Perspectives and opinions from frontline doctors -Interview Transcript
This interview was filmed on 19th March (prior to the enforced lockdown), therefore any reference to Government strategy is no longer true. Edited for ease of reading. You can watch the interview here .
Daniel: Thank you, my name is Dr Daniel Olaiya, I’m currently joined by my colleague. Introduce yourself please
Adam: I am Adam Ali, I am one of the doctors here on the Unit(?).
Daniel: Fantastic, so we are currently working here at Public Health England but, right now we are talking to you on behalf of Afro Health Initiative. You guys had some questions for us regarding the coronavirus and we are going to try our best to answer them.
So the first question was whether black people, African people are less likely to be infected? Now this is a funny one because a lot of people have been talking about this. It has been going around on social media and there have been lots of rumours but, what is the actual truth? Now I’m going to say my opinion and you will hear Adam’s also. Essentially, it’s about evidence. We are doctors, we are scientists, we believe in evidence. There is no evidence that I can see or made available to give a reason why black people, African people should be less likely to be infected. There is no reason for that to be the case.
Yes, people talked about the fact that you know, the only people that have been recorded or have been publicised to have died from the corona virus in Africa have been European people, like the German person in Egypt but that doesn’t mean anything about black people and their chances of getting infected.
What are your thoughts Adam?
Adam: As we were discussing earlier, there are some conditions or medications that may be particularly used in black people because there is a scientific or physiological reason why there might be a difference between black people and people who aren’t black. I can’t think of any reason physiologically why coronavirus would particularly affect black people or not particularly affect them or be protected. As you said, at the moment, there is no evidence to suggest that.
Daniel: That’s the thing, it’s an interesting one actually. If we look a bit closer at the details and look at the differences between African populations and European populations then we can start to see why there may be some differences. Of course, the average age in Africa is 19. Shocking, I know. Because of that, it holds certain differences between the different types of diseases they [African Populations] will get and the type of diseases that will kill people. You know a cold, a flu, a bad case of coronavirus as we know is less likely to kill young people. There is [a lot of] younger people in Africa so that could be a reason for that. On top of that there could be less testing in Africa. There are going to be less stringent controls on these cases, so people are more likely to get it and not seek any help and just kinda get better because of certain factors. So those cases go kinda, underneath the carpet. Anything else you want to add to that Adam?
Adam: Nope, agreed that’s what we discussed before about testing. If you are testing less, you might not necessarily know if people have the condition. So if you would [then] postulate that maybe black people would be less seriously infected and may not even know that there is testing. [We were just talking about economically in terms about what the country’s economic status]. Africa, as a continent obviously, there are areas that are wealthy- where there is more wealth but, as a continent it will be in less of a position to test than let’s say Europe. Generally speaking, unless testing facilities are made available, you won’t know, unless you know people that are infected.
Daniel: There we go. The next question we wanted to answer was about the way we think thing are going to go in the UK. We have a unique position seeing things from [Heathrow and (?)] a public health and of course our own experiences. How do you think things are going to go? What do you think is going to happening, you know bring a bit of clarity?
Adam: Dunno. I think it is very difficult if you have been watching the daily press conferences with Boris Johnson et al. you will see, I think [of] the very difficult position he is in because people keep asking him and his advisors what’s gonna happen at this point? What’s gonna happen at that point? And the truth is it is a novel virus, we have never dealt with anything like this before. Maybe the last time was the flu pandemic in 1918 the so-called Spanish flu so how can you expect them to know the future?
All we can do is be guided by the science and the evidence to model as best as we think things will go. That is what our chief medical and chief scientific officers are doing. So, I would be probably be guided by them. It looks as if things are going to get a bit worse and the general party line is that we are trying to “flatten the curve” which would probably counter — intuitively, prolong the duration of the pandemic but also decrease the burden on our health services.
Daniel : That’s it, that’s it. I couldn’t have said it better myself. Just to clarify a couple of those points. I think “flattening the curve” and understanding that paradigm and that idea is very important. This “flattening the curve” is all about creating a situation where we slow down the spread. So that we can manage the number of cases that we have.
If you have 10 beds in ICU, we have the equipment and the speciality knowledge to deal with these various patients. Say you have 10 spaces and you have 10 cases at the same time you can deal with it. If you have 20 cases at the same time, you can’t deal with it. It is all about closing the influx so you get as many cases as you can deal with at a time — that is flattening the curve. That is what it is all about.
The other thing to understand is about how government, our government's strategy — herd immunity. Let’s be honest here, herd immunity if you look at a textbook, if you look at how herd immunity is being done, it is done with vaccines. That, how you can ensure you have immunity to a disease. However, we have no vaccine. The hope is that enough people get it and get immunity to it- we hope they have immunity to it so they don’t get it next time and therefore spread it. That is a way, that is a strategy our government are attacking this. In that, there is a saying that there are going to be people, a lot of people who will pass away who won’t be able to get over that hump and get over that initial infection. That is the issue. It is important to understand the way we are attacking it.
We are not doing lockdown, we are not doing strict measures, we are saying okay everyone is going to get it let’s just slow everyone getting it and I think that everyone will have their own opinions on that. Whether they agree or not. But that’s the situation.