavioral scientists say in your head 2 meters is a distance but when meter cis late reaching you're touching someone and we see this i mean i i have not been in a public this year and i have no intentions of going into one but when you see people sitting outside 8 people since for her leaning forward their heads are close together they're breathing droplets over each other and i just don't think it's. will to control the virus that is taking place the evidence says that in our border areas that had some walked out over the past few weeks if it insists that rate of transmission is slowing they are so the fact that would be limited to the number of

people you can have in your house and meetings and outside insulin is having an effect probably not have even if it fostered half so well i'm very sad. i think we're going to have to maybe not completely shot pops but we're really going to have to have people behaving very different. come public health measures of that the survive us bottom of control and doesn't the messaging have to be crystal clear yes said mrs james the messaging has to be 2 things that has to be very clear but just the very concept of you know telling people that they are irresponsible idiots and so on is not a good way of persuading them to do the messaging that we had initially which is one which was behave in this way and your will be a good citizen helping you know other people sad kind of positivity we're all in

this together that having graveside having whoa next in the paul steiger a mormon so and is not helping your granny has not helping your fellow student says not helping your mom and guide their whole if anything is going to kill them and we're already beginning to see increasing numbers of elderly people testing positive which was what we predicted 3 or 4 weeks ago so it has to be a message that says being a good citizen involves practice doing what the government is telling you and being sensible about it. and finally had above this they look at internationally as a been one thing from a public health perspective of all the countries experience we've seen that stood out for you you saw it and said right that's the way from a public health perspective to get the sort of virus under control you see that

your question new zealand where people grass so they had to have a government who was very honest west of the nuclear wants them to get worse sorry seeing new zealand one of 2 other places have been very successful in this and it's all come from the 3 people who are shared we're going to help each other out here 1st ali baba's newly elected president of the british medical association thank you so much for joining me on the examen show so a pleasure. the virus is back the u.k. threat level heightened and few western countries have been able to cope certainly not the u.k. we're locked into is now is very real possibility certainly not the us where deaths per 1000000 have this week overtaken the u.k. and certainly not in france where the oldest holiday season has come with a very high corporate price there are countries which have been islands of success

and many of them have indeed been islands however worldwide on current trends by the end of this week the mortality rate will approach 1000000 and by the end of the shear the international infection numbers will surpass 50000000 people today are 3 experts have given state responses to some of the biggest questions and deployed them with profound commonsense their comments on the connection between the threat of new emerging viruses and the destruction of the natural environment and therefore the sustainability of the human condition we're particularly pertinent whether that can be to sleep. it into a new and better policy direction remains to be seen but for now from alex myself and all the show stay safe i hope to see you all again next week thank. you alex thank

you. thank. you. it's going to be hard to reclaim freedom and we're going to have to work at it but as people recognize from examples like. what repression and digital systems need to. i hope people will start fighting. saying we won't tolerate systems our streets in our homes that can't possibly track what we're doing.

in advance is 24th of september germany is deliberately delaying a response to requests to hand over data on the alleged poisoning of aleck's in the valley in every possible way russia's permanent representative to the global chemical weapons watchdog tells me. to deliberately delaying the process the impeded the completion of the preliminary inquiry in russia that was held in order to ascertain whether there is an offense or not. astonishment and anger french condemned the health ministry for not consulting with them 1st and reimposing coronavirus restrictions across the country as covert cases spiral since the national law. plus god.