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December 2020

December 1 2020

The UK recorded 603 more deaths from coronavirus in the last 24 hours, with 13,430 new cases of the disease. It brings the country’s official death toll to 59,051. Separate figures published by the UK’s statistics agencies suggest there have now been 74,000 deaths involving Covid-19 in the UK.The figures are a sharp increase from Monday, when 205 new deaths were reported. However, a reporting lag over the weekend often leads to higher numbers on Tuesdays. A week ago the UK recorded 608 deaths and 11,299 new cases. The higher number of cases today suggests the second wave has not yet tailed off, despite falling infection rates.This should make it clear to all the sceptics that we are not yet ready to relax. The month-long lockdown, has in the last 10 days or so showed a fall in the number of new cases demonstrating it is effective. However because of the lag effect the number of deaths remains at a disturbing level. I had anticipated and hoped it might be nearer 400.I will have to publish this before the vote in the Commons is announced, so I shall add the result later this evening. It seems that with the Labour party deciding to abstain from voting there is little chance the Government will be defeated. Our Opposition party it would seem, enjoys sitting on the fence on the one hand showing support to the Government whilst never overtly supporting their actions. Today’s abstentions are aimed at highlighting divisions in the Conservatives not supporting them. When the Government introduced the lockdown 4 weeks ago there were 34 rebels.Debenhams are in serious trouble now. Already in administration, a potential rescuer has pulled out leaving the real possibility of permanent closure.There is a claim that I cannot verify that there are some 10,000 shipping containers stacked in the docks at Felixstowe, containing millions of pieces of PPE such as masks aprons and gloves. The Government is alleged to be paying £1m a day for the container storage. It would seem the NHS has no spare storage. The National Audit Office (NAO) is reporting that the UK spent £10bn more than the normal prices to secure PPE following the urgent shortage in the NHS and at Care homes at the beginning of the pandemic.Many contracts were rushed without the normal competitive tendering processes. The NAO claim that Ministers have not demonstrated that the money was spent in a fair and transparent way. It is doubtful they got the best available deal for the money.This shortage should never have been allowed to happen. Stockpiling PPE for an influenza pandemic had been part of Contingency planning for years. We have yet to have an explanation as to where it all went. It is a question we will need answers for but perhaps not until the emergency is over. Clearly it is thought some individuals profited enormously at this time.Another report suggests that in a week in November the causes of death on all death certificates were examined and 1 in 5 mentioned Covid 19.Mr Gove has apparently denied we will need to have Covid 19 passports. This is contrary to another ministerial view that it was a good idea. It would seem that as it’s not likely to be a compulsory vaccine, that requiring evidence of immunity to be shown to purchase tickets for events or to work in a hospital would be a sensible idea. Let me know what you think about this.A Shisha bar in Sheffield was raided and police found 20 customers smoking pipes behind closed doors. All the customers have been issued with £200 fixed penalty fines and some 70 pipes confiscated.As my supper seems to be of public concern, can I assure you it will not be a pastie or some scotch eggs, but a full meal, of the meat potato and 2 veg type.It seems to me that we will have the new 3 tier system. Please do not shed tears about this. I am sure it is the right and sensible way to go up until Christmas. Over the holiday we need to be extremely careful and the we will hopefully welcome the expected vaccines. Until then we must all play our part and stay apart. Stay safe every one.

December 2 2020

History will ultimately remember the 2nd December as the day the first vaccine for Covid 19 was declared safe and fit for widespread use by the MHRA. At least two other vaccines are expected to get approval in the next week or so. This has been a truly international and remarkable achievement to develop and produce this vaccine. The UK cannot take the credit for it although there has been great collaboration and our fiercely independent MHRA has pulled out all the stops to get it through all the testing hoops. The Human Medicine Expert Working Group and the Joint Committee on Vaccines and Immunisation have both also played an important part.The first doses will arrive in England next week. There are however logistical difficulties to overcome before the vaccine can be taken to Care homes. It has to be maintained at minus 70C and is distributed in packs of over 900 doses. At the moment the MHRA are yet to authorise a safe way of breaking down the pack size so they can take the correct number to each Care Home. While this is being resolved, packs will go first to hospitals to protect their health and social care staff. Pfizer have, at their own risk, manufactured a large volume of the vaccine at a factory in Belgium from where it will be transported to the UK.The Oxford Astra Zeneca Vaccine will almost certainly get the go ahead soon and this vaccine will be much easier to transport and can be stored in a domestic fridge. It will really not matter which one you are offered. Take whichever one is available. Remember it will not be effective until after you have had the second vaccine dose 4 weeks after the first. You must maintain protection for yourself until after the second dose. You should of course ensure that both of your shots are of the same vaccine. No one knows yet just how long the immunity after immunisation will last, you may well need an annual booster to maintain protection. It was made clear at the PM’s briefing tonight that we will have to live with this virus for ever. We also do not know yet whether the vaccine will prevent transmission as well as preventing the disease. Scientists are optimistic.When you realise that of the more recent pandemics with SARS, MERS and HIV no effective vaccine has been developed it makes this achievement all the more remarkable.The Thalidomide Society have said the comparisons with Covid vaccine are grossly unfair. It is unreasonable to make comparisons in the way many anti-vaccination groups have claimed. I certainly agree with the Society. Thalidomide did not pass the right safety tests in animals and was never tested on pregnant animals. It was not a vaccine. Following that tragedy the whole area of testing was restructured and made much more robust. Vaccines have the potential to save millions of lives. Thalidomide destroyed lives.A Hungarian MEP has been forced to resign as an MEP after he was caught in a compromised position at an illegal party in Brussels after the police raided it.Tescos have offered to pay back the Government the £585m it was given as business rates relief as the company found they did not need it.Bonmarche is the latest high street store to go into administration for the second time this year.I would like to have been a fly on the wall at Prime Minister’s question time. Sir Kier Starmer was demanding the Government hand over the full documents outlining an impact assessment of the tier system, not just the spread of the viruses but also on the economy and wider health issues. A report was published yesterday ahead of the vote yesterday, but Sir Kier said it was too broad and lacked detail.The Times reported the existence of a Covid 19 Sectoral Impact Dashboard which has been kept confidential. It apparently covers 40 sectors of the economy including aerospace, automotive industry, retail, hospitality, tourism, arts and sports which all have a code Red warning of significant job cuts and revenue loss.Sir Kier demanded maximum transparency and that the Government publish all reports in full. He went on to threaten to use an arcane political process in the Commons called a “Humble Address to the Queen” which could force the Government to do so. If anyone knows their Constitutional Law perhaps you would like to explain to the rest of us how this would work.From the many reports it seems the Prime Minister was upbeat today and easily ran rings around Sir Kier during question time at one point making a Churchillian V sign at Sir Kier. V for Vaccines. He went on to say “He dithers as we get on with the Job” and “Captain Hindsight has been promoted to General Indecision”. A reference to Labours abstention yesterday.Prof. J Van Tam known usually as JVT gave a useful list of the causes of virus transmission with the acronym of 3 Cs:1. Crowded spaces2, Where Crowding is unavoidable3 Close contact indoor is the normal. He added4. Duration the longer you are exposed the higher the risk5.Volume, the louder the noise with shouting and singing.If you get caught in a situation like JVT describes please just leave quickly. You will be in a very dangerous situation.Its just been announced that university students will stagger their return next term over a 5 week period. Unless very vulnerable they will not be eligible for immunisation for some months yet.With 648 deaths in the last 24 hours and 16,170 new positive cases this is not going away . There are still more than 15,000 in hospital.We must absolutely not blow it all now. We need the tiers, we need everyone to maintain social distancing, we should only relax as little as we can. The vaccine will take time to show itself we will need tiers for a long time yet with only very slow relaxation. Be pleased with the news today but do not relax in any way. Just stay safe.

December 3 2020

A report from Spain tonight to illustrate that the UK is not the only country with confusing rules and advice. The Christmas relaxation will run from 23rd December to the 6th January. You can during that time cross regional borders if visiting family or very close friends. Each region can then add further restrictions if they wish to, for example restricting the dispensation to only one or two days. The Canary and Balearic Islands do not need to comply with this. Students travelling home for Christmas are being advised to minimise their social contacts in the last 10 days of term, then to respect their home social bubble rules and try to interact outdoors rather than inside.On the 24 December, 25th December and 31st December there is a 10 person limit unless everyone is from the same household. On the other days over Christmas, each region must set its own limits. The limits in Spain always include children. In the UK children aged 11 or under do not count. There will be separate regional rules about curfews, drinking in the streets and major sporting events.Here in the UK- Aldi, Sainsburys and Morrisons have joined Tescos in refunding the tax relief the Government had given them. This now amounts to £1.4bn which the Government can re-allocate to those in greater need.A recent survey among people required to work at home during the pandemic was interesting. Nearly 50% were able to work from some form of home office. 20 % suggested they worked from their bed and some even worked in their bath. I presume they were not using Zoom. I am lucky to have a large comfortable office to work from but what conditions have you been obliged to work in? If I have to believe this survey at least 4-5 of you will have worked in the bath or shower. Do tell us all your work stories, we need light and humour at the moment.The number of positive cases tracked by Track and Trace dropped by more than a quarter in the week to the 25th November, a total of 110,00.This was the benefit of lockdown. For the first time they successfully followed up over 70% of the 246,604 contacts. They have always claimed they can be much more effective with smaller numbers. We must ensure this success rate continues to improve.Today’s statistics show:353,990 tests were done in the last 24 hours. A total of 14,879 tested positive at a rate of154.3 per 100k of the population. More than 2 million tests were done in the last 7 days.Deaths today amounted to 414. The death rate of 4.4 per 100k is rather static, having not changed for some days.15,236 patients had Covid in hospital on 1st December with 1,315 on a ventilator. The last daily admission figure was 1,350 on 22nd November.Compare the figures for the USA today with over 3,000 deaths in one day with over 100,000 in hospital beds.I was interested to read a large advertisement for facemasks as Christmas presents. They certainly looked attractive and comfortable. The advertisement claimed they will stop 90% of all bacteria as well as being an excellent fit and will survive 50 washings. Very stylish. Do not be misled. I suspect as attractive as they are, they will be useless in protecting you from Covid 19 which is caused by a virus. Viruses were not mentioned once in the advertisement. I suspect deliberately as they cannot claim anything about their antiviral properties because they do not have any.Please warn other as Christmas approaches, we must all wear masks that have a high protection rating against viruses. That’s why I personally prefer to use the disposable surgical masks that have a good track record of testing.Finally, I was pleased to see some humour in Parliament when Jacob Rees-Mogg was answering questions about safe travel corridors for Father Christmas. He took time to explain that yes there would be safe travel corridors. Father Christmas will manage, as usual, to visit everyone. He does not need a vaccination and all Santa’s Elves are very busy sorting presents. His presents will be safe and the Elves do not need masks.I will try and discuss some new issues about the vaccine tomorrow but it has been confirmed that at present it should not be given to pregnant mothers. Not because there have been any issues but because there have been too few pregnant women been immunised yet to be sure.You must all be aware we have to work hard to counter complacency and ensure every one plays by the rules of your tiers in the next few months. Only relax if it is essential over the holiday for your family sanity and even then play by the rules. Most if not all of us will help anyone in special need of help. Please share your thoughts and fears, it makes writing this much easier. Stay safe everyone.

Just to complicate matters for you. The Government via DEFRA have announced that from the14th December all wild birds kept on farms and gardens have to be kept indoors in secure sheds and pens as part of a Nationwide exclusion policy to cope with a rising number of Bird flu outbreaks. I stress there is little to zero risk of humans catching this but several strains of Avian influenza are involved. The biggest impact will be on poultry with Chicken Poultry and Ducks most affected, Many thousands of birds will have to be culled. and there are very strict hygiene rules for staff on these farms. You should keep away from poultry farms, do not walk your dogs near them. If you come across unexplained deaths in birds you should report them without touching or disturbing them.

December 4 2020

The Covid pandemic is now clearly shrinking as the figures clearly now show thanks to the last 4 weeks lockdown. Only in Wales is there an increasing number of cases still. We absolutely must not relax these restrictions until figures are very much lower and we are vaccinating the first priority groups. I cannot stress enough how important this is. We must not crash on the last lap.The R rate has fallen again and SAGE now estimate it to be between 0.8 and 1.0 Which means the number of new cases will fall. SAGE further estimate the number of new cases will fall between 1 and 3% each day. The Office for National Statistics estimate that in the week ending 28thNovember 1 in 105 people have the virus at the moment compared with 1 in 80 a few weeks ago. Despite this there are still calls to put the London Boroughs in Tier 3 at the next review. On the basis of the figures I cannot see the justification for this.The figures today are much as expected:-389,476 tests have been done in the last 24 hours bringing the grand total to over 41 million since 31st March.16,298 tests proved positive in the last 24 hours at a rate of 152.8 per 100k.There have been 504 deaths recorded in the last 24 hours.There are some inconsistencies in the hospital figures with different sites slightly different in their figures but I believe;15,236 people were in hospital on 1st December1,315 were on a ventilator1364 were admitted on the 30th November.The supermarket Lidl is the latest of the supermarkets to agree to pay back the business rates relief they had received.About 1.3 million of our poorest families will have to turn to food parcels and a further 760,000 will rely on donated food gifts. We surely all have a responsibility to ensure no one goes hungry whilst the rest of us prepare feasts for the holiday. The Hungry Campaign, The Felix Project and With Compassion are but three of the charities working together to deliver hundreds of thousands of meals over Christmas. The most recent figures for child poverty in the UK show 4.2 million under 16s living below the poverty line and is increasing steadily since the first lockdown.Dr Anthony Fauci has been appointed the Chief Medical Advisor in the USA. He has recently criticised British Journalists for gloating that the UK was first in the race to use an effective vaccine. I think not only journalists were guilty of this, some of our politicians were equally guilty.It should never be considered a race. It was truly international collaboration. There are differences between them and each will have its own set of guidance Fortunately the regulators both here and in the USA are fiercely independent. They would not be swayed to do anything to compromise the quality of their screening. There are a small group of very vulnerable people such as those on chemotherapy and those without a spleen who will need careful individual assessments by the clinician doing the immunisation. None of the eligible vaccines are live, but because of the lack of data pregnant women should not be immunised, but there is no evidence of harm so far detected.There are some as yet unconfirmed reports that the Lamp test for Covid based on saliva testing may not be as reliable as first suggested. Manchester are for the time being pausing its use in Care homes and Hospitals in favour of doing the more uncomfortable throat and nose swabs.The alcohol ban in Wales is causing rising anger as it comes into play at 6pm. It will be reviewed again before Christmas. There is no alcohol to be sold from pubs, restaurants and bars. History tells us that the prohibition in the last century caused widespread discontent and drove drinking underground. I am told the first Minister for Wales has been given a lifetime ban on all pubs in Wales. We should watch this carefully; it may cause more trouble that its worth.I brought to your attention last night the new country wide restrictions put in place by DEFRA to counter widespread outbreaks of Avian Flu. Several strains are involved but none of them are likely to cause disease in humans. It is carried by wild garden birds flying about. If you have a few garden chickens or you farm tens of thousands of turkeys you are by law obliged to keep them indoors in sheds. They are not allowed to free roam. There are strict rules for people working on poultry farms and the use of protective clothing. You can carry the virus on your feet or your dog’s feet. Do not exercise your dogs near poultry farms. You might want to secure your Christmas turkey before widespread culling becomes inevitable.Meanwhile do not relax, stay very alert, follow all the rules, wear a mask that does the job and remember the 2M distance. Don’t forget to share your thoughts and experiences and stay safe.

December 5 2020

News on Covid 19 is somewhat sparse in England, so I have looked further afield today. We may be seeing a reduction in the rate of new cases but we still had 15,539 new cases in the last 24 hours. There have been 397 deaths. This death figure is 20% lower but is probably because less deaths are reported on Saturday and Sunday. The 4 chief Medical Officers of the UK have jointly reminded us that vaccine will have very little impact over the Winter months. Hospitals will remain stretched with high patient numbers, as we usually are between December and March. It is not going to suddenly be better as more people are vaccinated in the coming months.In Russia, 70 Polyclinics are giving their Sputnik V vaccine to the general public. They have been using the vaccine since August despite the fact that it is still in phase 3 trials and has not yet passed all the safety tests required. They are not giving it to pregnant or breastfeeding women. Russia has now seen 2.4 million cases and 42,000 deaths. Remember every country does their own thing counting deaths so cannot easily be compared to our figures.France is planning to roll out the vaccine starting in January. There is apparently the highest level of distrust of the vaccine compared with anywhere in Europe. A recent survey suggested only 53% of the population wanted the vaccine, France’s Vaccine Minister has promised full transparency and information sharing. He has a big PR problem to cope with.Poor Kier Starmer has had to go back into isolation at home after one of his staff has tested positive. I imagine he can still sit on the fence there as well.Portugal is the latest country to announce its version of easing restrictions for Christmas. They are however going to crack down on New Year parties. Their Prime minister, Antonio Costa, has announced the travel ban between regions will be lifted from 23rd to 26th December but re-imposed for the New year. Every one must be in their own home by 2am. No street parties will be allowed. No more than groups of 6 can meet in public. I understand that Durham police have reopened their investigations of Dominic Cummings and his wife who went out whilst testing positive for Covid 19. A new dossier given to the police alleges perverting the course of justice which would be far more serious than breaking Covid rules. A number of different sources are now offering private testing to the worried well and those concerned they are visiting elderly vulnerable relatives and want to be sure they do not present a risk to them. Remember if you have symptoms or are told to test by Track and Trace you are entitled to a free test under the NHS. The only reason you may have to pay for a test maybe to prove you are negative before flying abroad.The sources of private tests include Boots and Lloyds in the High St. and Harley St. You can get a pcr test at Boots with the result back in 48 hours which would include a certificate for £120. I am not sure they can substantiate a 99% accuracy which they claim. Boots plan to offer the rapid version in the next few weeks. Lloyds offer the same pcr test for £119 and also an antibody test for £69 which involves a blood sample.If you prefer a trip to Harley St the pcr test is £175 with a result in 2 days. If you want premium service with the result back before 8am the next day it will cost £245.The London General Practice based in Harley St will do you a same day pcr test for £295 or if you want to know if you have antibodies it will cost £195. Superdrug claim 100% specificity for their antibody tests at just £69. I am sure no reputable test can be guaranteed 100%. Please remember you should not have to pay for a test unless for foreign travel. There are people ready with scams and others doing genuine tests at inflated prices. There are always some wanting to make money. Avoid a trip to Korea, where there are now several independent reports of third wave outbreaks in Seoul the capital. One cluster involves 249 from a dance class and another 21 cases from a wine bar. There were 583 new cases reported last Saturday,Finally in Iran, deaths have passed 50,000 with more than 1 million currently affected. There have been 321 deaths in the last 24 hours.There may not be much Covid news in the UK but many places I have mentioned still show we are still in the midst of a very serious global pandemic. We have no option but accept tight restrictions about mingling together . The only weapon we have is people being sensible enough to listen and cooperate with social distancing. Lockdowns and severe restrictions must stay with us till Easter at least. Herd immunity, despite the false claims, will take far too long. Vaccine immunity looks promising but will take a long time yet. There is a way out of this and we will get there. Listen to the main stream science. Recognise every country is in the same boat. Remember to look out for one another, be kind and friendly and help charitably where you can. Doing the basics. Hands Face and Space will get us all to the next great Christian Festival of Easter.

December 6 2020

In an interesting research study in Australia ,14 dogs are being trained to detect the volatile organic compounds (VOC) that are secreted in human sweat. Apparently, if positive for Covid 19 the human will produce a distinctive odour that dogs should be able to detect. If the training is successful the dogs will be use to detect positive individuals at Airports in Australia. It is thought the odour might be detectable earlier than when the pcr test become positive and whilst still in the incubation phase before developing any symptoms. There is a lot of work to do but it has the potential to be a very promising and rapid screening tool.The popular Christmas market in Nottingham has been closed just 24 hours after opening amid concerns the market was overcrowded and there was no social distancing in a tier 3 area.The England Cricket tour of South Africa is in Jeopardy as 2 staff from the England hotel were found to be Covid positive this morning just an hour before a match was due to start. The hotel was supposed to have very high biosecurity to keep the whole team safe. There will have to be questions asked as to what went wrong. I cannot see it is possible to play the planned games now.7 men in a Care home have died from Covid after one of their Carers contracted it at a wedding where there were over 300 guests. Several other guests worked in Care homes.A man has been jailed for 21 months after deliberately spitting in the face of a man during an affray in Kent, whilst knowing he was positive for Covid. He should have been isolating in doors.Over 800 police officers have had to have sick leave after being in contact with someone with the virus. This has had a significant effect on Police manpower issues.Today’s data shows:389.476 covid tests were done with 17,272 being found positive in the last 24 hours.There have been a further 231 deaths, remember a lot fewer are reported at weekends. This brings the figure for the last 7 days to just over 3,000. The death rate is 4.2 per 100k of population.There are still 14,556 people in hospital on the 3rd December. Of those 1,274 are on a ventilator on 4th DecemberThere were 1,444 admitted on the 2nd December. Encouragingly, this figure shows a 12% drop over the last 7 days.There is no doubt we are moving in the right direction but there is a long way to go. We cannot go on losing 3000 people a week and having over 14,000 in hospital. Vaccine is ready to go and will begin to roll out on Tuesday. We must be in absolutely now doubt that this pandemic is still very real and taking many lives and ruining many more. I have shared several stories today of what happens when rules are ignored. Please do not become another statistic. We must all stick to the rules for months to come. A recent survey is said to show confidence in the Government is falling. Now it is alleged only 57% of people surveyed have confidence in the Government’s pandemic response. 68% believe it to be confused and inconsistent. At least there is still more support than outright opposition to the Government’s approach. What is clear is that apart from those regularly reading these notes the population at large struggles to understand and therefore support properly the tiers, the rules and guidelines that support them, and which will eventually help us get rid of this pandemic. Tell me how we can explain complex issues simply that the average man in the street can understand. Tell me how we can identify and deal with false or malicious news. I still get them sent to me every day. There is still uncertainty about when the oxford vaccine will get its final go ahead. Matt Hancock says it may be before Christmas or just after. Dr June Raine the Chief Exec of the MHRA would not give a timescale. She said “we’re working continuously around the clock”. Its approval will help the storage and distribution issues with the Pfizer vaccine because of the need to store at minus 70C.My rusty schoolboy Latin suggests that the word vaccine comes from the word for a cow. Who knows the connection between the two? If you know, just say I do, so we give every one a chance to say they have no idea. Then an explanation will make it all clear.Finally my usual request to stay kind and supportive , follow all the rules, minimise the Christian shopping, do it on line when possible. Avoid packed shopping malls or Christmas markets. How about hand sanitizer as a gift for those who break the rules? Please Stay Safe.

December 7 2020

Firstly an apologies for a rather late and brief report tonight. I have been involved tonight in a major zoom conference with presentations from doctors and others involved in the ammonium nitrate explosion in Beirut back in August. It brought together many hundred Emergency surgeons, Intensivists and medical emergency and disaster planners. A truly remarkable series of presentations and discussions of lessons learnt.The UK media seem preoccupied with the introduction of the vaccine tomorrow we shall hear nonstop tomorrow about it, needle by needle.Meanwhile there is still concern that London should be reassigned to Tier 3. The R number has just crept back above 1.0 again and there has been a slight rise in the number of new cases again even though they had begun to drop. There were 164 per 100k this week with only 159 per 100k the week before.There is increasing concern that the rush to get out and do Christmas shopping at the weekend following the end of lockdown will result in a substantial rise in new cases in 7-10days time.The Treasury have a different view on things. If London remains in tier 2 it will impact financially on 50,000 Londoners whereas if London moves to tier 3 substantially more will be affected.A major Hospital in Peshawar in Pakistan recently ran out of oxygen resulting in the deaths of 7 patients ,6 of whom had Covid, Criminal enquiries are continuing and several staff have been suspended.My area is in Tier 3 at present, but I note Tescos is to resume opening for 24 hours from the 14th December and that Boots are also going to extend their working hours. They claim its to allow shoppers better social distancing but I am sure there are other reasons.Todays testing shows 14,718 have tested positive, the total done is not yet reported. There were 189 deaths, and no new hospital data. I would like to hope that is a real drop in the number of deaths, but I fear it will be up again tomorrow, this is still, affected by Sundays deaths being under reported.Another person has been summoned and faces a £10.000 fine for a party in Nottingham. When will they learn!Our huge problems with Covid are but nothing compared with the incident in Beirut when they were also coping with the pandemic. Tonight’s seminar put a lot back in perspective for me. I again apologise for having a short report. I would as always appreciate any comments, ideas, criticisms or other comments, were any of you impacted by the explosion in Beitut? Do not try to store fertilizer at home even in small amounts.Keep going , keep safe and stay apart. You do not need to shop till you drop.

December 8 2020

V day has arrived!. Matt Hancock first used this expression and seemed genuinely visually moved by the beginning of the roll out of vaccine. It certainly has been a remarkable achievement in such a short period of time. Billions of pounds have been spent trying to find a vaccine for HIV. Although we have many vaccines now, there are still a number of diseases where it has not been possible to create an effective vaccine.Whether we needed the massive media cover or not I leave you to decide. There are calls for the PM and others to prove it’s safe by being immunised in public. Matt Hancock has already said he will, but by the time we get to his age band it will be nearly Easter. There have been suggestions that the Queen and Prince Phillip might be given the vaccine in public. What has happened to privacy?Cases are rising again in 126 Local Authority areas compared to a rise in 26 areas just a week ago. The North East is now doing best where figures are dropping. In North Tyneside there is the biggest drop from 235.2 to 152 cases per 100k of the populationBy comparison Basildon has seen a rapid rise in cases from 290.6 to 390.5 in a week. In the South East which is in tier 2 cases have risen from 143 to 275 per 100kIn London 23 of 32 Boroughs have seen a rise with Havering being the worst. You can easily check how your areais doing on the gov.uk covid dashboard site.The statistics today officially show 12,282 people have tested positive from 215,981 tests done in the last 24 hours . This is actually a 1.5% rise in the number of cases in the last week.The death figures are worse than I predicted yesterday and is 616 in the last 24 hours. This is still a rate of 4.1 per 100k. a very slight 0.3 drop over the last few weeks.There were 14,807 people in hospital on 6th December, with1,271 on a ventilator. The last admission figure was 1,458 on 3rd December.My home town, Boston. remains very high, 4th in the country but the rate has dropped and is now 443.2. per 100kSo overall a mixed picture, the effect of lockdown has come and gone but already the tiers are showing problems in a large number of areas. I am sure some areas will need to rise to tier 3, especially London and parts of Essex. It is I am afraid a matter of sticking to the rules or else. We will see a third wave in January and back to severe lockdown. On a day when we can all see a time when this will end, as vaccine begins to protect us all we would be insane to risk it all now, It certainly is not over yet but it might be the beginning of the end, but it is still months away.Prince William and his wife have travelled the United Kingdom to help encourage and boost morale, they have been received with great affection. Because of the different travel restrictions some in Scotland and Wales have questioned whether they should be doing this. What do you think? How valuable is a royal visit to boost morale and give encouragement? Or is it an unwelcome distraction?Four lions have tested positive for Covid 19 in a Spanish Zoo where two keepers have tested positive. Although Covid infection is very rare in animals it has been seen in big cats before, as several lions have previously tested positive at the Bronx Zoo in New York.Finally there is a mystery illness hitting a town in India with over 200 in hospital, many of them children. They have all tested negative for Covid and so far all toxicology tests have been negative. The water source is implicated but nothing has been confirmed. My medical friends may remember the outbreak of a mystery illness at the Royal Free hospital. I am not suggesting the two are related but it is interesting to see how they are investigating it.Please keep going, but don’t go out unless essential. Support the efforts of others to get us safely through the winter. Stick to the basics and stay safe. Victory is now within sight, as long as the boat does not capsize.

December 9 2020

Day 2 of the vaccine roll out brings a caution not to have the Pfizer vaccine if you are known to have previously had an allergic reaction and need to carry an epipen for emergencies. Two health care staff had severe reactions to the vaccine, both had had previous reactions to vaccines and carried epipens. They are both fit and well again, One source described the reactions as anaphylactoid but not full blown anaphylaxis. I think this must be true as they both recovered quickly. The MRHA reacted quickly and their head Dr June Raine has advised people who need to carry epipens because of previous anaphylactoid reactions not to have the Pfizer vaccine for the time being. It is expected that there would be about a 1% allergic reaction rate. This is why patients are asked to wait for 30 minutes before leaving in case a reaction is going to occur.The widespread coverage of the patients on Television has raised some interesting issues. Many of you my readers will either have given im. injections or the rest of you will have had one. What are your views about the operator wearing gloves ? I am assuming both the nurse and patients have been known to be negative when recently tested. I notice a lot of apparently not medical people, asking why no gloves were being worn.My view is that this should be a no touch technique when handling the vaccine and diluent and I therefore would not normally be wearing gloves. I personally found the fine movements required to get the exact volume in the syringe with no air bubbles is a lot easier without gloves on.What colour needle would you use? It seemed split 50/50 between yellow and blue. I am used to the two different techniques used in giving injections. I use a dart technique whereas other just pushed. What do you think about this? What is your preferred method? I did not see anyone draw back to check the needle tip was in a blood vessel, but then neither do I, so that seems to have been dropped from training. I also notice the difference in skin prep. Some swabbed the area others did not. I was told at one stage in training not to bother with this as it increases the number of bacteria on the skin surface and increases the risk of infection. What do you think of that theory?Germany has high figures as we have in the UK. A very emotional Angela Merkel speaking quite personally was pleading today for people to follow the rules especially over Christmas. She warned Germans “you may not see your loved ones again after Christmas” if you do not exercise extreme caution.PHE has raised the issue of those with learning difficulties. Noting that a new study shows they are 4 times more likely to catch Covid. They blame this on health inequalities, but some of the problem is the inability to understand social distancing, their need for hugs and reluctance to tolerate a mask. The Evening Standard has highlighted this and is asking they get offered a higher priority than age alone.Wales has had a surge in cases after their firebreak ended. Their First Minister is blaming public fatigue and household mixing.Reuters have reported rather strange advice being circulated in Russia. Those being given the Sputnik 5 vaccine have been told not to drink any alcohol for 2 weeks before and for 42 days after their immunisation. As you can imagine, this is not popular especially at Christmas and the New Year. Others have said 1 glass will not hurt but you should have none at all for 3 days before the vaccine, This does not seem to be a joke, but imagine what would happen if that advice emerges for us tomorrow.Todays figures ;294.966 tests were conducted, with 16,578 tests positive, at a rate of 154.8 per 100k. The rate has risen by 4% in the last 7days.There have been 533 deaths reported in the last 24 hours at a rate of 4.2 per 100k. This thankfully is 9% down on a week ago but is still far too high.1,459 people were admitted to hospital on 3rd December, making 15,254 in hospital on the 7th December, with 1,272 on a ventilator on the 8th December,So. if offered a vaccination against Covid you should have one if not ill or have had a previous anaphylactoid reaction. You should have one if you are fully recovered from a Covid infection, but if it is very recent allow time to fully recover before you have one. You have to continue to follow all the rules after being immunised. And of course. if you catch it a week after the vaccination it did not cause it you had caught it before your immunity could develop. Your immunity will not be complete until 7 days after the second jab.You must all stay safe and stay apart.

December 10 2020

Deaths continued to be recorded as over 500 per day. showing we still have a long way to go, The 7 day rolling average was however 3.2% down compared with the previous 7 day average, the actual figure today was 516.369,586 were done in the last 24 hours with 20,964 being positive. this is a rise of 12.7% in the last 7 days and a rate of 157.8 per 100k.15,242 people are in hospital with 1,243 on a ventilator and 1,464 admitted on 3rd December, these figures seem static but are a week old.London again now has some of the highest figures in England with rate of cases rising in 24 of the 32 Boroughs. This has led to calls to put London in Tier 3 at the review due in 6 days time on the 16th December. An equally vociferous crowd are wanting to resist the move. I know I would not want to make the decision. Several boroughs just in Kent and Essex are seeing rapid rises as well.Matt Hancock announced to night that all school children aged 11 to 18 in the 7 worst London Boroughs are to be targeted with mass testing. This approach worked in Liverpool and Leicester and should help deal with the surge in cases there.Wales, another area with rising rates are to switch all secondary school teaching back to online only as from Monday, It does seem schools need more targeting at present.Italy has seen 887 deaths in 24 hours and the USA saw 3000 deaths We have global pandemic and it needs global leadership to resolve it. I have not seen any comment or news from the WHO recently.Apparently Track and trace has now reached 86% efficiency in tracing contacts. I understand if found positive now you can claim £500 through the T and T App.Three wings of the immigration detention centre at Gatwick have had to be closed following a Covid outbreak.The canary islands have been removed from the travel corridor again. Those who decided to grab a holiday will now have to self isolate on their return.The EMA or European Medicines Agency has confirmed it had been subject to a cyber attack accessing illegally some data on the Pfizer BioNTec vaccine. No details have been released.The most concerning news of the day is that the knock on effect on waiting lists for non urgent and some urgent surgical cases has risen from1,321 waiting in October 2019 when we were confident the waiting list would be cleared soon. to days figure of 162,888 waiting. They will take years to clear again and will leave many thousands with mobility issues and chronic pain. You will not see this in covid statistics but it clearly should be.Please remember if you are immunised tomorrow you will not have any immunity for Christmas and you will not be protected until a week after your second jab, so not till mid January at the earliest. If we have 500 deaths a day for the next 5 weeks another 17.5 k people will die of Covid, Surely that is enough for you personally to say lets minimise Christmas activities and stay apart, remembering Hands Face and Space Just play your part to keep everyone safe,

December 11 2020

Changes in the isolation rules have been announced today which most will welcome. If you have to self isolate after returning from abroad or if you have been told to self isolate by track and trace you only have to isolate for 10 days instead of 14 days. The new arrangements start on Monday. If you have already been in isolation for 10 or more days on Monday you can come out of isolation then. This is a UK wide arrangement from the 4 CMOs acting together. Recent research suggests less than 2% of people are infectious at 10 days. It is hoped more people will comply with the rules if the time is shortened, It also means that those beginning to self isolate on Monday will be released in time for Christmas day. They seem to be unable to update the NHS Covid App so you can now stop isolating when it tells you you have three days left to isolate, apparently it cannot be updated until Tuesday next,Another plan to reduce the social isolation involves giving those affected a handful of self tests to do daily. if you have seven consecutive negative tests, you can assume you have not contracted it abroad or from your contact and can the stop isolating after just 7 days.I am concerned that the army of track and trace workers that were recruited have only worked for 1% of the hours they were contracted and paid for, this means an enormous waste of money.It has been confirmed that MPS will no longer be receiving a £3000 pay rise next year. Their pay has now been frozen for next year. Many MPs, to give them credit, had said it was not appropriate in the circumstances.My computer again made me an offer of very attractive face masks and suggested them as Christmas presents. I read their spec. It told me all about the 100% efficiency in preventing bacteria penetrating it. I also explained its high resistance to dust. What it did not even mention was its performance against viruses. Any face mask you use in this pandemic is to help reduce the spread of the Covid virus. As it does not mention viruses in its selling points I suspect they are completely ineffective and will give you a false sense of protection. Please read the small print before buying masks.SAGE are still warning of the risks Christmas will pose. they have today called for a Covid fuel allowance to help people keep their house warm when frequently ventilating it to reduce the risk of spread indoors.I am pleased to hear the Historic Royal Palaces charity has been given a government loan to help ensure their survival.Nicola Sturgeon, always talks sense. Today she pleaded for caution in the shops. she advised that if you find them crowded you go away either to other less crowded shops or to come back at a quieter time.. She also reported a further £50m support package for Scottish sports.There is an interesting development on the vaccine front with the Oxford Astra Zenica team looking at a combined vaccine with the Russian sputnik 5 vaccines. Volunteers are being sought to take part in trials of a combined vaccine.The successes of getting from Lab to Jab in under a year are still being praised. The previous record was 4 years with the mumps vaccine at 4 years and the Ebola vaccine at 5 years.There is another emerging story to watch which suggests there may be a genetic reason why some are much more susceptible to infection than others. I shall follow this with interest and let you know if I can get more detailed facts.Morocco have started to use a Chinese vaccine.Eton School has closed after several students and staff are found to be positive. all teaching for the rest of the term will be on line. With Exit from the EU now looking to happen with no deal. keep an eye on changing rules. Driving in Europe may require an international driving licence and a green card for insurance. Importing or exporting semen may become a problem as well as transporting dogs to and from Europe. Their passports may become in valid.Statistic are last tonight as had not been published when I started writing. Over 400,000 tests were done with 21,672 positive. this rate is rising again today, 424 deaths are reported which is a 5% drop It remains to be seen if this is the beginning of a downward turn or just a quirk in the daily figures.We must just keep going Please consider very carefully what you are doing over Christmas. you do not have to do it just because you are allowed. Many of us will have a quiet Christmas and wait quietly at home until the vaccination programme begins to have an effect. Please all stay safe.

December 12 2020

SAGE is still making very strong warnings about the danger of relaxing the social distancing rules for 5 days over Christmas. They suggest there will be a very real risk of a third wave. I share their anxieties and would urge you all to postpone your Christmas get- Togethers wherever possible. Every family situation is different and some families have found the current conditions much worse than others.The daily statistics show that just over 400,000 tests were done in the last 24 hours. 21,502 of these were positive. that’s a positive rare of 167.3 per 100k of the populationthe death rate remains above 500 at 519 even though these are Saturday figures. There have been over 3,000 deaths in the last 7 days.Currently there are 16,531 people in hospital on the 8th December with 1,729 admitted on the 10th December.1.275 are on a ventilator.Rochester Cathedral is being used to do Covid testing and Blackburn Cathedral and several other churches are to become vaccination centres. they are expected to be used for up to a year.Peru has had to suspend the Sinopharm Covid vaccination whilst they investigate a possible side effect in a patient given the vaccine.they plan to give 3,4 million doses of the covid 19 vaccine in a month.Most of Switzerland is facing tight restrictions when all shops, bars and restaurants must close by 7.pm from tonight. Switzerland has a population of 8.6 million and has been seeing 5,000 new cases a day and some 100 deaths per day I am working on a report about the genetic variability in the severity of covid infections which I hope to write up soon You know what to do now; we must not lose it now. stay apart, follow all the rules and lay low over the holiday please stay safe

December 13 2020

I apologise for a rather technical report today to give you some idea of the background science.I promised today that I would try and update you all on recent studies on the virus SARS-CoV-2 which is the causative agent of the disease Covid-19. It is true that this infection can produce a remarkably diverse spectrum of outcomes ranging from asymptomatic to fatal. One large American study has shown that most infections result in mild illnesses that are managed at home. About 14% are hospitalised and about 5% prove fatal.Epidemiological studies have identified several risk factors for the severe form of Covid 19. Age is thought to be the greatest risk factor but the coexistence of some common diseases such as high blood pressure, type two diabetes, obesity and asthma. The male sex and being of BAME origin may also increase your risk of catching the severe form of the disease.The genetics is complex and unless you have studied genetics you may find this difficult to follow. I will do my best to simplify it without losing accuracy. There are two genetic loci (places on the chromosomes). One is on the chromosome numbered 9 near the ABO gene, which determines blood type. The other locus is to be found on chromosome 3 near a cluster of genes with known immune function.These two loci have both been studied and replicated with metanalysis conducted by a research group called the Covid 19 Host Genetics Initiative (HGI). This identified further novel associations on chromosome six near FOXP4; and on Chromosome 12 near a gene cluster encoding antiviral restriction enzyme activators. There was a further link to chromosome 19 near TYKO and on Chromosome 21 near IFNAR2. Other studies have also reported evidence of other rare variant associations, but this still awaits replicant studies.One of the biggest databases of normal individuals is Ancestry, a family history resource that looks for family matches to link family trees. Ancestry demonstrated that males were more likely than females to swab test positive than males (OR or odds ratio 1.36). People aged 18-29 reported higher exposure than all other age groups and were at a sightly elevated risk ( OR 1.28) for a positive diagnosis than those in the 50-64 age group, even among people with the same exposure and sex. People aged 65 and older were significantly more likely to be hospitalised (OR 1.60) compared to those aged 50-64 even when accounting for differences in health conditions obesity and biological sex.African-Americans were more likely to develop Covid 19 (OR 1.23 ) and were also more likely to report progression to a critical case compared to those with European ancestry (OR 2.34) after accounting for all their health conditions, age, obesity and biological sex.One locus indicated a genetic association with Covid 19 outcomes. This was found near the IVNS1ABP gene which is associated with influenza virus replication and this was only present in males. This may ultimately provide a clue as to why males appear at a higher risk of Covid 19 infection, hospitalisation and mortality.Researchers at the university of North Carolina identified a gene that when silenced by a mutation, makes mice highly susceptible to the SARS CoV which was the virus responsible for SARS (The Severe Acute Respiratory Syndrome). This gene is known as TICAM2 and it helps code for a protein that helps activate a family of receptors called toll-like receptors (TLRs), that are involved in the first line of defence against pathogens, the so called innate immunity. Now it is the SARS CoV2 virus of Covid 19 that is being studied carefully . This time it may help to explain the excess number of men who have severe infections. Men make up 73% of ITU infections with Covid 19 in France. Behavioural and hormonal differences may be partially responsible but genes are now thought to play a part in the mix. Women have 2 copies of the X chromosome whereas men have only one copy. This means women carry double the copies of the gene TLR7, a key detector of viral activity that helps boost immunity.The links with blood groups I have already mentioned were researched at the Southern University of science and technology in China , the study is not yet peer reviewed but they analysed the blood types of 2,173 patients with Covid in 3 hospitals in China . Blood group A appeared to be associated with a higher risk of contracting the virus whereas type O offers the most protection. Blood types bear two different kind of saccharide (sugar) molecules on the surface of red blood cells. Each kind of molecule is produced by an enzyme whose gene exists in two forms (one for type A and one for type B). A third gene variant encodes an inactive enzyme type 0 (derived from the German “ohne” without). If a person has variants of A and B of the enzyme they have the AB Blood group. People with blood group O have both anti A and anti B antibodies. Whereas people with blood group AB will have no antibodies. A study at the university of Nantes in France in 2008 showed that the binding of The SARS virus protein S to a cells ACE2 (angiotensin converting enzyme 2) which would be necessary for infection to take place is inhibited by the Anti A antibody. There is still no data for the Anti B antibody.The ACE1 enzyme is a close relative to the ACE2 enzyme and the former is important in Blood Pressure control. This seems to be why raised blood pressure seems to be a risk factor for severe Covid. If you want more technical reports from time to time please let me know, if you can help explain things simply please have a go. As always a lively discussion after this is published makes it worth while. Share your thoughts and ideas.Over 400,000 tests were processed on 10th December. 18,447 tests were found to be positive yesterday at a rate per 100k of 173.5, this represents a 19% rise in new cases over the last 7 days.Deaths were much lower but this I am sure is due to underreporting on a Sunday, the figure was only 144. I fear by Tuesday it will be up to 500 again.Brexit talk may have pushed Covid from the headlines but trust me it has not gone away. The death rate next week will stay very high. We still have a lot to do; please seriously consider how you can delay Christmas festivities for a few more months. The more of us that do it the greater the chances there will not be a spike and third wave around the corner, it needs a great proportion of the population to comply not just the faithful few. If London goes to tier 3, I will not be surprised, people are not staying apart. Sadly we all suffer then. Please follow the rules and minimise all social contact unless essential and keep alert, look out for trouble and walk away from it.

December 14 2020

Matt Hancock announced in Parliament this afternoon that the rapidly rising number of new cases of Covid 19 in the South East, particularly Greater London , West Essex, South Hertfordshire and Kent was largely due to a recently discovered new variant of Covid 19, this is due to a mutation of the virus. At first this sounds alarming, but it is not nearly as bad as it might sound. Scientists at Porton Down have worked out the genome of this new variant and it joins a list of about 4,000 mutations detected in the UK alone. Mutations are an every day event in the life cycle of a virus. There have been more than 20,000 identified since this virus was first identified. We know from previous studies that mutations of the virus are very unlikely to change things that would make the virus more harmful. It is also extremely unlikely to make any anti Covid vaccine less effective. But we will need to check this out. I gave you a lot of complex virolgy yesterday so I will leave it at this tonight. Look out for mentions of DNA strands labelled D146G and 20A EU1 where the latest mutations are found.The UK Recovery trial has stopped further studies on a cheap antibiotic called Azithromycin after a double blind trial showed no benefit when severe Covid was treated in hospital with it. Some 2582 patients were treated with it in hospital. a similar number were not treated with it. It showed no benefit with a 19% mortality in both groups.It appals me that the antivax brigade are out already in London complaining. I think the police will soon lose patience with them and we will see further conflict.There is serious concern about the NHS being over run in Wales. Almost all hospitals are running at capacity.The Netherlands starts a month long curfew from now until 19th January. All schools, non essential shops, hair salons, restaurants bars, museums and theatres shut.France returns to a curfew from tomorrow. Everything must close by 8pm. The Mayor of New York has threatened total lock down in New York after 10,000 new cases in New York just yesterday. There is no race between countries to be the worse affected but today Italy passed the UK in having the most number of deaths from the pandemic 64,520 compared with 64,267 in the UK.The Health Secretary moved rapidly and decisively to respond to the growing crisis around London by moving all of Greater London, West Essex and South Hertfordshire into tier 3 with effect from midnight tomorrow night, Kent is already in tier 3. He made it very clear that this was too urgent to wait for the review in 2 days time. Action was essential now.. Community Testing is to be greatly increased as well.We must seriously now consider and reconsider our plans for Christmas. Is a family party worth more than peoples lives. We can move our personal Christmas festivities to Easter or the summer without too much trouble and I know from your comments many of you feel like this now, many countries are not now relaxing the rules over the holiday and I do not think we should either now. We must do what ever it takes to keep going and survive until mass vaccination begins to bite.There is more interesting work being done on the long Covid syndrome. A new study, not yet peer reviewed, suggests a large fraction of long Covid patients have autoantibodies for multiple allergens. This may well lead to us finding away to interrupt the course of long Covid in the future. Remember an auto antibody is one that turns round and attacks normal health cells of the host in conditions like rheumatoid arthritis.The First World leader of a nation to die of Covid 19 was announced today as the prime minister of Eswatini . If you know where that is well done. I had to look it up. Most of would know it as Swaziland, a small country of 1.2 million next to South Africa. They have had 6,700 cases and 127 deaths. A new born baby giraffe born in a zoo this week has been named Margaret Keenan.We are at another crucial point in the history of this disease. Now much of the country is in tier 3. Before long if we continue to behave as we are we will need a tier 4 and then a tier 5. I urge you to minimise your Christmas festivities, look forward to a double celebration of surviving the pandemic and having a vaccine later next year. If you must go out, shop in the quietest times, or on line. If you must have a party leave the windows open and wear a coat.If you are honest with yourself you know you must just follow the rules. Keep going, keep apart and keep away from shops or markets, just stay safe.

December 15 2020

After a week of increasing pressure on the Government to rethink the plans for 5 days relaxation of the rules for Christmas, things reached a peak with the BMJ and the Health Service Journal sharing a leading editorial warning that the relaxations were dangerous, threatened lives and over whelming the NHS. SAGE had already suggested the rules should be reversed and even tighter restrictions were now required, The Independent SAGE asked where is the science in keeping the Christmas break. It is clearly a political one aimed at pleasing the public. Sir Keir Starmer has also asked for an emergency Meeting of COBRA tomorrow to discuss all of this. The Mayor of London has also supported requests to reconsider. Those of you who read my daily notes regularly will know I first called for a rethink over a week ago. As a result of all this pressure, as I am writing this, Michael Gove is chairing a meeting of the Devolved Nations to decide what if any changes they could make.Sometimes changing one’s mind can be a sign of strength and determination. Yes of course there will be complaints but for the vast majority it is a life or death decision, with most wanting to see their family next Christmas. The Government can claim the public were not complying with the rules properly, the rules are almost impossible to enforce, and there is a new variant mutation that has yet to be fully assessed, but may be able to be retransmitted at a greater rate. Of course there is a major socio-economical impact particularly on the hospitality sector; is it really worth 500 deaths per day? Of course there are psychological and emotional repercussions, but if we all pull together and reach out to support one another, if all use of the telephone and computer is free over the holiday and organisations like Zoom are supported to provide a free service we can go a long way toward countering the worst effects of disappointment and isolation. Many people will be only too pleased not to have to go Christmas shopping. A U. Gov. survey suggests 70% of over 4000 questioned do not want the tier rules reduced.Vaccines are being prepared at pace now. A recent study in the USA suggests the general population have begun to accept the vaccine. 27% say they will have one when available compared with only 13% a week ago. 21% say they will choose not to have one. I think there is a Trump factor involved here. In the UK nearer 80% are ready and willing to be immunised in due course.It is interesting to look at the total cases around Europe. Cases per country break down like this;Italy 65,011UK 64,500France 58,282Spain 45,013Russia 46,846.Looking at average number of daily deaths in the last 7 daysItaly 629Russia 542Germany 431UK 424Poland 397.Todays statistics from the UK show;18,450 positive cases in the last 24 hours and 506 deaths reported in the last 24 hrs. The figures for the Devolved Administrations are interesting;Wales 615 new cases and 9 deathsScotland 845 cases and 24 deathsN Ireland 486 cases and 6 deathsEngland 16,504 cases 467 deathsA hairdresser faces a £10,000 fine for turning her basement hair salon into a lively night club.The Moderna vaccine is close to being approved by the regulator.Weekly testing for all secondary school children is to start soon. this will be very welcome as there have been calls for term to finish early and to move on line. One council, Greenwich, voted to do this from tomorrow only to have it vetoed by the Government and threatened with legal action. I would like to see the science behind this extraordinary decision as I suspect it is purely political. I was very impressed by one headmaster who described his problems of being about 25 teachers down and about 300 children self isolating. The juggling of class teachers was a nightmare. he only had one approved first aider at work and if she went off for any reason he could not open the school. Similarly he only had one person left who can maintain the heating. If that goes off he would also have to close schools. I totally accept that education is important and for secondary pupils having them at school has them under supervision. I am sure primary school children could miss a whole year’s teaching and still catch up again. Does anyone have any evidence about this? If there is any change announced later I will try and report it. meanwhile revisit your plans consider whether you can alter or reduce what you wanted to do. If you are having a family group indoors, try and plan to improve ventilation , position seats so you are not facing one another. Even a move outdoors could be considered around some patio heaters or barbecue. Go shopping at the quietest times. always use your mask as required and wash your hands and use the sanitizer. Please stay safe, look forward to a Christmas feast at Easter.As always your thoughts, suggestions, ideas, and personal experiences are very welcome.

December 16 2020

This Christmas certainly will not be normal, but the PM announced it would be inhuman to cancel or curtail Christmas Festivities. He admitted that when the plans and rules were made, they did not anticipate the surge of cases we have seen. He and all other politicians and leading scientists are pleading for public responsibility in Christmas plans. Boris Johnson recommended that we consider, even at this late stage, whether we can change or modify our plans; “A smaller Christmas is a safer Christmas and a Shorter Christmas is a safer Christmas”.It was made clear that the limits set in law are the absolute maximum, they are not targets to aim for. However, responsible citizens will look to adjusting their arrangements and postpone their festivities until Easter or the summer whenever possible. Vaccines next year will make things easier.It was recognised that for a few, particularly those living alone, especially those with mental health problems will benefit from seeing family and friends.There was further advice to help over the holiday period. People were asked not to travel long distances or stay overnight unless absolutely essential. The law will remain the same so such actions would not be illegal. You could avoid meeting up with elderly relatives until they have had 2 doses of the vaccine whenever possible.Nicola Sturgeon gave similar advice urging people to reconsider plans and remain with your own households whenever possible. Wales on the other hand have said they intend to change the law to only allow a maximum of two households to meet together.I am afraid the powers that be, have been were unduly optimistic when they set the Christmas rules. We should have noticed what happened in the USA after Thanksgiving when there was a substantial rise in cases and the inevitable deaths.Prof. Chris Witty put it simply “Keep it small, keep it short and keep it local”, and the Prime Minister said “Have yourselves a very merry little Christmas…. And I mean little”.Please give the Christmas Boxing day sales a miss this year. The money you can save on bargains will just not be worth it.The Tiers currently in place are being reviewed today and will be made public tomorrow. So that will be covered in tomorrow’s report. The new Tiers will run from Saturday for 4 days and then be paused until 28th December when they start again.France plans to start immunisation in the last week of December. Usually, the European Medicines Agency urges all members of the Union to act together but their rules do allow for individual nations to act alone in an emergency.The American roll out of the vaccines is known as” Operation Warp Speed”.Todays figures were late once again but there were 25,161 new positive cases in the last 24 hours and 612 deaths. We have a long way to go yet, surely the numbers here will make many realise they could, just this year, cancel celebrations and plan to live to enjoy them later.There is an interesting study published today by universities in the USA looking at the effectiveness of the disposable 3 layered face masks used by me and many in the NHS. A new mask filtered out 75% of all particulates whereas when re-worn for a second time the efficiency fell to just 25% and continued to drop each time it is worn again. Virtually nobody wears masks properly and in some situations they can increase the risks to others.The Office of National Statistics have been studying “long Covid”. They found 20% of people with long Covid had had symptoms for at least 5 weeks and more than 10% had symptoms for more than 12 weeks.Mike Pompeo, the US Secretary of State, is the latest US politician to Catch Covid, he is having to self isolate.I let the PM of Sweden Stefan Lofren have the last words tonight. He says :“Don’t go to gyms, don’t go to libraries, don’t host dinner parties. CANCEL.” There is lots to discuss today and your thoughts make writing this worthwhile.Our Government would like us all to be sensible responsible citizens and to think of the common good before our own. They recognise the personal circumstances of some individuals makes this difficult if not impossible. That’s why they are not changing the rules to make a criminal out of some one who does have to travel and see very lonely, depressed family members . If 80 percent of us can change our plans we can save many lives. As today’s figures show, it is over 600 deaths per day. Please stay safe, stay at home and stay apart.

December 17 2020

As anticipated, the new Tier regulations that start at 1 minute past midnight on Saturday for England were announced by Matt Hancock today. Given the decision yesterday not to change the laws about the Christmas break, it was always anticipated that the Tiers would toughen as compensation.Bedfordshire , Berkshire, Buckinghamshire, Hertfordshire, Surrey except Waverley, Peterborough , Portsmouth Gosport and Havant, and Hastings and Rother all move up from Tier 2 to Tier 3. All the Greater London boroughs were moved into Tier 3 last Wednesday, so now over 79% or 38 million people of England are in Tier 3.Bristol and North Somerset were moved down from Tier 3 to Tier 2. Cornwall, the Isle of Wight and the Scilly Isles remain in Tier ! The furlough period has been extended for a further month until April and the Government Loan Scheme has been extended to the end of March.If we allow our lax and irresponsible behaviour to continue over Christmas and the New Year you can be sure that in January even tighter rules will apply again with the Government introducing a 4th Tier. They have already said today that a third lockdown cannot be ruled out.A devastating amount of food is likely to go to waste in the next few days. Many pubs and restaurants had ordered about 10 days supply of food to allow them to provide meals over the next 10 days. There are a variety of schemes being set up to minimise the wastage and to get it to the most deserving causes and food charities.The only thing left that I can see helping keep people at home could be atrocious weather. The forecasts suggest very wet and windy weather. We would need 2 ft of snow to stop things and that would be hardly fair on those who have to work through the atrocious weather. Fortunately, it’s not very likely either. We certainly do not want a repeat of the floods of a year ago.Dr Fauci the Chief Medical Officer in the USA says that the Moderna vaccine is likely to get FDA approval for emergency use tomorrow. 2.9 billion doses have already been transported to 145 central locations in anticipation of approval.Another single severe reaction to the Pfizer vaccine has been reported in Alaska. This time there was apparently no past history of allergies. A full investigation is underway.Spain is a worry again with new cases rising rapidly for 4 consecutive days. The cumulative figures for last week show the case rate is 201.6 per 100k.It is very likely that Tenerife will ban UK tourists from entering the island as again new cases are surging. Airlines are urgently trying to clarify the position. If already there you will be able to travel home. I hope none of you were planning a Christmas retreat to the island as you may be grounded.The statistics today seem skewed but that is because in the small print they explain that 11,000 positive cases in Wales “went missing” without being recorded and have now been found again*.364,388 tests were done in the last 24 hours with 35,383 positive*. The rate of positives is 213.5 per 100k.Deaths recorded in last 24 hours was 532 at a rate of 4.1 per 100k.In the hospitals, 1,725 were admitted on 13th December with a total in hospital on 15 December of 18,009. 1,340 were being treated on a ventilator.The picture remains grim in the UK as well as the USA and much of Europe. The stringent Tiers are the inevitable consequence of the collective disregard for a common-sense approach. They will get tougher after Christmas I am sure. If you are hungry or in severe need look out for some cheap food being disposed of by restaurants. If anyone is in real need please message or email me and I would do my best to help.Mean time remember, have a merry little Christmas, and keep it small, keep it safe and keep it short. Maintain well ventilated rooms, well-spaced seats, ban smoking indoors and all wear masks if there are vulnerable people present in your festive bubble.Stay safe everyone.

December 18 2020

There continues to be a lively ongoing debate about what should and what should not be done to control it. I think the vast percentage of us now accept that we have a serious problem still. I am saddened to still be getting the occasional message saying its no deal, its not worse than the flu. From time to time the conspiracy theories are used to try and shut me up!SAGE our very eminent and large group of scientists and medical doctors, who are advising the Government have reported with increasing concern that the reproduction number or R has risen to between 1.1 and 1.2 across the country. At the end of November it was 0.8 to 1.0 so you can clearly see why cases are rising again. The greatest rise seems to be in Eastern England and the lowest is the North East of England.Wales have seen dramatic rises in cases. At Merthyr Tydfil the case rate is 1,226.7 per 100k, the worst in the whole of the UK. Deaths in Wales have risen above 3,000 with 2,801 new positive cases yesterday. Their 7 day case rate is 566.2 per 100k. Wales moves to a local Tier 4 on Monday.President Macron of France, who tested positive yesterday, is reported to be unwell today with fatigue and a cough. I do hope he does not deteriorate and I wish him a speedy recovery.The Metropolitan Police are asking people not to attend any anti lockdown demonstrations. There are several planned around the country including Parliament Square. The public are warned that if they join a demonstration they will be committing a criminal offence. I do not think the police will tolerate flagrant public health risks that will be illegal.Sweden have tightened their national restrictions making face masks mandatory on public transport with bars and restaurants banned from selling alcohol after 8pm.The rise in the number of cases in prisons has been highlighted. There are 121 prisons in England holding some 79,000 prisoners. By the end of November 3,429 had contracted Covid 19 with 15 deaths in the month of November alone.Northern Ireland is to face a 6 week national lockdown starting on Boxing day. The Northern Ireland ambulance service is to be assisted by a number of crews crossing the border from the South.The WHO has also made an appeal for people to stay at home over Christmas.Bird Flu due to the H5N8 strain has appeared in a chicken farm in Orkney. An exclusion zone is in place and culling has begun. The chickens and the eggs are safe to eat and it is very unlikely to spread to humans.Another place to have a significant outbreak is a court house in Oxford, where 17 members of staff have tested positive for Covid 19. The court is being deep cleaned over the weekend,Worldwide the number of confirmed cases is over 75 million, and within the next day or so the total for the UK will pass the 2 million mark.Today 375,185 tests were done with 28,505 proving positive, that’s at a rate of 226.2 per 100k.Deaths showed 489 reported today. The 7day figures show a 4.4% rise and the rate of death is still above 4/100k.18,469 people remain in hospital on 16th December with 1,726 being admitted on 13th December.1,340 are on mechanical ventilators.Remember its not too late to change your Christmas plans and you should not have plans for New Year’s Eve.If for what ever reason you cannot change or modify plans stick as closely as possible to all the guidelines and plan to have a better festive occasion next summer. If you are called for your Covid vaccine, please do not decline it because its too near Christmas. We must not waste it.Stay safe out there.

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