TRIGGERnometry - Should We Vaccinate Children Against COVID? - Prof Karol Sikora

Episode Date: August 11, 2021

Professor Karol Sikora is a British oncologist of 50 years, who has been described as a leading world authority on cancer. Get TICKETS to TRIGGERnometry Live with Andrew Doyle here: https://leicestersquaretheatre.ticketsolve.com/shows/873619472 Join our exclusive TRIGGERnometry community on Locals! https://triggernometry.locals.com/​​​  OR Support TRIGGERnometry Here: https://www.subscribestar.com/trigger... https://www.patreon.com/triggerpod​​​ Bitcoin: bc1qm6vvhduc6s3rvy8u76sllmrfpynfv94qw8p8d5 Buy Merch Here: https://www.triggerpod.co.uk/shop/​​​ Advertise on TRIGGERnometry: [e-mail] Join the Mailing List: https://www.triggerpod.co.uk/sign-up/​​​ Find TRIGGERnometry on Social Media:  https://twitter.com/triggerpod​​​ https://www.facebook.com/triggerpod​​​ https://www.instagram.com/triggerpod​​​ About TRIGGERnometry:  Stand-up comedians Konstantin Kisin (@konstantinkisin) and Francis Foster (@francisjfoster) make sense of politics, economics, free speech, AI, drug policy and WW3 with the help of presidential advisors, renowned economists, award-winning journalists, controversial writers, leading scientists and notorious comedians. Learn more about your ad choices. Visit megaphone.fm/adchoices

Is this normal to vaccinate people who are not at risk of a disease to protect other people? Is that normally done? No, this is the first time it's been suggested. Hello and welcome to Trigonometry. I'm Francis Foster. I'm Constantine Kissen. And this is a show for you if you want honest conversations with fascinating people. A fascinating guest we have for you today.

He is a consultant oncologist. He's a professor of medicine at the University. University of Buckingham, and most important of all, a returning guest to the show. Dr. Caracaccaro, welcome back. Thank you very much. It's so good to have you back on the show. It's been about a year since we last had you on to talk about lockdown and COVID, and we didn't really get into Vactions, I think, much of the time. What have you made of the last year and everything that's been going on? Well, it's been fairly fast-paced, not what I expected. I mean, going into lockdown and when it began was easy. It was easy for the politicians. It was easy for those that

implemented in, getting out is much more complex. And that's what we're seeing now. We're seeing the tail end of getting out of it. And, you know, the ridiculous business of the different four countries having different rules within the UK. And yet anyone can travel between them. So the rules are sort of nonsense, basically. But I think now we're in a very good position. The number of hospital admissions has fallen. The number of cases has fallen. And we seem to be. getting out of the third wave? The pessimist, the gloomy boys, say, and girls, say, what about the fourth wave? And, you know, if there is anything, it'll just be a little blip. That's my reading of this situation. Well, what about winter? Surely there's going to be another peak in winter.

And I don't say this to someone who's in any way desperate for that to happen. It's more that I think it's been a year and a half of these constant expectations. And you're known for your positivity. Of course you are. And I think last time we talked, you were hopeful that. this would be over by previous January, but that hasn't transpired. So the concern for, I think, for everybody is that as winter comes, there will be pressures, whether they're COVID or not, there's always pressure on the NHS. And the feeling, I think, is given the public sentiment, which I find difficult to explain, frankly, at this point, we will be in another lockdown. Don't you think that that's likely? Well, if it was due to COVID, yes, but it's not likely to be

likely to be due to COVID. It's like to be due to other viruses and secondary pneumonia. It happens every winter. I was a medical student many, many years ago. And when I came out of the bookwork and went to the wards, the first year there was a flu epidemic. And it was chaos. The whole ward, no routine operations, everything cancelled because of flu. And mainly elderly patients got a bit of an infection with the virus and then they got secondary pneumonia. And some of them ended up on ventilators. And that happens every year. We call it winter pressures in the NHS. It's a euphemism. No other country has winter pressures. It's a failure to have the capacity to deal with it. And therefore, you have to shut down services such as routine, non-urgent

surgery to make beds, to make facilities available, to make intensive care available for those that need it because of the infection. So will we actually get coronavirus causing a in the winter, perhaps in a small way, but it's much more likely, though a whole road of other things coming along, flu, other coronaviruses that will dominate and cause the winter pressures. And of course... That's great. So I guess what I'm saying is I'm just,

you're positive that this is the tail end of it. But I do, should people, should people be positive about it? at it? I think they should. We've got to learn to live with this. We can't have this nonsense just this week about traveling. I mean, you know, either you go for it and you say that's it, we're opening things up, or you don't. You can't suddenly say, oh, this country's just become red on Sunday. And so unless you get back by Sunday, you're stuck. And this is Mexico where there's quite a lot of tourists have gone. And these people are desperate. I mean, you know, It costs an awful lot to organise your own trip home on a commercial airline.

And they don't get any help from their existing provider of transport. So I think it's that sort of thing that's really irritating. We've got to come out of it in a smooth way instead of a sort of a jagged way, which leaves bad taste. And then the rest of society, you know, there's lots of illogicality. The biggest one, I was in Wales a day before yesterday. Wales has different rules. So they're still with masks everywhere, with social distancing.

No one's enforcing it, but they have that rule. So I went to a little restaurant for a curry with a colleague and you had to wear a mask to go from the door. It's a tiny little place, no bigger than the studio here. And you had to wear a mask to go through the door. You sat down and you take the mask off. And this has seemed ridiculous that, you know, for 10 yards you wore a mask, then you took it off. and obviously the staff all warm masks.

So it's these sort of rules that are not based on any real science that seem to be still lingering. And we'll probably linger way until Christmas as people still don't get totally relaxed about the virus, basically. Do you sometimes worry, Carol, that with the lockdowns, we've opened the Pandora's box. So you say that every winter the NHS comes under pressure because of capacity.

the government's going to say, right, well, the NHS, we need to protect the NHS, let's shut everything down again. That certainly is a worry that you use the experience of the last year. Anything that comes along, whether it's winter or not, you say, let's shut down again. And you do a dramatic shutdown. The other way is to say, let's expand the NHS, expand healthcare, not necessarily in the same form as we've got it now, and develop places that people can go, that have chest infections.

And when you look at it, the problem we've got, you've got hospitals which are expensive, 500 pound a night for a bed in a hospital anywhere in the country because of the staff costs. And you've got care homes which have no medical care, no qualified nurses usually. Maybe the head person there is a nurse, but on the whole, they have no medical facilities.

And they don't want you. They're commercial, they're all private. And so, so, they're a head person. So there's only two choices. What we need is the third choice in the middle. For older people, they can go there and they can get medical care, a light version, not intravenous strips and not ventilators and things, but they can stay there and be looked after whilst they get better it well enough to go to the care home with no medical care.

So it's a matter of, it's called a step-down accommodation, but we just don't really have any in this country. Who runs it? The NHS or the private sector, it really doesn't matter. And it could be free at the point of delivery. So that's the key to it all. Care homes are not free, of course. Some people get them free, but you have to have very little money.

If you've got a house, you're going to have to pay for your care homes. So that's the problem. And Carol, we're talking about the NHS. It seems that the NHS, as long as I've been alive, we've been talking about how it's in crisis. But it does seem to be in crisis at the moment, particularly when you look at waiting, particularly when you look at the effects that COVID has had on the NHS. I think the reason COVID's impinged on our healthcare system compared to other European systems is simply capacity.

You know, weightingless and rationing have been there. I've been a consultant 40 years and we've had it all the time. And to get an MR scan, a magnetic resonance scan, if you've got backache or a knee problem, or even if you've got sort of weight loss and abdominal pain, It can take six months and everyone accepts it. And whereas in France, you'd go, within two days, you'd have the scan. There's the capacity in the system which we don't have.

So building up that capacity is clearly something that we can learn from COVID. And it came suddenly. And of course, nobody really knows how many people are on the waiting list. It's amazing. The figures vary. There's probably more than the government figures 5.3 million at the moment. But there's almost certainly more. if you take everything, including scans and blood tests and so on.

And we sort of accepted a very sluggish system, GP hospital. And to get to see your GP can take six weeks now. So just imagine you've got a, you know, you may have cancer, and you have to wait six weeks before you start. Then you get to the GP. Then you have to have a blood test. You wait two weeks for that. Then you get referred for an MR scan.

You wait another six weeks or even two months, even for an urgent one. So it's all that waiting that we have here that other countries have avoided by having more capacity. And why is that, Carol? Because, you know, the people on the left go, it's a funding problem. The people on the right go, you know, the fact that the NHS is bloated, it's misspending. What is the truth? It's between the two. It is underfunded for what can be achieved with modern medicine.

It's also challenged by old people, people, older than. than me. That's my definition of an old person. And people older than me are big consumers of it. And they, all of it from GP to hospital care and so on. And often there's not much health systems can do for old people. They have chronic comorbidities and generally body crumble. And you're stuck with that. For younger people, it's episodic care, which is what they want. You have the defined procedure for doing something for hernia or, you know, cataracts and so on, you get that done. The problem we've got is that the NHS is also a political tool, and it's very much bloated with middle management that want to be politically correct.

And for example, two months ago, I had to do my yearly appraisal. To do that, you have to do mandatory training online. And it involves all sorts of things. Courses on fire extinguishes. Well, I can see the use of the virus extinguisher, of course, just in case, I can see that. But to have to learn about equality and diversity, I understand the problems of equality and diversity, but to spend an hour going through it, and sort of almost religious. I was brought up as a Roman Catholic, so I'm used to catechismic learning where people tell you

this is what you have to do. And this is the right way. And so you have to go through all that. And someone has to supervise it. And ironically, most of these training courses are outsource to the private sector. So it's almost ridiculous that we all have to do this. But I think throughout the NHS, there's a sort of a cult of a religion there. And, you know, we saw it with a banging of spoons in COVID.

And that's the sort of almost a religious act that you're praising your priests, the high priests, the NHS. And you can say, what people are praising, of course, is the medical nursing staff. They're not praising the structure. And that's the problem. They have to dissociate that and try and move forward. And you talk about the priest class, which I think is actually a very important conversation. But there's been another area in which I feel that that's been happening, which you alluded to earlier, which is this notion that every restriction that has been imposed on the country, every decision that's been made, it's all been following the science, which is a phrase that irritates me massively, because from what I know about the science, both my parents are

scientists, the science is about discussion and debate and different points of view and testing hypotheses and sometimes being wrong and being able to admit it. The idea that the science has one particular view is frankly absurd. Yet that has been the messaging. What have you made of that? I think we've seen the politicians on one side trying to implement the advice they're getting from committees. And SAGE is the main committee, but there are little subcommittees. And it's very difficult. I mean, the committees work. They take the data and maybe 20 people on SAGE on the committee, obviously just doing it virtually.

And so you get one or two people that are very negative and want to have, you know, severe lockdown, vaccinate everybody, including babies, all this sort of stuff. Everyone has to wear masks everywhere. And so they tend to dominate the thinking of the group. So it's called group think, and they convert people. Everyone wants the committee to come to an end. So you have to get some sort of consensus. And so the consensus tends to go with the severest option goes down.

If you remove two or three people that are doing that, you'd have a much more balanced view. Hey Francis, do you want to learn another language? No mate, I'm English. If foreigners can't understand mate, I just shout at them. Think about it, you could learn how to say penalties in Italian. Leave it. But if you do want to learn another language because maybe you want to have new experiences live in another country, or maybe you just want to open your mind.

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The other beef I got about it is the data is not disclosed. So a great example last week. vaccinating 16 and 17 year olds. So, okay, it's a valid point. If the risk of getting COVID would lead to more illness, then vaccination, provided it doesn't cause a lot of side effects, would be justified. But, you know, where's the data? Show us how you've come to that conclusion.

And there was nothing. This was a subcommittee called the Joint Committee of Vaccines and Immunization. And, you know, it's been around for years and they've looked at how to do schedules for mumps and for measles and polio and so on. Now they're stuck with COVID. And immunising the 16 and 17-year-olds is a valid point. But let's see the risk-benefit analysis. And it's not public. And so we don't really know.

So all these GPs are going to have to go out and collect up the 16- to 17-year-olds and shoot them up with vaccine without really knowing if it's, if the risks of the vaccine outweigh the risks of getting COVID, because they're not a group that get ill with COVID on the whole. They get COVID, but not. And, you know, the ethic. Well, Carol, that's not good, is it? The GPs are going to be vaccinating people without really knowing whether the risk is worth it. Absolutely.

It's not a good thing, is it? You know, I've asked them to publish the data, but they won't. And, you know, one suspects the data are muddy, because, you know, the vaccine. And it's only the Pfizer vaccine that's going to be allowed. So the Pfizer vaccine is probably the best studied of the vaccines because it was the trials in the States and in South America were right at the very beginning. And they included young people, including children. Carol, sorry, can I just interrupt? Why is it they're only going to give the Pfizer vaccine to the kids and not the AstraZeneca? Okay. So the AstraZeneca doesn't go to anybody below 40 at the moment. And the reason is that

The AstraZeneca has a side effect profile, which is age-related. In other words, if you're over 40, you don't get the side effects. If you're under 40, the side effects on the heart and on the lungs are more severe with the vaccine. All vaccines have, you know, severe side effects, but in very small numbers of people. Even polio has side effects. The polio vaccine. The polio vaccine has side effects. And yet, but it's very low.

and the consequences of polio are very bad for a child. They can be paralyzed. And, you know, when I was a youngster, you could see people that had polio. They were limping around with a bad leg and calipers and so on. That's all gone for a society because of the vaccine. But coming back to SARS, the problem there is that you're going to immunize an age group that really is not troubled by the infection if they get it. Very few are going to be in hospital.

very few are going to be on a ventilator. So the ethicists love the situation because they say one of the reasons they want to vaccinate kids is because you're protecting the older people. So you're vaccinating, you're putting at risk a young person so an older person can live. Well, the older person has now been double vaccinated. So why should this help?

I mean, it's in a logical area. That's why it would be good to see the data on these sort of decision. Other countries have the same mess. I mean, it's not just us. Sure. So the United States, everybody over 12 is being offered the vaccine. And the data is just not there for that. Carol, what do you make of this?

Because it's not something that Francis, I know about. And these are real questions that I think a lot of people want to hear the answer to. Is this normal to vaccinate people who are not at risk of a disease to protect other people? Is that normally done? No. This is the first time it's been significant.

suggested. And that's why I'd be very keen to see the date. Forget the protection business. See what's the risk-benefit analysis on the patient, on the child, on the 16-year-old. What benefit do they get? I mean, you know, the story's all at, well, it's September's coming up, they're going to go back to school or back to college, and they're, you know, boys and girls at 16 to 17. Social distancing is not part of their agenda, and they'll go dancing and so on, so. So they need protection. But if the risk is greater than the benefit, we shouldn't be doing it. And so that's the sort of analysis you want to see. And, you know, it's all right saying this is our conclusion, accept it, without the data. Well, that's wrong. We should be able to see the data.

But it's never been done. What about smallpox? Didn't that get eradicated by the vaccine? It did. Smallpox was a great, smallpox and polio are the best success stories ever because there were lethal diseases. You know, the story of smallpox vaccination goes back nearly 300 years. And cowpox, it was noted by Jenna, Edward Jenner, the founder of vaccinology, really, that the milkmaids that have the cowpox didn't get smallpox. There was a cross-reaction. And so he went around vaccinating people.

Vaca comes from the word cow, Latin, I think way back from my O-Level all days. So taking the cowpox and scratching it into the arms of not milkmaids, but everybody. In fact, what was fascinating about Jenna, 20 years before, there was a guy called Benjamin Jesty. He wasn't a medic. He was a farmer in Yetminster, which is a small village in Somerset. And he did the same thing with his family and others around him. But he got no credit for it. He's got a blue plaque on his house, I've been there, the farmhouse he had. But he got no credit for it. Jenna got the credit because he was a physician, his portraits up in the Royal College of Physicians, whereas

our friend Benjamin Gestey, it's just the blue plaque on his farmhouse. But no, the whole business of vaccination is fascinating because you're taking normal, they're not patients. Right. People that are normal, as we are, the three of us sitting in the studio. And so you're going to do an intervention that must, by definition, carry risks for their benefit. Can you do the same thing for other people's benefit? And that's the question you're really asking. That's what I'm getting at because to me, look, I'm not a medical ethicist, but the ethics of that surely are questionable, aren't they? They are. And so that's why the data from JCPI on what benefit, what's the risk benefit to the person you're vaccinating. Forget

what benefit on the population. And is there not another way? I mean, if a, if a, if a, if a, If a 16-year-old could do social distancing from his grandparents, for example. And there's other ways of protecting the grandparents. One of the problems of the whole immunization business is voluntary. There's no compulsion. And it's the same for childhood of vaccination. As you know, with Andrew Wakefield and all that data about autism and vaccines, a lot of people stopped immunizing their kids.

And that has led to an increase in the number of children with measles and mumps. rebella and things like that because parents have just avoided getting vaccination. That's sort of disappearing now. With this, it's giving vaccination a bad name for the reasons you just suggested. If you can't see the data, why are we doing it? And it's a very, very, very good point. And you were saying that, you know, we don't coerce people into taking vaccines. We're kind of doing it now, aren't we, Carol?

Well, it's very clever game. You know, I think there's some very smart people in number 10. that are sitting there looking at how to persuade people to be vaccinated. These are guys that have been to top universities. They're very bright. And they've come up with this idea that what we do, we just drip it in. We don't say vaccine passports are going to be compulsory. We just drip it in.

And then you remove it. But because you're dripping it in and the PR comes out, you're going to have to have a vaccine passport. How is it really going to be implemented? A vaccine passport to go in the pub at the end of the road. Who's going to check it? Who's going to be able to validate that what, what you're showing is yours and all the rest of it.

It's much more complex. Crossing international borders is easy because you've got trained people that can look at documents. You can insist on various things. But going down to the king and queen at the end of the road, that's not the real pub. You know, this is a different level. So I think that the smart guys in number 10 have got a plan that you just keep going with it. People then get vaccinated. and then you remove the need for any certification because you succeed in.

The great thing about all vaccines, you don't need to do the whole population. If you do 80%, that's good enough. And of course, we're already at about 80% immunity because a lot of people have COVID. So you've got the infected and you've got the vaccinated people and both of them will have immunity. And so that stops the spread. So it reduces the R number of spread. Well, let's go into the whole vaccine passport thing. Francis, sorry, just one thing.

I know I've been hogging the mic. I just want to say one thing on that particular issue, which is the counter argument to everything you've said that we keep hearing, and I'd love for you to address this, is the idea that if there's a small unvaccinated population, then that will be the breeding ground for new variants, which will then reinfect and sabotage the whole program. What do you make of that argument?

I think that's unlikely simply because, if you destroy the roots of communication, transmission for the virus, you destroy the chances of a mutant getting out into the immune people. There's very little evidence that once you're vaccinated, you're going to get infected, even with mutants. So if a mutant arises an unvaccinated people, it's unlikely that it can transmit back to your immune population. Hold on. Aren't we seeing people in hospital with COVID having been double jab now? a few, but it's mainly people that haven't been double jab that go into hospital. Now, the serious illness is prevented by the vaccines, and there's no doubt.

What's not prevented by the vaccine necessarily is the transmission, especially after just one jab. But on the whole, the vaccinated population protects the unvaccinated population. So there is, again, this sort of, you know, it's a strange business. And if you look at, we've never had it before because if you look at things like polio, that doesn't, the vaccines are perfect compared to SARS vaccine, which is not perfect. It's, you know, 80% effective. So 20% you're getting no benefit for. So that's the trouble with it all.

And people play around with those numbers. I mean, you know, I'm not an immunologist, but I know enough to understand that it's so to say, well, the Pfizer vaccine is 95%. effective. What does that really mean? You'd really love to do the experiment. You've got a hundred people, you give them the shop, and then you infect them deliberately. And you see how many get it. Then you take another hundred people, no vaccine, shoot them up, you know, and they will get it. And that's the number you really want to do the comparison, but that would be an unethical experiment. So going back to the idea of vaccine passports, there's a lot of people who will say that

Those people are putting others at risk in an event, in a concert, etc, etc. We can't have them in that area. This is how we protect people. Do you agree with that argument? No. I think you can do it alternatively. You can do testing. We've got very good rapid tests now, lateral flow tests, which, sure, there's false positives,

there's false negatives, but they're really not bad. And I think that should be enough to gain your entrance to Wembley or some big event. I think it's interesting. I noticed an advert for cruising. I've never been on a cruise and I never want to go on a cruise, by the way. Saga cruises and it said everyone has to be vaccinated. So in the advert for the cruise, it's a vaccine people only or something like that. I know that's an interesting, exactly what you say, people feel more secure if everyone's been vaccinated on the boat. But it's much better to test everybody as they go onto the boat. The trouble with that is what do you do, people who are Southampton docks and someone tests positive, you're stuck. They've got to take their luggage back, they've got to go. They'll be really very distraught about the situation. So that is the problem of testing. But you could test before they leave the house. I mean, there's ways of doing it. And there are lots of around the corner from your studio, the place that says testing, same day service. And everywhere you can get these things.

Wouldn't you agree as well, Carol, that the interest, introduction of vaccine passports, or the threatened introduction of vaccine passports, actually heightened suspicion amongst people who are worried about the vaccine? It does. And that's why mandatory, making it mandatory, is probably the wrong approach. Now, a lot of arguments within healthcare, whether you can make mandatory vaccination of staff. And that is a really difficult issue. And we were all very privileged to be offered vaccination, right at the beginning. I got mine the first week of January. I went around to Hammersmith, my old hospital, and 8 o'clock in the morning, coffee in a bun, and shoot up. But there are a group

of people that just don't want it. Whatever reason they just don't want it. Now, can you insist that they don't work front line with patients? If they're going to insist on that, what use are they to you? Because if they can't, a nurse can't be on a ward, what are you going to do? Make her an or something. I mean, there's not that many roles for people that are, you know, frontline clinical to go behind because they won't be vaccinated. So much better to try and persuade them to be vaccinated or to, you know, does it really matter? It's back to following the science that you mentioned, Constantine. We don't have the, we don't really know if a small percentage, say 10% of your staff are not vaccinated, are they going to be,

a problem in dealing with patients. Because obviously, patient safety is paramount in any healthcare system, care whom is the same. And so can you immunise all the staff to prevent them being a route of transmission? And I think you can persuade them to be, without making it compulsory. Do you think it's illogical for people to be fearful of this vaccine? I'll give you an example. My girlfriend's 32 years old. She had the AstraZeneca. It's now said that you should be over the age of 40 to have AstraZeneca. There's countries that have said that banned AstraZeneca for a certain period of time. Is it logical for people to be concerned about this vaccine and not want to take it if you're looking at the science and the data? I think the AstraZeneca has a different toxicity profile,

side effect profile than the Pfizer. On the other hand, it's a much more established way of making a vaccine, taking another virus and coupling it up with some problems. proteins that it expresses to make it look as though it's a SARS virus to the immune system. The Pfizer is just a little bit of RNA, which is the message that DNA makes protein with. And so it's a sort of genetic engineering, if you like. You're putting an artificial gene in the arm, which is going to turn over proteins that, again, convince the immune system you've already been infected and therefore develop a powerful resistance if you do get exposed to the virus.

So, you know, the side effect profiles are different. And what's emerged in the clinical trials that the Pfizer seems to have less side effects in younger people than the AstraZeneca. And that's the reason for the age cut off. Other countries have made it 60 rather than 40. So Scandinavian countries won't give AstraZeneca under 60 to try and avoid this.

And the most serious problems are in the heart, the brain, in the lung and it's inflammation, it's non-specific inflammatory change. Most cases it's transient, you know, two or three weeks it gets better, but in some it doesn't and that's the worry. And there have been deaths, but there are deaths with both vaccines. The real trouble with relating anything to a vaccine is, you know, people are primed when they get the vaccine, anything that goes wrong, they blame the vaccine. And it may have happened anyway, And you can't separate that. Then how do you convince these people who are worried, of which, I'll be honest with you,

I am one of them. Because like you said, I saw the way that they changed continually. And I was thinking at one point, do I take the AZ? Oh, I can't take the AZ. How do you convince people then? But also, Francis, you've had COVID, right? Yeah, and I've had, but I've had COVID. So I think to myself, should I take it?

Should I not take it? I've had COVID. I was fine with it. I felt rough for a week, but then I got over it. Do I need the vaccine? The answer is, Francis, nobody knows what to advise an individual. And that's where we are, that we can't advise an individual. We can look at the whole population and look at the benefit in terms of preventing COVID-related illness, and then including long COVID, and then we can look at the risks of having the vaccine. And in someone of your age, they're relatively small, whether it's AstraZeneca or five. I mean, they're almost trivial.

But if you do get bad side effects, they're not going to be trivial. And that's the problem. So the advice for populations is get immunized. How we persuade people. I mean, I think it's crazy persuading people by giving monetary offerings and $100 in the States and so on. Or a big Mac. have a big mac. This seems counter insured to have, with chips, of course.

And a nice, fizzy, high-calorie drink to go with it. So bribing people doesn't work. They have to understand. And I think the other thing, we've not spent enough time, is working at why people are scared, what the reasons for it. But, you know, it's still very sad. There are families that don't, the mothers won't let their kids have polio, for example, vaccination.

That seems a little strange in the modern world, but people have different beliefs. And I guess my training within the NHS for diversity means you have to encompass all beliefs and not force things through. I mean, in the sense, lockdown was forced through, although our lockdown in the UK was very light compared with a lot of other countries which used police and military in a much more aggressive way to keep people. you know, you got shot if you came to the door, you know, that's something. And but, you know, you were certainly accosted to, I don't know why you were moving around, whereas here it was almost voluntary. And you talk about the lockdowns and the sort of various measures. Have you been concerned by the government's willingness to coerce people into doing things,

whether that's, you know, taking the vaccine or whatever other measures that they're, encouraging it. The thing that's really concerned me about it is the willingness of the government in a free society to use, you know, Boris Johnson saying, oh, well, if you want to enjoy life, you're going to have to get the, to me, that's quite a forcible way of doing things, isn't it? Yeah, I really don't like it. Civil liberty is really important. And we've seen that go a bit. But as I say, the UK has not been the worst country. We call these interventions MPIs, non-pharmacological intervention. It's not a vaccine, it's not a drug, it's social distancing, it's mask wearing, and it's lockdown. I mean, avoiding crowds, shutting restaurants,

shutting all these things. And, you know, all these rules, these bubbles, I never understood the bubbles and why restaurants wouldn't take more than six people, because otherwise you'd be breaking the rules. I just couldn't get my head around those. And again, they varied in Wales and London and Glasgow and so on. So the enforcement is not easy. And I felt sorry for the police. I mean, they were trying to enforce it. And now and again, you get some heavy-handed, you know, episodes happening.

A couple of ladies walked around a reservoir somewhere, and they got arrested and fined for having a cup of coffee there. And that sort of thing is bad taste. And I remember seeing a picture of roadblock somewhere in the way. West Country and they were looking in the boot to see if you'd been shopping. You had to show you shopping. But this is ridiculous. I mean, it's there. So I think that's been the problem that no one wants it. And I think you have to persuade people that vulnerable people need to be older people, people with or existing chest disease who, if they do get COVID, are going to get it bad. They should avoid restaurants. They should just not go out. But you and me, we can go out because we're healthy. I mean, that's the sort of way I'd look at it. What do you make of the counter argument to that that people make very often?

Because, you know, the conversation the three of us are having here is not representative of the public mood of the positive to be believed, right? So the counter argument that people often make is, well, you talk about your civil liberties, Carol, but actually by being in a restaurant, let's say me and Francis, who both had COVID but haven't had the vaccine. Yeah. you are denying me my civil liberty to be in a restaurant because I have to be afraid for my health. What about that argument? Isn't that a reasonable way of looking at it? It's a very interesting point. I travel in from the suburbs from where I live and I come on the train and I don't wear a mask, but nearly everyone else is wearing a mask I've noticed. Now, why are they wearing a mask? Some of them probably think they're protecting themselves.

That's a misconception that they want to believe it's protecting them. feel better with it, why not let them do it? Others think it's their civil duty. And in fact, on the railway sign, it says, please be considerate, wear a mask, it would help if you wear a mask in crowded places. How do you define a crowded place? Obviously, London Underground has been crowded throughout this whole thing. And the central line is particularly bad. And a lot of people have never worn a mask on that. So it's a very difficult issue. And again, it's civil liberties. Do what you want. The other thing that's fascinating, that very few people seem to be aware, is the exemption. And the exemption is just ridiculous. Anyone can be exempt. You don't have to go

to a doctor, and you don't have to go anywhere. You just can phone up or email, transport for London, and they'll send you a badge. I mean, it's, and you can cut one out from the website, and you can declare yourself exempt. I mean, it's just crazy. And there are all these inconsistencies in the whole system. And I think, you know, the business that you, even during the beginning of lockdown, we allowed people to walk a dog. So, well, this is, either you have lockdown or you don't. They allow people to go shopping.

You allow, you know, other countries didn't. My granddaughter lives in Peru. And the story she tells, well, obviously it's a bit of a military police state there. And they do have a serious problem with. And there you walked out and police would come and find you and take you back and, you know, go and tell your parents off. It's a different system. Are you tired of using bulky old wallets, giving you a bulge where you don't want it to be? My old wallet was massive, so it brought all the ladies to the yard, which was a huge distraction

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which means if you want, you can have only one wallet for the rest of your life. Ridge are so confident in the quality of their product, they will give you 45 days to test drive their wallets. That means you can get the wallet, use it, and if you don't like it, you can return it within 45 days. Because Ridge is such great guys, they're going to give you 10% off and free worldwide shipping and returns. To take advantage of this incredible offer, go to ridge.com forward slash trigger. That's ridge.com forward slash trigger and use our special code, which is, of course, Trigger. The civil liberty side always worries me. But what also worries me is the effect that this has had on cancer patients.

And stopping the system for lockdown, what effect has that had on you and your department and the cancer departments across the country? Huge effect. And that was one of the reasons I got a Twitter account is to point this out right at the beginning, that cancer patients are going to suffer here. And what happened way back in April 2020, so more than a year ago, was suddenly the whole system's ground to halt.

So you couldn't go and see your GP. The GP couldn't refer you to the hospital. You couldn't get even a chest x-ray was difficult to a ray. Even if you were coughing up blood, you couldn't get a chest x-ray, which would diagnose tuberculosis or lung cancer. So even if I presented at the GPB and saying, look, I'm physically coughing up. blood, which is a classic sign of lung cancer. Yeah, nothing would happen. And there's a good paper in the British Medical Journal pointing that out that people with hemopatists, which is coughing up blood in medical terms, were ignored in April and May. And the best evidence there was a serious

problem was looking at the number of biopsies for cancer. So biopsy is putting a needle somewhere and taking a sample. And that's how you know someone's got cancer. It's the only way you can really I mean, x-rays and scans do help you, but it doesn't, it's not convincing that that really is cancer, the shadow, they have normal shadows of cancer. So the biopsy level, the number of biopsies per day should be around a thousand every day. So, and you look at the numbers, they dropped to about 50 during April and to about 200 in May. And then they gradually came up as the year went on.

But even now, access to certain services are limited. because if you've got a waiting list of 5 million, probably more, in there there are cancer patients that don't know they've got cancer, nor do the doctors know they've got cancer, but once whatever the procedure they're waiting for is done, cancer will be diagnosed. I've got a couple of questions for you on that particular issue. The first one, again, the counter argument to what you're saying is, well look, if we didn't do a lockdown, if we didn't take all these measures, the NHS would have been overwhelmed, and you still have a massive backlog, but also loads of people are dying of COVID.

Didn't we need to do all of that to just stop the system from collapse? I would say no. It was finely balanced, especially with the second wave. But this way, there's no effect. I mean, the number of people going into hospitals not flooding it at all. The second way was a bit different, and it was getting close. Now, the other interesting thing is how difficult is to predict what's going to happen at any point in time with this.

So it's very easy to look back and say, oh, we should have done this, we should have done that. But at the time, you couldn't work out where the curves were going. And the government's politicians are easily swayed by extreme views, extremely negative views about where it's going. You know, the one thing that was quite amazing, and what a waste of money it was, were the Nightingale hospitals. In building these places, like one close to here in Excel in London,

And no one seemed to give any thought to where the staff were coming from. Where are you going to get the people? They're in the hospitals. They're busy. They've got jobs to do. And getting retired doctors, retired nurses, you know, some of my friends signed up for that. My wife signed up. She's a nurse.

But they never got used. And quite frankly, they would need to be retrained. If you're doing intensive care in Excel, you'd have to be retrained to do it. You couldn't just take old people, like my wife, if you'll hate me for saying that, and sort of give them a couple of hours and say, they go on the ventilator unit. And so they were never used. I mean, there were a tokenism. They put a few patients to recover in there and then closed it down.

But it must have cost a billion pounds at least for the building that system. And, you know, I remember seeing a brigadier in full camouflage kit, you know, with a stick, pointing out how they were building this and doing it. It's so easy to do that, as long as you've got money. It's so easy to create things. It's much more difficult to run them because in healthcare, its staff is always the problem. And not really doctors.

Who's going to be there all the time? Healthcare assistance you need people that know how to do things. And that wasn't thought through it. So my second question then is the other side, which is, and it's a very sad question, but we obviously understand from what you're saying that there will be a backlog of cancer patients, many of whom have not been diagnosed yet,

many of whom, and we know people like this, and we get messages every day as I'm sure you do, by God I'm sure you do, for people whose cancer went from being a small lump that was easily curable to full stage four, incurable, inoperable, deadly cancer. What will be the cost do you think of all of this in terms of cancer deaths, but also, of course, you then have to heart disease and all of that.

But the thing that I've never understood, and I've said this to people, every journalist I know, I said, why are you not asking the politicians how many people die from lockdown? Why have we never had that conversation? What is your take on that whole thing? I kept trying during the height of lockdown to convince people, we've got to get the cancer of patients out, we've got to get the heart attack people and the stroke people, fast-tracked into hospital. And if you're waiting for your hip to be replaced, you can wait.

But if you've got cancer, you can't. And the story of cancer is very straightforward. You know, the four common cancers are lung, breast, colon and prostate. And if you've got a stage one cancer, which means the cancer is confined to the organ, it can usually be cured with either surgery or radiotherapy or both. And the chances of cure are 90%. percent for stage one cancer. Once it starts spreading to the lymph nodes and then beyond the lymph nose to stage two, three, and then four more widespread to the lung to the liver and so on,

the chances drop to less than 10 percent chance of cure. So you go from 90 percent cure to 10 percent cure. The time it takes to get there is very variable, depending on the speed of growth of the cancer, the type of cancer and so on. But a rough rule is that three months probably drops your stage. In other words, and six months drops you two stages. So you go from what the lawyers love to do for litigation cases of delay. On the balance of probability, you would survive your cancer if it's 90% if it's stage one, to the balance of probability you're going to die from your cancer if it's stage three or four.

So you drop that within three to six months. And that was the problem. Now, we won't really know until another couple of years goes by. so by 2023 and so on, and when we look back at the cancer survival, and we'll see a blip in the patients that presented during lockdown because they couldn't access care. Just as the same way, we'll see it for people that have heart attacks. And a lot of people, it's not just services weren't there.

They were too scared to go to hospitals. So they sat at home with chest pain, or they sat at home coughing up blood because they were too scared to use the health. Also, they were psychologically sort of corrupted, if you like, by the slogans, protect the NHS, stay home, save lives. Your life's not important. You're all staying at home to protect other lives. And that was the, you know, it's very clever.

Again, these smart guys in number 10 came up with that. And there are always three little slogans in the strap line. And very powerful messaging. And what we see now, now we're coming out, is that people are still psychologically brainwashed into the old thinking. Doesn't the government need to take responsibility for that, though? If you've got someone literally at home dying of a heart attack and they're too terrified to come in because they're worried about COVID,

because the government has given them a disproportionate fear, it's basic common sense that a heart attack is far more dangerous than COVID. It is, but if you've convinced people to stay home and protect the NHS, the threshold at which they'll call for help is raised considerably. And that's been the problem, whether it's cancer or heart attack or stroke. The threshold has changed. And so we've got to get it back. We've got to get people back into the system.

But that's going to take a lot of convincing. If you've essentially given them a diet of fear, a propaganda of fear for 18 months, how do you undo that? People are so fearful. I mean, again, it's back to the mask wearing on the train. and people avoiding me because I haven't got a mask. And this sort of thing, they're still very scared. And these people are double vaccinated, you know,

and yet they're still so scared. We've got to remove that and sort of embrace it like we embrace the flu. We just live with it. You know, if someone goes off work for the flu, that's fine. They come about a week later and we get back to work. But this is different somehow. This is a, you know, the fear factor is much greater. for COVID. Carol, speaking of fear, you're obviously an optimistic, cheery guy. Francis and I are not.

In your quiet moments when you're just, you've got a minute to yourself, do you ever wonder if we're ever going to get back to normal? I think the population here and in other countries has really been badly hit psychologically. It's going to take a long time. It's going to take probably two or three years. And even then will we get back? other words, will air travel still need PCR tests beforehand and afterwards, this sort of thing? You know, bureaucracy creates jobs for bureaucrats and they won't want to give up. They want to carry on doing it, just like immigration controls and all the work permits, the whole bureaucracy around that.

I can't see it going away very soon. And you're right. It'll last at least for two years, maybe even longer. And the fear factor here, I bet even after Christmas people will be still wearing masks on the train because they're scared and they think the mask is going to help. But it's great. It's like having worry beads in Arabic nations. They all go with worry beads and they play with them. Same thing with a mask.

If you want to wear it, why not? So just wrapping up then, do you think we need a public inquiry after this to find out? Not least because we need to know what to do next time. It's not the last pandemic. Interesting. We do need to do something. We need to have a review. Public inquiry, there's no point using it to find fault with the politicians. They're incompetent. You can see they're incompetent. Why would a journalist in The Spectator and other journals like that become Prime Minister?

I mean, it makes no sense. Why is that training to be Prime Minister? And the same for all of them in reality. They're there for not for their skill set. And they've got very smart people that advise them, but now and again it goes wrong. So I think going forward, what we need to do is work out the various bits that went wrong and how we can avoid them if it happens again. And of course, we have to broaden it from SARS. It's got to be any infectious agent. It could be Ebola, which is much more serlasa fever, anything like that that comes into

the country. how we can protect against it and implement a plan. It's a very, very good point because I don't know about you. Do you think we're going to enter a stage where we see more pandemics now? Or do you think it's going to be, I know it's a ridiculous question almost to ask, but do you think we're going to see? I love the original. Yeah, yeah, it is.

It is. Just stop asking your stupid question for instance. Do you think we're going to be seeing more pandemics as we go on? I think the threshold again for pandemic fear is lowered. In other words, as soon as, if you remember way back in 2012, we had the MERS. And then in 2003 and 2004, we had the SARS, the first SARS. And it didn't really cause that much disturbance to everybody. But now we've all been prime.

Well, that's done now. That's never going to happen again. It's never going to happen again. We're going to be much harder and stopping, trying to stop with non-pharmacological interventions, the spread of anything new that comes. And we're going to have better monitoring systems. So you don't suddenly realize that half your population have been infected. In any pandemic, any infectious agent, there are only three types of people.

Those that are actually infected, those that are susceptible, and those that are immune, either because they've had it or they've been vaccinated. So you've just got three groups of people. And what you want to do is reduce the susceptible group to as small as possible and increase the other two go on. You don't want too many affected, but you want the immunized people or the natural immunity people to go up and reduce the susceptible. That's got to be the aim.

And a public inquiry, going back to the last question, could help. The public inquiries I've been involved in have just been whitewash. And lawyers get in and they've long, have produced long texts, and not much happens. So I think what we need is a direction of travel for prevention of a further incident like this ever again. It's a very, very poignant note to end them, because I think we all agree that we need an investigation because we can't allow the mistakes to be repeated. Carol, thank you so much for coming on. Our final question before we've got a few questions from our local supporters is what's the one thing we're not talking about, but we really should be?

The thing we're not talking about is still death. I said that the last time you interviewed me and age. What's the value of life? And is the value of someone of your age greater than the value of someone my age? So that is the thing. At the moment, the health service doesn't use age. It's age. But why shouldn't we use age? If you're 85, do you deserve a very high-cost cancer drug if you get cancer? If we can afford it, yes, but the priority has to be for the 40-year-old or the 30-year-old to get that drug. And that's something that no one likes to talk about. And if I do talk about it, they say, oh, this is a dangerous territory. So why should it be dangerous?

We have to make decisions. Carol, thank you so much for coming on. If people want to find you online, where is the best place to do that? The best place is Carol Sikora at Hotmail.com. You're going to get lots of emails now. And you're on Twitter, of course, as well. And I'm on Twitter, Prof Carol Sikora. Exactly.

Carol Sikora, thank you so much for coming back. And thank you all for watching. We'll see you very soon with another brilliant episode like this one or Rorschow. All of them go out at 7pm UK time or 2 p.m. Eastern. Take care and see you soon, guys. We hope you've enjoyed this incredible interview. Remember to subscribe and hit the bell button so that you never miss another fantastic episode. And if you believe that the work we do here at Trigonometry is important, support us by joining our locals community using the link below.