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Professor Sikora was the key note speaker at the Alleyn Club Dinner in November where he reflected on the coronavirus pandemic and the impact it has had on cancer care in the UK. Karol also gave us a glimpse into the world of social media and how he went almost overnight from a novice user of Twitter to becoming a significant voice with over 340,000 followers. To many he became known as the Positive Professor but he spoke candidly too about the barrage of abuse he has received since taking to the social media platform at the beginning of March. Below we offer excerpts from Karol’s talk.
KAROL SIKORA
Karol Sikora was at Dulwich between 1959 and 1965 before going to Cambridge where he became a Foundation Scholar and achieved a double first. He received his PhD at Stanford University, where he also served his clinical fellowship. As a physician he has specialised in oncology for over fifty years and is often described as one of the world’s leading authorities in cancer care. In the late 1990’s he was briefly Chief of the Cancer Programme for the World Health Organisation and a member of the UK Health Department’s Expert Advisory Group on Cancer, as well as the Committee on Safety of Medicines. He is currently Medical Director of Rutherford Health, a company he founded in 2015 to provide proton beam therapy to cancer patients. He is also Professor of Medicine at the University of Buckingham, and a partner in and dean of Buckingham's medical school, the only private medical school in the UK.
The key performance indicators are simply not clear enough and data, which is the bread and butter of the medical profession, has been hidden, delayed, often difficult to access and when applied to the home countries, confused. These imperfections have had significant implications on the way in which we have reacted to the disease. The testing system has proved challenging and the thinking around lockdowns has been muddled. The only reason we should be using lockdowns is to prevent the NHS being overwhelmed. Yet the rules governing any closure of either the economy or society need to be evidence based, so far that has been far from the case. The pandemic will end when society says it will end. When Heathrow is busy again and people are walking around not wearing masks nor washing their hands anywhere near as frequently as they are now. In the short term we are going to learn to live with Covid -19, just as we have learned to live with SARS in 2003 and more recently MERS in 2012. On the continent, spare capacity is built into the system yet here in the UK we have fewer diagnostics, fewer doctors and nurses. We are in many ways the the poor man of Europe. Take CT scanners per million of the population, even the Czech Republic and Poland have better critical care capacity than we do. In Germany it is not unheard of that procedures that can have up to a three month waiting list in the UK take just three days there. Our health service operates at full capacity, that is simply not the case in Germany and other European countries. It is not just critical care where the system has failed to cope. We have also had to stop quality of life operations including amongst others hip and knee replacements, cataract removal (the most common operation in the UK) and procedures to treat retinopathy.
COVID - It seems extraordinary now that I was in Wuhan in October 2019 on an official government visit with the Department of Trade and sitting one evening on the banks of the Yangtze River opposite the centre for virology. An institution that a few short weeks later would become one of the very first laboratories to identify and work on the SARS -CoV2 virus; soon to be named CoVid19. Back in January of this year the initial thoughts generally were that Covid would not be too bad and that it could even blow over by Easter. As it happened, both the medical profession and society at large were proved to be sadly wrong. Since then everyone has become an expert on coronavirus – teachers, doctors, postmen and women. The disease has affected the whole of society; not least politicians for whom this unprecedented journey has been and continues to be a rather bumpy ride. And at a time when the country has been looking to our politicians for leadership. I am afraid they have been shown to be seriously wanting. The NHS - Every country is struggling but the lower capacity of the NHS has put increasing pressure on our systems. During the first lockdown everything we did was predicated on stopping the NHS being overwhelmed. However, Covid did not put a stop to other diseases and it felt that those which need a timely intervention such as cancer, heart attacks and strokes, were just left on the shelf. During the first lock down people were too scared to go to hospitals or it was too difficult for them to do so; they stayed at home. We know now that there were many, for example, with non fatal heart attacks who stayed away from hospital and either self medicated or did nothing. In most cases this was enough to get them through the initial trauma but it often left them unaware that they were storing up trouble for the future and risking further attacks as a consequence of heart muscle that was now permanently damaged.
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