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Right. No recording again. So yes, just sort of following up on that, has the work we've done on area transmission,

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level transmission changed policy, for instance, in this country?

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You've told me what's happened in W.H.O.

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I think the work I did on masks, I think did have some influence on the policy decision to introduce masking in July 2020.

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I think the work I've done on airborne transmission has had some influence, but I think to be honest,

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what's happening in the UK at the moment, speaking in early November 21, is.

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We seem to have gone into a policy of relying on vaccination and assuming that we now can drop all other measures.

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So the question of whether this is an airborne virus or drops the virus has really

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been parked because it's now seen to be a virus that's controlled by vaccination.

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And there is a narrative that we have uncoupled the from the transmission of the disease from severe effects, the disease.

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That is not a view I personally hold.

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It's only a couple of days since we have nearly 300 deaths in this country.

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You know, we're regularly getting over 200 deaths a day.

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And yet it is assumed that because everyone is vaccinated or many people are vaccinated, it's not a serious disease anymore.

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We've kind of conquered it. That is highly, highly problematic for you.

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I am very, very troubled by this concocted truth in inverted commas.

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I wish the debate on the mode of transmission was front and centre, but it is not currently, which is a great shame.

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I think well, we talked about this a bit, but I just focus on why you think it's been so difficult for the medical science as a whole.

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Actually, there's another question on both the. Evidence based medicine.

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I remember when the phrase kind of first came in and everybody thought, Oh, what a good thing would come from this time,

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when it was all kind of [INAUDIBLE] conceit based on personal experience to it, to a time where treatments are all based on evidence.

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But the term almost seems to have. Broken down in a way, because you have to question what is what is evidence?

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How is how do you decide what evidence to pay attention to what what's your view on that?

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It's very, very interesting, isn't it? I think evidence based medicine was a very clever piece of marketing.

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And actually Mia Grey,

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who is an Oxford professor who claims to have developed the term evidence based medicine to kind of market the ideas of clinical epidemiology.

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And clinical epidemiology says if you want to make a treatment decision in an individual patient or indeed diagnosis decision,

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you should be taking account of research into populations.

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You shouldn't just be treating the patient on the basis of whether the previous patient got better at a particular drug.

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Now, I think we're all signed up to that, but that doesn't mean that the methods and evidence hierarchies that are appropriate

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for assessing the efficacy of drugs or the the accuracy of diagnostic tests.

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Applied to every aspect of anything health related.

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And I think the evidence hierarchy of evidence based medicine has been naively misapplied to dismiss aerosol science.

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And if you go back to what I was saying about interdisciplinarity and how my

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own personal doctoral work shifted from a biochemical focus to a much broader,

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you know, anthropological focus and. I think we need people who can change horses.

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Change disciplinary horses when it's needed. And the problem with evidence based medicine is.

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It's really just code for clinical epidemiology and it is a unique disciplinary perspective which favours epidemiology.

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And we don't need epidemiology, or at least it shouldn't have an exclusive or privileged position.

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I mean, epidemiology of COPE is very important. But when what when the question is, is the virus airborne?

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You need aerosol scientists, you don't need clinical epidemiologists because they're not trained to do that.

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This seems to me to be such a basic thing.

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I honestly. Cannot.

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I can understand why people got it wrong, because it's all about the link between science and power.

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But. It's it's something I think future historians are going to look back and say, gosh, gosh.

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Even with so much research funding, so much scientific evidence, they still completely dropped the ball there.

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That's great. Thank you. I think, again, you mentioned this a bit that we can develop it a bit.

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To what extent have you personally felt threatened by the infection, either in the initial phase or more recently?

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I want to take this infection very seriously. And I haven't had it.

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I have you know, I'm a cancer survivor.

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I've been very sick with sepsis in the past.

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And I don't want to repeat that experience because I was convinced from an early stage that this virus was airborne.

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I have not been on public transport since the beginning of the pandemic.

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I have only been into my department three or four times.

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Every single time was on a Sunday or late at night, and there wasn't anyone else in the building.

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And I have been to very, very few face to face meetings, maybe two or three since the beginning of the pandemic, because I don't want to catch it.

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So. You know, I haven't personally had it.

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As I said, my mother died of it. My son had what was actually pretty mild COVID.

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So it wasn't very nice at the time. But, you know, ten days later with better and.

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I think the way COVID affected me. Apart from losing my mother, was an awful lot of my staff were affected by lockdown and furloughed.

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You know, all were homeschooling their kids, that kind of thing.

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And I think I'm not alone in that, but certainly.

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It was a bit of a struggle, but that was a sort of indirect, really.

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You know, physically I've been completely unscathed. Again, you've answered this one that you could perhaps again develop say how it panned out later.

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Did you work longer hours than normal during the pandemic? Crazy as crazy I was.

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And in fact, someone asked me recently,

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what would you have done differently if you if you if we could kind of play that first few months of the pandemic again?

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And I said I would I would have taken more breaks because we were working at an extraordinary pace, an absolutely blistering pace.

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I published more than 50 papers in 2020.

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It's one week. It was crazy.

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And actually I've published over 40 this year and I finished.

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Yes, I hadn't got much better. But actually, of those first 50 papers, you know, I'm talking to you about five or six of my papers.

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There were an awful lot of papers that weren't that good, actually, looking back.

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And although every single one of them was done in good faith, we tried hard.

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I think if we taken a step back, taken a weekend off from time to time or something like that,

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we may have done a few pieces of work, but done them slightly better.

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Having said that, I don't think we would have known at the time which ones we should have focussed on them, which ones we shouldn't.

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Because that first masks paper, the one for the precautionary principle.

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It only took a couple of days to write. We didn't know it was going to go viral.

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We didn't know masks were going to be such a big thing. So it's all very well with the retrospective scope, isn't it?

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But in the in the fast unfolding of events, it was quite hard to know what to focus on.

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And I think, I mean, you said it was five months that you had this extremely intense period,

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the implication being that since then you haven't been getting it quite such a blistering pace.

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But on the other hand, you have produced you did produce a huge number of papers.

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Did you actually get a chance to take time off or did you institute a regime of regular breaks from that time?

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Um. I've had two weeks holiday in the last two years and I've got another one the week after next month.

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She said that by three weeks and two years, so that's not very much.

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On the other hand, it's quite hard to go on holiday. I do stop now most evenings.

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I think. The pace of work.

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I think doing 16 hour days was crazy.

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So now I could do 12 hour days. But there's still plenty of work to do, actually.

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And also, although, you know, I'm working long hours, as I said, I don't feel particularly stressed by it now.

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It's quite fulfilling. I'm finishing off quite a lot of projects that have been running for a few months.

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I'm finding it quite sort of comfortable intellectually.

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There's some very, very interesting philosophical work I haven't talked about much, but for example,

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I've been linking up with some pragmatist philosophers because I think pragmatism is a really,

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really interesting theoretical lens to look at the pandemic through.

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So one of the papers I've got under review at the moment is around.

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Crisis policymaking through a pragmatist lens.

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That's almost like a hobby and it's very different from the kind of work I was doing at the beginning of the pandemic,

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which was very much about how can we stop people dying today and tomorrow?

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I've now shifted gears a bit and started thinking.

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Wait a minute. What does this pandemic tell us about pandemics generally or crises generally?

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And that, I think, is is quite rewarding and productive.

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You know, you can see all the. Feel particularly stressed right now.

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Time to do this interview if you don't speak about this.

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18 months ago, I said sorry, ample time. So I think things are settling down a bit.

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Yeah, I do. Is there anything that you do within your group to support the emotional well-being of your colleagues?

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That's a really interesting one, isn't it? I am cynical about some of the emotional well-being stuff that goes around.

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So we have this email that comes around every Wednesday and the headline is Wellbeing

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Wednesday and it says things like Take 20 minutes away from your work or that kind of thing.

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It's too formalised, it's too technocratic.

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It's like going on a resilience course. I think the way.

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I have. Tended to do it is.

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Picking up a lot of bitty things that people weren't coping with.

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And so I would pick them up and.

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You know, help them with it. Various people,

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various of my early career researchers had been slogging away at a paper for months

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and not being very productive because all the stuff that was going on and I.

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Had more input to those papers than I would normally have had,

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but I've made sure that they got the paper finished, submitted and published, so they've got the line on the CV.

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I actually think that kind of input is a lot more helpful than let's all have a virtual coffee morning.

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Although we do do virtual coffee. It happens once a week.

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They tend to do it without me, actually. Some people find it very helpful.

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Some people don't. I've done. A couple of other things with my group.

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I'm friends with a Danish academic called Nina.

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Maya, and Nina has an interest in.

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The support of the and mid-career researchers.

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That's one of her research interests.

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And she was in a situation where she wasn't doing a massive amount of pandemic related work and she had a bit of extra time during the pandemic.

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And she said, Is there anything I can do? And I said, Well, can you do some sessions for my team?

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So she did some virtual sessions on academic writing and helped individual members

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of my team with some of their papers and gave them feedback on draughts of writing.

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And they found that enormously helpful.

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I think mainly because Nina is wonderfully gentle and slightly motherly and in a nice way, if I can say that.

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And it was because it wasn't me helping them.

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I think they were sort of saying interests kind of going off saving the planet.

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We've got this protected space with Nina who's not doing pandemic stuff.

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She is committed to us. And actually I use some of my pandemic money to.

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Pay her for that. Now, talking of pay and money.

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We also responded. We applied for University of Oxford Pandemic Funds to return people to work after the pandemic.

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Now we have lots of different people with different problems and challenges,

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but what I did was I helped, I think, seven or eight members of my team each to apply for £5,000.

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And we used that money to pay the salary of somebody who came in as a research assistant, and they used her time.

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Flexibly however they wanted. So they said, Please, I want you to help me do the background work for grant application.

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I want you to help me finish this paper.

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And it was good for the research assistant because that person had come to the end of the contract and would have been made redundant.

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But it was also good because I said to people, I don't care what you do, I don't want to.

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I don't even want to know. Here's an extra pair of hands.

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And other people would say, Oh, that's brilliant. That's just what I need.

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And they would come up with an idea for using this person's time, which is far better than what I would have come up with.

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So practical help was important. What else?

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Sounds like pragmatism again? Yeah, just true. I was very pragmatic. But then.

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But then pragmatism. It's not just about being practical.

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It does have a kind of philosophical underpinning which is which is something I'm getting quite interested in.

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But I didn't say onto this tape because I'm actually a novice on pragmatism and I probably get it all wrong.

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So will you be involved in your institutional department's code safety regime?

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No, no, I offered to be, yes. But I was told that I wasn't needed.

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What? Are you satisfied with how it was implemented? No. There's droplets which are everywhere, which is one to go in.

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I'm quite gobsmacked actually at the.

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The way in which droplet theatre has.

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Dominated Oxford's response and the way.

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Airborne precautions have not been taken on. I'm just I think yesterday or the day before, we published a new paper.

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Peer reviewed and welcome. Open research. All about getting back to campus, know, returning to on site teaching.

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It was a rapid, systematic review of the literature on what should be done.

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The most important thing is vaccinating staff and students and getting vaccination levels up to 90%, if we can.

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The next most important thing is instigating airborne precautions, including masks, etc.,

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etc. and that we published it or a version of it through the U.S. you through universities and college union.

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It was sent to every member of U.S. U. And it's now being published as a peer reviewed journal with a few more references.

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But it hasn't kind of hit the desks of the people who are running the response.

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And my emails. I don't think I've had replies to them.

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So. Yeah, that sad. Sad.

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On the other hand, if we talk about emotional well-being, you know, in the end,

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you can only do your best in the end if they're not going to take any notice.

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I'm. I mean, I remember when I was a junior doctor,

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I used to cry myself to sleep when a patient died and someone took me aside and said, You never can survive in medicine.

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You did what you could do. And if someone came in with crushing chest pain and you gave them the right drugs and you got the drip into the vein,

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and you, you know, you would there and you put the monitor on and they still died.

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They were going to die. And it's not your fault.

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And I sort of take a bit of the same approach here, is that unless if you can't do that, you're going to go crazy.

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So I've done my best. I've made my offer.

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I've published these very high profile papers.

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And if they choose to ignore it. You know.

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I'm not going to beat myself up. You mentioned earlier that that your public profile that you cannot tell you at all.

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How have you felt about that, both in conventional and social media?

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You're you're now a name that's known much more like, um.

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It's not something I was seeking out. I don't court the media.

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I don't have an agent. I say no to 90% of requests.

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And I've very narrow, very much narrowed down.

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So people phone me up, they Google my mobile number. They say, please, will you be?

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I got a phone call yesterday because you have Good Morning Britain tomorrow.

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And then you say, well, what's it for? And they'd say something.

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You think, Well, I could talk on that subject, but I'm not the world's expert on it, and it's not what I'm known for.

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So I will say, No, I'm not going to talk on that.

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I'll talk about mosques and I'll talk about airport precautions, and that's it.

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And they'll talk actually about revoke, but they can go find someone else to talk about the other stuff.

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But actually, in recent weeks, I've refused all media.

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And that's partly because, although I'm not feeling particularly stressed, did actually stresses my family.

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It's just it's my husband and it's often they want you at 10:00 at night and then they'll keep you waiting.

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So you're actually not on to quarter to 11. And then it's actually quite hard to get to sleep.

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But you've done live TV, so I've done quite a bit.

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It's. It's very time consuming.

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I don't like the attention. I don't like if I've done a TV appearance.

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I didn't get 20 emails from people saying, Can you do local radio tomorrow?

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And I don't like the abuse. I haven't talked much about the abuse, but I was going to ask you today.

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Yeah, I don't need explicit examples, but I mean, it's it's it's something that anybody with a high profile.

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Yeah. Something. And so I think the mosques thing has been the worst.

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Um. People have. Systematically set up groups to attack me.

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There are the sort of dark Web sites of, you know, libertarian groups.

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I know that I'm on that list.

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So, for example, one person will put out a tweet or site reply to one of my tweets, and within minutes there'll be 200 replies,

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all saying very much the same thing as if they'd been told that this is the version to use.

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And sometimes it's identical text. And you just think.

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I've got better things to do with my time than engage with that.

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And I go around knocking people. But this is not what I want to spend my time doing.

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It's time consuming. It's exhausting. It upsets my husband because he doesn't either.

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I mean, obviously, there was someone put out on Twitter the other day that I should be raped with a bayonet.

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Well, you know, that's all very well. I just think. Well, that's what 14 year olds say about women they don't like.

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It really didn't bother me that much. But, my goodness, you know, it upset my nearest and dearest.

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So I don't really want to spend my time inviting that kind of thing.

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I don't lose a lot of sleep over it. I just try to avoid it.

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Do you find in general you have found Twitter useful?

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Yeah, because I because I control I block people.

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I use mass blocking tool sometimes to block everybody who follows a particular extreme libertarian think that they're following that person.

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I don't want them to have anything to do with me, so I'll put 500 of them or something.

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Then I have to apologise sometimes because sometimes people have followed them and

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then they've forgotten they're following them and they don't agree with them. So I have to kind of unblock people, but that's what you have to do.

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Obviously, number one, we're. Another ten minute.

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So how have you. I'm just just clarifying this.

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I think we talked about a little bit earlier. But are you are you not associated directly with any policymaking body?

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That's right. Oh, goodness. No, I better get this right at night.

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Until quite recently, I sat on a committee at the World Health Organisation,

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but it wasn't the one that was dealing with the covenant response, so it was the Alliance for Health Policy and Systems Research.

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I sit on, I think last count, about 13 national committees.

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I am on the long COVID National Task Force. I was on the nice oversight group for the long COVID guideline.

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I've done various pieces of work with the.

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What's it called? NHS England. Digital Primary Care.

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Primary Care Digital Transformation Team. That's what its primary care digital transformation team.

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I think I'm an official advisor to them. So, you know, one one works with policymakers.

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Yes, but I'm not on any of the formal convened the ones that are.

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Should we say in the public like. In relation to Cove.

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It's safe to say I'm not on Sage, I'm not on Nervtag.

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I applied to be on the stage actually, and I was told that my expertise wasn't appropriate, which I think is clever.

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What would the other ones? I'm not anyway. I'm not all any of those know, and I'm not even on independent sage,

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which is quite interesting because often when you've got a high profile scientist who's not on Sage, you'll find that they are on independent sage.

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But I have appeared on the Independent Sage, you know, that broadcasts because, you know, I've gone there as a guest.

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So I'm friends with them, shall we say.

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So has the work you've done raised new questions that you might be interested in exploring in the future?

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Yeah, I think all the stuff around pragmatism, I just put in a grant to the MRC under No Child for funding to appoint a postdoctoral philosopher,

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to look at how pragmatist philosophy can help us in these very action oriented research approaches where you've got to generate stuff in real time,

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interpret it, apply it all in a big sort of unfolding jumble, if you like.

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And that's interesting. That is the thing that's most grabbing me at the moment, actually.

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Yeah. This is a last question.

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Has the experience of Coke changed your attitude or approach to your work and the things that you'd like to see change in the future?

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Um. That's a really interesting question.

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And it's out of all the questions you've asked me, it's the only one I haven't got an immediate answer for,

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and I think it's because I'm still too close to it. I think if you asked me in a year's time, I would know.

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But it's because I'm still experiencing code for it, I think.

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What on earth is going to happen in the future? I don't know.

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I mean, I've got a, um, I've got an application which I doubt will be funded,

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which I put in about nine months ago for a leaf, a human senior fellowship to write a book about Wittgenstein.

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And there was a.

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A friend of Wittgenstein who was a doctor who wrote a book called The Danger of Words.

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It's a chapter called Mastery, and it's all about how some of Wittgenstein's insights are very relevant to medicine.

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And I applied to leave HUME to.

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Right, a modern day version of that book, because actually it was written in the 1950s, early sixties, I think, and medicine's changed hugely.

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But actually some of the work of the later Wittgenstein would be incredibly relevant now.

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I put that in thinking I would if I got it, I could then spend three years writing a book and then retire because I'm 62 now.

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Would that be wonderful? And then I thought, would I actually do that?

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Because I would have thought when I wrote the application, I thought the pandemic would be over by now.

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Whereas actually with pandemics now grumbling along, there's all sorts of, you know,

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terrible things happening, like be dropping old precautions because of the,

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you know, the idea that we think we're vaccinated so that that can I really can't just go and sit in the Bodleian and write a book about Wittgenstein.

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Even if I get funding, I'm not sure. I really don't know what the answer to that is.

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It'd be interesting, anyway, that my hand would probably be false because they probably won't fund it.

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But it would be. It would be a big change. It'd be complete transformation if I did get it.

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Thank you very much. Oh, don't do that. Okay.