THE ADAM BUXTON PODCAST - EP.116 - DR XAND VAN TULLEKEN (RE. CORONAVIRUS)

Episode Date: March 26, 2020

Adam talks with Dr Xand van Tulleken about the Coronavirus crisis, how it's being handled in the UK and how Adam's own family has been adjusting to social distancing. This episode features two Skype conversations recorded on March 16 and March 22, before the announcement of the UK lockdown.Thanks to Séamus Murphy-Mitchell for production support.RELATED LINKSXANDER van TULLEKEN ON TWITTER: @xandvtCORONAVIRUS, HOW TO ISOLATE YOURSELF (CHANNEL 4)AUSTERITY BLAMED FOR LIFE EXPECTANCY STALLING FOR FIRST TIME IN A DECADE (GUARDIAN ARTICLE, FEB, 2020)'MARMOT REVIEW 10 YEARS ON' (PAPER ON EFFECTS OF POVERTY) (FEB, 2020) Hosted on Acast. See acast.com/privacy for more information.

I added one more podcast to the giant podcast bin. Now you have plucked that podcast out and started listening. I took my microphone and found some human folk. Then I recorded all the noises while we spoke. My name is Adam Buxton, I'm a man. I want you to enjoy this, that's the plan. Hey, how you doing in these strange and uncertain times, podcats? That's how you have to begin every email these days, isn't it?

Some variation of that. You can't just go in and say, Hi, Mangela, I was wondering if you could send that invoice again. I seem to have lost it. Instead, you are obliged to acknowledge the current situation. And because it's a serious situation, you should do so in a way that is somewhat poetic. Something like, I hope you and those close to you

are managing to stay safe in these anxious and unsettling times. And I was wondering if you could send me that invoice again. I seem to have lost it. Or you could go for something even more ambitious. I've had a couple of these recently. I urgently hope you are well and able to find tiny moments of solace in these dark and uncharted waters.

And if you could send me that invoice again, I'd be grateful as I appear to have lost it. I mean, that's hard to beat, isn't it? Anyway, Adam Buxton here. And as I speak, in late March 2020, it's the first week of a UK lockdown that the Prime Minister, he's called Boris Johnson, announced on Monday evening, the 23rd of March 2020, as part of an effort to slow the rapidly rising rate of infection in this part of the world from COVID-19, the coronavirus. I mean, I leave you alone for three months, three and a half months, and this is what I come back to. Now, I am out on a walk with Rosie. It's our usual track out here in the East Anglian countryside,

and as usual, it is entirely free from people. One of the reasons I like it, but it's particularly useful now because there's no chance we're going to bump into anyone. Rosie, as far as I'm aware, being a dog, is not vulnerable to the coronavirus, which is good. We can still enjoy valuable hugging and scritch scratch fun I was hoping to return with the podcast a few weeks later than this I said mid-April I think at the end of the Christmas podcast with Joe probably I would have made a few lame references to Brexit and start bollocking on about how I finally finished my book, which I have done. But then the fucking balls with the little trumpets on them arrived. And now everything's

gone. I'm going to stick my neck out and say bad. But the situation encouraged me to start the podcast up again a bit sooner, albeit with this COVID-based episode. The other episodes I put out in the forthcoming weeks won't be like this. They'll be more like regular ramble chats. But earlier this year, I met a director called Jonathan Van Tulleken. And he mentioned he was the younger brother of Alexander and Chris Van Tulleken, identical twin doctors. It sounds like the setup to a 70s TV show. They are identical twin doctors who appear regularly on TV talking about health matters. twin doctors who appear regularly on TV talking about health matters. And it turned out that Alexander or Zander listens to this podcast. So a few weeks ago, when the coronavirus crisis

escalated, then became a pandemic, I thought I would get in touch with Zander, seeing as I don't know any other doctors, at least none that would appear on my podcast, and have a conversation about the difficulty of knowing how best to respond to the crisis and how it's being handled here in the UK. You know, especially as no one else is really talking about it, are they? First, it was a little tricky trying to find time to talk to Zander because he was filming a documentary for channel 4 called coronavirus how to isolate yourself which has already aired but it can be watched on channel4.com channel 4od you'll find a link in the description of this

podcast but i was able to speak to him eventually on the evening of Monday, the 16th of March, when, as you'll hear, I was fretting about whether it was a good idea to keep sending my children into school. And the day after we spoke, last week, all of this seems like such a long time ago now but it really wasn't the government announced it would be closing schools the following friday then last weekend as we saw in the newspapers on monday people flocked in large numbers to british seafronts and went holidaying in Snowdonia, apparently ignoring the advice to stay home. And so I checked in with Zander again, another Skype call last Sunday night, to see how he thought the government was doing as far as handling the crisis. We also talked more generally about some of the challenges that families and individuals face just on an

interpersonal level while we stay home in an effort to help and protect not just ourselves but all the people keeping the show on the road medical staff and care workers and teachers looking after their children and food suppliers, delivery drivers, police, rubbish collectors, the people that keep the internet running. I mean, so many people who are continuing to stop everything grinding to a complete halt. Anyway, the day after that second conversation with Zander was when Boris Johnson announced a more formal UK lockdown to last for an indefinite period of weeks or months until the infection rate begins to come down and the health system is able to cope. I'm going to play edited versions of both my

relatively short conversations with Zanda in this podcast. And at the end, I'll be back just to say very briefly what I've been up to and give you an idea of what the rest of the podcast run might look like. But I thought I would start by playing you a, I suppose, particularly pithy section of my conversation with Zanda. In fact fact it was uh the the end of our second conversation and this is what he said sort of in summing up what I'd say is if you are out there thinking oh my god why is he doing a whole podcast on this it's all going to be fine it's not a big deal this is not a dangerous virus I would say you

need to take it much more seriously and everyone needs to change their behavior really dramatically right social distancing massively reduce your social contact so you're not having people over for dinner you're not going to other people's houses you're not doing any of that stuff but there are also people totally melting down and saying this is going to be the end of the world and to all of those people i would say the evidence i've seen from talking to people who are doing the modeling and doing the research, who are proper scientists, right? They're only interested in what the data tells them. And the people who are responding to that data and setting the policy is that there is a plan. And this is not the end of the world.

I think it will look very bad. It will look very bad on the telly and it will feel very bad to anyone who is caught up in the healthcare system for the next few weeks and everything we can do to minimize that and slow that down will be really really good but this will pass and life will get back to normal and so i don't think people should be panicking but i think everyone should take it seriously and i hope everyone can find a little bit of space in the middle there. It's been very hard for me as well, but to not feel too anxious, to take it seriously and to be generous and nice to other people around us, even if we perceive that they are not being as virtuous as us maybe.

Yes. There we go. So that's a kind of overview, I suppose, of my conversation with Zander, or at least the headlines as he saw it. But now I'm going to play you the more kind of waffly conversations that we had, both of them in an edited form, including various insights into the workings of the incredible unit that is the Buckles family and other COVID-19 related talk. The first bit I'm going to play you was recorded just over a week ago on Monday, March 16th. And as you'll hear, Zander's experience in

the medical field, I would say, makes him more qualified than most to comment on what is an endlessly complicated and difficult situation. And given the seriousness of what's happening, it's probably worth being clear that, you know, this is a podcast. Not only is this a podcast, it's my podcast. So it shouldn't be considered the final word on anything we talk about. It shouldn't be considered the final word on anything we talk about. If you have urgent questions or need further clarification, your doctor or the NHS are the best people to talk to.

But you can also find Zander on Twitter at XANDVT. OK, here we go. Blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah we go. So, look, you're not sort of an epidemiologist or anything like that, are you? Or what's your field of expertise? Well, so bizarrely, I'm a medical doctor. I trained in infectious disease and particularly tropical disease, so kind of strange infections. And I also trained in public health and particularly in global health. And so this should be completely in my wheelhouse. And within that, I specialized in crises and emergencies. So I've worked in epidemic control for the World Health Organization. And in fact, I'm lucky, possibly not just because of my own

training, but my identical twin brother is a molecular virologist, as well as a medical doctor, and works at the School of Tropical Medicine at the Hospital for Tropical Disease. And so he is very, very close to the group of people that are responding to this. And indeed, he looked after some of the people with Ebola who are being treated in London. So weirdly, I get a lot of insight from him. So I'm not trying to set myself up as an expert, but I should know a huge amount about this. I should have all the answers. And instead, I feel baffled and confused and quite frightened, like lots of people. And so I've spent the day making a documentary about the self-isolation and about the pandemic at the moment. And so I've spent the last couple of days interviewing people and speaking to people. So I'm kind of on top of the situation.

I'm not directly involved in the response i'm nervous that i might get called back into medical practice because i'm not a practicing doctor at the moment um anyway sorry that's a lot of guff about me but does that sort of put in context like i don't know nothing but i'm certainly not going to claim that i know everything and um most of what i do know i've got from other people i trust yeah that sounds reasonable. And how's it going, though, with your doc? How are the people who are self-isolating so far getting on and how long have they been self-isolating? Well, today is a very strange day because everything changed in the middle of the day. The government advice switched from self-isolate for a week and keep away from

your family to if one person has symptoms in the house, the whole household self-isolate for a week and keep away from your family to if one person has symptoms in the house um the whole household self-isolates and um it's for two weeks which is a big deal and then they've also said the advice is coming around the corner pretty quickly for everyone who is vulnerable so probably the over 70s and lots of other people as well to kind of self-isolate for at least the next 12 weeks but they may be staring down the barrel of a lot longer self-isolate for at least the next 12 weeks but they may be staring down the barrel of a lot longer self-isolation than that so i in fact just one of the delays to us speaking was me chatting to my mum yeah um and dad and um it's been strange making the doc everything's changing all the time but what started as channel four let's try and make something quite fun and engaging with a slightly lighter side about how to self-isolate four let's try and make something quite fun and engaging with a slightly lighter

side about how to self-isolate but let's give it a bright tone to engage people not silly but you know to not be too gloomy and the journey you always want to go on a kind of journey as a presenter and it really feels like um i'm two days in and the journey has been very very strange for someone who's meant to know what they're doing anyway and how how did you feel watching boris johnson's press conference today what were your thoughts after that i think that public health england have done a really good job and i suppose i'm not a fan of boris johnson there he's dropped a few balls there are a few things that could have been done slightly differently i suppose but mainly he has appointed two of the best people in the world in Chris Whitty and Patrick Valence.

Chris Whitty is the chief medical officer. And then he's listened to them. And those two know so much. And I think there's a sort of, you know, in different areas, there are people where you might go, he's good, she's great. But those two, there is total consensus that they are world experts and everyone thinks they're brilliant and they have a huge amount of knowledge a huge amount of experience but they also have a kind of feel for an epidemic i think it's very hard to get they just worked all over the place and so boris johnson has listened to them so when i listen to boris johnson i think he is doing what he's told by them and that's. Well, my wife wants to know if we should send the children to school tomorrow. You have to keep doing the my wife thing.

My wife wants to know. There we go. So your wife wants to keep – sorry, I was totally fixated on that. What was the question? Your wife wants to keep sending the children to school. Well, this is how it's gone for us, right? So first of all, I should say, we are lucky enough to be able to keep the children home. We both work from home anyway. It's not a huge disruption to our routine. I understand that part of the impetus for keeping

the schools open is that most people or a lot of people are going to be really in extra trouble if they have kids to look after as well. They can't send the children to school every day. There's going to be a lot of healthcare professionals who are relying on being able to leave their children to go to school in order for them to carry on working. But I wonder if the government would prefer that people like us who were able to have the children home from school and it's not a massive imposition. Is it a good idea to pull them out or is it going to make no difference whatsoever? Should we just keep on sending them in and play ball along with everyone else? No one should feel responsible or guilty about any of the choices they make in this, unless you are hacking cough and you get on a crowded underground train or you decide to host

a rave, you know. But the rest of us, there is no perfect guidance and we cannot stop this virus. We can all contribute to slowing it down. But this is not something you should have a big argument with your wife about. I don't know if you have, but your wife saying, keep the kids going to school and you're saying, why not bring them home? And you're both a bit right. There's a logic to both of what you're saying. Yeah, because the headline in my mind is flatten the curve. We've got to flatten the curve. If it spikes, then we're finished because the spike is going to overload the healthcare system and then societal collapse and everything that comes from it. So it's all about flattening the curve. And if we can practice

social distancing, we should. Yes. So the reason that, so there's not, the more you flatten the curve, the worse the economic consequences are and the harder it is for people to do the things that need to flatten the curve, right? So part of, you've got to flatten to flatten the curve you've also got to allow the health care workers to go to work and if you send all the kids home from school no one can go and run the hospitals and then they're going to die anyway so you've got you've got a really really complicated set of interrelated things education is good our children are not going to die i mean if there's one like lovely bit of optimism it's that the children are not going to die and so it's up to you but i think the schools will close eventually and there will be a moment where your kids definitely have to be

at home and that is going to be difficult for anyone who's had christmas or just anyone with a bloody family right i mean we all get to sort of slightly listen in on your family and so and i feel like you're you're honest enough to go you portray a sort of uh like a proper family where everyone's got their own deal going on and it's complicated and so like my family if you lock us all in a house together for a long period of time we start to go a bit mad now you're all going to be able to go for walks you can still take the dog out and all these things so you're you're not going to be totally housebound unless one of you symptomatic but in the countryside that probably matters less but i guess part of me goes you know what you're not being told education is important you're not

being told to take your kids out of school we do have good public health advice in this country and if i was in your house i would say keep the kids going to school because you are kicking off the moment where it will become unavoidable and you will have to do some forced home thing for many weeks yeah and um and that's going to be really really tough so i think you're right you're lucky but i feel like i keep saying i know i'm lucky and i'm lucky in all kinds of ways but i'm lucky but i'm still vulnerable and we're all still vulnerable and we're all going to have a rough time so i think if you can possibly make life easy for yourself as individuals i don't think that's an irresponsible thing to do i hope this won't you know by the time you put this together and send it out i may look i don't think i'm

going to look ridiculous about this but the schools may well be closed you know they may close them soon but as long as they're open i would say prioritize education and make them wash their hands when they come home all right right. That makes a lot of sense. But I don't want to, you know, I'm not here to settle your family dispute. Like, if you want to win the argument with your wife, you can edit this bit out and just tell her that I agreed with you. I'm not going to get involved in that. Yeah, well, obviously, I'm going to do that. But no, this is very good. I mean, it would be great just to have you at the end of the line to settle a number of other disputes.

As well. Should the toilet seat be up or down? Yeah, that kind of thing. I mean, come on. The dishwasher door is just constantly open. And she herself tripped over it today. And I had to really stop myself from just saying, you see, that's no good, is it? So what about closing it every now and again? Anyway, I didn't. Last question. One pattern that I've been seeing with a lot of my friends is

that their parents are just sort of in denial or they they're just going, oh, it's a lot of fuss, isn't it? I mean, we'll be fine. It's the flu. Come on on everyone's staying at home everyone's gone mad my mum is somewhat in that camp she lives down in reading we're out here in norfolk but i wonder i feel like should i be trying to convince her to come and stay with us and keeping her safe here or is that just going to be extra problems no No, because your kids are, I think you get to re-evaluate that. But I suppose that, I think in the UK,

we are particularly good at having these slightly meaningless interactions where we go, oh, it's all going to be fine. Oh, it's all silly, isn't it? And we've got all these sort of conversational ticks that allow us to get through awkward moments. And I suspect, certainly with my parents, when I phoned them this evening and said, I'm worried about you, the conversation was different, right?

The danger is that you make it a lecture and then everyone puts up barriers, right? Instead, I just sort of said, like, I'm really worried about you. And of course, parents don't want you to worry. I think that's the thing I realized having a child now is that I want him to be okay. If he says to me, Dan, I'm worried about you, I wouldn't, so I want to reassure him, but I want to discuss it. And I feel like that's probably the thing we should be saying. And then your mum will go, you know what? Actually, I am a little worried.

And then you've got the foot in the door to going, look, give it a few days, see how you're doing. But if you're feeling vulnerable, we can always come in the car and get you've got the foot in the door to going, look, give it a few days, see how you're doing. But if you're feeling vulnerable, we can always come in the car and get you. But that will, you know, then she's coming to your house with more people, kids at school, more chance of getting it, but you're all together.

So that's a bit nicer. So these are the things you're juggling, you know, not necessarily easy for everyone to have their mum at home for a long period of time. So I think there's no right or wrong thing, I suppose. Everyone should be trying to solve their problems in a way that works for them. And remember, tomorrow you can get up and have another conversation with someone and change your mind. You know, that's the thing.

You can reevaluate it. I don't know if you've got another question. I suppose there was one thing I didn't say, which… Yeah. Can I say one more thing? Sure. I think there is a kind of hopeful thing that this will pass. The nature of epidemics is that they do end.

Whether we have a first wave and a second wave, eventually this will be over. And I think we will avoid the second wave here. So there's a moment where life will get back to normal and lots of people will have lost loved ones, but we will survive and people do grow from these experiences. We get post-traumatic stress, but we also get post-traumatic growth and people can manage these things. So I suppose a bit of me goes, there is this chance to look at our

relationship with travel, with farming, with animals, with the way that we treat the planet. Those are the things that cause the virus to trump, right? Viruses come out of animals because of intensive animal farming, because of destruction of ecosystems, because of global warming. That's what's driving these pandemics. We have a moment where we can say what this reminds us of is the value of human contact, how much we all need a hug. Like, literally, we're going to be a nation without hugs for a little while and that's going to be very tough and so we get to reaffirm how much we love people we get to reaffirm how much we should be treating the planet with a bit more

respect and treating animals well and those things can be really good that we end up growing as a i suppose as a species without wanting to sound too kitsch about it so i feel i know i sound pessimistic and i think it will be bad and i think everyone should take it seriously people should be prepared for isolation that's the other thing is you've got to prepare for isolation probably more than we're managing to but um there is a bit of light at the end of the tunnel there's quite a lot of light at the end of the tunnel i think I think. OK, back outside on my walk with dog in the deserted fields of East Anglia on a beautiful evening as the sun goes down. The sky is very blue and it's extremely quiet. No planes in the sky. And what would normally be the distant roar of the rush hour traffic is just a whisper.

It's all very much like a weird dream sequence at the start of an episode of The Sopranos. Anyway, you just heard an edit of my first conversation with Dr. Zander van Tulleken from Monday, March 16th. Just to remind you, the following Friday, the schools closed. And at the end of that weekend, last Sunday, as I speak, I Skyped with Zander once again for a catch-up Corona chat about how the country and also the residents of Castle Buckles were responding to the crisis. Here we go.

Hello. Ah, that's better. How are you doing? I'm good. How are you, Zander? Yeah, I'm all right yeah i'm all right i'm all right i have been i'm self-isolating because i'm poorly but but i'm feeling better than i have done for a few days which is good when did you start feeling poorly so um we finished the shoot maybe thursday midday and then we headed into the edit to sort of have a look at things and i was gonna watch it watch sort of everything they'd got and then just thought no i'm feeling quite tired i think i'll go home and then got home and felt really really really shattered and then um by friday night had a temperature of 39

which is not as high as it could be but um it still makes you feel terrible and of course i'm telling you this as if there's sort of the high drama of having COVID-19 when I have absolutely no idea what I have in it. I may just have a cold. But of course, then I'm on my own. I'm feeling very sorry for myself. I'm feeling rather anxious about potentially exposing other people. I'm worried that I'm going to end up on a ventilator or need a ventilator and there's

going to be one. My brother's away. So then I ended up feeling rather tearful and sad. And so then the weekend's been a bit slow but i'm feeling a lot better now okay good that is the thing i i wonder like if people do feel ill i mean nothing except a proper coronavirus test is going to put their mind at rest is it i mean you you're not going to get it and think oh there we go i've had it now so i can go back to normal and just wonder about not infect anyone or be infected no it's it's strange how much i would like a test and i think before i got poorly i thought well you know it doesn't actually affect your management very much it's hard to do tests for everyone so everyone just has to follow this guidance and this is

very sensible public health what we're being told to. But as soon as you start to feel symptomatic, you get very anxious. Everyone around you gets very anxious. You know, you're told it can come and go even when your temperature goes down. You think, oh, well, maybe it will come back. And you're reading all these reports of doctors dying and stuff like this. And so, yeah, a test would be very nice. Yes. Anyway, listen, I wanted to check in with you zander because we spoke one week

ago and it feels as if a lot has changed especially in the uk this time last week i was asking you if you thought i should continue to send my children to school because i'd been online reading lots of stuff listening to podcasts from people saying this is is serious. It's time to practice social distancing as much as you are able to do. Don't wait for people to announce an official lockdown. If you can stay home, and if you are able to take your children out of school, do it. So me and my wife were having fraught conversations about what we should do, especially as we were the only people that we knew who seemed to be thinking along those lines and it seemed a bit extreme and the children were reluctant to stay out of school especially my two sons who are in the their gcse and a level years

and you know my son in his a level year is not going to see any of those people again, assuming the schools don't reopen before September. And so this is it. You know, all these children are suddenly the whole drama of moving on to the next stage in their lives is suddenly evaporated. And they can't have their big parties and farewells and all the rituals of leaving school. And so they were saying, you've got to let us go back. You've got to let us. There's no reason for us staying out of school. And we were saying, well, look, we don't want to get it.

And also we don't want to give it to other people. We don't want to be part of a culture that is making it possible for the virus to spread in the UK the way that it has done in Italy we don't want to find out that because we were just lagging behind we're in exactly the same spot as the Italians in a few weeks you know with those horrific scenes in the overcrowded hospitals and it's just a disaster area and it seemed as if the government was coming round to that way of thinking I don't know if they'd been pressurised or if they just looked at the data in a new way. But sure enough, by the end of the week, the schools were closed. And when i spoke to you last you were sort of yes you were saying well if i was you i would let your children go to school and the economic aspect of this crisis is significant as well and to the extent that people are able to carry on with

their normal lives as much as possible we should try and do that how do you feel about it all now yes um well i i thought about the buxton householders that was announced and wondered if it would be a nice case if i told you so for somebody i wasn't exactly sure how the prime minister's announcement would sort of play into your family debate i suppose my logic was um you are all going to have to self-isolate for a period of time i think i i did feel like it was likely the schools were closed yeah and um that will be very difficult when it happens uh for lots of families and probably you know certainly mine would be no exception i imagine yours any household finds that difficult and so um i felt like as long as you were able to take

the pressure off yourselves for as long as possible you should probably do that and i think i guess my sense of the week is that there are sort of two parallel things happening one is that the government is unrolling effectively a fairly long-standing pandemic plan that in the department of health and social care and public health england and all sorts of other labs and universities and places where they study this stuff and the group that prepares for this, everyone has been aware that at some point in our lifetimes there will be a pandemic and there are plans on how to deal with this. And so the government has rolled out a series of escalating changes that have definitely required a lot of short-term very rapid detail work and have been driven by new data over the course of the week but also that were not unexpected right like i don't think i felt that the schools wouldn't close i just felt that you should probably wait until you were told to take your kids out of school yeah i think that's what i was saying yes yes

we were both talking in terms of well it's probably going to happen this friday right so so i think um yeah it was it was it was imminent wasn't it so what you've got filtered through the mad politics of westminster is an escalating plan that is being gradually explained to a public who including me who are just reeling from every single day the changes in our lives that are extraordinary. And some people are reacting by fully panicking and screaming, we should close the parks, we should close the churches, we should close everything down, everyone should have their doors welded shut. And other people are going, the last thing we should do is let this virus defeat us. And then there's a bunch of people in the middle who are worried. But I feel like the government has tried to introduce these measures over a fairly short period of time, but hasn't just dumped them all out at once in a way that I think is pretty

sensible. And so I guess I look at it and go, then there is this commentary that says, well, if you're going to close the schools on one day, why not close them a day earlier? It takes a huge amount of adjustment for people to do things like close all the pubs and restaurants in the entire country yeah the idea that it has happened over the course of a week is extraordinary and so i'm not i mean you're not sat there screaming at images of people gathering on beaches still and going what the hell are you doing you're dooming us all i guess i feel like righteous indignation is the most delicious emotion right and and of course i want to indulge it when people are tweeting these cues of the people in the supermarkets you know they're jam

packed and everyone's gone to snowdonia and the australians are all on bondi beach and all these things and you think oh it's so easy to indulge in this sort of, how dare you? You're killing my parents with your irresponsible behavior. But what we are asking people to do is not just not go to the beach. It's completely re-imagine how their lives are. And we're also asking a huge number of people to give up their sources of joy, their sources of income. And most people in the UK are in, or at least half the people in the UK are in a somewhat financially precarious situation. And so I think to do that over the week, when I look at the Twitter commentary, especially all this stuff today, I don't know

if you've read about all this stuff with Dominic Cummings and how he wants to kill all the old people. That all feels like Westminster bullshit. It is all just flap and bollocks. All the stuff about every new study that comes out that says there's going to be a million dead bodies in the street and all this stuff. What is very clear is the plan is stepwise for a reason. There is a plan and it is being rolled out with some fairly rapid adjustments based on data and based on multiple good models. And that the NHS will be overwhelmed and it won't be for a very long period of time and capacity is being increased and that that is probably the one area where i think gosh it's very hard to see how they've screwed up getting enough masks and things like this it does

feel like early on the doctors and nurses and the other health care support staff maybe even more importantly have been kind of let down by that yeah but i think the idea that the nhs wasn't going to be overwhelmed at some point was very hard to imagine there was no possible way we could build this level of capacity that we needed in the amount of time no matter when we'd started yes and even if we had the number of lives that that would save is not an enormous number now that isn't to say we shouldn't be doing it, but the government is sensibly trying to strike a balance between going, we know this disease will kill a certain number of people

if it's allowed to spread at a certain rate, and slowing that down will allow a certain number of those lives to be saved. But also, the chief medical officer, Chris Whitty, and his team know as well as anyone in the world the health effects of extreme poverty and financial catastrophe which are massive right they're so massive and so i think they're doing a reasonable job of trying to go we're gonna kill people with this massive closure

of everything these huge disruptions to life you know i don't know much about the economics but i think the stimulus has been pretty welcome. That's the sense I get, is they're just trying to oscillate between the deaths from those two things. And I guess I feel like at the moment they're doing a reasonably sensible job. The death rate is probably not nearly as high

as some of the studies imagine it to be. When you look at the cruise ships, for instance, the death rate, despite a very vulnerable population, the cruise ships for instance the death rate despite a very vulnerable population that cruise ships are some of the few places we have what you imagine a really good denominator like out of how many people this number of people died and we don't really know the total number of infected people in many places we don't have enough tests and those may well be quite country specific quite strain specific and so on and so there is reason to believe that the death rate is not as high as lots of studies are saying. And so if you imagine the death rate is, say, less than 1%, then by altering the NHS, you're going to shave a fraction off a

fraction of 1%. Now, those are my parents is the problem. They're in that fraction of 1%. That's possibly I am, like possibly any of us are. So we should be worried about that. But in terms of the very global big picture, that has to be balanced against the economic catastrophe. And can you foresee 12 months from now, some people are going to be looking back and going, well, that was a massive overreaction on the whole. And actually, the lockdown measures proved to be far more disastrous than the actual virus would have been if it had been just allowed to blaze through the population.

Do you think anyone's going to be saying that? Yeah, it's interesting. It's going to be very hard to do because in the same way you know there have been several studies michael marmer um from ucl who kind of studies the health effects of inequality and poverty recently published a paper on the deaths caused by austerity and it's very controversial it's very very hard to prove that poverty kills people or that it killed a specific person whereas we'll be able to say coronavirus killed my mum um and so you've really got it in for your mum haven't you um i mean the mother's day phone call was uh it was funny because it started quite poignant this morning and then we remembered all the mother's day that my brothers and i had forgotten

as children or messed up in some way right there's a certain amount of recrimination about that but anyway so yeah look i think we're going to get footage of dead doctors dead health care workers of all kinds we're going to get people being turned away from hospital and being asked to die at home people will be filming that on their cell phones and for the next 12 weeks we are going to see some very very very strong stuff in the news about the failure of the health service to fully meet everybody's needs and that is going to be set against a sort of, you know, well, I lost my job and my pub can't open, which is always going to seem more flippant. But I think in a year's time, we're going to see this really complex balance play out. I would say probably

at six months time, we're going to be people begging to lift the restriction and going, yes, a lot of people have died. But we're not looking at a total decimation of the population we're not looking at massive numbers of deaths and and in the meantime my life is never going to recover unless i'm allowed to open my business again well the government was talking about this kind of roller coaster curve this strategy that seemed to be a kind of relapsing remitting model of infection whereby distancing measures are relaxed for a period during which more people would go out go back to normal become infected and then when the nhs is at peak capacity again the restrictions come back in for a few more weeks and so on that that sort of up and down model of infection and

restriction over the next i don't know six months nine months or something like that do you get the sense that that's a realistic strategy yeah i mean it's hard to see how they could do anything else because i think they're going to be desperately trying to balance these two things to try and run a health service you know people are still going to get cancer they're still going to have heart attacks they're still going to fall over at home and so they're going to be desperately trying to run a health service that can function alongside an economy that functions basically you're trying to adjust the the acceptability of the intervention and its health effects and so you're just turning things up and turning things down a little bit as it sort of goes along. But the virus isn't going to go away,

I think is the problem. So in the end, the very, very difficult thing is that even with intensive care, large numbers of people are going to die. That's not an argument to not do anything. But it does mean that you're having to very carefully weigh up the costs on both sides. And I guess the central point I'm trying to make is that all the commentary seems to act as if there was never a plan and they've made it all up in the last week and they haven't thought it through. since we last spoke, I went into the Department of Health and Social Care, met Chris Whitty, didn't formally interview him, interviewed Jenny Harries, who's the Deputy Chief Medical Officer, had a chat with some other people. And I worked in epidemics in different places in the world where people are floundering and out of control. And they always say they've got things under control. And you've seen people when they haven't. They are going through their plan.

They're professionals. They know what they're doing. I had no sense that they were floundering. Okay. That maybe sounds like my bit of bullshit intuition where I'm like, hey, don't worry. I went into the building. It all sounds fine. And it's like, well, clearly they could just be putting a good face on it. But they do know what they're doing.

And it would be mad to think that they don't. You know, they have a lifetime of work. Chris Witte's worked all over the world in loads of different epidemics he's well well well aware of everything that the opinion pieces are saying at the moment yes do you know what i mean yes what how did the news i'm curious about your house because everything has changed in the last week for you how did the school closures play out and how is it going for you like you're trying to manage as well as everyone else yes although we're in a very fortunate position out here in many ways we're sort of isolated we can go for walks and not

really bump into people and as i said to you before i think my routine when i'm at home is fairly solitary anyway so you know there hasn't been that much disruption for me as far as a normal day is concerned but i'm already feeling the strain as far as being a husband and a parent and the whole school closures thing the fact that i felt strongly that the schools should have already closed and we had to wait another week before they did so uh that was tricky and um i really am i'm not the kind of person that can just go in and say look this is what's happening it may be right it may be wrong tough shit you gotta live by it and uh that's the end of the story i'm just like well i don't know i mean maybe i don't know uh i feel as if you probably shouldn't go into school.

But if you really, really want to and you feel you're not going to see your friends for a while, I can understand that. Maybe you can go in for a bit, but don't touch anyone. Don't hug anyone. And, you know, it was alarming when we heard stories about my son's friends ringing up and saying, Yeah, man, are you coming in tomorrow? We're all going to go out for a drink and a big celebration and say goodbye and i was like no that's not what you're gonna fucking do uh so that was for did you stop them doing that uh yes and no my wife was as usual a little bit more coherent eventually we sort of compromised with a targeted swoop with my wife

driving them in for a couple of hours to say goodbye on friday after they hadn't been at school for a few days because that was the thing like before they actually officially closed the schools they were happy to stay off you know they were like oh yeah but then when they realized oh shit the schools are going to close and they're not going to be open again for a while and in fact it doesn't look as if we're going to serve out our time there as uh you know gcse or a level students we're not going to be able to say goodbye uh so then it got a bit more urgent and And then the whole exam thing came down. That was very, I mean, still is very surreal. So many questions thrown up by that. And what life is going to be like for this generation?

Are they going to always be tagged as a COVID generation who will be entitled to special treatment when it comes to their grades and special consideration? Or is it just tough luck part of me sort of thinks well you know i've always kind of thought exams were a load of shit anyway and they weren't really a a brilliant you know indication of a person's ability um they are maybe for some people but not for everyone at all you know so i don't know this is just another random factor but it's been really odd all that stuff has been thrown up just in such a short space of time and then on top of it you've got more trivial concerns about how you all interact in the house you know and the things you get annoyed by. And usually under normal circumstances, everyone gets time apart. Everyone goes off to school and you can decompress there,

or I go off to work or my wife goes to London or whatever. Every few days there's some release valve, you know, and now all that's been taken away. So for someone like me, who's quite a silly, immature and petty man, a lot of the time, it's potentially dangerous. And a series of constant adjustments are having to be made.

And I'm having to up my apology game fairly massively. I mean, I think if you can up your apology game, that's probably for all of us pretty good it's so interesting he described that because you are describing the full describing a nightmare for everyone right like everyone is just throwing this situation that literally nothing in our lifetime has prepared us for so there were two things that i really noticed

this week sort of trying to organize my thoughts for this film and around being ill and things like that so i guess there are two things that struck me one is the government is asking us all to do this stuff and there's a ton of rules that we're all going to follow and the rules are really complicated like you're going to stay two meters away from people if you have symptoms which involve diagnosing yourself with the temperature or a new persistent cough which sounds easy but i'm a doctor and i was like i don't have a thermometer i don't i've got a cough but of course now i need to cough but um yeah i've got a cough but i don't know is it a new persistent cough like you've been talking to me i don't know if it's persistent or not i've coughed a couple of times sounds pretty bad to me it's sorry to say

the um problems that we're all being given are sort of handed to us by the government saying you have to uphold these rules and things like if you live alone you self-isolate for seven days if you have symptoms but if you live with other people you self-isolate for 14 days unless someone else in the house gets symptoms after the first seven days of self-isolation in which case they have to do a further seven days but everyone else only has to do the first 14 it's like this is really hard and there are loads of people in the uk who care desperately about saving other people and they're very hard to understand that we don't want to stop this we just want to slow it and so people are feeling enormously guilty about doing it wrong and enormously angry at other

people who they see breaking the rules when they're making so much effort yes and this virus is invisible and everything that comes into your house could be contaminated you only need a few hundred maybe a few thousand viral particles to get you infected and they can kind of lurk anywhere and drift around in the air and so so there's this sort of desire that we all adhere to a new set of rules like we've joined a new religion with a load of mad rituals and there's sort of washing ceremonies now where we have to sing as we wash and all these kind of things yeah and so that's giving us all a sort of mindset of guilt and blame and i think that is really divisive in a household where everyone has different agendas because you know

your kids understandably want to go and see their friends and that's massively important for their mental health and their wellbeing and their physical health isn't a risk. Your physical health isn't too at risk, but it's different to them. And your mental health is endangered when they're going out and spreading it around and perhaps doing the wrong thing. And so we all want to control it, but none of us can do it perfectly. So I guess one of the things that i'd say really strongly is no one should feel obviously if you'll stop piling hand gel and selling it to oaps on the street corner for thousands of pounds then you're a month yeah but in general if people are struggling with

this new regime and struggling to adjust let's give them a bit of a break and let's try and help them rather than screaming at them yes but can i just pick you up on on a very tiny thing when you said the particles drift around in the air that's not the same as saying that it's airborne so if someone coughs near you on the street yeah and there's a little mist and that drifts into your face then you could catch it so it's not very airborne but it is a bit airborne it's carried by air over short distances yeah exactly so you can in other words i'd have to touch you to catch it from right um and if i'm in a bedroom hacking away and you come in to bring me a cup of tea there will be an aerosol of particles of dried out cough that are floating around with viral particles on them and so this

is not to make people feel frightened but just to say you can't you can't stop it you can't do it perfectly you and so we in catholicism there's a sin of scrupulousness where you're so fastidiously adhering to the rules that you forget that the general point is to be nice to people not to worry about everything else the bible says yes and in the same way with this it's like the general point is to be nice to people not to worry about everything else the bible says yes and in same way with this it's like the general point is keep your distance wash your hands limit your social contact rather than going that guy in the park got he was with 183 centimeters away from me you know but i think i mean it's very like the situation you're describing with all the luckiness and everything it's really hard

right kids think they don't want to go to school but actually kids love school they just don't like necessarily doing work kids think they don't want exams but those are essential right of passage that people need and so you know your kids are literally changing their identities of who they are and what journey they're planning to go on their entire future that was mapped out pretty clearly is now like just a void yeah and i think it's very hard especially for my 15 year old to stop himself from just blaming us because we're the people that are you know we are the people that are enforcing these measures essentially he's not watching the news and saying oh well this is what boris johnson told me to do this is what mom and dad have said so as far as he's concerned we

are just the biggest shit bags in the entire world and now he's got to spend the rest of his summer with these shit bags and it's pretty it's pretty dark but you're being the prime minister in your house or at least between you and your wife you are and for some people they're going to go i'm never going to stop going to the pub right it's essential or more to the point they're going to say i'm never going to stop driving my van i'm never going to stop running my shop because that's my livelihood and i have to or i'm never going to stop seeing my grandchildren and there are other people who can be more compliant they're just trying to dial up the measures to get enough people to change their behavior but yeah everyone's going to behave a bit

differently i mean it sounds to me like you're actually doing a very good job with an impossibly difficult situation and if you said to me actually it's all running really smoothly i would just suspect that you were all on drugs yeah i'm certainly not the prime minister at Castle Buckles, by the way. I am. I'm the minister for entertainment. It's my job to line up new bits of stuff to watch. And my wife is currently not very happy with my performance. We've come to the end of Vikings. She's tapping her watch and saying, when are you going to come up with something to replace Vikings? And so far, it hasn't gone that well. Could be with the prospect of a reshuffle indeed yeah i think my

17 year old son is rapidly becoming more qualified in that department but he likes things with subtitles though and that's going to be a tough sell for the rest of the house do you think i mean one of the things that everyone loves dishing out advice and they're like structure your day structure your day everyone should have a schedule everyone should have moments together and moments apart have you tried to impose that or is it realistically with the range of ages and interests and frustrations under the roof is it just about navigating around the worst dangers um we are thinking about like shit we we probably do have to introduce some sort of formal structure to our days otherwise it'll just degenerate we'll just get ill because we're so unfit and

tensions will flare so yes we are cautiously starting to say look, you guys have to step up a bit more as far as cleaning the house, doing chores and also exercise. You know, we have to you can pick when you do it, but you have to do at least half an hour a day. It doesn't matter what you do as long as you're doing something. It's so hard for that. I mean, my son lives in Western Canada. He's meant to be here this week and instead he's in canada yeah so that was kind of heartbreaking for me and he was a bit disappointed although he took it pretty well and he took it well because he just went look dad we've saved the money we can spend the money on the next holiday and even be a even better holiday and i was so proud of his like positive attitude

and then he went on to say i think all this stuff about this virus is a load of nonsense and it's all overblown and i don't know what we're all worried about i was like you understand your grandparents might die and he sort of couldn't his way of coping was also his flippant irritating sort of smug 11 year oldness and you couldn't fix one without destroying the other um but even then like i was chatting with this mom about her mom who's very ill and i said at the end he's sort of eavesdropping we're all just on the ipad he's playing on his computer i'm chatting with his mom and i said are you listening to any of this like you have to at least help with the laundry there's three buttons on the machine learn how to do the laundry yeah yeah okay okay and i thought i just couldn't work out if this is his way of protecting

himself he's probably anxious but he's covering it up and pretending he's not. He's also very lazy about doing laundry. I just felt like it was obvious that he should step up. Yeah, I felt like it was going to be impossible to make him do it. I think, though, I have to keep reminding myself that it's always this way with any significant change to the routine. that it's always this way with any significant change to the routine. And sometimes, very often, I have backed away from changes I knew that it would be good to introduce to the household because I just couldn't face the amount of whining and moaning.

But actually, even though there has been resistance to even things like just eating meals together more than we used to you know initially it's like do we have to but it's fine there's a period of adjustment that feels very painful and annoying where you just think god maybe is this really worth it with everyone being in such a bad mood but everyone is usually fine after a bit obviously i don't know if that's going to be the same for every family but certainly with mine it feels like that basic thing that you're saying is massively important just the patience of going it will bed down it will settle in it's going to take a bit of time yes

great this is an advert for squarespace. Every time I visit your website, I see success. Yes, success. The way that you look at the world makes the world want to say yes. It looks very professional. I love browsing your videos and pics, and I don't want to stop And I'd like to access your members area and spend in your shop These are the kinds of comments people will say about your website if you build it with Squarespace

Just visit squarespace.com slash Buxton for a free trial. And when you're ready to launch, because you will want to launch, use the offer code Buxton to save 10% off your first purchase of a website or domain. So put the smile of success on your face with Squarespace! Yes. Continue. Imagine all the people sharing all the things! Hey, welcome back. That was Dr. Zand van Tulleken talking to me there. I'm very grateful for his time.

and a reminder that he can be reached on Twitter at ZandVT, at X-A-N-D-V-T. That's his handle. I'm not on Twitter at the moment. Well, I haven't been for a long while. I sort of got out of the habit while I was writing my book, and then I thought, well, maybe I won't get back into the habit. It seems like a good time just to carry on not being on there to keep anxiety levels manageable. I am lining up a selection of delicious waffle for you over the next few weeks. Some of those conversations will be, again, recorded remotely for obvious reasons.

Others will be conversations that I recorded before the coronavirus pandemic. The next one I think I'm going to put out is with Daisy Haggard. She's a very funny comedian, actor, writer, an old friend of mine. And I thought, like several of the Skype conversations I have in the forthcoming weeks, will be with old friends so I'm probably at some point going to call up Joe Cornball's Cornish, Louis Theroux, Tash Dimitriou and people like that to waffle with so I'm not going to go on too much now. I'm going to go back home and carry on editing my conversation with Daisy so that I can put that out for you in the next, sometime in the next week or so, and then do my best to keep them coming regularly thereafter.

And probably in those episodes, I will be bollocking on quite a bit about the fact that I have finally finished my fucking book. Although my timing was clearly not the best as far as it actually coming out and being published, that will probably not happen now until the autumn, assuming everything is somewhat back to normal by then. Obviously, that goes for my book tour as well. Those dates are being rescheduled. But I'll keep you abreast. Before then, though, I think what's going to happen is that the audio version of my book is going to be available. I'm recording it at the moment in my little voice booth, nutty room at home. You know, I'm trying to put together a few little extra jingles and bits of music and put some bells and whistles on that stupid old bastard for you.

And so hopefully that will come out sometime next month uh april late april something like that but look that's it for this episode i hope you're okay in these difficult dark and uncharted waters do you want a hug? I mean, you don't have to. I assure you it's perfectly safe. Hey, come on here. Oh, mate. Come on.

Yeah, it's going to be Christmas podcast time with corn balls before you know it. Thanks very much indeed once again to Xander van Tulleken for his time. Thanks very much indeed to Seamus Murphy Mitchell for his production skills. Thanks to

ACAST for keeping this show on the road. And thank you very much indeed for listening. Take care. And until next time we meet, which will be shortly. I love you.

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