We are in a big mess, there is no doubt. We’re battling a deadly virus, the Prime Minister is in hospital and the country is in lockdown. A less optimistic person could argue that all is lost.
The constant howling from our media does little to help – portraying death and destruction nightly on our screens is just too harrowing for many to watch. Reporting daily numbers is necessary, but there should be a much greater focus on trends as any schoolboy mathematician will tell you. New infections are levelling off. It is clear that we are at the plateau phase of incidence with the numbers bouncing around a bit. A lot of the day-to-day variation just reflects delays in getting the numbers together for presentation. When the incidence falls significantly, and it will, the deaths will belatedly follow the same downward direction as in those countries further along the pandemic pathway.
People are terrified but hope is the best motivator. We now need a credible exit plan from this lockdown so people have something to believe in. And we need our politicians to push for this; epidemiology is not an exact science, but doctors are good at making decisions without all the data. Let’s publicly discuss a way out. We need to find the door to unlock the lockdown.
Assuming we see the number of infections continue to fall then following this closely will be a drop in hospitalisations and finally a fall in deaths. The crescendo of NHS activity is Easter weekend. The NHS can then begin to breathe a sigh of relief. In two weeks, the numbers could have dramatically improved and the focus will inevitably turn to finding that exit door. This is already starting to happen elsewhere in Europe.
Supposing my numbers are right I hope we can begin relaxing the lockdown at the end of April. This is only my opinion, not a prediction on how we should move forward. We need to start with tiny steps. Allowing small businesses and shops with less than fifty staff to reopen should be the first move alongside stopping the rigid isolation of families, hopefully by 27 April. We would need to continue to shield the old and vulnerable for some time. But opening small businesses would be very a positive kickstart to the economy.
But we would need to carefully monitor for any second wave. Assuming all goes well, the lockdown could be removed as early as 4 May. To the huge relief of millions of parents, schools could reopen, full public transport could be restarted and we can reduce widescale social distancing. Extreme caution would be required throughout, but on the whole Brits are a sensible group and will tread carefully.
As someone who enjoys a pub lunch in the sun, getting our bars and restaurants open will come as a huge relief. Hopefully in the middle of May this will be possible. Finally, if we still have a handle on the virus in June we could begin to hold mass gatherings and public events, with international travel happening soon after. This is an ambitious timeline but not out of the realms of possibility; other countries are already planning for the next phase. Shops and businesses are reopening in Austria as soon as 14 April.
The vast majority understand the danger that we face as a society but at the moment it is very difficult for many to see a way out of the darkness. I’ve treated cancer patients for almost half a century and the disease has taken far more loved ones before their time than coronavirus ever will. I’ve seen people overcome the darkest odds to survive and not once lose their hope. If we all show half the courage and positivity of my patients, it is only a matter of time before we can return to some normality. We only need to find the door that says way out very soon.
Professor Karol Sikora is chief medical officer at Rutherford Health and professor of medicine at the university of Buckingham