Wednesday 11 March 2020
Avoid care homes if you can – the Life Care Center in Washington state (courtesy Business Insider via ASON REDMONDAFP via Getty images)
If there is a turning point in the UK’s part in the Covid-19 crisis, today must be the moment. Have a look at this email, that I received from a colleague in northern Italy. I had sent him a brief message to see how he was doing. He happens to be an orthopaedic surgeon, and this is what he said:
“Mala tempora currunt! The situation is critical. Take this COVID-19 very seriously. I am sure you will after this mail.
ICU are full here. If you need ICU and you are lucky to get a place ….50% survival rate. Younger in ICU are going worse than older. Don’t ask me why! Hyperimmunity?
Suggestions:
Stay home. Reduce any human contact. Stop all elective surgeries and ambulatory visits. Only trauma and urgent cases. Prepare orthopedic surgeons to became pneumologist or anesthesiologists. Prepare yourself and your family. Panic is useless but a superficial attitude is deadly.
Ad maiora”
The situation this morning – 11 March 2020 (courtesy Center for Systems Science and Engineering at John Hopkins University)
This was my wake-up call. To whatever extent I might place my head in the sand, there are others whose heads are far deeper. Covid-19 is coming our way and there is not much we can do to stop it. We can reduce its impact, that much is certain, but we cannot avoid it completely.
When compared with others, UK is not doing so badly. There are slightly more than 119,000 cases worldwide, but we are sitting at number 14. Italy is in second place and trying hard not to be first.
Things are happening in the shadows that I do not properly understand. Around me I hear more ambulance sirens than I would normally expect. Meanwhile a good friend, not far from where I live, wrote to say:
“Thought you would like to know. Sadly, a friend of mine who lives near me was diagnosed with it (Covid-19). He is currently on a life-support machine at St Mary’s. Fortunately, I haven’t seen him recently. Was cooking him a birthday dinner but it got cancelled as a close friend couldn’t make it, and we deferred it until her return.”
I have another friend who works in a nearby NHS hospital and has been helping the rehabilitation of an elderly patient, somewhere in his late 80s. The patient was on the open wards and started coughing. Naturally, he was tested for Covid-19. No surprise to learn he was positive and is now hanging in there by a thread.
My friend asked to be tested but was told, because he was asymptomatic, there was no need. The result? My friend’s partner, who is in financial services, is now in self-isolation on the basis she might infect colleagues at work in the City of London. Meanwhile my friend carries on working, treating other patients and wandering the hospital corridors unaware if he is positive or negative for Covid-19. Where is the logic in that?
The test for Covid-19 that I understand is being performed is what they call a rRT-PCR or real-time reverse transcription polymerase chain reaction, in respiratory specimens. Here you are looking for viral DNA. There is also the Covid-19 IgM/IgG Rapid Test that can be used for rapid screening of virus carriers that are symptomatic or asymptomatic. This looks at antibodies in the blood and takes all of 15 minutes to perform.
Dr Ai Fen has spoken out (courtesy Renwu/Handout)
Governments around the world appear to be doing what they can to control the flow of information but thanks to social media, they are not always successful. The medical staff in Wuhan, where the outbreak was said to start – and the place of work of the original whistle blower, Dr Li Wenliang – are still up in arms. Dr Ai Fen, director of emergency at Wuhan Central Hospital has now spoken out, criticising the authorities for suppressing early warnings of the outbreak. Her interview, which appeared in a Chinese magazine, Renwu, states that she was reprimanded after alerting her superiors and colleagues to a SARS-like virus seen in patients in December.
I am becoming increasingly worried by one elderly member of my family, who is looked after in their own home by a carer. I am unsure what to do if the carer becomes sick. The last thing an elderly person needs right now is to be transferred to care home. Such places seem to be a trigger for Covid-19 infection. Some homes are now asking relatives and friends not to visit. The Life Care Center in the US state of Washington was recently the centre of a tragic outbreak. Since 19 February 2020, 26 of its residents have died, 13 of whom were confirmed to have Covid-19. In total, 19 deaths in the state have been tied with the centre. I talked through this situation with a relative today and we have decided to see what policies are in place for the company that provides the home care and base our next steps on that.
Why don’t they sell loo rolls this size in supermarkets There is plenty to go round (courtesy BBC News).
Panic buying continues. The only buying I am doing is cider, which is just as well because there presently seems to be a limitless supply. I saw a fight break out between two ladies in a supermarket today, over Wet Wipes of all things. Meanwhile there is a video going viral on YouTube, showing three ladies in Australia having a tussle over loo paper. One of our loo roll bosses has gone online to say that there is no need for us to worry.
A good friend of mine spotted the discrepancy in a text message to me today. “Some nations,” he said, “are known to hoard gold in an emergency. The Brits are hoarding toilet paper. Please now explain that.”
I cannot.
Others are seeing the humour, if there is any to be had. Again in Australia, but this time a garden centre, the establishment has declared that panic buyers are welcome with a rationed limit of 1000 plants per customer per day.
Covid-19 is proving to be no respecter of rank. Nadine Dorries, our Health Minister, and an ex-nurse, has tested positive for Covid-19 and is self-isolating. Here elderly mother lives with her and has, if Twitter is to be believed, now started coughing. The main discussion online and on Twitter at the moment appears to be the prognosis for her mother, but also puzzlement as to how Nadine Dorries was tested. She had not been to any at-risk countries, which is normally the trigger for such things.
Intensive Care beds are becoming hard to come by (courtesy PIAZZAPULITAReuters TV)
I now have a friend wandering hospital corridors untested who may be spreading Covid-19 to all he meets. Meanwhile there is a Minister self-isolating who has been tested, but who is now no risk to anyone save her own mother. That is risk enough, but can someone explain the sense?
Once again, the UK has shown its biggest daily rise in new cases, and we have now reached 460. If Covid-19 progresses as I expect, every day will be a bigger rise than the day before until, at some point, it will peak. The WHO has also declared a pandemic with their chief saying that he is “deeply concerned” by the “alarming levels of inaction.” He was careful to avoid saying by whom.
There is much chit-chat on the news at the moment as to whether the UK is ready for a major outbreak. There are all manner of options ahead such as school closures, restrictions on the use of public transport, stopping big gatherings, the use of troops to support the emergency services, legal powers to keep people in quarantine, with a police focus on the most serious crimes and keeping public order. I can see that with a population on edge, as it is right now, public disorder must be a risk.
I can feel it in the air when I walk the streets of London.
