Category: Technology

Coronavirus week 39 – Advent hope or Christmas cancelled?

It is 20 weeks since I did my last blog, or ‘CoronaDiary’ as it was named for the Swansea University project that it became part of. It seems a long time ago but serves to show how time passes quickly after I decided that the time had come to stop, with things apparently starting to ‘slow down’, ‘getting under control’, ‘living with the new normal’ or any number of ways of describing life in late summer/early autumn. There was also a possible vaccine in development.

I started several times to write another instalment as events and key points in the story of this year were reached, but each time my enthusiasm to finish them waned. Due in part I suspect to not wanting to repeat the same themes I had visited before, but mainly due to the fact that we too were doing some of the things we hadn’t been able to. We were fortunate to be in a situation where we could take a week away to each of the Norfolk coast, Cornwall and North Yorkshire. In addition we enjoyed days out walking around the Cheshire countryside and Alyson managed some open water swimming at a nearby lake in Shropshire. The project I am working on with the accountancy practice in Sale was reaching the critical ‘go-live’ point, and Alyson was getting more NHS 111 home-based call centre shifts.

Deaths – a change of measure but still increasing quickly..

I had set myself the target of writing another blog when the official figures for the number of coronavirus deaths reached the level they were at my last blog, as the government reassessed them, just after I published it, in light of some ‘mis-recording’. On 12 August, the total fell by 5,000 overnight from 46,706 to 41,329. Until then a death was recorded for anyone who had tested positive for Covid-19 at any time, regardless of the cause. So someone who had died of a heart attack or in a car accident but had a positive test 10 weeks before was added to the virus statistics. It would take another 11 weeks to get back to 46,513 at the end of October – an average of 71 deaths per week. Just over 7 weeks later we have surpassed the grim figure of 60,000 to reach 68,307 – an average of 3,113 per week. The other measure of all deaths where coronavirus is mentioned on the certificate is likely to be over 80,000 by the end of the year.

Key events I could have written about…

There have been some major issues and milestones in the time since my last blog. Ones I have had strong feelings about are;
– The exam results ‘fiasco’
– The on-going story of migrants drowning whilst crossing the channel, and my idea of requisitioning unused cruise ships anchored off the south coast to give them decent accommodation.
– Introduction of the tiers system of restrictions
– My (and many others) perception that GPs are hiding away
– Schools and universities returning to full-time teaching
– A study I read on how the virus circulates indoor via ‘aerosol particles’
– ‘Circuit-breaker’ or second national lockdown
– President Trump catching Covid-19, US Election & refusal to accept the result
– Announcing the vaccination program earlier than planned on the day the report into the Home Secretary Priti Patel’s bullying behaviour was published.
– The seemingly endless Brexit negotiations/deadlines and extensions.

So why now…

The recent excitement over the new vaccines, the hope that brings of a ‘light at the end of the tunnel’, allied to planning for a small family Christmas get together was shattered by yesterday’s Government Briefing. Our Prime Minister, the only one in the World known mainly by his first name, Boris announced a new ‘Tier 4’ for London and the South East plus severe restrictions on ‘Christmas bubbles’ and the time they are allowed to meet. It seems like another one of the many ‘key points’ in the pandemic, coming as it does with the fact that a ‘new strain’ of the coronavirus that is much more effective at transmission is circulating and spreading rapidly through the population. The disease is called Covid-19 because it was in late December last year that the WHO office in China reported a ‘new type of pneumonia virus’ being reported in the area around the city of Wuhan. Whilst there is still some dispute about where it originated, the virus has been traced back to cases in mid-November. The first anniversary of the discovery of what we now call SARS-CoV-2 seems like a significant event to record in my blog.

For those with an interest in the science, the new variant is being referred to as SARS-CoV-2 VUI 202012/01 and the more detailed description of the mutation is as follows;

This variant has a mutation in the receptor binding domain (RBD) of the spike protein at position 501, where amino acid asparagine (N) has been replaced with tyrosine (Y). The shorthand for this mutation is N501Y, sometimes noted as S:N501Y to specify that it is in the spike protein. This variant carries many other mutations, including a double deletion (positions 69 and 70).

US Centers For Disease Control and Prevention, Emerging Variants Briefing December 2020.

It is this variation in the ‘spike protein’ that scientists think accounts for its ability for increased transmission by better binding to cells in people who get infected by the virus. It remains to be seen if the symptoms are more severe or if it is resistant to the vaccine, but the early signs are ‘hopeful’. What will certainly be the case is that the number of infections will rise and given the pattern up to now, many people will need some treatment in hospitals. This is the factor that may lead to ‘Lockdown v3.0’ and more damage to mental health and the economy.

In recent weeks I have been leading four sessions on the season of Advent with our church Bible study group and there are some themes which resonate with the current situation. As we approach the end of an extraordinary year and try to look forward to 2021 it seems an opportune moment to write down my personal thoughts and feelings. This blog has always been for my own reference, but I continue to be grateful for all the comments it attracts as each one is published.

Advent – the season of waiting – 2020 theme ‘Hope’….

It is only in the last few years, after 50+ years of being part the ‘Methodist Tradition’ through my church membership, that I have understood the ‘true meaning’ of Advent. For many it is ‘just the few weeks before Christmas’ but it is so much more than that. It is a time of ‘waiting’ and ‘anticipation’ during which we are called to lament/repent for all that has gone before and wait for the arrival of the long-promised ‘Light of the World’ to arrive in the form of a small child. Our fellow Christians in the Church of England, or ‘the Anglican Tradition’ recognise this in a more formal way. In the build up to Christmas they don’t sing ‘traditional carols’ and for them Christmas starts on the eve of the 25th December. It lasts for 12 days until Epiphany on the 6th January.

This year in the ‘real world’, the commercial one and the one that the church has hijacked from the original pagan ‘winter festival’, after all the upheaval of Covid and the challenges and illness and death, there has been a desire to ‘go early’. When I worked in retail pharmacy we would have started to plan for all the Christmas stock arrival earlier in the year. Indeed, during my time as Managing Director of our ‘Pharmacy Sundries’ subsidiary company, January would see me and the sales team attending trade fairs in the UK and Frankfurt in Germany, to meet suppliers from all over the globe to purchase, and in some cases ‘design’, the gifts our stores would sell during the ‘Christmas Season’. Stock would be ordered, shipped from China or India or wherever the suppliers were based, duty paid, containers received and unloaded at the warehouse, and delivered to the shops by a small fleet of vans ready to fill the shelves. There was always a tension between the warehouse wanting to get stock out (and our small company to invoice the larger one!) and the shops saying it was ‘too early’. In the end together with the retail marketing team for the shops we agreed a rough policy that, whilst stock could be delivered during September the, ‘big reveal’ would happen after the solemn celebration of Remembrance had taken place on November 11th. After that it was ‘all hands on deck’ to shift as much as we could. On a really good year our shops would be calling the warehouse in the second week of December pleading for us to send more – the items we had chosen that they were sceptical of selling were flying off the shelves. In the last week it might get to the point that shoppers were so desperate for a gift that even the stock we had left from previous years would look like the ideal gift for a family member!

It seems that a lot of people after the year they have had decided to ‘go early’. There was a rush to put up Christmas lights and decorations not just earlier but in bigger volumes than before. Around our estate there are so many whole garden displays and inflatable characters they can probably be seen from space! Goodness only knows what the electricity bills will be like in January. Shops have sold out and many Christmas tree growers have shut as all the stock has gone. There is an understandable desire from people wanting to celebrate and have something to look forward to. I confess to liking it, but it can get a bit wearing listening to hours of the old pop Christmas favourites from the 70s and 80s.

The theme for the Advent study we chose this year was ‘Hope’ which seemed appropriate for the year and is one aspect of the season along with joy, peace and love. As churches we have readings about John the Baptist and the Old Testament Prophets foretelling the arrival of The Messiah, the story of Mary and the journey towards Bethlehem. Many of us light four candles (and many ministers refer to the classic sketch on The Two Ronnies!) coloured red in an Advent wreath of holly, lighting the fifth white candle in the middle on Christmas day to represent Jesus. .

In many of our times of study we referenced the difficult times we have had during the pandemic. We would lament people we have lost, pray for support for those going through difficult times, missing friends and family contact, particularly those who know people in care homes or have not been able to attend the funeral of a family member. We have given thanks for the key workers helping us through difficult times. More recently we have given thanks for the God-given skills of the scientists for developing the vaccines, the hope that brings and the ability to start ‘looking forward’ in anticipation of a better 2021. Many of the Christmas cards we have received, had a handwritten note to reflect this hope too.

Watching Boris, Professor Chris Whitty, Chief Medical Officer and Sir Patrick Vallance, Government Chief Scientific Adviser on Saturday evening announcing the new ‘Tier 4’ measures, and limiting even more the Christmas travel and bubble arrangements, it would have been easy to find a new low of depression, and lack of optimism. Sunday morning’s news headlines on television and in the print media could be summed up as ‘Christmas Cancelled’. During the summer and into the early autumn with infection rates falling, deaths levelling-off to a figure that we could probably live with, health services opening, people going back to work and children to school, things appeared a little brighter. Despite having to take a lot of measures on our holiday in Norfolk and again when we went to the lodge in Great Ayton, North Yorkshire, and the early figures for the ‘second wave’ seeming not to be as high as the first, my optimism was still there.

It was whilst ‘attending’ (via You Tube) the live streamed service from Methodist Central Hall Westminster (MCHW) on Sunday morning that I decided to write this blog. MCHW of course is now in Tier 4 so the chances of a few people attending the church physically on Christmas Day has gone. The reading was about Mary and her willingness to carry the child that would become our Saviour. We sang Joy To The World and O Come All Ye Faithful and accepted the challenge from Rev Gordon to take up whatever challenges we will face in the coming months. Both Gordon and Rev Tony who leads the service said that although we were in lockdown, Christmas itself wasn’t cancelled. Tony said he had received a humorous text about there being ‘only 370 more sleeps to Christmas’ but he wanted to state that wasn’t true. I posted the image below on my Facebook page on Monday and it attracted many likes…

The commercial ‘winter festival’ may have been curtailed and many would not be able to see family and friends, but nothing is going to stop Christmas being Christmas for Christians. It brought to mind this tweet from earlier in the week reminding us that other religions had their celebrations ‘cancelled’ at even shorter notice – in some cases the evening before the big family gatherings.

Admittedly, some replies pointed out that Easter was ‘cancelled’ at the start of lockdown and, as happens on social media these days, there were plenty of racist comments, but the point was the same one I had made the night before Eid. ‘Imagine the uproar if they cancelled Christmas…’

The most striking interview I saw on Sunday morning was with Rev Justin Welby, Archbishop of Canterbury on the BBC’s Andrew Marr Show. It appeared to me that the leader of our national church was shaken by the events of Saturday and, like many of us, struggling with an inner voice that was saying to him ‘I am really not sure that my faith is strong enough for this…’. But he found another inner voice and rallied to assure us that Christmas would indeed happen on the appointed day. He also talked movingly about the ‘hole in the celebration’ left by those who can’t be with us, either because they have died or are alone in a place we can’t travel to. He encouraged us all to celebrate the great festival by remembering those who have died, talking about them, and for those who are isolated to pick up the phone and speak to them. He encouraged the vulnerable not to attend church but to call one of the many phone numbers with services, carols or prayers being broadcast.

Some of the many people with a spare place at the table are the family of our school friend Clare who died in November aged just 61 from motor neurone disease diagnosed five years ago. Clare is the first of our contemporaries that we have kept in touch with for over 50 years to go. It is as much a sobering reminder of our own mortality as it is sad. It was also our first (and probably not last) ‘virtual funeral’, we watched the live stream whilst listening to the music chosen by Clare herself on You Tube.

As I sang along watching the service from Westminster to O Come All You Faithful I remembered the Christmas of 2016 when my dad died. We were celebrating at a cottage on the North York Moors with Alyson’s family. Dad was on end-of-life care in a nursing home nearby, and died the day we were leaving the cottage. You can read about that in the blog that I wrote at the time . I asked the minister if we could sing the hymn at dad’s funeral as he was a long-time member of the church choir and hadn’t managed to sing it that year. Rev Ruth said that it was a great idea and all we needed to change was the last verse usually sung on Christmas Day from ‘Yea we greet thee born this happy morning’ to …that happy morning..’. Alyson’s dad who was 90 and not in good health gave a short speech during Christmas Day lunch suggesting that this might be the last one he had with us. He died later that year in October.

So we had two Christmases in a row with spare places at the table. Such is the ‘circle of life’, we have lost Alyson’s mum since, but this year we have two small boys born to our nieces since. They represent the joy, love and hope of the Advent season.

Final thoughts and looking to the future…

There will be three households with us on Christmas Day, but only four people – Alyson and I, and our two sons who are single-person households. We will social distance as much as we can and maybe even eat outside. Other than that we have several ‘Zoom’ catch-ups planned with other family members and friends. We had one last weekend with my brothers and cousins (my older brother lives in San Jose California, 6 miles from the global Zoom HQ so was supporting one of his ‘local businesses’!). We have had one ‘virtual Christmas party’ with the head injury charity I am a member and trustee of. Ready-made meals were delivered along with a box of crackers, hats and gifts. We played charades, told jokes from the crackers and even tried to sing some carols. A great time was had by all who attended.

I heard from another friend that the company he works at had a ‘Zoom office party’ that started at 8pm and for some people went on until 6am. Apparently, the ability to drink and not have to drive home led to some problems with people saying and doing things that they would regret when reading the ‘chat’ the next day. So it seems a virtual party can be as good or bad as a real-world one!

I like to think I have always been generally an optimistic person, trying to see the positive in both situations and in people I meet. Alyson thinks I am a bit too laid back and even naive, and reminds me that earlier in the year I was still hoping that we would be able to get a sunny holiday overseas and was one of those who said it would be all over by Christmas. I try to find hope in the vaccination program but recognise that our governments record for ‘ramping up’ the testing capacity could induce pessimism that our ability to vaccinate the estimated 16.5 million people aged over 60. To get this done before Easter, considering the five weeks to achieve full immunity, will require an average of two million vaccinations each week. There have been half a million people vaccinated in the two weeks since 90-year-old Margaret Keenan became the first person on 8 December. We need an eight-fold increase in that rate if we are to reach the Easter target.

As I reflect on the end of a very strange and difficult year, my faith is strong, and my optimism remains at a high level. The hours of daylight are increasing from today, and I am looking forward to 2021

 

 

 

 

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

C22H29FO5 – 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 10 – taking things one day at a time

Week  10 in daily format.

I usually start these blogs at the end of the week but decided today that I will try doing a ‘daily’ note. This will allow me to capture my thoughts in real time and my mood in relation to events around the crisis. I will review and correct some grammar and shorten sections prior to publishing, but the essence of the days won’t change.

Monday 25th May – ‘I have never been so angry..’

Having made a determined effort in last week’s blog not to write much about Dominic Cummings, the story of his 260 mile trip to Durham, and Boris Johnson’s ‘defence’ of his actions at Sunday’s daily briefing, I woke up this morning quite angry. Not about the actions of the senior advisor, but more that I was so distracted by the whole thing that I missed a huge section of the blog which I had planned to cover.

Sunday 24th May was, for Methodists like me a special day. It is called  ‘Aldersgate Sunday’ formerly ‘Wesley Day’. As the web site for the Methodist Church in Great Britain explains;

In May 1738, John unwillingly attended worship at a Moravian ‘Religious Society’ meeting on Aldersgate Street in London. It was during this service that he felt his “heart strangely warmed”, as he experienced God’s love in a most personal and life-giving way. Until then he had known God in his mind, but not in his heart. Now he understood the value of a personal experience of God that would bring assurance of salvation to the believer.

This year the 24th fell on a Sunday so that made it even more relevant. Not so reluctantly as John Wesley, I attended a streamed service from Methodist Central Hall in London, just over two miles from Aldersgate Street in the City of London.  It was a wonderful service with over 1,500 watching. It was also the last service of their minister Rev Dr Martyn Atkins, former President of the Conference who was ‘retiring’ or as we call it ‘sitting down’ after over 40 years of service to his church. He was what we call ‘one of Mr Wesley’s preachers’, who had been ‘stationed’ in various places across the country as ministers in our denomination are called to be ‘itinerant’, usually staying in one place for around 10 years and then moving to another ‘appointment’ .

The penultimate service I attended in church before they were closed for lockdown was at Methodist Central Hall on 1st February. We were down in London for a visit and, never having been there, I decided to go for the Sunday service. It is an impressive place, built from the donations of one million Methodists, including members of my mum and dad’s families. Martyn was preaching and gave a challenging message about putting on the ‘armour of God’. I received a blessing and was anointed with oil by one of the Deacons at the end of the service. I  managed a few words with Martyn as we had briefly met a couple of years previously. It was in a small room at one of our closed churches, repurposed as a second-hand bookshop raising funds for the museum of Methodism at Englesea Brook Chapel, which is in our circuit between Crewe & Alsager. I was dropping some books off and Martyn was chatting to our Superintendent minister who worked there on his days off. Martyn had written an article for the ‘Methodist Recorder’ that came out that day and which was a challenge to modernise, and I told him it was thoughtful and a great piece. Martyn didn’t remember the conversation but knows the bookshop as he is a great collector of books, and said he would be going there a lot in the future as he and his wife are moving back to Derbyshire, less than an hour away from Alsager.

So, my anger was about not mentioning all that in last week’s blog.

However, the anger referred to in the heading of this section is my wife Alyson’s. Having never been ‘political’ before, she found the email address of our local MP this morning and wrote to him to express her anger at the situation over Dominic Cummings and her disappointment at the way Boris Johnson has handled it. I don’t think Alyson will mind me saying that her natural inclination is not to vote Labour. As a pharmacist and frontline worker who has seen the effects of coronavirus on her patients she wanted her MP to know. He is Dr Kieran Mullan who worked in the accident & emergency department prior to becoming our local MP for the conservatives and has gone back to work some shifts. It will be interesting to see if she gets a reply.

Neither of our moods was improved after the two press conferences that evening. The extraordinary lengthy one with the special advisor in which he showed no regrets but tried to explain why he could make special arrangements for his family. Followed an hour later by one with Boris Johnson. No one, particularly the journalists, was listening to details of how lockdown was to be eased by opening of shops and secondary schools in mid-June. Everyone wanted to keep talking about Mr Cummings. As the day ended the special advisor was still in place, left to be judged in the court of public opinion.

I sat and wrote my own email to Dr Mullan MP.

Tuesday 26th May – hey ho, hey ho, it’s back to work we go..

When the prime minister told the country two weeks ago to get back to work, I didn’t think it applied to me. I was enjoying my semi-retirement, time with Alyson, the warm weather and helping my church and the charities I am involved with. However, at 9.30am I found myself attending a Zoom ‘Monday Morning Meeting’ (moved due to yesterday’s Bank Holiday) with 18 of my new colleagues at an accountancy practice in Manchester.

My friend Steve had asked me back to do another systems project for his new company. If Alyson and I had been managing to take all the holidays that we had planned, there was no way I could have said yes. Truth be known I had some doubts about my ability but after a couple of meetings and 1-2-1’s my interest, and not a little ‘excitement’, was back. It took most of my day, and I had foregone the usual early morning exercise.

Meanwhile Dominic Cummings was still in his job, despite one ministerial resignation and a ‘revolt’ of 30 MPs and literally thousands of similar emails like mine to local MPs. It was left once again to the BBC ‘s Newsnight presenter Emily Maitlis in her opening ‘monologue’ to sum up as follows

Dominic Cummings broke the rules. The country can see that and it’s shocked that the government can’t. The longer ministers and the prime minister tell us he worked within them, the more angry the response to this scandal is likely to be.  He was the man remember who got the public mood, who tagged the lazy label ‘elite’ on those who disagreed. He should understand that public mood now; one of fury, contempt and anguish. He made those who struggled to keep the rules feel like fools and has allowed many more to feel they can flout them. The prime minister knows all this, but despite the resignation of one minister, growing unease from his backbenchers, a dramatic early warning from the polls, deep national disquiet, Boris Johnson has chosen to ignore it. Tonight we consider what this blind loyalty means about the workings of ‘Number Ten’. We do not expect to be joined by a government minister but that won’t stop us asking the questions.

Wednesday 27th May

Today was a warm one and started with my weekly 5k ‘local Parkrun’ which I have been doing as the usual Saturday morning one, I have done since 2016, has been suspended as part of the lockdown measures. We ate all three meals outside on our patio table and were delighted to see a pair of young goldfinches on our feeders.

The numbers of Conservative MPs asking for Dominic Cummings to  be sacked was over 40, and the prime minister was before a committee of senior members of parliament from all political parties. Their questions were supposed to be on his performance in the new parliament which started in December. However, they too concentrated a lot on his special advisor and what effect it might have in getting the message over for the rest of the pandemic.

Health secretary Matt Hancock tried to distract from the Cummings story by changing the sign on the podium at the daily press conference announcing the NHS test and trace strategy to help ease the lockdown. He was ambushed by the video question from a member of the public asking if everyone who had been fined for travelling to arrange childcare would have the money refunded. Perhaps taken aback by the questioner being,  as he so tweely described him, ‘a man of the cloth’, he desperately searched for an answer and promised to take it back and ask the treasury. The next day the answer came back – ‘no’.

At 9pm I logged onto the American businessman Elon Musk’s SpaceX website to watch a live stream of his Falcon 9 reusable rocket taking men into space in a Dragon spaceship that sits on top and carries astronauts Bob Behnken and Doug Hurley. It will dock with the International Space Station (ISS) and then return to earth. This was the first time since 2011, and it was cancelled with 17 minutes to go due to storm clouds. I looked forward to the second try on Saturday.

The virus touched this event when a photo of people watching the launch from a road bridge nearby caused a social media storm around social distancing and accusations that the picture in USA Today was an old one. I read an account on the paper’s blog that showed the picture from 2011 and you can see not quite so many  people, and some in the today’s one wearing masks.

We have watched the launch of a small rocket from a beach nearby the Kennedy Space Centre during a visit in 1994, so can understand the interest of locals in such a massive event.

Just before turning off my laptop to go to bed I made a sign parodying the one on  the daily briefing podium. Having done so, I almost deleted it immediately, worrying if such a thing was ok. I posted it on Facebook and Tweeted it to Rev Helen Kirk, our own Chair of District or ‘woman of the cloth’!

Thursday 28th May

The tactics seemed to work as the prime minister’s special advisor was not the top headline on news bulletins. My ‘funny’ podium sign was retweeted by Helen and liked on Facebook, so guess it was ok. This was the exchange between Helen and me.

When we had a coffee via Skype with friends David & Janis it was something they were annoyed about. Janis knows the road to Barnard Castle where the now infamous ‘test drive’ was taken and thought it unsuitable as a check for the type of journey back to London.

It was another very warm day and we had meals outside and did more work on the garden.

The evening briefing, after the cabinet had done their legally required 3-weekly review, brought news of another ‘easing’ of the lockdown measures. From next Monday we will be able to meet in groups of six in a garden or outside space, some non-essential shops, outdoor markets and car show rooms can open from the 8th of June.  Premier League matches would start from 17th June behind closed doors. Boris Johnson stated that he wanted to ‘draw a line’ under the Cummings affair and move on ‘as the country wanted’. Journalists had other ideas and asked more questions about the ‘illegal trip’, even trying to involve the Chief Scientist and Chief Medical Officer in the questions. There were questions about how people might hold ‘socially distancing barbecues’ in their gardens, and what if someone wanted to use a toilet in the house. Scotland, Wales and Northern Ireland announced different measures from England, just to add to the confusion.

The evening brought the tenth and final clap for carers. It was well supported and loud on our street, but it felt like the right time to end it.

Friday 29th May

We had planned to get up very early, have breakfast, drive to Delamere Forest, and see if we could manage a walk without getting too close to other people. We arrived at 8.45am and walked to a small isolated lake surrounded by some beautiful yellow orchids. It was not too busy with people, but there was a lot of litter from visitors over recent days. We resolved to take bags and collect it if we came again. We saw a lot of birds, went on a rope swing under a tree, and walked the parkrun course.  We arrived home by mid-morning and sat in our warm garden for lunch.

Alyson commented during the walk that it seemed odd to be in such a peaceful place surrounded by life when there were thousands of people in hospital fighting for their lives. I said that most days were like that, but it had been heightened in the last three months.

Rishi Sunak, Chancellor of the exchequer announced an extension of the furlough scheme and support for the self-employed until October.  It was at a slightly lower rate and employers were going to contribute towards the costs. Employees can go back part-time under the scheme.

We watched the last of the daily  BBC Two ‘Springwatch’ reports. It has been a joy to see all the birds nesting and trying to survive. Insights into nature, and a new section of ‘mindfulness’ where they show 90 seconds of pictures with no commentary. We have had river valleys, woodlands, seaside, and tonight’s was lakes and mountains. Wonderful.

This was followed by the satirical program Have I Got News For You, and we were back to Dominic Cummings again. The fun (laced with real anger) they had with the story reached new levels of satire. Apparently there is a Durham slang of ‘that’s a load Barney Castle’ meaning a pathetic excuse. It originates from medieval saying based on a siege in the castle. As one famous columnist is fond of saying ‘You couldn’t make it up!’.

Saturday 30th May

Another bright and sunny day. I got a new PB for my new regular ‘local parkrun’ and like every other week I finished in first place! Alyson was back on the frontline working a morning shift in a community pharmacy. It was again one where she felt safe with one patient at a time.

Two members of the Scientific Advisory Group on Emergencies (SAGE) broke ranks to voice concern about easing lockdown restrictions too early, risking a second wave and peak of infections. There was a worry that having announced on Thursday that people could meet up in larger groups for a barbecue in gardens, some would start early with the forecast sunny weekend. Our neighbours had two families together in their garden with little evidence of social distancing, and on Alyson’s afternoon walk she saw a group of youths playing a football game.

I watched the SpaceX mission finally take off to the ISS at 8.22pm. It was a spectacular event.

Sunday 31st May

Harold Wilson, labour prime minister in the 1960’s is quoted telling lobbyists before a general election, when it wasn’t looking good, ‘a week is a long time in politics’. He won the election with an increased majority. Well, it is a week since the papers and television were full of stories and accusations about a trip to Durham. It felt at the time like Mr Cummings would be sacked, especially after another day trip to Barnard Castle came out. Boris Johnson decided to try to ride out the storm, pushback on any questions, and focus on getting the next steps of easing restrictions out. It appears to have worked. The news today was of opening schools and some shops tomorrow, and the overnight announcement that those who have been ‘shielding’, and locked in their own homes for the last ten weeks are to be allowed out for walks in the local area but still not to go to shops. They can meet up with one person from another household in the open air but must maintain social distancing. As the virus is around less than it was the chances of infection have gone from 1 in 40 at the start of their self-isolation to 1 in 1,000 now.

This Sunday in the church year is Pentecost (what used to be called Whitsun), the anniversary of the formation of the early church and the day the first ‘sermon’ was preached by Simon Peter after the coming of the Holy Spirit. Watching the service streamed from Methodist Central Hall, preacher Rev Howard Mellor reminded us that the disciples had been effectively in ‘lockdown’ for coming up to 50 days waiting for the next stage in their work.  The image with tongues of fire raining down reminded me both of the fires burning in the US from the protests over the killings of the unarmed black man George Floyd by a white policemen in Minneapolis, and the power of the burning of kerosene and liquid oxygen that took the two NASA astronauts towards the ISS. The US riots had spread to many more cities overnight with more fires and looting. There was little social distancing going on there or at the protests in central London.

I watched the live stream of the docking manoeuvre on SpaceX’s web site as the Dragon-2 spacecraft gently attached to ISS. Despite the seemingly ‘slow and careful’ way the two vehicles came together; we were reminded by the commentator on the video that the two vehicles were travelling at 7.66km per second or over 17,000 miles per hour. As I watched the spaceship close in ‘slowly’ for the last 20 metres between the two vehicles which took just over a minute, they travelled over 300 miles or the distance from Crewe to Land’s End! All at 260 miles above the earth. Over 1.3 million people were watching live on-line.   Docking happened at 3:16pm and the alarm on my phone went off. It is set to remind me of the famous Bible verse John 3:16. My mind went back to the time last November when I stood on steps on top of the Hulda Gate up to the temple at the centre of the ancient city of Jerusalem. Our guide told us that when astronaut Neil Armstrong stood on them he said

I am more excited stepping on these stones than I was stepping on the moon.”

It was seeing earth from the Apollo spacecraft and from the moon that reinforced Armstrong’s belief in something larger than humanity. He had been brought up in a Methodist family and on return from the moon he gave a speech in front of the U.S. Congress in which he thanked them for giving him the opportunity to see some of the grandest views of the Creator.

The final daily briefing of the week gave the figures for deaths on Saturday as 113 compared to 215 on Friday and 324 on Thursday. The total of deaths at the end of week 10 was 38,489.

We shared a weekly family Zoom with the boys. David was happy to be back on the river Avon after his second session of solo rowing from his club in Bath. He had also managed a short swim as he capsized his single-seater boat!  Michael had been walking in Delamere again.

Alyson has arranged for a friend from her ‘knit & natter’ group to come around tomorrow and sit in our garden to share a coffee. We are planning to meet up with her sister and husband for a walk somewhere between our home and theirs in Coventry.

Next week I am planning to look at a single issue related to the pandemic, perhaps the future of the health and social care services, or the costs of repaying the huge financial debts the government support has built up.

Keep safe.

 

Life & Death – Coronavirus week 7 – preparing for the ‘new normal’

Using technology for good – to help us ‘ease the lockdown’.

In terms of the coronavirus pandemic, week 7 was one in which we all speculated on what Boris would announce during his ‘address to the nation’ on Sunday by way of a ‘road map’ for lifting the restrictions. Lots of documents were ‘leaked’ and guidelines for certain businesses were published on the .gov.uk web site.

At the start of the week daily death totals (now in all situations) didn’t appear to be falling as quickly as many had hoped, but the last two days’ figures of 346 and 269 were lower, even for a Bank Holiday. By Sunday evening the number of lives lost was 31,855. On a purely numerical measure the UK is second to the US in terms of total deaths. There were more discussions on international comparisons. I have written in previous weeks about statistics and the difficulty of comparing countries. Factors such as the age profile, ethnic mix, housing density in cities, poverty and whether a country is an international ‘transport hub’ need to be considered.

Another topic that took up a lot of time during news bulletins and daily briefings was the launch of a ‘Track Test Trace’ (TTT) application for mobile phones. This is an example of ‘using technology for the good of society’.

On a basic level everyone who downloads the app to their smartphone can collect data about close contact with others who have the same app. If someone shows symptoms of infection by coronavirus they complete some details on the app and a central server sends a message to all of the people they have been in contact with over recent days informing them of steps they need to take. As with all ‘technology’ and especially programmes or apps, things are not so simple as I explain below.

My life using information technology for almost 40 years could be the subject of another blog. Even though one of my sons, now in his 30s, recently called me a ‘dinosaur’ for asking what I considered a reasonable question about how he implements systems in the complex world of on-line and mobile banking apps, I think my knowledge of the principles still stands me in good stead. I am proud of showing him and his brother before they got to secondary school, that there was more to computing than the games they played on our Atari console. This probably helped set them on the way to the complex systems they are responsible for now.

So I asked our two sons their professional opinion on the planned NHS TTT app development, its data usage and architecture. I read some articles with concerns around privacy, and the two departments party to it, the NHS and the intelligence agency GCHQ, not having a good track record with implementation of IT projects. GCHQ is all about surveillance so is the app as much about location as it is tracking the proximity of nearby devices?

Their reports were that most countries are going with an app produced by two of the largest technology companies, Google and Apple joining forces. They are promising an approach where all the data is stored ‘locally’ on the users device which also sends messages to the relevant contacts if required. No central data is held on individuals. Their  ownership of the two operating systems that all smartphones use, means they can maximise the efficiency of the Bluetooth file transfer exchanges and minimise the use of battery power on the devices.  It is this deep technical knowledge that may cause other countries, including the UK, problems in developing their own. 

An example of the problem is that in its standard form Google and Apple restrict apps from broadcasting Bluetooth constantly, as this has been exploited by companies connecting and sending targeted advertising. This means that most apps only broadcast if they are running in the ‘foreground’ or looking at it. If your phone is locked or you are not actively using the app there is a danger that some interactions will not be registered. There is some debate as to what counts as an ‘interaction’ is it that you are close to someone for a certain time such as five minutes, or just when you pass by on the street?

Michael found an article referring to a petition by developers to the French government demanding that there is complete openness on privacy, asking for published details of exactly what sort of data is collected, how it is used and when it will be destroyed after use. This is part of the ‘privacy v health’ debate around such applications. The UK government wants to use data to track the areas the virus is spreading.  David’s ‘research’ concentrated on battery life and foreground running. He says that with Bluetooth there is something called  “Received Signal Strength Indication” to determine distance between devices, but it’s not particularly accurate. This probably means there will be a lot of false positives, and even cases where it’s picked up a neighbour’s signal through a flat or house wall.

Whatever the pros and cons of the privacy debate, my concerns are about the practicalities of the system.

  • What incentive is there to report symptoms when people get them?
  • Alternatively what stops someone maliciously reporting symptoms if they are so minded just to cause a nuisance?
  • Is there a necessity for a positive test before the messages get sent and if not won’t the ‘false positives’ cause a lot of unnecessary disruption?
  • Given that a lot of people will go to a supermarket once a week, many ‘contacts’ will take place. The consequence is that one or two customers getting symptoms can lead to many supermarket workers having to isolate. Similarly, one supermarket worker getting symptoms could lead their fellow workers and hundreds of customers isolating. The result, after a few days, could be no supermarkets open and no customers going in.
  • Most transmission currently seems to be taking place in hospital and care home settings where there are lots and lots of ‘contacts’, so I am not sure how practical it is to use the app in those areas. Most medical staff take care not to contact people at home or outside the work situation anyway.

The biggest problem with the TTT system is the same as with the current hard lockdown. If there is a large minority who don’t engage or download the app, and they are the ones responsible for being lax on other ways of controlling the spread of the virus, they will still be responsible for causing some ‘needless’ cases and deaths.

We await the results of the Isle of Wight larger scale test but given that we have been told the app will be available to us ‘by the middle of the month’ there doesn’t appear to be much time to analyse how the system is working.

Readers of this blog know I love an initialism, so the last word goes to the writer of a blog three days ago suggesting countries trying to develop a (deep breath..) Pan-European Privacy-Preserving Proximity Tracing app or PEPPPT, will find themselves changing course and adopting the Apple-Google model. He predicted that by the end of the month the UK will have done so.

Is the change in message another sign that we are in for a long haul?

If today’s papers are to be believed Boris’s ‘address to the nation’ this evening will change the message we have been used to seeing as illustrated below.

The not so subtle change from red to green along with a ‘traffic light system’ for alert levels suggest to me that we are in for a period of trying changes, and if they don’t work putting restrictions back on. If, as has been trailed in the press, there are a whole variety of ways that businesses, workplaces, schools and social situations will change, then confusion (and some anger and worry) could be widespread.  The words of epidemiologist Professor Peter Horby interviewed on The Andrew Marr Show stood out to me. He is chair of  New and Emerging Respiratory Virus Threats Advisory Group or NERVTAG – sorry folks it is too lovely an acronym to ignore.  He stated

the virus is not like a storm or hurricane where we batten down the hatches until it has passed by, and then emerge into the sunshine and it has gone. It’s still out there and most of us have not had this virus, so if we get this wrong it will very quickly increase across the population and we will be back in a situation of crisis. So we have to be incredibly cautious about relaxing the measures.

NERVTAG told the government that getting the relaxation wrong could lead to a figure of 100,000 deaths in the UK. We still don’t know the proportion of the population who have had covid-19, but if the professor is correct there might be a lower but steady number of deaths for many more months yet.

The fact that the extra Nightingale Hospitals haven’t been closed is probably a sign that the politicians expect if not a ‘second wave’, then a lot more cases. As well as balancing privacy vs health for the new tracking app, there is even more pressure to balance health vs the economy. 

Finally, on Sunday evening we listened to Boris address the nation. He set out the way the five ‘alert levels’ would be set by monitoring the R-level by an advisory group. He set out timescales for now, the end of May, end of June when certain parts of the economy such as construction, manufacturing, garden centres, shops, and eventually limited hospitality would restart.

He encouraged anyone who can’t work from home to return to work tomorrow, and from Wednesday encouraged everyone to take more exercise and play sport with their family.

However, the main ‘confusions’ straight after the announcements were;

  • How people, who the prime minister said should go ‘back to work’ if they could the next day, would get there given limited public transport.
  • The other nations of the UK have announced that they are sticking with the ‘old message’ about staying at home. Scottish First Minister Nicola Sturgeon even asked the UK government not to run the information ads in Scotland. In Wales where you can’t drive for exercise, people from England could get fined for driving to the Brecon Beacons for exercise. Do Welsh workers need to drive to England if their employer decides that they need to work?
  • The detailed instructions for all sorts of workplaces have not been set out, so it is uncertain how that might look.

We will see what happens in the coming week with clarification and further statements to parliament on Monday, and questions from the public in the daily briefings.

Other news this week.

  • VE Day was celebrated in a ‘socially distancing’ way on Friday 8th May. The 75th anniversary was a special one and street parties held, and old-time songs sung. An evening concert held at Buckingham Palace featured a ‘virtual duet’ with Katherine Jenkins and Dame Vera Lynn of the wartime favourite ‘We’ll Meet Again’. One lady told the story that on the original VE Day she and her sister had to ‘socially distance’ and sit on a separate table as they had mumps, and she didn’t think that 75 years later she wouldn’t be able to join in a street party due to social distancing again.
  • In last week’s blog I wasn’t having a go at radio DJ Chris Evans specifically over his fundraising efforts. I listen to Virgin Radio’s Breakfast Show most mornings and Chris and his team try to spread joy and positivity in these difficult times.  He has also been party to raising literally tens of millions of pounds during his time at Radio 2 and Children in Need auctions and events. Chris by his own admission comes from ‘humble roots’, found fame and has had his well-documented ‘excesses’. But he tries to see the best in people and teach others lessons he has learned.  The message from last week was that our much-needed public services should be properly funded by us all and not rely on the charity and voluntary sectors.  Chris, his family and many celebrity friends have now raised in excess of £1 million from two auctions of memorabilia, and his son Noah over £100,000 by sleeping in a den in the garden. This money will go to producing more than 220,000 sets of scrubs for the NHS workers. 
  • On Friday transport minister Grant Shapps gave news of a £2billion scheme to encourage us to cycle or walk to work. For people travelling on public transport to maintain social distancing then they need to run at about 10% capacity. 
  • Other countries started to ease their lockdowns and in Germany Chancellor Angela Merkle allowed all shops to reopen, pupils are gradually returning to classes, and the Bundesliga – the country’s top football league – will restart next weekend. Initial signs are not promising as the dreaded R-number, a measure of the number of people each confirmed patient infects – moved to above 1.

Thoughts at the end of week 7

We continue to enjoy good health and the warm weather meant we ate a few meals outside. Alyson planted more seeds and worked on the garden. I managed to put the last shelf up in our shed in under an hour!

After finishing Terry Waite’s book Alyson has started the one by John McCarthy and Jill Morrell ‘ Some Other Rainbow‘ that documents the same time and similar events. We have been watching some more ‘culture’ on YouTube with recorded performances of Shakespeare and ‘Frankenstein’ by The National Theatre.

At today’s live stream service from Methodist Central Hall, Rev Martyn Atkins talking about being ‘salt and light’ referenced a talk he had heard where a student illustrated Christians being all shapes and sizes of candle, some battered, some old, some coloured – but all shining as a light to others. Something we are called to do at this time. One of his daughter’s friends when she was frightened would ask her dad to ‘turn off the dark’! We needed to use the battered candle I display some Sunday evenings to remember our carers as we had a power cut on Saturday evening.

We have had the usual Zoom meet up with friends and family. The week coming up is both Christian Aid Week and Brain Injury Awareness Week, so I have two ‘Zoom quizzes’ to prepare and host.

Alyson is hoping to get back to ‘frontline’ work by helping the NHS 111 Service and doing calls to patients who have been referred to a pharmacist for advice. She has been training and is waiting on information on how to setup a ‘call centre’ from her study – i.e. our spare bedroom.

I am a follower of a blog by the wonderful modern poet Brian Bilston and if you have never seen his work I can recommend you looking him up. He has produced some thought-provoking work over these last few weeks and I leave you with one of my favourites;

On Leaving the House and Encountering Another Human Being

I’m sorry I dived into the bushes.
It’s not personal, you understand.
You happened to walk in my direction
and my nerves got the upper hand.

I’m sorry I screamed when you came near me.
Don’t take my angry shrieks to heart.
Idiomatically, let’s stay in touch –
and physically, six feet apart.

Apologies if it seems like you repulse me,
that I recoil when you come near.
In other times, we might have spoken,
shared a joke or had a beer,

or waltzed together down the footpath,
perhaps we may yet still one day.
But just for now, embrace the margins
and wave to me from far away.

© Brian Bilston’s Poetry Laboetry
 
 
Keep safe everyone and remember, ‘We’ll meet again some sunny day’.
 

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.

Life & Death – Coronavirus week 4 – ‘Squashing the sombrero’

Care homes and the elderly – a hidden crisis revealed?

This week’s main headlines have been dominated by two main issues. The first was around how many people have died from the effects of Covid-19 in care homes and the community. This has put a spotlight on how much this area of our health and social care system appears to have been forgotten, with an extra 4,000 deaths to be added to the total which stands at 16,060 at the end of the week.

I do think after this is all over it will be an issue of collective shame that ‘we’ didn’t bring the care sector into the national effort sooner. Perhaps we assumed that these people were already ‘shielded’ by being in a closed environment; or did we subconsciously think that as they were older, with some nearing the end of their lives, it would be sad, but not so disastrous if that end came sooner.

The other main issue of the week was the review of the lockdown that under the emergency powers the government has taken, needs to be looked at every three weeks. There were calls from the new Labour leader, Keir Starmer, for the government to layout the plans for how the restrictions may be eased. This was echoed by the end of the week when Conservative Ian Duncan Smith MP, a former Work & Pensions Secretary called for ministers to treat the country as grown-ups and not children who couldn’t understand.

We were told that any talk of lifting the lockdown in a few weeks might be giving ‘mixed messages, and lead to us not carrying on with the strict regime. I do begin to understand this, but my analogy would be that when you go on a package holiday and the rep tells you to be at the airport in three weeks for your return flight, I don’t think many people turn up for the flight the next day. They are two quite simple messages. It was good to hear that there is a group of experts looking at what other countries are doing, and data is being collected on the effectiveness of softening each measure.

The discussions are happening anyway, and it seems logical to ‘reverse’ the measures we put in place. This means children (or at least some year groups) going back to school, perhaps after the original end of May Bank Holiday half-term. Then opening some health care settings like dentists, opticians, chiropodists etc (with of course relevant safety measures in place). This could be followed by garden centres and DIY stores so that people can carry on with projects at home and give those businesses for who this season is a large part of their turnover, some much needed cash and return of profit. Many people who are working from home could continue to do so. I hear anecdotally  that many of them like the new way with not having to commute. I imagine those who have been furloughed on 80% (particularly those who are being paid the extra 20%) are enjoying their ‘sabbatical’ and if the good weather continues would be more than happy to carry on.

The government briefings continue to push the message of carrying on until we see a change in the data, and that the peak of infections/hospital admissions has not yet been reached. It came as no surprise that on Thursday it was announced that current measures will be in place until at least the 7th of May. As that is the start of the VE Day (Victory in Europe) Bank Holiday weekend, my own view is that they will be in place until that is over.

As the figures in the main image show, the death toll across the world keeps rising.  I admit to spending a lot of time looking at graphs trying to interpret ‘trends’.  However, without some deep grounding in statistical methods and how data is reported, some graphs can be ‘misleading’. I have even seen ‘logarithmic scales’ used for the vertical axis of ‘number of deaths’ which flattens the curve and lessens the steepness of the rise. Education is so important in these matters, but some of our journalists appear to think that cramming a few minutes of research via a search engine on epidemiology allows them to ask ‘searching questions’ of the health and science experts. One even got antibody (to see if someone has had the virus in the past and developed some immunity) and antigen tests (finding if someone has the infection now) mixed up.

The figures in this article come from Johns (notice the extra ‘s’) Hopkins University web site. They have a useful set of visual tools that display the data on Covid-19 from all over the world, updated daily.

You need to understand what a ‘normal distribution curve’ is to know what the line and the space under it mean. The graphs below appear to give some hope that the ‘curve is flattening’ and, as Boris put it so colourfully in an early press conference, we are ‘squashing the sombrero’.   These are today’s curves of reported cases.

Coronavirus Cases US & Italy 19 April

Even these diagrams have very different vertical axes with some in thousands and some tens of thousands. They are useful to see overall trends in the number of cases, but this is dependent upon the same testing regime being in place in a country for the period reported, and even more so when comparing different countries.

This is the one that compares the UK and Belgium.

The danger of trying to read trends in these curves is that they could be a small part of an even larger curve or the start of several ‘small peaks’ that go on and on. Looking at the curve below for example, in the data above, we might not quite be at point 20 on the horizontal axis.

The important thing to understand, should this be true, is that the area under the curve represents the total number of deaths. I heard one epedemiologist modelling the outbreak estimate that if we added the extra care home and community deaths, which could be as high as 50%, then even if there is a single ‘normal curve’ we need to double the total deaths currently, resulting in a figure in excess of 40,000.

To add some more ‘worrying’ numbers into the mix if, as some experts are saying, only 15% of the population have had the virus, then to get to the 60% required for the original plan of ‘herd immunity’ would require a total of four such curves and associated lockdowns. It does seem that the crisis will continue in some extended form for many more months.

Population numbers and density in a country are important factors that allow another way of looking at the figures. Consider the graphic below showing the number of deaths per 100,000 of the population. with a table below it showing some numbers.

Coronavirus Worldwide Mortality Rate April 2020

These figures are from a few days ago and some countries are at different stages of their outbreak.  There have been questions over the reporting in China where it is alleged that some of the administrators at a state level could be underreporting  numbers for fear of upsetting the central Communist Party. The figures were amended this week on the day China announced a negative Gross Domestic Product (GDP) rate for the first time in nearly 40 years.

Other news items this week.

  • ‘Captain Tom’ who I mentioned last week has now raised over £26 million and promised to keep walking as long as people keep giving.
  • In many countries with more ‘authoritarian’ regimes, there have been examples of extra surveillance via mobile phone location data, and extreme violence by police under the guise of enforcing the measures.
  • Protests have taken place in the USA and Brazil against the lockdowns showing that individuals are rebelling against the situation. In our country, apart from a few examples people have been generally compliant. No one wants to think about us getting the stage of extreme disorder and looting that has been part of the ‘Hollywood narrative’ in the disaster/survival movie genres.
  • President Trump continues to make headlines after declaring himself the only person who could decide when states release lockdown. This is not the legal situation as each of the states has a separate ‘government’ in their federal system. The next day he announced his decision….that each governor could decide when and how to lift their lockdown!

Thoughts at the end of week 4.

The virus has come closer to us after a member of my head injury charity, monthly coffee morning group, died of Covid-19 on Thursday. Blythe had some underlying issues but she was doing well at home after a spell in a care home before Christmas. Another person I know is in hospital with the virus but fortunately not in ICU.

The mother of the partner of one of our nieces died 13 days ago, not of the virus, but his father couldn’t visit her in the nursing home, and the family had the problem of organising a funeral under the new regulations . In addition our niece was furloughed and her partner told to take a 30% pay cut, at a time when his company wanted him to work from home and do even longer hours.

We are still managing to get some daily exercise and no problems with food or other supplies. We have had many Zoom coffee meet-ups with family and friends. I helped lead a Zoom Bible study group on Wednesday evening. We are ready for another extended period of lockdown and the forecast good weather is a real bonus. Alyson is missing trips to see wildlife away from our suburban estate, but is making the most of walks along a stream in woodland nearby.

We are doing more reading, watching films and recorded ‘live musicals’ shows on the Internet. Attending a live-streamed church service from Methodist Central Hall in London is now part of my Sunday routine.

Stay safe and, God-willing, there will be another blog next week.

Brian Bilston

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