Coronavirus week 19 – That didn’t last long…second wave starting

A short heatwave but signs of another wave of infection.

According to one of the weather forecasters I heard, to qualify as a heatwave there needs to be a period of three days of higher than average temperatures, but ours this week was only one day. It was 20-21 degrees on Thursday and reasonably sunny, by Friday afternoon it was 35 but by the evening it was cloudy muggy and raining and on Saturday it was back to 21 with a cool wind and some showers.

At the end of my last blog I suggested that I may not do another for a few weeks as things appeared to have reached a ‘steady state’, with falling numbers of deaths and a ‘levelling off’ in the number of infections. That idea didn’t even last for 24 hours. It wasn’t that a couple of people were kind enough to comment on my Facebook post saying that they enjoyed reading them; it was watching Channel 4 News on Monday evening.  It’s a way of getting updated on current events that I get the most from. All day ‘rolling news’ is a great thing, something we never had in ‘the good old days’ when there were only three or four terrestrial television channels. The problem is that even  BBC News 24, whose coverage I also enjoy, only touch the surface of a story. I don’t want to sound like a ‘grumpy old man’, but programme makers appear to think we are incapable of listening for more than 90 seconds, or in ITV’s case, that we also need the chance to win a £150,000 prize of gifts we probably don’t need.

Anyway, it was watching the news on Monday evening that there were so many items I wanted to write about, many of them linked to each other or to coronavirus. Hence this blog with all the topics originating with the items on that edition.

Holidaymakers returning from mainland Spain complaining that there were more cases of the virus on one caravan park in Shropshire, than the whole of the Balearic Islands, and they felt safer in a country where everyone was obeying the rules on social distancing and hygiene. By the evening, the islands had been included. Transport minister Grant Shapps went to Spain but had to isolate when he came back on Wednesday. I admit to thinking that I would go if insured, and suffer two weeks quarantine or extend the holiday as I was sure there would be extra capacity. By the end of the week, however, as local lockdown was declared for large parts of Greater Manchester, Lancashire, and West Yorkshire, like others I suspect, I was more doubtful.  I listened to arguments about having to declare whole countries as giving a simpler message than trying to exclude certain areas, and had to agree. Whilst the Canaries are further from mainland Spain than Venice is from London, it would not be difficult to get around the rules by taking a flight from the mainland to the islands and return from there. There is also the danger of catching the virus and having to be in hospital in a foreign country possibly for a long time where the care may be excellent, but my Spanish is almost non-existent.

Despite early criticism there appeared to be more acceptance later in the week when the rates of infection in Belgium (which had one of the highest rates in Europe in the earlier part of the pandemic), and Luxembourg, were rising very quickly. It seems a ‘second wave’ is starting to spread across Europe.

In the UK cases were definitely rising with average daily cases approaching 800 at the end of the week. The fact that average daily deaths was still falling to about 60 at the end of the week, could point to two things; that the lag between cases and serious illness is not showing yet, or that it is mainly younger people getting infections and they don’t generally suffer with the more life-threatening symptoms.

Boris says ‘get on your bike’…

Boris encouraged us (like Norman Tebbit in 1981) to ‘get on our bikes’, but this time not to look for work, but in an effort to fight obesity. The web site handing out free £50 vouchers to get bikes repaired crashed due to demand. Not surprising for £2.5million of untargeted benefits. Many would be snapped up by those who could well afford to repair the bicycle that had lain neglected in the garage for years. It all seemed a bit of a headline-grabbing gimmick. Boris has previous on this topic. As Mayor of London he encouraged people to use a Transport for London (TfL) scheme for hiring simple bicycles parked in many areas in the city to travel to other areas. Registered users could take any of the 5,000 cycles from any of the 315 docking stations in central London to any other for a relatively small fee. This was in 2010 and proved successful. The original bikes were sponsored by Barclays bank with a blue highlight. The scheme was transferred to Santander bank with the current ones mainly red and there are now 11,000 bikes and 800 ‘stations’ spread across 40 square miles of London. 

In a week of mixed messages I had one alert from GOV.UK announcing a ban on buy one get one free offers on unhealthy food, and the next one reminded me that I could go to the pub or restaurant and taxpayers will give me 50% off any meal. This is for as many times as I like. So presumably I could get a first course with chips, followed by a chocolate brownie/ice cream / sticky toffee pudding (with extra chocolate sauce) for 12 days (it’s only Monday-Wednesday) from 3rd to 31st August. All washed down with a nice glass of wine or beer – but don’t worry the discount is not off those and they don’t contain many calories. Even HMRC were putting out Tweets about the offer – even if they couldn’t bring themselves to think people might want other European or even British menus…?

The idea of making it a requirement to put calories on all restaurant menus is a good one, but many pubs and fast-food sites do that now. The problem appears to be the ‘education’ needed to allow us to make the healthier choices.

Channel 4 News had an interview with chef Jamie Oliver (who also has years of campaigning for us to make more healthy choices. He made the point that the good quality food is more expensive, and those with less money can only afford the ‘less good’. Rather than taxing sugar, he suggested that perhaps we should be subsidising healthier food.

It could be that this approach to obesity, exercise and healthy eating was related to Boris’s own experience of Covid-19 and the realisation that his own health may have meant not seeing his fiancee and young child? There are many in the Conservative Party who decry the so-called ‘Nanny State’ (itself a posh expression), but a government that claims to have been ‘following the science and experts’ appears in the past to have paid more attention to the food and drink industry lobbyists than ‘health experts’ when deciding policies. Like tobacco before it, the ‘curse of sugar’ needs mass cultural and social change if it is to be effective.

What it doesn’t need is ‘fat-shaming’ and judging people by their apparent excess weight. The majority of our population have some problems maintaining a healthy diet. No one wakes up one day and finds themselves several stones overweight.  The busyness of our lives and availability of cheap food make it hard to change. I have the luxury of a good income, the space to own an exercise bike, and a pleasant area go out for a run. In my case I have made a conscious decision to change, and am currently about a stone less in weight than I was at the start of March. I also know it will be a struggle to keep this way once we get back to eating out again on a regular basis.  I often wonder how people in poverty-stricken countries who have to walk miles to get clean water or a meagre amount of food to take back to a house with no electricity, would make of our kitchen cupboards and American-style double refrigerators. As if that wasn’t enough for them to take in, imagine trying to explain that we then pay a membership of £360 a year for the privilege of driving, three or more times a week ,to a large warehouse full of bicycles that don’t move and treadmills. All in an effort to lose the excess body mass we have!

The next item of news last Monday was one on rehabilitation from the after effects of having Covid-19, or one of its variants dubbed ‘Long Covid’, as the fatigue and memory issues and muscle weakness can last for months (maybe even years, we don’t know yet). The item showed a group using a gym closed due to lockdown, and sharing experiences with people who have been through the same thing.  This is just like my journey after brain injury, when I found the charity that brings together people from all parts of society and background to share with each other. Access to physio and rehab services across the country is patchy at best, but so vital. All of this should have happened years ago. There is a small charity that works with people who have been in intensive care for long periods of time. Patients may be physically well, but the mental effects can last a very long time.  If this step of physio is missing or not done thoroughly, there is more of a cost to the country in terms of lost working days and productivity, as well as actual treatment, medicines, and care in old age. It makes no sense health wise or economically, not having these services readily available for everyone.

The final two articles on the Monday evening news was one that US president Trump’s security advisor had tested positive, after a trip to Florida ,where there is a rise in cases of Covid-19.  Then that Brazil’s president Bolsanaro has been reported to the International Criminal Court, by an umbrella group representing health worker unions and social care organisations, for ignoring and mishandling the crisis. Their claim of crimes against humanity amounting to genocide are unlikely to be taken on by the ICC but demonstrate the strong feelings in the country.  There was an interview (on BBC news!) with a doctor in a hospital in Sao Paulo stating that they had people turn up at hospital still claiming it was all false and a hoax – but when they ended up in intensive care they say ‘doctor don’t let me die and tell my family to take care!’ 

Other news last week.

• We watched Jimmy McGovern’s powerful drama imagining the life Anthony Walker a young black man killed aged just 18 in 2005. He wanted to become a barrister. His mum asked the writer to show him qualifying against all the odds, marrying his (white) girlfriend at the time of his death, having a child and saving his best man from a life of crime by taking him to live with his family after becoming destitute. It brought me to tears. 
  Anthony’s mother, Gee Walker, has setup a trust in his name and as a Christian she believed this was part of Anthony’s legacy.  This will be something that is hard for those without a faith to accept. But I believe, as his mother hopes, that despite not becoming a civil rights lawyer and going to America, Anthony’s legacy through the work his mum does, and the effect of this drama, means more people could be touched. Some small comfort to his brave mum.
• Late Thursday evening health secretary Matt Hancock announced that Greater Manchester, East Lancashire and parts of West Yorkshire were told to go into a ‘local lockdown’. This was due to a ‘spike in cases’ from people going into each other’s homes. There was some confusion and a great deal of contention from the Muslim population as it was the eve of Eid one of the major feasts of Islam. One leader likened it to cancelling the Christmas Day at 9 o’clock on Christmas Eve, although another did acknowledge that when the original lockdown was imposed many Christians had to miss Easter Day celebrations.
  Writing as someone who is doing project work for a company in Sale, there was concern that some members of the team who had only returned to work because their parents could look after the children again, may have to go back on furlough until the lockdown was over.
• Another member of the team at the company developed some symptoms and was relieved when their test came back negative – but they had to wait over 3 days for the result.
• One report from Manchester showed a street where many of the rainbow posters drawn to put in windows to celebrate the NHS Heroes were faded and torn….perhaps a sign of how quickly we forget?
• One of the most worrying statements last week was from Professor Chris Whitty as he stood next to Boris Johnson at a Downing Street press conference on Friday announcing that the opening of face to face beauty treatments and bowling alleys was to be delayed for a further two weeks at least. He said

“I think what we’re seeing from the data from ONS, and other data, is that we have probably reached near the limit or the limits of what we can do in terms of opening up society.

“So what that means potentially is that if we wish to do more things in the future, we may have to do less of some other things.”

He expanded to say that if we are to get children back to school in September we may need to close some other places (pubs perhaps?) or put new limits on what people can do and who they can meet.

It really does feel this week that we are not in a ‘steady state’ anymore….!

How was week 19 for us?

After weeks of training and struggling with IT and ‘HR’ Alyson finally managed to book a few shifts on NHS 111 service…but only as reserve. She responded ‘I don’t want to be a reserve I want to be on the first team!’ Her wish came true on Friday when she was given just 20 minutes notice that she was working an 8-hour shift. This was due to late cancellations by two other people on the shifts. The deal is that people are supposed to get 24 hours’ notice. So, she managed to cancel one and worked 4-8pm. It was a tough shift, not only with the types of call, but using the systems for the first time. Reflecting afterwards Alyson felt that she had helped people at a difficult time, and knew that the next shift(s) would be better.

We both signed up as volunteers for vaccine trial in conjunction with the NHS and a pharmaceutical company. Unlike last week’s attempt we both passed the age & health requirements.

After the very warm day of Friday we went to Coventry for a ‘socially distanced picnic’ in a large park to meet up with Alyson’s sister and brother and their families in  Coventry. It was good to see everyone again including our two boys and our nieces. There were three generations and one of our nieces is expecting her first child in October  – she works in a hospital so was concerned about getting too close to us, but I think she enjoyed the day. The only member of the family who couldn’t come was our nephew who returned from the Spanish Balearic Island of Majorca so was self-isolating in his London flat.

On Sunday I attended my now weekly Zoom service at Westminster Central Hall Methodist Church. It was great to be part of a ‘congregation’ of over 1,100 people sharing in worship. Rev Howard Mellor gave an amazing sermon on the ‘original picnic’, the feeding of the 5,000, a miracle told in exactly the same way in all four gospels. Howard pointed out a small word that I had not noticed before – grass! Despite the disciples only having meagre rations of five loaves and two fishes, and thinking that was not enough to feed the crowd, Jesus managed to make it sufficient for all the people (more than 5,000 when including the women and children) and ‘still there were 12 baskets left over’. All this in an area which, because of the grass, was clearly a place of abundance where crops could grow. Howard’s message to those of us hoping to be modern day ‘good disciples’ was however little (in terms of skills and gifts) we think we have, if we give it to Jesus, he can help us achieve so much more than we ever believed.

Stay safe and let’s see if there is enough for another blog next week!

Coronavirus week 18 – the long wait for a vaccine

Will it be the scientists or anti-vaxxers who stop us getting a vaccine?

For the first time in the last 18 weeks of lockdown I found myself agreeing with Boris Johnson. He was visiting a GP surgery in London to promote the importance of flu jabs in the upcoming winter. Referring to the opponents of vaccinations he called them ‘nuts’. Ever since (the then doctor) Andrew Wakefield persuaded many parents 20 years ago not to give their children the measles, mumps and rubella (MMR) vaccine following some ‘research’ linking it to autism and inflammatory bowel disease (IBD), the use of vaccines has been called into question. 

Researching the claims by (now struck off doctor) Wakefield I learned the following facts from the General Medical Council (GMC) fitness to practice hearing of 2006 published in 2010.

• A good study will include many participants, and Wakefield’s study included only twelve children.
• Wakefield lied in the Lancet paper when he wrote that the participating children were referred independently after being diagnosed with IBD or other major gastrointestinal issues. In fact, many of the children were chosen specifically by Wakefield, and others were recruited with the help of the same lawyer who was paying him to conduct the study.
• Even before publication of the study, Wakefield was working on patenting his own version of a measles vaccine, which he would sell at a great profit as a supposedly “safe” alternative to the MMR vaccine. The father of one of the children in Wakefield’s study was a cofounder of the planned business that would market this product.

The problems caused by Andrew Wakefield were in the news last August. Children who didn’t get vaccinated as their parents listened to him and not their doctors were now students, and an outbreak of measles was happening leading to serious side effects. The UK along with other parts of Europe has lost its status of being ‘measles free’.

The cofounder of Microsoft, Bill Gates and his wife Melinda are an example of people who have acquired enormous wealth, but are trying to use that to help others. They have been victims of terrible social media attacks and conspiracy theories as a result of pledging literally billions of dollars to vaccination programmes for children. They are partners of Gavi a global alliance of the WHO, UNICEF,  The World Bank and donor countries with the aim of funding vaccination programmes for children in all areas of the world. This will improve health, prevent needless deaths and lead to less poverty. In June a little-reported summit of world leaders was hosted by the UK and pledged over $8billion over the next five years to the programme.

The UK can be proud of being the largest donor pledging £330million a year. As Bill Gates said at the time

To beat the COVID-19 pandemic, the world needs more than breakthrough science. It needs breakthrough generosity. And that’s what we’re seeing today as leaders across the public and private sectors are stepping up to support Gavi – especially Prime Minister Johnson. When COVID-19 vaccines are ready, this funding and global coordination will ensure that people all over the world will be able to access them.

In recent weeks Russia (who pledged no new money in addition to the $4milion per year share from a previous campaign) have been accused by the UK of trying to steal scientific secrets on the development of a Covid-19 vaccine. China, who also only pledged $4million per year, are still being accused as a possible source for the current outbreak. 

To be clear, the pledges are for vaccinations of all types and not just Covid-19. Since 2000 over 760 million children have been vaccinated against polio, pneumococcal disease, typhoid, MMR, meningitis and rotavirus (that causes diarrhoea). However, the lockdowns in various parts of the world and the WHO advice to temporarily suspend vaccination programmes, to prevent people from spreading Covid-19, could lead to an estimated 6,000 children dying every day from lack of protection that vaccination provides. It’s a terrible dilemma for many countries’ health systems.

Their personal $1.6 Billion pledge hasn’t stopped the conspiracy theorists putting false information out about Bill & Melinda Gates, accusing them of wanting to use the programme for mass sterilisation to control world population, and even implanting a microchip as part of the programmes, to track everyone in the world.

This week DHSC announced that eligibility for the programme of flu injections for the coming winter has been extended to 30 million people in an attempt to prevent the NHS being overwhelmed by a flu pandemic and a second wave of Covid-19. We have had years of creating vaccines for seasonal influenza which is a slightly different strain each time, but even these aren’t always fully protective, but can lessen the severity of symptoms and reduce the rate of infection. 

We have never succeeded in getting an effective vaccine against any of the coronaviruses. Even with about 150 programmes to develop one and almost 25 starting human trials, there are questions to be answered  before getting one. Here are seven according to an article I read this week.

1. Is the vaccine safe? Early results suggest that there can be mild side effects from the vaccines, but more worryingly these can we worse in those more likely to be affected by the actual virus – the elderly and those with comorbidities. It is possible that a vaccine could make the disease worse in those who have it already.

2. Does the vaccine work? The general view is that it is unlikely to be completely effective and Professor Chris Witty has said that at least 50% would be a good result.

3. Will protection from a vaccine fade over time? There was some excitement when the vaccine being developed at Oxford produced the type of reaction expected, but it could be that this fades after a few weeks or months. However, there is also a theory that some element of ‘immune memory’ could result that helps the next similar infection.

4. Can we mass-produce it? Whilst the UK Government claims to have pre-ordered 100 million doses and be investing £150 million in new production facilities, there will be a long timescale. Some vaccines need to be stored in specials conditions such a low temperatures before being given. This could also be a challenge both in transportation and worldwide in countries with poor facilities and health systems.

5. When will we really have a vaccine?  Are we talking about when we have a proven vaccine after clinical trials, when it is approved by regulators, when we have enough to give it to key workers in clinical settings and then those at greatest risk, or when we have enough to inoculate the whole world?
   There is a danger that if supplies are strictly limited only those who can afford it, or have the political leverage to get it will be treated. This will only exacerbate conditions in the rest of the world who can’t afford it – and the virus will be around for even longer.

6. Once we have a vaccine, will people want to get it? So we come back to the anti-vaxxers or even those who are just cautious. In a recent poll about one in five Americans said they don’t plan to get a coronavirus vaccine, while half said they would. The rest were unsure. The US has a system where people need to pay or have insurance, so even in the richest country in the world cost could be a barrier.

7. What about booster shots? It is likely that any vaccine could need more than one dose to maintain effectiveness, so all the points about cost and organisation of healthcare systems come back into play.

There was an appeal for volunteers to take part in the clinical trials for vaccines produced by Oxford University and Imperial College London, so I thought I might offer – but although I am fairly fit and healthy I am over 55 so that was the end of that.

Vaccines aren’t the only treatment and this week again there have been trials of a new therapy based on a protein called interferon beta that have shown promising results when given as an inhaled dose. This was previously shown to have been effective for the treatment of SARS.

Other news this week.

• A couple of months ago when the government was recruiting 25,000 people to train up to ‘track and trace’ contacts of those who had a positive test for the virus, there were newspaper stories of them having so little to do that they were watching Netflix movies. A story emerged this week that could have been interpreted in a way that could have suggested these people were making their own work. It was an ‘international’ story too.
  The English NHS ‘test and trace’ system has been outsourced to a US company that uses call centres based in Scotland.  Eight of the Scottish workers there tested positive for coronavirus, meaning that the Scottish system, called ‘test and protect’, had to get involved to trace their contacts – you couldn’t make it up!
• In an interview on the anniversary of taking over as leader of the Conservatives and moving into 10 Downing Street, Boris Johnson admitted that there were some ‘open questions’ to be answered about the handling of the crisis in relation to timings of lockdown and protecting care homes. There was a less than generous video doing the rounds on social media claiming that as the virus was spreading across the world Boris missed several COBRA meetings, was uninterested in briefings and more interested in throwing a party to celebrate ‘getting Brexit done’.
• Whilst the school holidays had started and some people were enjoying time in Spain, on Sunday morning all four UK governments brought back measures for people returning from the country to isolate for 14 days on their return. Despite FCO advice that travel to the Balearic and Canary Islands was still allowed, and only that to mainland Spain was not recommended, people returning from the islands still had to isolate. Such measures had been on the cards, but the suddenness and extent caused some controversy with many people again unsure of their holiday insurance situation. Many will also lose money as not all employers will be sympathetic to them taking more time away from work.
• The number of cases is still falling very slowly with average daily deaths at 64 by the end of the week, down 8% from last week. The number of daily cases was averaging 662, which is up over 6% from last week. We are definitely plateauing but possibly to a sustainable level to live with as a trade off for an economic recovery.  Total deaths reported for the outbreak was 45,752.
• At the same time as gyms and swimming pools are allowed to open, the government was trailing an old idea of getting doctors to focus on reducing the levels of obesity in the country. This is one of the key factors that makes people particularly susceptible to severe symptoms of Covid-19, as well as being bad for general health. Laws on advertising junk food will be brought in and GPs will be allowed to prescribe 12-week health plans and exercise.

How was week 18 for us?

It was back to work for me with planning for the project I am doing with the accountants in Manchester. The pressure is on to complete the first stages of the system in the next three months. We are not planning to be away on holiday any time soon so this should be manageable.

Alyson continued to come close to getting a first shift with NHS 111 pharmacy advice service. She had more technical problems but at the end of the week all appeared sorted and this is a photo of her ‘mobile call centre with a laptop with connection to the NHS systems, two screens, a smartcard and a mobile phone system that allows her to call patients using an NHS number.

In the week more sports opened up, I was pleased to be able to follow some Major League Baseball (MLB) as the team I support the Toronto Blue Jays started a shortened season in empty stadiums. As the only team in MLB outside the US, the Canadian authorities would not give them permission to play home games in Toronto as it would mean them crossing the border to play away games and US teams crossing to play at Rogers Centre in Toronto. Right up to Opening Day on 23rd the team had no base, but then it was decided to play games at their minor league team’s base in Buffalo in New York State. Their first series was away in Florida, so they need to get the stadium ready for the first home series, which was to be next weekend but has been put back until 11th August.
My other sports team, Middlesbrough football club managed to survive in the Championship on the last day of the season on Wednesday – ironically away at Sheffield Wednesday. Two teams previously managed by World Cup winner Jack Charlton, whose funeral was the day before.

Keep safe everyone and let’s see what the next week brings.

I am thinking about stopping this blog for a few weeks as the situation in the UK appears to be in a steady state.

Coronavirus week 14 – Not ‘the new normal’ but ‘a reorientation…’

‘So what’s the story?’….time for change

This week’s blog will be a shorter one (who shouted hurrah!) as I am busy this weekend taking part in a ‘virtual Methodist Conference’ along with 300+ other people from all over the country and the world.  The Conference met for the first time with founder John Wesley in the chair in 1744, and has convened annually in the 275 years until 2019 when I attended for the first time in Birmingham. It would be easy to characterise our church as ‘old fashioned’ and living in the past, but the first thing we did was spend half an hour voting electronically via ‘raised hands’ and Zoom polls to put aside our ancient rules designed for a physical gathering. This had taken a great deal of work by our Law & Polity team in conjunction with the Charity Commission. It could have been a very short conference if we hadn’t voted unanimously to do so. Who says our church is stuck in its ways?!

A casual glance at our new President Rev Richard Teal, dressed in black robes with a white collar, the 60+ year old white male that he is, might have reinforced the old-fashioned tag. But his message that this time of lockdown must lead to a time of ‘reorientation’ – to see people and do things differently in the future, shows we are rooted in the present not the past. He used the word ‘oriented’ to describe the way we felt just a few months ago, comfortable in our situation, and the example of his feelings seeing his new grandchild for the first time to emphasise the emotions that existed at the time. Next he talked about feeling ‘disoriented’ during the last three months, unsure of what it means, and without many of the things which make our lives stable, including family and being part of a local church with all its traditions and routines. What we need to do next is ‘reorientation’ as a church, with the things we have learned. We are finding more people than ever wanting to be part of on-line services and gatherings, we have reached out to those who live in our area most in need – particularly those who are lonely and isolated. We need to value those who do vital work and have been underappreciated in the past.

Richard follows a President in Rev Barbara Glasson who exemplified the diverse talents we have in our ordained ministers. Barbara has spent her ministry working with people ‘on the margins’ or outside our church. In Liverpool city centre she started a group of people including those with learning disabilities, from the LGBTQ community, the homeless, and young people, who came together every week to make two loaves of bread, then gave them away to whoever wanted it. Never the same group two weeks running, the ‘Bread Church’ is still going strong. She currently directs the Touchstone Project in another city centre, Bradford, that works from a terraced house in a Muslim-Pakistani heritage area on interfaith relations. They are about to move into a refurbished pub. Barbara is a blessing in our church. With 2019 Vice President Clive we were encouraged and challenged to tell our story of faith – hence many of my blogs using their phrase ‘So what’s the story..?’.

Our new Vice President Carolyn, in her 50’s, described herself as an introvert, activist, impatient, easily bored and liable to make flippant remarks – an honest assessment of her humanity. She confessed to being uncertain about taking on such an important role, but the testimony she gave on how she got here was powerful. She described the church as part ‘mad’ – some of our members can get very worked up if people use the wrong cups, wear the wrong clothes, put papers on, or take them off, the noticeboard.  There is a whole potential for trouble around anything to do with setting out, stacking or moving chairs!  It is also part ugly – this ranges from telling visitors off when they sit in ‘someone else’s seat’, we can say the cruelest things to each other, have inappropriate comments and touching, bullying and controlling behaviour. Ministers from our overseas churches can be subjected to racist comments from our members, and homophobia is not uncommon.  This ugliness extends to some extremely serious cases of abuse, which we need to continually guard against.

Carolyn’s hope is that the best of the work we do is really good and awesome; helping the weakest in society, and through our overseas relief and development charity, All We Can, those in poorer countries. She wants to use the year meeting with local churches and encouraging us to use our gifts to the utmost.

It is a very different conference this year, but our group of 8 local Chester & Stoke District representatives are keeping in touch, and helping each other during debates via a WhatsApp group.  We won’t be able to hold the deep and passionate debates where speakers come forward to give different views, but we will be reviewing some important reports and committing millions of pounds of funding to important mission and outreach projects. We will also do the ‘mundane and routine’ business such as approving accounts, membership of committees and working parties. There is a sadness that the vital debates we held last year, and the provisional legislation needed, to make us a more inclusive church that recognises a wide-variety of relationships as valid, will not be completed as it was felt the format would not allow the ‘deep personal conferring needed’. Those in single sex relationships are already welcomed, and can hold any position in Methodism, but will have to wait until the conference of 2021 to find out if they can marry in our churches.

Our ministers in training are usually ‘ordained’ on Conference Sunday, but this year they had to make their promises on Saturday via Zoom as the first part, but will have to wait until we can get back into churches to have the physical ‘laying on of hands’ in the special service with friends and family. After one of the candidates made her promise from home our chair Helen sent a message on WhatsApp saying ‘we need to get Natalie into our district’, prompted by a framed message on the wall in Natalie’s house that read ‘Gin is my saviour’!

In the conference last year we learned that language is so important, not only in what is said but how it is said. Hence my wish not to use the term ‘new normal’ for our post-Covid society but the hope that, using Richard’s word we will ‘re-orientate’ ourselves. This week with the ‘White Lives Matter’ banner flown over a premier league match we learned again this lesson of use of language.

With cases not falling as fast and the death rate levelling off to about 150 per day, there is concern that the ‘welcomed’ easing of lockdown has sent the message that ‘it’s all over, we can have a party’. Scenes at ‘block parties’ in London, the celebrations in Liverpool after their team won the Premier League title after a 30-year wait, and overcrowding on the beach at Bournemouth during a very warm spell, raised fears of a second spike of infections. And all that before the pubs open on 4th July. Add alcohol to the mix and arguments over what constitutes ‘one metre plus’ in crowded pubs will lead, as one punter said, ‘to even more fights on a Friday night’! 

I understand some of the reasons, but in my opinion it says a lot about our country that we work hard to get the pubs open, but not the gyms and swimming pools. Judging by the photo on the front page of one newspaper this morning, Boris Johnson clearly thinks an office floor is all that is need to become ‘as fit as a butcher’s dog’. Although I am not sure wearing a suit and tie is recommended gym wear?

We really are at a ‘turning point’ or maybe looking over a precipice with the virus. Infections are reducing, deaths at least leveling out, and there are signs of hope. Yet scientists keep telling us that there is no sign of the virus just dying out and it will be with us at some level for ‘years to come’. The next three months and how we as individuals react will be critical to the future path of the virus, even more than the past 14 weeks of lockdown.

We need to re-orientate our country if there is not to be a pandemic of unemployment. In my less optimistic times I worry about a complete breakdown of society as those in work continue to regain wealth, but those in lower paid jobs or no jobs get poorer and poorer – or am I kidding myself, as that has been the case for decades?

Other news this week

• The daily briefings came to an end on Tuesday with the announcement of the next stage of easing, adding to the ‘its all over’ feeling. Those who are shielding were told that they could leave the house at the same time. There is uncertainty and real fear among some. It may be that the presence of the virus is such that on average you need to meet 1,700 people before you interact with someone who carries the virus, but the effect if you are the unlucky winner of that particular lottery is no less devastating if you are vulnerable.
• With the briefings ending, you have to work hard to find the daily new cases and death figures. The four days figures Tuesday to Friday were 154, 149, 186, 100  and the total is 43,550 and the average new daily cases is about 900 which is at least moving in the right direction. Globally we passed 10 million confirmed cases and  500,000 deaths.
  
• At the weekend it was announced that from the 6th July we will be able to go to some European countries via so-called ‘air corridors’, meaning that on return there will be no requirement to go into two weeks’ quarantine.
• Infections in the US are continuing to rise at a dramatic pace and President Trump is still in denial, with his senior team appearing increasingly uncomfortable trying to defend the indefensible. It is such a large country and a major part of the world economy, even beyond the personal impact the loss of over 125,700 of its citizens.
• World number one tennis player Nova Djokovic arranged a short tour of his native Serbia, and Croatia in which there was little attention paid the social distancing or ‘covid security measures’. Djokovic himself got the disease as did his wife and several of the organising team. He is a self-declared ‘anti-vaxxer’, an area I plan to explore in a later article as the ‘conspiracy’ theorists and those who ignore science facts are dangerous for the rest of us.
  

How was week 14 for us?

It didn’t start well as on Monday Alyson was seriously ill with sickness and stomach upset. At first I did wonder if she had caught Covid-19 from working in the pharmacy on the Saturday. It turned out to be a reaction to a new type of antibiotic she was taking.  It was the first time in 93 days that she hadn’t been on our exercise bike and her Wii Fit.  We had to cancel our trip to meet friends from Shrewsbury the next day for a walk around a lake at a park halfway between us. It was a gloriously sunny day and such a shame.

The weather stayed hot and sunny and by Thursday when Alyson finally got to meet three former work colleagues in our garden, we needed to put up the gazebo we had bought specially, not for the rain, but so that they could sit in the shade. It was the hottest day of the year at 30 degrees.  

The opening of self-catering accommodation on 4th July means that our holiday at a National Trust cottage in a remote area of Norfolk is back on. It will be good to get away even if we can’t visit some of the places we planned to. It will be a change of scenery and walks along coastal paths. I admit to glancing at the availability of villas in Spain, Crete and Croatia when the air corridors were announced, but Alyson is a bit more cautious and is waiting for the ‘second spike’ and what happens when the ‘winter flu’ season starts again.

I continued to do my local parkruns twice a week and am feeling the benefits both in some weight loss, and clearing my mind of confusion.

We had a meeting of our head injury charity trustees via phone and the figures I had prepared as treasurer showed that our reserves have increased.  There really has been great support for small charities like ours who can’t hold fundraising events. We have been fortunate with the grants we have applied for – and received. Apart from the National Lottery the money we have received is from local trusts and benefactors wanting to support Cheshire-based charities.  We have not furloughed our two employees, as the work they do supporting members who were socially isolated even before the restrictions caused by the virus, is vital. We too will continue with ‘reorientation’ of our services, taking some of the ‘virtual coffee mornings’ and chat rooms forwards to reach those who haven’t wanted to attend physical meetings even in normal times.

Alyson’s hairdresser called to ask if she wanted an appointment in the first few days of opening. I am getting used to her long hair and she doesn’t want it taken back to where it was, just the fringe tidied up. I love the haircuts Alyson gives me with my trimmers and not sure I will ever go back to paying for one!

Although there was no formal Conference Service this year, our new President and Vice President joined the service at Westminster Central Hall via Zoom. Richard’s sermon was about John Wesley’s drive for Methodists to strive for ‘personal holiness’, but to live out the gospel we proclaim via what he called ‘social holiness’. This is a radical, active care for those in society who need it. Richard talked about the last letter Wesley ever wrote being to William Wilberforce supporting the abolition of slavery. He worked in the desperate slums of London where he saw people in extreme poverty continue to work and help others. Richard used a modern-day example of this social holiness by telling of a member in his circuit in rural Yorkshire, inspired by her faith to help the local food bank and deliver to the housebound and isolated in her community. 

Vice President Carolyn led us in prayers for those who are broken-hearted, worried about the virus, struggling with loneliness and living in conditions where social distancing is impossible. For countries where health systems are overwhelmed and asked that we use our social holiness to do what we can.

We finished with video messages from our sister churches around the world from, Bolivia, Rwanda, Australia, The Caribbean, and Italy. As Methodists we adapt one of  Wesley’s famously sayings ‘the world is our parish’.

Keep safe and let’s see what the next week brings us.

Coronavirus week 13 – The best and worst of the NHS – the old normal is back…

C₂₂H₂₉FO_{5 – the wonder drug}

As it is nearly 40 years since I was awarded a BA(Hons) in Chemistry, I think I can be forgiven for not being able to give the modern name for dexamethasone. This is the drug announced this week used to treat patients with Covid-19 resulting in reduced deaths for those receiving oxygen or on mechanical ventilators.

Nomenclature has changed since I taught chemistry for five years in the mid-80s. Looking back at the literature of the time it was called 9α-fluoro-16α-methylprednisolone or 6α-methyl-9α-fluoroprednisolone, but either way even having done a biochemistry module I am not sure I would have known it was a steroid derivative of the well-known drug hydrocortisone. One of the main topics I enjoyed was organic chemistry, that of carbon compounds. Looking through the 1,280 pages of Hendrickson, Cram and Hammond’s textbook from 1977 there is no mention of it, despite being used in a clinical way since 1961. To complete the confusion that people often express when I tell them I used to teach chemistry, it is always good to have a chemical structure to describe the compound. Here are two for this drug.

The slightly more modern version on the right shows the different elements hydrogen, oxygen and fluorine as different colours and the methyl (CH3-) structures as a dark triangle. My pharmacy consultant (and wife) Alyson tells me that I was on dexamethasone for a short time in 2012. I was in hospital for 12 weeks (the time we have been locked down now) with a brain abscess, and was given it to reduce the resultant swelling of my brain.

The research on dexamethasone done in British hospitals, with volunteer patients involved in the clinical trials, has been hailed as ground-breaking. The drug has potential to save tens of thousands of lives worldwide. It must be devastating for those who have lost loved ones who may have benefited from it. This and the amazing dedication of the care staff, cleaners, physios, pharmacists, therapists, doctors, nurses, and administrators demonstrate the best of our NHS. As a country and tax payers we need to fund them to the level required. We will have a thorough review and ‘learn the lessons’, but I fear that once ‘real life’ takes over and self-interest resumes its ‘normal life’, we will forget those weeks early on when as one voice we said ‘this can’t be allowed to happen again’.

The whole system needs a thorough rethink. There have been many reviews and reorganisations over the years, and it would be natural for those who work in it to think ‘oh no not again’.  The NHS needs rebuilding from the ground up, and possibly renaming. Before Covid-19 I think most people thought of the NHS mainly as the hospitals and local surgeries. In latter years, and certainly during the crisis, there have been concerns that care homes, mental health services, and some social care is linked to the NHS. Many people comment on ‘private business’ not getting involved in our health system as a bad thing. Well I have news for them, much of what we think of are ‘private businesses’. Community pharmacies which I worked in for over 20 years and Alyson has worked in for 40 now, are private limited companies owned mostly by pharmacists but some by medical wholesalers. The same is true of almost every doctor’s surgery who are businesses of doctors setup as a partnership of lead GPs who employ other GPs to help them. These private businesses operate as ‘contractors’ and are paid by Department for Health and Social Care (DHSC), itself only renamed in January 2018.  They are paid a rate for their services, whether that’s seeing patients, running clinics or dispensing prescription or carrying out medicine use reviews that is negotiated by their professional bodies with DHSC. It should not be a surprise that negotiating with what is in effect a ‘monopoly’ supplier is not one that leads to mass riches. What does surprise those doctors who visit pharmacies or chat to owners is unlike their partnerships, DHSC pays nothing towards premises or staffing costs of pharmacy businesses, or pay for the holding of large amounts of drug stocks. And don’t even get me on the subject of Dispensing Doctor practices – people who can write a prescription if they have too much stock of a particular drug, or choose the one that’s best for their business rather than the patient.

‘Business’ and the idea of accountability and competition has been part of the health service for many years, and now we have ‘Trusts’ who are independent organisations running services at a local or regional level. They contract to suppliers and surgeries, pharmacies and ‘buy in’ other services from blood and organ donation services, laboratory services and a host of other clinical ones. There are companies who contract for IT projects, finance, property building and maintenance, catering, cleaning etc. This started when I was still in pharmacy 20 years ago and even then I could see the problems of having local GPs on trusts. As with teachers and risk assessments I wrote about in an earlier blog, most GPs are not businesspeople and they can’t be blamed for conflicts of interest between their business and that of patients and other contractors.

Many governments have presided over reforms but the last major one by the coalition government in 2010 and overseen by Andrew Lansley has proven to be disastrous. Even before starting it drew criticism from a lot of areas. The idea of giving even more power to GPs and frontline staff and increased ‘competition’ on one level might seem like a good one, but in reality it led to a mix of systems and lack of any central accountability. The devolving of the social care and public health issues to local government foundered as the secretary of state for health, Jeremy Hunt, cut the budgets under the guise of ‘austerity measures’. The well-publicised ‘scandals’ with Mid Staffordshire NHS Trust and others in care homes can be laid at the lack of oversight on patient safety.  The organisation Public Health England (PHE) was formed as a result of abolishing Strategic Health Authorities (SHAs), and at the time several directors warned that this would compromise our ability to ‘fight any future pandemic’. SHA’s would have been able to lead on organising the local response and would have people on the ground able to conduct a ‘track and trace’ system. Andrew Lansley stepped down from government in 2015 and was rewarded for his efforts with a seat in the House of Lords.

Jeremy Hunt was the secretary of health who ignored the results of ‘Operation Cygnus’ in  October 2016 used to check the resilience of the NHS to respond to a pandemic (albeit one of influenza). As widely reported at the start of this pandemic, this led to a failure to replenish our stockpiles of PPE, antiviral drugs and ventilators. It is shocking to see him in recent weeks, as the now chair of the parliamentary health and social care select committee, taking the government to task over their failure on issues he was responsible for. When he was elected by MPs to this role in January there was a feeling that this conflict of interest might stop him questioning too much. It’s extraordinary to see the exact opposite happening, but his ability to wipe clean his own responsibility is equally unbelievable.

Andrew Lansley promised a ‘bottom up’ review but ended up with more ‘top down’ structures in place and setting up a whole series of ‘independent bodies’ to monitor things.

Several people have expressed surprise that hospices receive so little funding from DHSC and other government bodies that they have to rely on local fundraising and charitable status to continue. This was put in the spotlight early in the current crisis when fundraising stopped and no provision was forthcoming to help with PPE. If a national health service is supposed to cater for us from ‘cradle to grave’, what has gone so wrong that patients and their families who are facing the real end of the health system are left to donations and sales from charity shops for the provision of care to their loved ones. Another part of the health service that I have experience of, and which has been neglected are rehabilitation units. It seems Covid-19 is an illness that takes a terrible toll on survivors, with months of aftercare needed to even walk again. Many weeks on a ventilator in a medically-induced coma leads to mental health issues as well as physical weakness.

NHS IT provision, which I had some experience of when trying to implement the Electronic Prescription Service (EPS) in our pharmacy branches in 2005/6 was one riven with problems. With the help of our wholesalers and investment in NHS broadband we got all 50 branches setup just as we were sold to the Co-op. Alyson continued working in branch and even now, 14 years on, the system is not fully implemented and looks unlikely to be any time soon. Only recently can pharmacists see a very small amount of information held nationally on any patient who comes into their branchwhen they are away from the place they live. I know from personal experience that my local hospital, 15 miles from the one in another county and a separate trust where I was treated for my brain injury, can’t access any of my scans or records. This is why I have a lever arch folder with all my records and several CDs of my scans/x-rays that I can take in should it happen again.

As predicted by my sons in a blog six weeks ago NHS IT, or NHSX as it is now called, was criticised this week for the failure to deliver the NHS Test & Trace app, and are considering reverting to the Google/Apple model. As my chair of district tweeted;

In all the ‘clap for carers’ and accolades given to those in the health and care systems, we shouldn’t fall into the trap of thinking everyone is working for the common good. In an organisation of about 1.5 million people there will be some ‘bad apples’ and strong management and administration supported by decent pay and training is needed.

Our National Health service should be as much about prevention and encouragement to live a healthy lifestyle as it is about treating us when we fall ill. The effects of obesity, diabetes, heart disease and respiratory conditions on the death rate from coronavirus demonstrates this need. The savings made from prevention should outweigh the costs of later treatment.  Education, as in many things, is vital for health outcomes as is reducing poverty.

Let’s hope the next review takes all of the factors into account and, as I wrote last week, as a country we can fund the necessary changes. Our National Health Service has become a ‘Reactive Illness Programme’ (RIP), and needs to change, and quickly.

Other news this week

• The ‘old normal’ resurfaced in our area this week when 6,000 people attended raves in two separate areas of Manchester on Monday. Several people were stabbed, one girl allegedly raped and local people had to clear up the mess after everyone had left.
• Crime seems to be on the increase (or at least being more reported) and terror is back on our streets with the stabbings in Reading this weekend.
• There is more talk of reducing the social distancing requirements to one metre to get hospitality and self-catering holiday accommodation open.
• Dame Vera Lynn died this week at the age of 103. She was called the ‘forces sweetheart’ during World War Two and had shared her thoughts during the current crisis and her song was echoed in the address to the nation by our Queen when she said ‘we will meet again’.
• The Labour Party review on the reasons for disastrous results in December’s general election was published. It didn’t make comfortable reading for members of the party like me. We must work for Labour to produce policies which chime with the need to do things differently in relation to funding the new health and social care system, tackling poverty, improving education and closing the gap between the wealthy and poorer in society.
• The daily death announced totals continue to fall with the Monday-Friday total this week being 853 down from 1,065 last week (a fall of 20%). The total of deaths at the end of the week was 42,632.
• With numbers seemingly under control in European countries despite some local outbreaks in Germany, I looked again at the statistics on Johns Hopkins site and there are some awful looking graphs in other areas of the world. Here are the graphs for cases in Europe;
  
  
  These show that we are over the (first?) peak of infections. The story in two countries with presidents who think it is nothing to worry about, and are trying to get their country’s open again is not so hopeful…
  
  and note that the scales on these are tens of thousands rather than the thousands in Europe.
  The middle and far east countries are also showing curves which are concerning, with a ‘double peak’ for Iran. The cases are in hundreds but show no signs of decreasing.
  
  
• We need to start looking overseas again now that we are getting the UK cases down. There is concern from aid charities that helping less well-off countries will be harder now that the department for international development (DFID) and the UKAid agency has been subsumed into the Foreign Office. A move criticised by three recent former prime ministers from both Conservative and Labour.
• The debate and protests around racism and the ‘Black Lives Matter’ movement continued across the world.
• I was going to write that the demonstrations and actions of climate protestors, similar to the ones for Black Lives Matters with marches and ‘direct action’ had not resurfaced, when yesterday I saw an interview with Greta Thunberg saying that she was looking forward to going back to school in Sweden, and vowing to carry on campaigning.
• Greta’s target for criticism president Donald J Trump was back on the campaign trail with a ‘huge rally’ in Tulsa, Oklahoma where only 6,000 of a possible 19,000 seats were occupied despite over a million applications for tickets. For those who did attend there was little sign of masks or social distancing, and six of the organisers caught the virus. At the time of writing there are reports that Mr Trumps rally had been ‘turned over’ by teens and young people responding to campaigns on the Tik-Tok and K-Pop social media platforms applying for tickets then not turning up. Mr Trump said earlier in the week that a million supporters would come.

How has week 13 been for us?

Unfortunately we have another example of the ‘worst of the NHS’ in our household. Five weeks after Alyson applied to help out NHS 111 with taking phone calls from people who need to speak to a pharmacist, and after three polite chasing emails and responses from the HR team doing the ‘on-boarding’ stating that she will hear ‘in a few days’, there is still no sign of her contract or training plans. She has played her part by taking two more calls on the SOS NHS volunteering app.

We haven’t ventured to ‘non-essential shops’ yet and the crush at the Nike store in London and the lady interviewed in the Primark queue in Manchester who stated that she ‘felt like I’ve won the lottery’ didn’t pursuade us. We did go for another walk in Delamere Forest and had a picnic which was pleasant. The weather meant another postponement of meeting with friends in our garden, but we have a walk planned in a park further afield this week.

I have watched a couple of the Premier League football matches now live on ‘free tv’ and have been surprised how realistic the ‘virtual crowd noise’ is to make them seem more ‘normal’ despite empty stadiums. The  online radio commentary I heard for my team Middlesbrough was a sign of the ‘new normal’ being much like the old – we lost 3-0 and are looking at relegation again.

I had my first international Zoom with a call to our subcontractors’ office in India with the person who helps on the IT project I am doing. We have had training sessions with the team from our district who are attending the Methodist Conference in a week’s time. With over 300 representatives, Zoom will be in the form of a webinar where we can only see the person presenting and another speaker who wants to add to the debate. Voting will by the raising of a virtual hand or completing a poll on the screen, so the feedback on numbers should be much quicker than the usual manual count of raised hands in the conference hall.  I will write more about this next week. The conference service on Sunday will be at my now ‘virtual home church’ of Methodist Central Hall, Westminster in London.

Keep safe and let’s hope there is a safe further easing of lockdown in the coming week.

 

 

Life & Death – Coronavirus week 9 – easing the lockdown

We’re all in this together, again?

As I start this week’s account on Saturday afternoon, I wanted to resist commenting on the incident of government advisor Dominic Cummings trip to his parents’ home in Durham. But having just done so, I will leave it to the mainstream media, and the numerous self-appointed political commentators on social media, to report the story to what appears to be its inevitable conclusion as more details come out. It certainly appeared that the Transport Secretary, Grant Shapps had been ‘thrown under the bus’ at the daily briefing.

Instead I will confess that, however people have interpreted the ‘rules/guidance’ both during lockdown and now, we too have stretched them, or to be correct ‘broken them’. I confess to ‘excusing myself’ about driving faster than 70mph on the motorway on the basis that almost everyone else does, and to drive at exactly 70 or below puts us in danger from all the other ‘idiots’ who are speeding. There always appears to be a ‘get out’ clause if you judge it to be right in your own mind.

This week Alyson and I took advantage of the new guidance to drive outside our local area to a country park near Northwich. It was Alyson’s birthday and she was desperate to go for a walk somewhere else, and it is a place we have been birdwatching.  It is a 42-mile round-trip and it felt very strange to be driving even for half an hour. It felt very familiar as we queued in a traffic jam through roadworks over a closed bridge to get to the park. The car park was quite full and as we ate our picnic we wondered whether to come straight home. We didn’t need to pay & display as the machine was covered, presumably to avoid people touching the buttons, and everyone appeared to be keeping social distancing. The park is very large, so we walked to the birdwatching screen at the end of the lake. It was a sunny day and it appeared that there were family groups sitting alone enjoying the fresh air. We managed to pass other people with at least the required two metre gap. When we got to the bench seats at the screen which are about 15 metres long the only other person there, sat on the end, was our son Michael. He lives only two miles from the park, and I had text him to suggest he went as a birthday surprise for his mum. It worked, and Alyson was really pleased to see him. We chatted for a few minutes as he was on his lunch break from working at home. He looked healthy and happy. Alyson said afterwards that she just wanted to give him a hug. I ventured that Michael didn’t feel the same way! Have you spotted it yet? The current government guidance for this phase of easing the restrictions state;

I have highlighted the parts that make clear we broke the rules. Two of us met one other person outside our household to make a group larger than two. We excused ourselves as I sat two metres from Alyson and four from Michael and it ‘felt ok’. A lot of people will have done similar things over the weeks, using their own ‘excuses’. I know people who happen to have walked past their parents’ house with their child on their daily walk and stood at the end of the drive to talk to them, then later extended this by going through a garage (always keeping themselves two metres apart) to sit on chairs in the back garden and chat to grandparents. And if the young child who doesn’t understand social distancing happens to take a toy over to his grandparents, it doesn’t harm anyone else…. I have seen people who walk a dog in the morning and then the evening, presumably reasoning that it doesn’t do any harm.

There has been much discussion, some with a lot of hindsight, as to whether the lockdown was ‘too late’. It may have saved more lives, but even on the weekend of the 21st March, two days before lockdown was announced by the prime minister, I was emailing the owner of the lovely cottage in the north east we were staying in about renting it again the following weekend. I reasoned that it was so remote we could easily ‘self-isolate’, go for walks in the early morning from the door onto deserted moorland, take all the food we need, drive there and back on one tank of fuel etc etc. In the end we decided not to, which when we heard the ‘rules’ was the right thing. I even held out until the very end, that our week in Lanzarote could go ahead. 

I have re-watched two issues of BBC’s Question Time from March and even ten weeks on there are some things that are now shocking. On 6th March after the first death in the UK when there were 100 cases, health secretary Matt Hancock said that the majority of people will get minor symptoms and a few will need some extra care. There was laughter in the audience when a panellist talked about elbow bumping instead of handshaking, and another joked about not being able to find toilet roll. To be fair there was worry about older people and those who might not be able to go to work and claim sick pay. Matt Hancock said that the evidence was that large-scale sporting gatherings outside were not places where widespread infection spreading would happen.  It was in the ‘containment phase’ where the message was only people with symptoms had to self-isolate.  Professor John Ashton, former head of public health in north west England was on the panel on the 13th March, the night after the Liverpool v Real Madrid match at Anfield. His accent gave him away as a Liverpool fan, but he had stayed away, frightened that the virus had come to Merseyside and spread through the bars before and after the match. I watched this live and, like host Fiona Bruce, remember getting quite cross at what seemed a hysterical reaction when he started shouting about wasting four or five weeks already. 

The daily briefings had started,  but in my opinion there was no appetite for a full lockdown and if it had been imposed at the start of March compliance would have been much lower. Ironically, if it had happened and after two weeks ‘only 100 people a day’ were dying, people would have said ‘it was all a hoax and businesses are going to the wall so let us go back to work and school’. It is also clear that there were not enough tests available as we seemed pleased to be testing 2,000 a day.

For me, this week has been a rollercoaster of hope. One day I hear that the cases may be falling quickly and caught a clip on the radio of a scientist who believed that in a few months the virus would just die out. I started checking the booking sites for the holiday cottage in the north east. The next day there was talk of the virus being ‘with us for years, and life would never get back to normal….’.

It does seem that there is cause for hope. You don’t need to understand much about the way viruses spread to know that if there are no cases in your local population, it can’t spread. The origins of it may have been transmission from a mammal to humans, but that doesn’t happen spontaneously on suburban estates in the UK. New Zealand earlier in the week and Guernsey on Saturday released lockdown completely. They are both islands that have managed to almost full close their borders, and done lots of testing and tracking. New Zealand has a population of 4.82 million and only 21 deaths and on several days in the last three weeks no new cases, despite carrying out an average of 4,400 daily tests. Guernsey, a very small island with a population of 67,000 had no new cases for 22 days. There were pictures of families actually hugging grandparents. Shocking! But to repeat myself, you can’t catch the virus from someone who hasn’t got it. They have been developing ‘household bubbles’, firstly just two then last week putting 2+2 to make four households that don’t have to maintain social distancing. This very simple 3-minute video explains the approach;

This could be the way the UK government(s) decide to go. Let’s stay optimistic.

Test, Test, Test! or Education, Education, Education?

When the head of the World Health Organisation was asked for a message to countries fighting to control the spread of Coronavirus Pandemic in early March, his answer was very clear ‘Test, test, test’. It does seem that those countries who had a good testing regime allied to a system to do contact tracing, asking people who had the virus to isolate themselves, have managed to control the spread.

Former prime minister Tony Blair at the ‘New Labour’ Party Conference at Blackpool in 1996 gave a speech about his top three priorities if they were able to form the next government. He said ‘Education, Education, Education’.

Following on from last week’s blog, these two phrases have collided as the country tries to start ‘the new normal’ with schools being asked to start opening to more pupils. Teaching unions met with scientists and data has been published and discussed. There is still some uncertainty and natural concerns, specifically around the ability to do local testing and tracing. If we wait for a vaccine or 100% guarantees of no risk we will never get schools open. But with a combination of good risk assessments, the ability for schools or local authorities to determine phased opening in conjunction with parents, no sanctions for parents not wanting to send their children back, and exemptions for ‘vulnerable’ children and adults, backed with local testing hubs, it could work. We might even decide to ask parents to form ‘household bubbles’ based on the friends of very young children so that they can hug and go to each other’s houses to play. Some schools will wait two weeks which is the current time for infection rates to halve.

Other news this week

• The daily death count continued to fall even when ‘all situations’ were taken into account. The last four daily totals of 338, 351, 282 and 118 and the total of 36,793 appears to be a steeper decline than previous weeks.
• We clapped for carers for the 9th week on Thursday. I was pleased to learn that Dutch-born Londoner Annemarie Plas responsible for starting this initiative, suggesting that this coming week should be the last and tenth time. This will allow us to stop, reflect on the sacrifice and set a date in the future to remember again, perhaps annually. This will stop it going on and on and simply petering out gradually.
•  President Trump was causing concerns again with his announcement that he had been taking the anti-malaria drug hydroxychloroquine for two weeks. This is not a recognised prophylactic for the virus causing problems now, and even the US Food & Drug Administration (FDA) warn against its use. Being a pharmacist, Alyson has access to the online British National Formulary (BNF) of UK recommended drugs. She posted two pictures of the list of side effects on social media. I have highlighted two particular ones that President Trump should be aware of:
  More worrying than President Trump’s personal medication was a warning from the White House’s coronavirus taskforce member Dr Anthony Fauci that new localized outbreaks were “inevitable” as mitigation measures are relaxed, leading to the need to put in place a further lockdown. Given the dependence of the world’s economy on that of the US, however much we wish it didn’t, the decisions of the administration are vital to the rest of us.
• Airlines, travel agents, hotels and others in the tourism sector gave stark warnings of the economic effects on their businesses. Hertz Global Holdings Inc the US car hire firm, and Specialist Leisure Group, which owns coach company Shearings, both collapsed into administration. US business magazine Forbes stated;

Hertz was just another victim of the pandemic, people will say. It’s easy to blame the company’s misfortunes, as well as the other corporate casualties, on the pandemic. The reality is a different story. The failures of Hertz and the others have more to do with their own arrogant inertia and inability to recognize the fast-changing trends and a refusal to adapt their business models accordingly.

This is a narrative we will come back to when the whole economic story of the crisis is analysed. Some companies have been ‘found out’ by the pandemic while others have adapted in an economic equivalent of the evolutionary principle of ‘survival of the fittest’.

How has week 9 been for us?

We are conscious of the fortunate position we are in with regard to holidays. We have managed to get a full refund on our Lanzarote holiday, moved an Easter cottage and another Cottage in Ross-on-Wye, both with family, to the same weeks in 2021. This week the travel company moved a very expensive cruise in Norway to 2021, along with an upgrade and £45 credit.

We have been taking part in a UK Biobank project for over 12 years. They are a major national and international health resource, and a registered charity, with the aim of improving the prevention, diagnosis and treatment of a wide range of serious and life-threatening illnesses – including cancer, heart diseases, stroke, diabetes. We have been scanned, had blood taken and completed endless questionnaires on lifestyles. This week I received an email from them on behalf of Professor Sir Patrick Vallance, UK Government Chief Scientific Adviser. I volunteered to send a sample of my blood monthly for six months to be tested for coronavirus antibodies. The project will help the scientists track the course of the infection across the population.  As well as us ‘oldies’ aged 40-69 they needed some younger adults, so I sent invites to Michael and David.

This week I was very proud to wave Alyson off back to the ‘frontline’. It did feel a little like sending her off to war, as she set out with her mask, visor and hand gel to work a shift at a local community pharmacy. She had been desperate to play her part, but as she has a condition that would class her as vulnerable, she wanted to wait until safer conditions were in place. There was no way that she was going in at the start of the crisis with busy branches overwhelmed by customers and lots of other people working there. Her Saturday morning session was at a small local branch with screens between the customers and counter. You can see below pictures of some measures. There was only one other member of the team working so social distancing was easy to maintain. We have had a chat about her wishes should she contract Covid-19 and need to go into ICU.

Alyson also had an alarm on her phone go off as part of the local volunteering force. It was to call a lady recently discharged from hospital to check she was ok in terms of shopping, medication, loneliness and mental wellbeing. All was fine and she didn’t need to pass them on to anyone else.

Keep safe everyone and let’s see what the next week brings.

 

Life & Death – Coronavirus week 5 – what’s the next step?

An uncertain timescale, and new ways of working.

As the total passed 20,000 this week I fear the announcement of a high number deaths in the previous 24 hours is becoming part of our daily routine. I had some favourable comments about last week’s blog on statistics and am grateful to our son David for sending a publicly available link to the NHS Statistics site that details how these are compiled and it is at;

https://www.england.nhs.uk/statistics/statistical-work-areas/covid-19-daily-deaths/

David pointed out that the term ‘daily death toll’ is misleading as they are compiled from a series of numbers, some of which can be from a few weeks before. If you want to see how many have died in your local hospital trust these are on the different sheets in the spreadsheets.

The daily briefings are now showing some of the additional community and care home figures, which increases the totals. There has also been a discussion this week on how exactly registrations of death in the community are classified. The new guidelines allow for dying of Covid-19 or dying with Covid-19 and having one of the reasons as ‘pneumonia-like’ symptoms.

Looking at the current versions of the Johns Hopkins charts from last week’s blog, there is not really a definite ‘plateau’ in the figures, never mind any sign of a decline.

Unlike the virus, the shock of a high number of daily deaths appears to be something we are becoming immune to. Chief Medical Officer (CMO) Professor Chris Whitty suggested the current measures might need to be in place until the end of the year. The situation has been compared to a war, and in my less optimistic moments I worry that like the First World War when the ‘experts’ of the time, the military analysts, declared it would be ‘over by Christmas’, we will need to come to a more realistic appraisal. The first few months of the Great War were characterised by patriotic parades, rousing speeches, a general call to arms, volunteering and government spending. After Christmas, however, when it was clear that the proposed strategy of a short campaign followed by bringing enemies together to negotiate, was not working, countries had to change their economies and society and put them on a ‘war footing’ for the long-haul. Most of the time, however, I am optimistic that we can see out the current ‘war against an unseen enemy’, and a return to ‘normal’ is on the horizon.

No one wants to think of this war going on for a few years and our government having to borrow over 25% of Gross Domestic Product (GDP) annually, as happened in the two wars, compared to the short term 15-20% our chancellor has sanctioned so far. In the two wars GDP increased due to more production of munitions and uniforms etc. There is already some increased activity in sectors of the economy such as supermarkets, food manufacturers, logistics, suppliers of PPE and the pharmaceutical sector supplying medication and carrying out testing.  The problem (as it was during the previous wars) is that much of this expenditure is government-funded and needs to be repaid at some point.

An increasing theme of questions to ministers at the daily briefings, and from some of the government’s own MPs, has been a desire to talk about the plan to get out of lockdown.  The week started with former prime minister Tony Blair’s Foundation the Institute For Global Change producing an outline 10-point plan for how this might happen. It uses a ‘traffic light’ system of the metrics that would allow certain activities when an amber stage is reached, and more when a green might follow. If infections, hospitalisation and deaths start to climb again, it allows for a red stage and return to lockdown.

Nicola Sturgeon Scotland’s First Minister released a similar document to start what she called an ‘adult discussion’ about the gradual release of restrictions.  For example, on how schools might have to be adapted to keep social distancing measures. One of the opposition parties in Scotland claimed that this was as much to do with trying to have a separate track from the UK government, and to steal a march on the ‘English Parliament’, as it is a real attempt to plan.

We had an idea of how releasing the lockdown might look after I joined an ‘on-line queue’ last Sunday to place a small order with DIY retailer Wickes. We had a text on Tuesday when it was ready to collect. Alyson drove to an empty car park where a member of staff brought the order out and put it to one side for her to place in the car. It was so long since Alyson had been out that the car clock was an hour behind. Alyson was so excited that in a Shirley Valentine moment she said, ‘hello car, it’s been a long time, how are you doing?’. 

It may be that any retailer that wants to re-open, must think about making such adjustments and change the layout and operate a queue and collection system. As our good friend David said during a Skype call ‘every shop will be like Argos’. Talking to my brother-in-law Paul, on a Zoom call for Friday evening drinks, about Jaguar Land Rover (JLR) planning to restart production at two of their car plants, he said they will have ‘re-engineered’ the line. Paul knows about such things having been involved in similar plans before retirement. Instead of having two or three people working on the cars as they go down the line, the engineers will be changing the order and reprogramming the robots used to allow the build to continue within the ‘social distancing’ guidelines. Whether there will be the customers to buy the finished vehicles is a different question.

The UK is fortunate to have some really educated and clever people working in our small and large private and public enterprises. We must hope that, like JLR, they will have been working on ways to ‘re-engineer’ what they do in a ‘post-pandemic’ world. Some of these changes may have been the way to improved productivity anyway, and the space and time during this outbreak was needed to get them implemented. Other businesses less able to adapt and change and whose business model was not ‘fit for purpose’ will disappear.

Apparently a group of experts are meeting with the various sporting bodies to determine how the leagues and events might resume in May/June. There is talk of playing behind closed doors with safety measures in place for players/officials and broadcasters. I will return to this topic in the coming weeks, after more details are released. For now, I am curious how a game of football will look if players must keep two metres apart and the ball must be wiped down with sanitiser after every header or a throw by the goalkeepers!

For me the first few weeks of lockdown has brought an increasing number of video calls. Two months ago I knew about Skype, but Zoom was a new product to me. Such is the growth of this platform that, like Google, it has gone from being a noun to a verb quite quickly. We now say we are ‘having a Zoom’ with a colleague or we say we have ‘been Zooming our family’.  Looking back I have had 16 such meetings in the last fortnight and a few more 1-2-1’s helping people setup Zoom. This week we had our first ‘virtual coffee morning’ with members of the head injury charity I am trustee/volunteer for. Given one of our aims is to reduce the social isolation of people who suffer such injuries, I have no doubts that this is an aspect of our work that will continue whenever the situation gets back to ‘normal’. It was a wonderful time of sharing for the ten of us on the call from all over Cheshire.

Technology is another sector of our economy that is booming as people need to be setup for working from home. Some of this business-to-business (B2B) spending is from the private sector so, even if it is funded by borrowing, is adding to our GDP.

Another crisis in the nations’ health being stored for the future?

After last week’s headlines about the current crisis in the care sector, this week doctors leaders and Sir Simon Stevens, Chief Executive of the NHS, highlighted a fall in general attendance at hospitals and GP surgeries. There could be people who need on-going treatment for heart conditions, cancers and other serious issues not getting these. People showing other serious symptoms of stroke, early-warning signs of cancers are choosing not to get checked out. 

Related to this is the mental health of those who are isolated or trapped in homes with an abusive partner or parent. The increase in retail sales of alcohol, the boom in business for wine delivery merchants, some of which is the result of the closure of pubs and restaurants, should also be an area of serious concern.

Alyson and I are blessed to live as a couple with all the interaction that brings and so far are generally getting along amicably! I saw a piece on one of the news channels about the lack of ‘human touch’ that is becoming a real problem even for those who wouldn’t normally classify themselves as ‘touchy-feely’ types. This could be something as simple as a touch of a hand when upset or a hug with a child or grandchild. One new grandparent said, hopefully semi-seriously, ‘well perhaps I will get to see them before their first day of school…’

My thoughts have been with a church friend who lives on her own following the death of her husband last April. This lack of touch is becoming a real problem for her. She had to manage the anniversary of her husband’s death on her own, without the special touch from her son who lives 150 miles away. Her daughter lives in Australia and has a son who was born a few days after her husdand’s death. So she couldn’t even share a first birthday cuddle with him, just a ‘virtual cuddle’ via the ‘FaceTime’ app on an iPad.

Other news this week.

• Not a new item but a ‘correction’ from two weeks’ ago when I stated that the birds were singing more loudly as a sign of new life. During one of our virtual coffee chats with friends David and Janis, they sent a link to some research showing that the decibel volume of birdsong has actually fallen. This is true particularly in urban areas and near airports as they don’t have to compete with the ambient background traffic noise anymore.
• This week a potential vaccine against the coronavirus was injected into a human in the first stage of a trial. The remarkable speed at which this has happened is a chance for some optimism, but the scientists tell us that it will take months for any useful results to be available and analysed. In the rush to get this game-changer out to the world, great care needs to be taken to be sure that there are no side-effects that could make the harm done in the long-term far greater than the deaths of the outbreak.
• The science needed to understand vaccines and terms like re-infection rates, on-going immunity, blind trials, cohort selection, existing morbidities, aggravating factors etc are not simple. I tried to resist mentioning President Trump again this week, but his suggestion of injecting or inhaling disinfectants to ‘clean out the virus in a minute’ was not only dangerous but showed a complete lack of any of the science on which his experts have briefed him. I do think this quote, and his subsequent attempt to pass it off as sarcasm towards the reporters in the briefing room, will be seen as a ‘game-changer’ in the longer term. The idea that a President who has any sort of basic education is unable to see the difference of putting a powerful chemical on surfaces such as metal, porcelain or man-made plastics is no different to the delicate structure of skin or the inside of a human lung is frightening. It is like a parody of the story of ‘The Emperor’s New Clothes’ or in this case ‘The President’s New Coronavirus Treatment’ where everyone else can see it is completely ridiculous idea, but the person elected to lead thinks it is a brilliant one. Will any of his advisors or leaders in his administration have the courage to criticise him in public?
• There was some ‘outrage’ that Richard Branson would apply for a loan from the government to support his airline Virgin Atlantic. It was pointed out that he has a lot of personal wealth and despite putting his private island (valued at ‘only’ a few tens of millions of pounds) as an asset against the £500Million loan, his press was not favourable. I can see the need to support his employees in the UK, but this is one example for the government and big businesses to negotiate over. The ownership of the company by one of the major US airlines and the tax regimes they operate in needs considering. Denmark was one of the countries this week to announce that any company that hides some of its tax offshore, without true transparency, will not be allowed a loan.
• On Sunday morning it was announced that prime minister Boris Johnson had recovered enough from his coronavirus after effects to return to Downing Street and lead the government again. Writing as someone who has also come close to death during a 12-week stay in hospital, my hope is that the episode might have given him a new perspective on what really matters in life. The decisions he takes, the way he views the NHS and key workers, might mean a change in approach.

Thoughts at the end of week 5.

Covid-19 has claimed the life of another person I knew. Sharon was a local church treasurer in our circuit, and we talked at meetings. She had some other health problems, but the loss of any life, particularly from this virus, and the effect isolation has on close family is devastating.

The weather continued to be warm and dry so we enjoyed lovely walks outside viewing plants and wildlife. I went for two more substitute parkruns. The goods we managed to get from Wickes meant we could get on with work in the garden and complete painting the fence.

I have really enjoyed all my Zooming this week, particularly catching up with friends and family for coffee and chat.

Alyson continued learning her new skill of sign language and sewed a mask from cotton material should she need to wear it outside.

My lack of any new improved DIY skill was demonstrated by the fact that it has so far taken me over three hours to put up three simple shelves in our garden shed. The phrase ‘all the gear and no idea’ definitely applies to me. What made it worse was that the neighbour who backs onto our garden has made a whole Japanese design inspired pergola from scraps of wood in the same time. Complete with a decorative hand-carved finial. I looked on with some envy at the way he constructed it and used his power tools and screws in a way that I can only dream of. I will report how long it took to put my final shelf up in the next blog.

Stay safe and let’s see what week 6 brings.