Day Forty Six: Thursday 30th April 2020

Daily Diary: The Arsehole Factor

It’s still quite cold, wet and windy for this time of year – we’re almost in May, halfway through spring already. The seedlings in the propagator are growing well, their cotyledons are out and it won’t now be long before the first foliage leaves appear. Five microcress have sprouted and are standing tall and proud, and there are signs that two of the beetroot seeds are just breaking the surface in their potlets. On the windowsill all three geranium cuttings are showing positive growth. I have a bank of ten potlets that came with the sweet peas that the cuttings will vacate for some of the larger seedlings to occupy. The sweet peas are doing well. There’s something life-affirming about watching plants grow – it’s slow, patient, intrinsically calm and reassuring. A message from nature that things are getting better.

I chat to Steve U over the phone. He wants feedback about his Zoom presentation on Tuesday evening and I do my best to give my impressions. Steve in turn is really helpful in getting me to my next step in the unfamiliar world of video-conferencing and I need to get my act together, getting a small team to test meeting up online. We talk about other stuff too, as you do in a conversation with a friend. I tell him about the Coronadiary (which was the name I had at the time for ‘The Covid Chronicle’), its demands and revelations. I told him that we would have to redefine what we meant by “freedom,” from something that is idealistic and unavailable, to something more pragmatic and realistic, and the tensions that come with that paradigm shift. It’s part of the wider struggle between rationalism and politico-psychological realities.

“There’s always what I call the arsehole factor,” he tells me. “It doesn’t matter what makes sense because there are always arseholes.”

I think the comment arose when I referred to some of the groupings I saw out on the common that were clearly not from the same household. Staying isolated prevents the spread of a truly nasty disease, with truly frightening mortality levels among those admitted to hospital.

“Arseholes,” Steve pronounces. “It’s not that they don’t know, or for that matter even care. They’re arseholes.”

He goes on to tell me how his father tried to get community projects going in a village in Nigeria. Some people were well off enough to be able to pool cash for the community as a whole, for water supply and to prevent soil erosion. Many were willing to put their money into a collective pot to achieve such purposeful ends. But a number were not.

“You want me to part with the extra money I made? I can put that money to better use building a nicer house.”

And stuff like that.

So money wasn’t directed to prevent soil erosion, as it was a preventative measure, unlike the visible asset of the borehole for water, and sure enough, within a handful of years it became a major issue and having nicer houses didn’t help those who had channelled their money that way.

The arsehole factor. Now we have an arsehole running the most powerful country on earth and it seems there’s little at the moment anyone can do about it ……. apart from being philosophical and calling out, “Arseholes.”

Back to freedom. I mentioned that we have to be much more nuanced – not thinking about freedom as a pure entity. It’s becoming clear by now that Covid-19 attacks certain human genomes more than others. If we knew everyone’s genome, which is feasible, bearing in mind the rapid development of AI, it should be possible to know the consequences of being infected. Who would succumb. Who would survive. Who would show no symptoms at all. Everything inbetween. It could be known within days, maybe even hours of an epidemic alert. But the trade-off would be our most intimate of data – our DNA.

Steve also says we’ve got to be a lot more nuanced about freedom. He’s ICT smart. More so than anyone else I know. He steers away from Microsoft and Google without cutting off his nose to spite his face and is savvy enough to work the alternatives. He also knows that big tech firms like Google make fortunes mining data and most of us, in our casual lassitude, give that up readily. For the most part it constitutes metadata, in which we are little more than anonymous ‘pixels.’

“All I make sure of,” says Steve, “is they’re welcome to have pictures of cats. They’re welcome to that.”

I know what he means.

“That ancient Greek philosopher – the one who said what price freedom. I’ve got this friend who was obsessed – paranoid even – that Google was mining his data. So I told him he could get an android phone that’s Google-free. You have the benefits of android without needing to worry about Google’s intrusions, digging for your personal data.”

He told him about phone providers who would supply a service where the android system did not involve Google. You could opt-in, like downloading Play Store, for example, but that was up to you. But most people don’t want that and it would cost £500 for such a service.

“I’m not paying that for a phone!” his friend protested.

So freedom had a price tag on this occasion and it was around a monkey in LSD. Hypocrisy, Steve calls it, and he’s right.

The Bigger Picture: Mysterious, frightening and far-reaching.

It’s the end of April and following the US and Italy, the UK’s coronavirus toll is the world’s third worst. We are in a state of crisis, largely because of Boris Johnson’s complacency at the outset. He could have done his homework. The evidence from overseas was already showing the explosive consequences of the pandemic if the blue touchpaper wasn’t snuffed out soon enough. Now he leads Cabinet lockdown talks, driven by the remorselessness of events. The consensus is that Covid-19 is not going away any time soon and some matters that the government had been at the very least negligent about, if not addressed urgently, will lead to politically damaging outcomes.

So the hitherto deeply anti-immigration Home Office has expanded its visa extension scheme to include midwives, radiographers, social care workers and pharmacists, as well as doctors and nurses, for fear of the NHS collapsing under the weight of the pandemic.

Along with for years, the Government had turned a deaf ear to the homeless, including record rough sleeping and overcrowded emergency accommodation – problems that could now spread the virus, creating hotspots. Not to mention a systemic social housing shortage and reliance on the private rented sector where prices are too high, leaving half of renters in work just one pay-cheque away from losing their home. Building social housing – which Britain urgently needs – was barely mentioned in the new chancellor’s first budget on 11th March.

Now the home became the heart of controlling the pandemic. To make lockdown work policies had to put a roof over the heads of the homeless, and protected the financially vulnerable from losing their homes.

Between 17 and 27 March, along with Rishi Sunak at the Treasury, Robert Jenrick, the Secretary of State For Housing, announced housing policy after housing policy which would have been considered “radical” pre-pandemic. The politically “impossible” became possible, the progressive became Conservative.

 “It shows just how much can be done when you have the political will,” Hannah Gousy, head of policy and campaigns at the homeless charity Crisis observed.

If people lost their jobs because of coronavirus, our welfare system wouldn’t be able to handle a scenario in which private renters were unable to pay their landlords because benefits had been cut while rents had gone up. This would lead to evictions, which would cause even more homelessness, completing a vicious circle of precarity and hardship.

So the Government was forced to act, fixing previous housing policy failures in just over a week, reminded that social housing, a key element of Beveridge’s welfare state, largely dismantled over the last thirty years was intended to be a safety net and coronavirus has provided a brutal reminder of why we needed it at all.

The chances are that these changes will be temporary, even though it shows that ending homelessness is possible

While the Welsh government, of a different political complexion to Westminster calls upon former prime minister Gordon Brown to help advise on the aftermath of the coronavirus crisis.

Europe has shown positive signs that it is passing the peak of its coronavirus outbreak, the World Health Organisation (WHO) has said. Dr Hans Kluge, WHO regional director for Europe, said the continent – which has become an epicentre of the global Covid-19 pandemic – is now seeing evidence of “a plateau or reduction in new cases”. Italy currently has the worst death toll in Europe with 27,682 reported fatalities, followed by the UK at 26,097, Spain with 24,275 and France with 24,087. But during a virtual press briefing Dr Kluge said that the outbreak on the continent may now be heading in a new direction, adding a note of caution, “We must monitor this development very closely.”

He also urged governments to “reintroduce other health services quickly” amid concerns patients with cancer and other serious illnesses were not accessing essential care. “We cannot allow the impact of Covid-19 to be amplified by neglecting other health protection measures,” he said.

Nevertheless, despite this cautious optimism, how exactly the pandemic will progress remains as mysterious as many other aspects of the disease.

We think of covid-19 as a disease of the respiratory tract. When future generations look back on this pandemic, its iconic symbol will probably be the ventilator. But, although respiratory problems are at the core of the disease, covid-19 has revealed itself to be more than a straightforward viral pneumonia. It doesn’t confine its ravages to the lungs, but can push kidneys into failure, send the body’s immune system into catastrophic overdrive, and cause blood clots that impede circulation to the lungs, heart, or brain. It’s a disease of remarkable complexity, which even the most experienced doctors are struggling to understand.

The shortness of breath that’s most characteristic of covid-19 is reasonably well understood. It originates in the air sacs of the lungs, called alveoli, where blood and air are separated by such thin membranes that oxygen and carbon dioxide can pass into and out of the bloodstream, respectively. Between them, the lungs have somewhere in the neighbourhood of six hundred million alveoli. Severe covid-19 causes many of them to either collapse or fill with fluid. The virus attacks the cells lining the alveoli; our overactive immune systems, in trying to fight the virus, may be damaging them as well. The result is that not enough oxygen gets into the blood.

Doctors trying to solve this problem have two basic tools at their disposal: oxygen and pressure. They can give patients concentrated oxygen beyond the usual twenty-one per cent that is found in normal air. Alternatively, using a CPAP machine or ventilator, they can create a kind of sustained air pressure within the lungs, a “positive end-expiratory pressure,” or peep, which keeps the alveoli open, and thus more receptive to oxygen, at moments when the lungs would ordinarily be emptier of air. Doctors have also been improving oxygenation by “proning” patients—that is, periodically turning them onto their stomachs. Such positioning takes advantage of gravity to match areas of air-filled lung with areas of higher blood flow.

But doctors are finding, bizarrely, that some covid-19 patients can remain subjectively comfortable even when their saturation levels fall far below these ranges. This “silent hypoxemia” is frightening for physicians, who associate such low numbers with imminent death. And it’s deeply mystifying, since the numbers seem implausible. No one knows at this stage what leads to silent hypoxia.

Within hours of a viral invasion, the body’s immune system swings into action. The “innate” immune system, which recognizes protein structures common to many pathogens, reacts first, by releasing a family of chemical distress signals called cytokines. They spread from the site of the infection, instructing the body to raise its temperature and divert blood flow to the affected area; they also activate other immune-system cells, which begin developing antibodies specifically targeting the invaders. Without cytokines, the immune system would slumber while infections wreak havoc. But the cytokine system has a weakness. Some pathogens can provoke it in a perverse way, so that it goads the immune system as a whole into overdrive. In what’s known as a cytokine storm, fever and inflammation spike out of control. It’s unclear why some patients might experience this phenomenon while others do not.

Faced with a cytokine storm in a patient, a doctor can try to modulate the immune system’s response. The problem is striking the right balance. While some patients may benefit from a degree of medically induced immunosuppression, there are others for whom such an intervention could cause great harm. Some hospitals have begun cautiously administering steroids or drugs that inhibit the cytokine IL-6. High-quality clinical-trial data about such treatments won’t be ready for a long time.

It’s not only the immune system that must maintain a delicate balance. The bloodstream, too, exists in a perpetual tug-of-war between bleeding and clotting. Too much bleeding, and the smallest trauma can cause haemorrhage, even to the point of death; too far in the other direction, and clots will form in the absence of trauma, potentially obstructing blood vessels and causing lethal damage if they travel to the heart, lungs, or brain.

Doctors often test critically ill patients for cardiac-specific troponins—proteins in the bloodstream that are normally found only in the muscles of the heart. The presence of such proteins in blood suggests heart damage. Some severe covid-19 patients have elevated troponin levels; their hearts appear to be damaged. No one’s entirely sure what’s causing the damage, though, and so no one knows exactly how to treat it.

One major cause of heart damage is oxygen starvation: it’s what happens in a heart attack, when the sudden obstruction of a coronary artery prevents oxygen from reaching heart muscle. Starvation can also occur when failing lungs prevent oxygen from entering the bloodstream, or when sepsis causes such a drop in blood pressure that even properly oxygenated blood can’t get to the heart fast enough. These problems are significant, and, in broad terms, doctors know how to respond to them.

Another suggestion, from China, is that the virus could be attacking the heart muscle directly, causing a syndrome known as myocarditis. No one knows for sure what the best treatment for this form of myocarditis might be. Some doctors have reported that steroids can help—and yet steroids also act as an immunosuppressant. In critical care, it’s often hard to bring one organ system into balance without destabilizing another.

A similar story appears to be unfolding around the kidneys. Complete kidney failure is a death sentence if it’s not quickly addressed. Unfortunately, many critically ill covid-19 patients are developing it. Just as ventilators are substituting for failing lungs, so dialysis machines are taking over for failing kidneys. This is leading to shortages of the resources needed for dialysis: dialysis machines, the fluid used in the dialysis process, and dialysis-trained nurses.

We don’t yet know how kidney injury plays out in covid-19 patients. It’s likely that some people will recover their kidney function, while others could lose it permanently. We also don’t know why people are going into kidney failure in the first place. As with the heart, it’s possible that oxygen starvation is the problem. But some clinicians argue that the virus is attacking kidney cells directly—and there is post-mortem data out of China that supports this thesis, too.

Still other organ systems may be involved in covid-19. The ace-2 receptor protein, which is used by the coronavirus to enter human cells, resides not just in the respiratory tract but also on cells in the stomach, intestines, liver, kidneys, and brain. There are reports of coronavirus patients with encephalitis—a potentially fatal inflammation of the brain—and signs of an increased incidence of stroke. There have been covid-19 patients suffering from a severe complication of diabetes called diabetic ketoacidosis, despite having no history as diabetics.

In a month doctors have gone from asking about fever and coughs to understanding that the disease manifests in other ways, or sometimes proceeds with no symptoms at all.

It is a mysterious disease that despite the fact that at least 777,286 people around the world are known to have been infected since the outbreak began, and 37,140 people have died, much is still not sufficiently understood.

The science historian, Lorraine Daston, writes it’s natural to cast about for answers at the dawn of a pandemic:

“At moments of extreme scientific uncertainty, observation, usually treated as the poor relation of experiment and statistics in science, comes into its own.”

And as Clifford Marks and Trevor Pour of the New Yorker concluded:

Confronting a new disease, doctors have no choice but to turn to “suggestive single cases, striking anomalies, partial patterns.” Slowly, as our ideas about “what works and what doesn’t” help tell us “what to test, what to count,” the picture clarifies. Until then, “we are back in the seventeenth century, the age of ground-zero empiricism, and observing as if our lives depended on it.” One patient at a time, we have to work our way into the present.

In the UK a third of Covid-19 patients admitted to hospital are dying, with figures indicating the virus is just as deadly as Ebola for those forced to seek emergency medical treatment. The most common symptoms reported included a cough, seen in 70 per cent of patients, fever in 69 per cent and shortness of breath in 65 per cent. Coughing up mucus, a sore throat, a runny nose, wheeze, chest pain, muscle pain, joint pain, fatigue, abdominal pain, vomiting and diarrhoea were also observed. Professor Semple, who led the studies at Liverpool University, added, “Covid is as dangerous as Ebola, because it’s highly transmissible and it’s associated with a very high crude case fatality rate for those who go to hospital.”

This is where we’re at. Mysterious, frightening and far-reaching.

To my mind Oxford University partnering with Astra Zeneca to distribute the covid vaccine marks out today as a milestone in the history of the pandemic. What has been happening in a research laboratory is now being industrialised, and it’s the first sign that mass-vaccination in the coming year is a strong possibility. There were many steps along the way, as University of Bristol Professor, Adam Finn, chairman of the European Technical Advisory Group of Experts, advising WHO Europe, warned the media, but that column of dust breaking the horizon is the cavalry.

There is also some optimism in Gilead’s antiviral drug remdesivir, and the stockmarket has a good day as a result, but it is also known that it is not going to be a ‘magic bullet,’ a treatment that is guaranteed to stop covid deaths or severe symptoms. Nor is there any other drug in the pipeline that’s likely to be either.

So all we have is the response civilisations have used since ancient times – identify who has the disease and keep them well away from everyone else until the disease has run its course. Quarantine comes from the French ‘quarant,’ meaning forty – the Christian observance of Lent, with its emphasis on self-restraint, added weight where religion was so much more central in western culture. Sure, we’ve got a lot more adept at diagnosing diseases, but equally, Covid-19 challenges that with a substantial number of infected individuals being asymptomatic – a host of Typhoid Marys (and Martins) out there. Or should I say Covid Marys and Martins. 

“Test, trace, isolate” has become the slogan, but with its open borders and a largely privatised tracing system it’s all a mess.

Health secretary, Matt Hancock looks like he’s unlikely to reach his 100,000 daily Covid-19 antigen tests by the end of April. The latest figure, 52,429 tests carried out in England, Scotland and Wales on Tuesday, is from an overall capacity of just over 73,000 a day.

When asked about the Government’s missing its much-hyped 100,000 a day testing target, justice secretary, Robert Buckland replied that the public should recognise ministers for “being brave.”

A bizarre response in the face of incompetence.

And the politics of numbers gets criticised as they distract from a shaky strategy, that would, for example, include testing in care homes.

In America, the federal government launches a $500 million ‘Shark Tank’ style challenge (we’d say ‘Dragons Den’ in the UK) to speed the development of better coronavirus tests and much-blighted New York hires a thousand healthcare workers to begin contact tracing.

So at this stage of the pandemic, testing has become all-important, because there is so little to report about those other elements of controlling, let alone ending this plague.

And developments are big news: A coronavirus test that delivers results in 75 minutes is being trialled in London hospitals – and could be available for Londoners to buy and use at home in weeks. Its inventor, Professor Chris Tammazou of Imperial College, London, plans to rapidly expand production to 300,000 tests a month by July to establish a “Deliveroo-style” delivery service to homes and businesses. This will enable companies to test staff in order that they can safely return to work.

It will be superseded by a test that gives a result in less than 30 minutes, but the arrow is pointing in the right direction.

The combination of coronavirus and Brexit is driving Britain towards double austerity, but the blow to the economy won’t be even. Cash-laden firms do best, and it helps not to be owned by a hedge fund. With more people at home and online big tech does well, with Google’s parent company, Alphabet beating its first quarter revenue and hitting $41.2 billion. Others are not so lucrative. Helen Dickenson, chief executive of the British Retail Consortium, told the parliamentary business select committee that 69 per cent of non-food retailers have been ‘significantly’ impacted by the virus.

Transportation companies are also struggling. Uber is reportedly laying off 20 per cent of its workforce, some 5,400 employees. Last month business was down as much as 70 per cent in major cities. In America, Lyft and Boeing are the latest companies to cut workers amid the pandemic.

Banks are locked in last-minute talks with regulators to secure a pledge that they will not come under attack in future years over Rishi Sunak’s so-called “Bounce Back Loans” for the smallest businesses affected by covid. Under pressure from small firms unable to qualify for his main Coronavirus Business Interruption Loan Scheme, the chancellor this week announced new micro loans only requiring a one page application form.

The human food chain becomes a critical industry. Pret a Manger is to open a further 20 stores in London for takeaway and delivery.

But for supermarkets Covid-19 also adds to the overheads.

Sainsbury’s today warned the cost of making its stores safe and a plummet in non-food sales will dent profits by £500 million. The grocer has seen food sales boom in recent weeks as shoppers first stockpiled in March and later switched their usual food spending from restaurants to supermarkets. Sainsbury’s expects profits to be hurt by “significant costs” due to protecting staff and customers; weakened demand for fuel, clothing and general merchandise; and lower profits in its bank.

On the darker side of business, shameless sellers are cashing in on Covid-19 by hiking up the price of essential products, such as cleaning products and baby formula. This obvious display of price gouging is a kick in the teeth for what’s already a difficult time for most of us. Sellers are exploiting us to make an unjustifiable profit. The consumer organisation Which sets up a petition, demanding that the Government introduce emergency legislation to stop sellers charging unjustifiable prices for essential items during times of an emergency.

And Russia’s newest black market is in ventilators. The hunt for ventilators to keep alive people severely stricken by Covid-19 has taken a violent turn. Russian law enforcement officers exchanged gunfire with a gang suspected of trafficking the devices during a raid near Moscow, a Russian news outlet with close ties to the security services reported on Wednesday.

If you had submitted a script a year ago for a TV drama involving a shootout over medical equipment it would probably have been turned down for being too far-fetched.

But this is where we’re at. Mysterious, frightening and far-reaching.

And people’s behaviour is already beginning to fray.

Some of us fall prey to misinformation. The Italian Health Ministry debunks alcohol as a way to ‘boost the immune system,’ adding, “Breathing hot air from a hairdryer does not prevent you from getting infected. The hot air from the hairdryer cannot reach the temperatures at which the virus dies. There would only be irritation of the mucous membranes and the risk of burns.”

Some of us become conflicted by our own good intentions. On the one hand, based on their enthusiasm from the public on previous weeks Londoners were told today not to gather on Westminster Bridge to take part in tonight’s ‘Clap for Carers,’ as the Met warned it was “not acceptable” to put safety at risk by flouting lockdown rules.

‘Clap for Carers’ was an idea that started in Europe and was adopted in the UK by Annemarie Plas, a Dutch woman living in London, who promoted a campaign which took place every Thursday evening from 26 March. It started out as a genuine gesture of deep respect, appreciation along with togetherness and belonging.”

But then the Government muscled in on the act, not least the PM himself, his narcissistic presence catching as much, if not more media attention than the carers and their appreciators.

On Monday the BBC aired its current affairs programme, Panorama. The programme focussed on the lack of Government support with PPE, while at the same time the PM and ministers were actively encouraging the ‘Thursday Clap.’

Many people found the level of hypocrisy they were witnessing difficult to stomach.

“No, I won’t be clapping for our carers tonight,” journalist Ravinder Randhawa wrote in the Huffington Post, “And you shouldn’t be either.”

Some of us become confused by mixed messaging. Public Health England official Yvonne Doyle warned the public against travelling by car, as new figures showed that the highest motor traffic since lockdown began on March 23rd. Fears of the virus spreading on public transport have certainly been a contributing factor. Meanwhile, the open road of early lockdown was too much of a temptation for a few, as police record an eight-fold increase in speeding.

Some of us end up at the receiving end of ‘creative’ ideas by the authorities. The university town of Lund in Sweden is to dump a tonne of chicken manure in its central park in a bid to deter up to 30,000 residents from gathering there for traditional celebrations to mark Walpurgis Night on Thursday.

“Lund could very well become an epicentre for the spread of the coronavirus on the last night in April – I think it was a good initiative,” the chairman of the local council’s environment committee, Gustav Lundblad, told a Swedish newspaper.

Walpurgis Night, celebrated on 30 April, is widely marked across central and northern Europe with parties and bonfires. The festivities are classed as “spontaneous” so cannot be banned by authorities, but to avoid the risk of spreading the coronavirus many towns and cities in Sweden have asked citizens to give the tradition a miss this year.

Lund is home to one of Sweden’s biggest universities and many of the municipality’s 125,000-odd inhabitants are students who habitually gather in the park in the afternoon and evening for picnics before the Walpurgis party proper gets underway.

Philip Sandberg, the leader of council, told the paper it would “not be a pleasant experience … to sit in a park that stinks of chicken manure. But it will be good for the lawns, as chicken manure contains a lot of phosphorus and nitrogen, so we’ll get a really nice park for the summer.”

Sweden has opted for a light touch approach to containing Covid-19, in contrast to the strict lockdowns imposed by its Nordic neighbours and much of the rest of Europe and favouring personal responsibility over draconian enforcement. The government has banned planned gatherings of more than 50, but asked – rather than ordered – people to observe physical distancing, avoid non-essential travel, work from home and stay indoors if they are elderly or ill. Shops, restaurants and gyms have remained open.

Even in Sweden, it seems there are limits to how much the authorities trust the personal responsibility they espouse.

Even so……

Some of us blatantly won’t do as we’re told. Soon after a revered Hasidic rabbi died from the coronavirus in Brooklyn on Tuesday, his fellow congregants informed the police department they would hold a public funeral, despite the virus restrictions in place. However, 2,500 crowded the streets.

Some encourage that. As Elon Musk condemns lockdown as “fascist.”

Getting out of lockdown starts to preoccupy every western country hit by the pandemic. It’s looking increasingly that it’s harder to come out of lockdown than it was going into it. There are fears that many could be catapulted off a financial cliff-edge. There are fears that the London Underground could be ‘rapidly overwhelmed’ when lockdown lifts in London.

And restaurateurs fear reopening under social distancing rules could destroy profits. Chefs and business owners say that while it’s necessary, social distancing could mean that reopening is practically impossible. Nevertheless, cut-price pub chain Wetherspoons plans to reopen its bars and hotels “in or around June,” despite warnings from ministers that the sector was likely to be the last allowed out of lockdown restrictions.

More and more, it’s clear that governments have to take a lead and have clear plans in place. Spain, for example, plans to lift its lockdown in phases:

Phase Zero: The preparation phase of the transition to lifting lockdown. It’s greeted by citizens with a sigh of relief as adults are allowed outside by May 2nd. Children have been permitted to go outside for an hour of exercise every day since Sunday.

Phase One: Small businesses will be allowed to reopen, while specific shopping hours will be set for those over 65 years of age. Larger shopping centres will remain closed. Hotels and other tourist accommodation will also reopen; however, common areas will not be accessible. Face masks are ‘highly recommended’ on public transport.

Phase Two: Restaurant interiors will be permitted to carry out table service, while educational centres will also be able to reopen, with exceptions. Cultural events with less than 50 people in enclosed areas and 400 in outside spaces will be allowed.

Phase Three: This is an advanced phase in which restrictions will be ‘limited.’

Meanwhile we continue to witness what life under lockdown looks like:

There were three individual people’s stories of the day that particularly came to light

The first is that locals came out to applaud a Battle of Britain Memorial Flight flypast as it passes over the home of Captain Tom Moore as he celebrates his 100th birthday. His NHS fundraising campaign hits £30 million as birthday wishes flood in. He has also been made an honorary colonel.

The second is the rollercoaster of a pregnancy Boris Johnson’s fiancée, Carrie Symonds has had, from election to Covid-19. On top of that, it is a pregnancy that she has had to experience in the public eye.

But it’s the third story that stood out most of all. Unlike the first two it’s not about someone in the public eye. It’s a story that frankly leaves me with a sense of deep outrage, of injustice and the harsh treatment of minorities in the cruel shadow of Covid-19. A young woman from South Dakota who gave birth while on a ventilator died in federal custody on Tuesday after contracting the virus. Andrea Circle Bear, 30, of Eagle Butte, South Dakota, appears to be the first female federal inmate in the United States to die in custody after contracting the virus, according to data from the Bureau of Prisons, She had recently begun serving a 26 month sentence for maintaining a drug-involved residence on the Cheyenne River Sioux Indian Reservation, the agency said in a news release. It begins with a harsh sentence for a relatively minor drug-related offence and ends with her dying while in the custodial care of the state.

I’m left wondering about whether this story will quietly die, while those of Tom Moore and Carrie Symonds will live on, simply because Andrea Circle Bear was never in the public gaze for longer than a day. It seems that it will and that in turn seems wrong. 

Across America coronavirus cases pass the million mark. It’s a third of all cases globally, and in hot spots the death toll rises with it. A Massachusetts nursing home has had 68 deaths. Sometimes there are signs of reprieve, but at this stage of a pandemic they are illusory. For the first time in more than a month, New Orleans reported no new Covid-19 deaths on Monday – but it only lasted a day. It was the first time the Big Easy reported no fatalities from the virus since March 22nd.

Other news from the US:

  • The US economy shrunk at 4.8 per cent annual rate in the first quarter, its biggest contraction since the recession in 2008. Worse is to come.
  • Trump says that the federal government will not extend its social distancing guidelines.
  • He also declares that meat plants are ‘critical infrastructure’ and signs an executive order to keep them open.
  • We need the real CDC back, and we need it now.
  • Celebrity doctor and doctor to celebrities, cancer specialist David Agus has been swept up into the White House as it confronts the Covid-19 pandemic . Agus’s work is neither glitzy nor overtly controversial, but he’s found himself in the spotlight, having promoted hydroxychloroquine in March. Exactly what Agus’s role is in Trump’s White House remains unclear.
  • VP Mike Pence finds himself defending his maskless visit to the Mayo Clinic, some former patients also criticise the institution.
  • In an election year it’s becoming clear that voting online may well be more important. There are many, especially Republicans, who believe that despite the pandemic, voting online is not the way to hold an election, claiming It is still too vulnerable to cyber-attacks and other security breaches. These are the quiet beginnings to a story in the coming months that will shake not only American democracy, but the very principles of democracy to its core.
  • Across America, private companies step in to source protective gear. Citizens mobilise to fill America’s need for anti-covid PPE. It’s a valiant attempt to compensate for the federal government’s failure.
  • The acting secretary of state for the Navy on Wednesday ordered a wider investigation into the events aboard the aircraft carrier Theodore Roosevelt, apparently shelving for now a recommendation by the Navy’s top admiral to restore Captain Brett Crozier to command the virus-stricken warship.
  • In fading steel towns, chronically ill patients hope video visits stay after the pandemic goes.

Across the planet:

  • Angela Merkel sends out a warning call not to forget climate finance to the world’s poor. As rich countries spend billions bailing out industries hit by the Covid-19 slump, the German chancellor urged them not to forget their climate commitments.
  • There are still 33 countries and territories across the world which have not yet reported a single case of the novel coronavirus. Many are small, hard to reach island nations in the Pacific, such as Nauru, Kiribati and the Solomon Islands. Others include Comoros, Lesotho, Tajikistan and Turkmenistan. Several of these nations are the least populated parts of the world.
  • Infectious disease expert: Scientists need to collaborate across borders to fight the pandemic.
  • Overtaxed health systems, closed facilities and disrupted supply chains will curtail access to reproductive care for women and girls, particularly in low-income nations, according to UNFPA. Assuming six months of lockdown, 47 million women in 114 low to middle income countries will likely lose access to contraception because of the pandemic, leading to 7 million unintended pregnancies, the report says.
  • In France faith in central government fractures over the government’s Covid-19 response.
  • Hungarian schools are to remain closed until the end of May.
  • Brazil’s justice minister storms out of Bolsonaro’s government, calling the president a scofflaw, while as coronavirus deaths spike, Brazil’s leader says, “So what?”
  • Putin lengthens lockdown as Russia’s Covid-19 cases now surpass China.

This is where we’re at. A disease that remains mysterious, frightening and far-reaching.

But there are always positive souls to line our dark clouds with silvery sunlight.

On my local Nextdoor:

“Bonjour. In the current situation of lockdown, with free time at your disposal, why not try something new. When the schools have limited opportunities for pupils to practice and keep a good level for the future, let’s plan revisions  and boost their confidence with a fun approach. Maybe you want to learn or improve your French you studied at school a few years ago and wanted to reconnect with. 8 pounds an hour.”

Eight pounds an hour for personal French tuition?

Sounds like a good deal.

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