From David Maughan Brown in York: May Day

Route to handy vaccination centre

May 1st

May Day.  Variously, and somewhat contradictorily, regarded by some people as a celebration of the fertility and fecundity of Spring, deriving in part from the Roman festival of the flowers, Floralia, and by others as marking the transition from Spring into Summer.   The day the cows could safely be put out to pasture because the winter was finally over.   Given that the April just passed has been the first on record to boast a damaging frost every single night of the month somewhere in the UK (in our case an allotment on Low Moor in York), the farmers may be getting cold feet on that score.  If they don’t, the cows certainly will as another frost is predicted for tonight.   There won’t be too many people dancing around May-poles today:  a 5,000- strong maskless rave in a very large tent has been scheduled as a government-sponsored Covid-19 infection trial, but there won’t be room for May poles.

The particular significance of the date for me is that it is now exactly three weeks since my second Covid-19 vaccination, so I am technically about 90% safe from being infected, give or take any of the global variants busily developing around the world in an effort to thwart that statistic as the pandemic rages on.  But I wouldn’t be dancing around a May pole even if there were one in the back garden.   Being vaccinated isn’t going to make much difference to the way I live my life for some time to come.  Nor was the vaccination experience itself a particularly celebratory occasion.

When I had my first vaccination I was given two different dates for the second one: Easter Sunday, 11 weeks after the first one, or the Saturday after that.  When I hadn’t received any formal notification reminding me about the second one by Good Friday, I set about trying to establish which was the correct date.  A long story later I was directed to a website which told me brusquely and entirely erroneously, with a disapproving virtual finger wagging in my direction, that I had missed the date for my second one already and needed to book another one.  It then offered me a generous array of vaccination sites to choose from, which didn’t include the York vaccination centre three miles away.  Distances, I am helpfully told, are measured in a straight line; roads in the UK tend to have the odd bend here and there.  The closest was the Rimmington Pharmacy in Bradford, said to be 29.8 miles away, which I assume must be owned by a Tory friend of one or another Tory MP or cabinet minister in Westminster.  If I didn’t fancy Bradford, there was an option in Hull 33.2 miles away, and one in Darlington 42.7 miles away.   Perusing the list, I was torn between the attractions of the one in Bishop Auckland (54.5 miles away) helpfully ‘located in-between care home and GP surgery’ and the one on Cemetery Road in Darwen, 59.5 miles away – in fact 73.7 miles away by the shortest route if one doesn’t happen to be a bird – but I decided I should enquire further.

Another long story later, the Saturday date was confirmed and I set off for my 9.00am appointment needing to get back home to chair the monthly u3a Saturday morning meeting by 10.15.  When I got to the front of the queue I was mysteriously, but full of misplaced optimism, directed to much the shorter of the two subsidiary queues of eager punters waiting to be summoned to a booth.  In spite of being much the shorter queue, ours was static:  when a dozen or so people had been called from the other queue, with no movement at all from ours, it became apparent that I had been told to come on a Pfizer day for my AstraZeneca injection.   Nine out of the ten booths were offering the Pfizer ones, the tenth appeared to be having difficulty with a patient who must, to judge by the time being taken, have been trypanophobic.   Soothing organ music in a mediaeval cathedral might have helped better with the stress levels than a noisy tent in a carpark, but I did eventually manage to get back in time to log in and chair the meeting.  So not particularly celebratory.

Yesterday an NHS envelope arrived inviting my 42 year-old son in Cape Town to make an appointment for his first vaccination.  I forwarded a photograph of it to him and invited him to drop in for tea on his way.   In the meantime my 44 year-old elder son received a similar letter in York a few days ago and has been trying unsuccessfully to take its advice and book a vaccination.   So far the nearest vaccination centre he has been offered is in Wakefield (32.4 miles away) – presumably at a Tory-owned pharmacy somewhere near a crematorium.   It would seem the vaccine is in relatively short supply and that the York centre is fully occupied trying to inject second vaccinations into the arms of older cohorts.  So why the rush to invite younger and younger groups of people to try their luck booking vaccinations when they are very hard to come by – the required age dropping a year or two every day or two?  The answer is painfully obvious:  there are local elections in a few days time and our cerebrally challenged electorate has somehow allowed itself to be persuaded that the success of the vaccination programme can be attributed to the government rather than the NHS.   It wasn’t the NHS that generously and in all seriousness offered me a vaccination in Darwen, 73.7 miles away.

From Brenda in Hove: Give a Little, Get a Lot

3 February

Four days ago I had the AstraZeneca vaccine. I didn’t hesitate one second when I got the text from our medical practice and booked the first available (day-time) appointment in two days’ time. The Brighton Race Course is not a place one would associate with medical activity (except maybe heart attacks) but there it is, fitted out with desks and cubicles and an ‘observation area’ where you are required to sit for 15 minutes after the jab.

The parking arrangements are not immediately obvious nor is the one-way system of getting people into the ‘production lines’ and the howling wind and rain didn’t help. We didn’t go up the right road the first time but I was anxious to not be late so my husband dropped me and I squeezed myself around a gate and through an unavoidable puddle and ran the last 100 metres. There were people directing you at every junction – even outside.

When I clocked in I asked the woman at the desk if she was a volunteer. “Oh, we all are, dear! Every single person here.” So mostly because I wanted to thank people who were giving their time like this but also because I was interested – and sure enough, every one told me they were volunteering. Doctors, nurses, secretaries, every kind of person taking on even the most menial tasks. Not much fun standing outside in that foul weather and directing people, not much fun scrubbing down the seats and tables, not much fun filling in the same forms over and over again, not much fun plunging needle after needle into arm after arm – yet every single one said things like “what else could I be doing that is more important?” or “the least I can do” or “much more cheerful here than stuck at home by myself” or “there is such a good spirit here that I enjoy it all very much” (nurse who works full-time at our practice and has a family but still gives two of her three days off to this exercise) or “best thing I could do with my days off” (doctor). As of today 10 million people have been vaccinated in the UK and counting. Extraordinary.

When my husband found a parking place he was worried as to how he would find me and  asked one of the parking attendants. She said not to worry because there was a one way system and he couldn’t miss me in the observation area. And so it came to be. When we were leaving James leaned out of the window to thank her for her help and she said “I am sorry to see you found your wife!” Hilarious laughter followed – even from me – but I couldn’t help wondering what he had told her. He is not to be drawn!

The last few days since the vaccine have not been easy. 24 hours after the jab I felt as if lead had been injected into my limbs. I could hardly move and felt dizzy and nauseous. As if that were not enough, I cannot sleep. The doctor tells me it will wear off in a week.

Then I will see if I can volunteer myself to do something useful in this national endeavour. Inside the building – not outside.

From John in Brighton: The Last Post

31 December.

As this annus horribilis draws to a close so too by definition does the Covid 2020 diary and unless the pandemic shows a major change of course I anticipate this being my final contribution. Covid is ubiquitous and we have all been profoundly affected in different ways and have varied memories of the year. Herewith a few of mine.

The bellwether tinkled in early February and arguably the country’s first case was a businessman from my patch in Hove who acquired the virus in Singapore and transiently it felt good – our local NHS was praised for their handling of the case. Positive feedback to my erstwhile colleagues and hopefully that’s the end of it I thought…..if only. 

The pandemic has brought the very best out of people as communities and individuals have gone out of their way to provide food and money to those in need. To counteract the misery of loneliness strangers would befriend or shop for the isolated and vulnerable. And it was fascinating to me to see how factories and businesses could change course – aerospace producers transmogrified overnight to deliver face masks and booze distillers poured out bottles of hand sanitiser. Boris Johnson chose VE day in May to summon “wartime spirit” and the country responded in spades. And it was a WW2 survivor Captain Tom – sorry Sir Captain – who stole the limelight marching with his walking frame to raise money for the NHS. Target one grand, result £33 million which is quite incredible – an unprecedented response to an individual fundraiser I’d suggest. Wish I’d thought of that – he’s got Christmas in Barbados and Route 66 next!

But sadly the less positive side of human nature also declared itself. The selfishness that is panic-buying from paracetamol to toilet rolls to food and the powerful clip of exhausted and tearful intensive care nurse Dawn Bilborough has stayed with me and may have concentrated a few minds.  Back in March she ended her shift with a visit for food at her local supermarket only to find the shelves matched Old Mother Hubbard’s cupboard. Then more recently are reports of fraudulent workers claiming furlough payments despite being active in employment we can but hope that there’s the odd new year shock as HMRC attempt to track the culprits. 

Thursday evenings, noted for Top of the Pops in my youth and more recently Question Time, became Clap for the NHS night. Covid shines a light on the amazing dedication and skills that are sometimes taken for granted but perhaps will be acknowledged a little more henceforth. But equally we saw how another band of dedicated workers went the extra mile or more in care homes up and down the land even to the point of leaving their families for days on end to minimise the risk to residents. A flurry of deaths at the care home just round the corner from me hit the TV news and such a stark reminder helps to focus safety measures. Seriously underappreciated and underpaid let’s hope that this skilled and caring group will now receive the recognition and reward that they deserve. Call me cynical but I fear not.

No government in living memory has had to confront a pandemic such as this and deserve some slack …. but nevertheless there must be questions asked over some of the decisions. I could double the length of the blog but instead will select my cardinal cock-up – cronyism. The flaw in Michael Gove denouncing experts was clear to see in appointing party donor Baroness Dido Harding to lead Test and Trace when she has no background in healthcare whilst there are public health doctors up and down the land chasing infections, contacts and advising on management. And we wonder why it was a shambles? Not only was T&T key to cutting infections and deaths but the ensuing imbroglio served to further undermine public confidence.

In amongst the doom and gloom were sporadic moments that made me smile. The cartoonist’s gift horse with Dominic Cummings mistaking Barnard Castle for Specsavers and more specifically watching him squirm as he sat in the Rose Garden trying to exonerate himself – in most peoples’ eyes unsuccessfully. Just this morning I added a coda to my giggles hearing that Dom was invited to turn on the Barnard Castle Christmas lights …..but declined. Then there was the occasion Andrew Marr interviewed Oxford vaccine pundit Sarah Gilbert and concluded “professors give you such clear answers” which in reality applies to most scientists and medics – a snigger as I contrasted the evasive, duplicitous bluster that he gets from many politicians who ultimately have command control but not the responsibility of front-line workers in all the public services. Then there was Matt Hancock suggesting that Premiership footballers should donate from their inflated salaries – which many did incidentally – but his pleas paled against Marcus Rashford’s campaign to feed children adequately which triggered one of the Government’s many U-turns. Probably the side-splitter was Donald Trump proposing we inject bleach and especially the look on the medic’s face as Trump turned to him for support.

Word and paradox of the year? For the former mine would be unprecedented which we’d hear often several times each day as the pandemic gripped the World. And the latter is all but a double-paradox – prior to last year the question was whether, despite our potentially being more connected than ever, we were in reality feeling more isolated. Two key factors are families moving geographically further apart and increasing use of social media to communicate as opposed to face-to-face meeting. But this year where would we have been without Zoom and Face Time?  My lips are coated in the crumbs of humble pie as I acknowledge that social media and technology have their merits. And online bridge (along with the bicycle) has been a mainstay of preserving sanity as a shielder in my personal Colditz with the offspring ensuring strict adherence.

Is there any silver lining to the pandemic? If we seek it out and act then I’d suggest yes. To borrow a bit of football VAR demotic then there is one that is “clear and obvious”. The good deeds and community spirit was heart-warming – not the royalty, rich and famous but of Tom, Dick and Harry and their female counterparts. Hopefully this can be sustained. A second is more subtle and refers to the relationship between the human species and the rest of the animal kingdom. There is strong evidence that the corona virus of Covid was acquired from an animal with bats the top suspect and possibly via an intermediary host. Other serious virus infections have been acquired from animals – HIV probably from chimpanzees as bushmeat in Africa, Ebola possibly in the same way and for SARS the virus (another corona) was also possibly from bats. The Covid variant may more specifically have entered humans via the wet markets in Wuhan. Spending more time out of doors we learnt to enjoy the natural world much more but equally we need to respect it – reviewing the way we farm, manage and market our animals may prevent a new virus in the future. Conflate this with addressing global warming and our descendants will be forever grateful. 

As far as I recall I didn’t personally know any of the 72,548 UK deaths due to Covid but that doesn’t preclude a feeling of sorrow for they and their families. May they find peace in the sweet bye and bye. But someone very close to me died at the end of November and the collateral damage of Covid has been acutely felt as there was very little opportunity for close interpersonal contact over the last year which is when most needed as a terminal illness insidiously progresses. Having lost a hard-fought battle it seems apt, despite the absence of a military link, to dedicate this Last Post to Chris…

Ending on a positive note approval for the Oxford vaccine is announced this morning. Let’s hope for annus mirabillis in 2021. It surely can’t be any worse…. lingering virus, Brexit, can it?

If this does prove to be my final waffle then let me thank Brenda and Anne for the opportunity to share some thoughts and occasionally vent my spleen. 

From David Maughan Brown in York: It’s all in the stars.

December 23rd

Manston Airport in Kent: 22/12/20

‘It’s all in the stars’ – or, more accurately, to be a bit of a killjoy, in the planets.  A Grand Conjunction only happens once every 800 years so it must, of course, be redolent of cosmic significance, and Jupiter and Saturn chose to align for our benefit at the winter solstice in 2020.  What could be more significant than that?  Given what 2020 has dished out to everyone, astrological significance should come as no surprise, but when it comes to comprehensive interpretation one has to rely on the wisdom of astrologers.  What better authority to call on to tell us what it all means than the Daily Telegraph’s tame astrologer Carolyne (sic) Faulkner who informs the world that this conjunction is occurring in Aquarius, which is an air sign, and that all other conjunctions for the next 200 years will be occurring in air signs.  She goes on to say that whereas “Earth energy triggers people to become more grounded, practical, sensible; to have respect for politicians and institutions. Air energy triggers cerebral, less tangible happenings.”

I’m glad she told us that.  If we had been told that it was Earth energy that was holding sway over us we would have had to conclude that the energy, like that of the pink mechanical rabbit in the battery advertisement, was grinding to an arthritic halt.  There is very little that is grounded, practical or sensible in the way we are being governed, and respect for politicians, and many institutions – the NHS being a notable exception – dribbled away long ago.   On the other hand, if air energy ‘triggers cerebral less tangible happenings’ that explains why our entire economic and societal future is currently caught up in an ideological wind-storm with no tangible benefits whatever in prospect.  To take the latest example of the utterly delusional cerebral forces determining our future (giving the benefit of any doubt that anything resembling a brain is involved), one only has to cite our representative Home Secretary, the inimitable Priti Patel: ‘The government has consistently, throughout this year, been ahead of the curve in terms of proactive measures.’  She then went on to correct Boris Johnson’s absurd claim that only 170 HGV’s were queuing in Kent, by claiming the number was 1500, in itself a serious underestimate (today there are said to be 5000- 8000), and then pointing out that the number was constantly fluctuating as “lorries are not static”.  Tell that to the drivers of the seemingly motionless lorries ‘stacked’ on Manston airfield in the photograph above.   She might also like to tell them where they are supposed to find food, water and loos – never mind somewhere to sleep – for the three or four non-‘static’ days they are having to spend in Kent before being forced to be away from their children for Christmas.

The Grand Conjunction, symbolically hidden from the view of most of the UK by impenetrable clouds, should probably be taken as nothing more esoteric than a stark cosmic warning – a preview projected in the stars – of the much less grand, but probably equally far reaching, conjunction of Covid19 and Brexit.  The French government, understandably panicked by our callow Secretary of State for Health, Matt Hancock’s, ill-judged statement that the new variant of the virus was ‘out of control’, promptly closed their borders to all people coming from UK, and every single state in the EU, apart from Greece and Cyprus which are retaining strict quarantine regulations, immediately followed suit.  Many other countries around the world have now done the same.  So our proudly independent and sovereign little island nation is completely cut off; nobody wants us anywhere near.  Our rabidly jingoistic tabloid press promptly and predictably erupted with age-old Francophobic fury, accusing President Macron of playing politics.  Guy Verhofstadt, the Belgian politician, reflecting on the current chaos and probably on the empty supermarket shelves to come, commented that the British people “will now start to understand what leaving the EU really means….”  Matt Hancock, gaze fixed firmly on the national navel, and unable to see beyond the white cliffs of Dover, had been intending his comment to persuade those living on his little island to abide by their Tier restrictions, oblivious to the fact that the rest of the world was bound to be listening.  Those trying to argue that lorry drivers don’t pose any risk of transmitting the virus because they spend their time ‘alone in their cabs’, and should have been allowed to cross back to France, have the same problem with national navel-gazing: they would appear not to have heard that HIV/AIDS research in South Africa has demonstrated very clearly that the spread of HIV/AIDS in Southern Africa can be traced along the routes taken by long-distance truck drivers ‘alone in their cabs’.

The timing of the Grand Conjunction so close to Christmas 2020 has reawakened discussion of the theory that the star of Bethlehem in the story of the nativity could have originated with the conjunction of Jupiter with Venus (rather than Saturn) in 2BC. For those inclined to read messages into astronomical events, there might be a message there for our nationalistic ‘Christian’ xenophobes as they ponder the Nativity story in their unsung Christmas church services.   Perhaps the writing in the stars might be inviting them to compare the fates of two families, and two very young children in particular.   On the one hand, 15-month-old baby Artin who drowned in the English Channel in 2020, along with his parents, Rasoul and Shiva, his nine-year-old sister Anita, and his six-year-old brother Armin, after the family had fled from the violence in the near East, travelling from Iran to Turkey, Italy and France before having to try to cross the channel in a small boat because Priti Patel had closed off all legal and safe ways to get here under the pretext of Covid.  On the other hand, Jesus of Nazareth, whose parents had also had to flee violence in the near East, but who found refuge in a non-Christian country that was happy to provide refuge to asylum seekers long before there were international agreements requiring countries to do so.

It’s all in the stars – if one only knew how to interpret them.

From David Maughan Brown in York: Collateral Damage Part 2

September 1st

Any regular readers who had the stamina to soldier on to the end of my last entry might have been left with the uneasy feeling that that might not be the end of the non-coronavirus testing saga, and that they might find themselves subjected to a further chapter in the not too distant future.  If so, their apprehension is about to prove well-founded, probably a lot sooner sooner than they might have feared.

Having been told to anticipate that the results of last week’s hard-won test would be available in a mere five days time, I received an SMS yesterday evening announcing their receipt a day ahead of schedule.  Verily I say unto you, a truly world-beating testing regime – even if it isn’t for Covid-19.    The SMS said: ‘The result of your recent test has been received.  A further test is advised – please collect a form from the surgery at your convenience.’  No three-minute phone-call to say that the result had been received, and not to worry but they thought it would be helpful for me to have another test, or something similar.   Just a bald SMS giving no indication as to who it ‘is advised’ by, or for what reason.  One could only assume that whatever the test had showed up couldn’t be too serious because the style of communication suggested that if, for example, the test had revealed a third-stage brain tumour, the SMS message would have read something like, ‘The result of your recent test has been received, the purchase of a coffin is advised’ or, perhaps more humanely, ‘investment in a funeral plan is advised.’   ‘At your convenience’ rang a little hollow, given that last week’s saga was initiated by the receipt of an electronic form for me to print that didn’t require me, in a Covid-ridden world, to drive in and collect a hard-copy from the surgery.

So, at my inconvenience, I drove into the surgery first thing this morning, idly  wondering whether the NHS might not be on a secret mission to stack up the mileage so that petrol sales could contribute towards life-support for the economy.  I arrived at the surgery half an hour after it was supposed to have opened to find the front door locked and no sign of life whatever, although there were a couple of cars in the reserved parking spaces.  There was no sign on the door indicating opening hours and, as with last week’s surgery, the NHS had not been able to afford the installation of the promised bell to ring.  I checked that my mobile was still boldly declaring the surgery to be OPEN, which appeared to be an outright lie directly out of the Johnson playbook.  So I waited for ten minutes hoping somebody would come, and then steeled myself to try the surgery’s telephone number, which of all the telephone numbers I have ever phoned is the one guaranteed to ensure the most rapid loss of a caller’s will to live.   An asset for an undertaker but not, one might have thought, for a Medical Group.  When the interminable advice about Covid-19, which I must have heard thirty times over the past few weeks, had dragged itself to an end, I opted for the ‘Reception queries’ number and after a miraculously short two or three minutes got a real living person on the end of the line, which seemed a good start.  It didn’t last. I asked whether the surgery, which claimed to be open, was in fact open, the operator said she didn’t know (which seemed odd, given that the number I had phoned was ostensibly the number of the surgery outside whose very front door I was at that moment standing) but she would find out for me, and asked me to hang on for a minute, at which point the phone went dead.  I tried to phone her back after a few minutes, only to be told that the ‘Reception query’ number was now closed and that I should try again in two hours time.  Kafka came to mind again.

After another ten minutes of waiting, I decided that there couldn’t be any harm in banging on the door – it looked strong enough to withstand the force of any pent-up frustration the exercise might release.   Sure enough, a little bit of sustained, but commendably restrained, knocking dragged an extremely surly receptionist out of the bowels of the building, clearly deeply resentful of being interrupted doing whatever it is that receptionists do when doors are locked to ensure that there isn’t anybody to receive.   ‘Do you have an appointment?’ she shouted through the door.  ‘No,’ I replied, at which point she turned around to walk back to whatever it was she had been doing. ‘I was told to come here and pick up a form “at my convenience”,’ I added hastily.  The weight of irony I injected into the last three words passed her by entirely.  She demanded to know my name, date of birth etc. and went off to check whether I was lying.   When it turned out that I wasn’t just a stray passer-by who had nothing better to do than waste her time telling lies and pretending to want a blood-test form, she grudgingly opened a folder that had been lying just inside the door all along, waiting for me and others like me, handed me the form and told me to go to the infamous Nuffield Hospital, scene of last week’s tribulations.   I told her what had happened last week, and asked for an appointment at one of the Group’s clinics.   She couldn’t give me an appointment, that wasn’t her job, I would just have to go to the Nuffield Hospital, which she assured me had reopened for tests, and have the test done there.

Wearily resigned to my fate, I headed back to my car to try my luck at the Nuffield again.  As I got into the car my phone rang and the original receptionist I had managed to contact apologised profusely that I had been cut off.  I thanked her and told her I was on my way to the Nuffield Hospital for the blood-test.   ‘Oh no, you don’t want to go there,’ she said hastily. ‘They are only doing emergency blood tests there now.’ ‘Wouldn’t having to have a retest count as an emergency?’ I asked.  ‘No, I don’t think so,’ she said.  ‘I think you would be in the queue for a very long time on the day after a public holiday, and when you got to the front of the queue they would probably say yours wasn’t an emergency.  But, in any case, I’ve managed to get them to fit you in for a test at the Water Lane clinic tomorrow, if you would like that.’  I assured her that I would like that very much indeed, and thanked her profusely for her kindness.  There was no need for her to have done that for me, and her thoughtfulness went much further than she could have imagined to ease the frustration. But, dear reader (as the rather quaint saying goes), don’t bank on this being the last chapter of this particular saga.

There was a time not so long ago, before the blindly ideological drive for ‘austerity’, and the viciously xenophobic immigration policies of the past decade of Tory government put unsustainable pressure on GP practices, when I would have been phoned with my results by my GP, told what they meant and invited in for a blood-test on the same day.  Sadly, those days are gone, and will almost certainly never return.  

From David Maughan Brown in York: Investing in a whelk stall?

August 16th

In the unlikely event of future political scientists or historians perusing this diary in future years, they might, depending on their political leanings, be inclined to start making deductions about the effect of lockdown on the mental health of those who have been locked down.  Her Majesty’s Government, duly elected by a mature electorate to grace the illustrious benches of the Palace of Westminster, the Mother of Parliaments, in December 2019 couldn’t possibly have been as utterly hopeless as diarists have tried to make out.  The grumpy carping must have been an irrationally resentful response on the part of mentally fragile people, who happened to have nothing better to do than write diaries, to the wholly rational decision on the part of government to lock them down for their own good.  The tempting alternative would have been to allow a ‘herd immunity’ strategy to sort them out and save billions on state pensions at the same time.  You can never please some people.

A rapid run-through of a random day’s coverage of ‘Home’ news, in this instance yesterday’s, August 15th, by the Independent, a broadly liberal and by no stretch of the imagination radically leftist newspaper (not that ‘paper’ has much to do with an exclusively digital compilation of news-reporting and commentary) might give the historians pause to reconsider that diagnosis.   With the exception of a nod in the direction of VJ-Day, a story about a man who nearly lost a leg as a result of being bitten by a ‘false widow’ spider, and an article on the implications for the Arts of a premature termination of the current furlough arrangements for employees, the rest of the coverage focuses entirely on four issues:  the quarantine regulations, in relation to France in particular; the government’s handling of various NHS related issues; the A-Level debacle; and the on-going situation with cross-channel migrants.  I’ve written about these individually (in some instances several times), but the cumulative impact when they are all extensively covered on the same day is impressive.

The photograph on the front page is of the queues of people at the airport at Nice trying desperately to get a flight back to UK in time for them to arrive before the magic 4am deadline.  The editorial takes this as its topic for the day, suggesting very mildly that, given the implications of 14 days of quarantine, a collective shrug on the part of government and ‘Well, you knew the risks when you went’, isn’t good enough. It goes on to suggest that 30 hours notice of a deadline, generally poor communication, and weak quarantine enforcement, in a context in which the Cummings episode shows that the rules apply to some but not others, aren’t conducive to public confidence or compliance.  For my own part, the 4.00am Saturday deadline left me wondering which particular bit of science the government was following that dictated that anyone who set foot back on British soil at 3.59am was bound to be Covid-free, but anyone who did so at 4.01am needed to go into quarantine for 14 days to protect the rest of us.

Where the NHS is concerned the reports focus on the government’s declared intention to keep the outcomes of inquiries into the Covid-related deaths of 620 health and care workers secret; the recall from NHS hospitals of 200,000 defective gowns, following closely on the heels of the recall of the 50 million defective face masks; and the quiet removal of 1.3 million tests from the running total of coronavirus tests nationally as a tacit admission of double-counting.

The on-going debacle over the A-level ‘results’ was covered in four separate articles, one of which predicted similar levels of chaos when the GCSE ‘results’, based on the same algorithm are released this coming week.   It is anticipated that up to 2 million results are likely to be downgraded, with the examining bodies already swamped by appeals against the A-level outcomes.  As one commentator put it in relation to the A-levels: ‘Unless Gavin Williamson [the Secretary of State for Education] can set up an appeals procedure that resolves the worst cases within days, he will destroy any illusions that his government could run a whelk stall.’

One article on the migrants who have been crossing the English Channel in small boats in their tens and twenties during the calm weather was written by May Bulman, and focuses on our bombastic Prime Minister’s assertion that “this is a very bad and stupid and dangerous and criminal thing to do.”  Bulman draws on legal opinion in pointing out that there isn’t any legal obligation on asylum seekers to seek asylum in the first EU country they arrive in, and that they aren’t, in fact, committing any unlawful act in crossing the channel in small boats to seek asylum.  She argues that making the crossing is neither ‘bad’ nor ‘stupid’ if they are seeking asylum and choosing a country in which they would be joining known communities, and there are no alternative routes to do so.  Bulman quotes Frances Timberlake, coordinator at the Refugee Women’s Centre in Calais and Dunkirk, in this regard: ‘I would use stupid to describe most of the policies [in this regard] the UK has proposed so far, which have totally failed.’

The anti-migrant rhetoric is obviously intended to pander to the xenophobic right wing of the Tory party and the populace as a whole.  Any one of the other three debacles – the mishandling of the response to Covid-19 and its impact on the NHS, the A-levels disaster, and the quarantine issue – should, one might have thought, be enough to sink any government without trace in the opinion polls.   Future historians, even those sceptical about the mental health of those of us who have been self-isolating for five months, seem likely to agree.  But, while Johnson’s own credit rating is falling, the polls suggest that responses to his government as a whole seem to remain astonishingly little affected.  So anyone up for investing in a government-run whelk stall? 

From John in Brighton: DNA

28 July

Potentially an existential issue – but not the double helix and its crucial role to life but rather the future of the restaurant industry. Within a fortnight of the hospitality services resuming, albeit with reduced numbers and other restrictions, restaurant hosts up and down the land bemoan those who book and then don’t materialise at the appointed time. I suspect this is not a new issue but more sharply focussed in these straitened and challenging times. The most outspoken was Tom Kerridge who had 27 no shows at his bar and grill restaurant on a single Saturday night. He emphasised that such selfishness could be the tipping point for the industry which is “already on the verge of collapse”.

Welcome to our world Tom. DNA’s, Did Not Attend, have been a perennial problem in the NHS for as long as I can remember. An outpatient clinic appointment is booked for a certain date and time but the patient is conspicuous only by their absence. Figures vary from place to place and between specialities but on average 8% of appointments (just under 8 million in 2017-8) are not honoured. With each missed appointment typically costing approximately £120 that represents around £1 billion to be coughed up. Not to be sneezed at (even with a mask on). Speaking on Question Time exactly five years ago Health Secretary Jeremy Hunt expressed a personal preference for charging patients for missed appointments. The complexity of administering this and, I suspect, political unpopularity led by the other Jeremy meant it went no further. At the same sitting he also denounced patients who simply failed to take their prescribed medications which is another chronic wastage – so be grateful Tom, at least people swallow your food. The year after Hunt’s rant the body termed NHS Improvement was set up and in a report on “Reducing DNA’s” cited clerical errors and patients forgetting as the commonest reasons amongst several. To counteract these factors many clinics asked patients to ring in and book an appointment personally and then followed later with a reminder text a day or two before the consultation….but sadly not a panacea and still appointments go to waste.

Another ploy in the NHS is to book one or two extra patients in expectation of the absentees – bad news if it’s neither raining nor the World Cup and everyone turns up. But that’s less practical in the restaurant trade and especially with enforced social distancing. And the NHS is not a business whereas a restaurant’s bottom line and staff livelihoods depend on maintaining income. The current white hope for NHS appointments is to give patients the option of booking and changing appointments online. If it works in hospitals then perhaps it could be an option in hospitality as well. But until then a more immediate potential solution is to ask for a deposit at booking with a full refund should cancellation occur at least forty eight hours prior to the meal. To no show with impunity is ignorant and rude – maybe a forfeit would concentrate the mind. Interestingly, but perhaps unsurprising, is that psychologists have demonstrated that people value things more if they have had to pay towards them. The only difficulty I can envisage is the client taken genuinely ill on the day of the booking.
At the end of the day surely a key factor is that both action and inaction have consequences and we all have a personal responsibility for “doing the right thing” as the Tory mantra so often tells us. The NHS may be free at the point of delivery but that doesn’t mean that financial considerations are irrelevant and we all need to use the service responsibly and judiciously. Equally the patrons of restaurants have a duty to respect those providing them with a service and whose livelihoods depend on it.

From David Maughan Brown in York: Happy Birthday to the NHS

July 4th

Happy Birthday to the NHS on its 72nd birthday.   As everyone in UK who has made it to the Biblical cut-off age of three score years and ten knows only too well by now, 72 is a dangerous age in the Covid-19 era.   In this strange new world, people attain instant vulnerability on the day they turn 70.  In that respect people are actually rather luckier than the NHS, which becomes instantly vulnerable every time a Conservative government comes to power.  Right now, after a decade of Tory misrule, the NHS is more vulnerable than it has ever been, as the present pandemic has made all too obvious. 

So Boris, in his kindly way, has given the NHS an unforgettable birthday present, gift-wrapped, virtually if not literally, in the blue light that will bathe key buildings around the country in its honour this evening, and presented to the NHS to echoes of the applause that rang out around the country on Thursday evenings not so long ago. Boris’s present is to honour the NHS’s birthday by declaring it ‘Independence Day’ and encouraging us all to get out to celebrate it in the pubs which were opened in its honour today for the first time in three months.   Boris has suggested that we might want to ‘act responsibly’ in doing so, and has set the example when it comes to acting responsibly by boasting about going around shaking the hands of Covid-19 patients in hospitals, and regarding it as entirely reasonable for his chief advisor to go for thirty mile drives to test his eyesight.

So the NHS will be partying tonight to celebrate its birthday, with extra staff invited to come in to join the party.  The Independent reports that ‘all NHS trusts have been warned to expect levels of attendance usually seen during new year celebrations, and have been asked to prepare their A&E departments and free up bed capacity in their hospitals to manage the increase.’  A&E staff must be really bored by now with trying to save the lives of Covid-19 patients, so they are bound to welcome an influx of drunk and injured people, many with alcohol poisoning, instead.  Some of the drunks will be violent and abusive instead of singing Happy Birthday, as they always are, but that will give the police who always have to hang around A&E departments a good reason not to get themselves injured trying to break up the celebratory riots out in the streets.   Boris could, of course, have scheduled the opening of the pubs for a more boring mid-week evening, but that would have limited the opportunities for his compulsively grandiloquent rhetoric and for the close association of post-Brexit England’s ‘Independence Day’ with the USA’s Independence Day, and he would thereby have lost an opportunity to ally himself with his insane counterpart in the USA.

Dealing with drunks who might try to tear off their face masks will obviously heighten the vulnerability of NHS staff, so many of whom have died unnecessarily from Covid-19 already, but the vulnerability of the NHS goes far deeper than the immediate safety of its current staff.   Tory Party ideology fetishises the private sector and abjures large national organisations: privatisation offers more opportunity for private profit, profiteering, graft and corruption.   Adherents of the ideology maintain, in spite of all evidence to the contrary, that it leads to greater efficiency and promotes productivity.  One only has to look at our railways and the UK probation service to see the absurdity of that idea.   The NHS was progressively, and I suspect deliberately, starved of the funds it needed to maintain the quality of its service for a steadily ageing population through the years of austerity, as seen, to take just one example, from the woeful shortage of PPE equipment and ventilators when a long-predicted virus struck.  The drying up of adequate funding enabled bits of the NHS to be carved off and handed to the private sector, as will have been intended. 

The government’s ideological mind-set blinded it to the need to look to local authorities and GPs in establishing an efficient track and trace system rather than relying on privatised central laboratories, with the result that England’s failure, even now on ‘Independence Day’, to have an efficient system in place has made us the subject variously of international pity and scorn.   But, in spite of all this, this government has shown itself to be incapable of learning from its manifest mistakes.  They are still careering towards a no-deal Brexit whose symbolic success depends to their blinkered minds on a trade-deal with the USA.  This government knows, and doesn’t care, that what the USA wants most out of a trade deal with the UK is for us to be carving nicely chlorinated roast chicken on our Sunday dinner tables, and for our government to reciprocate by carving our NHS up for them and handing the potentially profitable parts to Donald Trump on a plate.   Happy Birthday, NHS, I hope it won’t be your last.

from David Vincent in Shrewsbury, UK: Telling the Numbers

July 1.  My job as a Pro Vice Chancellor at the Open University, working with Brenda, covered many areas, as befitted so protean an organisation.

Two of my responsibilities, ten years on, still influence all our lives.  I inherited the task, central to the OU from its creation, of working with the BBC to promote learning across society at large, as well as our own students.  And in what had become a digital age, I initiated the transfer of OU learning materials to a free-to-use site we called Open Learn.

The Radio 4 programme, More or Less, has just finished a series which has coincided with the coronavirus outbreak.  Its brief is to interrogate and illuminate the figures by which we understand our lives, some official, some generated by other organisations.  The programme is sponsored by the OU and listeners can follow up its broadcasts by going to the Open Learn site and engaging with further learning materials.

This morning, More or Less conducted a retrospect of its coverage of the pandemic from the first cases in Britain.  The emphasis was exclusively on what has gone wrong, particularly in England.  Data published in the last few days has demonstrated beyond doubt that we have the worst record in Europe, and over the long run are likely to be overtaken only by the disastrous populist regimes of Brazil and the United States.  The programme both summarised official data and demolished claims made along the way by Matt Hancock and Boris Johnson, particularly with regard to the tragedy in the care homes, which have accounted for 43% of all excess deaths.

Throughout the crisis ministers have sought to postpone any historical reckoning until some later date, when a leisurely public enquiry can accumulate the evidence and reach a conclusion long after the guilty parties have left office.  We are supposed to focus only on the future.  The More or Less programme was broadcast the day after Boris Johnson’s ‘New Deal’ speech in which he attempted to re-set the agenda of public debate, shifting the narrative away from the pandemic towards the glorious ‘bounce forward not bounce back’ economic agenda.  It’s not going to work.  We are all of us historians now.  We want to understand what went wrong, and, critically, we have multiple channels for helping us do so, including, directly and indirectly, the OU.

Amongst the comparisons made in any retrospective is with China, whose response, after a critical delay, has ultimately been much more effective that the UK’s.  The vast difference is in the level of public debate.  It is more than possible that in free society, the outbreak in Wuhan would have been spotted before it escaped to infect the rest of the world.  And there is no prospect whatever of Chinese citizens now discussing what long-term improvements should be made in the management of pandemics.  For all its ramshackle systems the British state is still exposed to the informed, Radio 4-listening, OU-studying, public.  

Much of the More or Less programme focussed on the missing fortnight in March, when the government failed to act on the information that was building up in Europe.  It concluded, however, with a new scandal, the failure to inform local health officials of test results in their areas.  The Labour MP Yvette Cooper tweeted today: “Our local public health teams, council, NHS doctors & managers in Wakefield have had to fight for months to try to get this data. In public health crisis, most important thing is knowing where infection is. Appalling & incomprehensible that basic info hasn’t been provided.”  Indeed, it is. 

A functioning democracy needs debate not just at the national level but in local communities, which in turn requires the appropriate data to be made available at that level.

from David Vincent in Shrewsbury, UK: Loneliness and Life Satisfaction

June 30. We are living through a time of drama.  Every week brings a new crisis, reported or anticipated.

History will record a belated response in the early days leading to thousands of avoidable fatalities, critical shortcomings in PPE, scandalous death-rates in care homes and amongst the BAME population, widespread failings in introducing test and trace procedures, the complete failure of the NHS testing app.  Today we have the return of lockdown in Leicester and later this week there is the predicted disaster of choosing a summer Saturday night to open all the pubs in England for the first time in three months.  And so it will continue in the face of a still unknowable virus and a government of still uncharted incompetence. 

And yet, if attention is paid to how people are feeling about the crisis, a very different picture emerges.  In my entry for May 27 I drew attention to the social surveys which have been launched at great speed in response to the coronavirus.  One of the larger enterprises, the UCL Nuffield Covid 19 Social Study, has now published four further weekly reports, displaying consistent data over three full months of the pandemic.*  The questions in the survey cover basic attitudes and emotions in the lockdown.  Each topic has its own trajectory since the last week of March, and its own variations by age, income, and living conditions.  But standing back from the detail, what is most striking is the absence of change over the period.

Graph after graph proceeds in an even line as each week passes, sometimes on a slightly upward trajectory, sometimes downward.  What is missing almost completely is the kind of volatility that we read in the headlines each day.  ‘Loneliness’ (see above) has been almost completely flat since the last week of March, unaffected by the recent marginal lifting of the lockdown.  ‘Life satisfaction’ has gradually risen from 5 to 6 on a 10-point scale [it should be 7.7].  ‘Happiness’ [you may not know what that is, but here it is measured by the Office for National Statistics wellbeing scale], has been at or just under 6, again on a 10-point scale, with very small fluctuations.  Levels of depression and anxiety have been higher than in pre-Covid times but have gradually declined through the Spring and early Summer.  Confidence in the English government showed one of the largest short-term changes, falling from 4.5 to 3.5 on a 7-point scale at the beginning of May, but has since levelled out. Notwithstanding this decline, willingness to comply with guidelines has barely altered, slipping over three months from almost 100% to just over 90.  The sharpest fall has been in worries about food security, which began at around 60% of the population and are now only a little above zero. 

The scale of the sample, which involves 90,000 respondents, inevitably has a dampening effect on variability.  Individuals who have lost their jobs, or have been ill, or have suffered serious bereavement, will scarcely report so uneventful an experience.  Nonetheless the absence of sudden change across the population in such fundamental areas as depression or life-satisfaction is a necessary corrective to the melodrama played out on the front-pages of the newspapers.

When the scores are broken down by issues such as income or living conditions, there are generally only minor differences.  In most categories the young are suffering more than the old, the poor more than the rich, but often the differences are small.  Much the largest variable on almost all issues is a prior diagnosis of mental ill-health.  Again the scores show little change over the period, but there are significant gaps between the graphs of the well and the unwell. On key issues such as depression, anxiety, loneliness and happiness, the mentally fit are between half and three times better off than those who entered this crisis already in trouble. 

According to a report by the charity Mind this morning, almost two thirds of those with a pre-existing mental health problem said it had become worse during the lockdown.**  When we consider where the effort should be placed in alleviating the consequence of the pandemic, the mental wellbeing of the population at the outset of the crisis will require particular attention.

* Covid-19 Social Study Results Releases 1-14

** https://www.theguardian.com/society/2020/jun/30/uks-mental-health-has-deteriorated-during-lockdown-says-mind?CMP=share_btn_link