Division, justice and vaccinations

Hi everyone

Happy new year! And what a year already.  Each day brings with it extraordinary news and developments. 

One theme that has struck me is how diverse we are. When I was between school and university I spent time in South Africa and remember having a conversation about the lack of education of the black population.  My South African friend said ‘They are so stupid, there’s no point’ and there the conversation ended.  Recently we had some building work and one of the builders was a flat earth man.  I could not penetrate his well thought out system which included denying even the presence of gravity. And I find myself most shocked by the events in Washington DC by the reply of a protester who, on being asked what he was doing there, responded ‘Defending democracy.’  Barack Obama talked of people being in information silos where our views are reinforced by what we are given to read or see.  Without some starting areas of agreement, it is difficult to find a meeting point.  Closer to home there are people – indeed professional people – who see the lock down and vaccination programme as part of an establishment control system to be avoided at all costs – while others are keen to have the jab as soon as possible.

How do we make sense of this? How, indeed, do we know our own truth?  On the few occasions I have been close to a news story I have been shocked to read how different the ‘facts’ in the press are presented.  And yet we tend to believe the BBC, the papers (chosen carefully to support our views), our like minded friends.  Silos indeed.

The most extreme situation where a person holds beliefs not consistent with the cultural facts is seen in the severe mentally ill – the psychotic.  However isolation – the lack of the normalising buffering of extreme views – can enhance that trend in ‘normal’ people – and whether or not you see the Donald as ‘normal’ clearly his increasing isolation will exacerbate his world class narcissistic viewpoint making him less and less appropriate to be President.  Thank goodness there are only a few days left for his tenure. For ourselves, this third lock down provides again a similar environment where extreme views are nourished through not just isolation but the feeding of targeted information that promotes them.  These often feed into emotional drivers such as anger which then reduces your ability to think rationally. (In the world of neuroscience we know that the amygdala, the brain’s emotional centre, blocks off access to the pre-frontal cortex, the rational centre). Further we know that whatever processes we use become reinforced with practice.

It may be that society has to go through these transitions – whether on Capitol Hill, or Brexit, or climate change or expressions of other divisions -  before it transforms to something different.  The process is challenging, of its nature destructive, but leads to a new equilibrium with more perceived justice – and our involvement in that justice process, both now and in the future is a healing process. South Africa and the Truth and Reconciliation process was a good example.  

For now, how do we live in the pandemic?  First, as we approach the last push, we can call on our collective and individual learning in 2020 to put our fears and anxiety in context.  We are much better informed at how to live in relative isolation than we were nine months ago – and that should really help.  Secondly we are smarter at staying safe - unless we have become complacent though the daily news should help tackle that particular attitude. Thirdly there is hope on the horizon – the vaccines – so for the first time there is a potential end in sight.  Above all we should allow kindness to be driver of our actions. And maybe consider planning a summer holiday.

As for keeping well and balanced – here is a list of free accessible actions: movement, mindfulness, creativity, community, sharing, innovating.

On a more basic level, it appears that the vast majority of infections are transmitted by aerosol spread (in the air) rather than by fomites (on things).  Which makes mask using really important.  I was asked about what types are best.  Here is an article covering this - https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-face-masks-what-you-need-to-know   A key point is to ensure you take it off from the back and wash your hands and it after each use.

Finally one jab or two?  There is no doubt the best way to maximise the nation’s immunity quickly is the one jab approach.  The Chairman of the Royal College of GPs writes: ‘People will still need to receive two doses but releasing the ‘reserved for second dose’ vaccine will release, we are told, close to a million more doses, which means we can give more first doses to higher numbers of people…….the modelling shows you need to vaccinate 250 people aged over 80 with the first dose in order to save one life. The decision to delay the second dose is particularly important when we can’t guarantee that the Oxford/AstraZeneca vaccine will be available at high volumes straight away.’

And does it work well?  You may have seen effectiveness rates of 54% for the Pfizer first dose but this included people who contracted covid in the 10days after the vaccination and before it was effective.  Remove them and the protection rate is around 90%.  So yes it is effective – from three weeks after the injection.  What we don’t know is how long that will last – hence the need for a (delayed) second injection.  Let us hope this delay which has not been scientifically tested does not through up other unforeseen issues.

And now the Christmas quiz answers:

a.       Name the Christmas song:

1.       🥬❄️🥬❄️🥬❄️ let it snow, let it snow, let it snow

2.       🚗🏠⛄️🎄 driving home for Christmas

3.       🕳🕳🌃 holy night

4.       🙏🌲📅 I wish it could be Christmas Every Day

5.       🥈🔔🔔 Jingle Bells

6.       ⬅️🎄🎁❤️ Last Christmas I Gave you my Heart

7.       🚫🔔🔔🔚 Don’t let the Bells End

8.       ❄️🥶☃️ Frosty the Snowman

9.       🧚🏻‍♀️📚🗽 Fairy Talk in New York

10.   😴⚪️🎄 Dreaming of a White Christmas

11.   🚶‍♂️➡️🎄 Step into Christmas

12.   🎅🏻👶🏼 Santa Baby

13.   🦌🔴👃🦌 Rudolph the Red Nosed Reindeer

14.   😄2️⃣🌍 Joy to the World

15.   🎅🏻➡️2️⃣🌆 Santa Claus is Coming to Town

16.   🔇🌚🌛 Silent Night, Holy Night

17.   🤴🏻🤴🏻🤴🏻 We Three Kings

a.       In what month was the first case of COVID-19 confirmed in the UK? January

b.       On what date the World Health Organisation declare the coronavirus a pandemic? 11th March

c.       What town did Dominic Cummings travel to for an eye test? Barnard Castle

d.       What item was corona famous for a hundred years ago? Typewriters

And for the cryptic crossworders

e.       Sounds like a large stretch of water coming before a turbulent void.  Covid

with love

Derek

Christmas cheer - bumper edition

Have you ever been on a rollercoaster?  Well it feels a bit like that now to me with the pandemic– you wish you had never got on but now there’s no option but for it runs its course – and you don’t want to fall off as it comes into the last straight.  Easter, one step beyond Christmas, is on the horizon when we shall finally be able to alight.  Vaccines are being rolled out and hopefully the NHS will cope again with one last big effort – although many are genuinely battle weary.  The darkest hour is before the dawn and we are entering that phase now.  It is important to remember while new variants may produce more infections, the infections are no more serious than the earlier ones – indeed with better treatment the outcomes are better – and the vaccines are effective against all the variants. 

And so to the neglected elephant in the room – climate change.  So much good news this week

-         the UK has committed to stop new finance for overseas oil, gas and coal projects

-         Jo Biden is appointing some very progressive environmental people

-         a coroner in London has ruled for the first time that air pollution made a material contribution to the death of Ella Kissi-Debrah which will likely impact on new builds

-         the Government’s independent advisors suggests the UK can make major cuts to carbon emissions more cheaply than previously thought and mapped an achievable path to reaching Britain’s emissions targets, which included strong endorsements of agroforestry and eating less and better meat. Climate Change Committee Report calls for decisive decade

-         in the Energy White Paper, the government committed to a smart and flexible electricity system based on wind and solar.

-         The Prime Minister’s 10 Point Plan committed to the end of the internal combustion engine in less than a decade

-         even the Supreme court ruling on allowing Heathrow’s third runway to proceed is a technical one and gives ground for hope of stopping it in the planning stages.

2020 ends with signs of progress for tackling this - the biggest issue of our time. For that at least we should be thankful.

And now the Christmas quiz - to be approached with your favourite drink and hopefully in the company of at least one friend:

a.      Name the Christmas song:

1.      🥬❄️🥬❄️🥬❄️

2.      🚗🏠⛄️🎄

3.      🕳🕳🌃

4.      🙏🌲📅

5.      🥈🔔🔔

6.      ⬅️🎄🎁❤️

7.      🚫🔔🔔🔚

8.      ❄️🥶☃️

9.      🧚🏻‍♀️📚🗽

10.   😴⚪️🎄

11.   🚶‍♂️➡️🎄

12.   🎅🏻👶🏼

13.   🦌🔴👃🦌

14.   😄2️⃣🌍

15.   🎅🏻➡️2️⃣🌆

16.   🔇🌚🌛

17.   🤴🏻🤴🏻🤴🏻

b.      In what month was the first case of COVID-19 confirmed in the UK?

c.       On what date the World Health Organisation declare the coronavirus a pandemic?

d.      What town did Dominic Cummings travel to for an eye test?

e.      What item was corona famous for a hundred years ago?

And for the cryptic crossworders

f.       Sounds like a large stretch of water coming before a turbulent void

Answers next time. 

For those missing out on the Christmas Cracker jokes:

1. What is Dominic Cummings’ favorite Christmas song? Driving Home for Christmas.
2. Did you hear that production was down at Santa’s workshop? Many of his workers have had to Elf isolate!
3. Why didn’t Mary and Joseph make it to Bethlehem? All Virgin flights were cancelled.
4. Why are Santa’s reindeer allowed to travel on Christmas Eve? They have herd immunity.
5. Why did the pirates have to go into lockdown? Because the “Arrrr!” rate had risen.
6. Why is it best to think of 2020 like a panto? Because eventually, it’s behind you.
7. Why couldn’t Mary and Joseph join their work conference call? Because there was no Zoom at the inn.
8. Why can’t Boris Johnson make his Christmas cake until the last minute? He doesn’t know how many tiers it should have.
9. What do the Trumps do for Christmas dinner? They put on a super spread.
10. Which Christmas film was 30 years ahead of its time? Home Alone.

Looking back at this year, I am reminded of the story of the man at the optician who was asked what he could see.  He responded ‘I see unused airports, empty football grounds, closed theatres, and masked people keeping their distance.’ ‘That’s perfect,’ says the optician, ‘you’ve got 2020 vision.’

Carols from King’s College no doubt will be available on Christmas Eve but for those who feel Christmas carols this year a little different try this. It’s interactive - you can drag the blobs up & down to change pitch or forwards & backwards for different vowels - or just drag them up, watch their lips purse & eyes roll & drop them again for some rather good blobbing! There are also some pre- arranged carols.

https://artsandculture.google.com/experiment/blob-opera/AAHWrq360NcGbw?cp=e30.

This season of ‘good cheer’ behoves us to remember kindness in our dealings as so many people now are dealing with loss on so many levels. The scarcity of our contacts makes each one the more precious and important. And remember ‘This too shall pass.’

Enjoy the festive period and thank you to all the contributors this week and over the year. It has been a privilege to be writing – this is the 27th edition - and to have had such positive contact with so many of you.

with love

Derek

Christmas and vaccines

Hi everyone

I was out this evening throwing a ball for Bramble our Labrador.  Reflecting my mood, the clouds were low, it was cold, there was faint drizzle. For Bramble the weather was utterly irrelevant – she is a retriever to her bones and expresses that completely and relentlessly whenever she can and in whatever the conditions. Lesson one - total passionate commitment leads to joy independent of outside forces.   Miraculously the clouds lifted and suddenly there was clarity on the horizon, a beautiful sunset and I actually felt joyful (not a frequent experience for this writer!). Beyond every cloud there is a silver lining. Lesson two – moods are variable when you are not completely immersed in an activity.

And so it is for most of us with the pandemic.  Suddenly the vaccines are within stabbing distance and the clouds are lifting.  They are like buses – you wait for ages then three come along together.  Of course we will have to wait our turn but you know they are en route.  All of them look great – effective and safe – the Oxford one made in the traditional way like the flu jab, the others using a novel approach which may prove to be the way of the future.  It really does feel liberating after these months of carefulness and relative isolation.

Which brings me to Christmas – I sense a nervousness about having family come into the home.  (Curiously it is our very own home, our ‘castle’,  that is most restricted now – in tier two you can eat outside with friends from up to six households but only have the one bubble at home). Is it worth the risk?  Like a gambler who has stacked a healthy surplus and then wonders whether to stake all on a final inviting bet. The covid incidence is falling and will probably be even lower by the 25th (before, I suggest, rising again).  It is a calculation everyone must make.  How important is the contact? And to have the contact at Christmas?

Meanwhile I notice a new issue – I have taken on a range of sustaining activities at home during lockdown – such as more time in the vegetable garden, making more contact with friends, yoga and stretching, some woodwork, bridge on line, some support work – and as the traditional activities become available again choices will have to be made.  Every activity has an ‘opportunity cost’. This is where the gift of the pandemic may lie – a revisioning of our activities so we do not return to exactly the same pattern as before but spend time on those closer to our heart.  The most nourishing are usually those in which you become totally absorbed – the Bramble teaching.  Including Christmas with family?

For some light relief I have just watched The Queens’ Gambit on Netflix – seven increasingly enjoyable episodes. Along with The Crown………..

Finally, to get some much needed perspective, I am resending the second musical clip from last week with a new and hopefully working link – https://www.youtube.com/watch?v=1f7OwFqTnco

with love

Somewhere or Anywhere

Hi everyone

Are you a ‘Somewhere’ person or an ‘Anywhere’ person? Since my last column (perhaps a bit pretentious to call it this but it has been suggested by one of the overseas distinguished readers) much has happened including over 60 million people voting for the now sulking Trump. Plus the shameless response to Priti Patel’s bullying, the exit of Dominic Cummings, the rising hope for a vaccine, a thin Green plan from the government, Leicester FC sitting at the top of the table. All quite big events in themselves but my attention has been on the 60 million. I have become curious about what is the Donald’s attraction despite (or because of) being so offensive to so many people.

Which brings me back to the ‘Somewhere/Anywhere’ issue. David Goodhart’s rather heavy book ‘Head, Hand and Heart’ suggests this is a good way of looking at the two camps that divide society whether in the US or over Brexit here. ‘Somewhere’ people are those who value where they are – localism, their community, their land, their family, tradition, simplicity, freedom from interference, an intense dislike for big government, intrusive technology. They tend to have jobs working from their heart and with their hands such as the caring services, drivers, manual services – people who have become more visible with the pandemic. ‘Anywhere’ people value ideas, internationalism, the power of the internet, equality, difference. They act from their head and tend to hold more prestigious positions. ‘Somewhere’ people are in general less valued in our society and often feel it. We all have a bit of both in us but which set of values drives your behaviour? Indeed your votes? I remember being in the voting booth for the Brexit referendum and my head saying Remain and my stomach saying Leave. It seems to me that this Somewhere/Anywhere model is a good basis for starting to listen to each other as there are so many values on both sides that we can identify with or at least understand.

We have arrived at this point of division not least through the effect of technology which has a ‘silo effect’ – reinforcing our views by showing us only information that supports those views. It polarises. On the other hand, the pandemic may have left many of us now feeling on less sure ground than before in this new reality – perhaps revisiting our values and plans. As Mike Tyson said ‘Everyone has a plan ‘till they get punched in the mouth.’ This time is therefore an opportunity to reach out. If Covid has taught us anything it is the importance of connection to each other, of acceptance of each other and of being kind. Perhaps we now have a framework to do this.

Finally I only attached this joyful clip belatedly last week so in case you missed it… https://www.youtube.com/watch?v=CcsSPzr7ays

And finally to provide some balance another musical clip:

https://onedrive.live.com/?cid=D5D5C68205F088BD&id=D5D5C68205F088BD%21309010&parId=D5D5C68205F088BD%21303025&o=OneUp

with love

Derek

Taking care - phase 2

Hi everyone

We’re in a holding pattern – America decides tomorrow, lockdown coming in three days.  Life as normal but big changes coming.  So I find myself thinking how will I approach another lockdown of indefinite length and what did I learn from the last one?  What actions will I take when the end of the week lands with its changes?  Am I ready?

First there is self protection from the virus – now known as ‘hands, face, space’ – with which to protect ourselves.  We know what to do but do we do it?  I went shopping this week and spent some time browsing in WH Smiths – bringing home some stationery, a card and a book.  I wore a mask and use hand gel as soon as I got into the car.  On returning home I washed my hands again and put the items down on the kitchen top feeling clean and virus free.  Then I thought about it – if any of the items were carrying the virus due to someone else browsing then my hands, the kitchen top, perhaps my clothes, the car door and back door handles etc etc were all contaminated.  Wow.  It is so easy to fail to take the precautions that are needed to keep your space safe.  It is months since I was advocating the use of the cooker for ‘incoming’ and in the process melting Sandy’s credit card. So it is worth reminding ourselves that there are four reasons why we all fail to do this (and many other things) – ignorance, carelessness, rebelliousness and complacency.  Perhaps it is worth considering which of these qualities drives your covid behaviour now.

Second there are measures to improve your own immunity and mental health.  Louis Pasteur said – ‘The microbe is nothing, the terrain is everything.’ So here are ten things to do:

1.       As the days shorten take a daily vitamin D. 

2.       Exercise – preferably of the aerobic variety.  Very good evidence this is good for mental health as well as your immunity.  This is a bit of a personal challenge.  In the spring I went biking which morphed into autumn swimming at the local pool - which is about to shut.  As is the golf course. However there are lots of options – walking, jogging, exercise bike, dancing or perhaps an on line aerobic yoga class.  What will you do?

3.       Eat well – multicoloured food and beware too much alcohol.  

4.       Keep busy. Find a project.  It could be a challenge – say reading a series of books or building a compost store or doing something creative.

5.       Act on problems. Move them forward rather than let them simmer.

6.       Avoid too much news – especially late in the evening.  We record the six o’clock news and watch it as convenient early in the evening and that’s it.

7.       Get enough sleep.  Get into a routine and avoid getting up late.

8.       Consider the opportunity to ‘go inside’ – with some meditation or mindfulness – there are several apps that are useful including Headspace and Insight timer. 

9.       Timetable in frequent calls with friends and family  – perhaps one or two contacts every day. Remember you can meet up outside with one other person. Include some down time.

10.   Reach out to your community – reaching out is life enhancing

Everyone is different but it is certainly worth reflecting on what worked for you before (and what didn’t) to help you get through the next phase - the isolation, the loss of in person contact, perhaps loss of income, and everything else that goes with this.  Taking action with a plan is in itself health enhancing.  Developing a routine provides a structure which simply makes life easier.

Let us hope the week brings hope and opportunity for us all and ……..bring on the vaccines. 

Finally  enjoy…. https://www.youtube.com/watch?v=CcsSPzr7ays

With love

Battle Fatigue

Hi everyone

I have found myself watching and nostalgically really enjoying clips from the 2012 Olympics – Mr. Bean and James Bond with the Queen.  How different it is now compared with both then and even when the pandemic started in March.  The numbers may be climbing but there are differences in what they mean; the health services are in a different place; the country is in a different mood.  It is said there are two certainties in life – death and taxes – but to that you must add change.

Starting with the numbers – at the moment the overall numbers remain lower than before and the rate of increase is slower.  Add to that the demographic that many more of the cases are in the younger population and the alarm bells are not ringing as loudly.  With so many students getting covid 19 with relative impunity there is an argument to put a ring of steel around the university campuses and let them get on with their lives.  Locking down this vivacious group is not a long term option. 

Then the health services have learnt a great deal on how to manage the disease.  Dexamethasone, a powerful steroid, has reduced mortality for those on ventilators by 30% and is widely and cheaply available.  There is greater understanding of the disease process so less people are put on ventilators – more people having oxygen treatment ahead of that.  Antiviral medicines are given though two recent trials do not suggest they are very effective.  The profession has upped its game on treating this new disease.  However the health service is now additionally being asked to do the routine care – tackle the massive waiting lists for treatments and at the same pace as before the pandemic – in effect to work even harder than before given the need for decontamination between patients.  As Professor Wright from Bradford recently wrote ‘We are no longer heroes…….. we are seeing a kind of battle fatigue.’ 

And this battle fatigue is being seen everywhere.  People are hunkering down for the winter with a sense of grimness.  My sense is that people are tired – of the ever changing regulations, the queueing at the shops, the inability to touch friends and family. And of the uncertainty - of no end in sight, of uncertain employment, or when or where to take a holiday. For some there is the additional and profound tiredness resulting from having been unable to grieve for loved ones.  The result is many are ignoring advice, many are upset at those ignoring advice. 

All this leads to the sense of unity being cracked.   We are seeing the rise of community leadership such as in Manchester and a breakdown of one rule fits all.  This new sense of localism is however different from that seen in the early phase of the pandemic – when there was an uplifting generosity and coming together against a common enemy.  Now angry tired communities fuelled by loss of trust are rising up for themselves and against the national government.  This time community building is divisive.  Perhaps we are seeing the beginnings of real localism – not just in Scotland, Wales and Northern Ireland but within England itself.  People and communities are saying enough of national policy especially national policy about which there are real doubts.  Local leaders reflect that, and national leaders will pay for that at least for now.  However when local leaders fail to meet local expectations, then where will individuals turn?  We live in an individualised, entitled society expecting the security and comfort that a first world country can give us while at the same time demanding our right to follow our personal paths independently.  This paradox and its consequences is being exposed. People want their cake and to eat it. The next few months may be the most difficult phase of the pandemic. 

On the upside, a vaccine may not be that far away – some talk of the early new year and that would be a life saver on so many levels.   

With love

Derek

Less is more

Hi everyone

Strange times indeed.  To start with the Trump situation, with all the disinformation it is difficult to know what is really going on but to keep it simple day 12 from infection – so around 11th to 13th October - is crunch time when either he will be better/getting better or he will be in serious trouble.  Unless you love the drama, best to wait until then for the definitive news.  It is also an extraordinary reflection of the US and its medical system in which doing nothing (masterly inactivity) is essentially not an option.  The public, the medics and the system demand activity and this is reflected in the astonishing fact that one in four deaths in the USA takes place (very expensively and unsatisfactorily) in intensive cares.  In the President’s situation, certainly the medics are busy. We know that one experimental drug – the antibody infusion - has already been given and another (dexamethasone) has been given much earlier than would be given here.  We can be grateful for the NHS culture which is less driven by the need to do something and more based on evidence. 

Changing tack somewhat there are now many more restrictions and much more guidance, much of it enforceable with fines.  I heard of a woman who was told to self isolate by Track and Trace and was phoned up some days later.  ‘Are you self isolating?’  ‘Yes’ she responded.  ‘Are you at home?’ ‘Yes’ she responded.  ‘Then could you let us in.’  Alas she was not there and was fined £1000 for not isolating, £2000 for obstructing the course of justice, £1000 in costs and given a criminal record. So beware.  (but if you are contacted through the NHS app and asked to isolate this is not legally enforceable).

One of the consequences of the regulations is that people stop thinking about what is best for their community/family and simply follow the guidance – and assume if it is not prohibited it must be ok.  Increasing regulation goes hand in glove (or gel) with loss of social and community responsibility.  Hence my regular focus on the need for strong community and mutual support.  An interesting study of 40000 people done just BEFORE the lockdown revealed that 43% of people feel we do not touch enough.  Touch is associated with well being and better mental health.  I imagine this figure has now gone up a great deal.  And yet we seem to have reached a point where if the virus count drops we are told this supports lockdowns and if it is climbing we need lockdowns…..

From a health perspective, my sense now is that the balance for our own health is moving away from lockdowns and regulations.  The physical and mental costs of the restrictions are immense and understated – through the lack of touch (especially for those in nursing homes), the delayed treatments for non-covid diseases, and in particular the upcoming adverse health impact of redundancies.  So what to do – put simply avoid the three Cs – crowds, close contact, and closed spaces….and get on with your life. 

I am a great believer in minimal intervention whether it be at a national level or for an individual patient.  There are of course times when action needs to be taken in the face of overwhelming danger (such as the initial lockdown) but let the body/community heal itself.  I fear neither our communities nor Mr. Trump is being given that opportunity – though in the latter case it may be that he is not giving it to himself.  Sometimes less is more.

Finally to cheer you up take a look at this:

https://www.youtube.com/watch?v=mg2NJ48jxYs

With love,

Short term is mmmmm?

It’s getting rougher.  After my last blog saying we are in a holding situation, the scene has changed – rising numbers of covid 19 cases, increasing personal restrictions, and the effects on the pandemic of the return to work and school yet to be seen.  Coupled with the upcoming economic consequences and the realisation that this really is a long haul is it any wonder people are feeling depressed/angry/intolerant/hopeless/selfish - coupled to any manner of behaviours.

The good news is that the death rate continues to fall as those people who are testing positive are disproportionately young with relatively mild illnesses and the treatments are improving.  This is reflected in the low/single digit numbers of daily deaths in England.  To get a sense of proportion, these numbers need to be seen in the context of the daily ‘normal’ death toll of about 1600.  Covid 19 deaths are a very small proportion of these.

So it begs the question of why, at enormous expense,  the entire social and economic system is continuing to be disrupted for an illness  with a low mortality in the knowledge that the collateral damage of isolation and delayed treatments from the restrictions will undoubtedly see rising morbidity and mortality. And it will take a generation to pay off the debt. Where lies the health cost benefit?

Part of the answer to why such decisions are being made is the nature of our society.  We have moved into a ‘instant’ society whose currency is the short term – driven by the immediacy of technology especially its social platforms with ‘twitter storms’ and instant messaging.  A casualty of this trend are the institutions and qualities that provide some ballast against the changing winds of the day. We see it in the organisation of the NHS where rapid access trumps continuity of care and relationship.  We see it in the brains of children who are losing their ability to concentrate as they use smart technology devices for gaming - reinforced by the entertainment industry with products which need only short spans of attention. We see it in the short term decisions regarding the environment where the comforts of the present outweigh thoughts of caring for the future. We see it in the election of populist governments and their disregard for both organisations that stand in their way (such as the inconvenience of international law and treaties with the new Brexit legislation) and even for the truth itself.  In this context, the government prioritises the avoidance of illness today over the consequences of its actions tomorrow.

This approach to the pandemic leads to other unhealthy consequences – increasing isolation and intolerance. As people become isolated (last week in Cornwall we went to a pub and had to order outside from an app avoiding human contact) they exchange views with fewer people.  At the same time technology reinforces their views through clever algorithms.  The isolation and the reinforcement creates certainty about that view.  Then coupled with infrequent contact, its expression becomes more radical, more extreme and more immediate. Extinction rebellion stopped the distribution of some newspapers for a day and the full power of the state responded by saying they might introduce primary legislation to re-classify XR as ‘an organised crime group’ with up to five year sentences.  Both the action and the response are examples of intolerance pushing people to develop more extreme positions.

So it demands of us individually that we pay increased attention to nurturing how we live, and to our relationships with family, friends and community where fortunately we usually still see the longer term as at least as important as the short term. It’s a choice. What’s yours?

Damned lies and statistics

Hi everyone

We seem to be in a kind of holding phase with the pandemic……..clearly phase one is over, the NHS survived, and numbers of new infections are low.  Now in phase two people are out and about and leading reasonably normal lives, with many making hay if not babies while the sun shines. There seems to be a resignation that phase three will include local outbreaks and restrictions, continuing travel difficulties, pressure on the NHS during the winter, economic hardship through unemployment and a bit of a return to the fearfulness we previously experienced. I think this is likely until a vaccine is ready.

However, keeping abreast of the latest developments is difficult. The statistics change and are difficult to interpret – for instance you will have noticed the number of UK deaths from covid 19 recently officially dropped by 5000.  In terms of immunity a survey of 100000 people showed that only about 6% of the country has antibodies.  In Sweden with its open policy (not shutting down the economy and keeping most activities open) the figure is 15%.  Although both may be an underestimate the prevailing wisdom is that we need around 60% of the population to be immune to effectively end the virus transmission and no-one is saying we are anyway near that – hence the need for the vaccine - and the government ordering 300 million doses from six different sources since no-one knows which one will work and how many doses people will need.  Despite the huge international research effort it still feels that we are finding our way in understanding the natural history of the virus and what precisely to do about it.

Clearly the number of infections is creeping up again nationally and internationally (for those who love figures check out https://www.worldometers.info/coronavirus/  - it really has a lot of figures). The better news is that the mortality rate continues to drop as more younger people are infected and the treatment improves.  It is now less than 5%. 😊 Other good news is that you can look up what your local infection rate is at https://www.bbc.co.uk/news/uk-51768274   Wiltshire today is running at 5 new cases each week per 100000 population, compared with Swindon at 41 and a national figure of 6.  Local measures kick in at around 20.  Countries are similarly graded according to their infection levels – with Spain currently having the highest incidence in Europe at 47.  Again a figure of 20 seems to be the cut off for approved travel. The time for trips abroad has probably passed.

Well we all know how irrational we are so the figures may not really be your thing.  And your ‘gut’ or other emotional drive may simply be the decider on what actions to take.  For many years you will have relied on whatever your process is for making decisions and it has probably done you well so don’t give up on it.  However combining it with some understanding of where we are both as a community and nationally could be the way to go.  That includes knowing what the rules and penalties are – a visitor to Guernsey was fined £4000 for stopping to pick up some bottled water en route to his hotel.  Serves him right - I have little sympathy for anyone buying bottled water these days.

With love

Change and social pressure

Hi everyone

The most encouraging news this week is from BP – whose new chief executive has said the company will be reducing its oil and gas exploration leaving some fields it owns untouched while expanding or starting a massive investment in solar/wind power and electrical infrastructure for cars.  Even Greenpeace has welcomed the statement. And given that BP’s carbon footprint is larger than the whole of the UK this is really highly significant.

One reason is that investing in the oil and gas industry has become less and less socially attractive whatever the financial return.  A consequence of this social shift is the increasing difficulty of recruiting top class staff without a switch in policy.  A tipping point has been reached….and others will follow this lead.  This is the way change happens.

The start of the school year approaches and it is not clear just how many parents will be sending their children back in the context of the pandemic.  People have concerns about their children becoming ill, about themselves becoming ill, and about the children infecting others such as grandparents or those shielding.  Putting aside the few exceptions of those at high risk of serious illness through their own already compromised state of health, we know that for the young and for children in particular this is a mild illness.  We also are reasonably sure that children with covid-19 are less infectious than an adult with the same illness.  We know that staying at home adversely effects a child’s development and wellbeing not least because of their lack of social contact.   And finally we know that unemployment which would be increased with their staying at home is unhealthy – indeed the ill health from the pandemic’s financial effects may prove to be greater in the long run than its short term direct effect. These are all rational arguments to encourage people to send their children back.  The hesitation comes from a different place – the very real pit of the stomach anxiety created by the successful project fear that kept us all in lockdown.  The national situation has moved on and many people have yet to catch up.  I find myself still anxious about doing basic things – I had a haircut this week and was alone in the underused barbers with a masked hairdresser – there might be a good short story in that.  We went to London on the train to see our son.  We bought first class tickets - quite unnecessarily it turned out - as the trains both ways were virtually empty as was the commuter car park.  Pre covid the 2200 from Paddington would have been standing room only.  Each step brings us face to face with how others are behaving and the economic effects of that behaviour.

As more and more of us take these tentative steps despite our anxieties, we will free ourselves up and make such behaviour socially acceptable and isolation less acceptable.  This is the same process  - driven by Extinction Rebellion, Greenpeace and many others - that has pushed BP to change its focus.  So while we can do this now for the health of ourselves and our community now we have the multinationals starting to help and together we can make a real impact for the next generation.  There is some hope in the gloom.

With love

Derek

Technology

Hi everyone

I was on my bike today and came across a longish section of road closed for resurfacing.  I was able to bike on the scraped rough surface and caught up with another cyclist – an unusual occurrence.  We joked  ‘it’s like lockdown…..there’s no traffic……..but the roads are in a terrible state.’  I felt nostalgic for when the world was simpler and we were all in it together.

There is concern about a covid-19 resurgence – numbers are rising across much of Europe as well as in Australia and elsewhere.  Many outbreaks seem to be driven by local clusters where people have spent time together and those people then unknowingly (before they get symptoms) seed the wider local population.  Hence the ‘whack a mole’ approach with local shutdowns etc.  The bigger encouraging perspective is that the current UK national death rate is lower even than at this time last year and that you have on average a 19/20 chance of survival if you do get infected.

Meanwhile if you are like me the initial fear has gone and I find myself worrying less and less about the virus albeit from the position of my privileged bubble.  We welcome guests on the assumption they are not carriers (entirely reasonable given the extremely low incidence) and move to a more normal social life. These are healthy steps though exactly the steps that might contribute in the future to more cases and which will be stamped down on.  We get lost in the figures; the BBC used to put up its main news figure relating to daily deaths.  Now its number of new cases which however reflects progress. What’s happened to the R figure?  Essentially we are relying on the government to guide us – not an easy trust given its track record.

Meanwhile I am sensitive to my own health.  I read that the UK, already the fattest nation in Europe before Covid-19, has put on weight during the pandemic -  for four main reasons.  More snacking, less exercise, more alcohol and a worse diet.  The snackers have put on about half a stone on average and we know this is bad news not just for dealing with covid.  It increases your risk of diabetes, heart disease and cancer – hence the Boris lose weight initiative.  Now it’s get on your bike to stay healthier, before it was get on your bike to find a job.  Soon it may be both.  For me getting on my bike is simply a pleasure and a revitalising activity as well as keeping my weight down.

One aspect of all this is the remoteness of contact that we now routinely experience.  It is driven by technology, justified by the pandemic and often supported by its convenience and efficiency.  But this development comes at the expense of loss of spontaneity and independence. Examples are everywhere - I went to the dump today to find I had to pre-book. The system was paramount.  GPs and hospitals have moved from face to face to remote consultations. It is predicted this will continue after the pandemic with perhaps 50-80% of contacts being remote compared with 25% previously. It has its merits – it can be more efficient when a ‘transaction’ is wanted such as a prescription or a test. However it lacks the very underrated human effect of being examined – being touched. There is much healing in the privacy of the consultation with a trusted doctor and I fear we will not realise what has gone until it has gone. You are becoming a sore throat, a breast cancer, a chest infection not a person with a sore throat, breast cancer or chest infection.  We should remember the words of Louis Pasteur, the great French microbiologist, who said ‘The microbe is nothing, the terrain is everything.’  We are not all the same, and we need to be treated and responded to as humans with different conditions, not conditions residing in (irrelevantly) different humans. It will be important that we review what systems are genuinely healthy for our society once the pandemic is over.  It is said that the greatest drug a doctor has is him/herself – and he/she should know the dose, the frequency and the side-effects.  The same is true for technology.

With love

Derek

Institutionalisation

Hi everyone

As the great Michael Jordan famously said on his return to basketball ‘I am back’ though I say this a bit more modestly and I probably won’t be appearing each week!  It’s been a month since I last wrote and much has changed – and stayed the same.

We are coming out step by step – there is nervousness and confusion, holidays are available and then quarantines imposed, people are not sure what is safe and what isn’t and even what the rules are – but we do know masks are on for shopping and much inside activity, outside is pretty safe, and washing hands and social distancing continue. 

But psychologically?  Many of you will have seen my favourite film ‘The Shawshank Redemption (and if you haven’t it’s a must) in which there is a scene where an inmate of the prison for 50 years is released on parole.  Because of his institutionalisation, he cannot cope and commits suicide.  Human beings are highly adaptive and I have been wondering how institutionalised we have become in our own bubbles.  Does this ring true for you?  Moving out has its risks and unpredictabilities – as in changing holiday advice. There is a comfort in not reaching out, a safety in the routine, an ease with a bit of zoom and avoiding those difficult decision-making risk-assessing activities.  However this a deadly comfort because it allows us to let fear rule – even when the incidence of new covid-19 cases is vanishingly small.  (In Wiltshire in the last recorded week there were 18 cases in just under half a million people or fill Wembley stadium and there would be three infected people.)  I say deadly because life is to be found in the moving out - whether it be to have a restaurant meal, take a holiday, travel, or have face to face contact with friends and family.  Without such things we live an impoverished life, a life with less meaning and pleasure.  But it requires effort, emotional as well as rational, to assess these situations and make our own decisions.  It is rather like having been ill and realising as you get better that being cared for in bed is now quite a pleasure and you could linger for a while – though you know in your heart that that way leads to dependence and potentially long term dis-ability.

Sandy and I have been moving out - welcoming guests, having a trip to Cornwall and so on – each time discussing the risks and coming to an agreement – as we move at different paces on this rehabilitation journey.  I urge you, while the sun is shining, the virus is in abeyance and there a lots of outdoor activities to do, to do the same.  It is life enhancing.

Weariness with wariness

Hi everyone

There is a weariness about – a weariness of wariness. The result is people doing their Cummings interpretation to the rules or simply ignoring them - and at the other end others fearfully remaining in lockdown.  The one set of behaviours feeds the other.  Pictures of Bournemouth beach packed with day trippers are alarming (and yet it had a low risk of transmission being outside, in the sun, with a light breeze, and most people bringing their own pieces of beach equipment.  Unfortunately too many then decided to leave them there causing a litter mountain.)

Taking the law into one own’s hands gives a sense of power but it is coupled with a selfish intolerance for others and a throwing out of the ‘we’re all in this together’ that has been such a feature of the pandemic.  One aspect of this is to fail to communicate one’s own recent history of contacts to give future contacts the opportunity to make their own decision about meeting up. When I had the swab test some weeks ago I chose not to tell a neighbour who was coming for a cup of outdoor tea and cake.  This was on the basis I was sure the result would be negative. When she later discovered I had had the test (even with its by then known negative result) she was furious that I had not told her earlier.  She was disempowered and felt deceived. That is exactly the result of what I had done under the guise of ‘not wanting to worry her.’ It was a mistake on my part. Communication is key.

As more and more of the old life opens up, I am wondering whether this is just the beginning of a move back to our focus on ourselves as separate individuals and away from community and our dependence on all around us.  That would be a great disappointment and a huge missed opportunity for a re-visioning of how we live.  

Answers to the quiz.

1.      Can you play tennis doubles outside with people from four different households? Yes

2.      Can you buy a second home? Yes

3.      Can you visit from England a second home in Pembrokeshire? No – travel in Wales limited to five miles

4.      Can you sleep in a second home in England? Not until 4th July nor any other house not your main residence

5.      If you visit a relative living alone, can you sleep over? See 4 – unless you are visiting someone living alone or you are living alone. So Q. 5 – yes.

6.      If you are visiting a house with only a back garden, can you go through the house to get to the garden? Yes

7.      Are public toilets open? Some

8.      Are playgrounds open? Very few

9.      The Premier League has restarted.  How many substitutes can a team now use each match (it was three previously)? Five

10.   If you are a fruit picker coming from the EU, must you be in self isolation for two weeks after arrival? No. 

11.   Can you currently book a holiday abroad? Will travel insurance cover you? Last week yes and no.  This week, yes and yes if the Foreign Office is allowing travel to your destination. 

12.   After the USA and Brazil, which country now has had the highest number of recorded deaths? UK ☹

13.   Which continent is now the epicentre of the pandemic? South America

14.   New Zealand had eliminated covid-19 until two infected women arrived there from abroad earlier this month. From which country did they come? UK ☹

15.   Which football team do I support? Leicester City and they need support now please!

It may be that I shall take a break next week from the blog – this is no. 15! – but I shall be back…..

With love

Derek

Entertaining and entertainments

Entertainments are opening up so time to think about how to manage your personal space with friends and how to spend your time. This week a review of key advice, a quiz and some entertainment pointers.

The track and trace system has become more like trick or treat – and which will come round first this year is anyone’s guess. So where does that leave us?  With no effective system in place, there is a greater danger of a second wave though other countries in general have not seen it as yet and numbers are falling week on week.   On a personal level, as more and more people do a ‘Cummings’ interpretation of the official advice, it is becoming increasingly important to communicate with visitors your last two week history of contact so they can assess their own risks. Otherwise you may put them on the spot or simply put them at a level of risk they would not wish to undertake (and which is different from your own attitude to risk). Meanwhile handwashing and social distancing (plus self isolation of symptomatic individuals and their households) remain cornerstones of containing the infection.

And for choosing what to do and where remember it is the viral load (time spent multiplied by dose being inhaled) that is important – so enjoy outside activities where the risks are minimal and use masks in busy indoor areas.

The quiz – so if you think you are well informed about the current regulations now you can find out:

1.      Can you play tennis doubles outside with people from four different households?

2.      Can you buy a second home?

3.      Can you visit from England a second home in Pembrokeshire?

4.      Can you sleep in a second home in England?

5.      If you visit a relative living alone, can you sleep over?

6.      If you are visiting a house with only a back garden, can you go through the house to get to the garden?

7.      Are public toilets open?

8.      Are playgrounds open?

9.      The Premier League has restarted.  How many substitutes can a team now use each match (it was three previously)?

10.   If you are a fruit picker coming from the EU, must you be in self isolation for two weeks after arrival?

11.   Can you currently book a holiday abroad? Will travel insurance cover you?

12.   After the USA and Brazil, which country now has had the highest number of recorded deaths?

13.   Which continent is now the epicentre of the pandemic?

14.   New Zealand had eliminated covid-19 until two infected women arrived there from abroad earlier this month. From which country did they come?

Entertainment

Highbrow: (thanks to one of our readers)

 ‘We have recently appreciated some virtual art tours and performances from Covent Garden and it may be that some of your readers might enjoy these too. "Cocktails with a Curator" comes from the Frick (frick.org) and is most enjoyable, particularly the Polish rider. There is also "Travels with a Curator" which is almost as good. There is a series of Youtube videos from the V&A in which the Curator talks about the current Kimono Exhibition (accessible by googling kimono@v&a). The Royal Opera House website allows access to a number of their previously recorded live performances and these are also free of charge.’ There are also streams from many centres including the Old Vic, the Met in New York, various orchestras, the Southbank centre etc…

Midbrow:            The Last Dance - about Michael Jordan the basketball player – Netflix series.

State of Happiness – light drama set in Norway – channel 4.

OJ Simpson – Made in America

Leicester city in the premier league

Lowbrow:           The rest of the premier league

Books:  I have just finished reading Hilary Mantel’s third book ‘The Light and the Mirror’ on Henry the Eighth and Thomas Cromwell - having watched some time ago the excellent TV series Wolf Hall.  It’s gripping reading but over 800 pages with a cast of thousands so needs commitment.  Highly recommended nevertheless.

Films – a review of the top ‘comfort movies’ for the pandemic came up with Titanic, The Devil Wears Prada, Waiting to Exhale, It’s complicated, Duck Soup, Notting Hill, The Princess Bride, Galaxy Quest, Paddington 2, The Pursuit of Happyness. Some surprising choices - ??Titanic no. 1 comfort movie

Quiz Q 15. Which football team do I support?

With love

Derek

All change

Hi everyone

Last week I touched on the endemic racism within our society and am grateful for this contribution from a friend which sums it so well – https://www.bbc.co.uk/news/video_and_audio/headlines/52988605/muhammad-ali-why-is-everything-white

This issue has touched a raw nerve and it is going to run.  I hope that we will not be side-tracked by the law and order issues arising from the demonstrations. For the younger generations it feels like a defining cause and they want change. 

One change that is really pleasing to see is allowing those living alone to be able to mix with other households.  Loneliness is so bad for your health and this will have a great positive effect.  I remember years ago a vicar pointing out to me that the only time some people ever touched another human was sharing the peace in church at Sunday services.  We are tactile people, and touching loved ones is such a core human need.

Indeed change is everywhere – there sometimes seems no firm ground to stand on. Joanna Macy in her book on the environment ‘Active Hope’ talks of three narratives – business as usual, the great unravelling, and the great turning.  Whether it be race, transgender, the financial world, the environment, truth, or covid-19 and its yet to be felt economic fallout we are seeing unprecedented change – the great unravelling - and it is deeply unsettling. Every institution and person is affected.  I expect we shall soon see the scientific community being seriously questioned – a perceived bastion of solidity behind which the government has been shielding itself.  Not that the scientists have got it all right by any means with their modelling.   

On a personal note, this week I phoned my GP practice for some routine care.  Now the system is designed to prevent you seeing your GP with IT systems and their algorithms funnelling you elsewhere. So I was asked to go online and complete a questionnaire. The system did not work. I phoned back and spoke to the same receptionist who this time effortlessly gave me a phone appointment.  The GP sanctioned my blood test.  A further phone call, a screening questionnaire, and then a nurse appointment.  For this, I spoke through a window and waited in the rain for an outside door to open.  I can see the headline ‘Retired GP catches pneumonia awaiting blood test at GP surgery.’  (Would that have counted as a covid-19 related death?) Good thing I was not ill.  Lovely nurse with great technique and painless bloodletting.  Each contact with a human was pleasant and supportive, each contact with the ‘system’ the opposite. What a difference from when I was a GP, when the technology was limited, when there was much more personal contact, much more trust.  Another change unsettling for me for sure. The NHS system is such a mixture of being so clunky, so user unfriendly, so administratively inefficient while full of wonderful staff – unless you are really ill when it is characterised by the three Fs.  Efficient, effective, and free. If only we could get the management functions to match the standards of the staff. 

As we witness ‘the great unravelling’ we will need to turn towards Macy’s great awakening which is summed up in a shift of attitude from focussing on who I am to what I am part of.  She says: ‘I think the most important thing we need to hear is the voice inside us which connects us to all beings and to the whole web of life. That is needed now to counteract the crippling of the modern self, which is cruelly contained, as in a prison cell, by the hyper-individualism of the last five centuries.’

I remember Sir Francis Chichester returning from his epic around the world trip and coming ashore.  He could barely stand up so used was he to the ever-shifting movement of the boat.  Then he found his feet again.  Perhaps his journey from a solid base, to endless movement, and back to standing on firm ground again provides hope for us all. 

With love

Derek

Division

Hi everyone

Summer holidays – an important item in many people’s diaries – are still on hold but perhaps not the planning – it is looking like UK holidays will be opening up on 4th July starting with self-catering.  A trip by car and then remaining relatively self-contained is a safe way to go and probably most facilities will be open, at least outdoor ones.  Overseas holidays are more problematic because of the current highly unpopular two weeks self-isolation on return – unless you go to Romania and come back as a fruit picker! I am not sure how widespread the covid-free corridors will become as we are even now the dirty man of Europe with the most cases though no doubt the economics of the tourist industry will have a major part to play in this. 

Three of the main stories this week are the higher risk of people with a BAME (black, asian and minority ethnic) background dying from Covid, the death of George Floyd and the Madeleine McCann developments.  How do we respond to such events?

I found myself saying this week that I do not think I am a racist – arguing that having lived in London for over 30 years with its multicultural society and mixing with people from many different backgrounds and colour it simply was not an issue. And yet having been brought up in a white privileged environment and living in a white dominated society this is unlikely.  There is a gap between what we think and how we respond under pressure.  As an example, albeit not colour related, I remember being in Australia and learning the difference between called a friendly Pommie Bastard and a Bastard Pom during an argument.  My nationality had nothing to do with the situation but a burning resentment came to the fore and I was labelled.  There was nowhere to go with the discussion, leaving a simmering mutual dislike.  I very much doubt my colleague would have considered himself racist, but conscious thoughts are not always aligned with deeper held reactions which become apparent when faced with an ‘in your face’ situation. His visceral emotional life had taken over, and both our capacities for friendliness and rational thinking put on hold. 

There is an argument that race of itself is not a risk factor in Covid but rather it is because of the associated higher incidence of diseases in that group such as hypertension and diabetes. Such an argument often bypasses the next question of why this should be so.  This group is poorer, eating less well, receiving less good care, living in areas with less well-resourced schools.  Is it because as a society we prioritise consciously or unconsciously white people?  It is difficult to imagine that the Madeleine McCann story would be on the front pages after thirteen years had she been from a BAME family.

These events raise the question of how divided we are as a society and what we can do to heal it.  The first step is to acknowledge that because of our background we all carry prejudice, consciously or unconsciously.  The effect of this is to ‘otherise’ people.  When you otherise someone you think they are either your enemy or of no importance.  This thought gives you comfort in making you feel superior and part of a clan. This thought generates adrenaline and cortisol – the fight/flight hormones – which reinforce the thought so when you face your ‘enemy’ you are in fight mode not dialogue mode.   You become aggressive defending your position, which in turn provokes retaliation so both sides escalate their levels of violence. And the divisions widen and are sustained over an extended period. Politicians are very adept at it – once you identify with a political party you accept with less discernment all its policies and begin to see the other parties as the other – the enemy – thereby creating division. Brexit was a classic example as was Trump’s election. He continues to be brilliant at reinforcing division and cementing his electoral base – it’s us against them.  The media is also good at it – it attracts more viewers/readers if what they put out exaggerates a drama – often using clickbaits - because again it tickles our adrenaline as it feeds our prejudices. 

And yet being in this continued state of fear/anger about others is known to be associated with a higher risk of death. It is the same for many of us during the pandemic – a background anxiety/fear/rage about lockdown and the virus.  What can we do?  First we can decide we do not want to continue in this self-destructive state whether it be about the pandemic or about race.  A friend recently said ‘I am not prepared to be fearful.’  Then seek connection with others – by being curious about why perhaps you and they are angry or upset.  If you wish to address or even explore your own racial attitudes reach out to a BAME person or read about people from this group.

It is said that life is made up of 10% what happens and 90% how we respond to it.  We can at least try to address the 90%.

I am thankful for some of these thoughts to a book just published which I recommend if you want to read more about this.  It is by my friend Dr Richard Gillett – ‘It’s a Freakin’ Mess – how to thrive in divisive times’ and it is available on Amazon. 

With love

Derek

Opening up and relating to nature

Hi everyone

I know many of you are curious about whether you have had covid-19 so I thought I would start with  an eye test.

So now you know

The 1st June is upon us and the country is starting to open up – schools, business, shops, sports and while some people are delighted and some fearful, pretty much everyone is fed up one way or another and the extraordinary Cummins saga has really lost the goodwill that Boris had just a few weeks ago. It is beginning to look like a free for all, with people taking their own decisions in the absence of trust and leadership.  It is also looking like an economic freefall in due course which may prove to be even more challenging than the pandemic itself.

So what may now happen?  If the scientists are right with their modelling then we would expect the number of covid19 cases to start rising in a week or so with the number of daily deaths rising in about 17 days.  Unless, and it is a big unless, the new centralised Test and Treat system is effective.  It has not got off to a good start.  Clearly the app used on the Isle of Wight still has its problems and to work it needs 70% of smartphone users to sign on (Singapore reached 40%).  So the system is going to have to rely on symptomatic people testing positive telling contact tracers whom they have been in touch with and for how long.  These contacts will then be phoned and need to be persuaded to self isolate for 14 days.  Even if they are at work, or have children at school who need taking and picking up.  Furthermore the authorities have said they will keep the personal data collected of both the people with a positive test and their contacts for 20 and 5 years respectively.  That does not feel right in such an independently minded nation.  In essence, I doubt the Test and Treat is going to work especially given the last week’s debacle.  So either the scientists are wrong or we are going to have increasing numbers of cases.  And it may well be they are wrong as a number of countries – e.g. Denmark, France, Germany – started opening up three weeks or more ago and have not seen the expected rise in numbers.  In which case not only the government but also the scientific community will have lost credibility and trust.  We shall see.

So looking for an upside the environment has had a good pandemic.  I have just looked at our energy consumption for May and it is the lowest ‘since records began’!   Compared with last year, we used a quarter of the electricity and did a third of the miles.  That is due to the many hours of sun feeding our solar panels and the simpler life which many of us are experiencing.  I am also astonished at the beauty of nature – the colours seem more dramatic, the sky clearer, and I have never been aware of such abundance (notwithstanding the coldest night in May for forty years wiping out much of newly sown vegetables).  Not everyone is as fortunate as us to live in such beautiful surroundings in the countryside – there are many people living without access to green spaces for instance – but at least parks are now open.  Studies have shown how important being in touch with nature is – there was a comparison of patients recovering in hospital after an operation having a bed either with a view of a green park or a brick wall.  The former group went home sooner and used less medication. 

Being in touch with nature is important for us all – it can help create the personal sanctuary where we can find some stillness, a centre if you like, to deal with the fears or impatience or other difficult responses, which many have experienced as being magnified during the pandemic.  It is particularly important now as lock down lifts and we face a whole new set of issues. 

Nature has shown that when left alone to its own devices it flourishes.  It is teaching by example. Will we as a society – will you as an individual – change your behaviour to live a more sustainable life?  Some tribes in the rain forest apparently make decisions based on their effect seven generations later.   That’s a million miles away for the perspective of our industrialised society and a government with a four year electoral cycle and agenda.  I do not hold out much hope that our PM can provide any vision notwithstanding his touching death and life in quick succession.  Wouldn’t that be something to pray for?

With love

Derek

I welcome feedback and do send details of any resources you have found particularly useful.

Making decisions

Hi everyone

Last week I mentioned that I had been using the covid19 symptom tracker app – two questions and you’re done.  Now I see a section has been added on how much have I been isolating over the last week and it suddenly feels to me intrusive and big brother-ish.  I have stopped using it.  My response reflects how much I trust the collection of data and what it is being used for and this stealth like extra demand certainly provokes in me a rebellion.  No discussion, no explanation, no permission sought – just an assumption that my privacy is available.  My sense is many people up and down the country have had enough of lockdown and the removal of their freedoms.  The message has become more blurred – nuanced the government might say.  The NHS has indeed been ‘saved’ – no mean feat by all concerned – and this is praiseworthy.  Hence ‘save the NHS’ is no longer on the slogans. But what are we doing now and why are we doing it?

First there’s a problem with leadership. I notice the leader in the Times on Saturday was titled ‘Where is Boris?’ and goes on to say that people are losing trust in both the policies and the policy makers.  Since then the revelation of Dominic Cummings’ travels and the official response has just fed into this.  The school issue is another good example. A review this week shows that children are about half as likely to catch the virus as adults and they have a mild/non-existent illness (with very few exceptions.)  What is not known is how infectious they are – it would be better just to say that and then have a discussion with all the concerned parties.  People are more likely to behave as adults if treated as adults – and more openness and more presence would be signs of real leadership.

Secondly there is a lack of perspective about risk. We are being asked to limit our freedoms for an unspecified length of time in the knowledge that the virus will be with us until either a vaccine is available or herd immunity is achieved. As someone said to me ‘I like the idea of herd immunity - I just don’t want to be part of the herd!’  As far as I am aware never before have the ‘well’ been asked to give up so much.  This notably includes the young for whom this is a mild illness and who will pay a huge economic price in the future.  Compared with other pandemics (1919 Spanish flu and 1968 Hongkong flu with 200000 and 80000 UK deaths respectively) this pandemic with so far around 36000 excess UK deaths is certainly not top of the list.  If you are considering your risk when out and about, you are probably more worried about people without symptoms who are infectious.  Doing the numbers is difficult, but I reckon that about one in 5000 people are becoming infected daily – or put another way -  taking into account they will be infectious for several days - about one in 700 people are infectious at any one time.  That is a low risk – maybe not accurate but a ball park figure.    

Thirdly there is a lack of perspective about cost. The lockdown was put in place to save lives. Some say 100000 have been saved which I think is probably an excessive estimate not least due to the increased numbers dying earlier from delayed treatments and the knock on effects of the widening of the social divide.  Nevertheless taking that figure the cost per life saved comes out at a whopping £2 million based on a shutdown cost of about £200 billion.  It’s unprecedented.  And to those who say we should not be counting the cost of saving lives I would say it has always been thus.  For instance, the NHS has always had a limited budget which results in some people getting expensive life prolonging care and others not.  Some of our attitudes relate to our unfamiliarity, and hence discomfort, with death and dying – Victorians talked about it a lot and never about sex; we do the reverse.  And inexperience and not talking about it leads us to poor decisions and much fear. 

Given such a current low risk of catching covid, and given the NHS has been shown to be able to cope, I believe the government should continue to open up society to minimise further economic damage with its related deaths and morbidity. At the same time, crucially and equally as importantly, it should be providing us with much more clear and transparent information about risks in different situations – such as going shopping, using public transport, walking with a friend outside, putting a child in school.  Some of these figures would be best guess estimates but they would be really helpful. There are some tough decisions being made – for instance going back to work with higher risks of infection or losing a job. Or putting children into school when living with an elderly relative.  With better information, everyone can make more informed decisions  - for themselves, their family and their community.  All life has an element of risk and we all make choices.  We need the best help we can get – even if it is flawed at times.  Providing this is one aspect of good national leadership.

With love

Derek

Answers to last week’s quiz

1.      Which country in Europe has the highest

a.      number of Coronavirus cases?   (Russia) Spain

b.      has the highest number of Coronavirus related deaths? UK

c.       has the highest death rate (ie per million population) from the pandemic? Belgium

2.      What is the difference between covid-19 and the coronavirus? Covid is the disease, Coronavirus is the type of virus.

3.      What do the letters/numbers of covid-19 stand for? Corona Virus Disease 2019

4.      Which of the following increases your risk of dying from Coronavirus?

a.      Being female – no being a man does

b.      Having diabetes - yes

c.       Drinking 5 pints of corona a day – perhaps indirectly through weight?

d.      Being from an ethnic minority – perhaps – taking other factors into account perhaps not

e.      Travelling by public transport – yes – wear a mask

f.       Being overweight - yes

5.      From which animal is it thought the virus transferred to humans? Probably the pangolin infected by a bat

6.      How many people so far have died worldwide from this pandemic? And in the 1919 flu pandemic? About 350000, compared with in excess of 20 million in 1919 ie 1-2% of that

7.      Where is corona beer made? Mexico

8.      Which animal is in danger in the UK where there are future local outbreaks of infection? The Mole – Boris’ ‘whack a mole’ approach for local outbreaks……perhaps not enough lateral thinking there?

9.      Which of the following safely reduces the spread of infection?

a.      Drinking domestos – no – it’s lethal

b.      Social distancing - yes

c.       Wearing a mask – yes in crowded indoor places

d.      Being outside - yes

e.      Using a 50% alcohol gel – no – minimum 65%

10.   When Carrie said to Boris ‘A no. 10 baby’ and he said ‘I didn’t think it was that many’ were they both right?  How many children does Boris have?  Both right and according to the media Boris now has six children.

A six pack of corona beer to anyone who got question 8 right!

I welcome feedback and do send details of any resources you have found particularly useful.

There is a summary of how to stay safe at https://www.bremzero.com/staying-safe-summary

Facebook page - https://www.facebook.com/groups/bremzero/

If you wish to be unsubscribed from the e mail list please contact me at derek1chase@outlook.com

Next steps

Hi everyone

I have been using the Covid 19 app which tracks symptoms – now with over three and a half million people contributing daily. You are only asked two questions – have you had a covid test and are you feeling normal?  One day I put I had some sinus infection and next day there was a call up for the test.  Surprisingly every time slot that day was available at Bristol airport our nearest testing station.  Very straightforward process but well over two hours in the car for the round trip which you would not want to take if you were feeling unwell.  Ironically I was hoping for a positive result – as not feeling very unwell that would be a great result to get it over with.  However as only one in six tests come back positive, it came back negative as expected.  The result gave me a little boost knowing I was all clear at least for a day or so. It also made the whole pandemic experience a bit more real and grounded.  We now know that only about one in four hundred people are carrying the virus and in Wiltshire fewer than that – to put your risks in perspective as you begin to move out!

Not only is there the issue of how we relate to the risk of covid19, but there is also the issue of what we take from the experience of the lockdown that may inform our going forward. We have seen many positive developments – more community support, more appreciation for others notably key workers, more delight in the simple pleasures – and a recent YouGov survey found that 'only 9% of Brits want the personal and social changes they have seen to return to normal. 85% say they would like them to be permanent. This has led experts to suggest there is a long-term shift in how people perceive food, farming, health and the environment.' What do you want the future to look like? What can you personally do to support that future?  A friend wrote in and said she was busy with three questions - what will she stop doing? what will we start doing? what will she continue doing?

We have established a facebook page to open discussions on this – https://www.facebook.com/groups/bremzero - so do feed in your tuppence worth on this and join the discussion.

Finally this week a bonus corona cwiz:

1.      Which country in Europe has the highest

a.      number of Coronavirus cases?

b.      has the highest number of Coronavirus related deaths?

c.       has the highest death rate (ie per million population) from the pandemic?

2.      What is the difference between covid-19 and the coronavirus?

3.      What do the letters/numbers of covid-19 stand for?

4.      Which of the following increases your risk of dying from Coronavirus?

a.      Being female

b.      Having diabetes

c.       Drinking 5 pints of corona a day

d.      Being from an ethnic minority

e.      Travelling by public transport

f.       Being overweight

5.      From which animal is it thought the virus transferred to humans?

6.      How many people so far have died worldwide from this pandemic? And in the 1919 flu pandemic?

7.      Where is corona beer made?

8.      Which animal is in danger in the UK where there are future local outbreaks of infection?

9.      Which of the following safely reduces the spread of infection?

a.      Drinking domestos

b.      Social distancing

c.       Wearing a mask

d.      Being outside

e.      Using a 50% alcohol gel

10.   When Carrie said to Boris ‘A no. 10 baby’ and he said ‘I didn’t think it was that many’ were they both right?  How many children does Boris have?

Answers next week.

With love

Derek

I welcome feedback and do send details of any resources you have found particularly useful.

There is a summary of how to stay safe at https://www.bremzero.com/staying-safe-summary

Facebook page - https://www.facebook.com/groups/bremzero

If you wish to be unsubscribed from the e mail list please contact me at derek1chase@outlook.com

Moving out

Hi everyone

I start again with a practical tip – if you are more bothered about when you get deliveries than who supplies it you can use the www.shoppingslot.co.uk website which pools times from a number of organisations.  Thank you dear reader for this tip.

We are now moving into more uncertain territory – the lock down rules are changing and each of us will need to be making decisions about what activities are personally acceptable - with whom, when and where.  With (even limited) freedom comes responsibility.  I remember many years ago a patient was transferred from Broadmoor where he had been for some years following a murder.  Their policy is to give their patients no freedom nor choice at all initially – in a padded cell.  With time some choice is introduced - until they have their own room which they could decorate.  Coming to our district psychiatric hospital was another step towards freedom – the ward was locked for the first month and then it was opened.  The question was whether the increasing freedoms – and choices – would be too much for him. (It was – he ran off, was picked up 300 miles away in Scotland and returned to Broadmoor.)

So what can give us confidence that it is safe and desirable to start moving out from our secure ‘stay at home’ last six weeks.  At least three factors are at play – being dutiful or independent, the desire to have contact and the fear of being infected or of infecting others.  The first two factors are probably fairly set so let us look at the fear factor.

We usually act because of underlying emotions (known or unknown) rather than logically.  Positive emotions are great drivers – as in the gratitude seen for health care workers.  However negative emotions, such as fear, especially if intense so that take us over, may not be helpful – indeed they can paralyse us.  The government’s (successful) message for the last six weeks has been based on creating some fear of the virus encouraging people to stay at home.  It worked for me as I now realise how fearful I am of being infected – even though I have a better than 95% chance of survival. Compare this with my decision to not take statins which statistically is riskier.  One decision is thought through, one is driven by emotion.  So as the country opens up, and I need to engage more with the wider world, how can I address this fear? One way is to begin to consider that some situations are extremely low risk while others are to be avoided. 

Let’s get back to basics.  Getting infected.  There are two ways – direct or indirect.  In earlier blogs I have covered the indirect transmission – from people to an object, from the object to your hand then face then into your system. See https://www.bremzero.com/staying-safe-summary 

Now direct transmission is becoming more relevant. This is the spread of disease by the direct inhalation of virus particles that are in the air.  The key understanding is that to become infected you need a certain viral load – and that load arrives through a combination of the rate you breathe in the virus and the length of time you are breathing it in.  An infected sneeze in your face gives you a huge viral load over a very short time while sitting at an adjacent table in a restaurant to an infected person gives you a low load over a longer period.  Both may be sufficient to infect you. Some factors reduce the likely viral load notably good ventilation (air con machines may be turned up in offices) especially outside with its additional benefit of ultraviolet.

So to assess the risk of any situation think of three things:  

1. numbers of people (as we know that infected people shed virus before they get symptoms so each person is a risk),

2. level of ventilation

3. length of contact. 

   On that basis some scenarios are higher risk than others:

              High risk – taking a meal indoors at a restaurant, cinemas, pubs, public transport including flights, some workplaces, some jobs eg bus conductors, working on the checkout, any crowded meeting in small rooms

Low risk – all contacts outside, golf, outdoor meals, supermarkets, jobs in well ventilated offices with few people

Social distancing is particularly helpful for the brief outdoor contacts, and masks particularly helpful for the higher risk situations.

(For more detail on this see https://www.erinbromage.com/post/the-risks-know-them-avoid-them )

By using this sort of risk grading we have a basis for gaining the confidence that we need to move out from lock down and begin to have more contact with friends and family.  The process allows us to note our fears, but not be controlled by them as we take simple graded steps towards a more normal life.

It also explains the government’s approach.  This cannot cover every situation so we will need to use our own authority and common sense.  Although there will continue to be deaths albeit in a reducing rate and although there will be localised outbreaks – give us local contact tracing – we are seeing the end of the beginning. 

With love

Derek

I welcome feedback and do send details of any resources you have found particularly useful.

There is a summary of how to stay safe at https://www.bremzero.com/staying-safe-summary

If you wish to be unsubscribed from the e mail list please contact me at derek1chase@outlook.com