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So I think John Bell, this is our third interview.

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And I'd just like to start by talking about how the whole pandemic experience impacted you personally.

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I mean, first of all, that you had presumably I know you had lots of other responsibilities, but you also had a lab research program going.

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What happened to that? Well, so so actually, the truth is, I have the odd graduate student here, there, but I don't run a big lab.

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So it meant it was easier for me not to be engaged in direct research myself, but to be sitting in the middle trying to mix this with that.

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So that that was sort of where that ended up. I was your lab doing any COVID research?

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No, no, no, no, no, no. I so I.

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Yeah, my lab is pretty distributed, so I've got a graduate because I get other people to take graduate students that I could supervise.

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Right. Because I spend so much time in London. Yeah. I can't really run.

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It's the same reason I gave up clinical work right.

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Ten years ago was that couldn't I can't can be in London talking to a minister when somebody rings up because one of my patients is dying.

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So I couldn't do that.

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So, so, so I, I spend quite a bit of time milling around, helping stuff happen strategically, getting the right people to talk to each other,

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but also setting strategies as to what needs to happen and finding people to get that stuff done.

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So so that this wasn't a change. I do that.

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That's what I do on a day to day basis. And so this was not a change in that at all.

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The thing the only thing that changed was the pace at which that kind of activity was required.

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And it started with a lot of discussions between myself and Jeremy Fellow at the Wellcome Trust, Trevor Mandela Gates Foundation.

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You know, the people who I interact with at a senior level in those organisations thinking about whether this was going to be a pandemic or not.

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So January 2020, actually in December 2019, you know, what is it?

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What's going to happen? Can we anticipate where it's going to go and what's the UK doing to sort it out?

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And I think we through through January for sure,

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we were all a bit frustrated because it didn't seem to be any there didn't seem to be any response at all.

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And there was a kind of damping down. Nobody should worry.

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It's not going to get here. It's not really a pandemic. Don't worry. Don't worry.

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Don't. And so that kind of rumbled on until two things happened.

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One was the outbreak in Italy, which then tore through Lombardy and collapsed their health care system.

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And secondly, the first initial sentinel cases in the UK, which were that couple,

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the Chinese couple in New York, and the guys who'd been on a skiing holiday in Austria or something like that.

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So they were the first case, COVID recovery. I think we covered most of that in the first interview.

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So I'm really I'm really trying to get at the impact on you personally.

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So you set the pace increased. So that I mean, one question I've just been asking everybody is did your working hours increase?

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And I'm sure you're somebody who works every other year anyway. But did you find yourself?

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Well, I was pretty busy up to so we could see the lockdown company coming and I was pretty busy up to the lockdown,

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particularly thinking about things like testing capacity.

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Yeah, I lockdown. I actually actually lockdown a week before the official lockdown because we decided just to get the kids home and lockdown at home.

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Yeah, but then the pace of stuff really escalated through that period of the initial weeks of the lockdown because you could see that.

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You could see the. You could see the pace of the pandemic really picking up in front of our eyes.

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And you could also see the impact of black preparedness starting to happen.

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So I would start the morning with a call with Lord Bethell, who is the junior minister,

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and he was the Lords minister in the Department of Health who was responsible for testing and the pandemic testing response.

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And I would spend half an hour to 45 minutes with him every morning talking about what time?

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7:00? Yeah. So I would be up and on the phone, cracking on.

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And we did that throughout the whole of the first year and all through the summer.

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You know, we're just boom, boom, boom. And we've got to be quite good friends. Actually, I still don't put it well.

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And in fairness to him, he did a really good job. I knew Matt Hancock because of course I advised Matt about life sciences before.

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So I was involved in lots of things with Matt. He brought me into lots of discussions.

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And Will Warr, who is one of my graduate students, was in number ten.

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So Will, of course, when they didn't know what to do, number ten would pick up the phone to me and say, What do we do next?

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So that dragged me into a whole set of different strands of activities.

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So my day would be involved in having meetings about the vaccine, having meetings about serological testing,

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analysing tests, having meetings about the Lighthouse Labs, which, as you know, we set up.

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And then ultimately lateral flow testing a little bit about clinical trials, whether that was really being done on its own.

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But I got in April, man did a lot of work on clinical trials, which ended up going nowhere, frankly.

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But the but that so that was it. And so I would start the morning and it would be one meeting after another.

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There'd be a lot of people who want as I guess after a month or two people wanted to hear

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what I thought was happening because there was a massive gap in information distribution.

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And I think the the general populace and indeed different organisations didn't trust the Government because they'd made such a hash of the beginning.

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And as a result, they wanted somebody independent to talk to them.

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So there was a lot of pressure from the press to be on the TV and on the radio, and that wasn't something that was new to you.

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I mean, you had done that kind of I'd done that. I'd done that time before, but I'd never done it at this pace, I have to say.

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And and I'd also never been I mean, these were everybody listen to these things.

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I mean, the stuff I did before, somebody might have heard you, but they weren't as bloody dull again.

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But this time, you know, you knew if you were on radio for there, you know, the whole bloody country had that radio thing.

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So it was there was quite a bit of pressure. And it was interesting because the government tried to stop me from doing that.

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Initially they they said, no, no, you can't talk to the press.

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And then they the press kept ringing the app saying, you've got to talk to us about again.

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And they said, Look, don't be so bloody ridiculous. I said, They don't pay your salary.

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You can talk to as you want.

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So in the end, after the third request to go on the Today programme, which had been denied by that, the guys in the HSC, I said, Well, screw this.

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So I went on and of course it was a big success for both. I was terrific.

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And then Matt Hancock commented, Oh my God. He said, That was terrific.

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So I said, Well, do you mind, Matt,

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if I do this because it might take the pressure off you guys because when you get on they ask you very different things than when I get on.

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So it actually helps cool the thing down. And at that stage I was telling people the testing was a mess.

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We're fixing it. We're on a trajectory. It's going to be fine. Everybody stay calm, seatbelts off.

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I'll be okay. So that said anyway, that, you know, it was up to a couple of times a week as I was on Channel four.

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I did a lot of stuff for ITV, I did breakfast TV and I did all that stuff for radio programmes, New World at one, all that stuff.

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So I got to be a sort of fairly familiar figure in the press, and I think if you analysed why that was,

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I tried very much to keep it simple and be positive because the truth is, none of us knew where this was all going.

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So if you don't know, then there's no harm in painting a slightly brighter picture than lots of other people going,

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Oh my God, the world was going to end. And I that was not my approach.

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And it turned out I was right and they were completely wrong. So that that was sort of helpful.

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But it was I, I almost invariably had stuff going into the evening.

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My family was at home and they were busy. The kids were trying to get some university work done and I was bloody hopeless and my wife had her

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own things that she had to do because she runs a lab and she was trying to keep that ticking along.

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So we had computers and Zoom calls from I had a little study which I worked in,

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and she worked out in the kitchen and the kids were up in their bedroom.

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So there's stuff going on all the time. And then we would a.

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Occasionally cross in the day and the kids would always be interested and say, what's happened today that I do now and then?

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And that would go then.

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I would usually try and break for dinner, but sometimes I couldn't because I was on a North American call, for example, that wasn't going to work.

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So I would probably normally come off the zoom call or come off what I was doing,

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because I was also trying to read a lot of papers to keep up to date with what people were saying and talk to,

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you know, key opinion leaders who knew what they were talking about. So talking to George Goude, to Jeremy Trevor,

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the people who actually knew what was happening in their own jurisdictions, I tried to abuse it back up about 10:00.

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I didn't usually go be on the ten, but it was sort of 7 to 10 with the odd break in the day.

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And I usually tried to break for dinner, although I occasionally had dinner in front of the zoom call.

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And how did that affect your wellbeing?

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I mean, some people thrive on adrenaline and some people know I was good.

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I was good. So I you know, I'm a pretty busy guy anyway, but it's very I mean, you have to understand,

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and I don't want this to be interpreted in the wrong way, but if you're a biomedical scientist slash immunologist,

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then this you know, the chance of this happening in your career is tiny and the chance of this happening in your

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career when you're at the top of the tree so you can actually get stuff done is even smaller.

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So, you know, I was I was in this position of significant authority and strategic I wouldn't say strategic control,

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but with an oversight of a lot of strategic decisions with which which was amazing because then you you had to make decisions.

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And something I learned because I do a lot of work with industry is that and this is something academics are not

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very good at is the most important thing is to make a decision it's not to think about that decision for too long.

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It's to make a decision and you have to accept that, provided at least half the decisions you make are the right ones, you'll be fine.

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And that so, you know, that was the attitude I took into this is let's just make some decisions if it's not working to stop or do something else.

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And so we could navigate this thing one way or another and, and not all the decisions we took were the right ones for sure.

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But that that that was it was a curious way, rather exhilarating, because every day you had a whole set of very,

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very big decisions that had to be taken or to which you could contribute a view.

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And that was yeah, that was good.

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So I, that was fine. I didn't, I didn't have sleepless nights.

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I went to bed, I slept, got up early in the morning. I, I ran every day at the beginning.

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I like to skull but I didn't skull because I was worried about stuff being in the

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river water because there was this story about story about the sewage and the virus.

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So but I used to run every day, so I was, you know, stayed pretty fit.

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And that helped me kind of get through the day and the night.

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So so it was yeah, it was good. That went on absolutely flat out to the summer.

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And then, as you remember, the pandemic largely went away and people started to go on vacations and all that sort of stuff.

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The family took a short break and my in-laws are living in Swanage.

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They're very old and pretty frail, so I thought, Bloody [INAUDIBLE], they're getting down there.

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So we went down there for a week, but that was the only break we had that summer and and the rest.

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And we were kind of pretty flat out.

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And then that carried on through the autumn because by then I was very engaged in the lateral flow testing programme, which was like really literally,

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you know, three or four times a week, lots of discussions of Porton Down, lots of evaluation data that was coming in from that programme.

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And again, that kept was very busy.

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And of course the vaccine thing got pretty interesting starting in about September because we were counting cases as to how many events we needed.

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And and then the results from Pfizer came in, I guess, end of October, beginning of November.

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So that was the first hit. And we thought, bloody [INAUDIBLE], this is a tractable disease with the vaccines.

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So we were pretty optimistic we were going to get there and our data came in and in November then there was a

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rush around Christmas to get regulatory approval and there was quite a lot of discussion with AstraZeneca.

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So I'd probably talked to AstraZeneca a couple of times a week about where we were and what we were trying to do.

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They were they were busy fighting off all kinds of trouble in the in the US because the US decided they didn't like us.

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So that was not helpful. And I was also yeah, we were also thinking, trying to think more strategically is if it worked,

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how would you, how would you get the vaccine out to people as quickly as possibly could?

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So that I was also talking to Oxford, Biomedica, where I know that chairman pretty well and the chief executive,

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because they were our major manufacturing site and they they had all kinds of trouble making this stuff in the autumn.

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And so I was trying to help them get to where they needed to get to to anyway.

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So it was busy, busy, busy. And did you I mean, you do just make that mention about the possible contamination of water.

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Water. And how personally threatened did you feel by the virus itself?

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So I like everybody else, you know, I didn't I really didn't want to die in an intensive care unit face down.

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And, you know, there were enough people dying face down in those days because there was you know,

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there's quite a surge of of this terrible pneumonia people got.

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And so I was over 60 and I was definitely over 60.

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So, you know, that said that, you know, I was, you know, and now one of my BMI is quite low, might be almost 21.

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And there's this remarkable correlation with BMI. So I thought it's probably I'm pretty fit, but, you know, my wife was really anxious.

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So, you know, we were getting deliveries of groceries to the door and then everything was getting wiped

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down before it came in the door because and this just reemphasize the point I made,

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and that is we started with a massive set of mis assumptions about how this was because everyone said, Oh my God, wash your hands.

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There's not a scrap of evidence that this stuff is transmitted by touch.

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And yet we went through months and months of everybody washing their hands four times a day, huge amounts of alcohol gel stuff being wiped down.

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Anyway, they it just goes to show you that, you know, you don't really I mean, I'm not saying was it inappropriate precautions?

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They probably were appropriate,

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but we could have worked faster to get the answer to that question that was saved everybody alive and well anyway that the yeah.

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So so my wife was pretty aggressive about controlling what came in and out of the house and it, it meant that I couldn't really meet with anybody.

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So I didn't meet with anybody face to face from about the second week of March until the.

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The lockdown ended in May or June. So, you know, it was bad.

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So I didn't go up to Whitehall and I've had people ask me to come up with, you know, why I'm doing that?

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But of course Whitehall was awash with the virus and they were all getting it and I got bloody Alan not going in there.

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So, so that was, so that was fine because you could do everything on the one hand on the zoom calls which are fun.

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So, so anyway, that so busy, busy, busy, but not, you know, tiring to a point,

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but at some level pretty interesting work and challenging work because every point I've made before, I've never said this to you before it.

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Almost every week something popped up and you learn something about this virus that we didn't know before.

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It's a brand new virus, didn't know anything about it. So it was tough. Did you know or did you know a lot of out didn't know that.

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Did you know half the people are asymptomatic? Well, no, we didn't know that.

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And, you know, the only study we got started in April.

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Yes, mid-April and very well. And that started to generate epidemiological data to say, did you know these people are a particular risk?

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These people are not at risk. You know, we're not seeing any of this. We're seeing a lot of that.

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And so, you know, that data was coming in all the time. And I was trying to assimilate all that data to try and keep the big picture

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of what actually was happening and then how you needed to respond to that.

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But it was that that was that was very intriguing because it was just an ongoing flow of new information.

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Well, that brings us, I think, quite nicely to this, going back to this statement he made to the select committee.

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And I'm afraid I haven't got the date for that. But it was quite early on, I think that.

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This whole epidemic has relied too heavily on assumptions that have turned out not to be true.

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My strong advice is to prepare for the worst. That must have been quite early on.

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But what were these assumptions? Well, the first assumption was it wasn't going to be a pandemic.

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Right. It was a dumb assumption. And that but that was clearly in people's minds.

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The second assumption is, don't worry, the NHS is great and it'll all be fine.

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That was a dumb assumption. Turned out to be completely not true.

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The third assumption and sequentially was that you can start trying to make a vaccine, but it's going to take at least three years to get there.

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So get yourself ready for a long haul. Turned out not to be true.

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Fourth assumption. How's the facts? How was the virus transmitted?

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That we still don't know. It is unbelievable. We don't know that, but we still don't know.

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I mean, it's obviously aerosol, but is it really aerosol? Is it particulates?

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Do the how much how well do the masks work?

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You know, probably work a bit, but they're not they don't work anywhere near as well as everybody thought that might have worked.

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And then this massive assumption that if you had the virus,

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you could just go back to work because you were then you knew you weren't going to get the virus again.

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And that underpins the search for a serological test to see who had had the virus, who hadn't had the virus.

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And the assumption was after that first wave or midway through the first wave, that, you know, half the population would have been exposed.

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Turned out only 5% of the population had been exposed. So that was a bit of a disaster.

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So that just showed that this was going to be a long grind.

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You know, after that first big wave. I don't think anybody expected 5%.

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Although interestingly, the Chinese after the Wuhan wave, they were only 5% as well.

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So it was it was incredibly severe lockdown. They had a massive lockdown, but they also had lots and lots of sick people.

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Germany, they were building those hospitals in a week. And I thought, boy, oh, boy, they got a problem.

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And so when the first data came out, actually, it was on the Georgia papers.

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And it's, you know, it was five, 6% that that was all it was.

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So so that all that was all that was a problem.

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And then then we sort of paused.

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So it took a while for everybody to understand that this was an immunological problem, not a viral, logical problem.

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It could be any of us. But the real question, what's the immune response? Because that's the thing that that's what vaccines do.

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That's what protects us.

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And so we started with the view that the antibodies, if you had antibodies to the virus, they would protect you against being reinfected.

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And it turned out that that was not true. So we've all got antibodies and we're still all getting infected.

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So that, you know, that is that turned out a completely inappropriate conclusion.

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And although antibodies are a reflection about whether you've been exposed to the virus,

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I'm not sure it wasn't true that they protected you, protect you from severe disease today.

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Probably not the antibodies. It's probably the T cells that protect you get severe disease because there isn't a very

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good correlation between the presence of antibodies and the presence of severe disease.

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So for example, there are lots of people who have very low levels of antibodies but who still don't get severe disease.

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And that so that's probably and severe disease is different than transmitting and getting a head cold.

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So so we hadn't nobody had thought about that and thought about well, actually,

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it may well be that you could protect yourself against the worst effects, but still have trouble in the background of the thing.

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Flipping along and remember, we were globally a completely naive population, so immunologically none of us had seen this virus before.

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Which is quite an interesting problem because with flu we've all kind of seen flu of one sort or another in a flu epidemic here.

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But some are worse and some are better. So so that that was all completely brand new.

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And so the understanding of what you are going to need to see the end of the pandemic was also very muddled.

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And I remember there were lots of authorities who would get on and say, well, we've got to vaccinate everybody and then we'll eliminate the virus.

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And then, you know, we've got to have zero COVID.

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That's the only end to this. And I remember I got on the radio, so you've got to be bloody joking.

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I said, That is never, never, never going to happen. So get that out of your minds because it's going to be here forever.

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So get used to it. And lots of people didn't like that, but in the course, it turns out to be to make sure that you know it is what it is,

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it's now with us and it'll be with us forever and it'll be really impossible to get rid of it.

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The the other thing is that was an inappropriate mis assumption, which I, in fairness, I got wrong in the beginning because people started to.

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Sequence a bit and they didn't start the sequence looking for variants. They started to sequence to use it for clinical epidemiology in hospital.

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In other words, that guy had that particular virus and the guy on level seven got the same virus.

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So they must have it must have gone from here to here.

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But honestly, it really helped very much because usually when there was a ward of people with COVID,

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they all had the same virus because they given it to each other. So that was, you know, that all looked at the dumped me so.

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So I remember he called me and they said, what do you think about this? I said, I think it's a load of noise.

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I said, I said I wouldn't pay much attention to it because it's not going to help very much.

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It then emerged that the variant started to appear and then it was pretty clear that you were going to need surveillance,

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genetic surveillance as well. But again, we didn't start out with genetic surveillance at all.

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We we we, in fact, quite the opposite. And although we were one of the first in the world to do genetic surveillance,

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the whole world was asleep at the switch because they should have started with that on day one, frankly.

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So there were lots of I mean, I think it was a mass, but I do remind people that we've never done this before.

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This was a new virus. We've never done it before. And we didn't have very many people who were expert at managing infectious disease outbreaks.

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Ebola was the last one we had. A few people were involved in that that had similar characteristics.

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And then there had been flu, which had never really got airborne.

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They got off the runway and actually turned out to be much less severe than we thought it was going to be.

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So there hadn't been anything in living memory where people got really good at this.

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And I think that lack of experience and lack of capacity and capability is was a really big issue for us.

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And it was made even worse by the fact that we had to make a lot of assumptions and a lot of those assumptions were turned out to be wrong.

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The modelling turned out to be particularly wrong, I have to say.

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And that was that was a massive source of misinformation they carried on throughout the pandemic.

250
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Well, there were different models when there. And that was another question that that I had that, you know, even within the scientific community,

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there have been differences of opinion based on these massive, massive differences.

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How how difficult was that to deal with? Well, it was very difficult to deal with.

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And I think the particular problem was that politicians who were terrified of making yet another

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mistake tended to take the most conservative view about the models and and and the academics

255
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and sage in particular promoted the the engineer type modelling and unfortunately those and quite

256
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a lot about that around for a very long time in the infectious disease modelling community.

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So they have always, always overstated the severity of these epidemics, the extent of the the spread, this verity of the outcome.

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And they did it in spades here because you could you might well have argued that as

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the population got vaccinated in 2021 and through that first six months of 2021,

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to the point at the summer of 2021, almost not everybody, but most people wanted the vaccine that had two doses of vaccine.

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It was all fine. They could have just stopped them because I don't you know, the lockdowns didn't make any difference to that.

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The death rate stayed absolutely the same with or without boosters, with or without variants, with or without it, right along the bottom.

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And yet we kept going on for another nine months saying, Oh, my God, we need a lockdown.

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And the government was running out. That was that's been very damaging to the scientific community's credibility,

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frankly, because politicians are now saying, why did we listen to those guys?

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They clearly got it completely wrong and we just lied there and let them tell us what to do when in fact, if we'd had people in the room saying,

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you know, the economy is on its knees, sort yourselves out, get back to work, we would have actually got to a much better place faster.

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I mean, the sort of say the word scientists, including scientists here in Oxford who were saying lockdowns were a bad thing and that what we needed

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to do was focus the protection on the extremely vulnerable and that everybody else would be fine.

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Yeah. And they were vilified largely. Yeah.

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That, that, that was a bad period actually because I think that was, I think at the beginning that was probably if I look retrospectively,

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that was probably not the right advice because the consequences of severe disease were pretty profound.

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And the worry was that if the health system collapses, which is what happened in Italy, then we're all toast.

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So the. I think the lockdown was probably and I say probably this gets back to our assumptions.

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I'm still not sure we've got the data to show that it actually made a difference, frankly,

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but I think it was the right thing to do given the the threat that once the March lockdown.

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That's right. But but as soon as as soon as the the disease became different because of widespread vaccination or previous exposure,

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then you could have easily said, no, no, no, no, no, no, no.

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We you know, by all means, if you've got frail, elderly people who you think are at risk and protect them,

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but the rest of the country could definitely get back to work and get stuff done.

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And that didn't happen with any pace at all. It was very slow because we've been in this lockdown mentality now.

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A couple of things about lockdown. So we were the manual for pandemic management.

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Two metres distancing mask is all 19th century and there's been a spectacular failure

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to gain evid evidence and an evidence base as to what works and what doesn't work.

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And the the example I like the best is in Africa where they had they couldn't do any lockdowns because of the lockdown in Africa,

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people starved to death because they've got to go out and do stuff. Otherwise can't get any food.

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So didn't they? And South Africa in prove lockdown. They said, forget this, we're not doing this.

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Everybody's going to die.

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So they let everybody else and none of the other African countries had any significant lockdowns, big urban areas, lots of transmission, quite stuff.

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And before they could ever get a vaccine, they most of those countries had auto vaccinated themselves with natural infection.

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They had serological rates of infection, were sitting at 70 to 80% before anybody had had a vaccine.

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So they'd actually done the vaccine thing themselves without any help from the from the injectables.

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But they had these very interesting ways of disease which go along like our way.

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Suddenly you say, Oh my God, we got another wave, and the numbers are going through the roof.

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And then they get up to a peak and then no intervention, no lockdown, no masks, no nothing, no washing of hands.

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It would disappear. It's exactly what happened here.

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So how do you infer that the lockdown was responsible for that when people didn't have the lockdowns, also had the waves got?

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So it's a natural feature of these infections.

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If you get to a certain level of transmission and then enough people are either actively infected or have been infected, that it actually disappears.

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And how would the death rates in those African countries? So nobody nobody really knows.

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In some place the death rate was pretty high in South Africa. There were a lot of people who died in places like Nigeria.

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It's been said that there hadn't been a lot of deaths. I don't know that the ascertainment is very good there, so I don't.

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But they do have an average younger population.

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They're younger and fitter, but there's no shortage of people with, you know, who are these who are in a high risk group.

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So, you know, it's not as if they don't have any of those people, quite a lot of those people.

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But that that I think the sense from Africa is that they didn't get clobbered the way that we did in Western countries.

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But it's fair until you actually had really good numbers, I think it'd be really hard to tell about that, to be honest.

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But that's and then in America, there's been quite a lot of work looking state to state.

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The states had different approaches to how tough to be,

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and there doesn't seem to be a very good correlation between the death rates, where the death rate count in America is pretty good.

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So the ascertainment, the number is pretty good,

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and the extent and breadth of the non-pharmaceutical interventions don't correlate with the death rate at all.

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So I still think there's some pretty big questions about whether the 19th century manual about lockdowns is the right answer,

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frankly, and that now when things were bad and I was asked, well, do you think we need to?

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I would often say, yeah, I think we probably will need another lockdown.

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As things got better in the spring.

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I started to back away from that position because I wasn't persuaded that spring of 2021, I wasn't persuaded that was necessary.

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And then by the time we got to November, December, I was pretty vocal about saying, What the [INAUDIBLE] is going on here, guys?

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Because this is a mild now a mild disease.

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People are not die. You know, what's going on?

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And I mean, there were a couple of us who put that into play before Christmas.

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In 2021 where the government had been pushed by the scientific community to do another lockdown.

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But there were a few of us who said, No, no, no, no, no, no, no, don't do it.

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And then when they looked at the numbers, they thought, actually, we're not doing the lockdown.

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Everybody go home and have mince pies and turkey and enjoy ourselves.

326
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It's all fine. So that was sort of when they broke the back of the orthodoxy of the monitors.

327
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And to be clear. Chris Murray, who's one of the great world's great model, is based in the University of Washington in Seattle.

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I spoke to him for I spoke to him quite a lot. He was doing numbers. He had great numbers.

329
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This is funny.

330
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JB He said you're modellers in the UK seem to come up with completely different answers to what everybody else does over here of [INAUDIBLE].

331
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That's not such a good bit of information. So massive variation and they overstated the extremes, the, you know, the worst extremes.

332
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And yeah, it was it was bad and it was bad.

333
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And I mean, how do you evaluate the impact of there just being a lot of sickness?

334
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I mean, just, you know, not severe illness, but people feeling ill enough not to feel able to go to work.

335
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Well, I look at that. There was always going to be quite a lot of impact of that.

336
00:34:34,080 --> 00:34:37,290
In fact, there still is. The people are going up again. Yeah,

337
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that's the so the early summer there were quite a lot of people down and it meant that the airports didn't

338
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work because lots of people like COVID and but a lot of that was probably again if you've tested positive,

339
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don't come to work. So there's there's that. And you could say, well, look, I feel fine and a little cough and out of nowhere.

340
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So you you actually, you know, there's a again, this question, what is the tipping point between who you keep out of the workforce if you don't?

341
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I we're going to go up again. We'll have our we'll have an autumn. So for sure, I think.

342
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But it's not clear to me that boosters are going to make any difference.

343
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So that yeah, that was the question I had really from a personal point of view.

344
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I mean, if you had the first two vaccinations, are you covered for life against severe disease?

345
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So far it looks like that it doesn't like. Yeah, well, how can I say that?

346
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Because four years out to date, that's enough.

347
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Yes. Because none of those people are dying from severe disease.

348
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So why would a booster keep it going longer?

349
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One might, but it also might not. And we you know, unfortunately, in the rollout of the vaccines, we didn't do it in a very careful way.

350
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We were in such a hurry to get vaccines into people. Just everybody line up with them all.

351
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And actually, in America, they didn't even record who had a vaccine.

352
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I just wrote it on a card and said, off you go.

353
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So, I mean, it wasn't like that because there was a push here for our columnists to say, actually, guys,

354
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why don't we randomise give people different vaccines, different age groups do large populations.

355
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Then as we go forward, we can then use those populations to work out what's happening and how it's happening.

356
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But we didn't just blast away so much what it was.

357
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I Yeah. Anyway the so where we're still got massive gaps in our understanding of the biology of this disease,

358
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the immune response to this is what protects you against transmissions.

359
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Do the boosters actually work or not? What do you make of this waning of antibody response after?

360
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Because of course, the more boosters you get, the faster the antibody response wanes.

361
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And now the antibodies last three months. Wow.

362
00:36:57,150 --> 00:37:05,070
So why haven't the booster that they seem to do a lot of good said but again there's a sort of orthodoxy so all governments feel like they

363
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have to be jabbing people right in the last bed and they've got in this model in the States where they they've approved the vaccine,

364
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which has never been in a human being before. So I mean, that's just completely dumb because you don't need to do that.

365
00:37:17,520 --> 00:37:25,860
I mean, human studies take a month to do so. So there's a lot of bad decisions ongoing in this community.

366
00:37:25,920 --> 00:37:29,620
So but I decided to step out of that discussion, actually.

367
00:37:29,700 --> 00:37:33,000
So you don't hear me on the radio anymore. I just had it. I got it.

368
00:37:33,130 --> 00:37:40,350
It's just going to get worse. So you've, you've stepped back from all advisory roles in relation to COVID.

369
00:37:40,350 --> 00:37:43,710
Yeah. Yeah, pretty much. Oh that's interesting. Yeah, yeah, yeah.

370
00:37:44,070 --> 00:37:48,809
Well, I mean, I, I kind of I did the job I was supposed to do.

371
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Yes. We got rid of that severe disease. We got the vaccine, we got the testing in place.

372
00:37:53,100 --> 00:38:01,410
We did all the things we said we're going to do. And now it's just a load of heavily opinionated people shouting at each other as to what to do next.

373
00:38:01,470 --> 00:38:02,700
I mean, it's just not.

374
00:38:03,120 --> 00:38:12,150
Oh, well, I was going to ask you whether the experience of the pandemic had raised the profile of the need for pandemic preparedness and whether we.

375
00:38:12,420 --> 00:38:18,830
Now I have the capacity in place to deal with a future pandemic that might five years or ten years or 29 is a really good question.

376
00:38:18,840 --> 00:38:25,950
So so the in the height of the pandemic, everybody said this is costing us trillions of pounds.

377
00:38:27,090 --> 00:38:40,050
We need we need to be ready the next time. And that when there was quite a lot of sickness around, people kept saying, we need to do it.

378
00:38:40,380 --> 00:38:47,040
Of course we won't forget it. Events have meant that it's been pretty much pushed to the back of the bus.

379
00:38:47,370 --> 00:38:51,150
So or in Ukraine, cost of living, crisis, energy bubble.

380
00:38:51,180 --> 00:38:57,420
But they're all. Yeah, no, but you never hear a politician talk about COVID ever, because it just comes right off the list.

381
00:38:58,020 --> 00:39:04,380
There's not. The new health protection agency has been established.

382
00:39:04,500 --> 00:39:10,079
They're supposed to be responsible for pandemic response, but their budgets are being cut right back to what it was before the pandemic.

383
00:39:10,080 --> 00:39:15,630
So they don't really have the money to do it. There's a few things still in place, but not many.

384
00:39:15,660 --> 00:39:21,600
We're doing a bit of the honest study cut back is still offering, so we get some sense about what's going on.

385
00:39:21,840 --> 00:39:29,510
What about W.H.O. and the global level? So Biden declared the pandemic over in America, which is probably true.

386
00:39:29,520 --> 00:39:33,329
It probably is over. I mean, they're still getting about 400 deaths a day, I think.

387
00:39:33,330 --> 00:39:40,440
But it's you know, it's largely over here. We're getting about I think it's for real COVID deaths.

388
00:39:40,440 --> 00:39:43,500
It's about somewhere between two and 400 deaths a week.

389
00:39:44,280 --> 00:39:47,940
But none of them are that pneumonia. None. Zero. Not a single one.

390
00:39:48,570 --> 00:39:52,350
And a lot of them are. Almost everybody does.

391
00:39:52,350 --> 00:40:00,180
It's over the age of 85 and they've got lots of co-morbidities, this stuff, and it'll be clotting or, you know, it's like people get a bad flu.

392
00:40:00,690 --> 00:40:08,190
You know, if you're over 85, you get a bird flu, you die often. So, I mean, it's the same do so so that you know, that that is what it is.

393
00:40:08,190 --> 00:40:11,670
And I suspect it'll come along like that and it'll go up maybe a bit.

394
00:40:12,120 --> 00:40:17,670
We get a surge and we'll get new variants and all that stuff, but it doesn't work.

395
00:40:17,730 --> 00:40:22,860
It looks like the vaccines are very good against all the variants, all the variants we've seen, we've seen some pretty weird variants.

396
00:40:22,860 --> 00:40:28,680
So I'm pretty confident we'll be okay. So I thought.

397
00:40:28,690 --> 00:40:33,010
But are we better prepared for a highly pathogenic flu?

398
00:40:34,600 --> 00:40:39,820
Completely unprepared. Are we prepared for a Nipah virus pandemic?

399
00:40:40,150 --> 00:40:44,379
Completely unprepared. You know, there's just, you know, we just novel.

400
00:40:44,380 --> 00:40:49,540
Things come back to the beginning. Travelling twang, the elastic band.

401
00:40:50,110 --> 00:40:55,270
So I'm just a bit surprised about how fast that happened. Just slightly this morning.

402
00:40:55,630 --> 00:40:59,430
Yes, indeed. So so I'm working on two things.

403
00:40:59,800 --> 00:41:08,020
One is a much more systematic approach for characterising infections,

404
00:41:08,830 --> 00:41:15,430
identifying pathogens early that are causing severe disease, and then putting up the red flag to say, guys, there's trouble here.

405
00:41:15,490 --> 00:41:19,360
So including doing genetic analysis and it's a shift.

406
00:41:19,750 --> 00:41:27,159
It didn't start this way, but it's ended up this way. And that is with the falling price of genetic sequencing, which is fine, really precipitously.

407
00:41:27,160 --> 00:41:34,420
Again, after five years, it looks like it's going to be cheaper just to sequence every pathogen that's causing

408
00:41:34,420 --> 00:41:38,470
trouble than to try and grow it up in a tube and see what it is and all that stuff.

409
00:41:38,980 --> 00:41:46,570
So the, the, the idea that you can have a systematic global system for characterising pathogens and

410
00:41:46,570 --> 00:41:51,400
then storing their DNA sequence in a database that allows you to see what's happening,

411
00:41:51,420 --> 00:41:59,470
where would be a much better way to identify new pathogenic outbreaks which what global umbrella body will come under?

412
00:42:00,010 --> 00:42:12,430
So we've been working with the G20 as the major US for that, and India is about to take over the G-20 and they are very keen on developing it.

413
00:42:12,940 --> 00:42:17,530
It'll probably they'll probably be nationally based because remember, this is health care data.

414
00:42:17,530 --> 00:42:21,069
So you can't really. It's got to be owned by each country.

415
00:42:21,070 --> 00:42:25,020
So the idea is to proliferated. African CDC is involved.

416
00:42:25,030 --> 00:42:28,150
The Tony Blair Foundation has been very involved.

417
00:42:28,630 --> 00:42:35,950
Gates Foundation very involved. So there are a lot of people who are keen on seeing this, exploit it and develop on an international level.

418
00:42:35,960 --> 00:42:39,210
So that's and that's all. So that's a surveillance program.

419
00:42:39,220 --> 00:42:46,660
It's a it's a it's a no, actually, it's it started as a surveillance program for COVID to say, can we spot the new variants?

420
00:42:46,930 --> 00:42:52,059
It's migrated now to be a complete transformation of clinical microbiology because

421
00:42:52,060 --> 00:42:57,010
at the moment they all have a plate and a loop and a flying and all that stuff,

422
00:42:57,340 --> 00:43:00,310
and they haven't that hasn't changed since the middle of the 19th century.

423
00:43:00,320 --> 00:43:06,430
So that's all going to be swept aside with this molecular revolution where everybody off the sequencer and,

424
00:43:06,430 --> 00:43:10,150
you know, take a sample and put it in the sequencer and read the data. That's how you do it.

425
00:43:10,630 --> 00:43:18,610
So that's so that and that's one. And then the second thing I'm working on is this thing called one shot, which is I'd turn.

426
00:43:18,640 --> 00:43:20,770
What are we got? Yeah, that's fine.

427
00:43:21,280 --> 00:43:32,920
So one shot is this idea which we cooked up, which says we're going to have a massively expanded manufacturing capability for vaccines and biologics.

428
00:43:33,160 --> 00:43:37,450
It's going to go from 5 billion capacity, 5 billion to 22 billion here.

429
00:43:38,740 --> 00:43:44,080
This is global, again, global. And you're going to have to then think about what you can use it for.

430
00:43:44,130 --> 00:43:50,650
You can use it for. COVID are so big for it's going to have to use for something else because otherwise the manufacturing is all going to go cold.

431
00:43:51,850 --> 00:43:55,760
Workforce laid off. Nobody knows how to run the machines. And then you're right back to where you started.

432
00:43:55,780 --> 00:43:57,310
So you want to keep that stuff going like this.

433
00:43:58,390 --> 00:44:04,600
And we've also got in almost all countries in the world the deployment capability for adult vaccination,

434
00:44:04,600 --> 00:44:10,840
which would enable vaccines to come in the arm, digital tools come in and get your vaccine.

435
00:44:10,960 --> 00:44:14,830
Africans do a Southeast, Asians do it. You know, everybody does it.

436
00:44:15,340 --> 00:44:19,720
And so you've got a much better sense for the demographic who needs vaccines for this or that.

437
00:44:20,440 --> 00:44:24,430
And and so you've got the backend and you've got the front end.

438
00:44:25,000 --> 00:44:29,650
The real question is how do you fill the pipeline so that you keep all that stuff busy?

439
00:44:30,460 --> 00:44:36,580
So we've come up with this concept of one shot, we call it, and it's a bit odd that not one shot, it's about 20 shots.

440
00:44:36,820 --> 00:44:40,990
And that is that there's there's been this revolution in new vaccine.

441
00:44:40,990 --> 00:44:46,240
So Adrian's malaria vaccine, the new TV vaccine is going into phase three.

442
00:44:46,240 --> 00:44:49,299
The new dengue vaccine just approved RSV vaccines.

443
00:44:49,300 --> 00:44:52,750
Two of them just approved COVID flu.

444
00:44:53,380 --> 00:44:59,890
New flu, which could be even better than old flu. And then old ones like pneumococcus and HPV and all the rest of it.

445
00:45:00,310 --> 00:45:07,660
And then there's a whole class of other injectables, which are essentially vaccines against things like heart disease.

446
00:45:08,140 --> 00:45:12,770
So they control your blood pressure, control your lipids, and you get one shot and then you go away for years.

447
00:45:12,770 --> 00:45:19,360
So they'd like an annual vaccine. So we're promoting this idea that as a step for prevention and public health,

448
00:45:20,020 --> 00:45:26,080
you use that capability to just use the deployment capability and the manufacturing.

449
00:45:26,420 --> 00:45:29,959
Capacity to make billions of these doses.

450
00:45:29,960 --> 00:45:34,070
And then everybody gets a call once a year, you only get four shots depending on where you are.

451
00:45:34,070 --> 00:45:38,270
You can you know, if you're in Zaire, you get malaria.

452
00:45:38,270 --> 00:45:42,770
If you're in if you're in Connecticut, you get HPV, you know, all that stuff.

453
00:45:43,070 --> 00:45:49,930
So that that as a prevention strategy, that's a terrific step for the health care system almost anywhere.

454
00:45:49,940 --> 00:45:56,900
It's very good for Western countries, but also for the long term. So we're promoting that as a as a legacy from COVID.

455
00:45:57,920 --> 00:46:02,660
Tony Blair, is it a general U.N. General Assembly today talking about themselves?

456
00:46:02,810 --> 00:46:06,440
It's quite it's quite a good way. It's got quite, quite a good airing, actually.

457
00:46:06,440 --> 00:46:09,559
The Indians are very keen. The Indonesians were quite helpful.

458
00:46:09,560 --> 00:46:13,460
So they ran in the last G20. So it's getting a bit of traction.

459
00:46:14,270 --> 00:46:17,389
I'd say it's got it'll definitely get picked up in some places.

460
00:46:17,390 --> 00:46:21,230
It may not end up being global, but it will be it'll be a helpful step.

461
00:46:22,360 --> 00:46:28,729
Oh, well, it's good to hear that. So there's nothing to that. So there's this other stuff going on and it's all prevention oriented.

462
00:46:28,730 --> 00:46:39,900
So I think that's good. Mm hmm. I think given that you've got to go very soon, I think that's a nice point to end on.

463
00:46:39,910 --> 00:46:45,790
So yeah, yeah, yeah. Well, it gives you a bit of a sense about where the world may end up and it may end up in a

464
00:46:45,790 --> 00:46:50,290
slightly better place than well down in a better place than we were three years ago.

465
00:46:51,450 --> 00:46:54,220
The question is, how much better is that? Okay.