welcome to the alex sullivan show from scotland where today we look at the long term health impact of the pandemic the impact on individual patients and the health impact on society as a whole our guest today professor humans government is in a unique position to judge he is professor of intensive care at university college london and also practices as a consultant in the whittington hospital today he has some harsh words for the u.k.'s failure in public health even with the national health service reform example we fashion over the good care of the recent success of the vaccination program the scent of you coming up soon but 1st it was when i was your tweet your emails or your messages thank you alex and another tremendous response tertiary last week on the storming of the capital in the us and we of course featured professor we did pursue that well tonight anthropologist to give us his views on the future of america kids away says really enjoy that i love the us and americans

but their politicians are very scary all empires eventually crumble but never should if the us influence in the world is good or bad creates you as far claudette says seriously can buy dinner by themself never mind america potencies mr we did is used as eloquent language but that doesn't make it true he goes on to say i've watched many biden interviews where he contradicts his own words christopher morris says contradicting views that you previously held is called changing your mind not lying gordon mckenzie says professor we did this is a fantastic guest i've seen 1st hand the divisions of recent still exist in the southern states maybe just maybe biden can help cement a more tolerant society. finally i got a lovely message from vancouver in an email in fact how alex is in the club and i want to show a night in vancouver every week it's a fessing to it someone who knows how to interview his guests well done as part of

the scottish task but it's comforting to know that intellect and common sense associated that people is alive and well take care well thank you very much indeed and now over to alex is interviewing professor hugh my government professor of intensive care medicine i university college london professor a government as a fair bet that very few people ahead of coronavirus just a year or so ago know just about everybody in the planet north a boater but few still understand that what exactly are these coronaviruses what is a good question because most people would have known coronavirus they just didn't know its name so coronaviruses are a family of viruses and so called because they have a series of spikes that come out from the surface which gives it a sort of halo or crown effect so the corona relates to the crown surrounding the virus and they're quite common 4 of them common the effects humans and we've all

had them they call was basically a little bit of a common cold so snottily no use of a drippy nose bit of a sore throat slight cough and really nothing more serious than that out of the animal kingdom there are very many more up and there are at least 5200 we know about that affect other animals particularly mammals and of course we haven't had any trouble you don't sit in until one of those seems to have jumped over from an animal into us and we weren't we haven't been exposed that before and that's where our problems come from. so the 4 that have affected humans have they been aware 1st the dawn of time what the common cold up of the bat of occasionally come from the animal kingdom as well what it's hard to tell and certainly viruses do cross a river they've been with us for a very very long time that much is certain but these viruses can cross over from

animals to humans i suppose if we think of the spanish flu the end of the 1st war that was an avian or a bird flu that crossed over then we had the bird flu is that only at this century the early noughties i suppose of course h.i.v. was a crossover most certainly from a simian immediate fish and sea virus so these things do cross over they consider much more commonly though if you degrade the environment in which those animals are living so you cattle animals more and more closely together you strip out some of the complexity ecosystem so they predate when they shouldn't and then if you put a large number of people big population densities nearby much as we saw we have bona and perhaps not crossing over as well now whether this one jumps from that sort of saying or whether it was meat markets and mixing animals up in the wrong places or again us eating things we shouldn't we don't really know in this particular case where it came over but from an animal it certainly came and the closest to variants genetically are bats and pangolin which is

a sort of scale looking and tea tree looking type creature the closest is the bat but it's still about 3 to 4 percent different from the one that's infecting us so there's still a question about whether that could it could have jumped from a bat and looking at a mutation rate that would have to happen about 70 years ago into another animal population and it's that we got it from and we don't know what animal population is so this could well be something to meijer e out of that we sitting. from which we caught it. now it would be fair to say professor governor that even after just a year we know more about this virus than just about any other are we still got lots to find out well we know a lot of apps a number of other viruses of course because we've had a very long time but you're absolutely right this that the learning curve for this has been absolutely staggering if you think that the 1st cases were really being

reported only 13 months ago it took only a matter of weeks before we had the whole viral genome sequence out that overnight people were coming up with the recipes that could be used in vaccines and it is extraordinary that we've managed to get to so many effective vaccines implemented really from a standing start in less than 12 months from the beginning without and i emphasize that without cutting corners this isn't the vaccine to be knocked out in some shoddy slightly dodgy way without proper testing it's just that everything was focused on their appropriate development and that is in itself quite extraordinary isn't it and of course this crossover between now and i'm a kingdom and the virus as a practical example some in the scale on the the many farms and denmark in particular the other european countries is that a case in point of the dangers of accelerated mutation as a result of the koestler so for the most humans spot on it absolutely is so if you

put very very very very notch numbers of animals of one species close to other species that will jump over but that cattle ng of huge numbers of animals together and i was very rapid transmission between those animals so you could think of poultry farms but in this case mink farms so we got it from some animal we don't know which yet possibly the fact this then got transmitted to mink and in lots of meat farms in europe actually but the big scam is written denmark where there were over 50000000 mink cattle together for slaughter for. beth firs and these are really just big vats in which this virus can breed replicate jump between animals and mutate and when you've got that sort of situation then as happened in denmark a nasty version that's been brewed up that can jump back to humans and so this was one particular version 5 there was a really big scan of big lockdown in denmark because it's not going to go south it

would have been very dangerous to us and could perhaps have been partly resistant to the vaccine so the animal kingdom teaches us a lot too about humans and it's one of the key issues related to the mass vaccination and the lockdown if you lift the lockdown to worry when you go to a very large number of people who could still get the marise you have another large pool in which that mutation can continue to happen and it might set up a mutation that makes a vaccine less effective so you really want sort of got rid of the numbers and vaccinated nearly everybody before you take your foot off the pedal because otherwise you could end up with a lot of people getting infected in new variants appearing then really in fact the people who had a vaccine who were no longer adequately protected and professor mcgovern it is it is it possible to put a number on how many vaccinations have to be done before it would be reasonable and safe that is the law. and by the conventional mass we real looking for at least 70

percent of the british adult population to be vaccinated and that's really important that we get there and therefore very alarming when you hear these myths put out everything from just insane conspiracy theories that were being injected microchips around us some of the senate they were injected with 4 g. i'm not quite sure how you put electromagnetic signal in a syringe all that it hasn't been properly tested or that it causes or that what i had most recently causes infertility. long term none of these things are true i'm not sure the myths come from but they're dangerous because. they're dangerous to the individual but the dangers to us all of people if we don't get this level of taxation up to where we need to be and that's our plight internationally as a well professor and the saying that if this virus is anywhere it considered to be everywhere again and that pool of potential affective at the variables and we patients there's that apply internationally as well as in this country yes it does

say this is one of the big worries and the world health organization you heard the mantra no one is safe until everyone is safe and it's very exactly that reason that if you leave a large pool of people that it was amongst whom the back seat of the virus is spreading it can be tate and then can come back in unless we become fortunate fortress britain and seal the borders and the ports and prevent anyone flying in which is unlikely to happen the question which is race of course is saying well this is very iniquitous that we have vaccinating the british public and there's an awful lot of very poor people around the world shouldn't we be distributing a vaccine we got to them and the answer is of course we must be vaccinating everybody because that's for our own good but equally equitably distributing it right now would be pointless because if you made one in a 1000 people immune in each country or even one in $100.00 that would not in any way hamper the spread of the iris so we do have to pick it off center guy sector and when britain we're lucky to be getting this vaccine which is needed to get it

on board will lead the ones that will escape the vaccine you know they may well yet come down the line this virus will continue to mutate we have to hope it does it in the way that influenza does every year but this is not a mutation which means we can catch it again it's probably not too bad we try and jinx that aren't the vaccine it'll bit protect us we have just have to hope that there isn't a sudden appearance of the real beast for instance that is much less responsive to the vaccine and much more dangerous for that that he's potentially that could happen professor mcgovern using of academic knowledge in the one hand and the practical experience an intensive care was on the other as a very of a you've seen what is your greatly in tab the treatment and the shape of things the carb. well the ones that worried us really is just hoping jenna for the future so the stereotypes the south african variants with the worry that they're not very much more lethal than cells they're just very much more hearty transmissible they

do because if they could be slightly more dangerous for instance the old lady scroope that might have a 5 percent mortality it might not shock to $6.00 to $7.00 but the main issue is the transmissibility and infected the way it can in fact it looks as if most of the vaccines will respond. or there are the virus will respond to most those axioms but the concern more is this race to break slack and what might come down the pike we might get something that could have a doxie more readily or something that be very much more lethal and show that extension of this mutation to. stay with us because coming up after the break we continue our discussion with professor if you might got me i'd ask the key question will coronavirus be ever with us we'll see you then.

we are now at a point where we cannot manufacture the basic foundational components of the 21st century economy we are literally taken ourselves out of the game by throwing the case to the economy to private equity groups wall street. financier's and money pressures and now it's too late. welcome back out of this continuing his discussion with professor hugh my gummy bear of intensive care medicine i think if i see call it. we have to have so much about soup of spreading of late which was very much in vogue at the start of the pandemic or what exactly is super spreading as about an individual nabbed an epic make up on is about the lifestyle as it can it. is

a very good question and everything in life is pretty much nearly everything in life is a bouncy nature nurture so for instance if we look at could or could have young child's good nature oh be a super spreader know pretty hard that they don't really contract the virus very readily they don't have a really huge viral burden as far as we can tell so whilst they could be a serious friend of mine in fact it may play with lots and lots and lots and lots and lots and lots of people and see lots and lots of relatives they'd be potentially at a slightly lower risk if you or someone of my age approaching 60 and being male i could get hit with this virus very badly and for maybe 40 to 50 hours before symptoms and for several days afterwards i'm highly infectious now the question then is am i a super spread of wealth for that it depends entirely on my behavior if i live like a hermit in a cave in the north of scotland and i can't infect anybody at all i am and i do live a bit like as we all do at the moment i don't say she lies i don't mix it's people

like cycles of work i can't be a seeker spreaded because i just don't get in contact with people and when i'm in the hospital i'm wearing a mask as we all should the situations where you put yourself when you're infectious and bear in mind how after they're infected don't know they're infectious they haven't got any significant symptoms if they go and spend a prolonged period of time. in a confined space let's think a pub or restaurant or a bar with poor ventilation let's think of those sorts of places as well so that in those it's cold the windows are going to be shut. and everyone's having to talk all shout loudly which we all have to do in pubs and bars then your coughing or your shouting or your singing along with the rugby or whatever it might be so if you cram a 100 people in for a big birthday celebration in a poorly ventilated bar where everyone else is not immune one person could

potentially in fact 40 to 80 people. freshman governor can we tell from their academic study of the vela paying virus the developing threat to your practical experience and past experience an intensive care ward in london how has the treatment of people with covert being improved over the last year and has that made a big difference well it has so if i think back to the 1st patients we started seeing which is that a year ago in february this disease was new to us and we'd never seen anything like it before it we thought we were going to get patients that sort of had a bit of bad flu in terms of their lungs the way we used to ventilate in peep with bad lungs with flu and sadly a lot of those people will die every year between quickly clear that one of the big problems with the low actionable so actually blood vessels something was going badly wrong with those we quickly learned blood clocks were forming in patients and killing them we found that kidneys went down we normally run patients

a bit dry in terms of fluids we try to restrict the amount of fluids that seemed to make things worse in the early stages so we had to do an awful lot of learning and a lot of that was literally 30 each other up saying i've seen this if you see nests and have you seen that we had zoom calls every week nationally with people literally just to trade information to say i've seen a few of these 2 is that it is that a real thing or is that not and we did it internationally as well. then moved on as we learned from sharing our knowledge in jeopardy practical experience into the trial platforms and britain has really led the world in this thank goodness we have a national health service and we have a national institute of health research which swung into action really quickly and stopped people just doing their own personal little treatments of trials of 10 people and basically said everyone we need it's out there we need to try to get them into trials and that's where you've seen these breakthroughs come from they've

really pretty much all come from britain. because we've actually been having that big studies that been a cynical genomic of the genetics one called remap cap which is an international study actually not just british but we've recruited heavily here for it and another called the recovery trial and they've given us the 1st treatments that really seem to benefit so the 1st that you remember being announced was steroids stairway treatments make things a bit worse actually if you don't have bad disease but if you're bad enough to be in a hospital and need oxygen they do significantly reduce mortality so the data that were pretty dramatic at that point around the death rate was around 41 percent in hospital and the mortality rate was reduced to a little under 30 percent say 29 percent with steroids so now if you come into hospital you're given this cheap a few pounds a day steroids for about 10 days we've now got other oxes there was a drug called rendez or via which is an antiviral agent that may have some impacts

but last week this drug could toss a loser mad which is an anti-inflammatory drug use actually not rightists but was thought may have a role for various reasons in this disease and so it appears the mortality rate looking at people these are people with quite low oxygen levels and inflammation it's a slightly different group with x. you can save about 5 lives for every 100 people you treat as the similar sorts of number for text messaging so these things aren't total gain changes but they are making a difference when added together now the mortality rates this time around are lower is around 32.8 percent mortality in intensive cath because more people across the board die and that if you hit intensive care we're now down to that's a lever on 32 percent or 70 percent patients still in intensive care from that cohort so the numbers likely to go up

a base i should think that's much better than we would get. in weight one which was north of 42 percent but then things are changing to we used we didn't know what to do with the lungs to start with we now do tight fitting masks on which provides some extra pressure and that seems to make quite a big difference to stopping a lot of requiring a mechanical ventilator to go on separating machine and it's just as well we work that out in weight one because we wouldn't in any way of coped with this weight if everyone had to go into a breathing machine it would have it we wouldn't have managed it it's all you know for every one person on a ventilator and we had tens of people on this other form of support on the wards us a little bit of what it's like with that it has been brutal and i know people see these pictures on the news in the evenings of what it's like but remember that you can't train up intensive care docs and nurses the number we've got now is pretty much the number we had

a year ago and in fact in this wave we've had fewer because people had to self isolate home school being off sick with coronavirus them saddles and so you ended up in the same number of trained intensive scan nurses and doctors as a year ago but looking after the equivalent of an extra $126.00 intensive care units of patients doing well over an extra 1000000 hours of work a week if that level of workload gutting that sums up that's a little bit more clearly so it's been very wearing has been long for everyone and it's been emotionally a long and hard journey for everyone in this last year. and what do we know now about phil called long over the hour we got her assessment of the bullet hitting affects the days can have a lot of been seriously ill it's a very good question so what do we know we know it's real so this was a disease old enough that probably the 1st disease in quite a while the patients to find for themselves because of course in hospitals we

weren't seeing it at clusters of patients on social media started saying to each other hang on i'm not right this disease we're told gets better in 3 weeks and i'm still ill we know that some people have severe lung scouring some have progressive infection some have think we're organizing new monia where the lungs progressive to get in trouble some will have blood clocks. we know that in some women yes reports mainly in the social media drive believed to be true of early men a pause and quite significant menstrual cycle staton says and worryingly although we don't have any data yet the protein that virus dines to is most strongly expressed in men in testes in sperm producing cells and testosterone producing cells so it's possible that part of this might be due to testosterone effects finally we're getting some signals that something's going very badly wrong with energy generation unsettles and we think it's not be due to an impact on these

think will mitochondria which the little power stations inside sounds and it looks as if they might have got damaged in some people too which would account for why they wark a couple 100 meters and feel like they just run for the bus that they're absolutely exhausted when they do that so we're trying to get research off the ground at the moment and others are doing the same to try to what we would call phenotype these people try to work out is is this a one thing i doubt it's one thing i suspect it's a lot of things and what are the mechanisms behind those lots of things and from that. find out is it going to get better on its own do we need a treatment for it to improve it but certainly if anyone knows someone with long prove it they do deserve you'll simply see because this is a real and real disease so how do we explain this a public part of docs where a national health service deals with acute care than the example of

a tremendous fashion where the vaccination program is going exclusively well in international terms across the health services of the administrations of the of the u.k. and yes a society in health terms of public health was unable to control the disease and as a result the u.k.'s one of the highest fatality rates in the world. well you're absolutely right on this and this is a wake up call to us about public health and there's a lesson here about inventing equality addressing poverty and trying to deal with public health as you say right be put to try to make kate the seed bed here that could nurture viruses of this so will be less of a problem because we are you know a lot of the people we see in hospitals have an obesity problem or a significantly overweight a lot of them live in housing where they can't of with other people and so forth so

we do need to having spent years cutting public health we need to reinvest in it and we also actually have to think a little bit too about how we want to recover in my view from as a society from this virus because we can't go back to that environmental degradation that's causing climate change as well as the potentially allowing these events to happen again in the farming practices we can go back 242 people a 2nd boarding a jet plane which is what was happening just to talk coded happen and that's what spread is around the entire world and we can have an economy that is built on hugs and hospitality and i've got nothing against going to the pub or castrati i do that myself as often as i can but is that how we want to recover our economy or not we have to we have to think a little bit differently i think about what we want to go on in the future now and 5 i think they have got the. jag the smalling and feeling good about it and i know that you invented the the fitness gene. professed by governor will it be before i

can get a jag for fitness as well as to prevent covert well wouldn't be a lovely thing i'd be 1st in line if i got that one and you know we found the 1st 8 affecting human fitness. but it's not as you say really everything is genes the environment you have to play the hand down and everyone can find some sort of exercise they enjoy and most dangerous school excellent entering geisha scottish dancing i mean that still seems to be justly lethal and soon each other around great fun but sent it might not be on a down school where we both went forward to a time when the all of us will be able to engage in that sort of like pivot again fessor human government to thank you so much for joining me once again adele examined sure thank you honey professor human government isn't a unique position to tell us about this pandemic

a 1000000000 academic physician he's the bomb who discovered the fact this gene nobody can tell us more about the genome of corona virus but he also bans awards in intensive care he says on a daily basis the impact of this virus on human lives and therefore when he tells us our public health measures need some attention that we have followed despite damage to get a grip a society then we should listen just as we should listen when he tells us that if this virus is anywhere it's everywhere and that is why total vaccination in the countries of the united kingdom is very sensible but it's not enough this virus has to be eliminated everywhere otherwise it will come back to bite us and that reservoir of mutations will frighten humankind for generations to come it may be that we're going to have to get used to the thought that called it like the poor are ever worthless but that doesn't mean that we've got to accept the situation as

inevitable and messages like the ones we've have today bring it home how vital the struggle is that it is not over by a long shot and there is no room for any sort of complacency that is going to be plain sailing from no it. so what does being a must sell for the all of the show stay safe and we'll see you again next week. measures human beings to change which absorbing. yes i think is what is lost versus if there's going to make people uneasy but really why should we be forced to buy

time just because nature. also being your brain why don't we get to choose that. the british and american governments have often been accused of destroying lives in their own interests or you see in this these techniques is the state devising methods to him to essentially destroy the personality of an individual. by scientific means this is how one doctor his theories were allegedly used in psychological warfare against prisoners deemed a danger to the state that was the foundation for the method of psychological interrogation psychological courtroom. disseminated within the u.s. intelligence community and worldwide among our allies for the next 30 years. the victims say they still live with the consequences today.

in the day's headlines the australian government flams facebook for banning news posts in the country accusing the tech giant of abusing its power. to spain is ron spying on russ over the jailing of cattle and rapper public after he was handed a 9 month sentence 1st lending the crown and glorifying terrorism. also this hour millions of texans are left without electricity and heat as authorities struggle to cope with the deadly winter storm sweeping the southern states of america. so this is a. clue.