Professor Karol Sikora: Now we know coronavirus is not a random killer

Now we know coronavirus is not a random killer, this one-size-fits-all lockdown must come to an end, writes Professor KAROL SIKORA

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Finally, we can say with confidence what many of us have suspected for weeks: not only is the end of the pandemic now in sight but also the people best-placed to recharge our economy have little to fear from it.

Thanks to definitive figures released yesterday by Public Health England, we know that Covid-19 is not a random killer, but one that targets specific groups – namely the old and those with pre-existing conditions such as diabetes or dementia.

The statistics are astounding: those aged over 80 are fully 70 times more likely to die of the disease than those under 40, while being morbidly obese increases your risk of dying by two and a half times. And fortunately the death rate among children is very low.

All of which means that the challenge now is to get the economy back to work, to get the children into schools, and our hospitals returning to the crucial diagnostic work and routine procedures that have been put on hold with devastating consequences we have yet to see.

Thanks to definitive figures released yesterday by Public Health England, we know that Covid-19 is not a random killer, but one that targets specific groups – namely the old and those with pre-existing conditions such as diabetes or dementia (file photo)

It should also act as a massive boost to our economy, as it means that factories and businesses, where workers are predominantly young and healthy, can reopen with sensible precautions.

The easy part of the lockdown was starting it. The message was simple: we are all in danger, do as you’re told, and if you don’t, we’ve given the police special powers to fine or arrest you.

Lifting it will be much harder, partly because the dangers of Covid-19 were exaggerated as a matter of public policy and people were brainwashed into a state of fear.

But now that we know that Covid-19 is a selective killer, we have to accept that we cannot have a one-size-fits-all approach to the lockdown.

Certain people are more vulnerable than others – and it should now be up to them to make a personal assessment of their individual risk.

After all, we make such judgements all the time. To take an extreme example, my wife has made a parachute jump; I have not, and never would. Our respective decisions are based on how scared we are at the thought of jumping out of an airplane, and on our rational assessment of the risks involved. So it is with Covid-19. As an oncologist, I have spoken to elderly patients this week with terminal cancers who will not live more than a few months. They ask me if they should take advantage of the easing of the shielding measures to finally get out of their homes, and maybe see their families before they die.

‘Certain people are more vulnerable than others – and it should now be up to them to make a personal assessment of their individual risk,’ says Karol Sikora

I tell them that they must make their own decisions, but I certainly wouldn’t blame them for taking a calculated risk to live their last weeks to the full. But, I say, be sensible.

While the latest figures should certainly act as a morale boost for people who can start thinking about a return to normality, many unsuspecting Brits will be shocked to read that they appear disproportionately at-risk.

Those of us who work in hospitals could not help noticing the depressingly high number of our Black, Asian and minority ethnic (BAME) colleagues who died from Covid-19 in the early weeks of the pandemic.

And those disturbing trends were confirmed yesterday with the release of ONS data showing that people of Bangladeshi origin are twice as likely to die as infected white Britons. It also showed people of African, south Asian, Chinese and Caribbean origin have between a 10 and 50 per cent higher risk of death.

We do not know yet how to account for this. Socio-economic factors may be an influence, and it is partly explained by south Asians’ greater risk of having kidney disease. There could be hidden genetic explanations we do not yet understand.

Elsewhere there is more encouraging news, not least the drop in the number of people dying with Covid-19 to 2,872 in the week ending May 22, down from 3,810 the week before.

Elsewhere there is more encouraging news, not least the drop in the number of people dying with Covid-19 to 2,872 in the week ending May 22, down from 3,810 the week before

So too the chance of getting infected has plummeted to around one in a thousand compared with one in 40 at the peak of the curve.

The truth is that Covid-19 in most parts of the world, Latin America excepted, is showing signs of petering out.

Of course, we must not ignore spikes in the disease, such as in South Korea and in our own northern cities. These require intense vigilance and swift local measures where necessary, but we should not be fearful.

Some colleagues say I am too optimistic, but I have a sneaking feeling we’ll be largely through this by September.

And when it is all over, we must do our best not to emerge into a ‘New Normal’ – in that dismal cliched phrase that suggests a dull, constrained future – but an ‘Old Normal’, as we seize back our former lives.

With flexibility from our politicians and the wise application of our own judgment, such an ending no longer seems impossible. 

Professor Karol Sikora is consultant oncologist and professor of medicine, University of Buckingham Medical School.

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