Day Thirty Nine: Thursday 23rd April 2020

Daily Diary: A Giving Tree In A Changing World

Outside the front of our house on the common there is a stump that is used by many people in many different ways. Kids sit on it when out with their parents taking the air. Exercisers use it as a prop – then sit on it when out of breath. I’ve even seen it take centre-stage in a photo-shoot between (I hope) housemates. It was an elm until not so long ago, until it succumbed to Dutch Elm Disease. It became necrotic and we feared it would die and fall our way. We were particularly concerned for Midge next door, whose house would most likely take the brunt, but cars in the street were vulnerable too. More troubling still was the risk to life and limb. We have a large secondary school a couple of hundred metres away and the thought of a tree crashing down on a child didn’t bear entertaining. So I sent an email to the council, politely stating the risk and gently letting them know that they would be sued in the event of any damage – and we really didn’t want that ugly little scenario, did we?

 Public safety is one thing. The jitters in a council legal department is quite another. All credit to them, the tree came down within three days of sending. I was pretty sad about the whole matter. Instigating the felling of a tree, even a sick one, is not a pleasant thing to do. Not quite in the same league as taking your pet on a one way journey to the vet’s, but it’s down the same road.

The long and the short of it all is there is a stump, that is still giving. It reminds me of Shel Silverstein’s bittersweet children’s story, ‘The Giving Tree.’ If you haven’t read it (or seen the You Tube clip), do.

Transformations are fascinating. How one reality morphs into another, sometimes suddenly, at other times almost imperceptibly.

That’s what’s happening with lockdown.

This morning I had black coffee. The leaking milk container a week ago has meant we have run out. So black it is and I quite enjoyed it. Washing, drying and putting away the crockery and cutlery has become part of the day. First the glassware, then the mugs, then the plates, followed by the cutlery, pots and pans. Each phase has something in the sink and something draining dry. I combine it with the research and writing that goes into this journal, so when I want to clear my head I move the wash one step along the production line. I don’t need to do much drying, as everything drains and evaporation does most of the work. It’s part of a system. Part of a routine, and I keep telling myself that the loss of a dishwasher is no big deal.

Even though in my heart of hearts I know it is, but allow me a little blend of OCD and denial – it’s good for lockdown morale.

But in that process, life has changed. Getting groceries has changed, purchasing goods exclusively online has changed, even the rhythm of the day has changed, even though Vicky and I are both retired, along with all its accompanying rituals and disciplines.

Things have transformed. There’s even tacit social messaging that they should do. Leaving me an intrigued witness to it all.

I’m treating the mail in a new way today. I’m using Ultraviolet (UV) irradiation. It stops the sogginess that comes with bleach, along with the municipal bath smell afterwards. I’m using a portable UV lamp and a box. I tell myself that for larger items a small cupboard or understairs toilet will suffice (even though I never get round to it). However, UV is dangerous – that’s why we can sterilise with it – so I always use gloves, wear sunnies and avoid looking directly at the light, pretty though it is. The UV also produces ozone which acts as a disinfectant, so best if it’s confined. Ten minutes each side – it’s a bit like grilling.

A couple of months ago I’d never have dreamt of doing this!

The Bigger Picture: The Emperor’s New Clues

I’m sure that the 23rd April 2020 will long be remembered for President Trump’s very public and truly bizarre foray into the medical treatment of Covid-19. It had all the madness of ‘The Emperor’s New Clothes.’

Only yesterday Rick Bright left his job as director of the Biomedical Advanced Research and Development Authority (BARDA), allegedly for disagreeing and therefore being disloyal to the president. Which could explain why the medical experts at the televised Covid-19 briefing session were so uneasily silent. Dr Deborah Birx, the White House Coronavirus Response Coordinator was visibly uneasy, to the point of squirming as her boss spouted nonsense about injecting household disinfectant and “hitting the body with ultraviolet or very strong light.”

These insane ramblings had no effect on the level of support from his base, but did on medical emergency callouts.

An NIH expert panel has recommended against using the combination of hydroxychloroquine and azithromycin to treat the coronavirus outside clinical trials, undercutting early claims that the drug was a promising treatment. New guidelines for the federal agency led by Dr Anthony Fauci said there is no proven drug for treating Covid-19 patients. For weeks Dr Fauci has emphasised the lack of scientific evidence to support any potential treatment.

Meanwhile, Covid-19 is spreading to America’s South with unnerving speed. In spite of that Southern governors are beginning to reopen their states. For most, it is too early, but despite that there is pressure as an informal coalition of conservative groups has been working to nurture protests and apply legal and political pressure to overturn stay-at-home orders.

There is evidence that that kind of denial is dangerous. News emerges today that two weeks after Republicans in Wisconsin State legislature forced the state to hold in-person  election, Milwaukee health officials have announced the first cases of voters testing positive for Covid-19.

In some world views life comes cheap.

In a desperate quest to have supplies available of sedatives and paralytics to treat the most severe covid patients a group of doctors write an open letter to correctional facilities in those twenty five states that still have the death penalty. Public records indicate that Florida, Nevada and Tennessee have at least enough medicine to treat 137 patients. Some states declare nothing, knowing pharmaceutical companies stance on the use of their products – rightly so – and keeping their cards close to their chests. Other states refuse to hand their stockpiles over.

While these drugs may only alleviate a small fraction of the total anticipated deaths, the letter argues, attempting to save each life is a central ethical directive. The letter concludes:

“At this crucial moment for our country we must prioritise the needs and lives of patients above ending the lives of prisoners.”

By contrast, in the months ahead, the president will authorise thirteen federal executions before he leaves office, the most any president has done in at least a century. If there aren’t enough drugs to facilitate execution by lethal injection the US Justice Department revises permissible methods to include hanging, electrocution, poison gas and even death by firing squad.

When Trump leaves office the death toll from Covid-19 will surpass four hundred thousand souls.

In some world views life comes cheap.

The xenophobia card is still there to play as President Trump declared yesterday that he would temporarily halt issuing green cards. It’s a card which has worked well in securing his base ever since he ran for office way back in 2016, starting with managing the southern border.

Step by step that xenophobia has now come to include China, now America’s greatest rival, as an ill-chosen war of words escalates into growing and dangerous tensions. Trump’s “China virus” and “kung-flu” inflame, rather than moderate and diplomacy. China, now expansive and aggressive, is by no means an innocent party. Intelligence agencies report the spreading of disinformation, China’s propaganda machine has highlighted other countries’ mistakes during this pandemic, while suppressing domestic problems, fuelling anger towards foreigners and domestic critics as well. While American warships have sailed into disputed waters in the South China Sea and a war of words between the US and China over the pandemic intensifies.

There are now two highly contrasting views in an increasingly existential struggle for the mind and soul of humankind.

It is one of a number of major paradigm shifts catalysed by the pandemic, telling us that life afterwards will never be the same.

The president has other distractions too, as the Trump International Hotel in Washington seeks a break on the terms of the its lease from the landlord, which happens to be his own administration.

But that has little to do with Covid-19.

Covid-19 is a disease with three stages – an airborne viral infection, a violent immune system overreaction known as a cytokine storm, and the slow to emerge, and even slower to understand, long covid. Dealing with the first two stages is problematic. Damp down the immune system too soon and the body’s defenceless against the virus or any other opportunistic infection. Do nothing and the body’s own immune system goes into auto-destruct mode, shutting down the lungs and other vital organs.

It’s not a one size fits all. Elderly patients are more likely to enter the second stage because the ACE2 receptors found in lung lining cells become more numerous with age, giving more viruses a chance to get a hold, and in turn stimulating a more extreme immune overreaction. But some relatively younger sufferers draw the short straw, simply through the perverse lottery of genetic variation. The fittest can still be at death’s door in some cruel game of chance.

The father of a middle aged marathon runner described the virus as “a combination of ‘Alien,’ ‘The Day The Earth Stood Still,’ ‘The Andromeda Strain’ and ’Apocalypse Now.’”

I would add ‘Life,’ and I might be guilty of scribbling corona critters, but I won’t give the virus a name like Calvin.

If you haven’t seen the movie, check it out.

The runner’s cytokine storm was arrested with the anti-inflammatory drug, Actemra, repurposed from treating  rheumatoid arthritis, another disease where the immune system goes into overdrive, following a process of induction by the physician and some encouraging results from China. There are other promising drugs, such as sarilumab, also known as Kezvara, in Italy, doing much the same thing.

It was yet another drug repurposed from treating rheumatoid arthritis, tocilizumab, along with sarilumab that were used to treat British PM, Boris Johnson. Jenny McGee, one of the two nurses dedicated to his treatment said he “absolutely needed” intensive care treatment after his symptoms worsened.

Repurposing a number of drugs, not just for treating rheumatoid arthritis, but also for dealing with other viral pathogens such as Ebola and HIV, is beginning to yield positive outcomes, shortening the length of the most critical second stage of the disease, but also improving survival rates. But in the process it becomes evident that beating future pandemics will require more medical laboratory professionals. People are dying from Covid-19 because we’re not fast enough at clinical research and research into other diseases such as cancer and Alzheimers has been overtaken in the drive to beat the virus.

It’s one of many ways in which Covid-19 is stealing the show when it comes to healthcare. Other critical functions falter. Transplants plummet as overwhelmed hospitals focus on the coronavirus.

But step by step we’re getting there as , not just in terms of how the disease works, but also in the way it spreads through the population.

Tens of thousands of households in England are being asked to take part in a new study to track the spread of Covid-19 infection and how many people have developed antibodies to the virus. The first part of the study will involve 20,000 households in England, chosen to be representative of the UK population in age and geography.

Mutations might be one of our biggest concerns about the virus, but thanks to genomics it helps in tracking the virus and understanding how it travels through a population. So the genetic sequence of the coronavirus that was detected in Seattle-area man who was initially believed to be the country’s first confirmed infection has become a crucial clue in understanding how the pathogen gained a foothold in the US. The fact that other preceding cases since emerged shows that the virus had not been seeded by a single point of entry. That broader ‘leakiness’ has been one of the major factors in countries like the US and UK where air travel and border fluidity have made the virus almost impossible to keep under any kind of control.

The spread of the virus is also counter-intuitive, or more to the point it cannot be figured out by a simple line of reasoning. For example frontline healthcare workers are found to be at no greater risk of catching Covid-19 than other NHS workers, according to research published in the Lancet. The study compared infection rates in Newcastle hospitals between doctors and nurses who deal directly with Covid-19 patients and the other hospital and administrative staff found that out of the 1,029 staff tested, the rate of infection among patient-facing staff was 15.4 per cent while for non-clinical workers it was 16.3 per cent. For non-clinical staff, such as finance or IT workers, the risk of being infected was higher, at 18.4 per cent.

We also find that zoonosis is a two way street. Two cats in separate areas of New York have tested positive for Covid-19 after showing symptoms of a mild respiratory illness. As time passes the transit of the virus to not only cats, but other animals too such as mink, happens to be more commonplace than was originally thought.

The virus and how it hitches a ride on the human population is not fully understood. There are fears, as the American CDC director warns that that second Covid-19 wave will be “even more difficult,” while the only hope of a way out for many – a working vaccine – is met with caution by the scientific and pharma communities, despite tens of millions of pounds being spent on trials that are now starting. Professor Chris Whitty, England’s CMO, poured cold water on the hope that an impending vaccine could be the way out of lockdown, while the CEO of Roche described a coronavirus vaccine in 12 to 18 months as “ambitious.”

Part of the reason why there are black holes in our knowledge of the pandemic is that it is a horrendously complex phenomenon, that becomes increasingly so as it spreads through the world’s population. But part of the reason is the wilful lack of transparency by governments, not finding the moral courage to admit that those in power, like everyone else, make errors of judgement.

China is very much in the spotlight on this score. In its bid for global hegemony its leadership cannot be allowed to be seen as in any way flawed. The country’s leaders have been accused of a cover-up, of simply not reporting the true scale of deaths in a country of over a billion people. “It can’t be right,” a Wuhan resident told Radio Free Asia on Friday. “The incinerators have been working around the clock, so how is it so few people have died?”

A Chinese journalist who went missing for nearly two months after streaming videos from Wuhan has reappeared, and claims he was detained and forcibly quarantined by police. Li Zehua was one of the Chinese journalists reporting from Wuhan’s front lines during the Covid-19 epidemic who mysteriously disappeared. A former employee of state broadcaster CCTV, the 25 year old was last seen on February 26th in a video he posted online. The hours-long live stream ended when agents entered his apartment – and he hasn’t been seen since.

But it’s not unique to China. In some parts of Europe people have accused their governments of not being transparent in the figures they are publishing. In Germany, Italy and Spain and elsewhere, daily death tolls are hospitals-only fatalities, which don’t include care homes and the community. Worryingly, according to a Financial Times analysis published today, in the UK 41,000 people may have already died, which is more than double the official figure of 17,337. There is also a BBC-leaked memo of recording Covid-19 deaths as pneumonia etc.

Number 10 becomes truly Orwellian as it coerces Simon McDonald, senior civil servant at the FCO, into retracting his words to contradict what he had reported to a Parliamentary Select Committee – that a ‘distancing’ from the EU was at least part responsible for the current PPE supply problems. While Matt Hancock’s department of Health and Social Care had ‘warned Number 10’ not to publicise PPE shipments.

You might not approve, but you can understand how soldiers can be expected to surrender their lives in support of a political narrative. But health and care workers?

It’s dark, but for now, by kicking the can of an inquiry into the handling of the pandemic, the Government escapes scrutiny.

Belgium appears to be an exception. It is a small country of 11 million people, which, at the time of writing, has over 6,200 recorded coronavirus-related deaths. But, unlike elsewhere, more than half of these deaths were recorded in retirement homes. And of the total deaths that occurred in those homes, four per cent were cases confirmed by a Covid-19 test and 96 per cent were suspected ones. The prime minister, Sophie Wilmès, said that the government “made the choice of full transparency when communicating deaths” linked to the virus, even if it resulted in “numbers that were sometimes overestimated.”

Some other countries use Belgium’s poor per-capita death toll as a means of pointing out their own figures, borne largely from less transparency, are not so bad.

So it goes.

Little over a month ago 50,000 fans watched Liverpool beat Atletico Madrid at Anfield, Lewis Capaldi sang to 12,000 fans (although fair, but slightly misguided, play to him, he advised them to bring hand sanitiser), the Government had all but abandoned test and trace in the community, announcing it was moving out of the “contain” phase into the “delay” phase, terms that were lost as they confused the pre-lockdown populace. The spike of infections was to be flattened over time, so the most serious cases could be managed over a longer period of time until herd immunity was to be reached.

Orwell’s pigs planning the fate of the sheep.

The rationale was something like this:

“The social distancing for the coronavirus is destroying the economy. Wouldn’t it make more sense to isolate the elderly and vulnerable and expose all the young and healthy people to the virus, thereby stopping the spread as they recover?”

But the Government went back on the plan when it occurred to them that not only would this result in a catastrophic death toll among the elderly, but the level of hospitalisations and intensive care far exceeded the healthcare resources that could be mustered.

There was talk that doctors would have to choose whom of those hospitalised to treat, and then the disease would start to kill those who should have survived, including the young and healthy. Italy reached the brink, and unofficial reports from Iran suggest they’d passed it. As a health crisis it would be calamitous.

But from a government perspective, as a political crisis it would be catastrophic, as, still focused on Brexit they had failed to protect us all.

Ask a politician in the Government now about their original discussions about herd immunity, look at your watch and count the seconds. It will be less than ten seconds before they change the subject, and in a year’s time they’ll be demanding your gratitude for the vaccine.

So it goes.

There is a set of metaphysical scales. At a glance they could be easily be mistaken for the scales of justice. But not so this time. The scales have the economy in one pan and human lives, like pennyweights in the other.

Senior Tory MP, Sir Geoffrey Clifton-Brown calls on the Government to give businesses “hope” as to when some sort of normality might resume. Housebuilder Taylor Wimpey said it plans to resume work on its construction sites on May 14th. Aston Martin, worried that after a difficult 2019, reopen their factory in South Wales.

But for most, returning to normality is some way off. By 4 pm yesterday, the Government’s furlough scheme has received 387,000 applications, covering 2.8 million employees. The help is not getting everywhere: a Government-backed start-up faces bankruptcy after being refused a Covid-19 loan. A street food vendor who launched his dream business with a startup loan scheme is now facing bankruptcy. In fact there are three and a half million the scheme does not reach.

If you are among that three and a half million there are captive animals doing better than you. Zoos and aquariums are to get emergency help to avert financial disaster. Animals still have to be fed and looked after, but no money is coming through the turnstiles. There were understandable fears that many animals in zoos might be destroyed, and one zoo in Germany had effectively set up an in-house food-chain, with its prized polar bear as the top exhibit, much to the public’s horror when the contingency plans leaked out.

As public borrowing surges to its highest March level since 2016.

In the US, the Senate on Tuesday passed the next phase of Covid-19 relief, a $484 billion piece of legislation that will replenish the small business loan programme established last month, as well as allocating funds for hospitals and virus testing.

All we have to do is to live from one day to the next and watch the old reality morph into the new like a Tik-Tok sequence in slow motion:

  • The Government announces that  social distancing restrictions are to stay until the end of the year, with schools set to remain closed until at least June 1st. It places much more of a burden on women, who are doing the heavy lifting when it comes to both looking after children and seeing that they are educated, in many cases while holding down a job online. There are many men who share the load, but the level of parity is disappointing, according to a number of preliminary studies. Covid-19, in the stark way in which it reveals weaknesses in society, demonstrates how far we still are from gender equity, let alone equality.
  • Coupled with that trend, domestic violence has increased during lockdowns. In America cities reports rose after shutdowns, while other crimes fell, but it’s not just America – it turns out to be a worldwide trend.
  • We spend more time watching TV and movies at home. Netflix adds 15.8 million subscribers in the first quarter.
  • For those who read the pandemic becomes its own obsession. Penguin sees a surge in sales of books about viruses. Plague books are popular too.
  • We get the first virtual Prime Minister’s Questions in the House of Commons. There were technical problems and MPs being like so many of the rest of us in being fazed, while traditionalists like Jacob Rees Mogg worried about something that was totally post-Victorian getting derailed. But it happened, and it worked, with a hybrid working model of a few MPs in the chamber and the rest appearing on-screen. With prime minister Boris Johnson still recovering it was Dominic Raab who stands at the Dispatch Box.  Keir Starmer grills Dominic Raab over the low levels of testing for Covid-19 in the UK. The new Labour leader used his first PMQs to grill Dominic Raab, and said that the UK is “way behind the curve” in terms of testing. It’s a massive challenge that the Government will continue to struggle with over the months ahead, but without it there is no way a lockdown can be ended safely.
  • The Covid-19 pandemic is causing hotels to raise the hygiene bar. Marriott International, the world’s third largest hotel chain, is rolling out hospital-grade disinfectants.
  • Andorra, the landlocked nation between France and Spain, has adopted a unique way of easing lockdown restrictions. Those who live in even-numbered homes are allowed to go out on even dates, while those who reside in odd-numbered homes follow suit on all other days.
  • David Attenborough hopes that working from home becomes permanent after the pandemic.

The new reality amongst medics on the frontline is now dominated by the shortage of PPE and the fear of both being infected and infecting others. Putting on a brave face becomes central to the political narrative. Deputy chief medical officer, Dr Jenny Harries, who believes she has had Covid-19, although in the early days if you didn’t go to hospital it was unlikely you’d be tested, has said the issue of whether members of the public should wear face masks is “difficult.”

It’s not that difficult, but it’s a reply that captures the moment. Human coronaviruses are mostly respiratory, and although other modes of infection, such as oral and faecal, are by no means unknown, the primary route is airborne. So the precautionary principle should apply and everyone ought to place additional barriers between themselves and others, and even if there is still much to be learned about Covid-19. That should have been the default position.

But in a government that’s gone from delay to crisis and is now enduring the chaotic consequences. The issue of masks is one of panicking over supply and demand whereas a little imagination would have come up with any face covering being better than no face covering at all. If we all went round like Jesse James on a bank job it would be better than not putting two barriers between two neighbouring people. Better still – and it’s beginning already – a cottage industry emerges to produce non-surgical masks.

Meanwhile, nearly three quarters of anaesthetists fear for their health due to inadequate supplies of protective equipment. A survey of the Royal College of Anaesthetists members finds that more than a quarter of the 2,100 respondents felt pressured to treat coronavirus patients without adequate PPE, It was also found that 17 per cent were unable to access the PPE they needed.

At least three London paramedics have been lost to Covid-19. They are inadequately protected and have to go into confined, often poorly ventilated and sometimes unsanitary places. In time there will be a number more.

What always stick in my mind are the personal lockdown stories. Here are four of today’s:

  • “I’ve moved back in with my parents to pay off my debt. It’s not what I expected in 2020.
  • “I’ve been looking for gluten-free self-raising flour now for the past two to three weeks. I’m in isolation on the shielding list. I’m terminal, along with many other issues, if you look at my main page, but we have found nothing as it is always sold out. Could anyone please help us? Obviously not after freebies, so will be fully reimbursed. Thanks so much x”
  • A teacher gave birth in her car outside a supermarket after a passing ambulance crew mistook her husband’s attempt to flag them down as cheers of gratitude towards the NHS. Hannah Howells, 33, and her husband, Andy, from Hamble in Hampshire, were driving to Princess Anne Hospital in Southampton on April 19th when she realised she wasn’t going to arrive in time.
  • The older generation in Russia are finding lockdown a struggle. One 80 year old is refusing to conform. “Old people have got to stay between four walls most of the time anyway, so not letting us go out is a torture.”

Globally, the outlook is bleak. Tedros Adhanom Ghebreyesus, CEO of the World Health Organisation warns that many countries are still in the early stages of the Covid-19 pandemic.

While the head of the UN, Antonio Guterres sent a video message warning that there is discrimination in the delivery of public service, and there are “structural inequalities that impede access to them.” He said the pandemic has also seen “disproportionate effects on certain communities, the rise of hate speech, the targeting of vulnerable groups, and the risk of heavy handed security responses undoing the health response.

There is a concern that poor countries might easily be forgotten in the Covid-19 battle.

And not just from Covid-19.

The world also faces a famine of “biblical” proportions, in which the number suffering from extreme hunger could increase from 135 million to more than 250 million, David Beasley, the Director of the World Food programme has warned the UN. The risk is particularly acute in ten countries – Yemen, the Democratic Republic of Congo, Afghanistan, Venezuela, Ethiopia, South Sudan, Sudan, Syria, Nigeria and Haiti – but has the risk of spreading further afield if swift action is not taken.

I have followed the work of Dr Jane Goodall ever since I was in the sixth form way back in the late sixties. In my pantheon of people to admire she’s up there with David Attenborough. So when she says that warnings of a pandemic were ignored and humanity has “disrespected the natural world” I listen. The renowned primatologist, 86, said she was not surprised at the current global health crisis, listing the trading of wildlife and the encroachment on habitats as contributing factors.

Some news from countries around the world:

  • European leaders continue to wrangle over the covid recovery package. Spain’s foreign minister, Arancha González Laya, has said that “the bloc itself is at risk. In this crisis, either we all sink or we all float. Spain wants everyone to float, for sure.” EU leaders have already agreed to a 500 billion euro package, but Madrid wants more long term aid, and is calling for a 1.5 trillion euro recovery package, to be financed by perpetual debt. They are not alone.
  • The Netherlands, likely to carry a greater financial burden in the rescue package, are not at all happy about the arrangement. They find themselves in a position reminiscent of pre-Brexit Britain, isolated in a recent European Union council of ministers, with attitudes described by other European leaders past and present as “repugnant”.
  • The French government wants all retail outlets other than restaurants and bars to reopen once the national lockdown is lifted on May 11th, finance minister Bruno Le Maire said on Thursday.
  • There are virus warnings for Ramadan as Pakistan keeps its mosques open.
  • The Peronist president of Argentina, Alberto Fernández has dealt well with the pandemic, but the virus arrived in a country already deep in recession and the country’s finances rather than the disease that will make or break it. Countries need stimulus packages as part of their overall recovery. Creating one when deep debt is already a problem will be a major challenge.
  • Cyril Ramaphosa has unveiled a stimulus package worth ten per cent of South African GDP – $25 billion – and will seek loans and support from the IMF and World Bank in a bid to prevent the lockdown triggering a severe depression.
  • Justin Trudeau is facing calls to increase the share available to people living in urban areas or living outside of reservations of a $350 million fund to help Canada’s indigenous population. Just $15 million is available, despite the fact that half of Canada’s indigenous population live off reservation.

Finally, I was intrigued by a set of predictions made today in iNews and, briefly, how they turned out twelve months later

Ten ways in which Covid-19 will change life in the UK:

Health: long term boosts for the NHS.

The NHS England budget is shown to fall from £148bn in 2020/21 to £139bn in 2021/22. In 2020/21 NHS England got £18 bn in extra funding for its Covid-19 response, in 2021/22 it will get just £3 bn in extra funding, although the cost of the Covid-19 response is unlikely to have fallen so sharply.

Economy: struggles for jobs and higher tax bills for those in work.

Low Covid infection rates and vaccinations lead to a surge in consumer spending. The unemployment rate is also lower than expected. The recovery is looking V-shaped, but what that means for the average person remains to be seen. There are concerns about inflation.

Politics: Brexit is delayed, the state grows and an inquiry awaits.

Boris Johnson secures the thinnest of free trade deals with the EU, with destructive consequences for exports, Northern Ireland and, most ironically, fishing. The state does grow and become increasingly autocratic, while the Covid-19 inquiry is kicked down the road, seemingly when its findings emerge after the next election, which the Tories are confident about winning.

Retail: high streets suffer but independents benefit.

This happens, with some major outlets like Debenhams folding up after 200 years on the high street.

Social care: funding issue is finally confronted.

This doesn’t happen. Social care is barely mentioned in the Queen’s Speech on May 11th 2021.

Education: inequalities grow at school as hard-up universities turn to remote learning.

During the COVID-19 pandemic, 15% of teachers from deprived schools reported that more than a third of pupils would not have electronic access to school work compared to 2% at more affluent state schools. The government scheme to ensure digital access for all pupils falls short, leaving many poorer households limited in how much children’s education is supported. There is a strong backlash from university students who find remote learning inadequate and certainly not value for money for the high fees they are paying.

Technology: consumer tech market falls, as surveillance grows.

The consumer tech market grows significantly with video-conferencing becoming a new norm, online purchasing growing considerably, telehealth, robotics, 3-D printing and more. Consumer desire for 5G outpaces hesitancy over surveillance, despite numerous conspiracy theories.

Environment: big climate-change challenges, but greener lifestyles.

There were almost immediate positive environmental effects, particularly for air quality and wildlife as people travelled less, and with this has come a growing and more widespread environmental awareness among people that change was possible. However, as lockdown was lifted people quickly returned to their pre-pandemic patterns of behaviour. Certain environmental issues, such as water quality have had more mixed outcomes and there has been no impact on use of plastic. When it comes to greener lifestyles there’s still some way to go.

Justice: more video witnesses with police needing to restore trust.

Confused messaging to the police by politicians along with home secretary Priti Patel’s draconian policing bill that exploited protest events during the pandemic leave the police with an uphill battle if they are to restore public trust.

Entertainment: more repeats as BBC bounces back.

The BBC and other entertainment channels become remarkably creative and adaptable. Initially there were more repeats but fresh material grew as the year progressed. Online and hybrid audiences in many shows became the norm. More viewers turned to Netflix and Amazon and other streaming services.

What we saw then and what we know now: It all goes to show how hard predicting the future is.

All we can do is try our best to anticipate it as best we can.

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