Sunday 8 March 2020
The medics are ahead of the politicians at the moment, but I wonder for how long?
It seems to me that the medics are several steps ahead of society at the moment. They are certainly ahead of Government. The medical profession finds itself hovering, waiting for Government to make a decision that healthcare has already made. Somehow, governments worldwide are doing plenty of tub-thumping, but appear always to be a slight distance behind. The result for this Covid-19 outbreak is thus very clear. It will continue to run for the moment. No doubt there will be an endpoint one day, whenever Nature decrees, but I see no sign of that at the moment. Meanwhile, China is busy telling the world how it has regained control, although it is difficult to separate fact from fiction. I am simply unsure how much to believe, so I follow my own instinct, as I can at least trust myself.
I can see why businesses and countries wish to present a life-as-normal approach. Yet the fact is that life is not normal right now and events can change in a blink. One of the issues I am finding, simply by virtue of being medical, is that folk seek my advice, even if I am a surgeon and started out knowing little about Public Health. I am now becoming an expert almost by default. What I see are people all around me behaving like ostriches. They feel better with heads in the sand, look up on occasion, dislike what they see, so bury their heads once again. Most want to know if they should travel, continue with a meeting, attend a conference, or something similar. The public is not being helped by the recommendation that no one should visit their GP if we are ill, as GP advice is, in part, being discouraged. Friends and family thus turn to those nearest to them, and that includes me.
I see no indication to travel at the moment (C Cagnin)
My latest approach was from a colleague in the USA, trying to decide if he should come to the UK for a meeting in two weeks’ time. This is part of what I replied, although I have anonymised people and places:
“Right now, in UK we are doing OK. By the time you get here, I am as sure as I can be that life will be very different. I was out and about on London’s streets yesterday and there are folk beginning to look slightly pestilent, if that is the right word. Noses being blown, coughing, sneezing, and the like, as one might see when the common cold is around and about, or at the start of an influenza season. Many, many functions have been cancelled or postponed…The Government has not recommended meetings are cancelled but only yesterday was beginning to talk about what they call “social distancing.” It appears that the public, and individuals, are taking matters into their own hands and Covid-19 is just about the sole topic of conversation anywhere. On the streets, in supermarkets, you name it.
What would I do? My views may be overly dogmatic. However, it is not so much getting ill oneself that I see as the problem, it is passing that illness on to others…If, for example, you had invited me to come and speak in 10 days’ time in (the USA) I would by now have begged your forgiveness and pulled out. There is also the matter of quarantine. At present, anyone who has Covid-19, or for that matter has been in contact with a case, is asked to self-quarantine for 14 days. We have no idea what your Government, or mine, will decide in order to reduce the spread of the disease but if one is to travel anywhere, it would be best to take a copy of War and Peace, just in case one finds that a border control does not allow you to exit, or to enter.”
My colleague decided not to travel.
There is more to staying free of virus than hand gel (Maridav)
This morning, I had breakfast once again in a central London, Austrian restaurant. Compared with last week, when I did the same, the atmosphere was different. There was hand gel on the reception counter. The gel had been well used and there was only 40% left. Despite this, there was a family with a young child sitting at a round and central table. The child was coughing productively throughout, the father was blowing his nose and I could not understand why they had even come to the restaurant, let alone why they had been allowed in. To be fair, the mother looked healthy, but self-conscious as her child and spouse spluttered each side of her. Then another guest appeared, a woman, and sat herself at a remote table in a far corner, as far away from me and the hapless family as she could. She, too, was coughing productively, while pretending she was well. Then, and only two tables away from me, a third party arrived. It looked to be father and son. The father was also coughing for Great Britain. After this third arrival I took the hint, guzzled what remained of my breakfast, paid up, and disappeared as fast as my legs could carry me. I doubt I will return to that restaurant until the Covid crisis is complete.
I suggested to the restaurant manager as I left that she should perhaps consider measuring everyone’s temperature before they were allowed in. As Covid-19 picks up pace in London, as it surely is, measuring temperatures may even be useful marketing. The manager looked interested by the idea, but this was perhaps her way of keeping me happy.
I sense the public feels that as long as everyone uses hand gel when they see a dispenser, that is all they need. Dear me. There is so much more to it, as any medic will say. Staying free of infection demands obsessional behaviour. It is perhaps why so many see surgeons as being sticklers, as a surgeon’s life is all about avoiding infection.
I understand that London is the worst affected portion of the UK at the moment, with more than 50 cases somewhere in the city. In the background I hear, almost throughout the day, sirens as ambulances speed this way and that. The ambulance chiefs are currently considering a ban on facial hair for their crews as beards are making it difficult for respirators to be worn properly. Apparently, there is no national policy on this issue.
Meanwhile emergency legislation is being brought in to help protect NHS volunteers. This is to allow those who leave their main jobs to help with the crisis, and to eventually return to their former employment once the current drama is over. This presumes that the economic effects of the disease allow these main jobs to continue, although I sense many employers will go broke in the coming weeks. For some NHS volunteers, there will be nothing left to return to, once the country has taken its fill, and paid the volunteers nothing in the process.
Italy has seen another jump in cases, with 49 more deaths in the past 24 hours and a total of 4600 cases. This is the greatest number of deaths outside China. It has led to Italy placing up to 16 million people under quarantine. Anyone living in Lombardy and 14 other central and northern provinces will now need special permission to travel. This affects both Venice and Milan. Meanwhile throughout Italy, schools, gyms, nightclubs and other venues have been closed.
Chinese men do plenty of smoking (WilliamJu)
There is some analysis of the early data about Covid-19 taking place at the moment. The ladies are luckier than the men, as fewer females seem to be infected and, even if they are, they have a better chance of surviving. I am unsure if anyone has worked out why. These figures come from China, where men smoke like chimneys, so it may be that the data are partly created by the high number of male smokers there. Few Chinese women take a puff, the habit being largely male dominated, but the precise correlation has not been made.
I have been overwhelmed by an article I wrote for my travel blog, Never a Straight Line. I did not travel very far. Basically, I walked up and down London’s Oxford Street and reported what I saw. I titled the piece, “If I was a virus called Covid-19” and placed it on LinkedIn as well as my blog. The next thing I knew was an avalanche of viewing, which so far has reached 2500 and keeps on rising. There was one comment from Switzerland to say that I was belittling patients by writing as I have done, but everyone else was supportive. I only have to look at the comments coming in to know that the medics are ahead of the rest.
All the bigwigs can do is follow, which is not a bad option.
