Day Fifty: Monday 4th May 2020

Daily Diary: The Times They Are A-Changin’

After an unsettling experience at Ian’s party the Zoom test with Emily goes well and I’m more reassured. It’s interesting that there’s a kind of generational takeover. An email from John Morris, paragliding friend and club secretary summed it up when he wrote:

“We are also keeping our heads down and so far, so good. We have a very neighbourly road, so the community spirit helps. Our girls and their families make us behave ourselves too!”

I’m minded of Bob Dylan’s “The Times They Are a-Changin’,” when he sings:

“Come mothers and fathers throughout the land,

And don’t criticise what you don’t understand.

Your sons and your daughters are beyond your command.

Your old road is rapidly aging.

Please get out of the new if you can’t lend your hand,

For the times they are a-changin’.”

So much of the lyrics to Dylan’s legendary song hold. The last verse goes:

“The line it is drawn, the course it is cast.

The slow one now will later be fast,

As the present now will later be past,

The order is rapidly fadin’,

And the first one now will later be last,

For the times they are a-changin’”

It was the anthem that brought the boomers into the limelight. That made the boomers masters of the zeitgeist. With all the hopes, ideals, along with more than a little laid-back swagger and a better world ahead.

But we fucked up. Like every generation since the dawn of history, we boomers fucked up. We get full marks for not blowing ourselves up in a nuclear conflagration. We don’t get any marks for the self-indulgent and wanton destruction our generation put into play. Where single-use plastic has so permeated the ecosphere that we will be able to date this short era since 1970  by the presence of plastic residues in fossils and mortal remains.

So ended the reign of the boomers, who in their drug-nurtured idealism dreamed of a better world, but were too greedy, too indolent and too selfish to bring it about. They came in, it seems, with the bang of rebellion in the 1960s and went out on a hospital bed, customised for intensive care, with barely a whimper.

So it was interesting talking to John Morris this morning. In a similar state. Told by our children to keep out of harm’s way. Lovingly. Caringly. A generation that hasn’t really deserved it being loved by the generation it let down. Badly. The last vestiges of the mindset boomers created, in a naïve sense of fairness, mutated into the self-serving ideas and actions of the libertarians, who still hold that their individual freedom is worth the suffering of others.

John was an emergency medicine consultant before he retired – an expert in critical care management. But now, like Vicky and I, John and his wife Chrissie are retired and keeping their heads below the parapet – under instructions.

As John said, he still finds the whole situation surreal. Like a bad dream, that were you to pinch yourself, would go away.

But it’s not a bad dream. It’s real, and things don’t work that way.

Outside, the wind blows, the plants grow. Inside they do too and the first foliage leaves are appearing on the geranium seedlings, telling me there is life, there is hope.

The Bigger Picture: The Loss of Normality

Three and a half million. That’s the number of confirmed cases of the novel coronavirus worldwide. Almost quarter of a million have died from Covid-19. It is a global catastrophe, requiring global action and EU leaders have pledged to raise billions of euros towards the global fight against the virus.

From its origin in China it has spread like a wildfire, embers creating new epicentres, spreading along the corridors of human activity and interaction, and because of the random manner in which embers may travel, settle and start new blazes the perplexing situation has emerged where some places have the virus running rife, while others remain largely unscathed.

So Covid-19 has killed so many people in Iran that the country has resorted to mass burials, but in neighbouring Iraq, the body count is fewer than a hundred. The Dominican Republic has reported 7,600 cases. Across the border, sharing the Caribbean island of Hispaniola, Haiti has recorded only 85.

There are already hundreds of studies underway around the world looking into how demographics, pre-existing conditions and genetics might affect the wide variation in impact.

New Zealand records no new Covid-19 cases for the first time since March. In Kabul, Afghanistan, a third of 500 people randomly rested were found to have the virus.

Russia on Sunday reported more than 10,600 new cases of the novel coronavirus, its biggest single day jump since the pandemic began. The increase marked Russia’s fourth consecutive single day increase, and pushed the country to seventh in the world, with 134,687 recorded cases and a death toll 0f 1,280. Russia’s Ministry of Defence also confirmed that members of the Russian military, including cadets, pupils and civilian specialists accounted for at least three thousand cases.

But the country with a world-beating level of disinformation might have worse figures still. Sergei Sobyanin, the mayor of Moscow said that as many as two per cent – 250,000 – of the capital’s population was likely to be infected, substantially more than the 135,000 cases officially reported nationwide.

Where the virus has struck, the cliché, “things will never be the same again” is proving to be true. The same kind of optimistic mentality that tells people that wars will be over by Christmas hopes for a break from the nightmare by September.  

It’s becoming increasingly obvious that that’s not so.

Come September everything will not actually start going back to normal.

We see all around us new social customs, distancing practices and mandates, and we are becoming aware that this will be common globally.

I remember seeing face masks being worn by many in the streets of Kathmandu only three years ago, thinking it odd and somehow un-western. Now Eurostar is telling its passengers they much wear face masks from today on its trains and at its stations.

No mask, no travel

Strictly.

Nevertheless, human ingenuity tries to work its way around restrictions. Partygoers dance the night away under lockdown, thanks to ‘car disco.’ Despite strict social distancing guidelines currently in place in Germany, people in the town of Schüttorf managed to party the night away on Friday as they attended a disco from the safety of their cars.

But day to day life suffers in ways that don’t first come to mind.

Amanda Pinto QC, chairwoman of the Bar Council told the Commons Justice Committee that a barrister-wide survey of the possible impact to their practices of the Covid-19 shutdown was “shocking.” She said, “The results are frankly, shocking – 56 per cent of all barristers cannot survive six months in practice. That takes us from the date of this survey to October of this year. 69 per cent of publicly funded barristers cannot survive six months. And almost 75 per cent of young barristers – those in practice for less than seven years – will not survive six months.

Our heroes of the moment are our healthcare workers. There is an outpouring of appreciation, from army generals recommending they receive bonuses, to fashion designers making scrubs more stylish. An anonymous donor in California has gifted a local hospital one million US dollars, designating that the funds go directly to staff, from floor cleaners to nurses. Another, John Heffer, seeing the difference a phone charger made to his father, stranded in hospital with a drained mobile. So he launched GoFundMe to buy chargers for hospitals across the US.

Most offerings of gratitude come in the form of unsolicited donations of food, to such an extent that it leads NHS staff to plea, “Give it to the local food bank.” The pandemic has sparked an outpouring of support for NHS workers.

They, however, ask for public empathy, not sympathy, in the job they have to do.

The toll on families is great. There are now countless stories of heartrending experiences. One family, 2,500 miles apart, faced excruciating decisions as their matriarch, Carmen Evelina Turo, fought the virus on a ventilator in a hospital on Long Island. They gathered online and in the ICU to prepare for the end, a common situation many families are facing themselves. One of the cruelties of the virus is the way it sweeps through homes. Across the country, reports are surfacing of long-term couples dying of Covid-19 in quick succession, redoubling the pain for those left behind.

There are stories too of quiet heroism of care workers, who forego their personal life for the well-being of their residents. It happens in a number of care homes. One such case tells that for 47 days and nights staff and residents of the Vilanova care home on the outskirts of the east-central city of Lyon waited out the storm together, while the illness killed more than 9,000 in other care homes in France.

It has consequences too. Eager as they are to get the country ‘back to work,’ the government finds it hard in the face of getting office workers back into the office. Recommendations like no hot-desking, shared pens and staggered start times, along with firms not having to enforce two metres social distancing as long as they can show they are keeping staff safe, are insufficient a lure.

The workplace is being rethought.

Although working from home might not be as environmentally friendly as first thought. Scientists warn that homeworking can actually push up emissions, especially if some people travel to work a few times a week.

But at the moment lockdown looks good for emissions, that are predicted to fall nearly 8 per cent – the largest decrease ever.

Other portents of a greener future may or may not be the result of the pandemic, but they become part of a momentary environmental new consciousness nevertheless. The brown bear appears in north east Spain for the “first time in 150 years,” while the white tailed eagle, UK’s largest bird of prey returns to English skies for the first time in 240 years.

But they are momentary reliefs from an era that will be remembered more for its darkness. More stories emerge of domestic violence under lockdown, this time from the Ukraine, where women and children are experiencing domestic violence during the quarantine.

And lockdown corrodes our history, our heritage, as smugglers in the Middle East and North Africa are taking advantage of the situation to pillage archaeological sites and sell their ‘finds’ on the online black market. With security focused on public safety, museums and archaeological sites are more vulnerable than ever.

It makes ‘Love Island’ being postponed until 2021 seem pretty trivial.

So pressures to lift the lockdown grow daily.  Government lockdown is coming under sustained criticism for a number of senior Conservative backbenchers worried about freedoms and the economy, including Steve Baker, Sir Graham Brady, Sir Charles Walker and Robert Courts, although the prospect of getting it wrong and allowing the virus to resurge is grim. Even PM Boris Johnson  is displaying caution, insisting that ending the lockdown early would be the “worst thing we could do.”

As long as lockdown endures UK unity also appears to be under threat as Scotland sends different messages. UK Government insiders are increasingly frustrated with Nicola Sturgeon’s messaging, which often upstages announcements from Westminster.

But PM Boris Johnson still wants to project his image of the great leader in a time of crisis.

“We are passing through the peak,” he declares, as he reminds the nation of the five tests that need to be met before the UK can follow its “road map” and move on to the next phase of the “virus battle-plan.”

Johnson’s taken to using such neo-Churchillian rhetoric, as if somehow this is all our finest hour. It takes some stretching of the imagination to believe it is. In fact there are still fears that deaths in care homes may be increasing and PPE levels are still not being met.

So what are those five tests?

  1. The NHS has the capacity to provide critical care right across the UK: Hospitals have not been overwhelmed by patients so far in the pandemic, and in some places have been aided by the opening of the new NHS Nightingales. There are 3,190 spare critical care beds in the health service, and that in most parts of the country the number of people in hospital with coronavirus is beginning to fall. This test, therefore, appears to have been met.
  2. A sustained and consistent fall in daily deaths from coronavirus: The high point of weekly average daily deaths was 851 on April 13th. Today, that figure is 555. There is a slow steady decline, and there are some suggestions that deaths in care homes may still be increasing. It seems that we’re moving towards meeting this test, but more data is needed.
  3. The rate of infection decreased to manageable levels across the board: The “R” value, or infection rate, is now thought to be somewhere between 0.5 and one, meaning that each person infected with the virus passes it on to fewer than one other person. It is likely this test has been met across the board, but the Government will be extremely anxious to ensure the rate of infection does not rise again.
  4. Operational challenges including testing and PPE are in hand, with supply able to meet future demand: Testing is struggling to pass the 100,000 a day target, but getting there. However, despite the distribution of more than a billion items of PPE, concerns over shortages remain, particularly among care home staff. Given the global spread of the disease, operational challenges in sourcing PPE may continue for some time. So far, this test does not appear to have been met.
  5. Confidence that any adjustments to the current measures will not risk a second peak of infections: This means that to “avoid disaster” the fifth test was that nothing the Government does lifts the R value above one. For the coming two months this will seem to be a possibility, but in the longer term meeting this test becomes unachievable with the policies and their changes that the Government adopts.

There is a clamour for a return to normality. For work and for all our everyday lives. But it’s going to be hard to achieve. Ofsted chief, Amanda Spielman says children should return to school “as soon as possible,” but qualifies her statement, admitting it was up to health experts to determine exactly when it was safe to send kids back into classrooms.

Britain is not alone in her desire to lift lockdown.

Belgium is starting its first phase of ending lockdown. Businesses can resume economic activities, but teleworking is strongly encouraged. People who must go back to work will have to follow strict rules such as wearing face masks. Public transport is open but only recommended for people who don’t have an alternative and outside peak hours. Face masks are mandatory for people older than 12, as soon as they enter a station. More generally, face masks are recommended where it is difficult to keep 1.5 meters distance from others. Walks and physical activities … in the open air which do not involve physical contact are allowed, although social-distancing rules still apply to people who do not live under the same roof. After carrying out these activities, the return home is obligatory. It is still forbidden to settle in a park to sunbathe or have a picnic. Private and public activities of a cultural, social, festive, folklore, sporting and recreational nature are prohibited.

Belgians are now able to “see a second friend or family member, always the same, under certain conditions,” Prime Minister Sophie Wilmès tweeted on Sunday. “We will have to resume our social life very gradually, although of course I wish it were different,” she said. Places of worship remain open, provided that social-distancing measures are respected, but most religious ceremonies cannot take place — with some exceptions. Funerals can be held as long as no more than 15 people attend them and social distancing is respected, while weddings can only be attended by the spouses themselves, their witnesses and the minister.

Shops that sell certain fabrics will be able to open to customers — a week ahead of all other shops — aimed at making it easier for Belgians to adhere to the mandatory mask-wearing on public transport.

While Greece has been gradually lifting its restrictive measures after a 42 day lockdown. As of Monday, many Greeks no longer need an SMS or carry a self-written permit to justify being outdoors.

And in Italy, lockdown measures will have eased from today, with travel between regions to visit family and takeaway services at cafés and restaurants allowed. Schools, hairdressers and gyms will remain shut, however, and masks will be compulsory in public.

In America, Donald Trump has insisted it is safe for individual states to reopen their shops, parks and beaches, so long as the public “stay away a certain amount.” The president’s comments come amid growing protest at the extension of lockdown in Democrat-controlled state capitals. Nearly half the US will reopen in some form from the beginning of this week. About a dozen states tentatively returned to public life on Friday, the first mass reopening of businesses since the pandemic brought America to a standstill six weeks ago.

India’s lockdown has been extended until 17th May, but some relaxations apply from today. Most travel remains banned and schools, restaurants, bars, shopping malls, cinemas and places of worship are closed. The country has relaxed some lockdown restrictions even as the pace of infection has slightly accelerated. On Monday, some economic activities resumed after a near total five week halt. Normal life, albeit with masks, social distancing and stringent hygiene standards have started to return in low risk areas while constraints on movement and work have continued elsewhere in the country. India has about 42,500 cases, 11,706 recoveries and 1,373 deaths, and has tested more than a million samples on Monday. But at 78 tests per million, India is among those countries testing the lowest fraction of the population. And experts warn that the virus has yet to peak.

Japan, with around 15,000 infections and more than 500 deaths, is expected to extend its state of emergency this week, although some restrictions on economic activity could be relaxed and bars reopened.

If the British Government has muddled its way through the medical and social aspects of the pandemic, where it does have some success is with the financial package, with furlough, loans and grants. Today on Nextdoor I receive two messages. The first is from the chancellor, Rishi Sunak: 

Last month I announced Bounce Back Loans. Today they open for business. Borrow between £2,000 and £50,000. Easy 7 Question form to fill. Interest-free for the first year. Repay over 6 years, 2.5 per cent interest. No early penalty.

The second is a Government Public Service announcement:

If Covid-19 is affecting your business you may be eligible for a grant. Small businesses in your area are receiving grants of £10,000 or £25,000 to help deal with the impact of the coronavirus. These grants do not need to be paid back. If you think your business may be eligible, get back in touch with your local authority and supply your payment details.

The UK’s arrangements seem much simpler than across the pond in the US, as the New York Times reports:

Requirements for using federal coronavirus loans are so complicated and confusing, some small businesses fear using the money altogether. Many of the small businesses that did receive loans through the Paycheck Protection Program are sitting on the money, insecure about whether or how to spend it. “I don’t accidentally want to commit bank fraud,” said Jodie Burns, who owns Blazing Fresh Donuts in Guildford, Connecticut. Under the rules, for example, business owners have eight weeks from the day they receive the cash to spend it in order to have the loan forgiven. That is made increasingly difficult when many states are still under strict stay at home orders.

But the UK’s tendency towards financial pragmatism goes out of the window when it comes to the ‘B-word.’ Calls for an extension to the Brexit transition in the light of Covid-19 are completely ignored by the Government – what turns out to be an act of pure folly. Part of the problem is the obsession about a trade deal. Talks on a post-Brexit trade deal between the UK and US will kick off with a conference call between Liz Truss, the international trade secretary, and her US counterpart, Robert Lighthizer tomorrow. Both parties are insisting that the pandemic will not disrupt preparations for an accord.

But actually it does.

Trade negotiations become a Quixotic quest, for something that never quite comes about, even though the lost trade with the EU dwarves any gains from a transatlantic deal.

But the Government fears letting Brexit go. It is a creature spawned by identity politics, so much so it has infiltrated ministers perceptions and priorities.

Not least the PM himself.

It’s almost viral.

It’s not just the virus. It’s the far-reaching knock-on effects it’s having on other areas of healthcare:

  • Tens of thousands of heart and stroke patients risk their lives by avoiding hospital Covid-19. It’s an effect that’s having a dramatic impact on a number of people that are now presenting at A&E with life-threatening symptoms.
  • There’s the chilling reality for some such as myself of cancer patients being kept awake during operations to protect them from Covid-19. Hospitals have increased the use of ‘awake’ surgery, which avoids the need for general anaesthetic and intubation – to encourage patients to undergo life-saving treatment. Having experienced the weird effects of a spinal block and being totally befogged by Midazolam, I can see myself being so out of it as not to give a monkey’s, but the very thought leaves me uncomfortable!  

There’s also a Covid-19 related mystery. In 1961 Tomisaku Kawasaki reported a condition whose symptoms were a rash and a fever in a four year old child and later went on to publish a paper about similar cases. It became known as Kawasaki disease. It was rare and mysterious, infecting young children, boys more than girls, and of South East Asian origins in particular. The condition has been known to inflame different parts of the body, including the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs, and to cause such symptoms as vomiting, diarrhoea, neck pain and rash.

Now, a small number children who have had the Covid-19 virus are expressing Kawasaki disease-like symptoms, in a disorder called multisystem inflammatory syndrome in children (MIS-C). Fortunately MIS-C is rare, albeit deeply troubling. The fact that Kawasaki disease long predates Covid-19 has led physicians and scientists to refer to MIC-C as Kawasaki syndrome.

Despite the troubled road in developing test, track and trace in the UK the Government still tries to put a positive spin on the situation. The latest is to call upon twenty first century tech. Transport secretary, Grant Shapps has described smartphone apps for treating the spread of Covid-19 as “the best possible way to help the NHS” as part of a pilot programme begins in England. The NHSX app is being trialled on the Isle of Wight this week as part of the Government’s test, track and trace strategy and will be central to its efforts in slowing the spread of the virus.

While much is made in the press of British scientists unveil a 99.8 per cent accurate Covid-19 antibody test. The tests are useful in checking whether someone has had the disease (or several months from now, also been vaccinated) but cannot tell if they currently have the disease.

When it comes to treatment British scientists working for Synairgen, a university spin-off firm, founded in 2003 by three University of Southampton professors, have started testing an experimental Covid-19 drug, which they hope will significantly improve the health of coronavirus patients. The treatment, known as SNG-001, has been shown to stimulate an immune response in the lungs of patients with asthma and chronic lung disease during trials. The procedure uses the naturally occurring protein called interferon-beta which our bodies naturally produce when we get a viral infection.

Synairgen have allowed BBC Panorama to make a programme about their drugs trial. It’s hoped that the treatment will help Covid-19 patients and prevent the most severe cases from requiring intensive care and ventilators.

While the prize still remains the vaccine. The race to develop it is compressing years into months and is an endeavour that has been compared to the Space Race of the late nineteen fifties and early sixties. Researchers have found themselves having to navigate safety issues, commercial challenges and geopolitical tensions. Seven of the roughly 90 vaccine projects being pursued have reached the stage of clinical trials, moving ahead at unheard-of speeds, but uncertainty remains over effectiveness, how quickly a vaccine could be made available to billions of people worldwide, and whether the rush will sacrifice safety.

Finally a message appears in my Nextdoor inbox:

Welcome to the group! Need connection with other self-isolating men during these depressing times? We share our thoughts and feelings, fears and pressures, whatever buttons are pressed and whatever comes up is welcome. We relieve pressure by speaking it out, listening and being heard. It’s not a process party! Let’s support each other towards conscious isolation, sharing our tensions and taking the edge off these turbulent times.

It’s not particularly aimed at me, but it is a reminder that despite the phenomenal increase we all have these days in online connectivity, loneliness is still an issue on a large scale and it takes a pandemic to bring it to the surface.

Sources:

Best for Britain, Euronews, Evening Standard, Financial Times, Forbes, Fox News, Gov.uk, Guardian, iNews, Mail, Mirror, New Statesman, New York Times, Nextdoor, Politico.eu, Sky News, Stanford Medical (Scope), Telegraph, Time, Wikipedia.

Day Forty Nine: Sunday 3rd May 2020

Daily Diary: Overwhelmed by Information.

I’m beginning to realise that I’m getting too good for my own good at finding stuff out. When I started this diary-of-sorts I’d probably be finding a dozen to twenty newsworthy items and I was limiting myself to headlines. Then my capability at finding out information improved. I was finding links that I seemed to pass by previously and getting feeds that I simply hadn’t previously anticipated. In the process I began to get a ‘feel’ for stories that simply had to be told. I think too the situation is getting increasingly involved and complicated, and with that even more human stories come to light. All of that leads to more work pulling the notes together and now it’s taking hours.

So, one way or another I’ve got to try to gather less and be a bit more discriminating in doing so, but the problem is will news pass me by? Often, a fascinating story starts off in a small way, then grows. Or I pick up a story that has come into full bloom and I realise I’ve missed the whole lead up to it.

In the process of trying to gather as much as possible I miss a valuable email from John Morris, our club secretary. He’s pretty experienced and adept with Zoom and has offered to help. And I missed it! So along with endorsing the last club meeting’s minutes I feel the need to apologise and I confess to feeling a bit guilty.

I’ve tried to limit my daily feed to make it more manageable, bearing in mind there’s happy birthday to my friend Ian at three pm and testing Zoom with Emily at five. So you cut your cloth.

I find the model I’ve been working on has too short a chassis. It simply doesn’t match the World War Two photographs for length. So, after measuring up photo after photo I’ve done a miniature ‘cut and shut’ and stretched the wheelbase. To my delight it’s worked a treat and I’m pretty pleased with the achievement. I quite like a change of task to break up what I’m doing. It helps me to focus. But I’m also amazed at how busy I’ve made myself as a result of lockdown.

Having said that, I’ll be glad when all of this is over, and however new or otherwise, there is some sort of normality when we’re no longer under siege if we’re not in the frontline.

Postscript:

Well I went to Ian’s Zoom party, was greeted by a young woman who then directed me to the conservatory, where Ian was, at a table with all sorts of snacks and goodies and a number of friends and family, practically all of whom I didn’t know. I felt really weird and unsettled and after a short time bottled it and bowed out. Even in RL I do have a problem with rooms full of strangers and find myself feeling awkward and not at my best. Zoom seems to exacerbate that feeling.

Not a comfortable experience.

Clearly I’m no zoomster!

The Bigger Picture: Learning From Bitter Experience

It can take a disaster to explode the myth that those with wealth, power and status have them because of the consent of those that don’t and a mutual trust exists within the social order that makes it so. It was true of the relationship between the class of passenger on the Titanic and the chances of their ice-cold watery demise. It is true of the novel coronavirus pandemic today – that those groups with wealth, power and status has a markedly greater chance of not dying from the virus.

Studies by research groups such as the King’s Fund and the Rowntree Foundation had been publishing studies of social advantage and life expectation for decades,  but they rarely made secondary stories, buried by the news of the day.

Now Covid-19 is the news of the day, and the stories take on a fresh gravity.

In Britain Covid-19 revealed not only disproportionate numbers of untimely deaths among the least well-off and ethnic minorities, but also, once lockdown had begun almost a fifth of households with children going hungry.

The New York Times reports:

More than 2.2 million Americans, through no fault of their own, lack access to clean running water and basic indoor plumbing the rest of us take for granted. Every state is home to entire communities facing this virus without being able to wash their hands, but the federal government has yet to form an emergency response that addresses their safety. It’s no accident that these places tend to be communities of colour. Decades ago, they were bypassed by government initiatives to build water infrastructure, and federal funding for water projects is just a tiny fraction of what it once was. Today, race is the strongest predictor of whether you have access to a tap or a toilet in your home. Nationwide, indigenous households are 19 times more likely than white households to lack access to complete plumbing, while African-American and Latin households are nearly twice as likely.

Donald Trump declares that the only way to cure the ills exposed by the virus and reopen the US economy is to break out of lockdown and get America back to work. In the deeply polarised country of which he is both a symptom and an active agent in creating it plays to the section of society that views all actions to control the virus as big government and an infringement of individual liberty.

His four point plan goes like this:

First: Remove income support, so people have no choice but to return to work.

Second: Hide the facts.

Third: Tell the people it’s all about ‘freedom.’

Fourth: Shield businesses against lawsuits for spreading the infection.

But the hard truth is that the biggest obstacle to reopening the economy is the pandemic itself.

It’s hardest for those at the very edge of society. In the US and elsewhere in the rich world, Covid-19 is spreading rapidly through the largely immigrant workforces of farms and most factories, but insufficient protections mean many migrant workers have no option but to keep on working, and have few options if they lose their job. Farmworkers and meat processors are particularly vulnerable to infection because they are exposed to elevated pathogenic loads, carcinogenic pesticides and other chemicals, working with little sanitation in cramped conditions. Yet, as immigrant employees they have very few crucial protections such as sick days, paid leave, or regulations against exploitation. Many live in makeshift housing with communal toilets, where social distancing is impossible.

For migrants elsewhere it’s even more bleak. One woman describes her plight:

“Stuck in a foreign land with no passport or work. I support a family in Ethiopia and have to pay my Lebanese sponsor who keeps my passport, and my cleaning work has stopped with lockdown.”

It’s a form of modern slavery called “situational vulnerability” as people are placed at greater risk of modern slavery due to their social isolation – which exacerbates the immediate vulnerability they have as a result of their destitution. These twin factors allow the marginalised to be enslaved as waste pickers and “manual scavengers,” an occupation that has been called “a particularly degrading form of exploitation.” In parts of India the caste system is at its root, and amid the pandemic, these workers face even greater risks.

So the myth that those with wealth, power and status have them because of the consent of those that don’t persists between people, classes, nations, even whole regions of the world. It’s a myth promoted by those with wealth, power and status, with strings, smoke and mirrors, hoping that the cogs and gears of civilisation run smoothly, without such glitches as a pandemic or the consequences of climate change to expose the unfairness and the deceit.

While the wealthy and powerful West fixates on Covid-19, more vulnerable countries are paying  the price. António Guterres, Secretary-General of the UN warns of a lack of solidarity with the developing world. 500 million people could fall into poverty. And in a world where debt-bondage is a feature among the world’s poorest, most vulnerable nations, as much as it is a feature of modern slavery among the world’s poorest, most vulnerable people.

There are some saying that, once the pandemic has passed, we will need to reboot the global economy.

 There are others saying we need to reprogramme it.

Covid-19 remains mysterious. It’s been compared to a jigsaw puzzle with many pieces missing and a limited understanding of how they fit together. This applies to its origins, the shape of the pandemic – a second wave appears likely, possibly a third, judging from history – and the emerging concern that the other, larger existential threat to humanity, climate change, may well make future infectious diseases even more difficult to fight.

Some of covid’s revelations are counter-intuitive. Observations from the Pitié-Salpêtrière Hospital in Paris indicate that smokers could be less likely than non-smokers to fall ill with the virus. With encouragement from the health minister, the organisations behind the Pitié-Salpêtrière study, which include the Pasteur Institute and the Sorbonne, are preparing trials. The plan is to offer nicotine patches to covid-19 patients, front-line workers and ordinary citizens. How they fare will be compared with control groups given a placebo.

Some have hypothesised that, although nicotine and other substances in cigarette smoke might not prevent infection, they might suppress that often fatal out of control immune response known as a cytokine storm.

Research might point to a way of treating the disease.

The pandemic brings its own twist to politics. When sexually active gay and bisexual men find themselves banned from COVID-19 convalescent plasma trials there is outrage expressed by the LGBTQ community, maintaining there is still a widespread view that being gay is still thought as a form of contamination.

The NHS point to guidance issued by the NHS Blood and Transplant agency, which claims these populations “are at an increased risk of acquiring certain infections through sex,” such as the human immunodeficiency virus.

It’s a storm that doesn’t subside quickly and in six weeks’ time the NHS will relent, recognising that people of all sexual orientations genuinely want to play their part in ending this disease, along with the hard impact the pandemic has had on blood donors.

Elsewhere, the Johnson Government having made such a big deal about Brexit Britain going it alone, quietly seeks access to EU health cooperation in the light of Covid-19, pledges £330 a year to Gavi, the Vaccine Alliance, which will help fund immunisation of 75 million children in the world’s poorest countries, and scrubs the £17 million order for 10,000 of Dyson’s built-from-scratch ventilators. The Dyson ventilator story becomes one of many examples of the ‘Johnson Chumocracy,’ as well-established ventilator engineering firms were passed over for the Dyson deal, along with Dyson himself being both a Tory Party donor and vocal Brexit supporter.

On a personal level, Johnson talks about the ‘death of Stalin’ arrangements that were made in case he died from Covid-19. He admits being in denial about how serious his diagnosis was, that he “really didn’t want to go into hospital” and was deeply frustrated about going into intensive care.

“Because the bloody indicators kept going in the wrong direction and I thought, ‘There’s no medicine for this thing and there’s no cure.’ That was the stage when I was thinking, ‘How am I going to get out of this?'”

Meanwhile, there’s a report from PA Media that a giant inflatable dinosaur has been spotted waddling the streets of Watford by delighted neighbours isolating in their homes. Georgina Cooper, a 35 year-old mum, has been using her daily walk to entertain her community as the friendly local Tyrannosaurus Rex. Mrs Cooper, who has two sons, aged one and five, said she bought the dinosaur costume from eBay “for fun,” but after its popularity “spiralled out of control” she began collecting money for PPE in care homes during the coronavirus crisis. She said she lost her severely disabled cousin Miriam, who the family only want to be known by her first name, after care home workers unwittingly brought the virus into her accommodation and she died after testing positive.

Captain Tom Moore inspires an army of OAP coronavirus charity heroes. Barely a day goes by without an elderly champion taking on a fresh challenge.

And queues have built up outside tips in Manchester as they are reopened for the first time since lockdown.

Freedom can be so prosaic.

Elsewhere:

  • Americans discover how powerful one to one is with pupils. After Covid-19 students are more likely to thrive if they have dedicated time with teachers, high school students are making Yearbooks for the class of 2020, while  schools nationwide are debating whether to issue grades to high school students during the pandemic and the two metre rule being reviewed amid hope that relaxed restrictions could allow schools to reopen.
  • There’s joy and trepidation as Spaniards enjoy an easing of restrictions.
  • Germany’s Covid-19 infection rate rises after lockdown is lifted,
  • Dentists in France have posted naked photos of themselves on social media in an effort to draw attention to their need for PPE.
  • With plans underway for a ‘Covid-19 Passport,’ resorts in Greece are now taking bookings and socially distanced sun loungers are being set up in Southern Italy.
  • China reports two Covid-19 cases for May 2nd. The country plans to crush new outbreaks with tough measures. Despite the personal and social cost being high, many see it as a necessary evil. A Wuhan British evacuee, Matt Raw, who was quarantined for two weeks when he returned to the UK has said he wishes he’d never left China, seeing how the situation in Britain was now much worse.

Finally, if there can be a silver lining to the darkest-bottomed storm cloud, the dean of an American medical school tells us the pandemic will make medical students better doctors.

Lawrence G. Smith, M.D., the founding dean of the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell writes in STAT:

No matter how great physicians’ technical skills are, they may not be considered healers until they’ve learned how to soothe and inspire, to comfort patients and family members alike (even when it’s compassionately delivering bad news), to deliver not only treatment but also hope. Working in hospitals packed with patients of all ages and demographics, and tending to those who, due to isolation, can’t be with their loved ones, will teach new doctors skills their older peers all too often had to pick up on their own.

There’s no substitute for experience.

Sources:

Business Insider, The Economist, Euronews, Forbes, Freedom United, Guardian, The Independent, Daily Mirror, The New York Times, Open Democracy, PA Media, politics.co.uk, Reuters, Sky News, STAT, The Times.

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!

Day Forty Seven: Friday 1st May 2020

Daily Diary: Silent Springtime

More spring! Passing showers and blue skies inbetween. One of the things I’ve noticed is how I don’t look at the weather in the same way as I did before lockdown. The plants are looking healthy and Emily has given us two wildflower seed packets. I really need to get outside, and Vicky reminds me about Midge’s garden, which gets wilder by the day. Out at the front the hedge needs trimming and gaps between the paving stones out front need whacking with the strimmer. I’m not a fan of herbicides.

It was good to see Emily again, and she’s offered to be invited to a Zoom session, so I can test the system as host. On Sunday, Ian, my good friend and erstwhile flying buddy – sharer of adventures in England, Wales and France, before, sadly, a problem with his shoulder grounded him – is going to have a Zoom party and this evening I’m going to test things out with always-helpful Nigel. I’m beginning to think that using Zoom for a meeting next Friday looks feasible.

Meanwhile, I try not to watch too much news on TV. Strangely enough, when you hear it, it has a different quality. The noise jars and it attacks your consciousness differently to picking it up in text and pictures. There’s a cerebral characteristic to finding stuff out silently, and often when I’m on task I am in silence. It’s peaceful. Even in lockdown things can get too loud, both for the ears and soul.

The Bigger Picture: The China Syndrome

Sooner or later we were bound to see how Covid-19 would change the world, not just as a widespread disease but in the way in which the direction of human civilisation would be set. “Things will never be the same,” you will hear the cliché, but there will be little qualification of how things will change and what the triggers of the inevitable paradigm shifts will be.

Consumer goods have become an almost universal addiction in wealthier nations and China, willing to produce them cheaper than anyone else, has become the dealer, profiting from the weaknesses that arise out of addiction, led to believe that endless acquisition is ‘freedom,’ an idea that was turbocharged by Reagan and Thatcher in the 1980s, based on the monetary theory of Milton Friedman.

But an economy with consumption at its core places a higher value on the price of goods and services than the means by which they were produced. Combined with the huge returns that came from financial investment in a global market, there was a much reduced emphasis on more local production, particularly manufacturing, and a level of ‘natural unemployment’ was seen as being an inevitable consequence of the economic model.

It’s not just that China, being run by an authoritarian government, the Chinese Communist Party (CCP) subscribes to a different economic model – its way of seeing the world is completely different. Western civilisation is as influenced by the ideas of Confucius as the Chinese are by those from the Age of Enlightenment. The Chinese leader at the time, Deng Xiaoping lifted the Mao-era ban on small businesses in 1979 and began the trend towards a current vibrant ecosystem of private enterprise, with its thriving startups and unicorns. Now, threatened by the more libertarian ideas that he sees accompanying free enterprise, China’s president, Xi Jinping is much more restrictive, favouring state-led development over the more agile of the private-sector.

The social attitudes that come with TikTok, AliBaba and Tencent, particularly among younger citizens are generational, and there is little natural appeal the elite, hand-clapping public sycophancy of the CCP hold for those a generation or two removed. 

In an authoritarian state you could be forgiven for thinking that’s the stuff paranoia’s made from.

Both superpowers see their vulnerability with respect to the other. Both desire hegemony. With hegemony comes power, with power comes control, with control comes the illusion that somehow the deep-rooted problems that have led to their vulnerability have gone away.

Each becomes the bogeyman to the other.

“China wants me to lose  re-election,” Trump announces, as if the United States of America will be beyond redemption without him as saviour.

It is at this point, with two conflicting views about the very way global economics should be working, along with growing trade friction that a pandemic appears.

A pandemic that in an overwhelming balance of probabilities started in China.

The autocratic CCP behaved to form. The state was slow to let the rest of the world know it had an outbreak, and in fact only did so when the story had leaked in the scientific community from mainland China to Taiwan, from which it rapidly reached first New York and then the rest of the world on December 31st 2019. China officially informed the rest of the world on January 3rd 2020, and made public Covid-19’s genetic sequence on the 11th.  

But China has remained opaque about two critical questions. The first is who is Patient Zero? The second is how did Covid-19 start to infect humans? The answer to the first question will most likely lead to being able to work out the second.

Was it the standard corporate response we’ve seen many times in environmental disasters – admit nothing? Was it the CPC’s intention not to present China as vulnerable in the current climate of clashing ideologies? Was it the understandable expectation that China admitting its liability would be played for all its political worth by President Trump and his officials?

Fu Ying is a former Chinese vice-minister of foreign affairs wrote in the current edition of The Economist:

“What has particularly dismayed the Chinese is a smear campaign against China by some American politicians and high-ranking officials, who try to shift the blame for their own underestimation of the threat, their slow response and the consequences. For me, the blame-game lays bare American ambitions to scapegoat China for its problems.”

That existing geopolitical tensions and a complete absence of trust in impartial analysis stop us all from knowing what happened.

It’s already happening, with a war of words breaking out between the Australian and Chinese governments, after the Chinese government warned that their consumers might boycott Australian goods after PM Scott Morrison called for an independent inquiry into the spread of the virus. And it bullied the European Union over an official report into Chinese disinformation about the virus, with officials saying its publication would “be very bad for co-operation” and make China “very angry”.

So what we’re left with is a bitter realpolitik choice between no information at all and misinformation in a world that increasingly confuses narrative with what actually happens, with bad actors feeding off that phenomenon like vultures tearing at a carcass.

But no information at all doesn’t stop dangerous conspiracy theories from flourishing, especially when it comes to how Covid-19 came to infect human beings. But it’s possible that is what the CPC wants. States will commonly send out dozens of counter-narratives if they’ve something to hide. In the case of the Skripal poisoning Sputnik and Russia Today sent out a total of 138 counter-narratives, many contradicting each other. What actually happened gets lost in all the noise, the aim being not to have people believing one conclusion or another – it’s not to have people believing any conclusion at all.

There are two main schools of thought when it comes to the origin of the Covid-19 pandemic. Both subscribe to the geographical origin of Wuhan, although Chinese media did report a story that the virus had been imported from outside China on frozen seafood, but the story didn’t stick. Nor did the story that the virus originated in America.

The first is that it originated in the wild, with bats or pangolins being the prime suspect and a wet food market in Wuhan being the point at which zoonosis, species-hopping by the virus, occurred. Whether from eating bats directly (they are not exactly the most popular Chinese delicacy) or from eating dogs who had picked up the virus from eating bats (it would only take one dog to scavenge on the remains of a dead bat) remains unclear. Likewise, it is illegal to eat pangolin meat in China, but not illegal to use their scales as a traditional Chinese medication, where they are claimed by practitioners to have properties that help with breastfeeding and poor circulation. Most pangolins, an endangered species and the most trafficked wild mammals in the world end up in China.

The second is that the virus escaped from a laboratory. It wouldn’t be the first time. SARS, a virus that killed 774 people in 2002-03, slipped out of a lab in Beijing twice in 2004. Laboratory escapes have happened elsewhere, including the US and UK. Between 2000 and 2009 America suffered 34 laboratory-acquired infections, resulting in four deaths. It happens, and one health-security index suggests that three-quarters of countries score poorly on biosecurity.

To add to that there are now around 70 “biosafety level-four” sites, designed to deal with fatal diseases lacking a cure or vaccine, in 30 countries. America has over a dozen. China has two, one at the Wuhan Institute of Virology. Although there are no obvious signs of deliberate genetic modification, it is normal practice for such laboratories to research in making diseases even more dangerous – more effective transmission, for instance, or more drug resistance. Scientists at the Wuhan lab were engaging in such experiments, known as gain-of-function, in collaboration with American and Italian scientists. The rationale being the better we understand the behaviour of a new disease, the more likely it is to develop drugs and vaccines to save countless lives.

But it’s so easy to get Doctor Strangelove meets Chernobyl meets the Andromeda Strain. Part of me wants to throw in a Zombie movie for good measure, but that would be going too far.

And it’s that counter-paranoia that Trump weaponises to link the virus with Wuhan’s laboratory.

Diplomatic relations between America and China, the world’s two greatest superpowers, descends into mud-slinging and slagging each other off.

With it, any rational assessment of the outbreak’s origins is for the birds.

So, despite the plausibility, even possibility of a laboratory being the starting point of the Covid-19 outbreak, I’m inclined to go along with the view of a number of experts that conspiracy theories woven by prominent individuals are far from helpful.

Wet market species-hopping or laboratory breakout, it’s still not a good look for China, and if a state sees an opportunity to misinform its way out of a corner, don’t be too surprised if it tries to do so.

Pointing the finger at China suits the White House – a deflection from America’s statistics looking very grim indeed. There have been more than a million Covid-19 cases, the spread of the virus accelerating and now averaging 100,000 each day. On Wednesday April 29th the country blew past 60,000, more than three months before the Institute for Health Metrics and Evaluation projected. Covid-19 has killed more Americans than any flu in half a century, and has surpassed the 58,220 deaths in the Vietnam War. The economy has shrunk by nearly 5 per cent.

Nevertheless, the White House declared on Wednesday that its response to the crisis has been “a great success story.” Little wonder a recent survey found that Americans trust doctors and the CDC and not Trump.

And it turns out that President Trump’s executive order declaring that slaughtering and processing of beef, chicken and pork to be ‘critical infrastructure’ followed weeks of lobbying by the meat industry. Whether he was hard to lobby, being a daily double Big Mac sort of fellow, is the stuff of speculation.

Meat processing industries, like so many others. Are experiencing a deep sense of threat from the virus. With a number of meat processing plants turning out to be local epicentres for Covid-19, it’s not too difficult to see why there was a need to lobby in order to survive. But there is a moral hazard here – that there is a lack of incentive to guard against risk where one is protected from its consequences. If the chance of these potential epicentres remains, the spread of the disease and everything that goes with it, including death, goes with it.

Rarely has the scope for moral hazard seemed to have been as massive as it is now.  To slow the spread of Covid-19 most countries have needed to devastate much of their economies.

The eurozone’s economy shrank at the fastest rate on record in the first quarter of 2020. Its GDP fell by a massive 3.8 per cent. This is the largest drop since current measurements began in 1995 and is bigger than the height of the financial crisis. France and Italy have slipped into recession while Spain sees a record decline in its GDP.

In the US the Federal Reserve leaves its interest rates at zero, as its Chairman, Jerome Powell vows continued aggressive action to prop up the economy. The national debt is growing faster than the economy but now, he says, is not the time to act on those concerns. This is the Fed in emergency mode and this is a time for unprecedented action, as it announces initiatives worth trillions of dollars. Nevertheless, 38 million US workers filed jobless claims last week for a six week total of over 30 million, despite billions of dollars of stimulus spending.

But an economy suffering a heavy body blow tells only part of the story. A fuller picture is weird. US stocks have their best month since 1987. Right now, Amazon and Apple both reported a jump in revenue in the first quarter. Facebook reported first quarter earnings of $17.7 billion – up nearly 18 per cent from a year ago. “With people relying on our services more than ever, we’ve focused on keeping people safe, informed and connected,” said Mark Zuckerberg.

For tech giants it happens that luck has favoured their market niche and kept the money flowing in, despite a threatened and vulnerable economy.

Others stay in pocket through sheer ruthlessness and opportunism.

Las Vegas casino billionaire Phil Ruffin, close friend and business partner of President Donald Trump finds himself at the receiving end of Nevada’s Governor Sisolak’s March 17th order for all non-essential businesses to close, including the state’s economic lifeblood, casinos. He told his paying guests to check out of his hotels then furloughed 4,400 out of 5,500 employees without pay. Ruffin certainly has enough money to pay his furloughed employees’ salaries, having a net worth of $3.2 billion and an estimated corporate war chest of $500 million.

According to Forbes reporter Will Yacowicz, Ruffin has enough cash to keep his casinos closed for 20 years, but if you’re one of the little guys, maybe a teller on the casino floor, a bartender or room service that cash is not for you. Not even at the height of a pandemic.

Little guys don’t seem to be doing too well as customers either as airlines in Britain and Europe fail to reimburse customers for flights cancelled as a result of Covid-19. Some try to issue vouchers instead, as a ploy to avoid paying back the cash, a legislated requirement. European Commissioner Margrethe Vestager put it, “There are many passengers who would need the money. People may have lost their jobs, they may need money for medication, to pay their rent.”

Dumping liabilities on those who can afford it least. Another aspect of how we conduct our lives exposed by the coronavirus.

Little wonder then that the travel industry is going local, with the bigger a country’s Covid-19 outbreak, the bigger it seems is its shift away from foreign travel.

Other weird realities are also emerging, For example:

  • Half of managers are saying that workers are more productive at home.
  • Some are earning more money as unemployed than while working.
  • Furloughed workers need to consider the impact on their pensions, as if you are temporarily not working because you have been furloughed your monthly payments could decrease.

And some of that weirdness will be here to stay beyond the era of the Great Pandemic. For a while, unless you happen to be on a desert island out of contact with the rest of human civilisation, watching out, no doubt, for the ever-rising tides (but that’s another story), the economy and the way of life it drives, will not only be smaller, it will feel, as the old hippie song went, strangely strange but oddly normal.

We’ll settle for it. It is after all the alternative to the even weirder lockdown we’re experiencing and beggars can’t be choosers. There’s talk of the ‘ninety per cent economy.’ The world economy shrank by 1.3% year-on-year in the first quarter of 2020, driven by a 6.8% year-on-year decline in China’s GDP. The Federal Reserve Bank of New York suggests that the country’s GDP is currently running about 12% lower than it was a year ago.

Working habits have changed, especially from those who can be networked online, so a significant sector of the workforce find it possible, and in some cases preferable to work from home. Already, in China discretionary spending is 40 per cent down on what it was a year ago and there’s some indication from Sweden, one of the least locked down countries in Europe, that the spending effects of a lockdown will persist even after it is over.

After an initial near-complete shutdown, travel takes a strange twist, with airline flights and public transport down, but car sales less affected, with a growing number of people in China saying that the virus has increased their desire to buy a car—presumably in order to avoid the risk of infection on public transport. The number of passengers on Chinese underground trains is still about a third below last year’s level; surface traffic congestion is as bad now as it was then.

Wanting a car, though, will not mean being able to afford one. Many are now recouping the loss of income that they suffered during the most acute phase of the crisis, or paying down debt. All this points to high saving rates in the future, reinforcing low consumption.

With crisis support from governments every effort is being made to stop businesses from going bankrupt. For now at least. A rise in corporate and personal bankruptcies, long after the apparently acute phase of the pandemic, seems likely. While rents, both private and commercial are allowed to go unpaid. Even where possible, enforcing contracts and recovering debts has become extremely difficult, with many courts closed.

A lack of social interaction, also stifles innovation. Firms whose employees are unable to meet in person are less likely to be creative. Planning new projects is especially difficult and meeting online through social media like Zoom has a different dynamic than meeting in person, with spontaneity being particularly hard.

Cities are starting to empty. The richest and likely more educated are disproportionately moving out more. In New York, MoveBuddha, a relocation website, says that searches for places in New York City’s suburbs are up almost 250% compared with this time last year. With emptying cities the engines of ideas run more slowly.

While working at home has a negative impact on women’s careers more than men’s, as they are more likely to take care of home-schooling and keeping bored children occupied and entertained. Already, research by Tatyana Deryugina, Olga Shurchkov and Jenna Stearns, three economists, finds that the productivity of female economists, as measured by production of research papers, has fallen relative to male ones since the pandemic began.

Perhaps it is the way the virus exacerbates humans’ predisposition towards unfairness. It kicks the disadvantaged and leaves most of the better-off alone. So the greatest job losses in a shrinking economy are among those who are paid badly. Researchers at Oxford University have found that an American who normally earns less than $20,000 a year is twice as likely to have lost their job due to the pandemic as one earning $80,000-plus. Many of those unlucky people do not have the skills, nor the technology, that would enable them to work from home or to retrain for other jobs.

It was a strong and confident world economy when the pandemic struck. Sooner or later, with vaccines already in development the pandemic will have run its course. It will take at least a year, possibly younger. But the world economy that will emerge will not only be smaller, it will also be different, as it is difficult to predict.

But pass it will.

South Korea, once one of the hardest-hit countries, reported today that it had no domestic cases for the first time since February 29th. Similar success looks within reach in Australia, New Zealand and elsewhere.

This could be reassuring. Or it could simply be a false flag.

An FT analysis of new and more complete data from the Chinese government has found that three-fifths of new Covid-19 cases were asymptomatic. It will further complicate the task of easing lockdown around the world. Professor Chris Witty, the Chief Medical Officer for England warns that eradicating Covid-19 is technically impossible and a second wave this winter could be more serious than the first.

Prof Willett, NHS England’s strategic incident director for coronavirus, said that the proportion of care home residents dying had increased from a quarter to 30%, adding, “The expectation is that for the next few weeks … those care homes will be the epicentres of transmission back into society and feeding the endemic problem that we will have going forward.”

There is a view among some, particularly those who have argued strongly against lockdown that most deaths among care homes’ elderly residents that most of them would soon have died of other causes. . In Britain many pundits have said that two-thirds of the country’s dead were already within a year of passing away.

It turns out not to be the case. Studies in Scotland, Wales and Italy reveal that Covid-19 had shortened life expectancies by an average of around 11 years and that even at the age of 80 the virus had cheated its victims of several years. Managing this particular niche of the pandemic is important, not just for society at large and the safety of care workers, but for the longer-term health and welfare of the resident themselves.

The virus has found other niches too. It’s begun to localise. Covid-19 death rates in London are significantly higher than in other parts of England, with the capital’s most deprived boroughs the worst-hit in the country.

Covid-19 is also not the only virus causing problems in Europe. There’s also African Swine Fever, ASF, which is a disease transferred from wild boar to farmed pigs. There is no risk to us. ASF can’t infect humans, but it does cause huge economic problems and Poland is currently on the front line. Originally, a cargo ship brought ASF with it from Africa to Georgia in 2007. It then spread through Russia and Eastern Europe, and entered Poland in 2014. Recently, the disease has entered Poland’s border with Germany. Wild boar are believed to be carrying it.

Covid’s pathology continues to puzzle doctors. Two aspects of the disease appear in today’s news. The first is heart damage. Up to one in five hospitalised patients have signs of heart injury. Cardiologists are trying to learn whether the virus attacks the organ.

The second is the way it creates skin conditions, including:

  • Chilblain-like symptoms.
  • Vesicular eruptions.
  • Wheals.
  • ‘Other maculopapules’ were identified in 47 per cent of cases and described as small, flat and raised red bumps. They were distributed around hair follicles in some cases and had varying degrees of scaling.
  • Livedo, or necrosis.

This incomplete knowledge has led to a vacuum that has started to fill with myths and theories. One suggestion after a study at Pitié-Salpêtrière Hospital in Paris is that nicotine may be a potential preventative agent against Covid-19 infection. Are smokers less likely to contract the virus, the question appears on Twitter. Meanwhile the Italian Health Ministry have debunked the idea that alcohol is a method to “boost the immune system.”

Part of the emerging covid mythology, are coronavirus parties. There is some basis for the stories from contact tracers who report cases where the virus was picked up at a party. Urban legend gets a hold and exaggerates these into tales of parties to deliberately infect themselves as part of a ‘natural herd immunity’ movement, or to get the disease over with, like the pox parties that were commonly held before the introduction of the varicella vaccine for chickenpox in 1995. Parties have happened, but usually the result of the folly of youth and defiance of lockdown rules.

The virus doesn’t care about whether there’s an ideology behind its victims’ behaviour or whether its plain reckless stupidity. It just infects.

Please don’t intentionally infect yourself, Professor Greta Bauer, an immunologist, warns in the New York Times, and gives the following seven reasons why ‘coronavirus parties’ are such a bad idea:

  • Immunity isn’t a sure thing.
  • Reinfection could be possible.
  • The virus could continue living inside you.
  • Even young people can be hospitalised.
  • Survivors could suffer long-term damage.
  • A ‘mild’ case is hardly mild.
  • There’s no shortcut to immunity.

Most people, however, are fearful of the disease. These include the retired medics returning to work. Thousands of NHS staff have signed up to help but their feelings about being in the thick of it again are hugely varied.

The quality of PPE is part of that concern. Especially issues about whether it is fit for purpose. An example is some healthcare workers on the frontline of the pandemic say that the standard sized PPE is mostly designed with male bodies in mind, and that puts women in danger as they treat coronavirus patients.

Delayed diagnoses and treatment in England due to the pandemic could result in 18,000 deaths from cancer, a new study by scientists at University College London and the Health Data Research Hub for Cancer suggests. The research found the predicted increase could also be the result of social distancing measures, along with a reluctance from patients to seek medical attention.

Dame Cally Palmer, national cancer director for NHS England said chemotherapy treatments were running at 70 per cent of normal levels, but two week referrals were down 62 per cent, she told MPs at the Health and Social Care Committee. She added that the NHS was still on track to meet a target of diagnosing 75 per cent of cancers at stage one and two by 2028, despite the pandemic.

Ms Walton told MPs that home births faced the biggest impact from the pandemic. She said, “Home birth services have been disrupted and there have been lots of reasons for that. Some services have had huge capacity issues with staffing, so in London at the peak of the staffing crisis there were 40 per cent shortages in midwives, so heads and directors of midwifery had to make decisions around how to keep women and services safe.”

As researchers across the world manage to design ventilators that cost less than $1,000 the move in ICUs is away from using them. A combination of elderly acute patients, the invasive nature of ventilation and the drawbacks of induced comas to make such procedures possible meant that in many cases the risks outweighed the benefits, so medics have started to depend increasingly on supplying oxygen and using drugs. They vary in efficacy. 

Gilead’s remdesivir has been among the more successful, reducing the mortality rate and shortening recovery time by almost a third. The Dow went up 500 points after news reached Wall Street. Now all that Gilead needs to do is manufacture enough to supply the world.

Doctors anticipate patient requests for experimental remdesivir before all the evidence comes in.

There is also promising news on the vaccine front.

More Covid-19 vaccines and treatments move towards human trials. Just three months after the start of the Covid-19 pandemic several biotech companies are beginning trials of promising vaccines and treatments. It’s a race, and the Jenner Institute in Oxford leaps ahead, preparing for mass clinical trials, now that tests show their vaccine to be effective in monkeys.

There are currently 8,939 volunteers in 52 countries, willing to be infected with the live virus in order to test vaccines. These are what’s known as human challenge trials. It’s a new, bold idea that could speed up a vaccine. It’s also dangerous, and the trials run almost immediately into an ethical minefield. It will be almost a year before the first human challenge trial takes place, again in Oxford.

It’s a very special kind of bravery.

And mostly unsung.

Unlike PM Johnson, whose journalistic experience has played a major part in the theatre he likes to create. Today he has been gushing. In response to demands for more clarity about his plans to ease the UK out of its Covid-19 lockdown there’s a torrent of optimistic hyperbole for the front pages of British tabloids. We are officially “past the peak” of the pandemic in Britain, and he announces a “comprehensive plan” for the economy, schools, the workplace and travel. The wearing of face coverings has been endorsed by his scientific advisers. Oh, and there won’t be any new round of “austerity” to pay for the coronavirus crisis response.

Catch a story if you can.

Another politician across the pond, Chicago mayor Lori Lightfoot has also been courting attention, using social media memes to change the Covid-19 message. On Facebook, Instagram and Twitter her quirky, humorous signalling got the message across.

Less well adapted to online communications have been the Brexit negotiators, who have struggled with Zoom videoconferencing and missing badly those in formal exchanges over a drink or two. It hasn’t helped at all that the UK government has wilfully neglected to extend the transition period until the worst of Covid-19 is over.

While some politicians have to withdraw from the field, at least temporarily. Russian PM Mikhail Mishustin has gone into self-isolation after testing positive for Covid-19.

In the UK the grip of the government over even the basics is slipping. Johnson’s promise everything boosterism might have a momentary effect on some and his approval ratings in surveys remains high, although signs of slipping have returned. Food banks record an 81 per cent surge in demand as Covid-19 causes thousands to go hungry.

One catering firm has managed to recover over a million frozen airline meals, which were due to go to waste. The food has been sitting in a warehouse near Manchester Airport and now will be distributed to people in need across the region. Open Kitchen, Manchester, has been working with food businesses for nearly six years, repurposing food that would have otherwise gone to landfill. The 1.1 million rescued meals are set to be sent to homeless people, families in poverty and others in vulnerable categories during the Covid-19 pandemic. Corin Bell, the founder of Open Kitchen Manchester, says the decision to repurpose the airline meals was a “no brainer.” Though admittedly “on a much larger scale” than the enterprise’s usual workload. Bell explains that their mission is more relevant than ever. Fortunately they were able to receive support from a local logistics company, which lent the use of its industrial-sized freezer to help preserve the meals as long as possible.

Britain is by no means the only country where there’s an increase of those in need because of the pandemic. Nor is it the only one where resourcefulness has combined with public spiritedness.

Last summer Portugal was one of a number of European countries to take in asylum seekers arriving from the Mediterranean. It provided support, lodging and access to the country’s healthcare system to help thousands of refugees. Now, some of them are showing their gratitude by helping the country’s fight to contain the coronavirus pandemic, in a solidarity kitchen organised by the Braga International School in Northern Portugal. It has distributed over 9,000 meals to those in need. Some receiving food have lost their income. Others are isolated at a campsite because they are infected with Covid-19. Ahmad Sido, a Syrian refugee, told Filipa he can imagine what they are facing. “The disease is like a war,” he said. “It’s more complicated because people don’t have help or food. We know how to help and we help.”

Sometimes the story is not so positive. Covid exposes the cracks within society. One particularly horrific story has been dozens of decomposing bodies found in trucks at a Brooklyn funeral home, The funeral director said that he had used the trucks for storage after he ran out of space in his chapel of rest. “Bodies are coming out of our ears,” he said.

Another has been the growing ordeal faced by Belgian prisoners, feeling forgotten by the rest of society as they struggle with overcrowded facilities that prevent social distancing and to serious hygiene problems. In some cases it’s impossible to wash their hands because there’s no soap.

Also forgotten are the fifty thousand cruise ship crews cast adrift, juvenile justice centres and vulnerable youth abandoned as systems fail to cope.

But more alarming still has been the treatment of some migrant workers. Amnesty International recently reported that dozens of migrant workers in Qatar have been tricked into detention and deportation under the guise of being tested for Covid-19. Migrant workers in Qatar are already at a disadvantage under the kefala system – a sponsorship system of employment tying migrant workers to their employer, leaving them vulnerable to exploitation and trapped in modern slavery.

Other stories from lockdown also catch the news:

  • An online fitness boom has emerged as the lucrative fitness industry becomes increasingly virtual.
  • Postboxes have been painted blue to thank NHS workers for their efforts during the crisis. Five have been given the new colour by the Royal Mail and bear the message, ‘Thank You NHS.’
  • BBC unveils Eurovision – despite contest cancellation this year.
  • All Costco customers will be required to wear a facemask inside stores starting on Monday, making it the first US retailer to mandate its customers to wear face coverings.
  • The suicide of two healthcare workers in New York, a doctor and a medical technician, cast an omen that there will be a Covid-19 mental health crisis.

It seems like the only beneficiary of lockdown is the environment.

  • Both China and Nepal have sent scientists to clean up Mount Everest during lockdown.
  • France wants to use the pandemic to make their national carrier greener. To receive 6.5 billion euros in aid, the Air France will have to cut carbon emissions along with less lucrative domestic flights. Germany’s Angela Merkel also presses for a green recovery.
  • The Covid-19 pandemic is predicted to usher in the biggest shock to the global energy system in more than 70 years. The International Energy Agency (IEA) has released its findings, which suggest that worldwide lockdowns will lead to a drop in demand of around six per cent. Carbon dioxide emissions are expected to decline by eight per cent to levels last seen ten years ago, the largest drop ever recorded. Having a third of the population under lockdown is actually a good way to give the environment a break from human pollution.
  • Climate change, however, hasn’t changed with the pandemic, even though air pollution plummets 45 per cent in major European cities. This is a looming, larger catastrophe, and it has its own inertia.

After releasing its findings the IEA’s executive director warned, “The only way to substantially reduce emissions is not through painful lockdowns, but by putting the right energy and climate policies in place.”

He’s right, No society can fix itself while in lockdown, and increasingly getting out of lockdown becomes many governments’ primary concern.

But how exactly to lift lockdown is unclear. Every country that tries to do so is carrying out its own experiment. There is no instruction manual.

The key appears to be Covid-19’s reproduction rate.  

The key is to keep the reproduction number, that is the number of people who can be infected by someone who contracts the disease (or even tests positive), below one. The most surefire way of doing that is through keeping people away from each other and the most surefire way of doing that is lockdown. In fact the appeal for locking down in the UK has been highly successful.

‘Slightly too successful,’ a leading statistician has suggested after data showed that Britons are fearful of easing a national lockdown. It turns out most Brits feel unsafe going to work and seeing friends if lockdown ended. A new poll finds strong support for social distancing measures to continue.

A poll in the US reveals that most Americans still want decreases in Covid-19 cases before returning to ‘normal.’

But where to start?

There is a view that governments should open schools first. There are many benefits to children and parents alike, but schools have the potential to become epicentres for the spread of the virus. Guidance on hygiene and social distancing, along with regular testing for Covid-19 become essential. It’s complex and requires sound management. To be fair most schools are up to that. Denmark has already reopened its primary schools. France is considering making attendance voluntary, but in doing so risk a loss of social mobility.

Some American states – Georgia, Hawaii and Florida – have started by opening restaurants, which soon become emblematic with freedom.

In the UK, KFC, Burger King and McDonald’s plan summer reopenings following lockdown. Independent restaurants lack the resources of the big chains, but must survive. Greggs will not reopen stores to customers next week in a U-turn decision, but they are going to practice operations and procedures with staff.

The South African government has eased its lockdown, with workers in the textile and manufacturing sectors, as well as some outdoor workers being allowed to return to work. Restaurants will be open, but only for takeaways. Outdoor activities such as running and cycling will be permitted for up to three hours a day, but wearing masks in public will be compulsory.

But there is an ominous spectre. Andrew Joseph writes in STAT, “It doesn’t stay where you started.” Reopening some states, he warns, heightens the risk of surges in others.

Lifting lockdown is going to be problematic, for sure.

Finally, an Imam in my neighbourhood Nextdoor, reminds me we have Ramadan under lockdown.

He gives the following advice:

“Staying at home during Ramadan will play an important part in the effort to slow the spread of Covid-19. Keeping yourself and your loved ones well during Ramadan this year will mean adapting the usual religious and cultural practices. This is particularly important for protecting vulnerable people who we are shielding because of underlying health conditions, as well as family, friends and carers of those who are most vulnerable.”

You don’t have to be a Muslim to be guided by it.

Simply a decent human being.

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.

Day Forty Five: Wednesday 29th April 2020

Daily Diary: So Many Stories

Today, I’m finding myself overwhelmed by the sheer number of coronavirus stories. They are relentless and the big story is changing all the time.

Steve U’s Zoom presentation on choosing the right paraglider went well and I started to get an insight into how Zoom could be used. Nigel and I had a long conversation about Zoom and its potential with a view to the next step of taking it to the club committee. Meanwhile, another good friend Ian has extended a Zoom invitation to his 60th birthday this coming Sunday at 3 pm and I’ll ‘go,’ beer in hand.

At the chemist’s, waiting for Vicky’s antibiotic mixture to be concocted I have an exchange with another customer who tells me he’s heard that if you smoke you’re less likely to be affected by the virus and it’s a reminder of the dangers of rumours, hokum and snake-oil medicine that are currently running rife.

I get the heads up from Andy, a local airsports veteran, that someone’s base-jumped off the Lizzy Bridge at Dartford. Whoever it was I’m putting in the same league as the headbangers out there who are using the empty roads to clock up speeds of over 150 mph. They walk, drive and even free-fall among us.

As does the hooded walker in the eighteenth century plague mask wandering the depths of Norfolk.

So be it.

Carrie Symonds gives birth to a baby boy, and Boris Johnson distracts us all yet one more time away from the folly and stupidity that all too often surrounds him.

The Bigger Picture: It All Ends With Someone Jumping Off A Bridge

The pandemic has layers. There’s my own personal experience and decisions being profoundly influenced by the all-pervasive presence of the virus, whether it’s in the air I breathe and the things I touch or not. There are those near and dear to me, under my roof, then among my family and friends. There’s my neighbourhood and the wider behaviour of those local to me. Then there’s the whole national state of things and the degree of competence and leadership with which it’s being managed. Then of course there’s the whole world, but even that is two layers rather than one. We have got into the habit of thinking about ‘the world’ as being the human world, when this pandemic has starkly reminded us that it is a ball of minerals with a thin living film on it – the biosphere – subject to natural laws which we abide by or break at our peril.

If you want to get a mental picture of exactly how thin that living film is, just wet an unwaxed apple. It’s a sobering thought.

The best analogy I’ve come across about how the pandemic spreads is a forest fire. It only takes an ember to be carried in the air to set up further fires elsewhere. It’s easy to extinguish an ember but all hell to put out a forest fire. The proviso is, of course, that every single ember needs to be put out in time. In the case of the virus the embers can’t be seen, so policymakers have to engage with the acute problem it presents in the abstract in order to prevent it from becoming a nightmare in easily recognisable reality.

Abstraction is something populist governments would rather avoid.

It’s impossible to do abstraction in an easily remembered three word slogan.

But there are those who start to imagine what the fallout will be for the human world. A pandemic is a major disruption of human progress. In some cases quite the reverse as a UN official warns that the pandemic response could become a human rights disaster. The United Nations Population Fund (UNPFA) has warned that the pandemic could spell disaster for women’s rights around the world. UNPFA says lockdowns and school closures designed to contain the spread of Covid-19 could critically undermine progress made in family planning, as well as causing an increase in child marriage and female genital mutilation.

Meanwhile, Global arms spending continues to rise. Optimists claim that Covid-19 will trim budgets and in the post-pandemic world governments will have other priorities. Realists look at the conflicts in countries that by all reasoning are the least able to afford them that are still raging on and think otherwise.

Another warning from the UN is that Covid-19 could double the number of people suffering from acute hunger, with nearly 265 million people at risk of starvation.

It’s not just the developing world where hunger is a problem.

“If I eat lunch, I don’t eat dinner,” Zakarias Darouich, a truck driver from Barcelona, tells Euronews as lockdown punishes Spain’s poorest, who can now barely afford food.

It’s not just simply a matter of money. The pandemic has seriously disrupted the whole supply chain.   A lack of seasonal workers is a big part of the problem. In Germany you are talking about 300,000 agricultural labourers who would usually work in the country’s farms. In France, the number is 200,000, while in Spain it’s 70,000 to 80,000 seasonal workers.

Go it alone Britain decided on recruiting local labour. After all, there was plenty about with lockdown and furlough. There has been a fair amount of wishful thinking here, including getting pensioners to be out there in the fields, harvesting essential crops. No consideration of creaky spines, grating hip joints and dodgy knees. Nor was there any real consideration that orchards and fields were on urban doorsteps where the lion’s share of the furloughed workers were. As it was, 36,000 applications were filled by British people in recent months, but only 6,000 completed interviews and a staggering 112 ended up accepting a job.

The UK has a clerical, computer-screen based education system that steers young people away from doing stuff with their bare hands. Mucky fingers? Yecch! That’s how we got to depend on migrant labour in the first place – before the country was encouraged to grumble about eastern European migrants and things got out of hand.

But that’s another story.

 So farmers and companies have been forced to charter planes and fly in thousands of eastern Europeans to pick that asparagus, those strawberries and grapes. And the UK government mulls over future visa arrangements, to get over their cognitive dissonance of ending free movement.

But it’s similarly confused elsewhere too. The EU has demanded that countries treat seasonal labourers as key workers, but some are still facing difficulties getting across borders . Like Hungary, for example, which has shut them completely. Or in Poland, where people have been put off travelling. With new rules stating that when you return, you must spend two weeks in quarantine, many will decide that it’s simply not worth it.

This is not just a European problem.

In America, meat supplies could be jeopardised as abattoirs also lose staff. Furthermore, meat plants, where animals are slaughtered and their bodies processed are considered essential during the pandemic and have therefore continued to operate. But rather than adapt and safeguard against the spread of Covid-19, these facilities are responding to the crisis by either cutting corners at the expense of animal welfare, or maintaining dangerous pre-Covid-style conditions for its workers that can cause infection rates to spike. In fact, several factories are already ‘hot spots.’

Animals and humans are suffering.

It doesn’t take much imagination to figure out that in the developing world the situation is going to be worse.

It’s emerged that Covid-19 has now killed more Americans than the Vietnam War, as the model used by the White House increases the death toll for the second time in a week. The world’s greatest superpower that should have been well prepared to fight the pandemic is floundering instead, hampered by slow decision-making, inequality and a safety-net full of holes.

To the country’s credit there have been countless acts of philanthropy, from corporations and foundations to individuals, who have so far collectively raised 5.3 billion US dollars to more than 1,200 organisations around the world, not to mention daily acts of more local generosity and charity, such as landlords waiving rent payments for some of the 26 million Americans who have so far applied for unemployment insurance and neighbours making lunches for local children who relied on their schools for a good meal. It has to be said that donations to immediate coronavirus relief efforts do make a huge difference, but will do nothing to tackle the structural problems the virus has exposed. And though impressive, the billions that philanthropists can muster is just a sliver of the trillions that the American government can unleash in stimulus packages. The virus hitting vulnerable groups hardest is a long-term consequence of social and economic inequality. When society does rebuild, pre-pandemic normality is no the place to return to.

Other news from the US:

  • New hospitalisations in New York drop below 1,000 for the first day in a month.
  • “I can’t imagine why.” Trump declares, as he denies responsibility for a spike in disinfectant emergency calls.
  • While hospital demand for Trump’s much touted medicine, hydroxychloroquine, to treat Covid-19, is waning.
  • High profile cases are being delayed by Covid-19, including multiple murders.
  • Nursing ranks are filled with Filipino Americans. The pandemic is taking an outsized toll on them.

And elsewhere:

  • Migrant workers cooped up in Gulf dormitories, largely ignored by governments, fear infection.
  • Clues are thrown up about Kim Jong Un’s Agatha Christie style disappearance Satellite images of luxury boats further suggest that North Korea’s dictator is at his favourite villa.
  • The penny drops that China has near-total control of the world’s antibiotic supply, exposing the biomedical insecurity of the west.

In Britain counting the Covid-19 death toll changes as Public Health England (PHE) develops a methodology that links data from three sources to provide broader coverage of deaths among people with a confirmed COVID-19 laboratory test, whether they occurred in hospitals, care homes or the wider community. There is a sudden jump from 21,678 to 26,097, although the real discrepancy is believed by many to be closer to 20,000. Even on the official figures, Environment Secretary George Eustice admits the UK may well end up with the worst death toll in Europe.

There have been 23,660 deaths in France, 23,822 in Spain and 27,359 in Italy, according to John Hopkins University Covid-19 tracker.

Despite these gloomy picture PM Boris Johnson has returned to work, delay paternity leave to deal with the outbreak and bringing his characteristic positivity with him, although a number of his critics prefer to call it “optimism delusion.” Critics he would dismiss out of hand as “doomsters” and “gloomsters.”

Things are bad. Even allowing for the change in counting there will have been around six hundred deaths in the last 24 hours. 

To succeed, Johnson will need to back up his rhetoric with results. He is already eager to lift the lockdown and is planning to both consult his scientific advisers and hold a summit with opposition leaders. Not far beneath the surface, however, Dominic Cummings is more than a bystander in Sage meetings, two people who were present at the 18th March have told Bloomberg, saying that the Downing Street senior aide pushed for pub closures and full lockdown.

Poor policy decisions and mismanagement lead to consequences with an unforgiving rapidity when it comes to covid, quickly putting ministers on the back foot. “The thing is, I think that’s unreasonable as a question, actually,” Health Secretary Matt Hancock said when asked to apologise for rising care home deaths.

It would have seemed to have made pragmatic sense to extend the Brexit transition period until Britain was at the other side of the pandemic, solving one problem at a time. But the Government’s political sense to ‘get Brexit done’ remains, a dangerous and damaging obsession with the country under a serious biomedical threat, but one which intends to play to the base.  So Dominic Raab, when asked about the EU negotiations, said the UK’s position remains ‘unchanged’ on the transition period coming to an end at the end of this year. He said that not doing so would add to the ‘uncertainty.’

Meanwhile, actor Emma Thompson urges the UK Government to protect migrants during the Covid-19 lockdown. “It’s imperative that our Government shows decency and humanity,” she said.

In the coming year her expectations are far from fully met.

Locking down is definitely working with hospitals becoming quieter. Admissions have fallen from a peak of 3565 at the start of this month to 1488 today and it is a definite downward trend. But from previous pandemics it is by no means over yet and we have to hold our nerve for a second peak. The chief executive of the Nightingale field hospital suggests it should take Covid-19 patients from other London hospitals to enable them to become ‘covid-free’ and restart normal treatment, the backlog of cases of other medical problems rising inexorably, stoking up a problem for the future.

There are also unanswered questions. There is an urgent  need to investigate patterns like the high number of BAME patients with Covid-19.

The other big question concerns transmission of the virus. Airborne transmission is suspected. The results from a study by a team of doctors and scientists in two Wuhan hospitals and published in Nature indicate that room ventilation, open space, sanitization of protective apparel, and proper use and disinfection of toilet areas can effectively limit the concentration of SARS-CoV-2 RNA in aerosols, with a recommendation that future work should explore the infectivity of aerosolised virus.

The droplet-transmission theory is independently borne out by other academics. Lindsey Marr, a professor of civil and environmental engineering at Virginia Tech says, “Those are going to stay in the air, floating around for at least two hours. It strongly suggests there is potential for airborne transmission.”

The idea is catching on with policymakers. The Scottish government have recommended that people cover their faces while in some enclosed public spaces, such as shops and public transport. But not everyone is convinced.  Professor Angela McLean, the government’s deputy chief medical adviser. Said there is “weak” evidence of a “small” beneficial effect for face coverings.

It’s a mystery with flu routinely causing thousands of deaths annually in the UK for countless years before the pandemic that airborne transmission has been relatively sparsely studied. It’s not exactly a new idea. More than a century ago, epidemiologist Dr Thomas Tuttle prescribed face masks and social distancing to slow the influenza pandemic. He made a lot of enemies. It cost him his job. But it worked.

Personally, I’ve been wearing a mask since early March, not because I knew about how the virus was transmitted but because of the precautionary principle, in the same way that I always have a reserve parachute when I go out paragliding, and I struggle to grasp that so many others don’t see things the same way.

It’s a common human error to assume everyone else sees the world the same as you do, and I’m just as prone to that error as anyone else.

Social distancing, including locking down and quarantining is one of two key elements in controlling covid. The other is testing and tracing. The UK is far from reaching its 100,000 target promised for tomorrow. Health secretary, Matt Hancock unveiled a major expansion of free Covid-19 tests by the “middle of May.. They will cover not just the staff and residents in care homes and NHS hospitals without symptoms, but also all people over 65 with symptoms, or people who need to travel for work and have symptoms. With any lockdown easing dependent on such a plan, it’s the first clue to a date for a shift in policy towards wider community testing, although it’s early days.

Thousands of Londoners were today urged to get tested for Covid-19 to help get the capital ‘back on its feet’ as the deadline loomed for the Government’s target of 100,000 deaths a day.

In America, the White House Covid-19 testing strategy puts the onus on states, says the federal government is a ‘last resort.’ CVS Health, Walgreens, Walmart and other retailers with pharmacies are prepping hundreds of parking lots and store drive-thru windows in a much anticipated effort to test Americans for Covid-19. By the end of May there may be nearly 2,000 retail sites open.

Another benefit of testing is that it creates data by which the pandemic may be better understood in subsequent research and analysis. More than a third of people in one of Italy’s hardest-hit provinces have had Covid-19 over the last two months. Authorities in Bergamo, Lombardy, made the estimation based on analysis of the Covid-19 tracking app released earlier this month.

One of the key emergent problems of the pandemic is that very few people appear to be capable of looking at the problem holistically. People’s mindsets travel down two divergent roads. The first is the epidemiological path. Lockdowns are a tried and tested means of controlling the spread of an epidemic, but they are blunt instruments, disruptive to economic activity. The second is the business path, but wealth is created by human activity, not all of which can happen remotely. That means human interactions, and with every one the chance of spreading the virus grows.

And things are worrying. HSBC profits plunge as Europe’s biggest bank faces a coronavirus hit.

No one seems to have found a middle path and the pendulum of trade-offs, along with the opinions of those who espouse them, swings between extremes. So the European Commission is now calling for a new ‘Marshall Plan,’ using money from the EU budget to keep the EU tourism industry afloat during the crucial summer season, without factoring in the effects of mixing populations on spreading the virus and enabling it to mutate, recombine and become more effective and runs counter to other governments’ initiatives to pay citizens’ wages (or at least a substantial part of them) to keep them away from mixing.

It’s a step taken not only by richer nations. In Malawi, for example, more than a million people will receive a monthly payment of 35,000 kwacha, equivalent to the country’s minimum wage, as part of the package of income-support measures for the country’s poorest and to help small businesses through the nation’s anti-Covid-19, President Peter Muthenika has announced.

Back to the EU’s new ‘Marshall Plan.’ The tourism industry is huge. In a couple of generations the prosperity of not only the west, but elsewhere too, has grown, and with it our demand for leisure. That meant a demand for travel, accommodation, eating out that’s grown out of all recognition over the last fifty years. As the virus hit country by country that sector became the first commercial casualty. British Airways is set to make 12,000 workers redundant, as it is expected to take “several years” for the airline industry to recover. Other airlines are not reimbursing customers for flights cancelled due to the pandemic and are now facing class action, as a British legal firm is threatening legal action against Air France, KLM and Ryanair over this apparent, and illegal, refusal to refund.

The airlines include some companies who avoided paying tax in good times and there is a growing sentiment they shouldn’t be getting bailouts now.

But the harsh economic reality is not universal. Elon Musk is expected to soon bank the biggest payday of his life during the global pandemic – a stock jackpot worth $600 million or more. And the pandemic is proving to be liberating firms to experiment with radical new ideas. Some of these will persist after the crisis passes.

There are well-founded fears that closing schools for Covid-19 does lifelong harm and widens inequality. Primary schools in particular are vital for social mobility. In America, President Trump is encouraging  governors to ‘seriously consider’ reopening schools, even though the professional consensus is that it is still too early to do so, especially as the spread of Covid-19 among children is largely unknown.

On the upside there is a drive to create online resources, with David Attenborough joining a host of stars, including Danny Dyer, Jodie Whittaker and Liam Payne stepping in to tech virtual lessons for children at home. The environmentalist-extraordinaire will be teaching geography through BBC Bitesize.

On the downside, there is a troubling lack of competence within the Government in making sure that such online resources can be accessed. Frustratingly to many, as it is still refuses to set out a plan for how children who don’t have adequate internet access or a device to access education during the lockdown.

In many families it’s a mess, with unprepared parents and limited resources trying to manage the learning and progression of children. It’s a contributory factor to the decline in the nation’s mental health.

As are money worries, and the omnipresent prowling of a deadly adversary in the invisible beyond.

Revealing a growth in human misery as seen in panic attacks, relationship breakdowns, drug abuse and alcoholism. To have weathered the disease in full strength can lead to PTSD among sufferers and deep anxiety among those closest to them. This is a cruel disease that also messes with minds.

The question remains:

“Can we flatten the curve without crushing our mental health?”

Theresa May urged ministers to consider rising domestic abuse and mental health, as well as the economy, when deciding how quickly to lift restrictions. “We cannot have a situation where the cure for the disease itself,” she said.

The horror of Covid-19 is all too real:

  • Death toll among NHS and social care workers rises to 108 as Sir Keir Starmer laments UK’s fatalities as “truly awful.”
  • The Government needs to prioritise care homes. Death tolls are heartbreakingly high and workers are struggling. For people with dementia, the pandemic is a particular nightmare, and it may do long term damage to efforts to improve their lot.
  • In the US there is a growing demand for insurance companies to reimburse fairly for tele-mentalhealth during Covid-19.

Pretty much from the beginning of lockdown, getting out of it has been at the front of people’s minds, from politicians to ordinary punters.

Eyes turn to Sweden, unique in Europe as a country that resisted lockdown in the first place.

Sweden, overconfident that the individual responsibility of its citizens, despite the pandemic needing community-centred approaches, and overconfident that if the elderly and more vulnerable could be shielded that herd immunity was the best way forward, allowing the virus to pass through the younger population, where serious illness and death were much less likely, acted as a beacon for all lockdown sceptics, especially in the west. “Lockdown-free” Stockholm “could achieve herd immunity in May,” has been claimed by the Swedish ambassador to the UK as she reveals that 30 per cent of the city’s population already have immunity.

Sweden’s approach had a particular appeal to postmodern libertarians in their opposition against modern authority, along with the tedium of ‘unemotional’ rationality and science, along an anti-traditionalist stance towards older generations.

It is a cliché that the young will always rebel against their forbears, but this rebellion, where the blending of COVID-19 epidemiology and postmodernism is such a dangerous – deadly – combination.

Neighbouring Lithuania’s capital, Vilnius, is being turned into a giant open-air café, with authorities opening bars and restaurants to set up tables outside, free of charge, in order to respect social distancing rules as the country gradually eases lockdown restrictions. Shops, hairdressing and beauty parlours, libraries, museums and cafes were allowed to reopen across Lithuania on Monday as the country started to lift some restrictions imposed to control the spread of Covid-19.

Britain, by contrast, starts considering its first tentative step in opening garden centres. Dominic Raab reassures a green-fingered public that SAGE have “looked specifically at garden centres and we will continue, as I’ve indicated earlier, to keep the evidence on each individual measure under very close review.”

While a Michelin-starred restaurant to reopen as a casual bistro to survive after the lockdown. The Oxford Kitchen will reopen as 215 Kitchen and offer the same quality food and standout dishes, but will adapt its new concept in a new world.

And in America, the state of Georgia opens for business, but patrons are few and far between.

Within lockdown, stories of the new reality continue:

Ahead of his landmark birthday on Thursday, Captain Tom Moore has already received more than 125,000 birthday cards.

Sleep-tracking data show Britons enjoy 42 extra minutes of lie-in under lockdown.

A food bank in London says it has seen a surge in demand as the economic consequences of the lockdown begin to make their impact known. The Hammersmith and Fulham food bank is handing out as much food per day as it would in a week. “This kind of thing, a crisis like this, it impacts the poorest people the hardest, it always does. And it’s not just right, it’s not fair,” said the food bank’s chief executive and funder, Daphine Aikens.

Lovers find absence makes the heart grow fonder: “I haven’t seen my girlfriend for six weeks – this lockdown has changed us as a couple. In our physical absence we have been more present for each other than ever.”

Couples wanting families are showing much more interest in home births.

While at the other end of life the pandemic also changes the norms: “To me, the role of a funeral director is to provide gentle care for those who die during their last days on Earth and to walk alongside their loved ones, helping and supporting them through their grief and helping them to say goodbye. So much of that has changed in recent weeks. We can’t sit down with families to learn about the person they’ve lost and what will make a fitting farewell. We can’t comfort them when they are upset. And we’re finding ourselves having to say no when we would normally say yes, while the restrictions are in place. And it’s the “no” in response to them wanting their family and friends to be there that hurts the most.”

The disabled hope that experience of lockdown will bring about a change in people’s attitude towards them: “Becoming disabled in my twenties helped prepare me for lockdown. After Covid-19 I hope society will be more empathic towards disabled people.”

In Norfolk, a walker in a plague doctor outfit draws the attention of police, reminding me of the sinister clowns craze.

In the Netherlands, trumpet-player, Ellister van der Mole did her best to keep music live in the shared garden of an apartment complex in Amsterdam. She stood exactly one and a half metres from her organist, Bob Wijnen. Their audience, high above their heads, huddled together on the balconies.

Finally, I get a very strange heads-up from a fellow paraglider pilot:

“John. Base jumping community have been off ban for ages. Heads up, there was a jump of the QE2 Bridge at 1 a.m. FACT – it did happen just before the rain and there are many still doing stuff. Crazy, but true. Anyway, think things will start to relax soon enough. Hope all is good.”

That’s the problem.

When it comes to humanity, it takes all sorts.

Day Forty Four: Tuesday 28th April 2020

Daily Diary: Such a Badass Day!

 Such a badass day! It does not start well. Our house burglar alarm goes off in its intentionally jarring, “this is the company ship Nostromo and I’m about to blow myself, the Alien and all other living things, along with a lot of industrial hardware, up into thermonuclear oblivion,” way. By the time I get downstairs to switch it off it has already alerted our neighbour via the ADT call centre, who kindly comes around to see if everything’s okay.

It is okay, I tell her. No burglar. No attempted entry.

I check the control panel and find it’s the kitchen PIR that got triggered. It must have been a mouse. ADT ring the landline but I don’t get to it in time. Then the mobile …… that just happens to be charging in another room. I miss both You can’t call back on the same number, but I have ADT’s number on speed dial and I call them.

The sympathetic guy in the switchboard tells me he’s had mouse problems as well.

“How did you deal with it?” I asked.

“Smell. They really are sensitive. Barring getting a cat, it’s the only way.”

He talked about mopping the kitchen floor with peppermint oil in the water until the smell drove him to the edge of sanity, let alone any mouse.

“I even thought of borrowing my friend’s cat.”

“It works, I believe, I said. “We never had a mouse problem when we had cats.”

We talked about mice getting smarter and more trap-shy. Every time you remove a not particularly bright mouse from the gene pool mice as a whole become more intelligent. That’s evolution. Deal with it. They simply don’t respond to traps any more. It doesn’t matter what bait you use. The rodent terminator from Environ, when he came round, said that mice were neophobic. They didn’t trust anything that was unfamiliar and tended to give such things a wide berth.

“I’m just an old-fashioned mouse

In an old-fashioned house.

I might be small and squeaky,

But credit me with nous.”

If you’re very lucky you can catch mice singing this, although it might sound to human ears, that happen to exist in a somewhat different reality, like a lot of squeaking. But slow down the recording and you can be forgiven for thinking it’s Eartha Kitt (not a very mouselike surname) singing, “I’m just an old fashioned girl.”

But I digress.

The prospect of getting a cat any time soon is unlikely at a time of coronavirus, and the presence of a litter tray is not something either Vicky or I would welcome at the moment.

That leaves war.

Ironic, isn’t it, that we can keep a virus out of the house, but are struggling with a small mammal. It’s that boundary between humans and nature that is so problematic in so many ways. On the one hand, we can only exist at all because of the stark, even cruel and certainly unforgiving natural laws. Of likelihoods leading to outcomes in a ‘biased-random’ way we sometimes call luck.

Well, it’s effing unlucky we’ve got mice!

So the day sees me spraying deterrent spray into strategic locations. Let’s assault the little critters’ nostrils and drive them somewhere else. Having a habitat that’s human friendly but rodent hostile is challenging.

Then I try to get a prescription changed. Would I phone the pharmacy, Vicky asks. Mike, our dentist, did get back to Vicky yesterday and did fix up a prescription of antibiotics to address her toothache. Lockdown means containment in many ways. It means deferring the inevitable – in this case the treatment/repair/removal of a tooth – until safer days in a less dangerous future. I fear such days are still some months, maybe a year or more ahead when there’s an available working vaccine, a drug that mitigates the more severe symptoms of the disease, making a Covid-19 infection not only survivable but bearable, or a means of telling whether another person is ‘safe’ or not. In the meantime we hide behind closed doors and wait for it all to pass with an unknowing hope it will do so.

I head over to the pharmacy across the common. I have my camera with me and have photographed life on the common countless times. I had even thought of making a daily photo diary from January 1st to December 31st and putting it out on You Tube, but had never quite risen to such a commitment. There’s a family flying a kite, or at least trying to do so. It is an image that has a character worth catching a moment of. I had thought of local pics being part of the diary. There’s also an Asian guy kicking a ball around with his kid a good hundred metres away.

“Oi!” he shouts. “Don’t take pictures of my kid!”

“What????”

“Don’t take pictures of my kid! You’re taking pictures of my kid.”

He starts striding towards me.

“What’s your problem?” I ask. “I’m taking a picture of that family flying a kite.”

“You’re taking pictures of my kid.”

“No I’m not. I think you’ve got problems mate.”

“Don’t take pictures of my kid.”

I feel that sense of adrenaline rising and that visceral unease that naturally accompanies aggression and confrontation. It’s one of the ways being an adult is a welcome escape from the emotional state of being a boy in his mid-teens, and it’s not a sensation I relish returning to. But this guy – jeez, I think he’s got a screw loose. Or maybe five weeks of lockdown has made him really edgy. From over a hundred metres away with a pocket camera, FFS! But I’ve been infected with his edginess. His hypersensitivity. That it’s not possible to take a picture of daily life without causing offence. Point a camera in the general direction of anyone and somehow that’s twisted, nasty, paedophilic. And the fact that in some people’s minds that level of suspicion, of paranoia exists is not just troubling, it’s a heartbreaking revelation about our wider humanity. From ‘To Kill a Mockingbird’ to ‘The Green Mile’ that reality of misinterpretation of motive, of prejudiced perception is deeply troubling.

“Look,” I tell him firmly. “I’m keeping a diary of this lockdown. This is part of it. This is social history. I don’t know what your problem is but deal with it.”

I turn and walk to the chemists. He does not follow, there’s no Parthian blow of a final retort and the encounter ends. But the exchange troubled me. The implied suggestion he had made and what must have been going on in his head to make it was really creepy.

Shudder!

I get to the pharmacy. It’s two customers at a time, but there’s no queue. I put on my mask and a pair of disposable gloves and go in. There’s a line two metres from the counter, with an X where to park my feet. It looks more like a post office than a pharmacy, with the counter glazed off and the assistant wearing a mask and gloves. She has the prescription and I collect it, buying a couple of interdent brush packs as I do so. I notice some bottles of hand sanitiser on the counter. It’s the first I’ve seen for months. Looks like a 100 millilitre bottle. Maybe 120 millilitres. There are also some single use masks for sale at £1.25 each.

“How much is the hand sanitiser?” I ask.

“£8.25 a bottle,” the woman behind the counter tells me.

Volume for volume I can buy an 18 year old single malt for around that price.

I didn’t tell her that.

“I’ll stick to soap and water,” I said, remembering days not so long ago when I could pick up that much hand sanitiser for less than a quid.

I return home across the common. The angry man kicking a ball around with his son is no longer there. Nor is the family with the kite. I put the prescription bag, the interdent brushes and the mask I was wearing into my home made UV sterilisation chamber. Then I pass the medicines to Vicky. She doesn’t open them until much later. They’re pills. Vicky has trouble swallowing pills and antibiotics are the most unpleasant of all to chew and swallow, so she tells me.

I ring the pharmacy. The pharmacist tells me he cannot change the capsules for a suspension. That would need a fresh prescription.

“It’s the law,” he explains.

So Vicky rings Mike the dentist, who’s busy with another patient. It all works out in the end but it’s a long trek around the houses to get there.

The episode with the angry delivery driver with my stationery barely warrants a mention. He was frustrated that the plastic wrapping had split. The rain is pouring on him almost as hard as if he were taking a shower. It’s been much like that on and off all day, so I can figure out why he’s so pissed off at life. I tell him to put it in the ‘airlock’ of our front porch – there’s no problem with it being wet from my point of view, and thank you….

So when my paragliding friend Nigel rings me about Zoom and club business the poor guy gets the brunt of a frustrating morning. He’s saved by someone ringing his front doorbell.

If I were Nigel listening to me, I would have rung it myself!

The Bigger Picture: Pinning the Tale On the Butt End of Events

“It’s not much of a tail, but I’m sort of attached to it,” said Eeyore in ‘Winnie The Pooh.’

We’ve got the same problem with some of our leaders, who seem to be stuck to the ass-end of events, and we seem to be stuck with them. Despite serious errors of judgement and other flaws, some leading to innumerable deaths, politicians’ approval ratings are generally more positively than expected. It’s as if whole societies are capable of suffering from a collective Stockholm syndrome.

We have a government happy to cheerlead a public display of gratitude to frontline workers by clapping and pot-banging, along with calling for one minute’s silence for those who have died saving others but slow to extend the offer of a visa extension, while sacked hospitality workers sleep rough at the height of a pandemic. The need for foodbanks has skyrocketed, while some farmers don’t know what to do with the excess produce. If they can get workers to harvest it, that is.

It comes home to me via my local Nextdoor forum. 

“I have a government food package delivered to my flat in Naval House but I didn’t request it. Please let me know if you live in Naval House and ordered one. I will drop it off at your flat.”

To which another local resident replies:

“I live in Woolwich Dockyard. Please may I be considered? Thank you.”

Mobile phone data shows that poorer workers are likelier than rich ones to keep commuting. Most frontline work is lower income.

And the huge deal about working from home overshadows that stark fact. The better off steal the show. It pervades the whole of society. Even universities, bastions of educated liberalism are not exempt as Covid-19 shows up shameful employment practices, with 54 per cent of staff on insecure contracts.

Health Secretary Matt Hancock announces that families of frontline NHS and social care staff who have died from Covid-19 will get a £60,000 payout. He also admitted there was ‘a lot of work’ to do to hit his target of 100,000 Covid-19 tests a day.

Frontline workers elsewhere receive no such compensation.

Boris Johnson is set to share his new lockdown plan as the country endures the crest of the first wave. He urges caution, as he comes down on the side of those in Cabinet and his party arguing about the importance of avoiding a second wave. He also pledged to include the opposition parties as much as possible in the debate over what comes next. In the fullness of time neither good intention comes to fruition, as the PM remains torn between his populist motivations and the need to be pragmatic.

The public are being led to believe that the Government is following ‘the science.’ It’s a useful foil for both good and bad decisions. There is a naïve belief being promoted that there is only one science, a virtuous body of knowledge, a universal truth to which the Government subscribes, and in doing so claims credibility and authority.

The reality is different. First, ‘the science’ is a massive endeavour involving thousands of scientists trying to answer fundamental, vital, and unprecedented questions. How fast does the virus spread if left unabated? How lethal is it? How many people have already had it? If so, are they now immune? What drugs can fight it? What can societies do to slow it? What happens when we selectively evolve and relax our public health interventions? Can we develop a vaccine to stop it? Should cloth masks become mandatory?

Second, data and analyses are shifting daily, honest disagreements among academic experts with different training, scientific backgrounds, and perspectives are both unavoidable and desirable. So when those disagreements are freely discussed and resolved they need to be influenced by scientific insights independent of political philosophies and party affiliations. What comes out of such discussions and resolutions is then taken on board by policymakers, academics, and interested members of the public to consider differing point of views and decide, at each moment, the best courses of action.

So when a member of the Scientific Advisory Group for Emergencies (SAGE) said they felt Dominic Cummings’ interventions had sometimes inappropriately influenced what is supposed to be an impartial scientific process, the conduct of science becomes indistinguishable from politics.

This is not following ‘the science,’ but steering the science to be followed.

There is a similar process going on in the United States. Donald Trump also experiences the deep conflict between promoting a political agenda and pragmatic necessity. Following the embarrassing household cleaner and subcutaneous sunlight farce on the presidential podium Trump has openly expressed a reluctance to make further announcements to the nation. The White House briefing is on, then off, then on again.

He hates being the object of ridicule – that’s for other lesser beings to endure from him –  but he thrives on media exposure. Since March 9th, when in the US public consciousness, the virus outbreak began leading to widespread disruptions, Mr Trump has spoken 260,000 words about the virus. The New York Times analysed every word and has found self-congratulation to be the most common theme.

Then, to add horror upon horror we find we’ve got the Covid-19 death count wrong. For England it’s around forty per cent higher than previously reported, new figures show. The figures from the ONS giving details of the fatalities where Covid-19 was on the death certificate, show 21,284 deaths in England up to April 17th. The previously published figure for that date was 14,576. NHS England have started to report the number of patient deaths where there has been no COVID-19 positive test result, but where COVID-19 is documented as a direct or underlying cause of death on part 1 or part 2 of the death certification process.

A problem with measuring the pandemic is that the parameters of what we are measuring change as time passes, and our understanding of what’s happening evolves. The number of cases depends on the number of tests being carried out, that in turn depend on the availability of tests to the general public, and their access to them. Hospitalisations also have a lot of variables in the situations that lead to them occurring, and ICU patients is a subset of that. There is not yet a fully reliable measure of a death being attributable to Covid-19 in a number of cases. Meanwhile, asymptomatic cases lurk like submarines, embedded within the population and ready to re-emerge as restrictions become relaxed.

Many fear what the UK prime minister talked about on returning to work this morning – a second wave. If Britain eases restrictions too quickly it would be to “throw away all the effort and sacrifice.” He is right to be concerned. Throughout history, epidemics have battered us in waves. The first reported plague outbreak in Athens hit in 430 BCE, 429 BCE and 427 BCE to 426 BCE, bringing misery and death with it year after year. The same was true of the Black Death in the 14th century and Smallpox  in the 18th century. And also, notably, the so-called Spanish Flu a century ago, which hit Europe in the spring of 1918, before re-emerging later the same year and then in 1919. Worryingly, it was the second wave in the autumn and winter of 1918 that proved more deadly in some places. Most scientists think that there will be a second wave of the novel coronavirus most likely in the second half of this year.

Trying to establish how deeply embedded the virus is within the population we’re still learning to identify the disease. On Sunday the US CDC officially added these six symptoms to its list: chills, repeated shaking with chills, muscle pain, headaches, sore throat, new loss of taste or smell, in addition to previously known symptoms of fever, cough, shortness of breath, or difficulty breathing. The symptoms can appear within two to fourteen days after exposure to Covid-19, according to the guidelines. In addition, the CDC described a set of emergency warning signs that should warrant immediate medical attention, including trouble breathing, persistent pain or pressure on the chest, new confusion or inability to arouse, bluish lips or face.

Covid-19 is a disease with many different faces and a study finds that people’s genes determine how severely people get Covid-19.

It is also a cuckoo-condition, driving other conditions out of the nest. Health authorities in the UK are encouraging people to seek help if needed, amid fears that people may be letting cancer and other serious conditions go untreated, because they’re scared of contracting Covid-19 if they go to hospital. Public Health England said visits to hospital emergency departments had fallen by almost 50 per cent in April, compared with the same month last year.

It’s also unforgiving of misconceived policy decisions. The elderly are paying the price for Sweden’s no-testing, no-lockdown Covid-19 strategy. Critics say it will not be looked upon favourably by the rest of Europe. It might be true that different countries should follow different approaches to Covid-19 based on their socioeconomic circumstances but it’s becoming clear that the policy of one country has repercussions on others, especially when it comes to a contagious killer virus.

For now, all we can do is keep ourselves out of contact with others, through various degrees of isolation, social distancing and covering ourselves. In the UK, stockpile failures date back 11 years, with the last stockpile having been created in 2009. One in four doctors are having to reuse personal protective equipment as claims are made that the Government failed to stockpile gowns, visors, swabs and body bags. Protective clothing should only be worn once and then discarded. The son of a doctor who died after a PPE warning demands an apology from Matt Hancock. 

The wider public are moving increasingly to wearing facemasks, whether by government edict or not. Germany demands masks in public transport, while Saxony becomes the first German state to make masks mandatory. Rio puts facemasks on its public statues. Russia’s famous matryoshka dolls get a Covid-19 makeover – they’re now wearing masks.

With the disease so new, and with so much yet to understand about it, there is no bespoke medication. Drug after drug gets repurposed. Hopes are raised and often dashed.

There appear to be three main avenues down which these repurposed drugs are set to treat hospitalised Covid-19 patients. The first is to attack the capacity of the virus to replicate itself. The hottest contender here is Remdesivir, manufactured by Gilead Pharmaceuticals and repurposed from being used to treat Hepatitis C, Ebola and Marburg. Remdesivir interrupts the replication of viral RNA by replacing one of its code components, adenosine. The molecule then behaves like a damaged zip fastener and the enzyme RNA polymerase can’t function in replicating it. A less successful medicine, Lopinavir, also known as Kaletra, repurposed from treating HIV and HPV, inhibits the assembly of viral proteins.

The second is to suppress an extreme immune response from the patient to the virus known as a ‘cytokine storm,’ in which small proteins called cytokines are released in overwhelming quantities and gunk up body processes, especially in the lungs, heart, liver and kidneys, but also elsewhere. Kevzara, aka Sarilumab, from Regeneron and Sanofi, has a track record as an anti-rheumatic dealing with auto-immune disorders.

Associated with suppressing an extreme immune response has been the observation that 75 per cent of Covid-19 patients needing ICU treatment have been adult males, who are also much more likely to die from the disease. Women’s immune systems have been known to be much more robust than men’s and a key element of that is believed to be the different balance of sex hormones between the sexes. The question is being asked and explored: can oestrogen help men survive Covid-19?

The third way is to swamp the body with bespoke antibodies before the virus can get a full hold. Actemra, from Roche, also known as Tocilizumab, from a background of treating autoimmune diseases is the most promising, although monoclonal antibodies remain very expensive.

There is a real urgency here, sending jitters through stockmarkets with each twist and turn in the saga as it reveals itself. With the pandemic being such a recent phenomenon, trials are small-scale, often without the rigour you’d expect in non-pandemic times, and with small sample sizes. Sometimes it’s simply been a lack of availability of the drugs to be trialled. Outcomes often contradict each other – when it came to Remdesivir clinical trials, positive results from Chicago were at odds with results from China where there was no difference between test and control groups. Sometimes there have been issues with ethics or the absence of a placebo group. 

But as George D. Yancopoulos, Regeneron’s founder and chief scientific officer, put it:

“When you try everything under the kitchen sink, most of the time it’s not going to deliver the results that you want, no matter what the small 20 or 30 patient studies say.”

At other times there would be the luxury of time.

It’s a commodity in short supply .

With a head start, Oxford scientists say their vaccine could be available by September. If it works. In Montana, six monkeys were injected with the Oxford University Covid-19 vaccine last month and have remained healthy despite exposure to the virus, unlike other unvaccinated monkeys in the lab. It’s a grisly reminder that to save our lives, other sentient beings without the capacity to object pay the ultimate price.

Meanwhile, the pressure group, Global Citizen, reminds us it’s Immunisation Week.

There is a whole world out there to vaccinate before we’re through with this plague.

It won’t be easy.

Nor is it easy to make sense of the pandemic’s economic fallout.  From the turmoil come winners, such as the speculator Carl Icahn, who bought oil when it was at a rock-bottom price earlier this month, knowing the price will rise back to pre-pandemic levels, is now taking a multibillion short position against the commercial real estate market, which he has predicted, will ‘blow up’ in a similar fashion to the 2008 financial crisis and banking on changes to post-pandemic working structures and practices.

There are losers, such as the customers of a number of airlines, both in the UK and EU, who have refused to provide refunds to customers whose flights were cancelled due to Covid-19, in contravention of UK and EU regulations. This comes despite massive bailouts to airlines by national governments.

The Parable of the Unforgiving Servant comes to mind. For those who thumb their bibles it’s Matthew 18: 21-35.

Try cutting and paste the reference into Google, if you’re sitting comfortably at your screen and can’t be bothered to go over to your Zoom bookshelf.

There are knock-on effects from the harsh effects on air travel from lockdown. Airbus warns it is ion an existential crisis, as it furloughs 3,000 staff in Wales after warning it is ‘bleeding cash.’

In the United States, the government isn’t disclosing which companies received aid under a troubled $349 billion loan programme that was part of the rescue package signed into law last month. That makes a full accounting of the Paycheck Protection Program impossible. Things are hard among working Americans as measures introduced to put one in every seven mortgages on a payment holiday.

So the desire to lift lockdown and return to normality is strong, not just among politicians and business leaders but the wider population too.

Green shoots are beginning to show:

  • New Zealanders queued for coffee and takeaways today as a month-long lockdown was eased. About 400,000 people returned to work after PM Jacinda Ardern shifted the country’s alert level down a notch. How New Zealand will ease lockdown rules after reporting five new cases of Covid-19. Some businesses will be allowed to reopen but the country’s borders will remain shut.
  • Hong Kong’s leader Carrie Lam said today most civil servants will gradually return to work from May 4th, although the government has not yet decided whether to ease travel and social distancing restrictions that are due to expire next week. Hong Kong reported no new infections for a second day yesterday. It has recorded 1,038 cases and four deaths since the outbreak began in January.
  • The UK boss of McDonald’s has said that the restaurant chain is carrying out its tests behind closed doors this week in preparation for reopening sites.
  • In America, Georgia diners are set to reopen, and the restaurant chain, Waffle House, braces for a slow recovery.
  • Iran, which has had one of the world’s worst outbreaks, will begin reopening mosques.
  • India eases Covid-19 restrictions.
  • Bangladesh’s factories, a pillar of its economy, reopen, but workers fear infection.
  • Switzerland eases lockdown, as Austria loosens its lockdown further, allowing events of up to ten people.
  • Italy’s plans to ease Europe’s longest lockdown get a cool welcome.
  • While in France, a reopening plan spurs controversy even before it is unveiled. Many believe it has been rushed.

Like in France, not everyone is confident. With some justification. Many US states are far short of Covid-19 testing levels needed for safe reopening, a new analysis shows.

Some countries are still cautious:

  • President Erdogan announces that Turkey will keep Covid-19 rules in place through May.
  • It is too early to consider lifting Japan’s state of emergency over the coronavirus, the head of a powerful physicians’ lobby said on Tuesday, adding that Tokyo would find it tough to host next year’s Olympics without an effective vaccine.

While locally, less cautious citizens are ending their own lockdowns themselves. Someone from my neck of the woods complains:

Has the lockdown ended? Gallions Park on Warepoint Drive resembles a Butlins Holiday Camp! Has anyone seen the police?

I didn’t see an answer.

But through a combination of strict rules, soft enforcement and in the case of a noticeable minority limited compliance a ‘new normal’ is taking shape:

Some find it harsh:

“Families are really struggling:” London foodbank sees a five-fold surge. “This kind of thing, a crisis like this, it impacts the poorest people the hardest. It always does.”

Some find it unbearable:

Calls to domestic abuse hotline in the UK have increased by 49 per cent and killings doubled in the three weeks after lockdown restrictions began. Researchers at the Counting Dead Women Project told British MPs 14 women and two children had been killed in the first three weeks of lockdown – the highest number in a three week period for 11 years and double the average rate.

Some find it unfair:

FC Utrecht is preparing to challenge the decision by the Dutch Football Association to call off the football season, after the prime minister, Mark Rutte announced that all major events would be cancelled until September. The team was three points away from a place in the UEFA Football League, with one game to play and a superior goal difference.

Some find it unsettling:

The pandemic is found to even infecting people’s dreams as it sabotages sleep worldwide.

Some find it frustrating:

Julian Assange, Elizabeth Holmes and other high profile people have had their court cases postponed due to the pandemic.

Some find it heartbreaking:

A woman shares the final text from her fiancée who died with Covid-19.

“Once I am asleep, I am in God’s hands”

This one simple story is a haunting reminder of the horror of the pandemic. Perhaps it’s its simplicity. Perhaps it is the imagery it conjures. But I find myself, above all other stories, unable to forget it.

Not all is bad, but I see it as the silver linings to towering dark thunderclouds:

Some find it inspirational:

Tom Moore smashes Guinness World Records. Captain Tom Moore, 99 year old World War 2 veteran has achieved the record title for the most money raised for charity by an individual, raising more than £28 million.

And….

Former state school pupils are inspiring younger generations in their careers. For ten years FutureFirst has been giving state school pupils an alumni network, and that’s continuing under lockdown.

Some find it strangely futuristic:

SoftBank-backed robotics firm Brain raises $36 million for expansion beyond autonomous scrubbers during the coronavirus crisis. “You always hear about sexy robots. I always say a sexy robot is lousy business. We want boring robots that actually solve problems and now it’s becoming more important because of Covid-19,” Eugene Izhikevich, Brain’s co-founder and CEO tells Forbes. “Robots don’t sneeze, they don’t cough and they don’t have fevers.”

Some find it eye-opening:

15 virtual classes to learn skills from around the world. Video classes to take you from Australia to Marrakech, have you cooking Thai food, yodelling in the hills and painting like Andy Warhol.

And some find it raises hopes and possibilities in times to come:

Residents of Istanbul have been treated to the rare sight of dolphins in the Bosphorus Strait. Much of the country is in ,lockdown with people confined to their homes for a firm day curfew over the weekend, but for dolphins there have been new and exciting worlds to explore.

There are other stories too from around the world:

  • San Marino is currently the world’s worst country in terms of Covid-19 related deaths per capita. The microstate has decided to take a more aggressive approach to battling the pandemic through intense tracking, a two-test strategy (a molecular and a serology test), medical home visits and generous relief packages.
  • France has severely controlled the sale of nicotine products after a study suggested smokers may be less likely to contract Covid-19. The measures aim to “prevent the health risk linked to the excessive consumption or misuse of nicotine products by people hoping to protect themselves from the novel coronavirus and to ‘guarantee the continuous supply for people requiring medications to stop smoking,’ the decree states.
  • The small southern Italian town of Castellino del Biferno is minting money to help the local community cope with the pressures of the pandemic. “However small this economy may be, there are three or four businesses still open, without considering bars and pubs,” town mayor, Enrico Fratangelo, said. He received €5,500 from the government to issue food vouchers to vulnerable families. The town council added its savings and distributed “Ducati” banknotes to 200 local families.
  • Argentina has banned all internal and international commercial flights until September 1st. The country closed its borders last month and imposed a strict lockdown, which has been credited with helping to keep confined cases to about 4,000, with just 200 deaths.
  • More than 2,200 Indonesians have died with acute Covid-19 symptoms but were not recorded as victims, a Reuters review of data from 16 of the country’s 34 provinces has shown. The figures indicate the national death toll is likely to be far higher than the official figure of 765, medical experts said.
  • Extremists compound the threat of Covid-19 in Burkina-Faso.
  • Covid-19 is spreading rapidly across Latin America, with fears that relatively weak health infrastructures could be easily overwhelmed. Brazil’s president, Jair Bolsonaro, is under fire for his crisis management, Ecuadorian authorities are digging mass graves at cemeteries and Cuba is dispatching doctors to South Africa.
  • Killing in Mogadishu, Somalia: An officer has been arrested and people have taken to the streets after at least one person was shot dead by police enforcing the country’s lockdown.
  • Kenya has demoted a top scientist in charge of overseeing the country’s Covid-19 testing, raising concerns about prompting criticism of the government’s directive. Dr Joel Lutomiah, the deputy director of the Centre for Virus Research at the Kenya Medical Research Institute was dismissed from the role after test results were delayed, according to news reports. Scientists at the Institute, however, said that he was fired for standing up to government officials and demanding more funding during this crucial period.
  • The Mexican government has almost entirely emptied its network of migrant detention centres, deporting people in them, to prevent the spread of Covid-19 among detainees, the authorities announced.
  • Afghanistan is set to release 60 per cent of prisoners as Covid-19 spreads.
  • Health care workers in Mexico, India and other countries are facing attacks. Ignorance, superstition and misinformation take a cruel toll.

Finally, a notice from my local council:

The Royal Borough of Greenwich Community Hub is here for you. If you are self-isolating and have not got a family member, friend or neighbour who can help, please get in touch with the community hub on 0800-470-4831, 7 days a week, between 8.30 am and 6 pm.

Good to know. There are people out there trying to do their best.

Day Forty Three: Monday 27th April 2020

Daily Diary: A Mundizzy View From The Chimney Pot

I’ve come across this new word – mundizziness. I have no idea where the word came from but you can be sure it’s not in the Oxford English Dictionary. In fact you’d get nothing by googling it either. I can’t even be sure writing about this over a year after I scribbled the daily diary in my notebook that I made it up.

So be it.

Mundizziness is (to my mind) making yourself busy in a mundane way. I seem to be getting pretty good at it and I’m certainly not at a loss about how to pass the day.

Last night Vicky’s toothache returned. The problem with toothache is it doesn’t go away of its own accord. At its worst, and left to its own devices it will worsen, progressing from an infection to an abscess, followed if neglected by further and deepening consequences like sepsis and fever. It is a perfect example of empathy in the universe. What you need to be concerned about is not that order will naturally descend into disorder, but how quickly it does so. She’s understandably worried that to treat her toothache will be the first time we will have broken out of the safety net of isolation to engage with a wild and unforgiving world out there, where, like in any self-respecting epic fantasy, the forces of chaos are running rife. But it has to be done. Like in such fantasy epics a dangerous journey must be made into a world of darkness.

Or so it seems from our safe little niche.

In our world the fact that there are countless brave people who go out into the virozone every day to ensure our safety passes us by. The medics, the other key workers, the organisers and fixers – all of whom are going where I cannot (or is it will not) go, in a world that if I blink twice and pinch myself has transformed into a science fiction dystopia.

I ring the dental surgery and get given a contact number by the head of the practice. So Vicky rings the contact number and is invited to leave a message on voicemail. Now it’s looking more like a thriller. Leave a message. Leave your telephone number. Will there be a reply? Or will it involve contacting another telephone number, or clicking on a link in an email, or picking up a brown paper package behind the third bush on the left – you know the one I mean.

Then there’s a knock on the door. It’s a passer-by, a short bearded bloke in his thirties. He looks concerned about something.

“There’s a cat on your roof. A black and white cat,” he tells me. “Do you know whose it is?”

“It’s our neighbour’s,” I reply through the glass.

“He’s up there…..”

“I know. Cats do that kind of stuff round here. They’re playing ‘Top Cat,’ outdoing each other over who can get the highest.”

“But he doesn’t look safe.”

“Oh he is. He’s done it before.”

“And he can get in through people’s top windows.”

“He’ll be fine,” I reassure him. “He’s being a cat. Thank you for your concern.”

“I just thought I’d let you know.” .

“Thanks.”

The surreal conversation through the glass pane of our front door ends there.

Cathy and Tom are pretty chilled about their two cats’ urban escapades and we’re all blessed to be in a tolerant neighbourhood. They come. They go. We know they can act as possible coronavirus vectors, but no one in our little corner of the planet seems to have it, so we let this rampant wildcard interface between the human and animal worlds happen. Here and there it’s been noted that cat species, large and small, have been infected with Covid-19, especially in New York, but the chances I think are too slim to justify a ding-dong about whether our neighbours should be letting their cats out. Keep them in with a litter tray and the whole house starts to stink of the nether emissions of cat. I know what I’d do in the circumstances.

After the exchange I do go out. There’s some garbage for the bin and I need to check if there’s been a stationery delivery. Tom is having an exchange with the postman. I think it’s about how to sign for a delivery while maintaining social distancing. This is an example of the many ways in which we are all learning by doing, and I’m sure all the postman’s clients have their own way of doing things in the absence of a procedure. It gets sorted and the postman then tells me that he’s sorry if there are delays with the deliveries, but the Post Office are being run off their feet by the sheer increase in the volume of parcels being delivered, so they’re constantly chasing their own tails, and all the post is a day or two behind as a result. I tell him not to worry as I’ve all the time in the world and, what’s more, I’m not going anywhere. He laughs and continues his round, going around the corner and vanishing from sight.

Then my first Zoom tutorial, spraying the chassis of the model 15 cwt Chevrolet that my dad was so familiar with in the Western Desert in World War II, and transfer the germinating geraniums from the kitchen paper hatching bed to a compost nursery. They are growing so well and it’s exciting watching them doing so.

Along with the routine rowing machine exercise and the research, a failed attempt to phone Nigel about Steve U’s Zoom presentation tomorrow, it’s all been so mundizzy.

The Bigger Picture: The Return Of The Man Who Would Be King

A narrative built up from the day’s news stories…..

Prime Minister Boris Johnson returns to work at Number Ten. He’s facing a number of real problems, resulting in part from a raging pandemic, in part from the disruptive, even chaotic way in which his government is running the country, and in part because of the central character he has created for himself in his own idiosyncratic personal narrative. It’s a moment that more pedestrian beings, as he would see them, would take stock of their brush with oblivion in an ICU and re-think the cornerstones of their lives.

Many watch his next moves and hope for a change.

Like Rabbit, hoping that Tigger will be traumatised into losing his bounce, expect to be disappointed. It does not happen. Some credit the influence of Johnson’s maternal grandmother, the artistic and colourful Frances Beatrice Lowe, who inspired him. He even quoted her advice:

“Darling, remember, it’s not how you’re doing; it’s what you’re doing.”

Living in the moment, not worrying about the consequences, was a childhood theme, leading to the mantra “Get on with it!”

The scenario is grim. In the last twenty four hours there have been 4309 recorded new cases, 360 deaths and an average daily death rate over the past week of 641. With a shaky and incomplete test and trace system the recorded cases only represent a fraction of what is almost certainly happening out in the population. In fact the country is flying blind through a fog of ignorance and the PM faces imminent pressure over PPE, testing and easing the lockdown.

Doctors are warning that protective equipment shortages are worsening, doctors warn and foreign secretary Dominic Raab, who has been standing in for Boris Johnson, raises fresh doubts about supplies. It’s dire. A third of physicians in high-risk settings lack long-sleeved gowns or full-face visors, a situation that has worsened over the past three weeks.

Teething troubles continue to blight the Government’s new Covid-19 test booking platform, with home kits running out again by 9 am. More than 10 million essential workers and their households are now eligible for Covid-19 tests as the Government scrambles to hit its much-hyped 100,000 a day target by this Thursday. Health minister Matthew Hancock says NHS staff should not have to wait for test results. The reality is very different. Some staff have had to wait for up to 24 days, making testing utterly pointless.

It’s announced that the military are to run ‘pop up’ testing sites for key workers and vulnerable people. At least 96 units will be set up by the end of May, travelling to care homes, police and fire stations, prisons and benefits centres.

It’s not a problem unique to Britain. In the US, testing shortages continue to impede governors’ abilities to reopen their states. As in Britain, great faith is being placed in newly developed antibody tests, and misunderstanding too in the way that they differ fundamentally from antigen tests in preventing the spread of the virus. There are concerns too about the tests’ quality. A team of 50 scientists evaluated 14 available tests for Covid-19 antibodies. Only three met the required standard. Governors still lack what experts say they need to track and contain outbreaks.

In both countries – others too – test and trace is seen to be critical in lifting lockdown, but real problems exist with regard to its organisation. At a certain level it works well, such as in the control of sexually transmitted diseases, including HIV/AIDS, but Covid-19 is burning its way through the population like a wildfire. Had the threat of the pandemic been registered and acted upon earlier, such as in New Zealand, test and trace would have been manageable. As it is, all current systems have been overwhelmed.

Another problem is that Britain’s borders remain open. Arrangements have just been announced that passengers entering the UK ‘to be quarantined for two weeks’ in new plans to halt the coronavirus spread. It’s belated and in the months to come, half-hearted and inadequately enforced. The irony is that a populist government has come to power in response to a demand from a large enough slice of the populace for tougher border control in response to a range of anxieties about identity, culture and economic security, and it has failed miserably to keep out a viral plague.

When it came to anxieties no one thought for a moment about the possibilities of a pandemic.

Rumour has it there has been a decline in crystal ball sales and enrolment on divination courses.

The day was crowned with PM Johnson delivering his first post-ordeal speech today. He described being infected with Covid-19 as being attacked by an invisible, unexpected, physical assailant “and we have begun together to wrestle it to the floor.” It’s Johnsonian, colourful rhetoric that calls up recent memories of TV footage of Usman Khan being wrestled to the floor on London Bridge by fellow ex-prisoners after the tragic murder of Jack Merritt and Saskia Jones at Fishmonger’s Hall during a rehabilitation meeting at the end of November.

He praised the British people for their forbearance, good sense and altruism during lockdown and warned against “the risk of a second spike.,” which could cause an economic disaster.” He said, “The UK needs to pace itself before ‘firing up’ the engines of the economy.”

He outlined ‘five tests’ that were needed to ease the lockdown: deaths falling, the NHS protected, the R-rate down below one, sorting out the challenges of testing and PHE and avoiding a second spike. He promised to be more transparent, to share more with the British people and relying on science as he had, he claimed, from the beginning.

Obvious by its omission was any mention of controlling the disease at the UK’s borders. It is to remain a major issue over the coming twelve months and more. There is a serious blind spot that there is no point controlling the virus within when it continues to arrive from outside.

Meanwhile, Johnson is warned that Post-Brexit talks with the EU are on a course to fail. In the circumstances it would have been wise to extend the transition period. First. because negotiators cannot meet face to face and, even in the age of Zoom, this is a huge handicap. Formal negotiations form only part of the discussions and informal chats behind the scenes are a vital part of the process. They are much less likely to happen in the current climate. Second, businesses which would be frantically preparing for a December deadline are, instead, wrestling with Covid-19. For many of them it is a life and death struggle, and it is at best naïve to believe they can also plan for our separation from the UK. Third, the Government itself has a limited capacity to deal with crises. It’s unrealistic and to expect ministers and civil servants to cope with a December deadline and Covid-19 simultaneously. The prime minister will take time to recover from the coronavirus and the same is true for the machinery of government.

During transition, not being fully severed from the EU has helped during the crisis. Many frontline staff, both in the NHS, but also in the care and other services are from Europe. The UK opted in to the EU scheme to bring citizens home from abroad. The UK is still eligible for many of the EU’s schemes to tackle a global pandemic, from financial aid to early warning systems to medical testing, along with We numerous acts of support from the continent, including the donation of 60 ventilators for our NHS from Germany.

This week Romanian workers were flown to the UK to help feed Britain. Giving the daily COVID-19 briefing, Environment Secretary George Eustice said only a third of the migrant workers who normally picked fruit and vegetables were currently in the country. Although the international food chain was continuing to “work well”, Mr Eustice said he expected there would be a need to recruit staff in the UK to harvest crops in the coming weeks. However, decades of disengagement with manual and particularly agricultural labour within British society has left a lack of motivation within the workforce and even urging furloughed workers to go out into the orchards and fields doesn’t fill the gap.

In many farms crops rot in the field. It is a legacy. We’re reaping what we’ve sown.

Or not, as the case might be.

A combination of Brexit, a toxic atmosphere of unwelcomeness and Covid-19 have depleted the numbers of EU migrants, many of whom have now returned home. For all migrants, the UK Government’s ‘No Recourse to Public Funds’ policy creates a sufficiently significant human rights issue to get the attention of Amnesty International, who describe it as “a scandal of neglect,” warning that many migrant workers are currently on the frontline of the coronavirus response in the UK, but without access to financial support many are being forced to continue working ‘at great personal and societal risk’. Others have lost work due to the pandemic and need support for themselves and families. The ‘No Recourse To Public Funds’ rules bar many migrants from accessing Universal Credit during the coronavirus crisis.

Steve Valdez-Symonds Amnesty UK’s Refugee and Migrant Rights Director added, “COVID-19 doesn’t discriminate on the basis of citizenship or immigration status but it’s clear the UK’s immigration system does ….. It beggars belief that during one of the most dangerous and devastating public health crises the UK has seen, migrants subject to the ‘no recourse to public funds’ rule still cannot access crucial support they need to stay safe and healthy.

This coincides with United Nations special rapporteur on extreme poverty and human rights, Professor Philip Alston criticising the UK government’s coronavirus response as “utterly hypocritical” after successive administrations implemented policies of austerity and public-sector cuts.

He added that globally “the most vulnerable have been short-changed or excluded” by official responses to the disease, which had claimed over 203,670 lives by Sunday evening, according to Johns Hopkins University.

“The policies of many states reflect a social Darwinism philosophy that prioritises the economic interests of the wealthiest while doing little for those who are hard at work providing essential services or unable to support themselves,” Alston said, warning that the pandemic could push more than half a billion additional people into poverty globally.

“Governments have shut down entire countries without making even minimal efforts to ensure people can get by,” he said. “Many in poverty live day to day, with no savings or surplus food. And of course, homeless people cannot simply stay home.”

He highlighted how the most vulnerable populations had been neglected, which “forces them to continue working in unsafe conditions, putting everyone’s health at risk.” And he warned that, while some nations were seeing curves flattening, the virus was “poised to wreak havoc in poorer countries”.

“As for the UK, my thoughts of course hark back to the sense of how utterly hypocritical it is now to abandon ‘austerity’ with such alacrity, after all the harm and misery caused to individuals and the fatal weakening of the community’s capacity to cope and respond over the past 10 years.

“And of course, many of the worst and most damaging aspects of ‘austerity’ cannot and will not be undone. The damage caused to community cohesion and to the social infrastructure are likely to prove permanent.”

The stretching and even tearing of the social fabric of the UK by a decade of austerity have left the country more vulnerable to the pandemic than it would otherwise have been. Food banks, which give out at least 1.6m parcels a year, have lacked supplies while care homes, where thousands are dying from Covid-19, have struggled for essentials including PPE and to maintain staffing levels. There have been real-terms cuts in public funding of social care in the UK, according to the King’s Fund, with a £700m reduction between 2011 and 2018.

“This pandemic has exposed the bankruptcy of social support systems in many countries.” Alston said. “While some governments have embraced far-ranging measures previously dismissed as unrealistic, most programmes have been short-term, stop-gap measures that merely buy time rather than address the immense challenges that will continue well into the future. Now is the time for deep structural reforms that will protect populations as a whole and will build resilience in the face of an uncertain future.”

The pandemic has exposed the weaknesses of the prevailing global social Darwinism mindset in a blatant and uncompromising way and as it spreads to the global south the stark gap between haves and have-nots, and the ultimate interdependence to which the haves have applied a selective partial blindness for so long becomes increasingly inescapable.

Gordon Brown declares, “The solution to this crisis is still global.”

He’s right, but to achieve that solution the haves, principally the West, have to transform their economic logic. History teaches us that those that have a surplus also have more power and use that power to share that surplus with others, and where expectations of economic growth have been shattered by the pandemic and the largest recession in history that accompanied it, local self-interest will prevail over wider largesse. The UK economy will take three years to recover from Covid-19, according to economic forecaster Ernst and Young.

Other current news about the economic fallout from Covid-19 include:

  • Germany worrying through a decision to provide state aid to national carrier Lufthansa.
  • While in Britain MPs are demanding that airlines should be made to cut their carbon dioxide emissions in exchange for a bailout.
  • Wimbledon’s organisers have demonstrated prudence and foresight in taking out pandemic insurance since 2003.
  • In the US the Trump administration is looking to use federal Covid-19 relief to prop up oil and gas industry.

Also in America Deborah Birx is bothered that Trump’s disinfectant comment remains in the news. Dr Birx has an exemplary career as a physician, diplomat and adviser. The level of her embarrassment was squirmingly obvious on video footage.

Covid-19 has weirded out politics: Walled off from voters in a distinctive kind of lockdown, Mr Biden has developed a routine of sorts, as he seeks the presidency from his basement. It seems to be working as a rash of ominous new polls and President Trump’s erratic briefings have the GOP worried about a Democrat takeover of both the presidency and the Senate in November if Mr Trump does not put the nation on a radically improved course.

There have now been Covid-19 superspreader events in 28 countries. The vast majority of superspreader events are indoor and the idea that the virus is transmitted by airborne droplets is gaining traction. Despite the fact that respiratory viruses have been commonplace for time immemorial it turns out we have very limited scientific knowledge about the mechanics of droplet transmission.

There is still much that is unknown. There is currently no evidence that people who have recovered from the disease are subsequently immune to it, the WHO stressed on Saturday, cautioning against the use of so-called ‘immunity passports.’ An initial study in New South Wales schools in Australia,  suggests that children are unlikely to transmit the virus. Despite the study not yet being peer-reviewed, the limited scale of the study or the fact that asymptomatic transmission  could be a possibility PM Scott Morrison uses the report to urge the reopening of schools. This becomes a continuing phenomenon in a number of countries, including the UK, where schools become an avenue to sustaining the spread of the virus.

Two other unknowns:

  • Homeless people on the street have turned out to be less susceptible to Covid-19 than expected.
  • Although children have been found to be massively less susceptible than adults NHS issues an urgent alert amid a spike in the number of children being admitted to intensive care with a new, possibly Covid-19 related ‘inflammatory syndrome.’

Blood oxygen levels offer an infection red flag. Professor Babak Javid, a consultant in infectious diseases at Cambridge University said measuring blood oxygen levels could help with the early detection of those experiencing Covid-19 symptoms. A low level of oxygen in the blood was a sign of Covid-19 – a symptom that could be measured with a blood oximeter. A ‘danger sign’ if oxygen levels fell below 96 per cent, especially with mild exercise, such as walking upstairs or going for a short walk.

An app that tracks self-reported symptoms of coronavirus among the general population suggests that there are more than 350,000 people in the UK who would be likely to test positive for Covid-19. The Covid Symptom Tracker app has provided “unprecedented amounts of data” according to researchers at King’s College London, who are working on the app with healthcare data science start-up Zoe. This is more than double the official figure of just over 140,000 positive tests in the UK, recorded by the Department of Health and Social Care, as testing is not routinely offered to people experiencing symptoms that do not require hospitalisation.

The app has been downloaded by more than 2.4 million people, with users asked to self-report daily on what, if any, symptoms they are experiencing.

While fever and persistent cough are the best-known symptoms of the disease, the app was also useful for flagging up other predictive symptoms of coronavirus. Loss of taste and smell was one particularly notable symptom that can be a unique identifier for coronavirus. Severe fatigue is another symptom that could be indicative of a positive test, he said.

The app is providing data faster than hospital records and is helping to track the patterns and spread of the disease in “real-time.”

In being on the front line in dealing with the virus the daily stresses faced by NHS staff is becoming an increasing matter of concern, both in terms of mental health due to the emotional and physical intensity required of them and the risk of the relentless trauma of the Covid-19 frontline leaving them with flashbacks, anxiety and PTSD, and in staff retention. The NHS could face an exodus of ‘burnt-out’ nurses after the crisis.

Meanwhile many patients with chronic conditions are staying away from what they perceive to be a greater risk. “Don’t leave non-covid conditions untreated,” UK authorities warn amid ‘empty’ hospital wards.

This is a bleak time. Not least in New York, who have experienced as bad a pandemic as anywhere. With no clue about when the pandemic may subside, New Yorkers are growing grimmer. Evidence of a mood shift could be seen in little spikes on data compiled by the city. Complaints to 311 rose in reports of loud televisions and a broad new category – lax social distancing. “There is a grieving of life as we once knew it wasn’t there before, as we try to come to terms with the new reality,” a psychologist in Manhattan said.

Every hospital in New York has struggled to cope with the pandemic, but the outbreak has laid bare the deep disparities in the city’s health system. The virus is killing black and Latino New Yorkers at about twice the rate of white residents, and hospitals serving the sickest patients often work with the fewest resources.

The situation in a Belarus orphanage for children with developmental difficulties is ‘extremely critical’ after at least 23 people contracted Covid-19, a charity has warned. The orphanage in Vasnova, some 175 km from Chernobyl cares for 174 children and young adults with genetic disorders, severe disabilities and compromised immune systems. It is supported by the Adi Roche Chernobyl Children, an Irish NGO. According to the charity, the situation is now ‘extremely critical’ after 13 children and 10 members of staff contracted Covid-19.

In the Central Jamia Mosque Ghamkol Sharif in Birmingham the holy month of Ramadan is underway. It should be full of worshippers but this year the main arrivals are the dead. While the mosque in the central English city has been closed in response to the Covid-19 pandemic, its parking lot has been transformed into a temporary morgue with room for 150 bodies.

While the Church of England launches a free ‘dial in’ service for the elderly.

There are many other tales from today’s lockdown:

  • Plea for urgent action on domestic abuse amid lockdown as calls to hotline rise by 50 per cent.
  • The London Marathon is replaced by the ‘2.6 challenge’ and has raised more than £4.6 million for UK charities. It will go on to raise over £11 million in the fullness of time. The 2.6 Challenge can be any activity you like – from running 2.6 miles to holding an online workout with 26 of your friends – remembering, of course, to follow Government guidelines on how to exercise safely.
  • Schools in England are warned over a ‘blind spot’ as vulnerable children stay home.
  • Two thirds of Brits altered their spending habits during the first month of lockdown.
  • The Premier League will survive lockdown. It is the rest of the sport we should worry about.
  • The Chelsea Flower Show goes digital with ‘virtual garden tours.’
  • In America during lockdown it’s 5 o’clock everywhere. From its birth in the Prohibition era to its death during the tech boom and now the soaring return of cocktail hour. What goes around, so the saying goes ….. is a little umbrella next to that olive in your glass ….. or is it a Maraschino cherry?
  • A Facebook group of art re-enactors that started in Moscow has gained 540,000 followers across the locked-down globe. Using frozen dumplings for skulls and air conditioning ducts as neck ruffs, re-enactors pair their photos with the originals.
  • New York couples are allowed to wed by video-conference amid lockdown.
  • South Koreans are confident that rumours of Kim Jong Un’s illness are wrong. BBC News reports a heart condition. He will go on to lose a lot of weight during the pandemic – as much as 20 kilos. So will his citizens. Some will starve.
  • 25 Dutch students on a sailing venture cruise in the Caribbean completed a transatlantic crossing in the same boat, a 60 foot schooner, Wylde Swan. Aged 14-17, they have little sailing experience. They were supervised by 12 experienced crew members and three teachers. Coronavirus prevented them from flying home from Cuba.
  • A high school student makes a plea to the editor of the Los Angeles Times to always remember the clean air of April 2020.

But the human condition is bruised, not defeated by the virus. After weeks of shutdown, people begin to slowly and cautiously re-emerge.

  • People flock to California’s beaches again, bringing hand sanitiser and hope.
  • Spain’s children are allowed out.
  • Italy to begin phased lifting of lockdown with reopening of some businesses next week. Beaches are getting ‘anti-coronavirus’ ready to save the holiday season.
  • Wuhan discharges all its Covid-19 patients as Beijing takes steps to stop a second wave.
  • New Zealand is preparing to ease its strict and successful lockdown rules.

Finally, from i-columnist Stefano Hatfield:

“Let’s celebrate the small things we’ve achieved in lockdown. I may not have perfected my Chinese or redecorated the house more tastefully, but I have kept my basil plant alive.”

Some went viral, others got knighted, but Stefano sums it up for most of us.

Day Forty Two: Sunday 26th April 2020

Daily Diary: All That Glitters Is Not Gold

The sky is blue again. On BBC’s Andrew Marr Show there’s talk of the skies being uncommonly blue, of the traffic haze being gone. But there is high cirrostratus – fine and wispy – suggesting that this idyllic weather will change in a day or so as a warm weather front approaches. I don’t study the weather anywhere near as closely as I do when I’m planning to fly, but obsessions are hard to bury. I tell myself it’s observation and all about growing plants.

About which the three geranium cuttings are beginning to look healthy enough to be potted, so I can use their planting tray to bring on the germinating geranium seedlings. At first the seeds looked like tiny gold nuggets, smaller than grains of rice and glittering like little treasures. This is day two and they have already begun to sprout. About half the 30 seeds have emergent roots, looking like tiny plumes from toy guardsmen on parade, with all their countless root hairs. I shall wait another day or so before the next stage of planting them.

I still need to look at the Zoom tutorial and book myself into Steve U’s online lecture on testing paragliders. I shall email the club committee about how I’m going to approach this and set up a Zoom group with them this coming week.

Out front the common looks busy. Inside it’s quiet. I confess to being intrigued by plagues in literature and download ‘The Plague’ by Albert Camus onto my Kindle.

You’d have thought that having a real plague out there I’d download something else!

The Bigger Picture: If Everything On Earth Were Rational, Nothing Would Happen

There’s a quote from Fyodor Dostoyevsky that’s stuck in my mind as a stubborn meme and I believe the only way I can dislodge it is to write it down.

“If everything on earth were rational, nothing would happen.”

Throughout history plagues have been alike in three ways. The first is that they have in common the pathogens – bacteria and viruses – that cause them. The second is that the initial responses people make towards these pathogens have always been the same. The third is that rumours and misinformation run rife.

It doesn’t seem to matter when the plague struck, the initial response to the outbreak of an epidemic has always been denial. National and local governments have always been late to respond and have distorted facts and manipulated figures to deny the existence of an outbreak.

In “A Journal of the Plague Year,” Daniel Defoe wrote that in 1664, local authorities in some neighbourhoods of London tried to make the number of plague deaths appear lower than it was by registering other, invented diseases as the recorded cause of death. In the current pandemic at least one NHS Trust had told doctors they were not required to put Covid-19 on death certificates. Following a Pre-Action Letter from the Good Law Project, they have withdrawn the faulty guidance and ordered a review into all death certificates issued in the last three weeks.

Nor does it seem to matter that there have been precedents, and there would have been lessons learned. But these precedents are in different places, different times, and even though promises are made in the weary aftermath, they soon become forgotten. So epidemic after epidemic spread rapidly because the restrictions introduced were insufficient, their enforcement was lax and citizens didn’t heed them.

In Belarus, arguably the European country most in denial, more than two million, about a quarter of population, including doctors and nurses, took part in a government-decreed national day of civic labour, despite worries about the country’s sharply rising Covid-19 infections, four times that of neighbouring Ukraine.

The plague is certainly unforgiving in its exposure of the carelessness, incompetence and selfishness of those in power, and the more power-obsessed leaders are, the harsher and more blatant it is its exposure. Confidence in populist leaders especially erodes, as real events are pitched against rhetoric and the idealism they promote us to believe in is swept away by the cynicism that all too often follows broken dreams. In the past the public raged against the institutions of organised religion, as they became powerless against a divine will that allows widespread human suffering. In the present there are more secular expectations are that the institutions of the modern state will be up to mitigating the worst and there will be the leadership to enable those institutions to function together to make it so.

The problem with populism lies in the fact that it plays to citizens’ desires, to some extent manipulated, but not entirely so, and many of those desires reflect the carelessness, unwillingness to take responsibility and selfishness of significant numbers of people – significant enough to get elected.

Mobile phone data are already showing that Britons are starting to flaunt the lockdown.

In America many flocked to beaches on Saturday, as one Florida county expanded access and California experienced a heatwave, even as Covid-19 cases hit a record high in the US the day before and deaths topped 200,000 worldwide. Hair salons and other shops in Georgia, Oklahoma and some other states opened for a second day as pockets of the country sought to restart their economies following a month of government-ordered lockdowns.

It appears that the pandemic is as much a morality play, a tale about the human condition, as it is about the biomechanics of pathogens. It’s as much about human behaviour as it is about anything else. It accounts for humanity’s other universal and seemingly unprompted response to pandemics – the creation of rumours and spread of false information.

Most previous plagues ran their virulent course in a sparsely informed world where newspapers, radio, television or internet left the largely illiterate populace with only their imaginations to figure out where the danger lay, how serious the danger was and the extent of the torment it could cause. For some it could be a malevolent, demonic presence who went about in the dark smearing plague-infected liquid on doorknobs and water fountains. For others, a human agent with malign intent. As time progressed and superstitions haunted imaginations less the agent of pestilence transformed into a miasma, an elemental entity of the air in the twilight zone between myth and reason.

But almost all the time the plague was foreign. It appealed to xenophobic fears, which in a world outside of reason gained traction as rumours circulated. When he wrote about the Plague of Athens (429-426 BCE), Thucydides began by noting that the outbreak had started far away, in Ethiopia and Egypt. The disease is foreign, it comes from outside, it is brought in with malicious intent. Rumours about the supposed identity of its original carriers are always the most pervasive and popular. Marcus Aurelius blamed Christians in the Roman Empire for the Antonine smallpox plague, as they did not join the rituals to propitiate the Roman gods. And during subsequent plagues Jews were accused of poisoning the wells both in the Ottoman Empire and Christian Europe.

You would have thought that the information-rich world infected with Covid-19 would be largely protected from such misconception and miscommunication, but it’s not so. Unfounded rumours and accusations based on nationalist, religious, ethnic and regionalist identity have had a significant effect on how events have unfolded during the pandemic, along with social media and right-wing populist media’s inclination towards amplifying lies.

So what we end up with is an ugly hybrid of reliable information about the pandemic, with animated charts and video footage of ICUs, military convoys carrying the dead, grieving relatives and a cocktail of real life terror, experiencing our possible fate in advance, along with rumours about how the virus came from outside.

Most of the world believes Covid-19 originated in China. It’s a reasonable and rational belief, the bulk of the evidence pointing that way. But the narrative from the Chinese authorities already is that it came from outside its borders, from imported seafood and its packaging, from the US military, and even eventually from Europe.

The plague came from outside.

It always does.

So now that a number of US states have started legal proceedings to sue China we know it’s the machinations of gesture rather than achieving any practical outcome. We come to realise that the world of Lemuel Gulliver is not confined to the eighteenth century, that somehow people were more absurd then than they are now.

“If everything on earth were rational, nothing would happen.”

President Trump (a name worthy of a Lilliputian character) wants to have control over pandemic relief, with zero accountability. So now he’s declared ‘presidential supervision’ over the new pandemic-related inspector general. Claiming executive authority, Trump says he’s planning to block this new watchdog from sharing information with Congress unless the inspector general has Trump’s explicit prior consent.

“When somebody is the president of the United States, the authority is total,” Trump declares.

With almost forty thousand covid-related deaths in the US to date, his recent remarks about ingesting disinfectant and shining bright light under the skin make a mockery of that self-proclaimed total authority.

And people laugh, every bit as much as if the emperor had no clothes and that mushroom was just as Stormy Daniels described it on TV.

He hates being laughed at.

That’s for lesser beings.

Donald Trump skips his national coronavirus briefing, saying “they are not worth the time and effort.” The White House is considering scaling back Trump’s daily Covid-19 briefings in the coming weeks.

Meanwhile, having placed what personal authority he has with his followers behind hyping the anti-malarial, hydroxychloroquine, as an antidote to Covid-19, the drug is now in short supply. For many sufferers of Lupus, dependent on hydroxychloroquine as a medically well-established treatment the shortage becomes a serious matter.

In Britain Boris Johnson claims he is ‘raring to go’ with his characteristic boosterism, as if he wants us all to believe that his gusto and enthusiasm will more than compensate for the mountain of problems he will be facing. The pressure to lift lockdown, particularly from his right wing backbenchers is intense, while scientists warn over grim virus data. Labour leader Keir Starmer steps up his demand on a lockdown ‘exit strategy,’ while playing the card that she knows she can appear more competent than Johnson, politically astute First Minister Nicola Sturgeon says Scotland may diverge from the rest of the UK.

In England there is no clear strategy. Without a vaccine the only possible way out of lockdown is test, trace and isolate, and it turns out the NHS has been using a flawed Covid-19 test, missing 25% of positives. Health minister Matt Hancock is under pressure to resign as leaked documents show that the NHS is using flawed tests. Warnings of ‘inferior’ Covid-19 tests were made two months ago and demands are made for an explanation why tests are being used that might ‘propagate’ the epidemic.

But there is hope, and the story of the flawed test is swallowed up by a more positive one about testing. The headline comes from London’s Evening Standard:

Immunity tests ‘developed by UK scientists’ in possible ‘breakthrough moment in coronavirus battle.

But this story about testing is about antibody, rather than antigen tests. Antigen tests show the presence of the virus. They warn of the presence of the disease and its capacity to infect others. Antibody tests show that someone has been infected, whether they displayed symptoms or not. They have their uses, but the Government describing them as a ‘game changer’ is hype. Shutting the stable door after the horse has bolted is replacing horse riding with searching for your adventurous steed, both sources of exercise, but not exactly the same thing.

The World Health Organisation announces there is no evidence that people who have recovered from Covid-19 have protection from future infections, and although in time it is shown by both infection and vaccination that immunity lasting a few months at least can be conferred, at this point in time this aspect of science is still in the dark.

But it’s hope, and that matters.

“If everything on earth were rational, nothing would happen.”

We need signs that things are happening. That we feel that the ship is somehow navigating its way through the storm and not just being bobbed about at random like a cork.

So when we read or see on TV that soldiers to man nearly 100 mobile testing units across the UK or that a contact tracing app is to be released within weeks we all feel we are getting somewhere.

In Europe, Spain’s downward death toll trend signals that the worst is over, the French parliament is shortly to vote on how to ease lockdown measures and as the virus lockdown eases, Italy ponders what went wrong.

Wizz Air has become one of the first airlines in Europe to resume flights during the pandemic. The budget airline said in a statement that some routes will be operating from Luton Airport from Friday. It said the aircraft would be disinfected each night and the cabin crew would wear masks and gloves on board and distribute sanitising wipes to passengers.

While Germany, notable so far for its prudence during this stage of the pandemic, warns against a race to restart tourism.

Further afield:

  • In secretive North Korea, leader Kim Jong Un has not been seen for days and is absent on Armed Forces Anniversary. There is speculation and rumour about his health.
  • Saudi Arabia partially relaxes lockdown for Ramadan but keeps a 24 hour curfew in Mecca. Aerial images show Mecca completely empty.
  • The pandemic’s devastating impact on the hospitality industry has left many migrant hotel workers in the United Arab Emirates fearing for their future and at increased risk of debt bondage.
  • While in the Gaza Strip, for the first time in years, sewing factories are back working at full capacity producing masks, gloves and protective gowns, some of which are bound for Israel.
  • Cuba has sent 216 healthcare workers to South Africa on Saturday, the latest of more than 20 medical brigades it has sent worldwide to combat the Covid-19 pandemic, in what some call socialist solidarity and others medical diplomacy. The communist-run country has sent around 1,200 healthcare workers largely to African and Caribbean nations, but also to rich European countries such as Italy that have been particularly hit by the novel coronavirus. The administration of US President Donald Trump has urged nations not to accept Cuba’s medical missions on charges it exploits its workers, which Havana denies. But the calls have gone largely unheeded as overwhelmed healthcare systems have welcomed the help.
  • Japan’s government refuses to impose a Covid-19 lockdown, dividing the country.
  • As cases first appear on the continent of Africa and testing for the virus begins.

The new reality tests people at the beginning and end of life:

  • A mother must wear a mask while caring for her newborn. A pregnant Belgian woman diagnosed with Covid-19 has given birth to a healthy daughter, but must learn to care for her newborn wearing and sleeping with a protective mask.
  • A woman is left alone and disconnected as she is unable to call her dying partner. Barbara Parry arranged to switch her phone and broadband from Sky to Now TV in March, a week before lockdown. Instead, She was left incommunicado as her line was cancelled and her phone number reallocated.
  • Self-isolation make-unders trend with celebrities. In a culture driven by narcissism, Hollywood’s biggest celebrities are eager to show how they have changed during quarantine, without stylists, colourists and make-up artists to keep them looking red carpet ready. In London some celebrities find an opportunity to model masks, a “smile for our NHS” fundraiser, launched by designer Ron Arad, with masks featuring famous artists.
  • And bizarrely, a Thai zoo forced a captive chimpanzee to entertain the crowd and make fun of the Covid-19 pandemic by riding a bicycle, wearing PPE and spraying toxic sanitiser at the crowd.

In my email inbox I’m reminded of this strange twilight zone we’ve drifted into with two public notice messages.

The first is from the Mayor of London:

“We want to hear directly from you about how your life has changed and what you would like us to do to help. Take the survey here…..”

The second, the NHS –

“Coronavirus: If you have the symptoms, even if they are mild, do not leave the house for 7 days. Everyone in your house must stay home for 14 days.”

And the WHO warns that the worst is yet to come…..

Day Forty One: Saturday 25th April 2020

Daily Diary: A Clear Blue Sky With Confetti Petals

Today is everything you’d imagine a fine April day to be. The sun is shining and there is a clear blue sky. There is a breeze, maybe ten to twelve knots and it is cold. It’s a day for making you’re in the sunshine and not in the shade. If you’re outside, that is, and for most of the day most still won’t be. It’s nice to have garden. A real privilege as it means an additional outdoor room. The apple blossom is at its end and the pink petals swirl about our small urban garden, like lost confetti, pirouetting in rise and fall spirals in the gusts that come and go.

A card came through from the council today. It reads:

Are you self-isolating? Do you need help? Do you know somebody else who needs help?

The Royal Borough of Greenwich Community Hub is here for you.

Then there are contact details, followed by:

Our volunteers and community partners are helping with things like:

  • Shopping/food supplies
  • Medicines and prescription collection/delivery
  • Phoning for a chat if someone’s on their own.
  • Dog walking.
  • Topping up gas/electricity meters.
  • Collecting pensions.
  • Putting out bins.
  • Connecting people with local groups, services and advice, such as how to stay active.

The virus has raised the importance of being a member of a community, of helping each other out, of the fact that despite whatever Margaret Thatcher said there is such a thing as society, especially in testing times.

Phil rang today and asked if we could do him a favour. It’s his wife Heather’s birthday on May 6th and, unable to arrange a weekend out somewhere special, wants to secretly buy her some presents. To keep the surprise would we be the delivery address, then he could collect them from our front lobby, aka ‘the airlock,’ the day beforehand when he comes off shift? Of course he can; more than happy to help.

I ask Phil how things are going. He’s a paramedic, so really front line. He alternates between manning the call centre phones in Waterloo and being out ‘in the van.’ The pandemic, he tells me, doesn’t stop people having strokes, heart attacks and other major health crises. Now, of course, everything is masked, gloved and aproned. The backlog of calls can run into hundreds – there aren’t enough ambulances to meet the demand by a long shot. At one point he told me there was a backlog of five hundred calls and the pressure on the front line was hard to imagine.

He tells me of the lack of liminal space between work and home. Those punctuation marks in life that defuse the stresses and pressures of twenty first century life, and even moreso during a pandemic. For my friend Phil his two main waking activities involve enduring working for a highly pressurised public health service and the demands of life at home, sharing the care and home-schooling of two young boys at home, bearing in mind that Heather works as well. Just keeping up must be very hard. I tell him that my problem is just the opposite. By comparison I have an easy and unpressured existence. All Vicky and I have to do is do our best to stay out of harm’s way and avoid placing an additional burden on Phil and his colleagues. I feel a sense of guilt, I tell him, of being looked after by our daughter, of being cosseted against the pressures that so many others are facing. He tells me not to. It makes no sense to feel guilty about your circumstances.

He’s right, but it doesn’t dissipate the guilt altogether.

Funny old thing, being human.

It’s all about minimalising risk and in practice that can be a tough one. If we could all self-isolate if we’re not absolutely essential then the coronavirus would only have a small part of the population to spread through. In a matter of weeks it would have ‘nowhere to go.’ But life’s not quite like that and we still need to occasionally to go out for food, medicines and other things too. Then the ‘perfect del’ falls apart and we end up in the kind of messy no-man’s land we’re in at the moment.

People in many countries are wearying of quarantine and there’s an understandable eagerness to end it. But the scourge of the virus is nothing personal. It just does, exploiting the weaknesses in our social interactions.

Meanwhile the box for Vicky arrives. All 6 notebooks are A5. They’re cute and look handy, but to a slightly OCD obsessive like me they’ve got to be A4 for this project.

I should have realised the price was too good to be true!

Which brings me on to The Covid Chronicle. I’m on the third notebook already. I have ten, maybe eleven days to get a new order in.

In the meantime there is much to record.

The Bigger Picture: You Want The Science? You Can’t Handle The Science!

Covid-19 has infected more than 2.7 million people around the world, with the death toll passing 195,000. By the time the pandemic has run its course there will be a number of individual countries with more cases and deaths than this number. Even before the arrival of Covid-19, humanity found itself stuck in several crises at once. If we’re lucky enough to live in the rich world then we can watch the ever-unfolding theatre of calamity on TV and display whatever level of empathy your genes and upbringing have endowed you with and take an action somewhere along the spectrum between making an immediate charitable donation to switching channel to watch something that leaves you feeling more comfortable.

The psychologist and Nobel laureate Daniel Kahneman said that humans are up to thinking about things in much the same way as cats are about swimming – we can do it, but we’d rather not, thanks.

If you’re unlucky enough to live in a less affluent spot on the planet then you are as likely as not to find yourself as a bit player in that theatre of calamity. You might even be scripted a few lines. Something like:

“It’s the same the whole world over,

It’s the poor what gets the blame,

It’s the rich what gets the gravy,

Ain’t it all a bleeding shame?”

Whether geographically or sociologically, it will be the poorest who are set to bear the brunt. Slowly but surely, babystep by babystep, two steps forward then a step back, there had been progress since the millennium, but now global poverty is expected to increase for the first time in over 20 years. The World Bank projects that the pandemic could push 40 to 60 million people into extreme poverty, setting us back three years of progress.

It’s not that the poorest countries can’t afford to print money, or furlough millions. It’s worse than that – they are being forced to choose between protecting people from Covid-19 and paying their debts. And if that doesn’t sink in, figure this –  the Democratic Republic of the Congo has five ventilators and an unknown ICU capacity for a population of 90 million, compared to Germany, which has approximately 25,000 ventilators and 28,000 ICU beds for a population of 84 million people. They also have to cope with Ebola and other tropical diseases alongside Covid-19.

What the world really needs is a new Bretton Woods to update the working order of the global economy. For some there are hopes that the current shock delivered by the virus could accelerate a paradigm shift that was already underway, resulting in a better and more sustainable world, brought closer together by this terrible shared experience.

Pinch yourself – it’s not to be.

Instead, Covid-19 will further deepen the fault lines that have been emerging since the financial crisis. We are seeing an increase in protectionism, the polarisation of society and a further shift to the right. What little was left of multilateralism has failed. We are experiencing the return of power politics.

The problem is that there are too many alpha males in the room. Authoritarianism rules, whether in Japan, China, the United States, the UK or India, basing their legitimacy on ultra-nationalism. The give and take of diplomacy proves much harder for them as they fear that compromises would make them appear weak. So there is a second pandemic of power grabs as autocrats see opportunity in disaster. The world is distracted, the public need saving and for now at least global protest movements have been dampened by lockdown. It’s a strongman’s dream. China is already taking advantage in Hong Kong.

I remember being riveted by a book called ‘The Emergence of Man’ by John Pfeiffer. I was so inspired by my own biology teacher, Don Belcher, who by pure coincidence bore a physical resemblance to the younger Charles Darwin, that I went on to teach biology myself. My interest in biology started with a small Japanese microscope I was given for my tenth birthday, where I could enter a world within a world. By the time I reached the sixth form, Mr Belcher nurtured this interest. I did a research project on human evolution. I’d have fun writing to hardline creationist groups – all they ever did in reply was send me a large number of leaflets and booklets with biblical references and slightly bizarre illustrations that were as much about post-war bible belt ideals as they were about principled argument, but hey, each to their own.

In the book there’s a chapter about baboons as social primates, the role of the alpha male in a baboon troupe and how that structured the wider social order. The first school I taught in was a large boys’ secondary school in South East London and I would reflect on how much the social order, and even tribalism among teenage boys resembled male dominance patterns I was reading about. As time passed it became clear this wasn’t just a baboon-thing but extended to a large number of animals.

I began to wonder if somehow this was ‘wired’ into human behaviour, especially when if we can find an easy ride out of thinking stuff out. Maintaining being the leader becomes more important than where exactly you’re leading people to. And it seems to be a male phenomenon too. Women leaders have on the whole are leading their countries much more successfully through the pandemic than their male counterparts, and alpha males, such as Trump, Bolsonaro and Johnson are performing particularly poorly.

So when Trump utters his now infamous line: “I see the disinfectant where it knocks it out in one minute ….. is there a way we can do something like that, by injection inside, or almost a cleaning?” there are those who find the remark ridiculous, even infuriating among those who already believe he’s risked lives with other ‘unproven cure’ remedies, but he’s not directly called out for it, and when challenged a day or so later passes it off as being sarcastic, and that in itself goes unchallenged.

Stable genius or dangerous ignoramus?

No one dares challenge the alpha male about the latter. Careers have been terminated for less. So he takes that as being an endorsement for the former, as he play acts sorting out the disruption of his own making. The world then becomes a stage for the ultimate performance and the adulation of millions – who are as unwilling to think it through as a pet cat is to join you in the pool – simply reinforces the delusion behind the spectacle.

It’s horribly Nero-esque.

When an epidemic killed thousands in ancient Rome, the chief physician of the emperor Nero circulated a recipe for an old miracle cure. It was an attempt by the emperor to sustain his legitimacy in the midst of this catastrophic event.

Two thousand years later, Trump does the same with hydroxychloroquine, , an anti-malaria drug that has not been shown to be safe or effective against Covid-19.

“What do you have to lose? Take it,” the president urged. It seems he’d been inspired by a lawyer, falsely claiming an affiliation with Stanford University, appearing on Fox News’s Tucker Carlson Tonight to declare the results: a “100% cure rate against coronavirus”.

Within hours Trump had hailed the drug as a ‘game changer,’ promoted it strongly and, facing questions from the press about his aggressive promotion of an unproven treatment, he argued against waiting for the completion of clinical trials. “In France, they had a very good test,” he said. “But we don’t have time to go and say, ‘Gee, let’s take a couple of years and test it out, and let’s go and test with the test tubes and the laboratories.’”

Meanwhile, Dr Anthony Fauci, the country’s top infectious disease doctor, has repeatedly warned that there is no conclusive evidence to support using the drug. Asked whether it should be considered a treatment for Covid-19, he said on 24 March: “The answer is no.”

Four days later guidelines were issued to patients and carers about using hydroxychloroquine sulphate. The FDA had been bypassed and the drug had been given Emergency Use Authorisation (EUA), letting federal officials greenlight the use of unapproved medical products in a time of emergency.

Never mind the science, don’t worry about the safety, just follow the leader.

It’s not been unique to the US.

The NSRA, National Security Risk Assessment was a 600-page confidential report produced for the eyes of Number Ten during 2019. It was, however, leaked to the Guardian newspaper. The Government’s chief scientific officer, Sir Patrick Vallance, one of the key figures steering the Covid-19 response, signed off the briefing and impressed the need for ‘robust’ plans to deal with a pandemic. The assessment said a relatively mild outbreak of ‘moderate virulence’ could lead to 65,600 deaths and could cost the UK £2.35trillion.   

Theresa May was prime minister when the report was written, but it was mothballed on the advice of Cabinet Secretary Sir Mark Sedwill so ministers and officials could focus on Brexit.

The Committee of cabinet ministers who were the intended audience, the Threats, Hazards, Resilience and Contingency Committee (THRCC), was scrapped by Boris Johnson in July 2019, six months before the coronavirus arrived. The THRCC had also been tasked with following through the findings of Exercise Cygnus, a simulation of a viral pandemic that was carried out in 2016. The Cygnus report concluded:

“The UK’s preparedness and response, in terms of its plans, policies and capability, is currently not sufficient to cope with the extreme demands of a severe pandemic that will have a nationwide impact across all sectors.” 

The Cygnus report found that nobody in the centre had oversight over everyone else. There were also particular concerns about the impact of a pandemic on the social care sector. Though discussed at an NHS board meeting and mentioned in a speech by the former chief medical officer, the report on Cygnus has never been published. In a response to a freedom of information request, the Department of Health claimed that the report needed to be kept secret so as to inform policy development.

However, the current health secretary, Matt Hancock, said that he had been told that all of its recommendations had already been implemented, suggesting its role in informing policy was complete.

It’s hard to see how that would have been possible.

So Johnson’s first major error, an act of careless expedience or Brexit tunnel-vision, happened within days of his coming into office as he ripped out the opportunity for central oversight at the start of any pandemic.

A former Cabinet minister who was a member of THRCC until it was axed said it could have ensured the Government reacted more quickly to coronavirus, adding: ‘Once the pandemic took hold in Italy… alarm bells would have been ringing.

It wasn’t simply that he was unprepared. He had removed the capacity to be prepared.

It was the act of a man with a history of being a chancer. The analogy that comes to my mind is skydiving without a reserve parachute. Only he had the whole country clipped onto his harness as a passenger.

Still more science-related stories:

  • On the subject of chancing, addiction specialists say there’s been a surge in advertising for online gambling during the lockdown, something campaigners warn is giving rise to new forms of addiction. The UK government says it will launch a parliamentary inquiry into the impact of problem gambling. In the meantime sports minister Nigel Huddleston writes a letter to the five chief executives of the largest gambling companies, urging them to go beyond existing proposals laid down by the Betting and Gaming Council (BGC) in a 10-point pledge that has been branded “weak” by MPs. Nothing much happens as a result and gambling increases during lockdown as a result, with half of those gambling switching to betting online. It’s a secondary effect, driven, like the mismanagement of the virus itself by financial interests trumping what’s known to science and public health, an ever-repeating leitmotif of the pandemic.
  • We’re being told repeatedly by Johnson that the Government’s following the science, while the Government’s senior adviser, Dominic Cummings attends meetings of SAGE, a supposedly ‘independent’ science panel advising Number Ten. Cummings has a degree in history and expertise in propaganda.
  • British armed forces are to be given insect repellent to protect them against Covid-19 infection, it has emerged. The Ministry of Defence confirmed on Friday that it plans to buy stocks of a product containing a lemon eucalyptus oil called citriodiol. But questions remain about its effectiveness with British officials refusing to reveal any evidence it would work.
  • Chief Medical Officer Chris Whitty told the Commons Science and Technology Committee that the “only circumstances” in which he would use the phrase “herd immunity” would be to refer to a population being vaccinated – a strong hint that he disagrees with others in Government who have misused the phrase.
  • The WHO launches a global initiative on treatments for Covid-19. The challenge is how to develop vaccines and drugs then get them to 7 billion people?
  • Pathologists are eager to quickly conduct post-mortems on as many Covid-19 victims as possible. They aim to determine who is at greatest risk from the virus and what damage it causes inside the body. Initial results are already available.
  • The results of Covid-19 serosurveys are starting to be released.
  • Hospitals are using AI to predict the decline of Covid-19 patients – before knowing whether it works.
  • Dyson’s £20 million ventilator is ‘no longer required’ by the Government.
  • There’s still no Covid-19 screening of passengers arriving in the UK. We’re the jumbled-Brits, all at sea in a sieve.

Financially, the body blow continues, as economies wrestle with the consequences:

  • In the US the Congressional Budget Office forecasts a $3.7 trillion deficit, a 5.6 per cent economic contraction and an unemployment rate of nearly 12 per cent by the year’s end.
  • The EU has managed to come up with a possible solution, using the EU budget to transfer money to those parts of Europe that need it most. Ursula von der Leyen made it clear that it would not be measured in billions but rather be more like one trillion euros. Though precisely how much, and what proportion will be grants rather than loans, will clearly be at the root of the contentious decisions yet to be made.
  • In the UK insurers face £1.2 billion in payments for the coronavirus crisis.
  • While two thirds of British restaurants will not survive without a rent holiday.

As Britain pass the peak of cases, hospitalisations and deaths politicians consider how restrictions are going to be eased. Each of the four nations differ over how and when to ease restrictions. Scotland, who have already published documentation, are already ahead of the curve. The government in England struggles with imposing rules. The irony is that much as it likes to take as many of the reins of power as it can, its libertarian ideology works against presenting itself as overly authoritarian.

George Orwell captured that deep conflict between the desire to feel free within a state whose electorate and political history shows all too well a disposition towards a right of centre mentality, when he wrote:

“Fascism is coming; probably a slimy Anglicised form of fascism, with cultured policemen instead of Nazi gorillas, and the lion and the unicorn instead of the swastika.”

Perhaps it’s the same conflict within Johnson himself that creates a resonance with so many of the electorate, that counter-intuitively they surrender to being gaslighted and become the sheep in the power games of people they have little or nothing to do with on anything approaching a personal level.

Could it be the same conflict manifesting itself in the Government’s muddled guidance on social behaviour during a pandemic? For example, Choose ten lockdown friends and family, as the Government considers ‘stay at home’ rules to allow small groups to meet for meals, share childcare and let couples who do not live together to see each other.

Or is the muddle more a matter of competence?

Progress with test and trace would suggest that, with poor collaboration, confusion and lack of capacity: How the UK’s efforts to ramp up Covid-19 testing have failed. Expansion of testing is branded an “utter mess” after the website closes. The Government’s new Covid-19 testing website for essential workers has had to be shut down after its 5,000 home kits ran out within just two minutes. Some 46,000 people tried to access the website, 16,000 tests in total were booked and the site was back up later in the day. Capacity rose to 51,121 per day. And as UK runs out of home tests for key workers, as concerns raised over need to drive to testing centres.

“A lot of people don’t drive or don’t own a car,” a Bristol councillor pointed out.

The new reality that’s overtaken us all reveals itself in a number of today’s stories:

  • Destroyer USS Kidd becomes the second US Navy ship hit by a major coronavirus outbreak on patrol to intercept drug smuggling. As of 22nd April CNN reported a total of 26 US Navy vessels in which crew members have tested positive. The US Navy recommended reinstating Captain Crozier, the fired captain of the aircraft carrier USS Theodore Roosevelt, who requested help with the outbreak on his ship. It never happens. As if to rub sea salt into the wounds, following an investigation in to the Theodore Roosevelt’s outbreak, the captain, an officer with a hitherto distinguished naval career will be criticised for the inadequate social distancing and quarantine measures on board his ship.
  • Across Europe, takeaway food services have experienced a noticeable spike since self-isolation measures began. This is being put down to what is best described as “cooking fatigue,” the feeling of wanting to eat lazily rather than having to cook all our own meals from scratch.
  • There’s a children’s confinement dance growing in popularity in France. Designed to keep children amused during the lockdown, it is growing in popularity in France. Lucas Elziere, a 35 year old musician in Rennes, developed the choreography to save his brother’s children from boredom.
  • There has been a surge in animal adoptions and fostering. But beware! Many cats and dogs have started behaving differently, since lockdown began, spooked by the change in the daily rhythm and their owners always being around. Some pets are growing clingy. Others are pouncing on exercise equipment, gliding across countertops, or hiding in corners, whining, growling and even shooting their owners concerned stares.
  • As if to remind ourselves that stay at home orders unsettle human beings as well there’s shocking footage showing Scots police clashing with louts in an East Lothian residential street. Since Police Scotland issued an appeal to observe corona lockdown rules there have been more than 4,000 orders to disperse, 1600 fixed penalty notices and 78 arrests across the country issued to those flouting the lifesaving measures.
  • Groups of adolescent and young adult males clustering is a growing feature across many parts of the UK. On my Nextdoor network a concerned woman seeks online advice about  reporting large groups gathering on Winns Common.
  • There is now hunger crisis in the UK, with 1.5 million people a day are going without food.
  • Labour launches a review into the Covid-19 impact on BAME people. Equality and justice campaigner Baroness Doreen Lawrence has been asked to lead the review and has been appointed as the party’s race relations adviser.
  • The lockdown is already leading to certain kinds of crime. Customs officers have found cocaine smuggled in a consignment of masks. There are fears that children could be recruited by gangs. Metropolitan Police officers are arresting around 100 people a day for domestic violence offences during lockdown. Charges and cautions from 9th March rose 24 per cent higher than last year.

By this time the world finds itself with an unevenly spread deadly virus. Some countries have been through the worst and believe they have reached better times ahead, as if a pandemic is a passing storm. It isn’t.

  • Some realise that fact. “It’s too early to celebrate.” Iceland’s prime minister speaks about her country’s Covid-19 success.
  • Some want to advertise their success to the whole world as if to compensate for a darker underlying truth. For the tenth straight day China reported no new deaths from the virus. Twelve new cases were reported on Saturday, 11 of them brought from overseas and one local transmission in the north-eastern province of Heilongjiang. How exactly the pandemic began in China remains a mystery and will continue to do so for a long time. The EU have released a report alleging that Beijing was spreading disinformation about the Covid-19 outbreak. China has sought to block it.
  • South Korea has reported 10 fresh cases of Covid-19, the eighth day in a row that the daily increase has been less than 20, as its outbreak slows amid tighter border controls and waning infections in the worst hit city of Daegu. The country also reported no deaths for the second straight day on Saturday.
  • Mexico says its auto factories are to reopen with virus safeguards.
  • India has eased the stringent lockdown for 1.3 billion people by allowing local and standalone shops to open with restrictions, such as 50 per cent of workers, wearing face masks and keeping social distancing.
  • While Sri Lanka imposes a curfew.
  • Cases of Covid-19 are overwhelming hospitals, morgues and cemeteries across Brazil as the country veers closer to becoming one of the world’s pandemic hot spots. Medical officials in Rio de Janiero and at least four other major cities have warned that the hospital systems are on the verge of collapse, or are too overwhelmed to take any more patients.
  • Congo’s smugglers keep hustling through the Covid-19 lockdown. The illicit economy makes it hard to stem the spread of the disease.
  • The Australian aborigine territory, Arnhem Land, is under lockdown, but you can visit it through online concerts.
  • While Vladimir Putin stays out of sight as Covid-19 hits the economy. It is very hard to gauge what kind of pandemic experience Russia has had. Information coming out of the country is far from reliable.

Finally, the pandemic can always be best caught in people’s personal stories. Look very carefully and you’ll see that the bigger picture is actually a mosaic of tiny individual pictures, each with a fractal reality in its own right. As mine is. As yours is too.

  • At the start of Ramadan the Prince of Wales has paid tribute to Ismail Mohammed Abdul Abdulwahab, a 13 year old boy who died after contracting Covid-19.
  • Caroline Lucas, Green Party MP for Brighton and Hove, says she doesn’t miss the PMQs scrum but she does miss the atmosphere. Like 649 others, she has a virtual MP finding it hard to build up momentum in Parliament’s Zoom waiting room.
  • 99 year old Captain Tom Moore and singer Michael Ball reached Number One in the UK singles chart with their rendition of, “You’ll never walk alone.”
  • On the Isle of Wight nine camping carers on ITV’s ‘This Morning’ explain why they couldn’t leave elderly residents during the pandemic.

In the last two stories I’m minded that some of those we admire will be remembered forever. Some haven’t passed first base when it comes to knowing their names.

In the final analysis it doesn’t matter.

What does matter is what they achieved to earn our admiration.