Day Forty Eight: Saturday 2nd May 2020

Daily Diary: The New Normal

We’re entering the seventh week of lockdown and the trope I really dislike is the “new normal.” It has all the attributes of gaslighting. All of a sudden, along with “stay safe” and “when this is over” it has entered the Lexington of the anglosphere. Politicians and presenters all over the place are dropping the phrase lazily – an expression of convenience. But to use it has an Orwellian ring about it. It can be manipulated, squidged here, squashed there, and before we’ve figured what’s happened, hurrah, here’s dystopia! But don’t worry your little head about it, we’ll call it “the new normal” and all will be well.

There’s a countermove to the new normal. It’s not particularly pleasant either. Not wanting the new normal – in fact not wanting any part of it – armed protestors stormed the Michigan State House over the Covid-19 lockdown. I’m not sure I’d want their “old normal” either. The Swedes have just said fuck it …… or maybe Fükkit, as I have a feeling there’s something useful travelling under that name in my local IKEA …… and carried on with the old normal, more or less. Seems to me that people are dying as a result. A horrible covid death that really doesn’t bear thinking about.

We’re only about 130 days into the outbreak – I mean 130 days since the virus ‘decided’ that human hosts would make a cool change of genetic scenery, and as the disease reveals itself, it’s turning out to be a particularly nasty piece of work. One way or another, it affects a number of human organs and we’re still in the process of learning about the damage it’s capable of inflicting. Evidence is emerging that even if you survive the disease your lifespan may well be shortened.

Some medics say sooner or later the virus will get to all of us and we’ll have to say our prayers to the Almighty, that in all his wisdom he has already fitted us DNA sequences that won’t let down Vicky, Emily, Tom and others near and dear to us. But that’s being selective and we know nature is pretty indifferent to all our existences. Harsh but fair, some might say.

 So as a rising 68 year-old it makes sense to batten down the hatches and ride out the storm.

On the home front I did a trial Zoom with Nigel. Despite the fact that he didn’t have a camera or a working microphone it worked (we had WhatsApp running on our phones in the background) ….. technically, that is, and there’s a Zoom chat with Emily this evening and Ian’s 60th birthday ‘party’ tomorrow. Becoming quite the zoomster, and certainly the angst hurdle is behind me. Other than that, a birthday card to my sister Judith went into the post and I made some more fiddly progress on the portee anti-tank truck my dad used during the war. I take my time with models – they’re calming and focus the mind. They always present problems …… and this, which is highly customised, is a real challenge.

And then, of course, there’s watching plants grow, which is a lot more positive and less messy than watching paint dry.

The Bigger Picture: Disorientation

It’s about a hundred days since a 35 year old man walked into an emergency clinic just north of Seattle with a persistent cough. It was January 19th and he’d just returned from a family visit to Wuhan. Since then, in America alone, over a million people have been infected by Covid-19 and over sixty thousand people have died. Factories have shut down, airplanes have been parked on the ground and workers are digging hundreds of graves on an island off New York City.

More than 26 million people have lost their jobs and the unemployment rate for the entire country is trending toward 20 per cent.

The pandemic spreads like wildfire, its embers spreading far and wide, setting up new epicentres like a rash across the nation, its speed of travel unprecedented and people in its way unprepared, from health systems to individual citizens finding the daily life to which they had grown accustomed disrupted beyond all expectations.

Within a month of America’s patient zero seeing the doctor about his cough people are dying. The suddenness and speed with which the pandemic strikes, establishes itself and spreads disorientates, leading to misdiagnosis that Covid-19 is little more than a bad flu. On February 28th President Trump is more concerned about a political rally he’s heading to in South Carolina than he is about a devastating disease. “As you know,” he says. “With the flu, on average, we lose from 26,000 to 78,000 people a year.”

A doctor from Italy warns on TV that everything you’ve done up until now isn’t enough. You have to start preparing. It’s a warning from bitter experience in the first European country to be hit hard by the pandemic, but it falls on too many deaf ears.

By March 23rd more and more Americans are fed up with the lockdowns. A Colorado businessman, sums up a widely prevailing attitude. “The government should get out of the way of the free market. People should decide for themselves if they want to isolate.”

It’s about small government and individual liberty, and Donald Trump is eager to tap into those very American sentiments. “Our country wasn’t built to be shut down,” he says at a White House  press briefing.

He’s fanning the flames of his political base.

As a result, In several states, angry, flag-waving residents have begun protesting the stay-at-home orders, and Trump turns to Twitter to offer them his support: “LIBERATE MICHIGAN!”, he writes, “LIBERATE MINNESOTA!” Finally: “LIBERATE VIRGINIA, and save your great 2nd Amendment. It is under siege!”

The latest is that armed protestors storm Michigan State House over the Covid-19 lockdown.

The problem is that light touch government and individual liberty at all costs, whatever their virtues in the post-Enlightenment western world are the kiss of death when it comes to pandemic management. 

Little wonder then, thatpublic confidence in President Trump’s ability to handle the pandemic has taken a considerable hit over the past month, and he has lashed out at aides last week after receiving internal polling that showed Joe Biden beating him in several important states. It’s a sensitivity that almost certainly leads to the White House blocking Dr Anthony Fauci from testifying before Congress about the Covid-19 response.

Trump also apparently feels the need to deflect attention to America’s growing rival for world hegemony – China.

Starting a world-blighting pandemic is not a good look.

He claims to have evidence linking Covid-19 to a Wuhan laboratory after a both an intelligence chief and the WHO say Covid-19 is natural in origin. Laboratory escapes are not unknown, even from labs studying pathogenic viruses for medical research, but Trump’s inference is somewhat more sinister than that, suggesting manipulation of the virus.

It sets in train events that make it impossible to discover the virus’ origins. From now on, China goes into ever-increasing denial, followed by active obstruction and eventually downright lies, starting the twilight of co-operation between the scientific communities of both countries.

More from America:

  • ‘America First’ gets darker as the Trump administration and major manufacturers press Mexico to keep factories that supply the US operating, even as their workers fall ill.
  • ‘Republican States First’ becomes the next step with Senate Majority leader Mitch McConnell’s crazy idea to let states go bankrupt rather than get federal aid, politicised as “blue state bailouts” has set off a debate that has engulfed Washington.
  • In the coming weeks, the Supreme Court will render a decision that will determine whether nearly 700,000 individuals protected by Deferred Action for Childhood Arrivals (DACA) will remain in the workforce, protected from deportation. If the court strikes down DACA, then every DACA recipient — including 29,000 physicians, nurses, health aides, and technicians — could be forced from the United States within two years. Some could have only weeks. That would totally jeopardise America’s pandemic response.
  • California is closing Orange County beaches after photos of packed beaches caused outrage. Governor Newsom called the beach crowds an example of “what not to do.”
  • A New York nursing home reports 98 Covid-19 deaths in a “horrifying” outbreak.
  • New York City’s subway system – one of the few in the world that runs 24 hours a day – will shut overnight to provide more time for disinfection.

It could be due to the shock and disorientation from the rapid spread of the virus that citizens living under lockdown in several European nations have showed a renewed support for democratic institutions in their countries, as well as their respective prime ministers or presidents. Or so a study at King’s College London found.

Or could it be that being stuck with whoever we had has led to a particular variant of Stockholm syndrome? Regardless? Who knows?

Even Boris Johnson, after all his bluster and blunder, along with a cabinet startingly bereft of intellectual heft and governmental experience, has an approval rating (likes minus dislikes) of +28, although it is slipping. There’s a lot of war lingo, fighting rhetoric and willy-waving, making the Government’s response to the coronavirus all a bit macho. But the British public seem to put up with it. Women’s voices in leading the nation through and hopefully out of the pandemic are notably absent, despite women bearing the brunt of the hit to the economy, are trapped in dangerous households and make up the majority of Covid-19 diagnoses in some regions. In fact, it took over three weeks of daily Downing Street briefings before a female minister took the stand – Priti Patel – on April 11th.

With Johnson’s “War Cabinet” being entirely made up of men – Rishi Sunak, Matt Hancock, Dominic Raab and Michael Gove – little wonder.

Yet for all the alpha male posturing of Johnson and his team, the reality is one of indecision. You could be forgiven for thinking that an 80 seat majority would result in a unity of purpose. But it hasn’t. Among Tories there are lockdown hawks and doves, there are those who see large scale state intervention as necessary, and those who see a return to small government at the earliest opportunity as the covid economic crisis deepens?

Some look to Sweden, that has controversially forgone stay at home orders and measures like public mask-wearing. As a result of this more relaxed approach the country is hard-hit by Covid-19, with a rising infection rate of 26 per cent, higher than its more restricted Nordic neighbours. Even President Trump says Sweden is ‘paying heavily’ for its failure to lock down as death tolls rise above 2,500.

The architect of Sweden’s approach was state epidemiologist Anders Tegnell at the National Institute of Public Health. Driven by a cost-benefit analysis of lives versus the economy, along assumptions about Swedes’ self-discipline, expecting them to act responsibly without requiring orders from authorities the Swedish government took a step back and allowed Tegnell to manage his model to run its course, even until herd immunity was reached within the population as a whole. According to the World Values Survey, Swedes do tend to display a unique combination of trust in public institutions and extreme individualism. As sociologist Lars Trägårdh has put it, every Swede carries his own policeman on his shoulder.

By late March it was becoming clear that Tegnell’s model was in trouble. Belatedly, and playing catch up the government found itself needing to step in. From March 29th, it prohibited public gatherings of more than 50 people, down from 500, and added sanctions for noncompliance. Then, from April 1st, it barred visits to nursing homes, after it had become clear that the virus had hit around half of Stockholm’s facilities for the elderly.

Further restrictions followed.

Tegnell had made assumptions about the special exceptionalism of Swedish social behaviour and the changing demographics of his country – a quarter of the population are of non-Swedish descent. Worse than that, he had not factored in the asymptomatic transmission of the novel coronavirus, a factor that was increasingly coming to light. In comparison with other Nordic countries, on April 17th Sweden’s deaths from Covid-19 were 136 per million, compared with 58 per million in Denmark, 30 per million in Norway and 15 per million in Finland.

UK deaths per million on the same day stood at 217 and much as PM Johnson and his government had entertained the idea of a model recognisably similar to the Swedish one – maybe without hypothetical personal police officers sitting on citizens’ shoulders – it was clearly not a path that could be trod.

It’s clear that the UK lockdown will have to continue until numbers are much lower, and the economy, along with government revenues will have to take a hit.

Businesses continue to suffer. Today’s updates:

  • The National Trust is set to lose £200 million this year.
  • Ryanair, Europe’s biggest budget airline, is cutting 3,000 jobs in order to survive.
  • According to a Law Society survey 71 per cent of high street law firms will be forced to close this year as a result of the pandemic, according to a Law Society survey.

But eyes are already on the next step – lifting lockdown and getting the economy to recover.

The PM and other officials are hoping some shops, offices and factories can reopen on May 26th, the Tuesday after the bank holiday. But this plan is only the ‘best hope’ and could change if the current slowdown in Covid-19 cases picks back up again. There is a suggestion that commuters should check their temperature before travelling. Other ideas to ease lockdown reportedly include wearing face masks, a reduction from 2 to 1 metres distancing, the distribution of hand sanitiser at bus stations and new signage to warn commuters against getting on to busy trains, as Boris Johnson prepares to lay out a “roadmap” next week for schools and businesses reopening. Other countries have been much clearer about their plans

The government has been criticised by Labour and business groups for failing to lay out a strategy for easing the lockdown, as other countries have done, but PM Johnson, true to form, keeps it vague with a fair sprinkling of boosterism. “What you’re going to get next week is really a roadmap, a menu of options,” Johnson said on Thursday. “Until this day comes [when a vaccine is ready], we are going to have to beat this disease by our growing resolve and ingenuity.”

Part of the problem, according to Sir David Spiegelhalter, a statistician at the University of Cambridge, is that the ‘stay at home’ message has been too successful, as polls show two thirds of people are anxious about going back to bars and restaurants. Perhaps, he goes on to suggest, Britain will need a campaign to persuade people to start living again.

The UK is far from alone in that respect. The Germans too are split over lifting lockdown. A growing number of people in Germany are resisting lockdown measures imposed to contain the coronavirus. The rift between those who support the measures and those who are critical of them is growing.

While in the US, as some states begin to relax lockdown orders and allow businesses to reopen, a new report from the Penn Wharton Budget Model (PWBM) on Friday found that reopening before June could save 18 million jobs but also result in over 200,000 additional Covid-19 deaths.

It’s a painfully hard trade-off.

In Italy, despite the number of Covid-19 cases slowly rising, the country enters Chapter Two of the Corona Crisis, as the country is now facing the next phase of a serious crisis: how to kickstart an economy that has been at a standstill for weeks.

Back in Britain, a government dominated by its Brexit agenda, finds itself in what can be described as a ‘Britain First’ trap in its messaging about immigration. Its assiduously driven ‘hostile environment’ policy persists, breaking the most vulnerable of recent arrivals with desperation and poverty. Forced to live on just £37.75 a week, asylum seekers are now facing an impossible choice between eating and staying safe. While in reality, the UK’s problem rebooting its economy after covid is likely to be too few immigrants, not too many, and the politically manufactured ‘hostile environment’ will be central to that problem.

Leaving lockdown is a lot harder than going into it, and every bit as perilous, not only in its economic challenges but it also means understanding the immune responses to the virus.

A lot is still unknown.

We don’t know what the future of Covid-19 will be. Recurring small outbreaks, a monster wave, or a persistent crisis are seen as being the three most likely possibilities, but they are very different. From previous pandemics a second wave seems likely, and maybe a third and more. A deadly resurgence of the coronavirus could change the way we live for many years to come.

We do know from experience dealing with Ebola that it’s not enough to fight one disease outbreak – systems need to be built to prevent the next ones.

Aspects of its transmission are still unclear, such as whether the virus can spread via the eyes. As are the mysteries of why Covid-19 expresses itself in particular ways, the most recent being how it is causing strokes in healthy people.

Many countries have learned the hard way the importance of testing. Limited testing and delayed travel alerts for areas outside China contributed to a rise in Covid-19 cases from late February, Dr Anne Schuchat of the US CDC said. The first case of the coronavirus was reported late last year in Wuhan, China, the initial epicentre of the global pandemic, but the US have since become the hardest-hit nation.

In America and elsewhere, testing becomes a business gold rush, as The New York Times reports:

Some biotech companies are cashing in on the race to produce Covid-19 antibody tests, taking blood samples from people who have been infected and selling them on at exorbitant prices. And the people who give their blood to help with the fight against Covid-19 may not realise it is making such profits for the companies. Documents, emails and price lists obtained by the New York Times show that several companies around the world are offering to sell Covid-19 blood samples to labs and test manufacturers at elevated prices. One is Cantor Bio Connect in California, which charged $350-400,000 for just a millilitre – less than quarter of a teaspoon – of blood. Another, the Indian company Advy Chemical has charged up to $50,000. The more antibodies in the sample, the higher the price. The companies insist they are not profiteering, but doctors call the practice unethical. “I’ve never seen these prices before,” said Dr Joe Fitchett, the medical director of Mologic, a British test manufacturer that were offered high samples. “It’s money being made from people’s suffering.”

While in Britain it becomes a battle for political credibility for a beleaguered government.

With the solemnity dial turned up to 11, the health secretary tonight declared that the Government had met its “audacious target” of carrying out 100,000 tests a day by April 30th. But with around 39,000 accounting for home testing kits mailed out, rather than tests actually used – it’s fair to say that the health secretary was bending the truth.

Professor John Newton, the Government’s testing co-ordinator toes the party line, insisting the 100,000 daily testing target was met, despite home tests being counted as they are dispatched rather than when they are returned. Home testing kits are as accurate as the swabs taken in drive-in centres, he added.

Matt Hancock’s 100,000 a day testing target is a key plank in the Government’s strategy for managing Covid-19.

But it’s all a numbers game, skirting close enough to misinformation to be kissing it. Without an army of contact tracers, 100,000 daily tests will be useless.

In fact, the only way to manage this pandemic with anything resembling control is to test early, test often, test broadly and repeatedly. When we look back on our response to this crisis, our failure to test the population will be one of the big mistakes.

Meanwhile, firefighters in Corsica are aiming to teach canines how to sniff out coronavirus, as they can other conditions. It’s hoped that detection dogs could be used to identify people with the virus at public places like airports. Their trial is one of several experiments being undertaken in countries including the UK and the USA.

They will turn out to be experiments that will yield promising results.

The FDA has announced an Emergency Use Authorisation of remdesivir as a Covid-19 treatment, despite the FDA’s actions, not everyone thinks that remdesivir is really that promising.

But that in some way misses the point. There is no magic bullet – it’s a matter of layers of mitigation against the more severe symptoms of the novel coronavirus, so research teams continue to screen thousands of older drugs to see if they have the potential in the fight against Covid-19.

In Britain 450 UK Covid-19 patients will be recruited to take part in trialling a ‘promising’ Covid-19 drug. Researchers are launching a study into a Japanese-manufactured medicine that could aid with treatment. The trial will see participants split into three groups. A third will receive favipiravir – an antiviral drug produced by Fujifilm Toyoma Chemicals in Japan, another set will be given a combination of hydroxychloroquine, zinc and azithromycin, while a third group will be given existing standard care for Covid-19. Chelsea and Westminster Hospital in London are participating in the trial, which also involves Imperial College and the Royal Brompton Hospital.

The other critical mitigation is keeping patients breathing. Invasive ventilation and ECMO machines that pump and oxygenate a patients’ blood outside of their bodies catch the headlines, but the heavy lifting for most hospitalised patients is done via oxygen masks and Continuous Positive Airway Pressure (CPAP) machines, so much so that their availability becomes a continuing issue throughout the pandemic.

These quests continue, as does a looming vaccine challenge. Again the headlines are being caught by hard working biomedical teams and their ingenious immunological technology and the millions – billions – of doses that will need to be mass-produced, but Professor Prashant Yadav, an expert in supply chains, reminds us, “what about the vials it is stored in, or rubber stoppers in the vials or plungers in the syringes become the constraint?”

Like the oxygen masks and the CPAP machines (cheap enough to buy on Amazon to stop you from keeping your nearest and dearest awake all night with your snoring) the modest matters every bit as much as the high profile.

Never in human history has psychology played such an important part in our understanding of a pandemic. People suffered, both physically and mentally for sure, and writers such as Albert Camus explored the human experience, surviving a pandemic, but the relationship between the disease and our mental health, not just to sufferers and those in immediate contact with them, but the wider community is something new.

For many, lockdown has meant physical isolation combined with information overload, especially in the rapidly expanding field of social media. Events are witnessed in real time, or close to it. It comes with its benefits and drawbacks. Zoom, Facetime, WhatsApp and other communications platforms have meant that staying in touch has become easier. On the other hand, misinformation is rife, and skills in what Hemingway and others referred to as ‘crap detecting’ have developed at a snail’s pace compared with the speed at which social media has evolved. Social media platforms such as Facebook find themselves in difficulties protecting the public from misinformation, not just simply from the volume of content, but by the limited amount of research into this concern on which to frame their policies.

No one has prepared in advance for lockdown. In many ways people were caught off-guard, left to their own devices with time on their hands. For many a corrosive boredom sets in:

“We’re really, really bored and struggling to entertain ourselves. At first, sitting down with drinks, chatting with friends over FaceTime added a lot, but we’re getting diminished returns on that. Or at least I’m feeling like that.”

For others, compulsive behaviours are given a chance to run loose:

“I spent over £2,000 on stuff I didn’t need amid lockdown panic. It was soon out of control and I was spending money I couldn’t afford to sacrifice.”

Where people are locked down together, some become victims of the behaviour of others in close confines, and signs already exist for a rise in gender-based violence, female genital mutilation and child marriages. Sexual and reproductive services have been stripped back, gender-based violence hotlines have seen an increase in calls globally, and disruptions in education and preventative services means millions of women and girls are at greater risk.

Among the surprises of lockdown has been a raised consciousness of the importance of the natural world on our mental health. It was a growing awareness pre-pandemic, as the storm clouds of climate change were growing – real and figurative, but the sense that the wheels of twenty first century life had stopped turning and the stillness that followed, as anyone who has heard a factory stop can attest, changes perception and appreciation.

Among the most bitter of blows Covid-19 has brought to people’s sense of wellbeing has been its unfairness. Not simply the unfairness that comes from the virus being a product of natural laws – the machinations of selfish genes that catch conscious beings, among other life forms, in their blind bid for dominance – but also the unfairness it exposes in how humans treat each other and the cruelty in the attitudes of those moulded in the Creator’s image.

The Office for National Statistics finds that people who live in Britain’s poorest areas are twice as likely to die from the disease than in the most affluent, while the Institute for Fiscal Studies has found that per capita deaths among the black Caribbean population in English hospitals are three times those of white British people. Both findings follow warnings from the Sutton Trust that two thirds of children have not taken part in online lessons during the lockdown and that pupils from private schools were more than twice as likely to get daily online tuition.

Women and young people are among the hardest hit by Covid-19. Young workers and low earners are facing the biggest financial consequences, while women are more likely to be key workers. A month ago the attitude that the elderly “were going to die anyway” was a factor in the scandal of care home deaths, until the shockingness that the elderly mattered to people – people with loved ones – partners, children, grandchildren.

The very nature that created the unfairness in the virus is an element in the unfairness we show towards each other is among covid’s most cruel revelations.

But humanity continues to show it can be better than that…..

In our spirit: NHS ambulance staff have created a heartwarming video to say thank you for the support they have received during the coronavirus crisis. The footage created by the Worthing Ambulance Station features smiling staff, sirens, clapping, a mountain of donated Easter eggs and a dog dressed as a paramedic.

In our ingenuity: Paul Hunter and Anthony Dunn have lived next to each other in Bowburn, south-east Durham, for the past 20 years. Frustrated that they could not spend time with each other because of social distancing, they turned their 6 foot fence panel into a horizontal table, using a hinge, so they can meet up and drink a beer together.

In our generosity: Greta Thunberg just donated her $100,000 prize to UNICEF to help the pandemic. The world famous teen climate activist said the pandemic is a children’s rights crisis, like climate change, so she donated the prize money to children.

While far and wide the stories keep coming:

Finally, medieval Britain was slow to implement quarantine too. Following the outbreak of plague in Ragusa in 1377, cities across Europe started emulating the city’s practice of quarantining plague victims. It would take England over 200 years and many outbreaks to finally draw up what were known as ‘plague orders.’

You’ll be pleased to know that by the time of the Great Plague of London in 1665, these orders were being ruthlessly enforced.

Always look on the bright side!

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s