NHS – Skat's Chat

Is ‘someone up there’ really looking down on me….?

It is a while since I have written a blog and that’s partly due to being busy with our new home, meeting new people, partly a lack of ‘inspiration’. Prompted by a note from Dr Michael Ward of Swansea University, who setup the CoronaDiaries Project of which mine is part, I did think about doing one more blog about the pandemic. The two-year anniversary of my first blog seemed a good time to revisit the topic. However, events of the 5th of March 2022 prevented me from writing that blog and are the inspiration for this one.

The simplest way to start is to reproduce the ‘incident report’ sent by Mark, one of the Run Directors (RD) of Delamere Parkrun, which I ran on that never-to-be-forgotten Saturday morning….

Ian Skaife collapsed around 1.2 miles into today’s run at around 9:15. He was immediately attended to by the following: June who was just in front of Ian and heard him fall, June’s partner Matthew, Nikki who was a little behind but did not see him fall. Nikki is a medical nurse (an unknown passing runner, not in Parkrun, who was also a doctor was in attendance and stayed until the paramedics arrived).

Around this time an unknown person called an ambulance.

Nikki reported there was no pulse and Ian was not breathing. Between herself and June and advice from the unknown doctor, they opened his airway and administered CPR for perhaps the next 15 minutes or so. Ian occasionally restarted breathing for a short while, but Nikki did not detect a pulse at any time she checked for one.

Shortly after the incident, perhaps at 9.20 the tail-walker (Liz) arrived who called the RD Andy. I was standing next to Andy when he received the call. At 9:22 I made a call to the Forestry Commission(FC) office. They collect the AED (Automatic External Defibrillator) and drove to the incident – the main FC contact on the day was Liam at Forestry England. I left on foot to the incident and was joined by marshal Katherine who is a medical doctor.

The FC team arrived at the incident at around 9:30 and on arrival immediately deployed the AED once. This was successful in initiating a pulse. Very shortly afterwards the paramedics arrived by which time Ian was conscious and had achieved some sort of satisfactory stability.

I arrived at the scene around 9:37 and called Ian’s ICE (In Case of Emergency number) from his wristband at 9:39. The ICE is his wife Alyson Skaife who informed me Ian was with his son, Mike Skaife (now at the finish), who Alyson then called. Mike appeared at the incident perhaps within 10 minutes.

By 9:50 Ian was on a stretcher, breathing himself and able to talk and knew where he was. The paramedics had been joined by air ambulance paramedics, though the helicopter had to land around a mile away (as we are in a forest).

At around 10:10 Ian left the immediate area in an ambulance to be taken to the helicopter which left with Ian around 10:25 for Stoke Trauma Unit.

Even now as I read the report it almost brings me to tears. I have no memory of the day other than arriving at Delamere and parking the car. I made it to the start where I met up with my son Michael. I can remember talking to a Crusader, a lady with a Superman top wearing a blue tutu and a couple of nuns! Alyson had to tell the nurse in A&E that I wasn’t hallucinating as the run was fancy dress to celebrate the 9th anniversary of Delamere Parkrun’s first event.

Mike had helped the paramedics get me into the air ambulance – apparently an older lady was nearly blown over after not getting out of the way as the helicopter took off from the crossroads where the traffic had been stopped. Alyson had been working at a pharmacy in Gobowen when she got the call from Mark and left immediately and drove to Mike’s in Northwich where they drove together to Stoke. It was the second time in almost 10 years that Alyson & Mike had sat in the family area of the hospital waiting to see if I made it. For those who don’t know what happened in 2012 you can read my blog from 2019.

https://skatchat.wordpress.com/2019/10/06/the-long-story/

I am relying on what Alyson & Mike have told me happened after leaving in the air ambulance as my next memory is waking up on Sunday morning in the Cardiac Care Unit (CCU). The junior doctor had written me a note telling me that I was in Stoke and they diagnosed that my heart stopped due to blocked artery and they had started me on some more medication. Alyson had written on the end of the note ‘Middlesbrough won 2-0’!
Back to A&E ‘Resus’ where I kept saying ‘Did I come in a helicopter? and Mike answered yes and I said ‘What a shame I missed that’. Over and over again! They decided to scan my brain for a head injury, but the image hadn’t changed since my last one in 2013. Alyson was pleased that I hadn’t been running in Oswestry as a) the defibrillator is not as close (note 9 April 2022 – having volunteered there yesterday I know this is not true as there is a portable one at the start), b) the ambulance service in rural Shropshire is not as responsive and c) they might have taken me to Shrewsbury Hospital which, although I wouldn’t have been in the recently sanctioned maternity unit, doesn’t have a good reputation. If they didn’t have my scan from 2012-13 goodness what they would have made of my slightly mushed brain!

Stoke is also where I had been diagnosed with angina in early 2021 so they were aware of that. I had been signed off after a ‘stress test’ in July when I went on the treadmill wired to an Electrocardiogram (ECG). Although I was due to have another test this coming July, as one of the A&E doctors remarked I had done my own stress test and failed spectacularly.
Alyson & Mike stayed with me until early evening and weren’t offered any drinks or food and didn’t want to leave me in case another doctor came with information. Eventually I was admitted to CCU and they sat with me there a while.

CCU is a ward of bays in a circle around a central nurses station. It is not a quiet place as we were all wired to heart monitors with electrodes attached to several sticky pads over our chests reporting to a central screen. Alarms were going off each time a lead came loose, and I was confused as I thought it was mine that was setting them off, so would try not to move. Also on my chest were two large sticky pads from the defibrillator used in the forest. The device made sleeping difficult but I was grateful just to be there. Alyson visited me later in the day and I started to learn more about what had happened.

Alyson and Michael had gone back for my car on Sunday morning as it was still parked at Delamere. Alyson parked outside the administration offices and saw Liam who had taken the AED and he was pleased to hear how well I was doing. He admitted than when he first got there and saw the medics working on me he didn’t think the ending would be good. Alyson thanked him on behalf of all of us, and only this week I emailed him to tell him how well I am doing. Often people who help others never find out what the outcome is, and that is a shame.

Alyson visited me later that day and brought my phone in so I was able to message friends and work colleagues to tell them what had happened to me. Mike was frustrated that only Alyson was allowed to visit me due to Covid-19 restrictions, and our other son David – who had been rowing with his club in Bath and left ready to come up when Alyson called him on the Saturday morning – had to make do with a Zoom update on the Sunday evening. Since the pandemic started we had been having a weekly call often with a short family quiz. I may have been able to join on my phone that evening, but was very tired and sore.

The soreness was something that, when the nurses asked me how I was feeling, I told them I was grateful for. It showed that Nikki, June and Matt and the unknown doctor had done a good job. A few weeks previously Alyson had attended a CPR and defibrillator use course, and told me that it was physically hard, and not something one person could do for more than a few minutes. Alyson had also text June & Nikki to thank them for what they had done. I sent an email to the ‘Core Team’ of volunteers at Delamere who I know well having volunteered there many times over the years. These ‘Hi-Viz Heroes’ as we call them in the Parkrun family are the reason events are free every week. I told them in the message that I was well and thanked them for what they had done.

On Monday Alyson came over in the afternoon but didn’t get to see me for long as I was taken down to what is called ‘The Lab’ to have a stent fitted. This was something that I had been due to have last July, but they decided my blood vessels were ‘perfect’. This time the situation had changed, so it was a case of putting one in to be sure. As it turned out my temperature was too high, so I was back on the ward after Alyson had left.

The next morning my temperature was fine and my bloods were ok, so I was back in the lab and this time the stent fitting was successful. As Dr Gunning my consultant said ‘that’s the plumbing sorted, all we need to do now is find a good electrician to sort you out…’. Alyson visited me later in the afternoon after tutoring pharmacy students at nearby Keele University. After getting up at 5am to travel there she said the work kept her busy, and took her mind off what was happening to me. She had also been very busy, as people often are when someone is in hospital, having to phone family and friends and taking calls from people asking how I was doing.

The ‘electrician’ turned out to be Dr Baynham who came to see me when Alyson visited on Wednesday, by which time I had been moved to a nicer room on a nearby ward. The room had been a ‘day room’ before the pandemic where patients could sit and watch TV and had panoramic views overlooking the helicopter landing site. It was converted to a 3-bed bay and was light and comfortable.

Dr Baynham said the plan was to give me an implantable cardioverter defibrillator (ICD) which would deliver a shock should my heart fail again. There were possible side effects such as infection, and it giving me a ‘shock’ when it wasn’t needed, but overall it seemed a good solution to my issue. I needed an app on my phone to send data from the ICD back to Stoke – Alyson was disappointed that it wouldn’t allow her to turn me off and on.

The procedure was planned for Friday afternoon confirmed at the ward round Friday morning. The device was fitted at about 3pm under a local anaesthetic. Due to the blood thinners I was on the surgeons struggled to get it under my collar bone in a ‘pocket’ they cut into my chest muscle, but eventually they managed. An X-Ray about two hours later confirmed it was in place with wires to my heart, and by 8pm my discharge letter and medicines were ready. Alyson came to pick me up and drove me home for 10pm. I slept in my own bed.

For the first few days home I was very sore and couldn’t sleep well on either side. This was both from the bruising to my chest and ribs from the CPR and the scar and the device under my left shoulder. I was also very weary from the whole thing, and this added to my ‘usual’ fatigue from the brain injury. I often have a short 40-minute nap during the day, but now needed one morning and afternoon. But it felt great to be home with Alyson.

The NHS had done an amazing job in the 5 days since I was admitted. I underwent two procedures, and the surgeon told me the ICD cost £30,000 (not sure if that is the cost of the device only or for the surgeons, operating theatre and nursing care). The care of all the nurses, doctors, pharmacists, physios, catering and cleaning teams was fantastic.

I sent WhatsApps to June and Nikki from Parkrun telling them that I was home and what had been done to me. I also said I was very grateful for the pain I had in my chest which showed that they did a great job! I said that without them I am certain that Alyson, Michael & David would be planning my funeral. Both sent gracious replies and June said although it was her slowest time for a Parkrun as they all took an hour and 14 minutes by the time they got back to the finish, ‘it would always be a personal best (PB) for a different reason..’ It had only been her 3rd run, and she nearly didn’t go, as it is her partner Matt who was the runner. I said that I hope that what happened wouldn’t put her off doing another!

The following weekend we had planned a trip to some cottages outside Scarborough in the north east where we have been many times. I felt strong enough to make the journey but as I can’t drive for 6 months Alyson had to do it all in our new all-electric car (the story of ‘range anxiety’ is for another blog!). We had planned to do the Parkrun at Whitby (Alyson is also a member of the ‘Parkrun Family, having done 35 since she took it up a couple of weeks before her 59th birthday). So at 9am on a Saturday two weeks after my incident the RD gave the usual pre-race briefing and when she mentioned that they had a defibrillator people start to laugh. Alyson shouted ‘It’s not funny! My husband needed one two weeks ago at a Parkrun!’ It went quiet and someone asked ‘Is he ok?‘ to which she replied ‘Yes, he’s over there watching the start..’.
Alyson enjoyed the run which was down a disused railway but reflected afterwards that the surface was hard paving, much less forgiving than the forest track at Delamere.

Last weekend we were also away at a large house with 18 of Alyson’s family and on Saturday morning a group of six went to Ross on Wye Parkrun. Five to run and me to watch. Alyson and Mike both ran in this one. However, this time no one laughed when the RD mentioned that they had one portable defibrillator at the start, and another was in the nearby sports centre. I was chatting to some other ‘tourists’ at the start, and one older guy from Leeds who, when he asked if I was running and I told him my story, announced ‘Oh I had one fitted 12 years ago and have run lots of times since including a few marathons.’
I have been told that I should be able to resume ‘normal exercise’ eventually, but am not sure I will ever do a marathon given the furthest I have ever run is several half-marathons and the last of those was the 2006 Great North Run! However, it gave me some hope.

I am not sure Alyson feels the same, but I have promised that I won’t go out on my own – as I had thought of doing the week before my incident when I fancied a quick jog up to the woods in our local area…

The final ‘twist’ to the story is that this weekend we celebrate our 40th wedding anniversary. We had booked a trip back to Paris to stay in the same hotel in the Place de La Sorbonne down from Notre Dame, where we went for our honeymoon and revisited on our 25th. There is a Parkrun close by and we had planned to do that one…it doesn’t bear thinking about what it would have been like if I suffered my cardiac arrest there – not with two failed O-Levels in French between us!

Something that Nikki replied after I shared the blog about my brain injury has stuck with me. She wrote ‘What an amazing story! I think someone up there is looking down on you!’ Another friend wrote ‘You know my thoughts on God, but you are a special case so I will pray for you’. A university friend who I will call Speed wrote ‘God clearly still has work for you to do! Thank God for all the prompt medical help you got.’

Even Alyson and her sister, neither of whom attend any church, in talking together when we were away in Ross on Wye concluded that God really didn’t want me joining him just now as that is twice I have tried and twice he has sent me back!

Since we moved from Crewe, a year ago this week, where I had been deeply involved at my local Methodist church and held various roles at circuit, district and attended the annual Methodist Conference, I have not found my ‘place’ in Oswestry. This is partly a deliberate choice as I wanted to take some ‘time out’ to discover the area and people. In September I met our local minister Rev Julia in her manse garden for a long chat. She was wonderful and encouraged me to work out what I wanted to do. This despite being very busy with pastoral care of 23 churches and knowing that, as in all places Methodist, there is a shortage of willing and experienced people for all the roles. The local churches have been very welcoming, despite numbers being down and attendance less during Covid. I have certainly not been to many services or joined local house/prayer groups, and even my attendance at the online Methodist Central Hall Westminster (MCHW) setup during ‘lockdown’ has been patchy.

Perhaps I am being given a ‘message’ through what has happened, and I definitely have more time to think things over, as I can’t just take myself out in my car without Alyson coming with me. I attended our annual ‘Covenant Service’ in January at which Methodists say a prayer which has these lines in it.

Your will, not mine be done in all things, wherever you may place me, in all that i do and in all that I may endure.
When there is work for me, and when there is none: When I am troubled and when I am at peace. Your will be done.
When I am disregarded: when I find fulfilment and when it is lacking;
The Methodist Worship Book P.288 (Modern Form)

The more traditional version is even more ‘stark’ with the lines ‘…Put me to doing, put me to suffering; let me be employed for you or laid aside for you..’

With all the cards. messages, calls and support I have had, I certainly don’t feel disregarded – quite the opposite. But in this season of Lent as we look towards the suffering of our Saviour Jesus on the cross, even though I am not doing a formal lent study, maybe I need to take some time to consider my place in the local area, my family and church, and commit to doing something positive.

I am definitely going to sign up for a CPR course and use myself as a living example of what can be done. I will commit to raising some funds or donating to any Parkruns who need to get a defibrillator. But beyond that I will try to find something in the coming months or years to take the place of the work I have done in the past for my local church and community.

I will continue to volunteer at Parkrun events and be a ‘Tail Walker’ who follows the slowest person so that no one ever finishes last. To be fair to the core Team at Delamere it might be some time before I turn up in my new branded orange Parkrun shirt – my old one having been sliced down the middle by the paramedics! And I will definitely update my ICE barcode wristband which currently says ‘ no medical conditions’!

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

C₂₂H₂₉FO_{5 – the wonder drug}

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Other news this week

The ‘old normal’ resurfaced in our area this week when 6,000 people attended raves in two separate areas of Manchester on Monday. Several people were stabbed, one girl allegedly raped and local people had to clear up the mess after everyone had left.
Crime seems to be on the increase (or at least being more reported) and terror is back on our streets with the stabbings in Reading this weekend.
There is more talk of reducing the social distancing requirements to one metre to get hospitality and self-catering holiday accommodation open.
Dame Vera Lynn died this week at the age of 103. She was called the ‘forces sweetheart’ during World War Two and had shared her thoughts during the current crisis and her song was echoed in the address to the nation by our Queen when she said ‘we will meet again’.
The Labour Party review on the reasons for disastrous results in December’s general election was published. It didn’t make comfortable reading for members of the party like me. We must work for Labour to produce policies which chime with the need to do things differently in relation to funding the new health and social care system, tackling poverty, improving education and closing the gap between the wealthy and poorer in society.
The daily death announced totals continue to fall with the Monday-Friday total this week being 853 down from 1,065 last week (a fall of 20%). The total of deaths at the end of the week was 42,632.
With numbers seemingly under control in European countries despite some local outbreaks in Germany, I looked again at the statistics on Johns Hopkins site and there are some awful looking graphs in other areas of the world. Here are the graphs for cases in Europe;

These show that we are over the (first?) peak of infections. The story in two countries with presidents who think it is nothing to worry about, and are trying to get their country’s open again is not so hopeful…

and note that the scales on these are tens of thousands rather than the thousands in Europe.
The middle and far east countries are also showing curves which are concerning, with a ‘double peak’ for Iran. The cases are in hundreds but show no signs of decreasing.
We need to start looking overseas again now that we are getting the UK cases down. There is concern from aid charities that helping less well-off countries will be harder now that the department for international development (DFID) and the UKAid agency has been subsumed into the Foreign Office. A move criticised by three recent former prime ministers from both Conservative and Labour.
The debate and protests around racism and the ‘Black Lives Matter’ movement continued across the world.
I was going to write that the demonstrations and actions of climate protestors, similar to the ones for Black Lives Matters with marches and ‘direct action’ had not resurfaced, when yesterday I saw an interview with Greta Thunberg saying that she was looking forward to going back to school in Sweden, and vowing to carry on campaigning.
Greta’s target for criticism president Donald J Trump was back on the campaign trail with a ‘huge rally’ in Tulsa, Oklahoma where only 6,000 of a possible 19,000 seats were occupied despite over a million applications for tickets. For those who did attend there was little sign of masks or social distancing, and six of the organisers caught the virus. At the time of writing there are reports that Mr Trumps rally had been ‘turned over’ by teens and young people responding to campaigns on the Tik-Tok and K-Pop social media platforms applying for tickets then not turning up. Mr Trump said earlier in the week that a million supporters would come.

How has week 13 been for us?

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

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

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

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

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