Professor KAROL SIKORA sees trouble ahead for Boris Johnson’s new coronavirus guidance 

Expert advisers have deep and very specific areas of knowledge, but can only offer a selective view of the facts – in this case a recent and modest rise in coronavirus infections in young people – to ministers.

The ultimate decision, based on a balanced assessment of the competing opinions, has to be a political one that convinces the public.

And I am afraid that the ‘Hands, Face, Space’ slogan, crowned with the Rule of Six – a ban on gatherings of more than six people indoors or outdoors – fails miserably on that count.

Of course it is much safer for 20 people to meet, socially distanced, in a park than have six people gathered in a crowded living room – but the new restriction makes no provision for this.

It is illogical and merely invites ridicule and disobedience from an increasingly sceptical and weary public who are confused and disillusioned by repeated stop-start initiatives, be it testing or quarantine or a return to the workplace, over the past six months.

And certainly the latest gimmicks do nothing to address the fear factor that holds so many in its grip.

Yet what an opportunity Boris Johnson had to change the mood of the nation on Wednesday night as he addressed us from the Downing Street lectern.

First, he might have saluted school teachers for coming together to end the social isolation of millions of children and kick-start their education again.

This is a crucial step forward in safe-guarding the mental health of children whose short lives have been upended in 2020.

Next he should have urged university and college students to start the new term with optimism.

Then he should have acknowledged that uptick in infections (as you’d expect when people start to mingle again) in the healthy young who are largely invulnerable to coronavirus, while emphasising another critical statistic: last week ten times as many people died in England of flu and pneumonia as of Covid.

Fourthly – and I speak as a cancer specialist – I would have rejoiced to hear the Prime Minister acknowledge the tens of thousands of people out there who, because of the impact of Covid-19 on routine NHS screening programmes and the restrictions under which many GP surgeries are operating, are failing to seek diagnosis or treatment for worrying symptoms.

For be in no doubt, these are the next wave of Covid-19’s collateral damage.

I wish Mr Johnson had told the nation to cajole or bully our loved ones to demand to be seen by their GP, via Zoom if necessary – because that really will save lives.

I doubt that the Rule of Six will make any material difference to the reinfection rate, but one thing is absolutely certain. Thousands more people will die in the coming months and years because of undiagnosed cancers, cardiac disorders and other treatable conditions than will succumb directly to Covid-19.

And the lack of urgency – acknowledgement – surrounding this growing crisis makes me truly despair.

The rationale of the initial lockdown was to ‘Protect the NHS’. Well, the NHS coped fine, essentially by shutting itself down to all but Covid admissions, A&E, and maternity care.

But we ignored the human health cost of this, and it will be very high indeed.

Basic modelling predicts at least 30,000 extra cancer deaths as a result of the hobbling of the UK’s diagnostic services. Take prostate cancer: as the Mail reported this week, referrals have halved since lockdown began.

As for routine bread and butter operations, it will take years for the NHS to recover, if ever. Waiting times for knee and hip replacements are the longest in 12 years, with 2.15million patients on the lists.

The trends are even more terrifying in cardiac care. Figures suggest a nearly 50 per cent drop in the number of heart attacks in the UK in the first three months of the shutdown.

This would be a jaw-dropping figure if it were true, but unfortunately it is not. What it really means is that thousands of people who suffered symptoms of a heart attack at the milder end of the spectrum were too scared to go to hospital for treatment.

If you are not treated for a mild heart attack, you might convince yourself you’ve recovered, but your heart muscles will have been weakened. You are much more likely to suffer gradual heart failure and sudden death in the next couple of years.

Psychologically, the fundamental problem with the Rule of Six is that it reverses the tide towards the return to normality which, as a nation, we desperately have to cling to. Worst of all, it undermines any effort to get people back to work, particularly via public transport. Any sensible person will wonder how it can be safe to get on a busy bus or train if it is deemed dangerous to gather their extended family in their own home.

And as for the ‘moonshot’ mass population testing plan, well I wish I could get excited about it.

There is one obvious problem here. Even if it can be achieved, testing on this level will throw up hundreds of thousands of false positive results, which would require those people, plus all their contacts, to self-quarantine. This is impractical, and will not happen.

I worry that Boris and his ministers and advisers have squandered so much political capital with policy shifts, U-turns, meaningless slogans and gimmicks that the nation – and especially young people – are beginning to dismiss everything they hear.

People will even stop obeying the sensible rules, like handwashing, wearing a mask in public and keeping a distance. I am currently on holiday in North Wales and I noticed when I went out for curry last night that an implausible number of people had registered under the name of Smith in the restaurant’s test and trace book.

This open defiance, I suspect, will become the norm, and the plan to employ Covid Marshals to enforce restrictions will, I fear, bring the authorities into further ridicule.

This Government has been very successful in the business of spreading fear about Covid, but in not much else.

What people desperately need now is belief that things can, and will, get back to a state of being that they recognise. Above all, they crave that most human of emotion – a sense of hope.

Karol Sikora is professor of medicine at University of Buckingham Medical School and Chief Medical Officer at Rutherford Health.