Monday 30 March 2020

Give Me Hope, Help Me Cope, With This Heavy Load

Apologies to the late George Harrison for stealing his lyrics, but they seem to fit the times.

It is the essence of the absence we are faced with currently; a lack of hope. Hope is the prospect of things getting better, the light at the end of the tunnel.

What hope is the government giving us? It's going to get worse? Nope, don't think that would cut it. Their strategy for dealing with the outbreak? Well, if they have a strategy it's a closely guarded secret, with less leaking than at any time in the history of government.

The indicators to look for, as to when we can start returning to normal? No idea.

Whilst the information from and indeed even the access to the senior medical figures to answer media questions (even if none of them seem to think any analysis of the issue, leading to proper and searching questions, should trouble their empty little heads), is laudable, when did they get to make policy?

Surely anyone would realise that 'this thing will last six months at least, reviewed every two to three weeks' would be interpreted as 'lockdown for six months'. Because actually, that's what you said.

The government urgently needs to get the message across that there is hope. And then explain why. Now if the reason they can't is because they don't have a plan then we probably are all doomed, maybe not today, maybe not tomorrow, but soon.

May I help?

The challenges are - stopping too many people getting seriously ill at once

limiting the disease transmission

planning for future prevention

increasing medical preparedness for higher levels of demand

We can only deal with this virus with knowledge. In the long term a vaccine, but in the short term lethality and spread. We don't have this information. Also, we could do with dialling down the panic in the NHS. The theme is that this is apocalyptic and a tsunami is coming, so doctors and nurses live in fear of that.

Then there is the fear of catching it. I'm not sure why we are hearing so much about how scared medical staff are, whilst the general public (well, the young) don't see what the problem is. Maybe it is because the media, with the goal of sensationalism constantly harp on about it and the BBC only interview union representatives, to get expert medical opinion (about what the [Tory] government is doing wrong).

Politicians have said they don't like the term lockdown and so I offer an alternative that is at least more accurate - hiding. By locking ourselves away and avoiding associating with others (or avoiding non-essential travel, as the police have interpreted it), we are not catching Covid 19.

We are also not building herd immunity. Why is this important? Well, flu could be just as troublesome, but it isn't because we have had long exposure to it's like and many of us are immune (I'm getting on and I have never had flu). That means the virus struggles to find people it can infect and kill.

Don't get me wrong, it kills loads of people every year, but you don't hear much about it. Apparently, if you have a pre-existing condition and catch flu, which then finishes you off, it gets recorded as death from your pre-existing issue (cancer, for instance). Not flu.

But with Covid 19, anyone dying who tests positive is a coronavirus death. It's illogical and doesn't help us understand the lethality of the disease. How many people does it kill? And it is part of the NHS panic. Another is the closure of hospitals to anything else and often, if you turn up with a temperature they want to send you away, rather than you bring this dangerous disease into their hospital (as happened to my one year old granddaughter).

So, the strategy as I see it should be, test as widely as possible to discover the extent of the disease today. If we find a significant proportion of the population have already had it (and I gather something like 40% would confer herd immunity, or something like it), then bingo! Let's reopen the doors.

If it is only partial then get the 'immune' who have had it back to work wherever possible. But we need to know and we need to stop mis-recording deaths and we need to get our strategy across to the public.

If you go back to the early days, all the warnings fell on deaf ears because we have heard it all before; SARS was going to be the apocalypse, Avian flu would kill us all and the delight at the WHO that this time their claims of doom seemed to be getting wings, didn't help. People were getting it and soon got over it, barely noticing.

The simple point that, as a new virus we could all get it at once and swamp the NHS was never clearly enunciated until Boris' broadcast about lockdown. Now, they are keeping from us how we get over the herd immunity issue, all hiding at home.

This crisis has shown there are some truly great people in the NHS, that many things 'impossible' in our medical system can be in place in hours and that large numbers of the administration is entirely unnecessary. Actually creates problems.

We have also seen the talent of politicians to talk to the wrong experts too often and take on what they are told rather than asking searching questions and making the decisions themselves. Boris originally wanted to get herd immunity as quickly as possible and so tried business as usual.

 Now this would risk swamping the NHS, but the reason he really did a U turn on this, was the loudness and shrillness of the 'experts', predicting 250,000 or even 500,000 deaths if he didn't do as they said. Something which, having got their way, their day in the sun, they are now backing away from.


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