Daily Diary: Calculating The Odds and Counting The Blessings

Covid-19 finally gets to the prime minister and health secretary. Earlier this month Boris Johnson was blithely talking about going around a hospital where there were patients suffering from coronavirus and shaking hands with everyone he met. Perhaps, ticking away in that brain beneath the haystack was some perverse and lazily thought through calculation that if it worked wonders for Princess Diana with HIV/AIDS patients it would work wonders for him too. Who knows? Twenty-four days later he’s in quarantine, having had a cough and a temperature.

There are echoes of Prince Prospero in Edgar Allen Poe’s ‘Masque of the Red Death.’

Yesterday our daughter Emily came round at five in the afternoon, wearing the mask we’d mailed to her, along with a bright yellow pair of Marigold gloves. Bless her! She has shopped for us at the Tunbridge Wells Sainsbury’s and made the hour’s drive to deliver. She’s calling herself ‘Em Deliveries’ and messages us as if she’s an up-market delivery company. We put a big ‘X’ on the front door with masking tape. Traditionalists would say that it should have been whitewash with ‘LORD HAVE MERCY’ daubed underneath, but we’ve moved with the times and the whitewash would have been a bugger to remove. We keep a healthy distance and she leaves the shopping on the front garden wall. There’s an element of fun to the occasion and passers-by in the street are mildly and politely amused. Emily has sprayed everything with a gentle bleach solution, which takes a little adjusting to, but it keeps us safe and that is what the whole exercise is about when all’s said and done.

Anyone who has studied biology, especially ecology and evolution, knows that everything is driven by probability. Stack the odds in your favour and you survive. But there is the caveat that it is random and only partly determinate. The weak link, and what stops Em Deliveries being a certainty is that her husband Tom has to go up to Westminster a couple of times a week. They try to stack the odds by Tom travelling on an almost-empty early train and returning on an almost-empty late one, but he’s in Westminster during the day, where the odds of being infected are high. Emily tries to compensate for that by insisting Tom leaves all his outdoor clothes at the front door and has to go upstairs immediately and wash his hands before he can unwind and relax. But it’s all about odds. Odds like where the fish is located in the shoal at any one time when the predators are circling. We’ll see! We’ll hope!

Emily told us that when she was packing the car, she had parked it outside in the narrow street where she lives. The woman car driver she blocked was patient, understanding, polite and friendly. They ended sorting their cars out by a kind of motorised urban ballet, with manoeuvres I won’t even try to describe. Once sorted, Emily finished loading up and before she set off looked up the street to the sheltered accommodation. There was a woman sitting on a bench, talking to her elderly mother, who was looking out of her upstairs window. All a bit Romeo and Juliet, or to be more exact Juliet and her mum. Emily found the scene touching.

Lockdown is made up of moments like this.

At 8 pm Vicky and I go to the front door and clap for our NHS, carers and all those on the front line. Cathy two doors down is out, as is Mercedes, our Spanish neighbour, two doors up, clapping with much energy. There are few others along the street, but across the common there’s a lot more noise and good cheer – even a firework or two. Then, chilled by the spring night air, we go back inside, hearing as we do so a couple of kids shouting, “Hooray for the NHS! Hooray for the NHS!”

Back indoors, to lives intertwined by social media. The whole world is changing!

Today there is more sun, but a cold wind blows. I have to confess that as a paraglider pilot I have become obsessed by weather, and in the British Isles that’s a fine line away from addiction. Now I’m beginning to notice that day by day the weather is becoming less central to my life as I continue to be indefinitely grounded.

You’ve got to consider there may be a few days when you are fully cut off. It encourages frugality. Some mistakes are hard to remedy, so the frozen chillies and garlic carelessly left outside the fridge for too long become ‘lost forever’ as their replacements would almost certainly not survive the time-lag of a delivery. Recyclable rubbish went out in clear plastic bags. Now, for the most part it is tipped straight into the blue-lidded wheelie bin. It’s feeling increasingly wrong to be wasteful. I also appreciate how fortunate Vicky and I are to be retired and, for now at least in reasonable economic circumstances. There are many stories of people really struggling and I can only thank good fortune and remind myself of ‘there but for the grace of God go I.’

We get two deliveries – a pretty little decanter I bought on eBay for £2.80 that I deep-clean before filling with whisky and some stationery I need to continue this diary. They’re left behind the bins as I don’t hear the delivery person.

Raymond Briggs’ “Where the Wind Blows” comes to mind, as I contrast my somewhat banal day to day existence with something terrible and epic taking place in a dangerous wider world.

Collecting the parcels, a couple of health workers pass by. We enter into a brief, socially distanced, conversation. I mistakenly think they are our neighbour Peggy’s carers because I mistake their identities behind the masks. They tell me they aren’t.

“God bless her,” one of them says.

“You are carers?” I ask.

“Yes we are.”

“God bless you too.” I put my hands together, Namaste-style.

“God bless,” they reply.

The Bigger Picture: If a Nation Wants to Beat Covid-19 It Needs to Figure Out How It’s Going to Adapt.

If a nation wants to beat Covid-19 it needs to figure out how it’s going to adapt.

First, all its citizens need to be singing from the same song-sheet. It sounds pretty straightforward but it does depend on the relationship between the majority of citizens and those in government.

In an authoritarian regime, such as China, citizens will be singing from the same sheet. No ifs or buts and make sure you stay in tune.

In a society that has recently experienced another epidemic, such as MERS or SARS in Vietnam or Taiwan, there’s a memory of what can go wrong and there’s nothing quite like having had the bejasus scared out of you already in living memory to make you take your government seriously.

Then you’ve got a precious few democracies where there is enough trust established between citizens and leaders for there to be a widespread willingness to pick up the same sheet and make the music that keeps Corona at bay. New Zealand comes to mind.

But it doesn’t sit easily with libertarians who believe that prosperity and personal freedoms are totally interdependent. Locking down is seen as the antithesis of that and where leaders like Trump and Johnson are predisposed to libertarianism, that cognitive dissonance paralyses both society and the economy. Lockdown measures are fine for the short term, but they threaten to rapidly destroy the economy and erode a fragile social order that’s been held together by the repeated endorphin fixes consumerism brings.

If libertarianism could once be defended as principled individualism, in the face of Covid-19 it has mutated into a species of malignant selfishness.

That great libertarian wave that Boris Johnson was riding, crashed abruptly on the spiky rocks of Covid-19.

Just four days ago, journalist Ian Dunt summed up the PM’s cavalier attitude:

“Johnson already looks bored of the coronavirus. Suddenly we need seriousness and professionalism. But it’s too late. We elected an after-dinner speaker.“

Today Boris Johnson tweets:

“Over the last 24 hours I have developed mild symptoms and tested positive for coronavirus.

I am now self-isolating, but I will continue to lead the government’s response via video-conference as we fight this virus.

Together we will beat this. #StayHomeSaveLives”

Health Secretary Matt Hancock also tests positive for Covid-19 and many wonder who else in Government has been infected.

In New York that paralysis arising from the conflict between the ill-conceived intentions of libertarianism and the hard-spiked dictats of Covid-19 appears in the desperate day to day life of emergency medics. The US now leads the world in the number of confirmed coronavirus cases, with at least 85,000 known infections. New York City is at America’s epicentre with more than 23,000 confirmed infections, with a current death toll of 365. A Navy hospital ship, the USS Comfort, is expected to arrive in Manhattan on Monday, three weeks earlier than previously thought. It will stay a month and only treat 186 patients. It’s easy to define this as a token gesture – showboating, if you will – but in the context of the time, seeing cases and deaths rising exponentially, the existence of a backup is reassuring, even if it might have been more psychological than practical. The same is true for England’s Nightingale hospitals.

A Rhode Island doctor writes:

“I feel abandoned by U.S. leaders who appear to be bungling through a national catastrophe with unearned bravado.”

And:

“Abandoned by US leaders, the only Covid-19 protection I can count on in my emergency department is trust.”

There is a scramble for the personal protective equipment, or PPE, that can help keep Covid infections from spreading. It’s not just at a hospital level – there is a global explosion of demand that far exceeds supply.

Brigham and Women’s Hospital in Boston is burning through an unprecedented 9,000 procedure masks,1,600 surgical masks and 800 N95s a day. Best estimates give two weeks’ supplies of PPE left and the pandemic is reckoned to get exponentially worse.

It’s now not a case of being able to eliminate Covid-19, or even a matter of controlling it. Test and trace is still far from developed, not just in the States but in many other countries too. Test and trace talk is all too often about possibilities rather than actualities, like the new antigen tests that can help pinpoint people who have recovered from undetected cases of Covid-19 and might be immune, even though no one is sure about whether immunity is a natural consequence of surviving the disease.

In the absence of an effective, safe and reliable vaccine or medication, ventilators hit the headlines. Drägerwerk, a world leader in the production of ventilators, finds it challenging to keep up with the current demand. There is a dash by scientists and industry to fill that gap. The Edison of our era, Elon Musk, promises to produce ventilators, as does James Dyson, who receives an order for ten thousand from the British government. There are even some new designs that can be assembled by DIY enthusiasts. While the White House haggles with the private sector for 80,000 ventilators with an accompanying $1 billion price tag.

The race for ventilators epitomises where we’re at in the closing week of March 2020. The mortality rate of Covid-19 patients on ventilators is 88 per cent, 97 per cent for the over-65s. We’re making a big deal over an action of last resort. 

Day by day the public are becoming increasingly aware that the threat of Covid-19 is growing. It’s alarming. We can’t eliminate the coronavirus and we’re barely able to control it. And how will it compound, and be compounded by other disasters in the near future, like wildfires, floods and hurricanes? Countries like America and many in Europe are left with mitigation and containment. That means social distancing. It’s not smart, like the Taiwanese approach, but it has provenance going back to the Middle Ages. Social distancing, from quarantining to staying a distance away, stops bugs from having an easy ride from person A to person B.

Because if the coronavirus gets too much of an easy ride it’s going to sink health care.

In America, President Trump succeeded in looking as though he was doing something about it. He said he planned to label different areas as “high risk,” “medium risk,” or “low risk,” to help states determine quarantine and distancing measures. He was taking charge and America would start reopening up parts of the country soon. Despite the growing number of cases, people still feel confident in government leadership. In fact, President Trump’s approval ratings have recently increased, helped along by repeated China-bashing.

It turns out that souring Sino-American relationships is another symptom of Covid-19. Like losing taste.

It’s been a volatile week on the markets as stocks struggle to climb back from the massive Coronavirus Crash two and a half weeks ago, the biggest in history. Like the aftershocks of a major earthquake there are falls followed by rallies, followed by further falls. A $2 trillion economic stabilisation package in response to the coronavirus pandemic, already unanimously approved by the Senate gets through Congress. Real estate tycoons, sunscreen makers and student lenders are among the many industries in line to benefit. Central banks all over the world bail out struggling economies. There is some optimism and big banks put off planned job cuts, to cover staffing shortages and to prepare for a potential burst of activity when the pandemic subsides.

Within the markets countless unexpected small stories emerge. On the upside, orange juice futures are soaring as demand rises among health-conscious consumers. On the downside New York’s laundry industry, servicing a stricken hospitality sector, worries about its own survival. Some companies switch over to dealing with the pandemic, so clothing manufacturers are retooling to make masks and other protective garments, engineering firms such as car manufacturers move to respirators and ventilators, tech companies are offering their huge computing capabilities to crunch epic amounts of data and distilleries and brewers switch from drinks and perfume to hand sanitiser. During World War II my father-in-law was an engineer, building Wellington bombers in a commandeered shoe factory in Peterborough. It’s the same needs must when the devil drives.

It’s called adaptation.

Yesterday the Westminster Government did the right thing and adapted to a public outcry by announcing it would scrap parking costs across all hospitals in England.

They also did the wrong thing in immigration detention centres as stories emerge of vulnerable asylum seekers being put at risk because of a lack of measures to safeguard them in those establishments.

They did a puzzling thing. Communities secretary Robert Jenrick explained why he included custard creams in 1.5 million food boxes for vulnerable people shielding from the coronavirus:

“I have always been partial to a biscuit, particularly when I’m in the house on my own, raiding the cupboards.”

They did a spurious thing in passing the Coronavirus Bill, when it comes to adult care. Under Schedule 11, ministers can free councils of their duties under the Care Act 2014, the legislation governing much of the adult care system.   If the measures are enacted, councils will no longer have to assess and meet the care needs of elderly or disabled people unless they are required to by the European Convention on Human Rights and will not have to provide adult care when children receiving social care turn 18. It’s emergency legislation, we’ve been reassured.

It’s like they’re asking us to trust them to do the right thing.

Bearing that in mind, it looks like they’ve done an untrustworthy thing. The EU has cast doubt on claims that an email mix-up was to blame for the UK failing to take part in a Europe-wide scheme for buying ventilators and medical supplies to tackle coronavirus.

Europe too has faced similar problems to the UK. Spain has suffered more Covid-19 deaths than any country, save Italy. The country is both stricken and shuttered. European governments have declared food supplies a matter of national security, but border lockdowns have cut off seasonal harvest workers. The crisis has forced a rapid reassessment of how to supply labour to farms.

The danger of a new euro crisis is growing. Weak member states like Italy need help if they’re going to survive the coronavirus lockdown financially. But the call for Eurobonds has been met with stiff resistance – especially from the Germans.

There are those who start talking about the coronavirus creating an existential crisis in the EU. But a history of working to harness 27 countries to common goals has developed cat-herding skills in the organisation and after a fumbling start it begins to cope better with the outbreak.

There are differences in the ways that countries tackle Covid-19. Most are moving to restrict public life, but there are outliers like Sweden and now Holland opting for less drastic measures, hoping for herd immunity and relying on the common sense of its people.

Further afield Moscow is implementing restrictions and will close all non-food shops until at least 5^th April while hotels, resorts and spas will close for an indefinite period.

Elsewhere, other countries wait. In Africa there are concerns that many countries are woefully ill-equipped to cope with the pandemic. Underdeveloped health systems and governments lacking the resources to provide financial support on a par with the wealthier countries in the developed world. The bottom line is, people cannot stay away from work if they have no money.

It’s possibly an even deadlier threat to the indigenous peoples of the Amazonian rainforest as Brazilian President Jair Bolsonaro does nothing to protect them, according to the former head of the government authority responsible for their protection.

One of the realisations arising from the pandemic is the degree to which the developed world has become complacent in a kind of nurtured superiority over lands beyond their borders.

Shraddha Chakradhar reporter for STAT writes:

“In fact, during a recent 11-day trip to see family in India, I found it striking that the country of more than 1 billion people, which has not yet seen the scale of Covid-19 that the U.S. is experiencing, seemed to be doing far more to monitor its citizens and educate people about the risk of the virus and ways to protect against it.”

That a whole country can skip several steps, so that its citizens can go from a standing start to full interconnectedness via smartphones in a handful of years seems barely observed in the west. That a government can then harness that technological leap to communicate pandemic alerts to over a billion citizens hardly registers.

Similarly, there is something hard to swallow that China, a society whose values we more than struggle to come to terms with,  has succeeded in controlling the first wave of the pandemic and is moving on to preventing the onslaught of a second, and worried that international travellers might trigger it, China announced that it was suspending practically all entry by foreigners.

It’s easy to get drawn into historical memes about China being closed to the outside world, as if we’re still in the era of Marco Polo, but the fact is, like it or not, they’ve pulled ahead of us in a game where we not so long ago believed we were laying down the rules and handing out the cards.

There’s also a failure to identify that there is nuance within an autocratic regime that we would neither want nor be able to abide. That there may be cultural differences but the underlying experience of being human is the same. So it should come as no surprise that Chinese people struggled under their lockdown, that they too found themselves mentally and emotionally challenged, that there should have been a mental health hotline helped residents of Wuhan living under lockdown as night after night, Dr Du Mingjun would be waiting by her phone receiving their calls and providing support.

But we cannot simply take China as the template about how to sort out our problems. It would be naïve to do so. Would we want a society unapologetic about its level of autocracy, surveillance and control? We already have the consumer goods that the Chinese people sold their freedom for and we still have most of the freedoms too.

Even though we might wonder about the degree to which we surrender ourselves to apps and data networks to keep tabs on the pandemic. And, in the process, ourselves. The Economist magazine coins the term ‘coronopticon’ and, somewhat tongue in cheek, warns about Big Brother is contact tracing us.

Nevertheless, it turns out, despite Orwell being part of our literary heritage, Brits are willing to give up their privacy to get help and to assist those responding to the coronavirus emergency. The Covid symptom tracker becomes the hottest coronavirus app in Apple’s App Store. So far, this app, product of the Kings College London and Guy’s and St Thomas’ hospitals alongside the health data company ZOE, has had 1.2 million downloads in the UK alone. Users in the UK have been downloading the app and inputting their symptoms, which are then anonymised and given to a team of epidemiologists faster than the government is handing over data. It gets a £2 million government grant.

In the absence of a comprehensive PCR test for the virus it’s probably the best we can do.

We are adapting.

Stig Abell writes in the Times:

“Britain is coping with the coronavirus crisis because of the quiet heroism of its citizens.”

I suppose it’s the case with many other countries too, as we all face the inevitable with an inescapable stoicism, lightened from time to time with coronavirus jokes, memes and funny videos, along with musical performances on balconies and applause for the medical workers putting their lives on the line to care for the sick.

The quiet heroism is an apt description of the hundreds of thousands of volunteers who take a step forward to help and I’m proud of our daughter for being among them. Just a few days ago the Government called out for 250 thousand. To date, seven hundred thousand have come forward.

Some volunteers are supporting the NHS directly, others helping the isolated and vulnerable, including many elderly, others yet again setting up home industry, getting sewing machines a-whirring to make masks or getting their 3D printers to produce face shields for doctors and nurses on the front line. In some universities, medical students volunteered to graduate early so they could start internships at city hospitals sooner.

In many ways this is lockdown’s finest hour, when we saw ourselves at our best. At our most altruistic.

And quiet exceptional behaviour was the norm.

We are adapting.

• We’re learning to share our life experiences online. For some older folk it has been a rapid learning experience.
• Cultural institutions – museums, galleries and zoos – have opened their doors digitally.
• Humanist pastoral carers in hospitals, hospices and prisons, along with funeral celebrants are recognised as ‘key workers’ delivering round the clock services during coronavirus.
• Leading restaurant chains combine for a £1 million campaign to feed NHS staff, working with actors Damien Lewis, Helen McCrory and Matt Lucas to launch FeedNHS.
• In the United States, delivery app GoPuff is now bringing groceries to doctors and nurses on the coronavirus frontlines. It’s a thoughtful move by this unicorn firm, based on what a chore visiting a grocery store is at the end of a long shift on the Covid frontline.
• Birmingham Airport is being adapted to erect a temporary mortuary, able to hold 1,500 bodies as a minimum.

On the upside:

• Mike Ashley, the billionaire owner of Sports Direct, has issued a public apology after drawing criticism for lobbying the British government to keep his stores open.
• Pollution has fallen dramatically in major urban areas as people have stayed home.

On the downside:

• Abortion services are ‘at risk of collapse’ because of coronavirus outbreak. A quarter of BPAS abortion clinics were forced to close on Tuesday, due to staff sickness and isolation.
• WeWork tenants are on the verge of rebelling as the company continues to demand rent payments.

Travelling some distance simply to go for a walk in the Peak District, strikes up a conversation on social media. There are views on both sides, about small-minded police officers using drones to catch Ethel and Bernie taking Bonzo for a walk on the moors, and about Ethel and Bernie (Bonzo didn’t know any better) being so bloody selfish, contributing to traffic jams in rural beauty spots when we should all be showing a lot more restraint.

It struck a chord with me, being involved in a particular outdoor activity and I would like to share my response:

I had to deal with a similar problem. I’m chairman of a hang gliding and paragliding club and we suspended all our activities before social distancing came into effect because we had a number of concerns. The first was, as a non-essential activity any incident that required intervention by paramedics or accident and emergency departments, however minor, would be an avoidable demand on our emergency services. You can be sure that there are many more call-outs in the Peaks for walkers than for paraglider pilots, because there are so many more of them, and pilots are trained and licensed, including hazard awareness, risk assessment and first aid.

The second issue was we really didn’t want the sport we loved to be seen by the wider public as cavalier risk-taking. We depend upon the goodwill of the public at all times and being considerate is central to that. The landowners of the places we fly from would soon ban us from launching. At these times, setting a good example of public spiritedness and responsibility is really important whatever we do.

Thirdly, we would be inadvertently acting as vectors of Covid-19 through our movements. For example, if we fill up with petrol, the pump we use has been handled by many others. At the checkout we are less than two metres away from the staff member the other side of the counter. We come into contact with the pay machine if we are spending more than £30 and so many other things. We must act as if we are all potentially infectious or have the infection to be infected.

Risk assessment involves multiplying the chance of something happening by the worst-case consequence, should it occur. Walking your dog in the Peaks has a fairly low risk of breaking your ankle but the risk exists and the consequence of that risk, especially to the vulnerable is unthinkable.

At the time we did have a slightly exaggerated idea about risk. But I have to say I always carry a working reserve parachute when I go paragliding. It cost a few hundred pounds to buy and needs periodic checking and maintenance. I’ve never had to throw it. I never want to. But it is part of the precautionary principle any sane person needs to have when facing hazardous situations.

This pandemic is a highly hazardous situation and I’ve often wondered whether in a world made so safe so many of us have lost the mindset of mitigating risks.

I also received this notice from a charity that means much to Vicky and myself, having witnessed the harrowing reality this incurable disease brings:

We have created advice and practical tips for people living with dementia and those supporting them – either in the same household or from a distance, to help during the coronavirus pandemic. These include.

1. Helping prevent the virus from spreading by washing your hands often with soap and water (or if this isn’t possible, a hand sanitiser).
2. And cleaning things you handle a lot, such as remote controls and taps.
3. Arranging getting essentials like medicine and food, by speaking to your GP or local pharmacy, using online deliveries, or asking a friend, family member, or local volunteer for help.
4. Making a plan of what to do if you or the person you care for becomes unwell, such as leaving the number(s) to call prominently displayed.
5. Staying active with gentle exercises and activities, like reading, jigsaw puzzles, listening to music, knotting, watching TV or listening to the radio.
6. Keeping connected with family and friends by phone, post, email or Skype. This is a challenging time for everyone, but a phone call can make all the difference.

Every day I’m thankful this isn’t Vicky or I.

As every day I dread the possibility.

There are many more things to be disturbed by than just Covid-19.