REASONS TO BE (A WEE BIT) CHEERFUL

Yes, the crisis is bringing out the worst in people (take note, panic buyers) but also the very best, with an outpouring of altruism. And of course we will get through it, by doing one simple thing...

IDON’T think it is an exaggeration to say this is the greatest health challenge this country has faced in our lifetime – but we also have the most advanced healthcare system ever. I can assure everyone that the NHS is ready and is adjusting to what it needs to do over the coming weeks and months.

It is more important than ever that we care for our friends and family now, as well as for those whom we need to look after us, such as social care and NHS workers, and staff in supermarkets.

I would like everybody to be kind, particularly to those groups, but especially to each other.

Prime Minister Boris Johnson is correct when he says be prepared to lose some of your loved ones.

In public health we use a horribly technical term, called ‘excess death’, but when you humanise that expression it means the actual people who will die because they get infected with coronavirus.

For First Minister Nicola Sturgeon to say that some of the decisions she has made in the past week have been the most difficult decisions of her life, that is the level at which we are acting and why we are taking it so seriously.

But there is absolutely an end to all of this and the health service will still be here. The vast majority of people will have mild illness and recover. Society will continue and we are hopeful that people – thanks to the intervention of the Chancellor and Scotland’s Finance Secretary – will survive in their jobs, and we will protect vulnerable groups.

We will come out the other end – and with fewer deaths if people follow the guidelines. That’s the simple, single most important thing to remember and act on.

We’re not messing around. If communities do what we ask of them now, there’s no suggestion Scotland and the rest of the UK will follow other countries and head towards a 15-day lockdown or that level of social isolation.

We believe Scotland will step up and help us to reduce the virus curve to an adequate level, to allow the health service to manage and people to be helped through this.

All the advice we have given so far, including the closure of social venues, is about precisely that.

If these guidelines are followed, people and families can continue to go out and walk, run, cycle, even play golf as long as it is in pairs and you keep your distance.

I’ve cycled every day this week back and forward to work. It’s all about social distancing, keeping back from crowds and people.

FITNESS, nutrition and sleep are very important for fighting viral disease, so I think it’s important that we keep doing that. This virus is not like the infections you see in the movies, where you pick it up in the air. We’ve got two types of science in this game.

We’ve got clinical science, which includes public health and epidemiology, and there’s behavioural science. It’s how people will behave when you do stuff, so if you tell 60 million people to do something, what happens? It depends when you do it and how you do it.

There’s a balance between making people worried and scared and making them feel it’s altruistic and best for them and their community. One of the things I have tried to do over the past 48 hours is to talk to young people about how their behaviour doesn’t just protect them and their 14-yearold friends but their 94-year-old great-grandmother and elderly neighbours. Fear will drive behaviour – but only for a short time. Altruism will drive behaviour for a much longer period.

Sir Patrick Vallance, the UK’s chief scientific adviser, said some measures could last for 12 to 18 months. He’s correct, but just as there’s been a curve into this, there will be a curve out of it. It won’t be like a cliff edge – we won’t suddenly say on a Friday night: ‘OK, everybody back, all is well.’

We’ll have to release the population slowly at the other end of this. It may be that the social distancing measures are relaxed for some groups and not for others, on a gradual basis. That may take some time to do.

The timing of that will depend on the viral spread in the community, and we are monitoring that. We’re testing and we will be able to test more and more as weeks pass.

We are following the right course and there will be changes to come.

The science moves fast because we learn more all the time.

We have to remember that the overall numbers of cases for the whole world is not in the millions, but in the hundreds of thousands – and that is a reason to be a little bit cheerful. And there are a whole lot of people who have had the virus and don’t even know.

We know that the virus hasn’t mutated because the scientists have isolated it in each country and there are very minor differences as it travels, but there is nothing significantly changing in the way it affects the people.

The other thing we have is patients, and it’s very helpful for us to know what happens when a person gets the virus and recovers, a person who gets the virus and gets very sick or a person who gets

I tell young people this is about protecting their 94-year-old great-grandmother

it and dies. This sounds a little harsh, but it’s helpful to not be the first country because you learn all the time from the actions other countries are taking.

I will never criticise another country’s response because it’s completely inappropriate to do so.

We are taking the science from Italy and China. On Friday one of my senior clinicians was in touch with the authorities in Wuhan and talking doctor to doctor about what the Chinese had done, where the responses were and the individual care for people with the virus.

We’re looking not only at the care but what is best to do with the population, and these are two different things that run at the same time.

We took radical steps in the NHS last week, and will again in the week ahead to prepare the health service for what is coming.

Our best estimate from the science is that if everyone does what they are being asked to do, and the health service does what it’s planning to do, the big peak appears to be in the next two or three months.

It’s going to be long because we don’t want it all to happen on a Wednesday. We actually want it to last a longer period because we want the curve of virus and line of health service capacity to meet.

We don’t want the health service capacity to be overwhelmed.

WE’VE had more warning than other countries, so we emptied the hospitals of those who don’t need to be there. We’ve cancelled elective surgery, such as cataracts and hip replacements, and we need people to be patient about that because we will catch up when this is all over.

Saving lives is the main thing. We’ve tackled delayed discharges of those fit to leave hospital safely, and we are doubling our intensive care capacity and going to move beyond that. Nationwide we are getting ready for the surge we know is coming.

Unfortunately, because of its tight population and extensive public transport, it appears that London is ten to 14 days ahead of us on infection rate.

In the meantime, it is correct that we are telling people to stop panic buying. It’s selfish. There’s no suggestion that food shops will be closing at any time as the outbreak continues. The food supply chain is intact and adequate.

The only thing that is making it inadequate is the selfishness of people taking too much. It’s beginning to annoy me, particularly when I see critical care nurses after a big shift unable to buy bread and milk. It’s madness.

But if panic buying is a negative, let’s look at the good things.

I’m seeing really good examples of community spirit, of people volunteering to help neighbours, and of having new ways of play and connection through electronics.

I’ve had teenagers thank me for saying on television that they could play video games more often.

People are buying headsets for their children, so that they can communicate with each other by chatting away while playing FIFA.

Society is stepping up and it’s terrific to see. There have been hotels and restaurants offering free breakfasts and free hot drinks for all NHS workers.

There’s something about society coming together to help with the overall population response that really gladdens my heart.