Society must “figure out how to live” with coronavirus : Dr David Nabarro

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Don’t bet on vaccine to protect us from Covid-19, says world health expert Professor of global health at Imperial College, London warns we ‘may have to adapt’ to virus

Humanity will have to live with the threat of coronavirus “for the foreseeable future” and adapt accordingly because there is no guarantee that a vaccine can be successfully developed, one of the world’s leading experts on the disease has warned.

The stark message was delivered by David Nabarro, professor of global health at Imperial College, London, and an envoy for the World Health Organisation on Covid-19, as the number of UK hospital deaths from the virus passed 15,000.

A further 888 people were reported on Saturday to have lost their lives – a figure described by communities secretary Robert Jenrick as “extremely sobering” – while the total number who have been infected increased by 5,525 to 114,217.

The latest figures, which do not include deaths in care homes and in the community, put further pressure on the government amid continuing anger among NHS workers and unions over the lack personal protective equipment (PPE) for hospital and care home staff on the front line.

In late March the government’s health advisers said that if UK deaths from Coronavirus could be kept below 20,000 by the end of the pandemic, it would be a “good result” for country. But with an estimated 6,000 people having already died in care homes from Covid-19 – a figure not included in Saturday’s official tally – the 20,000 figure is likely already to have been exceeded.

In an interview with The Observer Nabarro said the public should not assume that a vaccine would definitely be developed soon – and would have to adapt to the ongoing threat.

“You don’t necessarily develop a vaccine that is safe and effective against every virus. Some viruses are very, very difficult when it comes to vaccine development – so for the foreseeable future, we are going to have to find ways to go about our lives with this virus as a constant threat.

“That means isolating those who show signs of the disease and also their contacts. Older people will have to be protected. In addition hospital capacity for dealing with cases will have to be ensured. That is going to be the new normal for us all.”

The comments came as the former UK health secretary Jeremy Hunt said the only way forward was for nations to support a new global health system that would mean far more international cooperation between governments on health issues. It would also require richer nations doing more to support the health systems of the world’s poorest countries.

“I think global health security is going to be on that small but critical list of topics like climate change that we can only solve in partnership with other countries,” Hunt told The Observer.

In a clear criticism of US President Donald Trump who announced last week he was putting on hold funding to the World Health Organisation (WHO) Hunt added: “Surely the lesson of coronavirus is cure not kill…It certainly does not mean cutting their funding (to the WHO).

“One of the big lessons from this will be that when it comes to health systems across the world, we are only as strong as the weakest link in the chain.

“Although China has rightly been criticised for covering up the virus in the early stages the situation would have been whole lot worse if this had started in Africa. International cooperation and supporting health care systems of the poorest countries have to be a top priority in terms of the lessons we need to learn.”

Nabarro’s message is the second grim warning to come from senior ranks of the WHO in the last three days. On Friday, Maria Van Kerkhove, head of WHO’s emerging diseases and zoonosis unit, warned that there was no evidence that antibody tests now being developed would show if a person has immunity or is no longer at risk of becoming reinfected by the Covid-19 virus.

On Saturday it emerged that doctors and nurses treating Covid-19 face shortages of protective full-length gowns for weeks to come, as anger mounts over failures to stockpile them. Gowns were not included in a stockpile list prepared for a potential flu pandemic.

After The Guardian revealed new guidance from Public Health England which instructs healthcare workers to re-use disposable equipment, the GMB, which represents NHS and ambulance staff, said support was “draining away” from Health Secretary, Matt Hancock.

How would you rate India’s response?

The lockdown in India was quite early on, when there was relatively a small number of cases detected. This was really a far-sighted decision because it gave the whole country the opportunity to come to terms with the reality of this enemy. People understood that there is a virus in our midst. It gave time to develop capacities at the local level for interrupting transmission and sorting out hospitals.

Of course, there is a lot of debate and criticism, and inevitably with a lot of frustration and anger that life is being disturbed in this way. It is very, very upsetting. I think it is courageous of the government, honestly, to take this step and provoke this enormous public debate and let the frustration come out, to accept that there will be hundreds of millions of people whose lives are being disrupted. For poor people on daily wages, this is a massive sacrifice they are making. And to do it now at an early stage as opposed to waiting three or four weeks later when the virus is much more widespread, was very courageous.

Unlike in Europe and the United States?

Comparisons between governments are not very helpful, but I can say that there have been some countries where that kind of strong action was not taken early on and we see they now have to struggle with the most immense suffering. We are seeing health workers absolutely at the end of their tether, and getting infected because they are exhausted. We see long term lockdowns being talked about. For example, some people are talking about six weeks, eight weeks.

What about the people worst affected?

We need to save the lives of people who are badly affected. We must be looking after our hospitals, treating our health workers like they have to be treated considering they are on the front line, protecting them as much as we can and supporting them in society so they get looked after… really making sure they are secure and safe.

In imposing major lockdowns, all governments are having to juggle with the need to really get on top of outbreaks quickly and, at the same time, ensure that people through the lockdown are not experiencing extreme impoverishment or shortage of food.

There is growing recognition all across the world that we have to manage lockdowns very carefully. The size of some of these lockdowns is really massive, so having an integrated policy of lockdown management that deals with the social and economic consequences is always important. As far as I know, there are 70 countries and territories where lockdown is being applied, which is somewhere around one-third or half of the world’s population. So lockdown management is a key activity to get right alongside the response to the disease.

Will coronavirus go away or will it become a seasonal virus like the flu viruses?

We don’t know how this virus will behave over time and whether it will become less serious and whether it will have a particular distribution pattern. The virus is four months old, to our knowledge, and we are learning over time. I don’t know what will happen in hotter weather. I’m really very eagerly awaiting information from your country which is now going into the hot season to know whether or not there is the same level of transmission, or whether it is the same level of illness that we’ve seen in a temperate climate. I’m really hoping that it won’t be quite so severe and that weather will be on our side.

We also don’t know how the virus will behave in communities where there is quite a lot of illness, like for example malaria or other infectious diseases.

Will social distancing be the new normal?

Let’s wait and see but let us plan for the virus to be with us in the world for the foreseeable future. There is no evidence to suggest it will suddenly disappear and let’s see what that means for how we organise our lives.

I believe the coming reality for the world will be one where we are always defending against this enemy, like a kind of fire brigade is needed in place. And within that defence, then have the recovery of social interaction and economic activity but done in a way that keeps us all as safe as much as possible. I don’t think we have an impossible task but if we call on our collective ingenuity to establish norms that will enable society and business to get on with what they do best, which is enterprise that creates wealth and enables people to have a decent standard of life.

I’m asking people to consider the new norms at the same time they are imposing lockdowns because the new norms are going to be key to exiting safely from lockdowns without exposing people to disease.

SOURCES: THE GUARDIAN AND HINDUSTAN TIMES

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