Tag: Zoom

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 weeks 16 & 17 – will it all be over by Christmas?

Hi ho, hi ho, it’s off to work we go..

I couldn’t decide whether to title this blog ‘it will be all over by Christmas’ or the one I settled on. Unlike Boris Johnson and his government, on balance I decided to ‘trust the scientists’.  There are still too many unknowns to be sure. I acknowledge that the recent announcements were a ‘hope’ rather than an assertion, and one role of government is to ‘get the economy going’ in order to raise the funds needed to do all the spending needed, and there will be harm to health if there is mass unemployment and economic hardship.

The dilemma was summed up by Matt Pritchett’s cartoon in The Telegraph newspaper on Saturday.

Alyson asked me how I felt about the announcement and I replied honestly that I was conflicted. On the day when the statistics on deaths and new cases were also thrown into confusion (or to be precise more confusion), this added to my uncertainty. I have looked at statistics in an earlier blog, and whilst the figure for ‘excess deaths’ produced by the ONS is a more reliable figure, I have stated the daily announced figures from the government briefings in each blog. I am no longer able to do that as they are no longer being declared. It seems that we have been counting as a ‘daily death’ in England if someone dies of any cause but had been tested positive in the last few months. The example used was somebody having a positive test in March and then dying from a heart attack in June. The effects of any ‘error’ in these figures may be a few thousand, and acknowledging that every death is tragic, but in the overall view it will make little difference.

The best estimate we can manage is that the 7-day rolling average death toll is currently around 69 per day, slightly down on previous weeks. Average new cases have steadied off but are now rising slightly again to 621 per day.  The government has three ways of measuring total deaths with differing time periods as below.

The other change recently, and one that is probably the way forward, is looking at much more localised figures, along with giving local authorities and public health managers the ability to put in effective measures – the idea of ‘local lockdowns’. I wrote a few weeks ago that local systems had been dismantled and now they will have more of a role to play. This is the current data on ‘areas of concern’.

Before leaving statistics for this week, as I write the levels of coronavirus globally are still rising and the number of daily infections is the highest recorded so far with the WHO putting it at 259,848 with 7,360 more deaths. So while the situation in our country is levelling off, this still remains a global pandemic – a fact that we all need constantly reminding of. The Disasters Emergency Committee (DEC) appeal to help those around the world where Covid-19 is adding to poverty, famine, war and poor health provision is one example of people trying to help others in a practical way. It is good to see UKAid matching the donations as well.

New ways of working and a new economy.

Anecdotally, there is a reluctance to return to ‘normal work’ and particularly in office situations. This may be due to safety concerns, childcare or possibly that people are learning that there is more to life than commuting in crowded public transport, or sitting in a traffic queue. Whatever the reasons I do think there will be, to use a phrase from my last blog, ‘a reorientation’ of the world of work. People do want to spend more quality time with family, taking exercise outdoors, working remotely, and spending less on ‘stuff’ we accumulate. Endless ‘consuming’ of the world’s resources and damaging our environment are topics that will be higher on the agenda. These are complex and interrelated issues and some initial questions that need exploring and debating politically are;

  • Economically can we come up with a new model where value is derived from providing more ‘services’ and ‘experiences’ than from manufacturing things?
  • How will money flow from those providing such things and those paying for them?
  • Will there be sufficient tax income to enable government/society to provide essential services such as education, health and social care, and a ‘safety net’ for those unable to take part due to disability, health or social conditions?
  • Who will be the people/organisations willing to invest in these new ways of working/supplying?

I worry that it is all too easy for employers to simply ask people to work from home without providing the necessary environment for that to happen effectively.  Those, like us, who are lucky enough to have a large house with two rooms we can dedicate to be ‘offices’,  with good connectivity and equipment will be able to do more effective work. However, imagine being in a shared flat in the centre of a city where four or more 18-35 year-olds are trying to sit on a bed with a laptop for hours on end, not having enough bandwidth to download data or stream video, having to be ‘available’ for your ‘boss/supervisor’ whenever they choose. Possibly you will need to be close enough to travel into the office once a week/twice a month for face to face group meetings or to talk to clients/customers. You will be stuck in a no-win situation of neither being able to move to less expensive places to get on the property ladder, or having little time to take advantage of the social interactions needed to build up any sort of ‘team / business’ culture that separates good organisations from the merely satisfactory.

There could be upsides to this if planned effectively. If there is a collapse in the commercial property sector with large office blocks being freed up, then these could be re-purposed for affordable city living, and shops on deserted high streets in smaller towns could be converted to ‘work hubs’ where people could travel short distances to ‘hot-desk’ in comfortable offices with good connectivity, shared meeting spaces and good facilities. This would allow the separation of home from work that many desire, but still leave time to spend on leisure/social activities with friends and family. If I was a larger company wondering where my market was going, this is what I would be investing in.

Why the virus will be dangerous for a long time

The other aspect of the current situation that we need to resolve in this country is the suggestion (or is it a fact?) that the ‘virus is going to be with us for a long time’. Given there are countries across the world who have been through a very hot summer and also ones where there have been winters, it seems the virus is not affected by either. There were two snippets of news that I heard, but have not been able to research much at the time of writing, which are potentially worrying.

  1.  The virus is mutating (as all viruses like the flu one do) and the ‘second’ virus which mutated from the one originating in Wuhan is now the ‘dominant’ one and causing the current pandemic.
  2. Having antibodies from an infection of coronavirus is not a guarantee that you will be able to resist a second bout of infection – the antibodies are not ‘long-lasting’.

The two issues are interrelated, and both make it hard to produce an effective vaccine. There is no evidence that the mutation makes the virus more transmissible which is the other worry. We have been lucky in one regard that although the current version of the coronavirus is quite easy to catch, it only appears to seriously affect certain sections of the population, with many getting mild symptoms.

If we had taken more notice and put in systems and plans after previous outbreaks of MERS, SARS and Swine Flu, outcomes may have been better. We have had plenty of warnings. It is vital that we learn lessons as the real ‘doomsday scenario’ is that the next virus might be all of the following;

  • Very easily transmissible via contact or being airborne.
  • Able to last for a long time on many surfaces and in many environmental conditions.
  • Affect almost everyone who gets it in an extremely serious or deadly way.

The nearest we came to this was SARS which was quite hard to catch and cross borders, but spread to 26 countries and killed almost 10% of those who caught it . It was contained in a relatively small area of the world, and this is why wearing masks and contact tracing is more accepted in south Asia than in Europe or The Americas.  MERS was relatively short-lived and contained but with a death rate of around 35%. Both of them killed between 700-900 each. Swine flu in 2009 is thought to have killed between 123,000 and 200,000 globally, spreading to 214 countries in a year, but being a variant of the ‘flu’ virus many older people already had some immunity to it.

The so-called ‘second wave’ in the coming winter in  the UK will be due to a combination of a new variant of seasonal flu, added to coronavirus, and no effective vaccine for either.  In the good weather of the summer and autumn people are willing to meet outside or queue to get into shops, but imagine the effect of cold and wet conditions on our willingness to do those things. This is the reason leading members of the SAGE group continue to push hygiene measures and social distancing as effective measures ‘for many months ahead’.

Other news in the past two weeks.

  • A support package for performing arts and venues was announced and welcomed, but there are still many who will not survive and thousands of performers and technicians who rely on seasonal income are outside the scheme.
  • The environmental damage caused by careless disposal of billions of pieces of PPE that contain ‘single use plastics’ had added to the amount of micro-plastics in our oceans and on land. Much of the PPE should be classed as ‘clinical waste’ and incinerated but personal masks and gloves are being thrown away much like other litter. The increasing use of takeaway food from restaurants has added to this.
  • Wearing of face coverings in shops is to be compulsory from 24th July, but the police are not willing (quite rightly in my opinion) to enforce the new law which is more than guidance.
  • There doesn’t appear to have been a steep increase in new cases as a result of opening of pubs and restaurants and other shops.
  • There has definitely been an increase in traffic as junctions 16-19 of the M6 motorway near to us are back on the travel news with queues and accidents.
  • Gyms, swimming pools and beauty parlours can re-open.
  • Another example of ‘police brutality’ appeared on social media in England with a young white policeman kneeling on the neck of a black man. There were examples of young black couples being stopped and aggressively searched for driving in a new expensive Mercedes, and in another case for parking outside their house in a mainly white residential area.

How were weeks 16 and 17 for us?

Our main news from the past fortnight and the reason there wasn’t a separate blog for week 16 is that we have been on one of the holidays we booked last year.  A five-hour drive to a small National Trust cottage on the north Norfolk coast next to a disused windmill. It was very pleasant and great to be in a different and new place. Being self-catering and just the two of us it felt ‘normal’. Even for July the caravan park we were in was very quiet. We were not able to book a place to eat as the pubs were all booked up, and we did have to queue outside the small deli and convenience shop in the village. We walked miles of coastal path, went for two 6k runs and managed to keep social distances. We had a couple of ice creams, and ate pizza outside from a manor house with outside tables, we walked to one evening.

We visited several beaches which were busy with car parking but large enough to keep a decent distance and had clean and available toilet facilities. Alyson even managed to christen her new wetsuit with two swims in the sea, and on one of them she was joined by two grey seals sharing the same inlet.

Apart from having to plan stops on the way there and back – at a supermarket in Grantham on the way there and a farm cafe on the way back, our journeys were relatively straightforward. We noticed the extra traffic on the roads on our journey home last Friday as the official school holidays have started so it may be a different picture in the next few weeks.

 

I went to a meeting in the accountant’s office in Sale for a face to face project meeting on Wednesday 8th, and it felt strange but there were only nine of the usual 20+ people in so it was all very safe, and we managed to keep social distancing. It was much easier than holding a planning meeting via Zoom and sharing screens.

That evening I attended a church meeting via Zoom with 12 of us from across our district to look at grant funding applications. We decided that it worked so well, we would continue meeting this way in the future. It saves many of our group travelling for over an hour to an office so is ‘greener’, and we can get more people attending. It will be more pleasant than driving the narrow roads in Cheshire and Staffordshire on cold wet winter evenings.

David tried wearing his mask in a shop but declared himself feeling very claustrophobic so decided he would go shopping just once a week.

Michael has managed a few days in The Lake District in a remote cottage on his own and enjoyed early morning walks.

Stay safe everyone. 

Coronavirus week 15 – the fine line between hope and crisis…

Did we go too soon?

Most of the week has been spent anticipating the 4th of July or ‘super Saturday’, ‘Independence Day’ when the pubs, restaurants and hairdressers were allowed to reopen. Also self-catering cottages, campsites and some B&B’s along with theme parks. We were waiting an announcement on which countries people will be allowed to visit without the need to quarantine on return. There were some concerns from scientists that we were going too far too fast.

For all of the above there were some who took it as a green light to start now. Airlines had passengers off to Spain, France, Greece and whole host of other places where they had second homes or were planning to be away for many weeks. Such people clearly had enough money to ‘self-insure’ against any eventuality. Street or ‘block parties’ continued and some pubs were open early. By the time Saturday came there were camera crews and reporters ready to capture the inevitable response to cutting a bit of hair or downing a pint.

The reports appeared to be mainly positive, but watching the crowds in Soho roaming the streets on a sunny afternoon there didn’t appear to be much social distancing going on there.  As a reporter from the Associated Press put it

John Apter, chair of the Police Federation, who was on patrol in the southern England city of Southampton, said it was a busy shift, one that saw officers having to deal with naked men, “happy” drunks as well as “angry” drunks. He said the shift “managed to cope” but it was “crystal clear” that those who have imbibed one too many cannot, or won’t, socially distance.

I don’t usually use swear words but that last sentence is one to which my friend Gareth from the head injury charity might reply ‘no sh*t Sherlock!’.

A few days earlier the authorities decided that one place that the pubs and hairdressers would not be opening was the city of Leicester. Due to data showing the infection rate rising alarmingly in some post codes  a ‘local lockdown’ was imposed. Many words were written about the possible causes, some speculating that the ‘hundreds’ of local small garment factories in tiny buildings that continued working were the main reason. Others said that it was the fact that the city is home to many people of Asian heritage where the culture is to live together in multi-generational households, some in areas of deprivation. It is well-known that two of the groups more susceptible to infection are minority ethnic and the elderly.

I am weary from hours of attending the Methodist Conference along with 300 others on Zoom, voting by virtually raising our hands or completing  on-screen polls. I am emotionally drained by listening to speakers on so many topics that needed our action. They all seemed so relevant. We were diverted from our agenda on the first morning by several urgent ‘notices of motion’ that altered proposed resolutions around equality diversion and inclusion (EDI). I admit to being a little annoyed, but as speaker after speaker from the LGBTQI+, transgender, black and ethnic groups, those with disabilities both visible and hidden, spoke of injustice, hatred and, even worse – indifference, I couldn’t help but be determined that action is needed.

This is about justice and inclusion and the need to work more as a church to celebrate difference. Again I was challenged to look at the EDI learning kit – but it is so much more than that. It is easy to think that living as we do in a predominately ‘white European’ town, that I am not racist. But that falls into the example heard in church so many times, ‘well we don’t have any minority ethnic people in our church so we can’t be accused of being racist’! I would now be tempted to ask, so how many disabled, homosexual or ‘gender fluid’ members are in your church or even your circuit? Is the membership or attendance representative of the area you live in?

This focus on EDI may have influenced some representatives to elect our first BAME President elect for 2021. Rev Sonia Hicks also happens to be a woman. She has great experience having served as a Circuit Superintendent in three connexions: Britain, the Methodist Church in the Caribbean and Americas and the Methodist Church in Ireland (MCI). Sonia is quoted as saying;

As a Black person born in the UK, it is a great privilege to serve the church family I love in this new way. I will do all I can to honour this choice of the Methodist Conference and enable British Methodism to celebrate our God-given diversity.

Not for the first time, the Conference elected two women to the top posts as Sonia will be joined as Vice President for 2021 by Barbara Easton, a secondary head teacher from the West Midlands.

Next up at conference was Sam Monaghan, chief executive of our charity that provides services and care homes or living in the community Methodist Homes (MHA).  They have been very visible on our news programmes as a case study for the problems in care homes. 400 residents have died so far. It was obvious that care homes were forgotten initially. I was in tears as Sam recounted the story of those losses and that of three members of staff. Our district team decided there and then that as well as EDI, MHA would be one of our priorities for the year. One of our group with homes nearby said that some church members had commented that it is more expensive to live in them. That’s partly because they are an organisation that pays its care workers the ‘real living wage’, decided by the Living Wage Foundation, rather than the national (minimum) living wage set by our government – something to celebrate not complain about.

After the main session of conference finished for the day attended (via Zoom again) a ‘fringe event’ about how our ‘bank’ Central Finance Board (CFB) were deciding which oil companies to divest themselves from, on the advice of the Joint Advisory Committee on Ethical Investment (JACEI) of which the Methodist Church is a member. There was some ‘controversy’ that we were still investing in three oil companies who were not meeting the measures set by the Paris Agreement on climate change. CFB explained that reduced returns and loss of income had to be balanced with a judgement about the companies ‘moving in the right direction’. There were also difficulties in the metrics of how to judge the companies. Change costs money, and whilst change needs to be worked through and company’s encouraged, it won’t happen overnight ( I know we don’t have time here, but I believe that science and technology will play a large part in solving climate change – it just needs investment and a push).

We spent many hours the next two days discussing long reports on important projects and issues for our church, but as time went on I got more worked up about the young people of our church who we call ‘3-generate’ pushing hard on the climate issue, and asking for CFB to overturn their decision to keep the three oil companies. This came to a head in a debate when, despite warnings from our treasurer and others that the loss of income and costs of doing so would be many hundreds of thousands of pounds and our own independent pension scheme trustees might decide to ‘disinvest from our own bank’ to seek better returns elsewhere, a notice of motion was agreed to overturn the decision. I resolved that I would speak up on the subject. Having spent many hours preparing carefully what I would say, by the time I was called to speak it was the very last part of the final session and due to overrun I had to quickly cut what I wanted to say from three minutes, to two and then one. I nearly didn’t speak but had ‘promised’ out treasurer that I would. At the last minute my printer also ran out of ink. I was very weary and tired so, instead of putting one negative point and one positive suggestion, I stumbled my way through one minute of the negative before being cut-off mid-sentence. I was shattered and devastated. The clip is on YouTube as the sessions are up there. This is a screenshot of me making my ‘speaking debut at conference’, looking distracted by trying to read what I am saying off the other screen next to my laptop.

It has only been seen by 2,734 people (mostly watching live at the time), and as far as I can tell no more since. Fortunately it is only up there until 1st August so not many more will view it!

Other news this week

  • As well as final details of the releasing the lockdown, the prime minister announced the ‘big spend’ infrastructure projects to get the UK moving again, a boost to the economy, and providing work for many of those workers who have lost their jobs in the last four months. This led to the inevitable calls to cancel the HS2 rail project to save money and the environment. People against this often quote that there is no need for people like us in Crewe to get to London 20 minutes sooner than we do now, particularly with more people working from home in the future. My response is that HS2 is not about speed but capacity. It is to get more freight off the roads and onto rail. To develop the current system to add another line or so next to current ones will take much longer, be even more disruptive and be more expensive. Just imagine the number of ‘back gardens’ you would have to destroy and the stations, bridges and signalling that would need to be altered. There are already lots of delays from upgrading the present system to current standards, not much of which does anything for capacity, but is making up for decades of underspending.
  • The list of countries we are able to travel to without going into isolation was published at the end of the week. There were 50+ on there but some confusion as some did not want a ‘reciprocal arrangement’ whereby we are able to travel to them.
  • We had one last ‘clap for the NHS’ to celebrate the 72nd anniversary of setting up the organisation. It was supposed to be for five minutes at 5 o’clock on the 5th, but there were only a few households out near us and certainly not for the full time.
  • The figures for deaths and cases kept falling, but were beginning to ‘flatten’. The average Monday to Friday official deaths were 124 this week down from 152 last. Daily cases are averaging less than 900 now. The total at the end of the week was 44,220 and average new infections are just over 500 per day.

How was week 15 for us?

Well the NHS finally appear to have got their act together and, using the new terminology, Alyson was ‘on-boarded’ on Thursday. She received her updated NHS email address on Friday, and has spent the weekend doing some final training on the system. Alyson completed the other modules around safeguarding and GDPR. Hopefully the last portion of the training will be done this week and she can arrange to choose some sessions from the roster in coming weeks.

During my time at conference Alyson did some Nordic walking at Delamere Forest having not done any since before lockdown. Normally she is part of a group but felt safe enough to go on her own and really enjoyed it. On Friday I needed to clear my head, so we spent a pleasant afternoon walking the forest tracks for 90 minutes.

Saturday saw us forming a ‘bubble’ with Michael as we went to his house to help put up a trellis for his climbing rose on the side of his shed. Alyson took the photo below and titled it ‘danger Skaife and son at work’. As I wrote a few weeks ago I am not known for my DIY skills and have not passed any on to my sons. It was a successful afternoon as Michael only hit his thumb half a dozen times with the hammer putting in the metal staples!

Michael had gone into his office in the centre of Manchester for the first time in more than 12 weeks to setup a new colleague with the IT equipment needed to work from home. He said it felt very strange with the added element of social distancing.

I will be going into an office on the outskirts of Manchester this week in order to meet Steve the director of the accountants I am doing the project for. This was the result of a Zoom meeting when I presented my report to the directors and it was agreed that rather than me try to go over all the systems and project plan remotely, it would be more efficient to be in the office, either side of a large table and share the various systems on a large screen on the wall. It will feel strange, but the company has spent a great deal of time putting ‘Covid-secure’ measures in so I am certain it will be as safe as it can be.

When I attended the weekly live-streamed service at Methodist Central Hall Westminster, I was confronted by my disastrous speech on Wednesday again. Three of the main participants had been at the conference and Rev Paul was part of the main organising technical team, and the person who probably pressed the button to let me ‘into the room’. Anthony, a local preacher and rep from the London District, had spoken well to another ‘notice of motion’ to persuade conference to do more about EDI.

Sunday was the first anniversary of Alyson’s mum’s funeral. Again we reflected on how different things were then. Not only the social distancing and the ability to at least hold some sort of tea and meet friends and relatives, but the weather a year ago was very warm too.

Stay safe, and we will see if the easing means we cross the fine line back over to the crisis side and a ‘second wave’.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Other news this week

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

How was week 14 for us?

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

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

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

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

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

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

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

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

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

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

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

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 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.

Brian Bilston

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