His top gripe is that NHS management – who let the health system become the chief vector of transmission in March – is now so focused on eliminating Covid that person-to-person diagnosis of other diseases has stopped, to the net detriment of overall health.
“The reality, which they seem not to understand, is that we don’t have some virgin population. We’ve already been pole-axed, and as a result, it’s basically over. What happened in places such as London won’t be repeated, ever,” he says. Many others have reached the same conclusion.
“The ideology of zero risk is dangerous,” says Yonathan Freund, a Sorbonne professor and Editor of the European Journal of Emergency Medicine, who supported the original lockdown in France. “The consequences of this disease for the general population will never be the same again.”
The UK is not alone in swinging from inaction to overdrive. France is mandating masks outdoors (pointlessly), after having first declared masks indoors to be useless. It is becoming surreal.
My cardiologist friend was a hardliner in the first weeks of the pandemic, warning that the UK had failed to heed the lessons of Korea, Iran, and Lombardy and was allowing the virus spin out of control.
Now he and many of his front-line colleagues are on the other side of the argument. “I would keep face masks, protect the care homes, continue to ban mass gatherings, and probably be strict with pubs, but, aside from that, I would basically return to normal,” he says.
Contact tracing should continue – or rather start in earnest, after a rolling shambles – and should preferably be left to local authorities with German follow-up routines rather than be left to the inertia of Serco.
In a sense there is much to celebrate. The fatality rate of intensive care patients in the NHS dropped from 42pc in early April to nearer 20pc by mid-July, thanks to dexamethasone, anticoagulants, earlier use of oxygen, and a steep learning-curve at the clinical front-line.
A worldwide meta-study published in Anaesthesia had a different figure, down from 60pc to 42pc but the cut-off date was the end of May. There have been steady gains since then.
The mounting evidence from T cell and modelling studies is that large numbers of people may have immunity despite not yielding detectable antibodies. Many may have some degree of underlying protection, perhaps as cross-immunity from earlier coronavirus colds, or because of genetic variability. They are the “dark matter” cohort.
I recognise that we do not have all the facts (when does one ever?). We don’t know the severity of “long Covid” pathologies. Nasty surprises keep cropping up. Young people who seemed to brush off the virus at first may suffer lasting lung, heart, and organ damage.