In my January editorial I discussed change in a new decade, little did we know the extent of change we were about to experience or the profound impact that change would have on our businesses and our lives. The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the pandemic of Covid-19 it is causing is perhaps not unexpected when one considers the properties of the virus, but it's fair to say we did not predict it and were not ready for it.
Before writing anything else I want to acknowledge the appalling human cost of the pandemic and offer my condolences to any of you who have lost friends or family.
As a veterinary surgeon with an interest in population medicine and epidemiology, watching the daily news briefings and hearing politicians, journalists the public and even my own teenage children talking about herd immunity, R0, vaccine development, viral mutation rates, etc. one's mind turns to the concept of one health. But are our colleagues in public health and the policy makes they advise using all the knowledge and expertise available to them? As livestock vets we are experts in managing populations at risk of infection; the impact of air quality and ventilation for example in bovine respiratory disease, the use of vaccines, managing immunity, the risk of mixing susceptible animals from multiple sources etc. Viewed through that lens most public transport seems like a system designed to spread SARS-CoV-2! We should be asking whether lessons learned in a veterinary context are being considered in managing this pandemic? As Sibley and Brownlie recently wrote in The Veterinary Record (doi.org/10.1136/vr.m3004): ‘Vets would not manage Covid-19 this way’. In my opinion, the only viable long-term way to curtail the pandemic now that infection is widespread in the population is to achieve herd immunity. In the long-term each existing case must infect less than one other person, in other words R0<1. The downside of course is that without a vaccine immunity can only be achieved by infection. As Sibley and Brownlie quite rightly say, we must protect the vulnerable and promote immunity in most of the population if herd immunity is to be achieved. This seem obvious to me, and I thought was going to be discussed in a ‘grown-up’ way by our politicians a few weeks ago, until the term herd immunity disappeared from the daily political vocabulary as quickly as it had entered. The reason for this may be illustrated by the comment I received on Twitter when I suggested herd immunity was now the only way out of the mess we were in, someone said we couldn't go for herd immunity because we couldn't cull people! Not for the first time in recent week I was transported back to 2001, but it illustrates how difficult communication on these things can be.
Vets know about active and passive surveillance, problems of test sensitivity, specific, representative sampling etc., will this experience and knowledge be utilised in finding a way out of the lock-down? Finding infection is easy, determining freedom from infection in a population less so.
Our lives will be changed forever by this pandemic. Will we for example find ourselves getting on the early train, or plane, to London at great cost both to our pockets and the environment to spend most of the day travelling for a 2-hour meeting, after holding all our meetings online for months without even leaving home? After the divisions of Brexit one can't fault the way society seems to have come together to support one another of late, within the profession the RCVS, BVA, BCVA and of course many others are working hard to support members and the profession. I would urge you all to support each other and seek help from all the professional bodies out there. I'd like to particularly point anyone who is struggling at this time to the wonderful work and support provided by Vet Life (www.vetlife.org.uk Tel: 0303 040 2551), don't suffer alone, help is there if you reach for it.