Won it meet earlier ready to go for it as advised by professor blanchflower john says its been so disappointing to see us follow the tory lead which has been bumbling undernet best weed in a well being collaboration with new zealand in iceland both are doing way better than us why we not turn on their experiences and successes why are we not leading the way in the u. K. David says the thing about making hard to manage your work is that the disease requires between 8 to 10 ways before it can work in the meantime many many people die and were talking a lot of numbers this disease is going nowhere and a vaccine is a long way off john says the government are clearly imposing the locked and more palatable 3 week chunks when the reality is that this will continue for longer than that schools need to be responsible Patient Income while accepting the short term destruction for a longer term wellbeing market says great show alex sort of session to see questions that are honest in the lightning and can be despondent to honestly sonia said look forward to visiting multiple game probably next year night. As martha closed the deal before a flight ticket everyone donal says boeing sure alex and very thought provoking a universal income now i would help do such a struggling norma says best half of the week calyx can you do want everybody to help us always very interesting thanks norma david says cook isnt a scottish problem and stop life Getting Better in scotland born in scotland they may have been but peaches they are not and finally lorna says really could have this discussion nobody is talking about the possible exit and the economy 1st human governor of University College london was one of the 1st taxpayers to explain clearly the dramatic difference in infectivity between corona virus and normal seasonal flu seasonal flu if you allowed the infection interrupted 5 of 10 times a move to the 1st perhaps 14 people were in cans in one case the figure of the relevant figure the comparable figure for corona virus is 57000 that is how infectious this new diseases i spoke to human gov from the front line of fighting the disease in west london. 1st youre one of the people of my state explain the difference between. Their fate to meet the fact of 1. 3 of infectivity fact of perhaps 3 as of the case of corona virus could yes that is way above what difference that makes the number of people who can be infected by a single case yes indeed and of course this is the biggest year its not the fact that everyone who gets this disease becomes critically unwell and dies far from it so i mean its probably between 50 and 80 percent of people who get this disease probably dont even know theyve had it and get very mild symptoms its the remaining group that become profoundly gone well and its a question of numbers so an ordinary flu which comes from seasonally every year every person will in fact on average somewhere around 1. 3 people that if there were such a number which means that by the time you get to the 9th or 10th generation of people passing that on each one person passing it on stats on a number in total when you get the night pass youre passing it on to maybe 15 or 20 people and in total maybe 60 people have been infected if this virus behaves as it does which is highly ineffective in affecting north of st people per person by the time he gets that 9th transmission that wave is transmitting to 59000. 00 people and in total over 100000 people are being infected and so you can see that even if only lets say one in 200 of those dies its still a very very large number indeed and this is really why the only solution to allow the Health Service to cope has been to limit transmission because there is no specific treatment for this everyone hears about chloroquine and drugs and there is the proof yet the trials are ongoing so currently we dont have a magic bullet to treat this all we can do is take patients who are dying otherwise put them on an intensive care. I you know since support them as best we can to allow their bodies to recover which they do in roughly 50 percent of the cases that we are now missing and that has the lessons louboutin allow to a simple techniques of payment even though the posture of the paste. Parents of care i understand can be quite significant cos the problem why theres very low oxygen levels in the blood is because the blood supply in the lung is often going to areas of the lung where there isnt very much oxygen because im the only the lung tissue is badly affected or the areas that have got good options apply coming in from the outside dont have much blood supply and thats known as ventilation and the fusion mismatch youre giving blood to the wrong dates of the loan and for various reasons you can improve that to a degree by allowing the patient on their tummy and we found that actually we can do that very early on so patients coming in with level extra levels now even on arrival in the motion see department and on the wards we are suggesting to these patients that they lie now on that chests essentially and i sort of modify slimmest position say one arm above the heads one arm down by the sunlight and they do that prisoners they can tolerate and that does seem to improve oxygenation and allow us to get away with less aggressive treatments at that time when people are put on ventilators or machines that do the breathing for them on intensive care pretty much all of them are now needing to lie in this prone position so between 168 and 18 hours of each day. That has its own problems its not the healthiest thing pressures in our eyes become a government pressure on faces and its not a comfortable position so these patients are paralyzed with drugs and heavily sedated. And its very hard to get them to improve so a lot of our patients are still spending 16 to 18 hours a day in this present position even after 2 weeks on our intensive care units. Little of yourself and your colleagues their national Health Service of not being overwhelmed in the way that many people fear of the start of the earth outbreak. How is the situation where for potato mcquillan which has been well reported as a major scandal that the people are being sent into the front line with the proper equipment how is that been resolved professor norman well because it hasnt as yet and the course this is. Said to say that the n. H. S. Has managed to cope thus far but its largely being to teach the heroic efforts of the British Public to be honest the fact theyve taken the lockdown so seriously that has flattened the wave as they say tend to tsunami into a much longer slower road but the burn rate on materials and resources has been huge so most hospitals are in trouble with the numbers of pumps a half were running out of the filtration units the things that are used for a kidney support when kidneys fail and indeed for the fluids were running short of the sedatives and im ascetics and paralyzing agents and this isnt just britain this is worldwide every country is facing this sort of challenge because the production and supply and distribution of these drugs wasnt good for an event such as this and it takes time to ramp up so its a it is a real challenge we are beginning to try to work out even today how were going to get around this is it possible to wash and clean equipment use different sorts of clothing and so forth. But thats itself can have challenges one of the ways in which this bug is most readily spread is in actually taking off the clothing where just the act of shaping the fabric can release of the virus so were going to have to develop new patterns of working if we are going to start reusing this protective equipment rich i suspect that we are 1st mcgovern the key emphasis has to be on Public Health at the present moment that theyre the organization to stop the spread of the virus until such time as there is a drug therapy available which can make a crucial difference. Yes or indeed in fact until theres a vaccine because until there is a vaccine this disease will continue to spread and will in fact pretty much everybody that hasnt had the disease until we get up to this thing called herd immunity where as enough people to make transmission between patients were between members of the public very much harder so this is going to continue to spread until a vaccine appears or until the bulk of people in the population of contracted the disease and the only way as we say that we can cope with this is to shoot the most vulnerable and kill a large number of the public have been infected and get the disease after harder to transmit but also such that there are the a trickle of patients coming in in a more continuous fashion rather than a tsunami of patients hitting us in which case the Health Service can code and this is going to be a real challenge to any politician can anywhere in the world and weve seen this in japan it managed to lock down very hard aggressively suppress transmission of cases at that now because there isnt very much herd immunity its coming back in Massive Force and this will apply to any country thats managed to suppress the virus when they lift the foot off the brake it will spread like brushfire again so the trick can to me get a vaccine will be to try to take ones foot off the brake sufficiently to allow can people to contract the disease but not in such numbers that the Health Service in that country cant cope and then of course theres only 5 weeks sense in the u. K. Of the were holding the cello festival where for 100000 people grouped together or their 6 nations rugby were for 20000 francs supporters across had been. Rather obvious things for what with levon the infectivity of this condition it went at least woodstock that sort of event. For the foreseeable future well indeed and of course it is there it is worth pointing out that the social isolation as well that. The distancing measures even when people are together make a massive difference so when im in the hospital obviously i have to work with colleagues and outside were not swearing p. P. S. Well we were in the precursor protective equipment is when we have it is a red zone with patients but we maintain a to meet a distance from each other we dont pass each other on stone wells when were doing handovers the chairs a position to be to meet the park one another we wash our hands regularly and frequently whenever i see an alcohol gel bottle or sink on washing my hands and by doing that it makes infection exceedingly difficult to contract so the instance in my own hospital has been very very low indeed and this applies to the general public if they do it once the lockdown is lifted a bit if they do maintain that to meet a distance if they do continue not to shake hands if they do wear masks not to themselves but to prevent coughing and transmitting to other people in asymptomatic phase and if they wash their hands regularly all the time because whatever they touch may have been infected and if they themselves are asymptomatic they can be spreading the disease that way that in itself makes an enormous difference. And finally with a speedy and she have had on the front way married to your your vast academic expertise on the subject if you had one lesson to deliver to policymakers around the world given the experience of the vicious condition what would that be in terms of how they develop the policy weve got to put this i think in a much broader context of the way in which were treating our planet if we tracked down rain forests aside that we can see exotic meat and cattle together everything from snakes bats pangolins which. Pickens and dogs in market spaces and then everyone thinks its their right to fly around the world as often as they like wherever they go then there is no hope for us because this will continue we have to start recognizing that the planet is itself a vulnerable that we are biological organisms as part of an ecosystem on it we need to reconsider completely the way in which agricultural creates trait the way in which we manage our Natural Resources and the way in which we travel because these sorts of behaviors supporters to this point and they will continue to do so again so the world needs to rethink how it behaves and also to learn to paid a great deal more cooperatively as we are learning to do now unfortunately sad times a great deal more cooperation has been before and we need to make friends not enemies 1st my governor from west london thank you very much and good wishes to you and your colleagues thank you very much like having me. Coming up after the break i will speak to dr chris smith the cambridge football just who runs the naked scientists podcast. Financial guy. Im with you. Some of my its from the future cracker. So what weve got to do is identify the threats that we have its crazy. Let it be an arms race. Spearing dramatic to follow only. I dont see how that strategy will be successful very critical. To sit down and talk. Welcome back and the be having a family and dr chris smith the vote all just from Cambridge University who forecast very clearly the extent of the coming few early today he joins me from the village of boddington just a few miles outside cambridge. Dr chris murphy from the information we have today both in this country and of course internationally what has surprised you about the nature of this virus the speed with which it appeared and then spread and then spread through society and the impact its had you know ive been giving lectures for more than a decade on emerging infections these are infections that are newly appearing in the human race or used to be confined to one small geography and of suddenly started to extend and spread across a bigger range and so i was fairly familiar with what could happen but its even taken me by surprise you know the scale of this the Economic Impact of this and the psychological impact of this i never knew what it could be like to be confined to my living room and now im finding out santa dont like it how course in your estimation are we to ward see drug therapy which can make a difference. Well drugs take a long time to make especially new ones and the current estimate is youre looking at about 10 years and 10000000000. 00 and i dont mean 10000000000. 00 tries i mean 10000000000. 00 in some cases and if you ask most people in charge of pharmaceutical companies they will tell you that 90 percent of their ideas fail so theyve got about a 10 percent success rate so its a rule of tens here and so its not exactly easy to deliver a new agent with a new drug and against a new virus weve known about for just a matter of months this is a very tall order its not impossible but a very tall order so what people are doing instead is theyre saying well are there any drugs that we already have which we could repurpose now the basis of this is that all drugs have side effects and sometimes just by chance you find that a drug that you made to treat a totally different condition just by chance happens to hit this new infection or this other disease and cure it as a side effect this is called repurpose ing because if you can take a drug thats already on the market its already been through safety trials we already know how it performs we know how to handle it safely its much faster to take that existing drug and create a new use for it and thats exactly what doctors and scientists are trying to do with this new coronavirus outbreak theyre exploring a number of avenues but again these things do take time and theyre not guaranteed to work its not like your tayla making an agent like you would with a new drug so all all cards are on the table no cards are off the table are you and your colleagues at cambridge are part of that effort is a genuinely International Effort to fight that sort of. Yes both whats amazing is the way that this has galvanized and brought together the Scientific Community people are sharing data the deluge of publications and information and science coming out every day is impossible to keep up with this so much of it and the whole collaborative feeling of people working together to try and find a solution is really heartening really heartwarming a really exciting and Cambridge University many universities doing this but im really reassured and boyd up by the fact that theyve taken one of the one of the biggest departments in the university and one of the most powerful with a really big headcount and basically repurposed what that departments going to do and made its main focus dealing with the coronavirus and that means dealing with understanding how it makes people im well it means dealing with understanding how to treat it better with possibly finding new drugs and also possibly pursuing vaccines as well so theres some really bright people from across a range of different disciplines all working on this and its really amazing to see how universities are able to in this very agile way change their focus to to deal with this so im kind of reassured because weve got some amazing scientists in this country and some amazing doctors and so were really well placed with some of the best universities as well to take this on and i think its really bringing people together. And despite the amazing scientific b. S. And the extraordinary efforts of the last full Health Service the death rate unlimited kingdom per head of population is 5 patients the germany and 50 times that of korea though these differences all lie in the realm of Public Health imho the intercepted the virus or are there any other explanations for example genetic or population fight no cards are off the table people are investigating and pursuing this actively youve got to be careful though with any kind of comparison that youre really comparing apples with apples and this is one of the frustrations various countries are testing various people in various different ways in various amounts and generating data and its very easy to say well this is what germany have done and this is what career of done and this is what britain have done you must make sure that the denominator is the same germany havent tested the same spectrum of their population that we have for example so germany knowledge that they have tested a very large number of Young Healthy fit people a significant component of which were downhill skiers there are not many older people who are with multiple Health Problems going downhill skiing perhaps a few but not many so if you go and test lots of people who are otherwise fit and healthy and theyre low risk youre going to report an artificially low rate of death what we do need is testing to find out whos immune and this is whats coming next is proved a bit of a frustration for the government i think because its a very new virus its very hard to make really good tests that work reliably and work at the kind of level and scale that were going to need but that will be very valuable because then well be able to tell people who is and who isnt immune and then we can begin to decide who can safely go to work and work with patients or work with say older more Vulnerable People who at the moment might be reliant on a carer to bring them shopping or to take care of their day to day needs and that cara could also bring them coronavirus whereas if the. Karas known to be immune then that carol wont bring them corona virus so it could be that we can use a test like that to help people keep people safe while also exploring other avenues such as a natural herd immunity approach to ending this lock down a dog to smoke on the spot of the family im unfortunately for your forecast was for all to correct in terms of the dangers of the violence i must put you on the spot again what do you anticipate happening as the guards the drug therapies and treatments that may write to our rescue when do you think given the knowledge we have at the present moment these will become viable lemaire to come to humanitys rescue in terms of a vaccine it would be wonderful if we had a vaccine that we could very quickly produce produce at scale and by scale were talking billions of people are going to need to be vaccinated if were going to stop this thing and we need a vaccine that will work quickly and a vaccine that will be very safe that is an incredibly tall order to produce in a matter of months some people who are suggesting will have one by the autumn well i really hope theyre right but talking to the vaccine experts and for all just that ive been discussing this with they are not optimistic in either my theyre talking about at least 18 months maybe longer and to produce something at that sort of scale is a really really tall order so whats the plan b. Well i have a very sneaky suspicion that what were going to have to do is some kind of staged deescalation of this lockdown which is going to be informed by understanding where the virus has circulated most in the country where it continues to circulate most in the country and this will be informed by testing both antibodies showing whos immune and who isnt and whos currently got the virus and i suspect that what well do is come up with a way of driving a degree of of natural herd immunity while safeguarding and shielding those people who are most at risk in society so that we arrive at an end point where we have enough people who are immune to stop the virus circulating appreciably. Or treat people without the need for enormous amounts of p. P. A. Or go and look after elderly people in care home residents so were not putting them at risk but we can at least drive that immunity we all need because i just cant see us getting out of this anytime soon if we dont resort to some strategy like that i dont think anyone can foresee it being possible to do multiple lockdowns and then reductions in lock downs because all you get is a boom and bust situation as were seeing with other places like hong kong and singapore and i dont think that that unpredictability is any better for people than the present situation the economy certainly wouldnt take that dr chris murphy from cambridge thank you very much indeed and best wishes to you and your colleagues thank you very much thanks for having me. This said on the global flu pandemic of a century ago the socalled spanish flu actually got very little coverage at the time one theory is that despite killing up to 50000000 people it was difficult for people to rationalize the deaths of so many fit young people and the aftermath of the killing fields of the 1st world war there were these things an entirely different thanks to 24 hour modern media the new killer virus was well known about everyone even before mabs from one province in china just so theres no policy maker on the planet who can claim an alibi of lack of knowledge or information about the coming few really and faced with that challenge it should be said that a number of governments east and west rose to the challenge and the results of very clear to see south korea taiwan germany new zealand molto iceland the pharaoh islands each of these countries and each of these governments have been the only ways managed to keep the killer virus bay and they have employed Rocket Science theyve all followed in terms of their own suckin stances the World Health Organization of christ to test test test trace trace trace and as a result of managed to suppress the tell a virus no doubt theyll continue to try and do so until such time as a vaccine or the therapeutic treatment writes to humanitys rescue other ministrations of failed them failed utterly sprogs the case italy was overwhelmed before the virus was clearly understood that the snow is chris for the governments of belgium france of spain of the United Kingdom and above all perhaps the United States each of these administrations failed to act until the virus was spread throughout the communities and the high casualty of the death rate among the populations as a result. That is not to the client under way and anyway those in the front line and all of these countries the people in the Health Service the caring professions who are making superhuman effort to stem the teller tide but to continue in the 1st one a war analogy these people or the lions will be led by donkeys. It is to be hoped no that the same governments having failed to stop the spot i had the flu pandemic all of whom possess extraordinary resources will know dedicate these to planning a rational way out of the the grip of the virus and it will also fund scientific based on the International Effort required to find a vaccine or fed a few to treatment and above all the hoppes will understand the a many millions across this planet whose governments neither have the resources even if they had the results to tackle the violence effectively its only through that collective effort that will avoid d millions dying of coronavirus in 2020. Or so from cosmina myself in the west of the team its goodbye from now and well see you next week. This is. So so. That what it. Was and. Am i think. The world is driven by dreamers shaped by some person or those. Thinks. We dare to ask. E. U. Leaders scramble to draft a final coronavirus to rescue plan as the worst hit countries accuse the other bloc that this is not doing enough. The us is gripped by protests against look down measures that as the pandemic leaves millions of americans out of a job and Small Business its on the brink of collapse. As italy hopes to turn a corner when its fine to get skopec 191 for the patient from turun shares with us his story of how he was admitted into intensive care but managed to beat the virus. In the beginning i viewed it as negative positive later when