Royal Preston Hospital doctor: Wearing face masks in public is controversial - but it could stop spread of disease

Dr Ikenga Samuel is a registrar in the Intensive Care Unit at Royal Preston Hospital. Here he talks of reopening the economy

By Michael Holmes
Wednesday, 29th April 2020, 3:45 pm
Updated Wednesday, 29th April 2020, 4:26 pm

The question on almost everybody’s mind, most especially the policymakers, might be: when can we safely reopen the economy?

Further questions might be: how do we balance the risk of continued infections from the virus and that of protecting the livelihood of our citizens? Are there ways of ensuring we can do both at the same time? Can our way of life ever return to normal?

These are difficult questions to answer but will have to be, by policy makers most likely guided by data not available to ordinary residents. The figures released daily on hospitalisation and deaths from coronavirus are still very high and suggest we shouldn’t be reopening the economy yet , but we should be planning and making necessary arrangements to do so.

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Dr Ikenga Samuel is a registrar in the Intensive Care Unit at Royal Preston Hospital

The safest time to open the economy would be when we have a vaccine for the virus, however this is clearly many months away and economies of the world will probably not last that long.

The next thing will be to ramp up tests capabilities for both viruses (current infection) and antibodies (previous infections). Governments around the world, including that of UK are improving in their capacity to do so, but it is also almost not feasible to have all these tests available to all residents and citizens in a couple of months.

Moreover, the challenges of getting a really good test kit that will both have a great specificity to the virus and also very high sensitivity to the virus/antibodies still remains and might take some time to surmount.

That leaves mostly the option of limiting spread and great personal protection techniques. Health officials including staff on the frontlines likely will want the shutdown to be kept a little longer to try and reduce the risks of future spikes in infections.

So far, except for the regrettable loss in lives of its frontline staff, and still persistent challenges in getting enough PPEs, the NHS has largely withstood the impact of the virus.

This might have been because most elective surgeries were stopped, other wards and theatres converted to Intensive care units (ICUs) and staff redeployed to main areas of need, with rescheduling of leave for most staff.

So attempting to reopen the economy must have to take into account the capacity of NHS to withstand more cases and how gradually the hospital can return to taking care of other aspects like elective surgeries, cancer treatments etc. There must also be emphasis on protecting the most vulnerable- residents in care home, the elderly, cancer patients and transplant patients from the virus.

We are probably not yet ready to re-open the economy this week or the next one, but we can work towards re-opening in following weeks. Having highlighted our current limitations in vaccines and tests, other mechanisms can be employed towards our goal of lifting the shut down like maintaining the messaging on personal hygiene- regular washing of hands, social distancing rules, and use of face coverings (clothes, masks etc).

The use of face masks is still controversial as opinions vary on its efficiency, and it’s much publicised scarcity around the world, however it might be beneficial as it can help prevent asymptomatic spread of virus to otherwise healthy people, thereby helping in controlling the spread of the disease.

If government officials are thinking of reopening the economy in the coming weeks (as I suspect they are), encouraging residents to initiate and maintain personal hygiene-washing hands regularly, face coverings and social distancing rules will play a large role.

Also important is encouraging businesses to observe safer rules like more distances between tables and people and encouraging less face to face interactions like the use of home deliveries if possible.

These changes might help in preventing spikes in infections in the country. It might also be better to have a plan to partially enforce shutdowns in areas that have spikes in cases when they occur while waiting for vaccines.