Thanks for invitation @BBCRadio4 World Tonight.
No easy choices in the UK now, every choice has very significant negative consequences. But delay before implementation is a decisions in itself & will make later interventions harder & need to be deeper & in place for longer.
Naively would be great if can avoid turning this into party political issue - this is a national crisis & will need a national solution.Every country that has managed well so far has done so on the basis of a national approach & consensus, trust, local ownership & broad agreement
The latest government plans are an attempt to compromise between health and the economy but may end up damaging both.
We didn’t use the summer months to get an effective, supportive & trusted track-trace-isolate system in place as other countries managed to do. That would have helped get r right down. Instead we headed into autumn with r too high. We’re sadly seeing the consequences of this now
New measures shift responsibility to local authorities, but as the CMO made crystal clear, at base they will have little to no effect on transmission. This is the worst of all worlds, the economic damage of more restrictions without the gain of a reduction in transmission.
We now need to get r down quickly to prevent things spiralling out of control. Because we don’t yet have T-T-I fully functional,the only way to do that now is with a return to the restrictions we had in April and May (though ideally & as the priority with schools open this time)
Best time get ahead inevitable winter increase would have been >3wks ago, but 2nd-best time is now. Pandemic can still be controlled,transmission can be reduced,hospitalisations,pressure on NHS & tragically people dying can be prevented. It can be done It is never to late to act
But if we wait, the government will inevitably have to change course again in 4-6 weeks, but the longer they leave it the harsher restrictions will have to get and the longer they will need to be imposed.
The interests of health & the economy are completely aligned, it is not false choice to make: the quicker we get through this the quicker we can get back to normal. Because of where we are now, getting through it quickly regrettably now means a return to more restrictions.
I know more restrictions will be a crushing prospect for millions of people. Govt has to put in place greater support for people & businesses bearing the brunt of this pandemic. Cost of this is trivial compared to economic,& social & health costs of the pandemic going on longer.
The only thing more economically damaging than supporting people through this crisis is not supporting people through this crisis.
I am optimistic we will soon get treatments & vaccines to end this crisis. Perhaps early 2021. But we have to get thru winter first. Now, regrettably we need greater restrictions to protect lives & the economy in the medium & long term. We need them now.
This can be done, epidemic can be turned around, lives can be saved, jobs & livelihoods protected.
But delaying critical decisions & by acting later will be much harder. Never act slower than the epidemic itself. And never think it is impossible to turn it around. It is possible

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More from @JeremyFarrar

10 Oct
Plan Continuation bias (PCB) - playing a role in COVID19? Lessons from aviation industry. A fancy name for “get-there-itis”. PCB which is an unconscious cognitive bias to continue the original plan in spite of changing conditions — & it can be deadly for general aviation pilots
Plan continuation bias was identified in a NASA Ames human factors study from 2004 which analyzed 19 airline accidents from 1991 to 2000 that were attributed to crew error. Out of those, almost half involved plan continuation bias. humansystems.arc.nasa.gov/flightcognitio…
Problem is in how it manifests. Study offered it becomes stronger as you near completion of the activity (e.g., approach your destination). It essentially impedes pilots from recognizing that they need to change course of action & because it’s unconscious,it often goes undetected
Read 10 tweets
9 Oct
The tragedy is how predictable this has been since at least early July. It was not inevitable. It is not inevitable now that this worsens, but to avoid spiralling out of control needs to be action now. We are close to or at events & choices of 13-23 March.
theguardian.com/world/2020/oct…
More data always useful, but don't try & bring more precision to public health interventions than a highly complex system allows. If strategy is to reduce r<1, transmission, hospitalisations,deaths,pressure NHS directly & indirectly it will need package of interventions now.
We are back to choices faced in the early March. With the lag time between making a decision, its implementation & its effect measured in weeks the longer the decisions are delayed the harder & more draconian are the interventions needed to change trajectory of epidemic curve.
Read 5 tweets
6 Oct
Latest data-COVID UK.Tough political decisions to be made. But data is clear. Community transmission increasing. Number people needing hospitalisation increasing. Tragically more people dying. Options for interventions might be debated but data is clear.
theguardian.com/uk
UK is on an epidemic path. The epidemic will continue to expand under the current restrictions. A choice we face. Need to be honest about the implications for the choices that are made. wellcome.org/news/covid-19-…
Some questioned the data & comments from @uksciencechief & @CMO_England on 21st September. Two weeks on, their comments were spot on.
standard.co.uk/news/uk/whitty…
Read 7 tweets
6 Oct
Great pleasure to join the @isirvAVG Therapeutics Meeting.
Thank you to Alan Hay & Fred Hayden & Organising Committee.
isirv.org/site/images/co…
1) Critical need for therapeutics for COVID19 in prevention, treatment & to halt progression of illness. Understandable focus globally on vaccines but even when we have vaccines we will still need therapeutics (& Diagnostics & Health Systems to make them available).
Always good to remember that for many infectious diseases we do not have vaccines despite many years of great effort & we know therapeutics can play critical role in reducing transmission, burden disease & save lives - HIV, TB, Malaria, Dengue & many others.
Read 18 tweets
26 Sep
Tomorrow's @thesundaytimes. Data is clear. Political & societal decisions on what to do extraordinary difficult. Very little room for a middle way that keeps things open & also prevents transmission, illness & COVID/NonCOVID deaths. Needs a national debate thetimes.co.uk/article/no-fud…
Not possible keep society & economy open as now & suppress transmission,prevent hospitalisations & deaths COVID & non-COVID & pressure on NHS. Anyone suggesting there are easy political decisions or possible to open society & economy & control epidemic is doing a great disservice
Need urgent national debate & political decisions to be made & fairly binary choice:Open up society & economy but accept higher transmission,hospitalisations & deaths vs further restrictions implemented now, reduce transmission, keep schools open & reduce COVID illnesses & deaths
Read 8 tweets
24 Sep
Inborn errors of type I IFN immunity in patients with life-threatening COVID-19 science.sciencemag.org/content/early/…
The ability to control the initial infection through type I IFN may be so important in COVID and also many other acute viral infections - Flu, Dengue, Yellow Fever, Chik, and others.
Idea that these infections are characterised by inability to control initial infection. As a result of a poor early immune response. Followed later by an exaggerated & uncontrolled response.
Read 5 tweets

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