Covid#20 - On the Government's scandalous neglect of frontline workers

I’d planned to write a really upbeat, positive blog-post today about how coronavirus has brought out the good in so many people.  Then I watched last night’s Panorama.

Over one hundred NHS workers have now died from Covid19 and there is no doubt in the minds of some of their colleagues that many may have lived if they’d had the personal protective equipment they needed to protect them.

PPE has been in the news since this emergency began.  Healthcare professionals have been on the news every day questioning the quality and adequacy of the equipment with which they have been provided.  Relatives of those who have died have publicly asked why they weren’t better protected; on the radio this morning, the son of one doctor asked the Health Secretary for an apology.  Fearful carehome managers have been crying out for better supplies.  Carers, nurses and doctors have been making do with flimsy plastic aprons – described by one doctor as suitable only for dinner-ladies – and scrambling to buy their own PPE – or doing the best they can with bin-bags.  Volunteers are making facemasks, gowns and visors for hospitals, medical centres, surgeries and carehomes and seeking charitable donations for the materials they need.  My own school has placed an order from one collective of volunteers; incredibly, it’s suggested that panty-liners are used in the masks as filters. 

Matt Hancock and his cabinet colleagues have told us over and over again that everything in their power is being done to deliver the PPE so desperately needed across the country.  Two weeks ago Hancock launched a new plan for guidance, distribution and future supply of PPE, which emphasised the need to ‘ramp up’ domestic production, and said he would ‘stop at nothing’ to protect those on the frontline and that there was a ‘herculean effort, supported by the military’.  That was the very same day that saw the biggest rise in Covid19 deaths in UK hospitals, by which time nearly 9,000 deaths had been recorded in total.  Horses bolting spring to mind.

Still today, Hancock seeks to reassure an increasingly sceptical and critical public that the Government is on top of the PPE problem.  ‘What we do have is constant focus on the realities of getting PPE to the frontline,’ he said at today’s briefing, adding, ‘we have been moving heaven and earth’ in a ‘mammoth effort’.  His present-tense claims about what is being down now are intended to deflect from questions about what they should have done in the past, yet the questions keep coming and his broken-record answers seem increasingly desperate.  The effort has been herculean, ramped-up and mammoth, but still it isn’t enough; still it was necessary for Boris Johnson to focus on PPE today at his first coronavirus cabinet meeting since returning to work – as if it is a new problem; still the frontline they claim to protect, complains that it’s being neglected. 

Cynical-me thought he couldn’t be shocked by anything revealed on Panorama last night.  I was wrong.  It emerged that stockpiles of PPE have been run down despite that a pandemic has been deemed the greatest threat to Britain for almost a decade.  No hospital gowns or visors were purchased.  Elsewhere, it’s been suggested that our preparedness for a pandemic has been the victim of the Tories’ austerity agenda and the diversion of officials to Brexit planning. 

Most days now, we’re told how many millions of items of PPE have been delivered to the frontline, but in a typically tricksy bit of Government number-work, it turns out this includes such things as cleaning equipment and bin-bags and that gloves are counted singly rather than as pairs.  Ministers hail a total of 1.3 million hospital gowns delivered to the frontline, but hundreds of thousands are needed every day.  In five weeks, a total of 360 gowns were delivered to one NHS Trust, equating to a total of ten per day across the whole Trust; guidance issued at the start of February by the European Centre of Disease Control specified that for the most serious cases of Covid19, around twenty sets of full PPE would be needed per patient, per day.  Having not yet been approached by the Government for supplies, potential PPE manufacturers based in the UK offered their help in March but were ignored so took their orders from other countries instead.  Michael Gove has explained that important safety standards had to be met in the manufacture of essential equipment; meanwhile, doctors and nurses made do with whatever they could find at home!

In March, Covid19 was downgraded from a high consequence infectious disease despite having been designated such just two months previously and being the most dangerous outbreak in a century.  Conveniently for the Government, the conclusions of the Health and Safety Executive for what PPE was required for the worst type of disease could therefore be disregarded and it’s indifference to the advice of the World Health Organisation concerning PPE is seemingly justified.

If a pandemic had been completely unexpected, the Government’s unpreparedness could be understandable.  If its own plans hadn’t specified exactly what we needed and now lack, it may have been able to justify not having it.  If it had sprung into action in January when the threat first emerged or at least a few weeks later when the virus reached Europe, we might now forgive continuing shortages.  As one doctor put it, however, ‘It is unprecedented but it wasn’t unexpected’.  It’s all well and good the Prime Minister prioritising PPE on his return to work, but where was he at the start of this crisis when the Government had the opportunity to hit the ground running and get ahead of the virus and, as The Sunday Times reported, he was absent from all five of the first COBRA meetings?

The Government exhorts us to protect the NHS in order to save lives.  Meanwhile, it fails to protect our doctors and nurses and too many of them are dying.  Today, there was a minute’s silence for key workers who have died during this emergency.  Every Thursday, we’ll applaud the living once again, but as the weeks pass our gratitude for their hard work will be matched with sadness for their colleagues who have succumbed to the virus and anger at the Government’s scandalous neglect of them.

Covid#19 - On feeling inadequate

I sat in the sunny garden this afternoon, reading about King John as background for a History lesson, occasionally throwing a ball for the dog, and pausing from time to time to listen to the birdsong, watch a blackbird peck in the grass for grubs or follow a swooping, chattering swallow over the hedge and across the field.  It was blissful; it was easy to forget about a ravaging virus; and once again, I felt lucky.

I also felt hopelessly inadequate.

The most useful thing I can do to combat the spread of coronavirus is stay at home and follow the social distancing rules.  It protects the NHS and saves lives.  The graphs they show on tv seem to show that longed-for flattening of the curve in the numbers of infections and patients in hospital and a gradual decline in the number of deaths.  759 deaths were reported yesterday, bringing the total in the UK to 18,100.  It looks like the peak was a couple of weeks ago when 980 deaths were recorded on 10 April, which suggests that it took about three weeks for the lockdown to start having an effect.  They reckon that before the lockdown, one infected person passed the virus on to 2.7 others; now the transmission rate may have fallen to below one.  For all it’s the only thing I can do, isolating like this seems to be working.

Just sitting around at home and basking in sunshine makes me feel guilty though.  Sure, I’m working – researching and planning lessons, sending work to the students in my class, checking on their welfare and staying in touch with them – but it’s nothing compared to the efforts of others.  We have a small number of children attending school and a rota of staff working with them each day.  So far, I haven’t been required in school myself so I can’t claim the credit my colleagues across the teaching profession deserve for caring for the children of key workers so they, in turn, can do their essential work, nor for the increased risk to which they put themselves. 

Doctors, nurses, paramedics, hospital staff and carers on the front line selflessly confront the virus every day, caring for the sick and dying, and saving lives.  Volunteers are making visors, sewing scrubs, providing meals and delivering food parcels.  Dustmen, postmen, supermarket staff, bus drivers, police officers … they’re all out there, doing their day-job, working hard, knowing that at any moment, they could have a life-threatening encounter with the virus.  Captain Tom walked his garden and raised £28million for charity and an army of other fundraisers are raising many more millions for NHS charities. Meanwhile, I watch tv, walk the dog, play cards, bake cakes. 

I know that by staying at home, I’m helping to limit the spread of the virus and protect others, but it feels selfish, like I’m just looking after number one, shielding myself.  It’s frustrating not being able to do more while others are doing so much.

I’ve thought about what more I can do, which is why I’ve joined the 2.6 Challenge, walking the Cornish clifftops, not just for my own pleasure and peace-of-mind but for charity and with care home workers in mind.  The £400 I’ve raised so far for Alzheimer’s Society seems paltry next to the millions being raised elsewhere, but it’s something.

I can be thankful for the hard work of others too.  Personally, I can put four names and faces to the frontline workers saving lives: my cousin, Anne is a nurse in Perth, Australia, and in Bournemouth, Adam is a doctor, another Adam is a paramedic and Claire is a nurse.  When I see masked medics on the news, it’s their faces I see behind the visors; when I think about and applaud the heroes of the NHS, I picture them.  Every day, I want each of them to know how much I admire them and how grateful I am for what they’re doing.  I want to send them gifts, buy them a drink, throw them a party, but I can’t, and it wouldn’t be enough anyway; nothing I can do and no words I can write can truly express my admiration and gratitude for them.

I’ve wondered when each of them decided to join their professions, what or who inspired them.  I like to think that for some of our medics and social care workers, their understanding, knowledge, skill, compassion, and the values they demonstrate in their relentless hard work, care for others and the courageous way they tackle the biggest challenges of their career is, in no small part, thanks to good teachers.  Perhaps my friends had great teachers who cared for them, nurtured their interests and ambitions, helped them to learn and achieve their goals and set them on the road to be the heroes of this emergency that they have become.

My friends and all our key workers will be role models for the Covid Generation; maybe one of the children I’ll teach in the coming years will want to be a doctor, nurse or paramedic just like them.  I’ve concluded then that being a teacher might be no small thing, not if I too can nurture ambition in the students I teach and help them to achieve their goals, not if I can help some of them to be the Adams, Claires and Annes of tomorrow.

Covid#18 - Time to do my bit

Four years ago yesterday, my gran died.  She spent her last few months living in a care home with dementia.  Grampy had died four months earlier, just before Christmas, and until then they’d lived together in their own home, largely independently but with support too from family.  I only visited Gran once in the care home – the last time I saw her, a few weeks before she died – and it was funny, poignant and sad.  I was wonderfully lucky that until then, she had still been pretty lucid when I’d seen her, confusing me with my brother at times but still conversational and still good company.  Her condition deteriorated a great deal after Grampy died and when she last saw me, it was as if a thick fog separated us.  I’d baked cakes for her and naively expected her usual enthusiasm for them even though they were decidedly average, but she was suspicious of them and refused to eat one.  She’d spent the night camping in a tent on Dartmoor, she told me, and did I recognise the old man sat opposite us?  She was convinced he was her own father.  Sadly, this time she didn’t know who I was.  Nonetheless, I think she knew I was someone important to her; we held hands and there was a lifetime of recognition in that touch.  In fact, she never let go.

If Gran and Grampy were alive today, she’d be ninety-seven and he’d be ninety-four.  I miss them both, but I’m glad they’re not living through coronavirus.

Were they alive, they may well have been living in a care home, probably among those at highest risk of dying of Covid19.  We would have been desperately anxious for them and the thought of them isolated in a small room, shielded from the virus as best they could be, would have made us desperately sad.  I’ve tried to find words to describe how it would feel not to be able to visit them, have a cuppa with them, reassure and comfort them, and hold their hand; the fear that the inconsequential previous time we’d seen them could be the last time we saw them.  I can’t find the words. 

I’m reminded again of a woman on the television news, trying to talk to her confused father through the window pane of his care home, their hands touching only the cold glass, their kiss on the glazing and the tears she shed when they parted.  There are so many heart-breaking stories like this as we endure this pandemic, and many are worse.  Every day, bereaved family members tell of how a mother, father or grandparent passed away alone in hospital, comforted only by kind nurses; of the awfulness of final words spoken only over a telephone or through an intermediary medic; of grief exacerbated by not being able to give a final kiss or hold hands for one last time.  It’s utterly tragic.

If Gran and Grampy were in a care home now, we’d have enormous admiration and gratitude for the carers looking after them.  Remembering those who cared for Gran, we’d have confidence in their understanding and compassion and know they would do their utmost to stay cheery, setting aside their concerns and fears for their own safety and their own families.  We’d be worried for their safety though and frustrated by the lack of PPE available to them and the lack of testing in care homes.  They’d be our heroes alongside the doctors and nurses of the NHS.

This week ninety-nine year old Captain Tom Moore has captured the nation’s imaginations and hearts by raising £18million (and counting) for NHS charities by walking lengths of his garden.  NHS Charities Together has set a target of £100million to raise altogether; I predict they’ll smash it.  It’s a very worthy cause but it’s also highlighted the plight of the country’s other charities.  It was reported at the end of March that UK charities expected to lose a-third of their income over the next three months – approximately £4billion.  Charity shops have closed and major fundraising events like the London Marathon have been cancelled whilst demand for support from some charities has soared directly as a result of the pandemic.  Many charities have been left fearing for their future.  We’re all reminded of the importance of the work they do and how much, as a society, we rely on them.

I think it’s time to do my bit!  Organisers of mass-participation events like the London Marathon have launched the 2.6 Challenge and it’s a brilliant initiative.  To plug the gap in charitable donations left by coronavirus, the challenge is to raise money by doing something on the 2.6 theme on or from 26 April, which would have been the date of the London Marathon.  I’m setting myself the goal of walking 26,000 steps on 26 April, which – judging from the walks I usually take – will equate to around thirteen miles or a half-marathon.

The money I raise through my JustGiving page (https://www.justgiving.com/fundraising/mrmikeparker) will go to the Alzheimer’s Society, to honour the amazing work of carers at this most challenging of times and in memory of my lovely Gran.   

Covid#17 - Boris' conversion on the road to recovery

I was glad to see the Prime Minister discharged from hospital on Easter Sunday – no more so than for any other patient who has recovered from Covid19, but glad nonetheless.  His personal relief and emotion were clear when he spoke of his illness and treatment at St. Thomas’.  After thanking the medical team that had treated him, singling out nurses Jenny from New Zealand and Luis from Portugal for special praise, he went on to say, ‘Our NHS is the beating heart of our country, the best of our country, unconquerable and powered by love.’

They were powerful words from a powerful man and good to hear but they made me suspicious and I wondered how closely matched his words were to his previous positions.

Most recently, of course, he’s wanted to be seen to be a champion of the NHS, promising it £350million per week once he’d won the Brexit referendum, funding it to the tune of an extra £34billion, pledging to build forty new hospitals and recruit 50,000 nurses, and happily being filmed and photographed with medics on hospital wards as he campaigned for votes in the run-up to last December’s election.  He’d probably rather we forgot his dismissal of photographs of a four year old lying on the floor of an overcrowded hospital.

There are, of course, problems with every one of Boris’ commitments.  £350million wasn’t accurate; £34billion equates to £20.5billion in real terms, adjusted for inflation – the same amount announced by Theresa May in the summer of 2018 – and represents a 2.9% increase according to analysis by the Institute for Fiscal Studies compared to average rises of 3.7% since the NHS was established; forty new hospitals turned out to be funding for six hospitals to upgrade existing buildings; and 50,000 nurses will actually be 31,000 new recruits.

The bigger question though is whether, if they are realised, Boris’ plans will make up for his party’s previous neglect of the NHS.  2.9% increased spending over the next few years sounds good even if it is less than the historic average, but between 2009/10 and 2018/19, during the Tories’ years of austerity, budgets rose by just 1.4% each year on average.  UK health spending per person is now the second lowest in the G7 – way behind France and Germany.  In 2018, when Theresa May announced the increased funding for the NHS, the Health Foundation described it as ‘simply not enough to address the fundamental challenges facing the NHS, or fund essential improvements to services that are flagging’.  Earlier this year, the National Audit Office questioned the financial sustainability of the NHS and warned of an increasing risk of harm to patients.

In the same period, the number of beds in NHS hospitals & other facilities fell by 14,463 or 10% of the total.  The numbers of acute & general medical beds fell by 7,547 despite warnings that bed reductions were unwise given the increased pressure caused by the ageing and growing population.  In 2019, Chief Executive of the NHS, Simon Stevens said the policy had gone too far and that hospital beds had become ‘overly pressurised’ as a result of years of closures. 

By the end of last year, the number of people on hospital waiting lists had risen to nearly five million and one in six people visiting Accident and Emergency Departments in England waited more than four hours to be seen – the highest proportion since 2004.  Essential parts of the NHS in England are experiencing the worst performance against waiting times targets since they were set.  According to the Health Foundation, ‘longer waits are a symptom of more people needing treatment than the NHS has the capacity to deliver.  This reflects a decade of much lower than average funding growth for the NHS and workforce shortages’.

There are now around 40,000 nursing vacancies in the NHS.  Arguably, the reasons for this include Boris’ Brexit.  By December 2019, 8,800 nurses and midwives from EU countries had left while the number joining the register from the EU dropped dramatically.  Additionally, in 2017 the Conservative government cut funding for the nursing and midwifery student bursary, resulting in students facing £9,000 per year tuition fees instead of fully-funded degrees, a decline in the number of applicants, and certain courses having to cease due to poor intake.  In the same year, Boris himself voted against scrapping the 1% cap on pay-rises for nurses.  At the end of last year, itv.com suggested that many point out the lack of a long-term plan for increasing staffing levels.  This probably shouldn’t come as a surprise given the Tories failed to deliver on their 2015 pledge to recruit 5,000 doctors; the intervening period actually saw doctor numbers fall.

In October 2016, the government ran a national pandemic flu exercise, codenamed Exercise Cygnus.   One conclusion reached by then Chief Medical Officer, Sally Davies was that Britain faced the threat of ‘inadequate ventilation’ in a future pandemic.  She was referring to the need for ventilation machines.  According to the New Statesman, the government’s planning for a future pandemic did not change, despite that not one of the three plans published in 2011, 2012 and 2014 mentioned ventilators.  The 2011 preparedness strategy referred to plans for increasing the capacity of critical care services but according to the Sunday Times on 15 March, such planning was non-existent.  ‘Pre-existing pandemic plans never went into the operational detail’, a Downing Street official is quoted as saying.  At about the same time, then Health Secretary, Jeremy Hunt was preoccupied with the first strikes by junior doctors in forty years, after he dismissed their concerns for how his proposed working conditions would directly impact on patient care and safety.

It’s not thanks to the Conservative Party that the NHS is ‘unconquerable’ but Boris himself can’t be held responsible for the failings of his party in government from 2010; he himself only re-joined the House of Commons in 2015 before joining Theresa May’s government in July 2016.  Arguably, however, he was highly influential throughout, yet very quiet when it came to his party’s policies on the NHS.  Moreover, we know from the position he took on the EU withdrawal deal – resigning from May’s government – that when something really matters to Boris, he’s not afraid to stand up for it, even against others in his own party.  It seems then that he approved of his party’s policies; either that or the NHS just didn’t matter to him.

Historically, Johnson has not exactly been an effusive fan of the NHS.  In a 2004 column for The Daily Telegraph, it was not for him unconquerable but ‘unimprovable’ and he has long been a proponent of greater involvement by the private sector in health services, defending Michael Howard’s plans to give NHS patients choice to be referred for private treatment with a portion of the cost covered by the NHS, for example.  In a column for the Spectator Magazine in 2005, he criticised his own party as cowardly for not introducing charges for some health services and in a 2002 speech to the House of Commons, he criticised the ‘monopolistic’ NHS, advocating provision by the private sector.  ‘We need to think about new ways of getting private money into the NHS,’ he wrote in his book ‘Friends, Voters, Countrymen’ in the same year.  It’s a theme he’s returned to regularly with almost ideological fervour.  Given these views, the fears of some that they could lead to a two-tier health service and a diminished NHS could be understandable.

On another issue – that of immigration – Boris told Sky News in December that he would stop EU migrants treating Britain ‘as their own country’.  What, I wonder, did Luis from Portugal make of that?!  Now that he has seen first-hand just what many immigrants contribute to the NHS and now that his own life has been saved by them, perhaps the Prime Minister will rethink his assertion that they have no right to think of this country as their home.

I hope Boris’ apparent conversion on the road to recovery and his new sentiments for the NHS are genuine.  I hope too that he remembers them long after he shakes off the mantle of poster-boy for recovery from this emergency.  You’ll forgive my scepticism though if I have some doubts.

Sources:

The Independent, 9 December 2019: https://www.independent.co.uk/news/uk/home-news/boris-johnson-eu-migrants-immigration-britain-general-election-a9238941.html

The Guardian, 9 February 2020: https://www.theguardian.com/commentisfree/2020/feb/09/the-guardian-view-on-boris-johnsons-nhs-it-needs-more-than-pr

The Guardian, 27 November 2019: https://www.theguardian.com/commentisfree/2019/nov/27/the-guardian-view-on-boris-johnson-and-the-nhs-a-problem-of-trust

Euronews, 11 December 2019: https://www.euronews.com/2019/12/11/the-nhs-has-barely-survived-under-tories-boris-johnson-s-victory-death-death-knell-view

itv.com, 19 December 2019: https://www.itv.com/news/2019-12-19/is-boris-johnson-s-nhs-pledge-as-generous-as-it-sounds/

Business Insider, 7 December 2019: https://www.businessinsider.com/boris-johnson-said-patients-charged-to-use-the-nhs-2019-12

Newshub, 13 April 2020: https://www.newshub.co.nz/home/world/2020/04/opinion-boris-johnson-thanking-the-nhs-for-saving-his-life-has-more-than-a-touch-of-hypocrisy.html

New York Times, 10 December 2019: https://www.nytimes.com/2019/12/10/world/europe/nhs-election-boris-johnson.amp.html

Sky News, 26 November 2019: https://news.sky.com/story/general-election-does-boris-johnsons-nhs-spending-claim-stand-up-to-scrutiny-11860557

New Statesman, 16 March 2020: https://www.newstatesman.com/politics/health/2020/03/government-documents-show-no-planning-ventilators-event-pandemic

The Independent, 28 November 2019: https://www.independent.co.uk/news/uk/politics/boris-johnson-nhs-private-insurance-healthcare-general-election-tories-a9225061.html

The Independent, 10 December 2019: https://www.independent.co.uk/news/uk/politics/brexit-eu-citizens-nhs-crisis-migration-boris-johnson-hospital-health-a9239791.html

Covid#16 - Finding causes for hope

Easter is supposed to be a time for hope.  Yesterday, in his traditional but far-from-normal Urbi et Orbi sermon, The Pope called for a contagion of hope and in her first Easter message, The Queen spoke of lit candles, of how light and life are greater than the darkness of death and grief.  ‘May the living flame of the Easter hope be a steady guide as we face the future,’ she said.

Children’s drawings of rainbows have become the symbol of hope during this pandemic.  So, what causes are there for hope?

First, we can look east to where it all started.  Five days ago in China, seventy-six days after the lockdown began, people were allowed to leave the city of Wuhan for the first time as flights and train services to destinations around China restarted.  The recorded rate of infections has slowed dramatically in recent weeks and nearly a week ago, for the first time since starting to publish daily figures, China reported no new deaths from Covid19.  There have been a handful of deaths since and new cases of infection, but almost all among people arriving in China from abroad.  Restrictions remain too but whilst it’s early days, there is hope that China has turned the corner, that they have the virus under control, that normality will gradually return and that other countries will follow. 

Maybe, just maybe, it’s possible to also look closer to home for a germ of hope.  Yesterday, Italy reported its lowest number of deaths for more than three weeks.  In Spain, the rate of infections has been falling and today the number of deaths reported there was more than one hundred fewer than yesterday.  Prime Minister Pedro Sanchez warned that Spain is ‘far from victory’; nonetheless, some restrictions there are being lifted with people in some sectors returning to work.  In Italy too, a small number of shops and businesses will re-open tomorrow.

All around the world, the personification of hope is a doctor or a nurse.  In Rio de Janeiro yesterday, the statue of Christ the Reedemer was illuminated as a doctor and emblazoned with messages of hope in different languages.  Echoing the feelings of everyone in the country, the Prime Minister left hospital yesterday declaring, ‘Our NHS is the beating heart of our country, the best of our country … and is powered by love.’  The incredible, ceaseless and brave hard work of doctors, nurses and carers is giving us hope.  It’s thanks to them that 434,455 people around the world have recovered from coronavirus.  Our new-found, deep regard for the medics of our NHS and our wider public services is spawning long-term hope for the post-coronavirus world too – that our priorities will have changed and that our world could be better.

Most of us have also found hope in each other.  The response of the vast majority of people to the emergency and the restrictions that have been placed upon us has been at least responsible; at best, we have given up much of our personal interest and discovered a cause far bigger than ourselves; we’re protecting the lives and interests of people we don’t know and wider society in a way cynics among us might have thought had become impossible.  Many of us are doing this just by staying at home and through social distancing but the lengths to which some are going to protect and care for others are inspiring.  750,000 volunteered to go to the aid of the 2.5 million who are most at risk and every day, there are heart-warming stories of people providing others with meals, delivering medicines and simply making each other smile.  Maybe it’s another glimpse of the post-coronavirus world to come – one with a stronger sense of neighbourhood and community and in which we care more for the vulnerable.

A final source of hope is the remarkable effort of scientists around the world to understand this new virus and develop tests, treatments and vaccines.  At least twenty vaccines are in development around the world with the first human trials of one beginning in the USA in March, and in Australia, tests on two others began at the start of this month.  It would normally take one to two years to reach this stage but thanks to extraordinary international cooperation, it’s taken just a few months.  Researchers have hailed the speed and level of global collaboration as unprecedented.  Gary Kobinger, Director of the Infectious Disease Center at Laval University in Quebec, called it unique, adding, ‘It’s not about my vaccine, your vaccine … So many people are getting more optimistic, believing that they can make things happen faster.  I think it’s very promising.’

While we’re still waiting for the peak of our own emergency, it’s easy and probably natural to focus on the suffering, the sick, the dead and the grieving.  Those colourful rainbows in windows across the country though are a reminder of all the good reasons there are to have hope for the end of this emergency and for a bright future.

Covid#15 - Gratitude for the monotony of my days

I don’t think about coronavirus as much as I did a couple of weeks ago. 

I’m lucky to be spending the lockdown in a small village in a remote and beautiful corner of the world.  We’re blessed with glorious weather so I occupy my time walking the clifftops of the Lizard peninsula, exploring new paths and photographing the wildlife.  I’m not ignoring the news, but neither am I obsessively reading or watching it.  I’m a teacher in the middle of the Easter holiday so there’s no pressure of work and my concerns for the summer term and the children in my class and their families can wait a few more days.  When the new term begins, I have what I need to work remotely and will do the best I can.  I miss my friends but we’re in touch via social media and I’m fortunate to have company here – someone with whom to walk, talk, eat, watch tv and play games.  There’s no complacency in this village but there’s little sense of an emergency either.

Thankfully, I haven’t been directly affected by this terrible disease.  Through social media, I know of a handful of people who have been unwell with Covid19 but no-one I know has been hospitalised and no-one I know has died.  It seems impossible that I won’t eventually be personally touched by it, but like all the things we dread most, I’ll try not to think about it until I have to.

It’s impossible to forget about the virus, but in my good fortune and the lockdown rhythm and routine I have created for myself, I am finding consolation and peace.

Nonetheless, I’ve found that my routine includes two points to every day when thoughts of the virus are especially inescapable.

The first is the short-lived and disbelieving moment each morning when I wake as if from a nightmare.  In those blurry, disoriented seconds, I dare to think that none of it is true.  None of it has happened.  The virus, the pandemic, the emergency, the fear, the lockdown, the isolation: they’re all so unimaginable as to only be possible in some darkly imagined dream.  Then, as the personal reality of the new day dawns for me, the brutal truth of Covid19 solidifies once more and I remind myself of my good fortune, resign myself to the restrictions and another day much the same as the last, and I hope I can stay positive.

The other is at the very end of the day, when I find myself alone once again.  It’s then that I feel crushingly sad.  It’s then, surrounded by the literal darkness of night, that I can’t help remembering the impact this emergency is having on others.  Pictures and reports from the television news come back to me: the confused old man in a care home kissing a window – his daughter on the other side; her tears; exhausted nurses holding back their own tears; desperately sick and fearful intensive care patients, struggling to breathe, surrounded by machines; the patient saying what could be a final goodbye to a loved-one before being sedated and ventilated; the bereaved denied their last goodbye, a last kiss, time to hold hands and facing an inconsequential funeral.  When I finally turn to sleep, it’s with relief that I have few ‘alone’ times to dwell on the awfulness of this epidemic and gratitude for the monotony of my days.

As of yesterday, 1.7 million people worldwide have contracted coronavirus and 103,244 have died.  In the UK, 917 people died yesterday bringing the total number of hospital deaths to 9,875.  It’s now thought that the UK will be the worst affected country in Europe.

Covid#14 - Thinking of Boris (and everyone else in hospital tonight)

Anyone who knows me won’t be shocked to read that I am no fan of Boris Johnson!  As of last night, however, the man’s in intensive care after being admitted to hospital in London on Sunday night, and his condition then worsening, and I am thinking of him with nothing other than good wishes.

In the past twenty-four hours, news teams with the BBC and ITV have taken us behind the scenes of intensive care units at hospitals in London and Bournemouth.  We saw desperately sick patients surrounded by trollies of equipment, screens, wires and tubes.  Machines whirred, whistled, pinged and beeped and patients gasped for breath.  Doctors and nurses in their blue gowns, masks and visors worked ceaselessly with professionalism, care and remarkable composure.

‘It’s unimaginable,’ one doctor commented, ‘None of us have ever seen anything like it.’  A nurse described how physically and emotionally draining it is, adding, ‘Some of our staff really can’t cope with it … it’s not uncommon for some to have panic attacks – just finding this so, so stressful.’  Another said she was scared.  Patients themselves told of how taken aback they had been by the severity of their illness, how hard it had been and of how they owed their recovery to the efforts of the medics who had treated and cared for them.  It was a harrowing insight to the struggle to save lives on the front line; yet, undoubtedly, what we saw on our screens barely scratched the surface.

Today, it’s hard to think of Boris Johnson as Prime Minister at all, or as the politician I dislike; today, I can only picture him as a fragile patient in an oxygen mask, probably anxious, possibly scared, surrounded by all that noisy paraphernalia of the intensive care unit.  He’s one of the many thousands of seriously unwell people in this country and around the world, fighting a very personal battle against a deadly virus, with friends and family who are deeply concerned for him.  He’s another victim of this dreadful disease, putting his faith in the hard-working medical team at St. Thomas’.

Last night, I asked a friend if he had heard that Boris had been moved to intensive care.  A short reply came back: ‘It’s sad for everyone going into intensive care with this virus.’  I was embarrassed by my own reaction to the news about the PM; in terms of this pandemic, he’s not special and as he himself would probably remind us all, the virus is indiscriminate.  Why should I be more shocked by his illness than anyone else’s?  Why should I – of all people – care more about him than anyone else?  The outpouring of concern for Boris on social media, the ‘get well soon’ photos, posters, signs and placards, the 8pm clap for Boris – they’ve all made me uncomfortable.  What about all the thousands of other people in intensive care tonight?

Maybe it’s inevitable that Boris now becomes the personification of the fight against Covid19 in the UK.  Once he recovers though, that will only increase the responsibility he bears.

Most of the time, I wish he wasn’t our Prime Minister.  Now though, I only wish him a speedy recovery and return to good health.  Importantly though, my prayers for Boris will be no more nor greater than for everyone else fighting for their lives in hospital.

Covid#13 - What's the plan?

This weekend started with reasonable concerns about how disciplined people would be as the sun shone, temperatures rose and the Easter holidays began.  There were warnings; if we ignored the social distancing rules that have been imposed, the virus would spread, infections would spike, the NHS would be overwhelmed and more people would die.  It seems that most people have stuck to the rules.  Sure, there have been well-televised exceptions, but here in Cornwall, for example, the car parks have remained empty and beauty spots like Kynance Cove and Lizard Point that would normally be rammed on a sunny weekend like this are completely deserted.

It might get harder the longer it lasts but so far, many of us have adapted surprisingly well to our social isolation.  Perhaps because we daren’t contemplate how long this might actually go on, one thing we’re not thinking much about is how it will end.

There are only two ways this can end and social isolation isn’t one of them.

The first is a vaccine but apparently, even if the testing of a vaccine is expedited, it is likely to be more than a year until one would be widely available.  Maintaining a strict lockdown for that long isn’t practical and the impact on us all individually, socially and economically would be disastrous.

The second is ‘herd immunity’.  This social isolation, however, means that we can not build it; apparently, it requires at least 60% of us to contract coronavirus but in doing so, the numbers of people who would become seriously ill would overwhelm our hospitals and Imperial College models suggested that up to a quarter of a million would die.  In suppressing the virus by ordering this lockdown, the Government’s reaction to that suggestion a couple of weeks ago was rapid; when you’re responsible for life-and-death decisions, a number like that is obviously unacceptable.  It’s not just the elderly and vulnerable who are shielded from the virus now, as was the original plan; we all are.  Consequently, there can be no herd immunity. 

At the earliest opportunity when the curve on that day-to-day graph of new infections firstly flattens and then heads back toward zero, this lockdown will have to be lifted.  The virus will not have gone away, however, and without herd immunity or a vaccine, it will likely resurge and we could find ourselves back in lockdown.  And this could become a pattern: lockdown, release, lockdown, release, lockdown, release.  Crucially, the NHS may just be able to cope with waves of infection controlled in this way, but it’s not an ideal solution. 

The long-term strategy must be to build that herd immunity, which will mean carefully managing the spread of the infection.  There will need to be efficient ways for people to report their symptoms when they fall ill, widespread testing, surveillance and support of those who self-isolate and effective contact tracing to identify others who may have been infected.  In China, one of the advantages authorities had was their everyday culture of surveillance and the access it gave them to data from mobile telephones.  Once a person had symptoms of coronavirus, he was able to use his phone to alert the authorities and a test was then arranged.  Remarkably, they were then able to use data from his phone to identify exactly where he had been and with whom he had been in contact.  This meant that if, for example, he had traveled somewhere by bus, the authorities knew exactly which bus he had been on and who else had been on that bus.  The bus was then taken out of service, the people who had been on it were instructed to self-isolate via their mobile phones, tests were arranged and there was further contact tracing.

In our western liberal democracies, we shudder at the thought of such state-intrusion on our lives.  It flies in the face of our freedom but perhaps in these exceptional circumstances, we need to think differently.  And we already are; understanding that our responsibility to wider society outweighs our individual rights, most of us have readily accepted restrictions on the freedoms we usually take for granted.

If, however, we can’t countenance even temporary Chinese-style surveillance, different means of achieving the same ends will have to be implemented.  Either way, we need to hear more from the Government about its long-term plan.

Covid#12 - What would Florence Nightingale make of coronavirus?

The new Nightingale Hospital at ExCeL, London opened yesterday, having been constructed in just a couple of weeks and with eventual capacity for up to four thousand Covid19 patients.  It’s impressive but another grim symbol of the magnitude of this emergency.

Over one million people in 181 countries have now contracted the virus and 53,000 have died.  The USA recorded over a thousand deaths in a day for the first time and looks to be on the brink of a catastrophe.  The PM is still in isolation with a fever and looks dreadful.  684 more people died in the UK yesterday – as my mum keeps commenting, that’s 684 more families.  They include two nurses: Aimee O’Rourke and Areema Nasreen. 

Florence Nightingale was a medic ahead of her time.  While she never saw a pandemic on the scale of Covid19, she certainly witnessed epidemics of cholera, typhus and typhoid in the Crimea, so I wonder what she would make of our twenty-first century response to Coronavirus.

On one hand, she would probably be in awe of the hospital that now bears her name, of the doctors that will save lives there and especially of the nurses.  She would commend the cleanliness, the hygiene, the disinfection.  She would approve of the training, the professionalism and the compassion.  She would be impressed by the attention we pay to washing our hands.  She’d recognise herself in the nurses and her admiration for them would be boundless.

She would also share the widespread concerns about the lack of personal protective equipment for health and care workers.  When Nightingale herself arrived in the Crimea, she was so appalled by the lack of supplies, that one of her first purchases was of towels and she later provided enormous supplies of (amongst other things) clean shirts and soap.  Today it’s masks, visors, gowns and ventilators that are lacking. 

This week, the daughter of a healthcare assistant from London who died from Covid19 blamed his death on the Government’s failure to provide vital protective equipment.  The BMA has called the death of frontline medical staff in Italy ‘an urgent warning’.  With hospital trusts giving up on the Government and striking deals directly with private manufacturers and companies openly asking why the Government has ordered nothing from them despite asking two weeks ago what protective equipment they could make, demand has grown for answers from the Government, together with sufficient PPE.

Nightingale would be fascinated by our advances in Science and especially our capabilities to test for illnesses.  I doubt it would take her long to question why more people are not being tested for Coronavirus.  This week, the Health Secretary, Matt Hancock – fresh out of isolation himself – promised to increase testing to 100,000 a day by the end of April.  There’s a sense of panicked catch-up in his response to some bad headlines: ‘550,000 NHS staff, only 2,000 tested’ screamed Thursday’s Daily Mail.

Criticism mounted as daily coronavirus testing passed 10,000 tests per day in the UK on Thursday – two days later than promised – while Germany tested 50,000 per day.  There’s suspicion that this is a legacy of the Government’s dismissal of the need for widespread testing when the pandemic first took hold here, despite the World Health Organisation’s insistence that it was critical to slowing the spread.  There’s also scepticism about Hancock’s promise to increase testing ten-fold in a few weeks.  There are issues about lab capacity to process tests, although the Government now says it will use private companies in addition to NHS labs.  Like many of us, Florence would roll her eyes and ask why they didn’t do so sooner.  Worldwide demand for the specific reagents needed for the tests far outstrips demand.  South Korea and Germany apparently started out with greater capacity for testing – South Korea has huge virology labs following the SARS epidemic of 2003 and Germany has long been a global testing base – but both acted faster than the UK Government, which has only just called on GlaxoSmithKline and AstraZeneca to make the required reagents.  Even now, a Health Department spokesperson has clarified that the promise is to have 100,000 tests available by the end of the month, not necessarily to carry them out.  I can imagine Florence’s exasperation.

More than one person has suggested that Johnson and Hancock might do better to promise less and deliver more, but Boris does like his numbers, which more often than not need some clarifying - £350 million per week for the NHS; 50,000 new nurses; 20,000 new police officers.  Some skilled political bluster and a good slogan might deal with questions about those figures; that won’t work when the numbers of infected and dead doctors and nurses rise.

Describing Scutari Hospital in January 1855, Assistant Surgeon Henry Bellew wrote, ‘There has been somewhat unaccountable neglect in the arrangements for this hospital.’  Today’s Government tells us, ‘Stay at home.  Protect the NHS.  Save lives.’  Fears are rising, however, that the Government itself might not have done all it should to protect our doctors and nurses.  Florence Nightingale would mourn the tragic passing of Aimee O’Rourke and Areema Nasreen.  With the advances in science and medicine that have been made since the nineteenth century and the resources available now that she herself could never have drawn upon, she would also be scandalised by modern-day unaccountable neglect.