Right. No recording again. So yes, just sort of following up on that, has the work we've done on area transmission,
level transmission changed policy, for instance, in this country?
You've told me what's happened in W.H.O.
I think the work I did on masks, I think did have some influence on the policy decision to introduce masking in July 2020.
I think the work I've done on airborne transmission has had some influence, but I think to be honest,
what's happening in the UK at the moment, speaking in early November 21, is.
We seem to have gone into a policy of relying on vaccination and assuming that we now can drop all other measures.
So the question of whether this is an airborne virus or drops the virus has really
been parked because it's now seen to be a virus that's controlled by vaccination.
And there is a narrative that we have uncoupled the from the transmission of the disease from severe effects, the disease.
That is not a view I personally hold.
It's only a couple of days since we have nearly 300 deaths in this country.
You know, we're regularly getting over 200 deaths a day.
And yet it is assumed that because everyone is vaccinated or many people are vaccinated, it's not a serious disease anymore.
We've kind of conquered it. That is highly, highly problematic for you.
I am very, very troubled by this concocted truth in inverted commas.
I wish the debate on the mode of transmission was front and centre, but it is not currently, which is a great shame.
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.
Actually, there's another question on both the. Evidence based medicine.
I remember when the phrase kind of first came in and everybody thought, Oh, what a good thing would come from this time,
when it was all kind of [INAUDIBLE] conceit based on personal experience to it, to a time where treatments are all based on evidence.
But the term almost seems to have. Broken down in a way, because you have to question what is what is evidence?
How is how do you decide what evidence to pay attention to what what's your view on that?
It's very, very interesting, isn't it? I think evidence based medicine was a very clever piece of marketing.
And actually Mia Grey,
who is an Oxford professor who claims to have developed the term evidence based medicine to kind of market the ideas of clinical epidemiology.
And clinical epidemiology says if you want to make a treatment decision in an individual patient or indeed diagnosis decision,
you should be taking account of research into populations.
You shouldn't just be treating the patient on the basis of whether the previous patient got better at a particular drug.
Now, I think we're all signed up to that, but that doesn't mean that the methods and evidence hierarchies that are appropriate
for assessing the efficacy of drugs or the the accuracy of diagnostic tests.
Applied to every aspect of anything health related.
And I think the evidence hierarchy of evidence based medicine has been naively misapplied to dismiss aerosol science.
And if you go back to what I was saying about interdisciplinarity and how my
own personal doctoral work shifted from a biochemical focus to a much broader,
you know, anthropological focus and. I think we need people who can change horses.
Change disciplinary horses when it's needed. And the problem with evidence based medicine is.
It's really just code for clinical epidemiology and it is a unique disciplinary perspective which favours epidemiology.
And we don't need epidemiology, or at least it shouldn't have an exclusive or privileged position.
I mean, epidemiology of COPE is very important. But when what when the question is, is the virus airborne?
You need aerosol scientists, you don't need clinical epidemiologists because they're not trained to do that.
This seems to me to be such a basic thing.
I honestly. Cannot.
I can understand why people got it wrong, because it's all about the link between science and power.
But. It's it's something I think future historians are going to look back and say, gosh, gosh.
Even with so much research funding, so much scientific evidence, they still completely dropped the ball there.
That's great. Thank you. I think, again, you mentioned this a bit that we can develop it a bit.
To what extent have you personally felt threatened by the infection, either in the initial phase or more recently?
I want to take this infection very seriously. And I haven't had it.
I have you know, I'm a cancer survivor.
I've been very sick with sepsis in the past.
And I don't want to repeat that experience because I was convinced from an early stage that this virus was airborne.
I have not been on public transport since the beginning of the pandemic.
I have only been into my department three or four times.
Every single time was on a Sunday or late at night, and there wasn't anyone else in the building.
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.
So. You know, I haven't personally had it.
As I said, my mother died of it. My son had what was actually pretty mild COVID.
So it wasn't very nice at the time. But, you know, ten days later with better and.
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.
You know, all were homeschooling their kids, that kind of thing.
And I think I'm not alone in that, but certainly.
It was a bit of a struggle, but that was a sort of indirect, really.
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.
Did you work longer hours than normal during the pandemic? Crazy as crazy I was.
And in fact, someone asked me recently,
what would you have done differently if you if you if we could kind of play that first few months of the pandemic again?
And I said I would I would have taken more breaks because we were working at an extraordinary pace, an absolutely blistering pace.
I published more than 50 papers in 2020.
It's one week. It was crazy.
And actually I've published over 40 this year and I finished.
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.
There were an awful lot of papers that weren't that good, actually, looking back.
And although every single one of them was done in good faith, we tried hard.
I think if we taken a step back, taken a weekend off from time to time or something like that,
we may have done a few pieces of work, but done them slightly better.
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.
Because that first masks paper, the one for the precautionary principle.
It only took a couple of days to write. We didn't know it was going to go viral.
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?
But in the in the fast unfolding of events, it was quite hard to know what to focus on.
And I think, I mean, you said it was five months that you had this extremely intense period,
the implication being that since then you haven't been getting it quite such a blistering pace.
But on the other hand, you have produced you did produce a huge number of papers.
Did you actually get a chance to take time off or did you institute a regime of regular breaks from that time?
Um. I've had two weeks holiday in the last two years and I've got another one the week after next month.
She said that by three weeks and two years, so that's not very much.
On the other hand, it's quite hard to go on holiday. I do stop now most evenings.
I think. The pace of work.
I think doing 16 hour days was crazy.
So now I could do 12 hour days. But there's still plenty of work to do, actually.
And also, although, you know, I'm working long hours, as I said, I don't feel particularly stressed by it now.
It's quite fulfilling. I'm finishing off quite a lot of projects that have been running for a few months.
I'm finding it quite sort of comfortable intellectually.
There's some very, very interesting philosophical work I haven't talked about much, but for example,
I've been linking up with some pragmatist philosophers because I think pragmatism is a really,
really interesting theoretical lens to look at the pandemic through.
So one of the papers I've got under review at the moment is around.
Crisis policymaking through a pragmatist lens.
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,
which was very much about how can we stop people dying today and tomorrow?
I've now shifted gears a bit and started thinking.
Wait a minute. What does this pandemic tell us about pandemics generally or crises generally?
And that, I think, is is quite rewarding and productive.
You know, you can see all the. Feel particularly stressed right now.
Time to do this interview if you don't speak about this.
18 months ago, I said sorry, ample time. So I think things are settling down a bit.
Yeah, I do. Is there anything that you do within your group to support the emotional well-being of your colleagues?
That's a really interesting one, isn't it? I am cynical about some of the emotional well-being stuff that goes around.
So we have this email that comes around every Wednesday and the headline is Wellbeing
Wednesday and it says things like Take 20 minutes away from your work or that kind of thing.
It's too formalised, it's too technocratic.
It's like going on a resilience course. I think the way.
I have. Tended to do it is.
Picking up a lot of bitty things that people weren't coping with.
And so I would pick them up and.
You know, help them with it. Various people,
various of my early career researchers had been slogging away at a paper for months
and not being very productive because all the stuff that was going on and I.
Had more input to those papers than I would normally have had,
but I've made sure that they got the paper finished, submitted and published, so they've got the line on the CV.
I actually think that kind of input is a lot more helpful than let's all have a virtual coffee morning.
Although we do do virtual coffee. It happens once a week.
They tend to do it without me, actually. Some people find it very helpful.
Some people don't. I've done. A couple of other things with my group.
I'm friends with a Danish academic called Nina.
Maya, and Nina has an interest in.
The support of the and mid-career researchers.
That's one of her research interests.
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.
And she said, Is there anything I can do? And I said, Well, can you do some sessions for my team?
So she did some virtual sessions on academic writing and helped individual members
of my team with some of their papers and gave them feedback on draughts of writing.
And they found that enormously helpful.
I think mainly because Nina is wonderfully gentle and slightly motherly and in a nice way, if I can say that.
And it was because it wasn't me helping them.
I think they were sort of saying interests kind of going off saving the planet.
We've got this protected space with Nina who's not doing pandemic stuff.
She is committed to us. And actually I use some of my pandemic money to.
Pay her for that. Now, talking of pay and money.
We also responded. We applied for University of Oxford Pandemic Funds to return people to work after the pandemic.
Now we have lots of different people with different problems and challenges,
but what I did was I helped, I think, seven or eight members of my team each to apply for £5,000.
And we used that money to pay the salary of somebody who came in as a research assistant, and they used her time.
Flexibly however they wanted. So they said, Please, I want you to help me do the background work for grant application.
I want you to help me finish this paper.
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.
But it was also good because I said to people, I don't care what you do, I don't want to.
I don't even want to know. Here's an extra pair of hands.
And other people would say, Oh, that's brilliant. That's just what I need.
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.
So practical help was important. What else?
Sounds like pragmatism again? Yeah, just true. I was very pragmatic. But then.
But then pragmatism. It's not just about being practical.
It does have a kind of philosophical underpinning which is which is something I'm getting quite interested in.
But I didn't say onto this tape because I'm actually a novice on pragmatism and I probably get it all wrong.
So will you be involved in your institutional department's code safety regime?
No, no, I offered to be, yes. But I was told that I wasn't needed.
What? Are you satisfied with how it was implemented? No. There's droplets which are everywhere, which is one to go in.
I'm quite gobsmacked actually at the.
The way in which droplet theatre has.
Dominated Oxford's response and the way.
Airborne precautions have not been taken on. I'm just I think yesterday or the day before, we published a new paper.
Peer reviewed and welcome. Open research. All about getting back to campus, know, returning to on site teaching.
It was a rapid, systematic review of the literature on what should be done.
The most important thing is vaccinating staff and students and getting vaccination levels up to 90%, if we can.
The next most important thing is instigating airborne precautions, including masks, etc.,
etc. and that we published it or a version of it through the U.S. you through universities and college union.
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.
But it hasn't kind of hit the desks of the people who are running the response.
And my emails. I don't think I've had replies to them.
So. Yeah, that sad. Sad.
On the other hand, if we talk about emotional well-being, you know, in the end,
you can only do your best in the end if they're not going to take any notice.
I'm. I mean, I remember when I was a junior doctor,
I used to cry myself to sleep when a patient died and someone took me aside and said, You never can survive in medicine.
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,
and you, you know, you would there and you put the monitor on and they still died.
They were going to die. And it's not your fault.
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.
So I've done my best. I've made my offer.
I've published these very high profile papers.
And if they choose to ignore it. You know.
I'm not going to beat myself up. You mentioned earlier that that your public profile that you cannot tell you at all.
How have you felt about that, both in conventional and social media?
You're you're now a name that's known much more like, um.
It's not something I was seeking out. I don't court the media.
I don't have an agent. I say no to 90% of requests.
And I've very narrow, very much narrowed down.
So people phone me up, they Google my mobile number. They say, please, will you be?
I got a phone call yesterday because you have Good Morning Britain tomorrow.
And then you say, well, what's it for? And they'd say something.
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.
So I will say, No, I'm not going to talk on that.
I'll talk about mosques and I'll talk about airport precautions, and that's it.
And they'll talk actually about revoke, but they can go find someone else to talk about the other stuff.
But actually, in recent weeks, I've refused all media.
And that's partly because, although I'm not feeling particularly stressed, did actually stresses my family.
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.
So you're actually not on to quarter to 11. And then it's actually quite hard to get to sleep.
But you've done live TV, so I've done quite a bit.
It's. It's very time consuming.
I don't like the attention. I don't like if I've done a TV appearance.
I didn't get 20 emails from people saying, Can you do local radio tomorrow?
And I don't like the abuse. I haven't talked much about the abuse, but I was going to ask you today.
Yeah, I don't need explicit examples, but I mean, it's it's it's something that anybody with a high profile.
Yeah. Something. And so I think the mosques thing has been the worst.
Um. People have. Systematically set up groups to attack me.
There are the sort of dark Web sites of, you know, libertarian groups.
I know that I'm on that list.
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,
all saying very much the same thing as if they'd been told that this is the version to use.
And sometimes it's identical text. And you just think.
I've got better things to do with my time than engage with that.
And I go around knocking people. But this is not what I want to spend my time doing.
It's time consuming. It's exhausting. It upsets my husband because he doesn't either.
I mean, obviously, there was someone put out on Twitter the other day that I should be raped with a bayonet.
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.
It really didn't bother me that much. But, my goodness, you know, it upset my nearest and dearest.
So I don't really want to spend my time inviting that kind of thing.
I don't lose a lot of sleep over it. I just try to avoid it.
Do you find in general you have found Twitter useful?
Yeah, because I because I control I block people.
I use mass blocking tool sometimes to block everybody who follows a particular extreme libertarian think that they're following that person.
I don't want them to have anything to do with me, so I'll put 500 of them or something.
Then I have to apologise sometimes because sometimes people have followed them and
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.
Obviously, number one, we're. Another ten minute.
So how have you. I'm just just clarifying this.
I think we talked about a little bit earlier. But are you are you not associated directly with any policymaking body?
That's right. Oh, goodness. No, I better get this right at night.
Until quite recently, I sat on a committee at the World Health Organisation,
but it wasn't the one that was dealing with the covenant response, so it was the Alliance for Health Policy and Systems Research.
I sit on, I think last count, about 13 national committees.
I am on the long COVID National Task Force. I was on the nice oversight group for the long COVID guideline.
I've done various pieces of work with the.
What's it called? NHS England. Digital Primary Care.
Primary Care Digital Transformation Team. That's what its primary care digital transformation team.
I think I'm an official advisor to them. So, you know, one one works with policymakers.
Yes, but I'm not on any of the formal convened the ones that are.
Should we say in the public like. In relation to Cove.
It's safe to say I'm not on Sage, I'm not on Nervtag.
I applied to be on the stage actually, and I was told that my expertise wasn't appropriate, which I think is clever.
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,
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.
But I have appeared on the Independent Sage, you know, that broadcasts because, you know, I've gone there as a guest.
So I'm friends with them, shall we say.
So has the work you've done raised new questions that you might be interested in exploring in the future?
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,
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,
interpret it, apply it all in a big sort of unfolding jumble, if you like.
And that's interesting. That is the thing that's most grabbing me at the moment, actually.
Yeah. This is a last question.
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?
Um. That's a really interesting question.
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,
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.
But it's because I'm still experiencing code for it, I think.
What on earth is going to happen in the future? I don't know.
I mean, I've got a, um, I've got an application which I doubt will be funded,
which I put in about nine months ago for a leaf, a human senior fellowship to write a book about Wittgenstein.
And there was a.
A friend of Wittgenstein who was a doctor who wrote a book called The Danger of Words.
It's a chapter called Mastery, and it's all about how some of Wittgenstein's insights are very relevant to medicine.
And I applied to leave HUME to.
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.
But actually some of the work of the later Wittgenstein would be incredibly relevant now.
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.
Would that be wonderful? And then I thought, would I actually do that?
Because I would have thought when I wrote the application, I thought the pandemic would be over by now.
Whereas actually with pandemics now grumbling along, there's all sorts of, you know,
terrible things happening, like be dropping old precautions because of the,
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.
Even if I get funding, I'm not sure. I really don't know what the answer to that is.
It'd be interesting, anyway, that my hand would probably be false because they probably won't fund it.
But it would be. It would be a big change. It'd be complete transformation if I did get it.
Thank you very much. Oh, don't do that. Okay.