Words by Professor Karol Sikora, consultant oncologist
Every day I am bombarded with hundreds of tweets all asking the same question: "When will the lockdown end?"
To be honest, I don’t know. Nobody does and this is the problem. In a society so used to quick fixes and omniscient search engines, the coronavirus has turned the world on its head. Epidemiologists don’t know the answer, oncologists don’t know the answer and most importantly neither do the Prime Minister or Health Minister.
Rarely do I feel sorry for politicians, but they are making life and death decisions in areas they know little about, with only extremely vague data to go on. It is all too easy to criticise their approach. I have my own reservations but this is uncharted territory for everyone.
For some, the lockdown has caused minimal disruption. I’m able to work with relative ease from home, after a brief wrestle with the technology, I can effectively communicate with my patients. It has cut down on travel time, my dog has had more attention than he knows what to do with, and my wife hasn’t got too tetchy with me yet.
But, unfortunately for others it hasn’t been so easy. Businesses are closed – some never to recover; people are being laid off and stress is rising. Every commentator agrees the lockdown has to end as soon as possible, but when and how are the total unknowns.
One thing is for sure however, the measures are working. Earlier this week the London School of Hygiene and Tropical Medicine estimated that before the lockdown one positive person would infect 2.6 other people, now that number is just 0.62.
Scientists get very excited about this value – the R0. Most experts agree that the coronavirus has an R0 of around 2.6, meaning one corona-positive patient will infect on average 2.6 other people.
This may not sound like much, but over a population that number quickly grows. By forcing the R0 below one means the virus runs out of hosts to infect and it burns out. The lockdown is starving it of healthy bodies to infect and so the infection rate will fall. This has happened in Spain and Italy and it will happen here.
So the question is how do we release the lockdown and keep the R0 below 1? I’m more optimistic than most and have been willing to put rough dates on my caveated timeline.
Assuming there is no mutation of the virus and people remain compliant with the strict social distancing measures I believe starting in early May we can begin to return to some normality.
We currently have around 40,000 confirmed cases of coronavirus in the UK, but that figure is almost useless. We could times that figure by ten and still be a long way short. Without effective widespread virus and antibody testing, it could be anywhere between 0.5 and 30 million - or more.
Once it gets to more than half of the population, the virus has nowhere to go – the great phrase herd immunity kicks in. Getting a proper handle on the number already infected needs to be an urgent priority for the Government -ordering 17.5 million of these tests is a hugely encouraging start.
April is going to be a tough month. Cases, hospitalisations and deaths will rise, with the most upsetting death tolls coming around the 20th. It is going to be a stormy few weeks - but we will get through it.
By May, I hope the situation will have improved. If the antibody testing shows that the virus has spread far more widely than first estimated, businesses and shops can start to get back on their feet.
The strict social distancing measures could be relaxed and life will feel a lot more normal.
Parts of Asia have led the way in demonstrating how to beat back the virus. I read a piece from a Donegal man living in Seoul who was enjoying the South Korean nightlife with most bars and restaurants back to normal, albeit with widespread mask wearing and extra hand sanitiser. He was enjoying himself far more than his friends in Dublin.
If everyone behaves themselves now, there is no reason why we shouldn’t be able to get our pubs and restaurants open in time for summer. With large gatherings and international travel resuming shortly afterwards, by the height of summer the current lockdown will feel like a long time ago.
Faced with a choice between hope and fear, I choose hope every day of the week. I’ve treated cancer patients for almost 50 years now - you learn very quickly that fear will eat you from the inside. We have to see the light at the end of the tunnel, and there is one.
By the summer I hope to be back to seeing my patients face-to-face, leaving at home a very relieved wife and a slightly lonelier dog.
Coronavirus: Everything you need to know