I was a Covid sceptic. No longer

In recent days, we have seen some critics of the early pandemic restrictions breaking ranks and offering support for the current lockdown.

I agree. Given long experience of hyped up health scares and pandemic false alarms, I too was sceptical at first about the menace from Wuhan. Then I began to see patients coughing and gasping in general practice and heard reports from colleagues of waves of nursing home deaths. Covid-19 was clearly something new and something different.

Faced with a disease more infectious and more lethal than the familiar flu, and in the absence of any specific treatment or, until last month, any vaccine, our only hope lay in measures of social distancing, quarantine and lockdown.

Unfortunately, some sceptics continued to blame public health authorities for scaremongering over Covid-19. These complaints persisted even as sceptical summer predictions that the pandemic was ‘over’ were falsified by the steady rise in cases and deaths in the autumn. If some now accept that Covid-19 is serious, others still insist that the lockdown is even worse.

That there will be hardship, poverty and even deaths as a direct or indirect result of lockdown policies is undeniable. When the economy suffers, and inadequate health systems fail, people suffer. With a vaccination programme in progress, of course it is imperative that plans are made now to repair the damage. But I feel that the duty we owe to those who now face a clear and present danger of dying from this disease must be the immediate priority. And we owe that duty just as much to the old as to children. That this has to be said is the pity of it.

We now need to balance taking Covid seriously with healthy debate about lockdown policies and what can be done to mitigate their impact. Some sceptics have sensibly come to recognise this and to accept that earlier claims that we had “reached herd immunity” have been overtaken by the rampant second wave. Yet others have doubled down in their dogmatic outlook, becoming, in some cases, quite irrational. Indeed, they have given a more grounded scepticism and wellfounded questioning a bad name.

A gut feeling

A reader reports the alarming experience of developing explosive diarrhoea and cramping abdominal pains shortly after testing positive for Covid-19. She writes to urge the importance of wider recognition of these symptoms, which may be overlooked by doctors – though not, mercifully in her case, by the paramedics who came to her assistance.

It is indeed true that Covid is still regarded as a primarily respiratory infection, though there is a growing literature on its gastrointestinal manifestations. Early studies from China and Italy reported GI symptoms in up to 30 per cent of cases – and in around 10 per cent as the presenting complaint.

As Robert Glatter, the gastroenterologist at New York’s Lenox Hill Hospital, says: “This virus has thrown a curveball at us, as we now realise that gastrointestinal symptoms may be the initial signs of the disease, even without cough, fever or difficulty breathing.”

The “good news”, says Glatter, is that GI disease in Covid is “typically mild”. Covid emergency: Ambulances queue at the Royal London Hospital

Smallpox returned

Further to my recent reference to smallpox in Bradford in 1962, several letters have pointed out this was not the last outbreak.

In August 1978, Janet Parker, a medical photographer at the Birmingham medical school, was diagnosed with smallpox and died three weeks later.

Some 500 contacts were hastily quarantined and another 500 immunised. Only one other person – Parker’s mother – contracted smallpox, but in only a mild form.

Her father died, presumably of a heart attack, while in quarantine. Another casualty of this was Prof Henry Bedson, an internationally recognised authority, whose laboratory was assumed (though never proven) to be the source of the outbreak.

Overwhelmed by guilt, he committed suicide. The last natural case of smallpox had been recorded in Somalia in 1977 and in 1980 the WHO declared its eradication.

If some now accept Covid-19 is serious, others still insist that the lockdown is even worse