Santé!

January 2021

In the week leading up to 19th January, in the UK, there were almost 40,000 new COVID cases. And, on that day alone, 1,358 deaths. That is somebody who had earlier tested positive for COVID, dropped dead on that date. Our government’s statistics, at the start of this, were woeful, but they have had over a year now to get things right.

There is also a number, the scientists call it the R-Number, which indicates the growth rate of the virus. It is partly calculated from models, so I have always taken it with a pinch of salt. But in a nutshell, if one person is infected, how many other people will they go on to infect?

Continue reading “Santé!”

Letters to the Editor – 3 May 2021

Dear Sir,

As the UK’s vaccine programme is now moving into fifth gear, would it not be a good idea to begin splitting our daily death total, and indeed our totals for new infections and hospital admissions, into two columns: those who have been vaccinated and those who have not?

This approach will give each of us indicators of both the effectiveness of vaccines in general, plus the robustness of the process that approved them so quickly, based on empirical data rather than manufacturers’ press releases.

Yours faithfully,

The Mister Bump site logo

Who Won the Week (21 February 2021)

*Not* in response to Fandango’s Who Won the Week post, I have been looking at my own newsfeeds.


Exit Strategy

A story I picked up on this week was about Israel and COVID. Israel (population 9M) has inported a huge amount of the Phizer vaccine. Leading the way, it has currently vaccinated 46% of its population (at least one dose) and today started re-opening swathes of its economy. Claiming a drop of over 95% in COVID cases, in people who have had both doses of the vaccine, the plan is to re-open the economy fully over the next month.

Spookily, this coincides with an election there!

Their plan is that, as people are vaccinated, they get a “passport”, and certain things like gyms, hotels, theatres will only allow people to attend provided they have this passport. As far as I can make out, they intend still applying social distancing rules.

That struck a chord with me because here, a big provider of cruises has already announced that they will only allow people onto their holidays, when they can prove they have been fully vaccinated. It wouldn’t surprise me if other companies did the same, just to try and offer peace of mind. I have no idea about distancing rules, I suspect they will decide nearer the time, as the UK is, technically, still locked down.

There’s a parallel argument developed (here, at least), that we are creating an apartheid system – those who are vaccinated versus those who aren’t. With the added counter that if somebody gets excluded from something because they simply refused the vaccine, so what? That’s part of the price they pay.

Personally, I have no problem if an owner says “you chose not to get vaccinated? Therefore I choose not to admit you”. But there’ll coma a point where countries have to say “it is what it is”. Vaccines aren’t compulsory, I don’t think, so countries will need to decide whether, and how long for, they want a two-tier system. But straight away, I can see people who fall through the cracks, whether they were willing to be vaccinated or not. One of my Age UK clients has been told that, because of their history reacting to vaccines, they will not be considered. End of story. I hope they didn’t have any cruises planned!

So, who won the week? Well, good luck to Israel, for hopefully being able to lead us out of this. They have various advantages – a small population which is probably pretty compliant. I doubt it would play out so well either here or in the USA – if someone refuses even to wear a mask, how readily will they agree to be vaccinated? But, good luck to them in any case, for hopefully showing us a way out of this mess, if we choose to take it.

That the programme probably stems from Netanyahu’s desire to be re-elected is just one of those unfortunate things…

No, thank you

There was a very interesting article on the News just now. Leicester is pretty much slap bang in the middle of England, It has a large proportion of Black, Asian and Ethnic Minority residents (BAME). It also got hit quite badly by COVID. They were one of the first hotspots way back last summer, and they never really calmed down.

Now that the vaccine has arrived, they’re starting to see an interesting statistic. Uptake among White residents is high – it is high pretty much everywhere in the UK. However, uptake in the BAME population is significantly lower.

Okay, some of us could maybe put that down to education. BAME people do not understand the benefits of the vaccine in the same way that White people do. But this argument is nonsense because they also surveyed the sectors in which people worked, and BAME *doctors* were also a very low uptake. I’d have thought a doctor would be savvier about the benefits of the COVID vaccine than most, wouldn’t you? And yet they still refuse the vaccine.

Where there was a correlation, however, was in trust. As in, how much these people trust the system.

It’s funny, because we have people who quite eloquently, and very vocally, point out how BAME people are treated differently to Whites. From what I have seen, everything they say is true. And it is only 10 years since our government was found out – trying to forcibly repatriate people back to the Carribean, because they didn’t have the correct documentation, which they had never been given in the first place. Hard-nosed politicians seem to have, for years, felt that they can take these steps with impunity, they could do whatever they want without repercussions. But I wonder whether what we are seeing is the payback?

Them or Us

The EU is having this weird spat with AstraZeneca at the moment, and the UK seems to be piggy in the middle.

AZ signed a contract to provide so many COVID vaccines to the EU. AZ has plants in Belgium and the Netherlands which it had earmarked for production, and they can’t keep up.

AZ also has plants in the UK, which are supplying the UK with the vaccine.

The EU thinks that the supplies earmarked for the UK should be diverted to make up the shortfall. So, that’s the extent to wgich the UK is involved – the EU wants AZ to reroute supplies which would otherwise be destined for the UK.

Yesterday, I saw stories about the EU introducing export controls (presumably they want vaccines made in the EU to be reserved for EU citizens, which seems strange when it has strict rules about protectionism) and today, I saw a story about checks on the Irish border (which is the land border between the UK and the EU).

Doesn’t all this seem a bit silly? I mean, we’re in the context where somebody could carry the virus, quite easily, from UK to EU, or vice versa, so does it not seem silly to be worrying about who gets vaccinated first?

And it makes me realise that this is a whole lot bigger than the UK and the EU. It could happen between any two neighbours. One has the vaccine and one does not, but because borders are porous, what difference does it make, who gets the vaccine first? Plus, of course, airline travel allows us to fly globally, so the spat is not even restricted to neighbours.

I suppose the cynic in me recognises that politicians will be elected by their own people, so their care stops at that point. But surely the one thing the pandemic should have taught them is that there is no them or us?

Vaccinations

I’m not sure how they are prioritising vaccines in the UK. If you look at the media, it is by age, although the media is notorious for dumbing things down. My wife (a nurse) is due to administer vaccines (her first time with COVID, although she gives flu and baby jabs all the time) next week. This, apparently, is to “over 80s”. So if we’re delivering by age, that’s where we’re at.

Last week, I received my first COVID vaccination. If you’re interested you can read about it here but it is sufficient to know that although it was above-board, it was completely by accident. I was, for once, in the right place at the right time. I’m 53 and despite the stroke, I’m not considered vulnerable.

So how could this be? The sessions are for over-80s, and yet a 53yo gets jabbed? I have asked myself this same question.

It is one of those scenarios where you think differently, depending on whether you are thinking from your own perspective, or from the wider “public health” perspective.

From a personal perspective, of course I was going to be vaccinated, as soon as it was offered. At present, who would say “no”?

I do think it is a big flaw, however, that we have not drawn up lists of people, with some kind of priority rating. We haven’t done this. There is some loose arrangement to prioritise people, now, by age, but there hasn’t really been much thought about it.

I’m not fussed who would come up with that list, although doctors’ surgeries would seem to be a good starting point. They. after all, already know about the most vulnerable people in society, because they are regularly prescribing meds for them. I repeat, this has not happened, at least, not in any coordinated manner.

This task should have been started last March – I think a lot of questions arising from the pandemic will be “why did they not do x sooner?” – in the full knowledge that sooner or later, this would be a real problem. And, if manpower were a problem, hire people. There were plenty of people at the time, with nothing better to do.

Now, doctors’ surgeries will not have known about people’s occupations, so the story doesn’t end there. But once those initial lists were in place, they could have been expanded to incorporate emergency workers, supermarket workers etc. Any other sectors chosen to be “high priority”. In that way, they could have gradually built up a picture. And the more time available, the better the picture could have been, the more factors could have been taken into account. So, when a vaccine finally did arrive…

It wouldn’t be perfect. There would be holes. But it would be a better system than phoning the nurse’s husband to ask if he wanted the jab. There would be cases like mine, because no system is perfect, but they would be minimised.

I am incredibly forgiving toward our government in the area of COVID. The situation is unprecedented and they were bound to make mistakes. But this aspect is something that should have been foreseen by either the politicians or the bureaucrats, and this is just collating names. This isn’t challenging work – it’s not even in the same league as managing the pandemic itself- it should be bread and butter. It should have been somebody’s job to be thinking about this.

Fandango’s One Word Challenge (22 October 2020)

for Fandango’s One Word Challenge(FOWC), alleviate.

There is this really strange story going on in the UK for about the last week. I’ll just report it briefly, and you can form an opinion for yourself. You can imagine several alleviates going on, so I feel justified in using it to answer the prompt.

COVID in the UK is getting worse, and the government has announced a three-tier system, with restrictions increasing, tier on tier. There are arguments about how useful this system is, but that is beside the point today.

The government (who hold both the numbers and the purse-strings) have decided that some areas are so bad, they should go from their current tier to the next one up.

The areas are pushing back. In particular, Manchester.

Why? Because, to each area, the government is offering a compensation package in return for greater restrictions. The areas are saying “it’s not enough”.

Now, I have no idea whether it is or isn’t enough. The one thing that was reinforced was that it is all about money.

Meanwhile, the virus marches on.

image from the UK government web site, https://coronavirus.data.gov.uk/

Coming Out

I don’t pretend that this will be a particularly interesting post, but I just wanted to get these ideas down on paper somewhere. I’m sorry for boring you, but it’s what I’ve been thinking about. Please just skip if not your cup of tea.


The map I use to look at my COVID numbers is quite finely-grained. It splits the UK into about 7,000 zones. The zones vary in physical size, seem to be driven more by population. I estimate that London has about 1,000 of these zones, real examples include South Hampstead or Central Westminster. What we might think of as a “suburb” generally splits into 2 or 3 of these zones.

Out in the countryside, where I am, my zone covers this village and the next. A far bigger area than Westminster or Hampstead.

I’m obviously talking about the UK, but there’s nothing really stopping other countries applying this too. My friend in Australia says he knows COVID data to the postcode level, people in the US say they know at the county level. The point is, it’s quite finely-grained.

On my map, each of these areas has a number of cases, confirmed within the last week. They fuzz up the numbers when they are very low, just because there might be 1 or 2 residual cases, presumably because those few cases are not statistically significant. But 100 cases in that zone, we’d see it!

I don’t think that’s a bad start, but I would sooner see a count of the number of active cases. We can calculate rates just by looking at how these numbers vary over time. I think there is currently an issue that somebody who tested positive eight days ago, who might still be infectious, drops off the official numbers. And I wouldn’t fuzz-out any data, because the agency’s role should be collation and presentation, not interpretation.

And, how do we decide when a case is no longer infectious? On that, I’d take advice.

My idea starts with that kind of granularity. By all means, disseminate these numbers, but I would just use two headline colours to describe one of these zones – “Red” and “Green”.

I see a Green zone would be no COVID cases. Or, very few. There would probably need to be a time element in there, too, like “no cases for the last 4 weeks”. Again, I’d take advice on the exact length of time.

Also, to qualify as being Green, all of the zone’s immediate neighbours should also be Green. Just because it is inevitable that people will travel at least to the next zone.

Inside a Green Zone, shops and businesses open as usual. People can move about their green zone. Masks (and distancing) are optional – neither is necessary if the place is virus-free. If people want to travel, that is up to them, but if they travel into a Red Zone, they should mask up.

A Red Zone, on the other hand, is one where there are COVID cases. Or, has a Red neighbour. Again, because people will move about.

Inside a Red Zone, the advice is to discourage mixing. This might mean people staying home, and some shops and businesses closing their doors, if they cannot operate without mixing.

And, because the goal is to discourage mixing altogether, any rules like “no more than 6” or “no more than 10” go out of the window. Same household only. Quite a grim scene, something looking like March more than September. Travel outside of the zone should be minimised and any excursion to any destination, Red or Green, requires a mask.

It’s a pity, pitting people’s mental health against their physical health, but physical health wins out, because of the “infectious” aspect. If someone might have COVID, even though it might help their mental health if they can see other people, they cannot be allowed to spread it. Put in those terms, it becomes a no-brainer. With some things, we just have to say “tough”.

In terms of whether a zone is Red or Green, I’d see those values being calculated daily (numbers are already recorded daily in the UK), everywhere. It’s not as if we require a human to make a decision – it is simply applying a formula, can be recalculated in seconds. A zone is Green or Red because of…. some definite criteria, not somebody’s judgement. And, it is possible for a Green Zone to become Red, as well as the other way around. End dates? Are really for the virus to decide. Right now, a reasonable end date seems “forever”.

There are a million more details to iron out, but those are my top-level thoughts.

First among those details, we need to be sure that the numbers which drive these decisions are as accurate as possible. So, that means lots of testing. Test enough, and we could even scale this down to the Red/Green Household level.

Second, we’re again telling businesses that they must close, telling people to stay home from work, so there are financial implications. I don’t think that locking down automatically means dire financial consequences, as we are all in the same boat. If everybody loses a billion dollars, nobody really loses anything. The difference is that a nation’s approach will dictate the speed at which it comes out of this and gets its economy back on track. And that speed *will* make a difference.

Third, it seems clear to me that, whatever plans we have, we have very little enforcement, at least in the UK. The police were a prime target during austerity. It is far too late this time around, but we should be asking ourselves whether we want enforcement in the future. That might be a pandemic, or it might be something else. And if the answer is “yes”, shouldn’t we be doing something about it? Another pandemic? No way? Well, how many once-in-a-lifetime events have we seen in recent memory?