November 2020

November 1

Well, after the almost inevitable news of last night, comes those who want to argue, too much or not enough; too early or should have been a month ago; Should close schools or must keep them open; incarcerate university students or send them home now. Most of those arguing miss the most important point that whatever is included or not included is nowhere near as crucial as 99% of all of us complying with 99% of the rules 99% of the time.If all of us do it properly this virus will be stopped in its tracks. As the lockdown is for a month, two full Reproduction cycles will be severely restricted and that R number will fall below one. You will remember if its above one, as it is now, the virus spreads. Bring it below 1 and cases diminish. Some good news for young mums has been clarified this morning. One person is allowed to meet one other outside in a public park. Previously if one person had a baby or a toddler in arms or in a pram that counted as two so they were very isolated and could not meet a friend. Children under school age will not count when two people are allowed to meet in a park. it means the loneliness of many young mums can be helped by this measure and a grandparent perhaps has a chance to see their child and grandchild.The Roman Catholic church has formally objected to the banning of public worship. Many Congregations had made their churches Covid compliant and were managing corporate worship very well.It would seem too that marriages are a casualty of Covid. They would seem to be banned except in exceptional circumstances. The exceptional circumstances do not seem to have been identified yet. Socially distanced funerals can take place. limited to 30 and then only 15 can attend by the grave for burial or to attend the setting of a headstone.The definition of clinically vulnerable has changed. You were automatically in that category if you were over 70. Now the age is reduced to 60.anyone over 60 is considered vulnerable whatever other illnesses they may have. The list of pre-existing medical conditions have not changed and you can be very vulnerable at any age if affected by a medical problem.University students have been told they must remain on campus until the end of term but can then return to their home. If much of their teaching is on line and all night life is closed I can see a lot trying to find away back home.All unnecessary travel must stop. You may not move to and from a second home and if travelling you should not stay overnight. Travel corridors still pertain and you should check the situation if you have to travel abroad. I strongly advise against it unless absolutely essential. We await guidance on travel into and between the 4 nations of the UK.Todays statistics show a testing capacity of 480,961; 347,626 were done in the last 24 hours and 23,254 were positive. That is a new positive rate of 227.8/100k of the population. Deaths (it’s a Sunday so low) were 162 with a rate of 2.3 per 100k. There is no new hospital data published today.We have just 4 weeks to prove we can do this. We have no choice just do it. Stay at home indoors with your household as much as possible. Only go out for the essential reasons I described yesterday.Work from home whenever possible. if you have symptoms self isolate and get a test. Remember the virus can only spread if it can find someone to land on so do not give it a chance. Wear a mask at all times away from home and wash hands and surfaces frequently Stay alert to danger and stay well clear. please stay safe everyone. I know one of our regular readers is in hospital with Covid tonight, I am sure all your thoughts and prayers if appropriate will be with him and his family. Thank You and Stay safe.

November 2

Today has been quiet except for the flack flying around after the leaks and then the announcements about England’s lock down starting on Thursday morning. A lot of detail is still missing from the plan but we are assured the detail is coming. The vote in Parliament is a forgone conclusion as the Labour party will support the move but a few conservative rebels threaten to vote against it. The Queen is highly unlikely not to give the Royal Assent so it will be law by Thursday.The self employed have got what seems a good deal. They will get 80% of their normal anticipated profit for the month of November. this is twice the 40% provided in the last pay out, The claims window has also been brought forward to the 30th November in an attempt to get the grants paid out quicker,All driving lessons and tests are to be paused. Museum, Exhibitions, Gyms and swimming pools are to be closed and I understand, but not confirmed, public golf courses are to be closed and not just the 19th hole,Only essential foreign travel will be allowed . no detail about the definition of essential is available yet, and this may also apply to travelling to or from Wales and Scotland as well. The statistics, today, reflect that a lot of the last 24 hours was a Sunday. Figures will surely rise again tomorrow with Wednesday Thursday and Friday, the highest days of the week. The 500,000 target was met today for the testing capacity; but only 270,473 were processed. 18,950 tested positive which is a rate of 225.1 per 100k of the population. Deaths were recorded at 136, with a rate of 2.3 per 100k . A very sad statistic is that now over 1 million of us in England have been confirmed as infected with covid 19 and the death rate is nearing 50,000. On a lighter note I understand Her Majesty the Queen and Prince Phillip are approaching their 73rd wedding anniversary, They will be staying at Windsor Castle which is apparently known in royal circles as HMS Bubble!We can do this, indeed We must do it. We can and must go on making sacrifices, by not going out for that meal, not going to see a friend. Every single sacrifice you make will help to supress this pandemic. Remember we face a moral and medical disaster if we don’t. What ever you feel about our Prime Minister he has this time acted on Medical advice quickly albeit it was an ultimatum from the scientists.. It’s our collective fault as a nation, we have badly failed to cooperate with the right steps to stop it. We have to face the economic consequences over the next few years . You and I have no choice, so just do it, I realise many of you have led by example and complied fully. We have to persuade the many other short sighted idiots like those at the rave in Bristol to do the same.I was amazed at the response from you all to the picture of the mini-Shetland with his new rider at a party. It shows just how desperate we all are for some good news. No parties for us! remember to stay apart , stay at home unless essential and remember the BASICS with hands face and space Start tonight do not wait till Thursday. Just stay safe everyone,

November 3

After the atrocity in Vienna last night it is important to remember that Covid is not the only threat to us all. The national threat level for terrorism has today been raised to “severe”. That’s the second highest level. Please stay alert and remember this is another good reason to stay at home and not out and about in city centres.Some of the restrictions due to start on Thursday have been clarified during the day. As I see it now all the following are to be closed for 4 weeks;-Gyms, restaurants, pubs, bars, electrical and clothing shops, and other non essential stores, hairdressers, nail salons, spas and beauty bars, vehicle show rooms, travel agencies, betting shops, auction houses, tailors, car washes, tobacco and vape shops.theatres, concert halls, cinemas, museums, galleries, casinos, adult gaming centres, arcades, bowling alleys, bingo halls, zoos, other animal attractions and botanical gardens.Body piercing salons, non medical acupuncture and tanning salons.Shops allowed to be open include supermarkets and garden centres as well as bakers and other shops selling food, Pharmacies may open to deal with prescriptions medical products and toiletries.A small correction to last night ; public tennis courts and golf courses must close.Mass testing of the whole of the city of Liverpool will begin very soon. This is a bit of an experiment for the UK but has been successful elsewhere. The test is offered to every resident with or without symptoms and can be repeated weekly or more frequently if required. The army are to assist with the logistics and will be using tests which give results in 20 minutes. The test is reputed to be accurate with only a 0.1% false positive rate. That’s one in a thousand and a negligible false negative rate. I will follow the results of this trial with interest.Canada Life insurance have published the results of an interesting survey which has showed many less people want to work beyond the statutory retirement pension age of 66 this year compared to last. It was a large sample size, 51% want to carry on working compared to 71% a year ago. You can draw your own conclusions.Sir Ian Botham, one of our great cricketers, who now sits as a cross bench peer in the House of Lords made his virtual maiden speech today urging the Government to provide substantial tax relief to community sports clubs. The go ahead to build a bran new hospital in Belmont Sutton in Surrey has been given the go ahead. It will be a specialist emergency care hospital, it is due to open in 2025.The North West Ambulance service is under such pressure with the number of calls that they have declared a major incident. Another Ambulance service is having some of their emergency calls diverted to another control centre. This together with the increase in the numbers in hospitals not only with Covid but also with other winter pressures shows our NHS very close to capacity. One major teaching hospital with over 2500 patients does not have a single bed.There has been a “technical problem” tonight and none of the usual statistics have been updated since yesterday. One thing you can be certain of is that the situation will continue to deteriorate for at least two weeks before the new measures hopefully start to work. In the mean time stay at home, only go out if you must, and ride out the storm supporting one another and being kind. Sort out and label family photographs, find those old board games, find a new hobby or try an old one again. Please stay safe. The regular reader I mentioned a while ago has been moved to special care so please go on remembering him and his family.

Tonight’s statics have become available.test capacity 521, 016Tests processed 207,817. this means the system is only functioning at less than 50% of capacity. No reason given.Of todays tests 20,018 were positive , that is 225.2 per 100k of population.The number in hospital beds is 11,458 updated last on Sunday 1st November. of these 1,075 are in ventilator beds on Monday 2nd.New admissions in last 24 hrs 1,540 updated last on 29th OctoberDeaths amounted to 397 which is 2.4 per 100k of population.. The high number of deaths is a reflection of a low figure yesterday and catch up after the weekend.

November 4

We are now in the final few hours before the second “national lock” down begins. The more I look at the details, the more I realise that it is nothing like the first lockdown. The restrictions are nowhere near as tight as before and makes me wonder if it will be as effective as before. I do hope that by balancing livelihoods with health in the way proposed we do not fail to adequately protect either of them These are very complex issues and trying to meet two opposing considerations in a fair and equitable way must be a real nightmare for our Government. I have been impressed that very few British politicians have been willing to comment on or criticise publicly the fiasco going on in the USA as I write this. It would seem that they cannot count votes accurately and reliably, any more that most countries can count cases of Covid 19 and associated deaths. Whoever eventually is elected, they face an enormous problem to defeat Covid in the USA. They must have a united population fighting the pandemic irrespective of the colour of their politics. My fear is the country will have civil unrest and fight one another instead of the virus.So far tonight only the number of positive tests has been reported for today and it stands at 25,177 and almost 500 deaths have been registered, the actual number being 492. This is slowly rising again with the death rate now being 2.6 per 100k of the resident population.The vote in parliament to ensure the latest measures become law resulted in a win for the government proposals by 516 votes to 38. There were a few notable conservatives who did not vote with the Government on the grounds it was not the right action to take.At the same time, Chief Constables announced that their plans included action to see greater enforcement of the rules.The NHS has followed the growing health crisis by announcing it is moving its threat level to the highest from tonight. It has to cope with the rapidly increasing numbers of Covid patients and the usual winter pressures from seasonal flu and chest infections as well as any casualties caused by terrorism or public disorder from demonstrations.For the sake of our NHS I would urge any of you wanting to exercise your right to demonstrate not to do so at this present time in respect for the NHS we clapped for so energetically earlier in the year. Please also help yourself and the NHS by having a flu jab soon if you are eligible.There remains a small chance that a vaccine could start being used before the end of the year. Testing it continues on track.I am concerned that pubs are to be allowed to sell take away beer, but people will not be able to congregate outside and will potentially be dispersed by the police. This is a recipe for confrontation and casualties. According to the National Union of Students many students have left University today to travel home to their family. Students will want to be where they feel safe and comfortable and for many that will be at home with mum to care for them. Remote lessons can easily be received at home. It was unreasonable to expect students to stay in their tiny rooms on their own all day. There have been some interesting discussions and suggestions as to how to plan your lockdown to make it more bearable and even enjoyable. I have discussed some ideas before. Look at new hobbies like painting, gardening, cooking. Try and find a buddy to start a new hobby with you, not necessarily the same hobby, but encourage and support one another. Maintain a diary which reflects on the days’ activities. Anything we can do to help our own mental health and that of others is of great value.Whoever becomes President, the world needs to work together, we must leave our leaders to deal with the big matters of State. We can concentrate on shutting things down effectively enough to stop this pandemic in its tracks. 4 weeks should stop two reproduction cycles and bring the R number below 1.0 . Let’s make this very different Christmas one to remember. Let’s brighten our life with lights and decorations both inside and out. Follow the lockdown rules and stay safe everyone.

November 5

In a welcome move today the furlough arrangements have been further extended to March 2021for the whole of the United Kingdom. To my mind the “lockdown” that has started today may not be sufficient on its own to defeat the virus. We would have had a much better chance if the lockdown had been as strong as first time. There are many areas where it has been relaxed or exceptions were made with good reason to help the public cope. If we are able to make this modified lockdown work it will require every one to be thorough in complying the rules. There is no room to relax at all; unless we want to go in and out of lockdown until Easter.Well it’s Guy Faulkes night and as yet I am pleased to say I have not heard a single firework. I know this evening is often a nightmare for dog owners and hopefully they will not have major problems.Most of the uncertainty about the new rules in England have been clarified. The local authority “dumps” can remain open although you may need an appointment to dispose of your rubbish.For the second night running there is a technical problem with the statistics for England. The daily deaths are likely to be approaching 500 today when eventually they sort it out.There was confusion about weddings last night. It is now clear that only death bed weddings are allowed with a maximum of 6 present.The Prime Minister, supported by the Head of the NHS, provided the now familiar briefing this evening. The PM claimed the United Kingdom is ready. He claimed we have the largest test and trace programme capable of half a million tests per day. Thanks to the efforts back in March, 30,000 ventilators are available. Many retired nurses and doctors (like me) have been brought back to work with emergency reregistration. The Prime Minister referred to the City wide testing in Liverpool due to start tomorrow, and thanked all those involved. He also announced extra funding for Local Councils for providing shelter for rough sleepers.The head of the NHS said he had been speaking with colleagues on the front line about what he should talk about. He said it came to three issues. Firstly, this pandemic is both real and serious. Secondly everyone in the NHS is working extremely hard to cope with the pandemic and to provide as much routine care as possible at the same time. Thirdly the ability to cope with the second wave depends on everyone doing their utmost to stop it in its tracks. He explained in a simple way the time delays between contracting the virus and going home cured or dying.From being infected to having the first symptoms is about 5 days.From first symptoms to needing admission is also up to 5 days.The acute illness then lasts from 9-19 days when most either recover or sadly die. So if people were exposed to the virus a day before lockdown It can take 30 days for it to pass on.The NHS is ready. There are 159 A and E departments, all have had some upgrading, There is a 4 month stockpile of PPE and staff and equipment all prepared. They want to deal with the back log and deal with the pandemic. Give them every chance to do this; stay at home and stay apart.Some other items of news. You are not allowed to go on holiday locally or abroad, you can be fined up to £6400 if caught.GPs are busy giving flu jabs, they have already given more than last year.We are not alone, The Netherlands, Belgium, France, Italy, Spain and Germany are all in the same serious position with varying degrees of lockdown.Job losses are going to build up in the next few weeks, Roll Royce have cut 1,400 jobs and Sainsburys are cutting 4,200 jobs and closing all deli counters. Sorry to be a bit late tonight , my report was interrupted by having to give some complex medical support and help to a caller in distress.So its much more of the same please. You know the rules by now. Do not leave home unless you must for essential reasons. Similarly do not let people into your home unless for essential reasons. Do your part , stay apart and we will win this battle. Take extra care.

November 6

Statistics first for a change; they have moved yet again in the web site to what is said to be an easier to understand format.23,287 tests have been positive today from a total of 344,045 tests performed. Deaths were recorded at 355, a rate of 2.9/100k of the population. With the hospital data there is often some delay , 12,999 were in hospital on the 4th November with 1,181 in ventilated beds on 5th November. There were over 10,000 people admitted to hospital.Figures for the Greater London area are showing some welcome improvement . 21 London Boroughs show a decline in cases since last week according to the Evening Standard, There is an average of a 12% fall in new cases with the best Borough being Kingston, showing a drop of almost 30%. While this sounds good news, the news from Denmark is worrying.In Denmark their mink are being infected with a different strain of co-v sars 2 virus . Some 250 mink farms are affected in the Jutland area. Plans are hastily being made to kill all 17 million mink on farms in the area to prevent a new mutant strain potentially affecting humans. Some cases have already been found in humans, a quarter of a million residents of the Jutland area are now in a tight local lockdown. The UK has placed Denmark on the quarantine list and anyone travelling here from Denmark is required to self isolate for 14 days.In the midst of this crisis it is easy for us to forget the disaster in Central America A hurricane and severe flooding in Panama and Guatemala has killed at least 57and many thousands made homeless.Things may be stabilising in the Czech Republic where things have been pretty grim with their health service almost at a state of collapse. They have 2000 doctors and 6.5 thousand nurses off sick with the virus themselves. There is a severe lockdown in place with schools closed and a night curfew. The daily case rate was over 15,000 for two days but has dropped back to 13,000. They have had the worse death rate in Europe at 23.3 per 100k of the population compared with 2.9/100k here in the UK.Not only does the USA have to cope with their election issues at present but they have exceeded 100,000 new cases every day for the last three days and was almost 122,000 yesterday, put this another way its more than 85 new cases per minute.There has been an admission that one of the charts used to illustrate the need for a lockdown here had an error in it. Instead of a prediction of 1,500 deaths a day it should have been 1.000 cases a day. Whilst this is 33% less than shown, the error has been spotted and corrected. It seems to have been a simple transcription error due to the speed these graphs were prepared. There was I am sure absolutely no deliberate intent to mislead. The overall picture is very much the same.The Edinburgh Woollen Mill has gone into liquidation tonight.The ONS say that I in 90 of the population in England had Covid in last week of October compared with 1 in a 100 in last week of September. Put that statement in a different way and 89 out of 90 people did not have covid in October and 99 out of 100 did not have it in September. All of us are working hard to ensure the odds of catching it becomes less and that this national lockdown helps halt the spread. By staying at home, and staying indoors and having no where for the virus to go will ensure we succeed. I am setting us a target to say that, by Christmas, only one person in 500 will have the virus. Please all do your best to follow all the rules all the time. Stay Safe.PS just heard our regular reader who is in hospital with Covid is well enough to be discharged home to his family who are also positive. Excellent news.

November 7

The UK Government has imposed immigration powers against foreign visitors from Denmark following widespread outbreaks of coronavirus in the country’s mink farms.As of 4am on Saturday all non-British national or resident travellers who have been in or transited through Denmark in the last 14 days, will be denied entry into the UK.It comes after Transport Secretary Grant Shapps announced that Denmark would be removed from the Government’s list of travel corridors on Friday.British nationals or residents who are returning to the UK either directly or indirectly from the country are now required to self-isolate along with all other members of their household, until two weeks have passed since they were last there.A spokeswoman from the Department for Transport said in a statement: Unlike other travel to the UK, there will be no exemptions to this quarantine policy.Anyone who has returned from Denmark within the last two weeks will be contacted to ensure they complete the self-isolation needed to ensure the virus does not spread across the UK.The travel ban and extra requirements will be reviewed after a week, the department added.“Decisions on border measures and travel advice can be changed rapidly if necessary to help stop the spread of the disease and further announcements regarding freight will be made later today,” the spokeswoman said.Denmark was also added to Scotland’s travel quarantine list, with Nicola Sturgeon announcing the move at the Scottish Government’s coronavirus briefing on Friday, minutes before it came into effect at 12.30pm.The problem in Denmark is potentially quite serious. The virus causing Covid 19 has spread to the mink population where it has mutated and now some humans have contracted the new mutated virus. It is a very sensible precaution to try and prevent this mutated strain reaching the UK and I applaud the UK Government for acting quickly and decisively to keep the mutation from coming to Britain. This action buys us time to investigate the properties of this strain more thoroughly. Mink are quite closely related to ferrets which are known to be able to catch Covid 19 and are often used in vaccine trials.Greece has also announced a three week lockdown.Liverpool’s Director of Public Health claimed the mass testing started there yesterday is “showing positive signs”, although there had been long queues of up to 45 minutes at a testing station to start with.It is of great concern that some 30,000 NHS staff are now either off duty with Covid or unable to work because of a requirement to self isolate. The NHS had seen over 500 deaths from Covid by July. This is a clear indicator of the urgency to find a vaccine that works for those on the front line. We will need every available pair of hands in the NHS in the next few weeks.Dominic Raab is self isolating having been in contact with someone who has tested positive.Its a weekend again so figures reported tend to be lower than on Tuesdays to Friday. 344,045 tests were processed (5th November) with 24,957 positive in last 24 hours, that is a rate of 234.9 per 100k of the population. Deaths in last 24 hours were 413 , that’s a rate of 3.0 per 100k. There was no hospital data released today. The national R rate is still 1.1-1. A Manchester man has been fined £10,000 for holding a very loud party in his two bedroom flat where no one wore a mask or was socially distanced. Optimistically I can believe there might be early signs of a levelling off but it may all be due to weekend under reporting. We will have a much better view of progress by Wednesday of next week. I sincerely hope we are bringing it under control.The USA may have elected a new President but they certainly do not have their pandemic under control. They do have a great deal to do now.Lets hope for good news next week. Please just keep going with staying at home and avoiding everything which could possibly help spread the virus. Lets help the NHS staff stay at work. Stay safe every one. Do not go out in a mink coat , You could get culled!

November 8

The situation in Denmark continues to cause considerable concern with the Government taking swift action to keep any mutant strain of Covid from reaching the UK. In a further step this morning all connections both by sea and air have been severed with all ports closed to those from Denmark including cargo ships. The only exceptions are British nationals returning from Denmark who must quarantine for 2 weeks. Health officials are trying to trace about 6,000 people who entered the UK from Denmark in the last two weeks before the restrictions were imposed.Much closer to home, a surge of Covid admissions to the north of Lincolnshire to the hospitals in Grimsby, Scunthorpe and Goole have led to a major incident being declared. All three hospitals are relatively small. The local Health Trust say they now have 106 Covid patients in the 3 hospitals with 12 beds occupied in the ITUs. Of the staff at these hospitals 140 are not available to work, either because they have the virus with a positive test or they are being isolated because of contact with a positive case.By tomorrow, the world will see its 50 millionth case of Covid. It took just 21 days to rise from 40 million to 50 million whereas it took 32 days to rise from 30 million to 40 million. This means that now there are 1 million new cases every 3 days across the globe.India has the second highest case level in the world after the USA. India now has 8.5 million cases, with new cases at an average of 46,000 per day according to Reuters. In Cambodia schools have been closed for 2 weeks after the Hungarian Foreign Minister has tested positive after visiting Cambodia last week.There are only limited statistics again because it’s a Sunday. It will be Tuesday before we see a true picture. 344,045 tests were processed with 20,572 being positive, that is a rate of 236.8 per 100k of the population. Deaths were low at 156, but far less are reported on a Sunday. Hospital data has a built in delay, 1,621 were admitted to hospital on 4th November. 1,185 were on a ventilator. The total number in hospital with Covid 19 was12,949 on 5th November. A public house in Birmingham is the latest to get a £10,000 fine for having a party indoors after hours with 40 people.Many of you, I am sure, will have watched or taken part in a socially distanced Service of Remembrance. Though very different to what we are used to they portrayed the very deep emotions of sacrifice and thanksgiving we all have and will never forget. The numbers left who fought or even lived through the last war are dwindling every year. I was struck by the fact that the many military medics, doctors and nurses were also included. A significant number have lost their lives to Covid, and many others have supported our NHS staff in hospitals up and down the country.It is most humbling to realise the extent of suffering during world wars and more recent conflicts. Why, oh why, are so many unwilling to sacrifice just a little of their freedom whilst we fight this silent war against Covid? If we all stay apart and stay safe we will win.

November 9

Very encouraging news today. Pfizer together with bioNTech , a German company have announced that the first interim analysis on their Covid vaccine suggested a greater than 90% efficacy in phase 3 of their study. There were 43,538 participants, there have been no serious safety concerns so far but more data is still to be collected. This vaccine like many of the others requires 2 jabs 28 days apart. Protection is achieved 14 days after the second dose. The UK already has an order in for 40 million doses. There is a logistic challenge for storage and distribution as the vaccine needs to be kept at -80C, much work is being done to solve this problem. Jonathan Van Tam, speaking at the PM’s briefing today, thanked all the volunteers taking part in this and other vaccine trials. He pleaded with the public that we stand fast with this development but not to get too excited and drop our guard. We must continue with all our current measures to minimise the effects of the second wave we are in. This vaccine will have no impact on the second wave but may well do on the 3rd and subsequent waves, if all the safety checks are met.The Joint Committee on Vaccine and Immunisations has drawn up a priority list of those to receive the vaccine, It’s too long to record here but it is available on the JCVI web site. Age is singly the most important priority. The vaccine works on the S (spike) protein of the virus as well as the antibody response. This will prove important to other vaccines in the pipeline as many of them also work on the S protein. We know that the vaccine will prevent disease, what we do not know yet is if it will prevent transmission.Today brought the end of the firebreak in Wales where there has been an encouraging and significant fall in the number of new cases per 100k of the population, especially in Merthyr Tydfil where over the last week the number has dropped from 752.6 to 586.8 per 100k. In Neath Port Talbot the rate has fallen from 404.7 to 287.5 per 100k. In Torfaen it has dropped from 272.5 to 158.4 per 100k. Most other areas have also seen a drop, only 3 areas have seen a rise; Bridgend, Ceredigan and the Vale of Glamorgan.Having a quick look around Europe, Hungary is the latest country to impose tough new restrictions. They have had 5,000 new infections in 24 hours and with over 4,000 on ventilators they are close to capacity. Portugal has declared a State of Emergency. 70% of the population are ordered to stay at home on weekday nights and only allowed out in the morning before 1pm for essential shopping only.Italy is still in a critical condition with 41,000 deaths now reported and ongoing night time curfews. Shops, bars and restaurants are closed.Russia has a record number of new cases reported today. 21,798, which is twice as high as the highest figure in the first pandemic wave. The Kremlin are trying to avoid re-imposing restrictions.Belgium believe they have reached the peak of the second wave. There were 400 hospital admissions yesterday compared with 879 a week ago. New cases are down by 405 compared with a week ago.In the Czech Republic things are also improving. They had 36,000 new cases on Sunday, the lowest level for 4 weeks and 3,000 less than a week ago.Germany also is seeing a flattening of the second peak, but I could not find data to support that assertion.Finally in France they believe there are early indicators that the latest surge is slowing. The situation in French hospitals is still grim with all hospitals at full capacity.I think overall a slight improvement for Europe but a very long way to go. The Director General at WHO , Tedros Ghebreyesus said countries have to unite to battle the virus, ” we might be tired of Covid 19 but its not tired of us”. He went on to say, ” It preys on inequality, division, denial, wishful thinking and wilful ignorance. We cannot close our eyes and hope it goes away. It (the virus) pays no heed to political rhetoric or conspiracy theories. Our only hope is in science , solutions and solidarity.” Somewhat ironically the MP for Weston-Super-Mare, John Penrose, has been told by track and trace that he has been in contact with a positive case. Apparently he is now isolating but his wife Dido Harding has not been told to do so by the organisation she is responsible for.I am afraid there is as yet no data for England yet today. If and when it is available I will try and post it. Tonight there is some cautious optimism, but I have no doubt the statistics will show we absolutely must not relax any of the rules, as that would be disastrous. If you are over 80 years old and working in a care home with positive patients you might just get a jab for Christmas but for most of us it will be nearer Easter. Please do not stop now, keep going, but that light at the end of the tunnel is visible again.

Today’s statistics late againTests processed 276,998 as of yesterdaypositive tests in 24 hrs 21, 350 at a rate per 100k of 236.3deaths 194 with a rate of 3.2 per 100k.No hospital data, Mondays figures are usually low because of the data includes some from Sunday.

November 10

Looking around the British Isles, Wales has announced today that there will be no GCSE examinations or A levels taken in Wales next summer. They will be replaced by teacher managed assessments. Some work will be set internally, and some set and marked externally.In Scotland, Angus , Fife and Perth and Kinross have move to tier 3 of the Scottish system. Pubs and restaurants are prohibited from selling alcohol and must close by 6pm. The last entry is 5pm to ensure they close by 6pm.In England the mass testing in Liverpool is to be extended to 67 other Local Authorities and to some universities. This is a lateral flow test and does not require laboratory analysis. Results can be available in 20 minutes. It is hoped that Universities can use the tests on students to ensure they are safe to go home to families at Christmas.The Metropolitan Police in London have released some interesting figures which show a substantial rise in bicycle thefts. In April 2020, 1,069 were reported stolen and in September it had risen to 3,079. These are likely to be underestimates as many thefts are not reported. Of course many more bicycles were being used in the summer so it is difficult to interpret this. If we look at the numbers stolen as aa percentage used in each month it may not be such a dramatic increase. No one wants a bicycle stolen so please have at least two padlocks including a D lock. Get your bike security marked and register it with the bike register. Many research papers are being released now, all trying to add to our evidence base. It is not surprising that Oxford University have confirmed that the virus may trigger psychiatric and psychological disorders, but its useful to have evidence to back up what I think we all knew.A second man has now been fined £10,000 for his part in a rave in Bristol. Surely no rave can be worth that ?There are two things to watch very carefully. Firstly the spread of the virus from mink back to humans and what effect that has on transmission. We are fortunate everybody has reacted firmly and quickly and lets all hope it will be prevented from spreading further. Secondly let’s carefully watch the MHRA (Medicines and Health Care Products Regulatory Agency) as they scrutinise the safety of the first vaccine against Covid whilst it is further tested.There is at last some science to support the concern that masks with valves do NOT capture virus particles as they are breathed through, they only help to protect the wearer from much larger dust particulates. There is strong advice not to wear this type of masks. The European Council says do not wear them as they give no one any protection from Covid. I don’t wear a mask to protect my self, just to protect others. I urge you to do the same and just stay apart. The light at the end of the tunnel is clearly visible and an end is in sight. Please just keep going. Keep your guard up and stay safe.Yet again the data is late being published. When I have it I will post it., Here it is at 20.45.Total number of tests 234,079. Done in last 24 hours. Total positive 20,412, at a rate of 3.2 per 100k. The cumulative deaths from Covid this year will top 50,000 tomorrow.1,366 people were admitted to hospital on 8th November.Total number in hospital on 8th November was 13,617.Number on a ventilator was 1,268 yesterday 9th November

November 11

Today the statistics were available earlier than usual so l will start with them. The total number of Covid test processed was 304, 843 yesterday.The number testing positive today was 22,950 a rate of 237.7 per 100k.There were 595 deaths recorded today with a rate of 3.4 per 100k.There were 14,196 people in hospital with Covid on 9th November, with 1,518 admitted on that day. 1,219 were on ventilators yesterday.Sadly, exactly as predicted, the numbers in hospital are still rising as is the daily death rate, the number of new cases is however showing signs of stabilising as our lockdown begins to have a benefit. The UK is the first country in Europe to reach 50,000 deaths.Plans to put GPs in the centre of the mammoth task of mass immunisations are announced. They have already given more seasonal flu jabs than in any previous years. The Nightingale hospitals may be used as mass immunisation centres. The first group of patients to be immunised will be elderly residents of care homes. They will need to be treated in the homes where they live. This of course pre-supposes that the vaccine will get its final approval. For all the University students awaiting a rapid test before Christmas a “student travel window” has been announced between the 3rd and the 9th of December, immediately after the national lockdown is scheduled to finish. All teaching must be on line by the 9th December. Students will have a rapid test and a result done before they have a staggered chance to travel home, if the test is positive they will not be allowed home and arrangements are being made to care for them for 10 days.There are trial plans that visiting relatives of residents of 30 care homes will also be tested and must be negative in order to visit. This will be most welcome as the lack of visiting in care homes has caused much distress.The Czech Republic, a nation of only 10.7 million, and has been one of the worst countries affected in Europe, is to reopen the 1st and 2nd grades of elementary schools on the 18th of November. The remaining elementary years, secondary schools, colleges and Universities must remain shut. Pupils who can go to school must wear masks all day. Classes are to be ventilated half way through each lesson. This is an excellent idea I have not seen enforced elsewhere but might make the classroom very cold this time of year. There will be no PE or music lessons.Italy have now seen over 1 million cases. There were 32, 961 new cases in the last 24 hours. The number of deaths is not far behind the UK. Lombardy and Milan in particular have been hardest hit.Scotland has seen 64 deaths in the last 24 hours, the highest since May. They like England are seeing the effects of tight restrictions now but deaths are the last figure to respond.Do you remember bird flu ? There have been a scattering of cases in birds in Devon, Dorset and Gloucester of the H5N8 influenza. I have not seen any reports of it spreading to humans. DEFRA will need to be very vigilant watching this carefully.Overall an encouraging picture but so much of our plans now depend on the mass testing and the effective vaccine, if both come good, the light at the end of the tunnel will be quite bright. While we wait, we must keep going and make sure we stay apart and stay safe.

November 12

A look around the world first tonight. India has the second highest number of cases in the world with 8.7 million so far. They had 8,593 new positive cases yesterday. On top of this, Delhi, the capital has been hit by the usual winter smog. The winter temperatures have dropped suddenly making the smog more of a problem The Air Quality Index is now reported as severe. This triggers a ban on all work in the construction industry in addition to the already tight Covid restrictions. This Saturday brings the annual Diwali celebrations with large crowds gathering for a good time.In Italy, deaths have reached a total of 43,000 in the country , the 6th worst number of deaths in the world. Naples is in a critical position with insufficient hospital beds available. There are reports of many patients in their cars being given oxygen and intra-venous infusions whilst they wait many hours for a bed.In Russia their Sputnik V vaccine continues its validation processes, the manufacturers claim it is 92% effective, The WHO have been asked by the Russians to add it to the vaccine emergency use list. It will not be allowed to avoid any of the thorough testing required at phase 3.I have reviewed a new paper looking at the Speed , Evidence, and Safety, Characteristics, Approvals by the US Food and Drug Administration, FAO. Over a 10 year period the FDA considered 21 applications for vaccine approval, most commonly Influenza and meningococcal vaccine. Of these only 4 had accelerated approval. There were no vaccines approved where their use was subsequently suspended. I also looked at 174 medicines and drugs that have been withdrawn from use since thalidomide in 1960. There was not a single vaccine in the sixty years withdrawn. These findings lead me to conclude that once passing the hurdles of being approved by FDA and in the UK by MHRC. The new Vaccines approved for Covid will be extremely safe and everyone should have one when invited to do so. Back in England, Hull now has the worst figures with an infection rate of 726per 100k. They have 161 Covid positive patients in the two city hospitals, a 73% rise in a week with 245 cases found positive in the last 24 hours.The React study led by researchers at Imperial College, have shown that 1 in 80 of the population were infected with Covid in the UK between 16th October and 2nd of November. When faced with a statistic like that presented to you, always turn it round and say to yourself that means 79 people out of every 80 have not got it. It sounds better and is less likely to worry you. It is however of concern and means we have a way to go yet with our lockdown and other restrictions.Ten London NHS Trusts have been allocated lateral flow tests for their staff. Some Trusts have only been allocated one test per member of staff when the test should be done at least twice per week. Other London Trusts are yet to receive any tests. If a test is positive it needs to be validated with the conventional PCR test as there are about 1 in 1000 false positive results using the lateral flow tests. I am reassured that there will be more than enough tests available it is just the initial logistic of distribution.I am impressed with the immediate and robust response by DEFRA to the number of small outbreaks reported in the UK and in Europe of bird Flu due to the H5 N8 strain of influenza. The latest is in Herefordshire near Leominster. All birds in the affected area mostly poultry are to be humanely culled. There is very strict biosecurity with minimal access to the birds for staff. There are strict control zones in place at 3km and 10 km. I can reassure you that there is a very low risk of transmission to humans and a very low risk to poultry in the food chain. Your turkey will be safe!. The NHS could learn a lot from the speed and efficiency of DEFRA who have well rehearsed plans to cope with epidemics, not only bird flu but Foot and Mouth in Cattle and swine fever in Pigs.Today’s figures record 377,608 tests being done. There is capacity of doing 500,000 now. Of these tests 33,470 were positive. Put in another way, 242.1 people per 100k of the population were tested positive.Yet again there is a problem counting deaths in England . Yesterday there were 595, that is 3.4 per 100k of the population. Admissions are no longer reported daily the latest was 1,668 on the 8th November or 16.1 per 100k of the population.Because of the built in delays between catching Covid 19 then 5 days later becoming ill with it, a further delay when some become very ill and need to be admitted, then a further delay when the most critical ending up in intensive care and on a ventilator, and a few will die. We can expect to see a continuing rise in hospital admissions and deaths for a while after the number of new cases begin to plateau. The situation is changing rapidly around the country but there are signs now the lockdown might be beginning to have an effect.Its up to each and every one of us to keep going, to stay at home and not venture out unless essential, to remember the basics of hand washing, wearing masks, and keeping well apart from every one else. With rapid testing and a potential vaccine almost ready . It will begin to be easier next month. Just please stay safe.

November 13

Today is World Kindness Day. The World Kindness Movement, an international organisation promoting global kindness, was apparently started in 1998 in New Zealand . The world needs kindness more than ever today. Take a couple of minutes time out, when you can, today, just to consider what acts of kindness you have done today. Consider what else you could have done if you had thought about it. Plan what you could do tomorrow to spread little acts of kindness. Suggestions include giving some gloves to someone in the street without any on a very cold day. Buying a cup of coffee for the person behind you in the queue. Offering to do the neighbours shopping or to clear their leaves as well as your own. There are so many little things we can do which can make everybody’s day a little brighter. If you have a good idea or have received an act of kindness do respond and share what it was, so we can all enjoy it.I have listened to an interview with Melinda Gates today of the Bill and Melinda Gates Foundation , founders and owners of Microsoft. She was discussing the urgent need to get the vaccine out right across the world and not just to those who can afford it, they have just donated a further $70 million to support the ACT Accelerator scheme run by WHO and others . She said there must be “no vaccine nationalism” . It must be distributed fairly across the world. “Every life is of equal value” she insisted. she also publicly criticised Donald Trump for withdrawing the USA from the WHO and its associated finances in the middle of a pandemic.The Gates Foundation regularly donates $3 billion annually for public health issues and were a major contributor to eradicating smallpox and minimising polio in the world and are now battling with Covid.The statistics for today show;379,955 tests performed on 12 November.27,301 tests were positive in last 24 hours, that’s 248.6 per 100k.Deaths amounted to 376 today, that’s a rate of 3.6 per 100k.Patients in hospital were 14,714 on 12 November.Admissions were 1,723 in the 24 hours of 9th November.Requiring a ventilator were 1,275 on 12th November.The R rate has dropped slightly and is calculated as between 1.0 and 1.2 which is excellent news.Remember there are several outside factors that account for day to day fluctuations in the figures and it is better to look at weekly figures. However there is too long a delay to be helpful to us.Northern Ireland announced last night they were extending their lockdown for a further week. This followed 2 days where the UK had seen over 500 deaths.Portugal has extended its version of lockdown to more areas and introduced a night time curfew.Much of Greece, apart from a few islands, have been removed from the travel corridor, so most coming home from Greece will need to go into quarantine.The United States are suffering terribly. There have been over 10.4 million cases and over 240,000 deaths. The death rate has risen 40% in 2 weeks with 1,100 on Wednesday alone. There are some 65,000 in hospital. California as a state has seen over 1 million cases and 18,000 deaths.Other immunisation programmes like the MMR have been paused, the uptake has been very poor . There has been a 50% rise in deaths since 2016 in part due to the false claims by the now disgraced researcher who falsified study results suggesting it was responsible for autism.Pfizer have responded to concerns about their vaccine and temperatures required to store it. It will be stored in vials containing 5 doses. 195 vials can be stored on a tray and five trays will fit into a super-cooler box which uses dry ice. 100,000 super-cooler boxes will be ready at the end of November and double that number again by March. The vaccine will be stored in the super cooler boxes with a temperature of around -70C. These trays can be delivered to vaccination centres and stored for up to 5 days at temperatures of a normal domestic freezer about -20C. Vaccine will then be removed for each session and brought to room temperature before use. This should not cause any problems and has been carefully thought through.I was intrigued by a trial in a supermarket in Corsica where a “tunnel of disinfection” has been made, it looks like an airport security gate. As you pass through any virus on you is bombarded with ultrasound waves, ultraviolet light and a fine mist of a hyperclorous solution. I have my doubts because if you hold your breath as you walk through you could still breath out live viruses even if those on your clothes and trolley are killed when you emerge in the shop.WH Smiths are to shut 25 High St Stores after an annual loss of £280 million pounds. My favourite coffee shop, Cafe Nero, is in trouble. They have today secured a Company Voluntary Arrangement or CVA as part of a restructuring plan. They employ 6,000 staff and hope to use the CVA to negotiate better lease terms with the landlords in an attempt to avoid redundancies. It gives them a chance of recovery.Breaking News is the resignation of Dominic Cummings tonight with immediate effect. You will all remember his trip to Bernard Castle!Remember National kindness Day, which we all need to celebrate and go on looking for small acts of kindness. It could be a very profitable new way of life. With the R number dropping, its good news but hospitals are going to get things worse before they are under less pressure .Please stay safe, stay apart, wear a mask , wash your hands and most of all be kind.

November 14

Continuing the theme of the Festival of Lights. There is a city in Northern India called Ayodhya where Hindus believe the God Ram was born. The town lit 606,569 oil lamps and kept them all burning for 45 minutes . A new entry in the Guinness book of Records.Sadly there have been further protests in both Birmingham and Bristol today with a significant number of arrests. Under the rules of Lockdown no more than two people may gather to protest.In is not surprising given the behaviour above that the Church leaders are to challenge the Government by judicial review on the banning of corporate worship. The churches have gone to great efforts to accommodate reduced congregations all socially distanced without singing or choral music but with masks. The government action may have breached article 9 of the Human Rights Act as they may have failed to properly risk assess the provisions the churches had made to allow corporate worship when the tiers were operational.The limited Saturday statistics show;The R number is stable between 1.0 and 1.2 We must get this below 1.0 and keep it there.379,955 Covid tests were done on 12th November.26,860 were positive at a rate of 247.9 per 100k in last 24 hrs.There were 462 deaths in the last 24 hours at a rate of 3.8 per 100k1.806 people were admitted to hospital on 10th November.14,915 people remain in hospital on 12 November.1,355 people were on a ventilator yesterday.A report from SAGE published yesterday warned that the number of children between 12 and 16, testing positive, was rising steadily but that in the under 12s it was rising but much more slowly.I know there are several readers who are fans of vitamin D supplements to help combat Covid particularly in the winter when very little is available naturally from sun light. Matt Hancock has asked his Health Advisors to produce new Guidelines on its use. He has just announced that 4 months supply will be offered free to 2 million vulnerable and elderly in England following the Scottish lead. He must be sure of his ground to pre-empt the advisors’ advice.I say nothing and will lose no sleep at the sudden departure of a staff member from Number 10, except to say it is time to restore Respect, Integrity and Trust to all aspects of public life, and to re-assert the Noland Principles of public life.We must continue all our combined efforts, working together to bring the pandemic under control by being a light to the world, by being kind to one another and making sacrifices for the common good. Stay Safe and Stay Apart.

November 15

I was very saddened to learn of a fire in an intensive care unit in the town of Piatra Neamt some 220 miles north east of Bucharest in Romania in which 10 patients on Ventilators were killed and 7 others critically injured. They all had the Covid virus. One doctor who was also seriously burnt has been flown to to the capital Bucharest for treatment. I have been interested in health care in Romania since 1990 when I was involved in the massive effort to get medical aid to Romania after the fall of the communist regime of Nicolai Ceausescu in December 1989 and his subsequent execution. My son Stephen assisted with this work as well and we visited numerous hospitals delivering medical aid donated in the UK. We made many good friends in that country. A period of time neither of us will forget.My local hospital, The Pilgrim in Boston, declared a state of emergency last night, resorting to messages on local Facebook groups asking all available staff to return to work as they had had an outbreak in the hospital requiring 3 wards to be closed. They also requested any available nursing staff with a pin number to just turn up and report for duty. This crisis will be seen regularly in the next few months I fear.Being a Sunday limited figures and are incomplete I am afraid. Tests done on 12 Nov. 379,955.Tests Positive on 15 Nov. 24,922 at a rate of 250.2/100kDeaths today 168 with a rate of 3.8 per 100k.In Hospital 14,915 on 12th Nov.Admissions 1,922 on on 11 Nov at a rate of 17.4 per 100kThere is a further strict lockdown in Austria for the second time with 9,586 new cases reported on Friday.France is showing some improvement tonight as the rate of new cases has dropped significantly.I see a bus passenger has been fined £1700 for failing to wear a mask without reasonable excuse on two successive days. Many people are putting up their Christmas lights earlier this year. I suggest we all do this and concentrate on the theme of light and hope. Stuck at home and a bit bored, many will have time to be very creative with the decorations both outside and in. Bring some brightness to your passers by.Prof Sahin head of Bio N Tech working on the new vaccine says that if all goes well things will be back to normal this time next year if his vaccine lives up to promise. I just wonder what normal will be? How many of us will lose loved ones or even our own lives by then? What will our high streets look like with so many companies going to the wall. This brings us to the difficult issue about vaccination, Just suppose for a moment it is found to be efficacious, about 90% effective and as safe as any other vaccine in use. It does prevent on going transmission and will last without boosting for a year. So all looks good it will help rid this virus from the world. Should it be voluntary to have the injection (subject to excluding the rare few with known anaphylaxis to eggs and other ingredients) or should it be mandatory at least for a while. If not mandatory could employers refuse to employ you without evidence of being vaccinated? Should schools require it to admit your children to school? It’s compulsory in the armed forces to have appropriate immunisations. In the NHS you must have a hepatitis B vaccine to work with patients and a positive test for TB. Historically we have had smallpox vaccine compulsory in the past and I have several vaccination marks to prove it. It was required every 3 years when I was a child and up to starting medical school.Feelings are bound to be strong with all shades of opinion. I do not think there is a right answer. We must try and discuss it with the respect, openness and honesty we have considered yesterday. Above all, be kind to those with opposing views as we are all a bit nervous if we are honest.We may have a few weeks before this is a real issue. Is it a political, moral or religious issue? Please post your views and discuss it kindly. In the meantime just stay safe, stay positive, the lights of Christmas herald a brighter future.

November 16

Last night we learnt that the NHS Test and Trace scheme had asked the Prime Minister to self isolate having been at a meeting with Lee Anderson MP on Thursday who then developed symptoms of Covid 19 the next day. On Sunday he tested positive. Five other MPs also have to isolate and several officials as he was almost certainly infectious when he met the PM.Being told to self isolate can never be a welcome instruction especially for poor Boris who was working hard on damage control following recent episodes and the Brexit issues becoming critical. On the other hand a short period of enforced rest at home may be what he needs to improve his leadership out of the crisis.He certainly sounded upbeat today in his usual style saying he felt fine and “my body is bursting with antibodies”. I am sure he has had an antibody titre done . The problem is we just do not know what his chances of being re-infected are. There are about 25 cases documented world wide of people documented as being re-infected. This amongst 50 million cases is a very small number. We do not know whether he could pass it on or how long his antibodies will last. He sadly has to stay isolated again.Which is the correct word when we are talking about preventing the illness is it an immunisation or a vaccination? We always talk about a vaccine but I am sure I was told that vaccination was used for the technique used to do a smallpox vaccination and immunisation used for the rest of the procedures when a liquid is injected into the body as in flu, measles, typhoid etc. Has the usage changed over the years and now the two terms have become synonymous. What do you think? What about inoculation? Another term we rarely hear.Hull as a city is in a critical state, the worst affected in the UK. The Local Authority have asked the government to be allowed to enhance the rules locally by closing schools . Some 30% of Hull school children are already in isolation. The infection rate is 770 per 100k which is triple the average in the rest of England. Hull has 188 confirmed cases in hospital today and a further 38 suspect cases. The request to close schools has been refused so far.Matt Hancock chaired a Ministerial briefing tonight. Quoting figures from yesterday he said there has been an average of 413 daily deaths in the last week compared with 332 a week ago. This disease is not going away until there is much more test and trace and vaccination becomes possible. Two more “mega-labs ” are to open early in the new year to give the UK a chance to be major diagnostic industry. The prevalence of “Long Covid” is growing all the time and 40 new multidisciplinary clinics are due to open by the end of November specifically to deal with these cases. We do see this from time to time after other viral infections and is particularly common in glandular fever.We learnt that the Royal Mail are to empty mail boxes more regularly in attempt to speed up track and trace tests in the post.Turning to vaccination, the competition is hotting up which may well be a good thing. We need variety, we cannot afford to have all our eggs in one basket. The UK already has 350 million doses on order from 6 different companies. today the has ordered a further 5 million dosed of the Moderna vaccine which will not come on line until Easter at the earliest and only then if it passes all the safety tests. It is maufactured in Boston Mass, in the USA and is an mRNA vaccine similar in efficacy to the Pfizer vaccine. It has been claimed to have an almost 95 % efficacy. So far in preliminary testing 95 people have developed the disease in the trial. 90 of them had a placebo with no vaccine but 5 people developed the disease despite having the vaccine. All the severe cases were in the placebo group. Another plus point is that it can be stored in a normal freezer at -20c for 6 months and in a conventional fridge for up to a month. This will make distribution much easier. Results on the Oxford vaccine are expected any day. That will work in a more conventional way.At the moment if you live in England you cannot travel abroad for a holiday but that rule relaxes in early December. If you were planning to escape to the Canary Islands for Christmas you may hit a problem. As from 23rd November you cannot enter the airport without a negative pcr test (not a lateral flow test) in the last 72 hours. This could prove impossible over the Christmas period forcing travellers to purchase private test at the airport. You have been warned.The WHO, itself, now has 65 positive cases at their large HQ on the edge of Geneva. It has a 7 story building with a 2,400 work force . There are several clusters now,Nicola Sturgeon will address Scotland tomorrow she is likely to say other areas of the country will be in their tier 4.So a mixed bag tonight, some excellent news but still far too many cases and too many deaths We must deny this virus the connections it needs. We must be patient and persevere, We must be kind, stay apart and remember Hands Face and Space . Stay safe everyone.

November 17

Today Nicola Sturgeon has pushed Boris Johnston out of the headlines as she announced the next set of restrictions for Scotland tonight. Remember their tier system is different to that in England but she has placed 11 council areas into tier 4. The highest level of restrictions and the first time they are implemented. They begin on 6pm Friday and will end on December 11th. They can be enforced by law. The Councils concerned are; City of Glasgow, Renfrewshire, East Renfrewshire, East Dunbartonshire, West Dunbartonshire, North Lanarkshire, South Lanarkshire, East Ayrshire, South Ayrshire, Stirling, and West Lothian. Over 2 million Scottish residents are involved.People living in tier 3 or tier 4 areas are not going to be allowed to travel out of their local authority area to anywhere without there being exceptional circumstances requiring them to travel in an emergency.Nicola Sturgeon says she aims to have an impact before Christmas and Hanukkah celebrations in the hope of relaxing the rules again.Mr Jenrick , the English Communities Minister has hinted there will be changes to the English tier system at the end of the current lockdown.There is increasing evidence that tier 1 restrictions have very little effect on the spread of the Covid virus in the community.In China there are 4 different vaccines that have reached stage three clinical trials out of the 13 globally that are progressing well.Boris Johnson is still stuck in isolation until at least Thursday. He has had a lateral flow test for antibodies which was said to be negative. Apparently, he was included in a trial of the test, for all the staff of 10 Downing St. In a change of approach there are to be alterations to the way the police have issued £10,000 fines for breaches of Covid regulations involving parties and raves. Instead of issuing fixed penalty fines they will now be taken to court where their income is assessed before the size of the fine is fixed.The part of Lincolnshire where I live has seen a very rapid rise with over 400cases per 100k, the 13th highest number in the Country. Hull to the North of us also has been badly hit with 4 out of 10 children not attending school compared to the national average of 1 in 10 away from school. If you have checked the situation in your area please share it in the discussions later.India has just passed the 8.5 million mark of Covid cases, coming second to the USA and just in front of Brazil . We hear very little of what’s happening Brazil , I wonder why?The Government web site where I get the daily statistics from about 4.30pm has a notice again which says that due to technical difficulties the statistics will not be posted until after 6pm. Its now almost 7pm and no signs yet. There is another notice which suggests Public Health England have changed the way they count the locations of death— not sure what that means.I therefore can not give you the figures yet but anticipate they will have been following the pattern of being higher than average on a Tuesday due to catching up over the weekend, I suspect nearly 500 new deaths and perhaps 27,000 new cases testing positive.I can see very little sign of lockdown here and I suspect that’s why our cases have risen so much, traffic is as heavy as usual and every one is out on the streets doing Christmas shopping. This is just not good enough. Rules are necessary If you do not comply with them you have seen nothing yet, this could get very much worse .I believe the vast majority of my readers do follow the rules so I apologise if I am preaching to the converted. Please stay safe.

Tuesday’s figures now available;Total number of tests done 234,189Tests positive in last 24 hrs, 20,051Deaths recorded in last 24 hrs 59815,830 in hospital on 15th November1,391 on a ventilator on 16th November1601 new admissions on 13th November.Numbers in hospital and deaths indicate the problem still great. the number of new cases is pleasingly lower than expected which may reflect that lockdown is beginning to restrict spread.

November 18

There are 7 NHS regions in England, three of them have already passed the levels recorded at the peak of the first wave of the virus and a forth region will pass it in a matter of days. NW England, NE England and Yorkshire, and SW England have all recorded more patients in hospital than at the peak of the first wave. London however is still well below the first peak. You will recall that the natural history of this disease is to come in waves, the second wave in a pandemic is usually much worse than the second. We knew what we faced and we tried and failed to stop the second wave coming. It seems we did “too little too late.”We must learn by the actions in New Zealand and now in South Australia who had a “Go hard , go early policy”. South Australia have just announced a six day circuit breaker lockdown in response to a sudden outbreak in Adelaide There are 23 confirmed cases in the city and this has lead to over 7,000 self isolating. South Australia has a population of about 2 million. They have ordered immediate closure of all schools, most shops, pubs, factories and takeaway shops. Out door exercise in any form is banned. Only one person per household per day can go out in a mask for essential shopping only . After this almost total lockdown it will be followed by 8 days of slightly less restrictions. The UK must learn from this reaction in South Australia, our rather pathetic gesture towards lockdown has so far not produced the effects we need.Even the new level 4 in Scotland comes no where near the restrictions in South Australia. As a reminder under the rules of level 4 in Scotland there is a ban on home visiting. A maximum of six people from two households can meet outdoors. All pubs bars and restaurants are closed but not takeaways. Hotels B&Bs, self catering properties, caravan and camp sites can only open for work related stays or other essential purposes, not holidays. There can be no non-essential travel in and out of the level 4 area. If necessary limits will be placed on travel distance, or people told to stay at home. Exemptions for essential work, education, shopping, health, outdoor exercise, weddings and funerals will be permitted. There is no use of public transport, except for essential purposes. Car sharing should be avoided. All public buildings closed, driving lessons not allowed. All events banned with all leisure and entertainment venues closed. Gyms are closed.I listed the level four areas yesterday. The level three areas include North Ayrshire, Clackmannanshire, Falkirk, Inverclyde. City of Edinburgh, Dundee city, Angus, Fife, and Perth and Kinross. There are no places in Level 0 so the rest of Scotland is ether level one or level two.Europe has seen a slight overall fall in Covid 19 infections, for the first time in three months. There were still 1.84 million new cases last week despite much of Europe being under various lockdowns. Europe has now passed the total of 15 million cases and is about 50% of all global cases.Deaths do continue to climb with 29,000 fatalities in a week representing an 18% rise. This reflects that the benefits of lockdown may be beginning to reduce the number of new cases but the deaths represent people infected before the lockdown and will lag behind.We must remember this is a worldwide problem with over 4 million new cases in the week ending last Sunday and 62,000 deaths in the same week. If you have any information about countries that do not often get mentioned please share the information by posting in the discussions.To my mind and speaking personally, I am extremely disappointed that the current rules of lockdown in England are being widely ignored or are so lax as to be ineffective. We are not going to see the dramatic reduction in new cases and deaths we hoped for by early December, when it is scheduled to end. So what happens next? We could have a very tight lockdown for a week Australia style, but that would have a great impact on the socio economic position as traders try to save something of their anticipated Christmas trade. We could extend the current arrangements for a week or so. We could just give up and hope the vaccine will bale us out after Christmas. Someone has to come up with an idea which will balance the morbidity and mortality of the pandemic with the socio-economic effects of lockdown, not to mention the psychological effects of fear, loneliness and uncertainty. If you have an idea do not keep it to yourself discuss it laterTodays statistics have just arrived!Covid 19 tests done 283,358 yesterday. With 19,609 tests positive, this is a welcome drop.Deaths in the last 24 hrs 529, a rate of 4.0 per 100k which is slowly creeping up again.There are 16,271 patients in hospital which continues to rise.1,589 new cases were admitted to hospital on the 14 November at a rate of 18.3 per 100k of population.1,420 are now on a ventilator.Don’t forget lets all discuss this together, your ideas and opinions are important and valuable. Just remember to keep it kind and not personal. We can and will beat this with the help of vaccines, in the meantime we have to do it with personal sacrifices, stay at home whenever possible. stay apart and remember the basics ; Hands Face and Space. Did you see the good results from the use of mouth wash at least daily? Stay safe everyone.

November 19

Statistics are available early tonight so I will start with those.The R number is estimated between 1.0 and 1.2.364,490 Covid antigen tests were done on 18th November.Of those tests 22,914 were reported positive, that’s a rate per 100k of 256.6.Deaths are 501, at a rate of 4.1 per 100k. The rate continues to rise slowly whereas the absolute number has fallen over the last few days but is still over 500 per day. There were 16,409 people in hospital with Covid 19 on 17th November. 1,641 people were admitted on 15th November , that’s a rate of 18.3 per 100k of the population.1,430 patients are currently on a ventilator as of yesterday.My local figures have risen dramatically recently, Boston has 478.8 per 100k of the population testing positive.Now a remarkable success story to cheer us all up. A female Consultant Rheumatologist in the UK became ill with Covid and was admitted to her own hospital where she worked. She deteriorated and was put into an induced coma and ventilated for a month. Just a small problem, she was about 6 months pregnant with twins when she became unwell. Whilst still in an induced coma doctors decided her twins had the best chance if delivered early by c section rather that wait till nearer term. She had this done whilst still in the induced coma, the twins were born alive and transferred to the Neonatal intensive care, She is now out of her coma and feeling well, the babies are thriving and they have all gone home. They were clapped by staff all the way out of the hospital.There is a lot of talk today about possible announcements of some sort of amnesty to celebrate Christmas, followed by a renewed lockdown. Public Health England are said to be very worried. PHE have said that for every day of relaxation it will require 5 days of tight restrictions to restore the status quo. Nicola Sturgeon has asked her officials working with her Chief Medical Officer to write a plan which must be safe. She has been in talks involving all 4 nations and they hope to have a UK wide policy. It remains to be seen what they are going to come up with but most of you will share my concerns that we must not risk undoing what has been achieved. What does safe really mean anyhow?The USA, with the worst figures. in the world have now surpassed a quarter of a million deaths.There are studies suggesting young adults are moving back into their parental home in large numbers. One study of 2000 young people suggested as many as 43% were going back home largely to save money but also for company during lockdown. Its not been much fun shut in a single room all day for many on their own.The head of the United Nations Migration Agency has told the EU Parliament that asylum seekers should have equal access to Covid 19 vaccines.A court case I am watching with interest involves a Dr Cathy Gardener, a virologist, who has brought an action in the High Court today against both the NHS and the Dept. for Health and Social Care (DHSC) over decisions and measures taken in relation to the Care Home where her father was resident. More specifically the local hospital discharging a patient to the care home concerned without doing a test to establish the discharged patient was Covid positive. Her father subsequently caught Covid and died. Dr Gardener alleges the isolation arrangements were totally inadequate and staff lacked training. The court gave the go ahead for a full hearing.Sky News is reporting as a headline that a recent report suggests supermarkets are the most common exposure setting for Covid transmission. Apparently PHE conducted a study with Track and Trace data in people testing positive between 9th November and 15th November. Of the places visited by those people by far the highest recorded was supermarkets with 18.3 % having visited one in the incubation period. Therefore they say that was the commonest place to catch it. Can you see what is wrong with this conclusion and how it will never pass peer review processes?Well there was no control group! How many people who tested negative with the same Test and Trace group had also visited a supermarket recently? It could be less or could be more. I would actually have expected a higher number than that would have been to the supermarket. For the study to be meaningful it would have to show a significant excess of supermarket goers in the positive group compared to the negative control group. The Oxford vaccine working with Astra Zenica reported excellent results in their phase 3 trials, with particularly good results in elderly people, the companies will compete to be the best but we need different vaccines that work in different ways. this should not be allowed to develop into a race for the top. We need lots of good vaccine, that works well. The oxford vaccine will be easy to store in a simple fridge, and cheaper to produce in bulk.Another study on outbreaks in schools suggest England has seen 822 outbreaks in secondary schools and 732 clusters in primary schools, We are aware that whole school years have to isolate if one case is found, were we really right to keep schools open to keep children safe and still learning? They certainly are not dying in significant numbers but yo-yoing in and out of school has caused havoc for many working parents.All hospitals in Switzerland are full and the WHO head says 1 person dies of covid 19 every 17 seconds in Europe.Sweden has seen a rise in cases which may be due to cases in mink. But these cases have not been due to the mutated form seen in Denmark where all the mink have been culled.We have had some excellent discussions recently. Please carry on responding to my comments and adding your own thoughts. above all stick with the rules, never mind Christmas, we all want to see Easter, so stay safe everyone.

November 20

Tonight, that light at the end of the tunnel seems to have got a lot brighter and I think I can write more positively than I have done for a while now. Pfizer Inc. have today formally applied for the emergency use authorisation of its Covid 19 vaccine from the FDA in the USA and Matt Hancock has just announced that the British Government has also asked the MHRA to look at Pfizer’s vaccine. Both these organisations the FDA and the MHRA are fiercely independent of both governments and the pharmaceutical industry. If they are satisfied and all safety issues approved the vaccine can be rolled out starting in December.The Pfizer vaccine is a novel one using mRNA which is injected in a fat droplet into the patient. This causes the patient to make the spike protein in their immune cells. This stimulates the whole immune system and produce both antibodies and T cells. Then if the person meets the virus then the antibodies and the T Cells fight it off together.The Oxford Vaccine and the Moderna vaccine are very close to being considered by the FDA and the MHRA in the same process. The Oxford vaccine is a more conventional vaccine, it’s much easier to store. Studies show it to be particularly safe and effective in the elderly. It is important to have any vaccine rather than delay waiting for a specific one you fancy. The difference between 90% and 95% effective is negligible. Far better to have the one first offered. Most people are agreed that there are now early signs that the lockdown is just beginning to have an effect. The number of new cases are levelling off in both England and Scotland and slightly decreasing in Wales and Northern Ireland. The R or Reproduction number is now between 1.0 and 1.2.More good news tonight. there is enough influenza vaccine for every one over the age of 50 to have one, I would strongly urge you to accept a free one, which from 1st December will be offered by your GP surgery. You should not have to ask for it they should automatically invite you to attend.In France student morale is worryingly low. Many have resorted to the use of food banks where they can get food at 10% of the normal cost. or they can buy a complete meal for 1 Euro from a mobile canteen.There is concern that the inevitable pay freeze that will come to help meet the enormous costs involved may affect police, firefighters and teachers as well as NHS managers. NHS staff facing patients are not expected to be affected. I stress this is leaked speculation, we will not really know till the next spending review. It is always disconcerting that it is much easier to impose a pay cap on the public sector, whereas it cannot be done in the private sector.The Brexit talks have been suspended for a while as one of the EU negotiators has tested positive and has to self isolate, Michel Barnier himself had the disease earlier in the year.Italy has the second highest death rate in Europe behind the UK. Italy had almost 700 deaths yesterday and over 37, 000 new cases. The disease is still very active there.A survey carried out officially yesterday confirmed the feelings in our discussions last night, that over 50% of people remain happy to have restrictions still in place over Christmas.In the ministerial briefing tonight, Matt Hancock reminded us all that vaccines are second only to clean water in the Public Health armoury. It remains vital that we keep this R number below 1 and its not quite there yet. There are still over 500 deaths every day. We are half way though the national lockdown now, the number of new cases may well be flattening, but day today variations make it difficult to see clearly. The decisions about Christmas are going to be very difficult to make, balancing risk against benefit. I would not want to have to make them. Being cautious I would always say if in doubt don’t. I have no very young children in my extended family which makes it easier for me and my family can all understand and have their own valid opinions. I rather like the idea of a 2 day bank holiday in June next year to have a mid summer Christmas and hopefully to say goodbye to Covid and welcome to the new post Covid era.We must ensure we can all survive till then so, all the rules all the time please. Please stay safe.

November 21

Even with a caveat that, being Saturday, the statistics today tend to be a little under reported, it would seem that in most places now we can see a levelling off or even a reduction of the number of new cases. With the lockdown beginning about 2 weeks ago we are now able to see the results of our efforts to stay apart. For the first time for a while the number of new positive tests is below 20,000. only 19,875 tested positive in the last 24 hours. A total of 395,436 tests were performed yesterday. This represents a 13% drop in new cases in the last 7 days. We just cannot afford to relax yet, this is still an infection rate of 244.2 per 100k of the population.The number of deaths reported have dropped below 500 and now stands at 341.The rate of death per 100k has stayed the same at 4.1 per 100k of the population.The hospital figures lag behind the infection rates by about a week or so. We still have 16,390 in hospital with Covid on the 19th November and 1,421 on a ventilator yesterday. The daily admission figure has not been updated since 17th November when it was 1,682.If we are able to stay on track over the next week we should be able to avoid the NHS being overwhelmed. The next week is critical. Difficult decisions about Christmas will have to be made. We cannot afford to relax in any way just yet. A party in Russia came to a sticky end when they ran out of alcohol and resorted to drinking hand sanitizer instead. The result, 7 are dead and 2 others critically ill. Normal alcohol we drink is ethyl alcohol. The alcohol in their hand sanitizer was methyl alcohol which is extremely toxic and can easily be fatal. Interesting the medical treatment is to administer ethyl alcohol which will displace the methyl alcohol from their system; sadly treatment was too late. I have come across fatalities from this before. Make sure all the youngsters in your extended family know never to drink methanol.Donald Trump junior is Covid positive today and is reported to be quarantining in his Hunting Cabin. His mother, Melania and brother Barron were both positive last month and recovered, his partner Kimberly was positive in July. There are clearly still outbreaks in the White House as Rudolph Giuliani’s son Andrew has also tested positive.In an attempt to encourage the Christmas spirit, the Government have made a change of policy and allowed Christmas tree sellers , both at farms and on stalls, have been allowed to reopen from today. It would seem that trees are now essential shopping.In a further relaxation of some rules, foreign poultry workers are to be allowed entry to the UK ahead of Christmas to assist in the preparation of turkeys for Christmas.With the end of the tight restrictions in Wales, up to 4 people excluding children under 11 can meet in cafes and pubs. Gyms hairdressers and places of worship can reopen in a Covid safe way. People may be asked to prove their home address to prevent people crossing the English boarder to get to a pub. There is still a 10 pm curfew on pubs and restaurants.There is more good news on the vaccines. Can Sino Biologics from China are starting further human trials of its vaccine in both Argentina and Chile trials still continue in Pakistan, Russia and Mexico. The candidate vaccine is known as Ad5-nCoV with the trade name of Convidecia. It is based on a harmless common cold virus which carries the genetic information of the Covid virus proteins, This is one of 5 home grown vaccines in China progressing well through the testing processes.The Christmas tree for Parliament Square arrived from Northumberland arrived today and has been erected with the help of a large crane. (The one in Trafalgar Square comes from Norway.)We may not be able to celebrate Christmas in the normal way but lets us all make a real effort to light our house and gardens with the lights of Christmas. They can be a beacon to light our way out of this darkness and into the light of a New Year. We are on course now to bring the second wave to an end, and then to begin a massive vaccination programme.Many like the idea of a mid summer celebration next year to allow all the parties and family gathering we may have to postpone. To make sure we can all do this please go with the rules for another couple of months. There are real signs we are winning but still a long way to go. I have appreciated your many messages of support and encouragement to write these daily reports. I do not think I will be able to stop them any time soon. Please go on contributing, asking questions or just posting comments. We are all in this together and together we will come through. Remember the Hands, Face and Space. Remember to be kind and supportive and above all stay alert and stay safe.

November 22

I was all ready to write tonight’s report and had to wait for the daily statistics to be released.When they were released they were prefaced by a message which read. “Due to a processing update, 141 previously published deaths within 28 days in England were excluded from the published data on 21 November.This issue has now been corrected for data published on 22 November, which includes deaths omitted yesterday in today’s total and daily number of newly reported death”I may be slow, but I am still trying to work out what this means! Today there are 398 deaths reported which is still at a rate of 4.1/100k of the population. If I take yesterdays figure of 398 and average the two for the weekend we have 369 deaths per day which is still a lot better than the 500 + we saw each day last week. Remember week end figures tend to be low so we must wait for Tuesday’s figures to see just how much the number of deaths are falling.395, 436 tests were performed yesterday and 18,662 were reported positive. That is a positive rate of 237.6 /100k. This figure is beginning to go down.As for the hospitals, 16,390 were in hospital on Thursday last with 1,421 on a ventilator on Friday. There is no daily admission figure since 17th November when it was 1,682.There seems to be very little real news of the pandemic today. There is a great deal of speculation about what has gone on in the Cabinet meeting this afternoon and what will be announced to Parliament tomorrow and at a briefing to the media at 5pm tomorrow.Sir David Spiegelhalter claimed today that in his opinion the average R number in England is now below 1. His opinions are usually sound so this is excellent news, although he admitted there still were a few places where it is above 1.0 locally.SAGE is due to publish a paper tomorrow which has been widely leaked. The thrust of paper is alleged to show that returning to the restrictions in the three tiers before lockdown will not be strong enough and England must tighten the restrictions.If you are returning to the UK and have been forced into self quarantine for 14 days it will soon be possible to reduce it to 5 days, providing you take a test on the 5th day of isolation and you are shown to be negative.There is still great anxiety that there are so many staff shortages in ITUs that the safety of some patients could be compromised. There are leaks and rumours about further funds being made available to the NHS to be revealed in next Wednesday’s spending review. Some £3billion will be available and divided between mental health, reducing back log of urgent work and to ease existing pressures. Over 140,000 patients are awaiting urgent procedures that have been delayed.As I see it, by tomorrow night we should be clearer about what is to happen next:1. Lockdown in England will end on 2nd December2. Three tiers will return to England on the next day, Which places will be in which tier will not be announced until Thursday of next week.3. Christmas from 22nd-28th December will see a UK wide agreement of some relaxation of the rules to allow families to meet and celebrate Christmas together. Details should be set out tomorrow.4. There is to be a blitz on testing which is not being done to capacity. 67 more towns and cities will be treated like Liverpool, with a plan to deal with 10% of the population each week in those areas. If you regularly have 2 negative tests a week you might be given a freedom pass but no details of this yet.5. Vaccines are almost ready. The NHS has draft plans to have immunised every adult by April with the staff of the NHS and the most elderly done before Christmas. This really would be a fantastic achievement, but realistically I think personally, that’s too ambitious and it will take nearer 6 months especially if a lot of people need persuading to have it.So be sure to read tomorrow’s report there will be a lot to digest, meanwhile please share your hopes and fears about the arrangements to come. It has been good to read your experiences and as a group we do a lot to support one another.Let the Christmas lights bring also the Christmas good will. Please all stay safe in these stressful times. We do not have all the answers, but you can always phone a friend We cannot afford to relax. The next few weeks require a real effort from each and every one of us to minimise the social mixing and always to remember the basics of Hands, Face and Space.

November 23

As I reported last night, the Prime Minister introduced his Covid -19 Winter plan in Parliament this afternoon. There had already been plenty of speculation about what it would contain. It is 56 pages long so I have only been able to skim through it quickly.Here are the key points from Mr Johnson’s statement to the Commons.– Meeting family and friends;The rule of six will return, with variations on whether socialising can take place indoors or outdoors depending on the tier.In Tier 1 – medium alert – people will be able to meet in groups of six indoors and outdoors, while in Tier 2 – high alert – socialising with five others will only be allowed outdoors.In Tier 3, the highest alert level, groups of six will only be able to meet in outdoor public spaces, such as parks and sports courts – but not in private gardens. Pubs, bars and restaurants;Hospitality will be closed except for takeaway in areas under Tier 3 restrictions, but the rules are slightly more relaxed for Tiers 1 and 2.In Tier 2, hospitality must close unless it is operating as a restaurant, and alcohol can only be served with a substantial meal.In Tier 1, venues must be table service only. The 10pm curfew will be replaced with a last orders call at 10pm, and venues must close at 11pm, for Tier 1 and 2.Shops, entertainment and hairdressers;In every tier, retail and personal care – such as hairdressers and beauty salons – can reopen.Indoor entertainment venues – such as cinemas, theatres, bowling alleys and casinos – will be allowed to stay open in Tiers 1 and 2, but not Tier 3.Weddings, funerals and worship;Weddings and civil partnerships can resume but with only 15 guests, though wedding receptions are banned in Tier 3.Thirty people will be allowed to attend funerals, but only 15 will be able to attend a wake.Places of worship can reopen in all tiers for collective worship, but in Tiers 2 and 3 people must not interact with anyone outside their household or support bubble.– Gyms and exercise;Gyms and swimming pools will be able to reopen in all tiers.In Tier 1, classes and organised adult sport can take place outdoors, but must follow the rule of six indoors.Indoor classes and organised adult sport cannot take place in Tiers 2 and Tier 3 if there is interaction with different households.In Tier 3, classes and organised adult sport can take place outdoors, but people are advised to avoid higher-risk contact activity.Elite sport and live performances;Large events – such as theatre and spectator sport – will be permitted in Tiers 1 and 2, but with reductions on capacity.In Tier 3, they will still be banned but drive-in events will be permitted.ChristmasThe Government is working on a time-limited Christmas dispensation with Scotland, Wales and Northern Ireland.Mr Johnson said Christmas would not be “normal” this year but recognised that “time spent with loved ones is even more precious for people of all faiths and none” in a period of adversity.We will have to wait until Thursday to learn which tier each region will be placed in. We were assured that there would be no add ons and that the tiers would always be the same. As I have said before I fear this is not easy and a five tier system would have allowed more flexibility.There is to be a talk to the nation at 7pm. I plan to try and post this before then and will add a second report afterwards if there is anything significant to tell you, if nothing pressing I may leave it till tomorrow as I will triage supper as more important ( I told you my food is important to me),The Oxford Vaccine has some further excellent news today. Their testing shows the vaccine to have 70% effectiveness and in some situations 90%. 70% is still a brilliant result. Most annual flu jabs have only a 50% efficacy. Anything over 70% is excellent. Remember it is a 2 dose course, it is very cheap to produce in bulk and can be stored in a domestic fridge. Production in bulk has already commenced as they are certain the data is robust and that the MHRC will approve it for use.Sweden is still seeing a significant rises in cases with 6000 daily cases and a death rate of 3.0 per 100k which is still lower than in the UK where it is 3.1 per 100k.Covid restrictions have improved air quality right across Europe particularly with NO2. In Barcelona it has dropped 59% since early Spring. Madrid has seen a 47% drop and Rome about 39%. Sadly as restrictions are eased it is certain the pollution will rise again. Interestingly Transport for London have been concerned by the deaths of 41 deaths of bus drivers from Covid 19. This is 3.5 times more than last year. Engineers have developed a system to give the bus cabs separate ventilation from the rest of the bus. The air around the driver will be changed 100 times every hour,PM briefing about to start I will continue after that.

Todays statistics showed 279,041 tests were done in the last 24 hours which included a sunday, 15,450 tests were positive today. Deaths were the lowest figure for some time which is very encouraging at only 206. The hospital data is all several days old so I will not repeat it again.The PM has tonight confirmed most of what has already been discussed. The general theme was to be very cautious over Christmas. We must not give an inch and people take a mile. It is vital that if restrictions are eased over Christmas they are not abused in any way nor exceeded. To lose control of this virus again just as the vaccines come to our rescue would be ludicrous and catastrophic. As the PM said Christmas is a time to be jolly—- Jolly careful.In many ways the stricter restrictions next month will prove a problem particularly for the hospitality industry but for all of us it cannot and must not be a normal Christmas.There was widespread praise and thanks for the thousands of volunteers who have been involved in vaccine trials. With the Oxford vaccine there have been over 10,000 volunteers who have had the vaccine or the placebo I imagine many of you will have listened tonight so I have not repeated everything. Get those Christmas lights shinning out, give thanks for all those who have worked all hours of the days and nights to get this vaccine to the point of being almost ready. We owe it to them not to spoil it now. Stay safe every one.

November 24

Well having been greatly inconvenienced by getting a virus on my Facebook messenger today I hopefully have stopped that spreading any further. I now turn to stopping Covid in its tracks. If only I could do that in three hours!If everybody here agrees not to send any video connection via messenger and we all try not to open one there is a good chance we can go a long way to stopping this. We can do this by working together. We should all manage the same with Covid 19.The sooner we are all able to accept we are in this together and until at least March, the better. You are going to need a mask in public places until at least Easter. Do make sure you get a good supply in. We do not want people to run out over Christmas. If you wash and reuse them please make sure you do wash them regularly and regularly change them. Keep a supply in your car, jacket or bag so you are never far from a mask.Today there has been the inevitable increased anxiety about the Tiers which will come into effect on the 2nd December in England. This is particularly strong in Greater London where the hospitality industry are concerned that if London is placed in Tier 3 it will devastate the industry from which much will never recover. When the rates per 100k of the population in local Authorities are considered, Hull remains the worst hit area. London has no Boroughs in the top 100 of nearly 350. Looking at the last 7 day average there was a new infection rate of 197.2 yesterday, just slightly lower than Saturday when the rate was 198.9. If these figures continue I would anticipate London just making Tier 2 which will be a great relief to many.We can all do our part every day but the balance between scientific advice and politics is always going to be a pressure to get it right.Tuesday’s figures are always the worst day of the week. Figures are catching up after relatively low death registrations over the weekend. Today only 212,533 tests were done. Why when we need so much testing did we manage less than half the daily quota? Of those tests only 11,299 tested positive. This is a substantial drop. We have been used to daily figures of over 20,000 recently. This I think confirms beyond doubt that the lockdown is making the number of new cases fall.The death rate lags behind by about 2 weeks so its not surprising that the daily death rate is higher than it has been since the first wave. 608 deaths recorded.In hospital there are now 16,158 cases on 22 November, 1,487 of these are on a ventilator on 23 November. The daily admission rate is last available for the 20th November and was 1,506, which is also a slight fall. The all important R number is between 1.0 and 1.1.Michael Gove has chaired a meeting of the Devolved Administrations and leaks from the meeting seem to suggest agreement between them on a common UK policy over Christmas. The leaks suggest that 3 family units will be able to meet indoors and share a meal between 23rd and 27th December. Travel restrictions across the UK will be relaxed to make that possible as will the question of overnight stays which should be possible. One sticking point has been the exact definition of a household and it remains to be seen exactly how that has been defined.It has been pointed out to me that for many particularly those in Scotland, Hogmanay may be more important than Christmas day for many. The UK government have been strangely silent on this and I fear they would rather it did not happen. If we have anything like the normal mass crowds with fireworks, singing and dancing it could be catastrophic just as we begin to be able to get things under control. Please be willing to forgo that and watch the new year in on television.Another interesting anomaly for England tier system is that you are not allowed to travel out of your local area if you live in tier 3 but you are allowed to travel abroad. Most people have to travel to get to an international airport so how will they be able to jet off to the sun or the ski slopes without breaking the local travel rules? Then you might face quarantine both on arrival on holiday and on your return. Would it be worth it?Finally there is a row about the suggestion about the UK cutting its overseas aid budget in the middle of the pandemic, as part of our efforts to save money, We normally allocate 0.7% of our gross national income to overseas aid. This is a formula accepted by politicians from both main parties since Tony Blair’s time. We also know that many charities have struggled to survive and donations have dropped back to nearly nothing. I know many thousands in the UK face financial hardship, but it is nothing compared to the real starvation still seen across the World. We are hosts to the G7 group next year. Surely we should maintain at least our normal contribution and encourage other G7 members to do the same. As usual please discuss this and give me some feedback and discussion on this and other aspects of the briefing. How should we manage both central and personal charitable giving in these circumstances?I have battled with two viruses tonight; remember with one it’s Hands, Face Space and staying at home as much as possible, with the other never open a Facebook message with a video attachment and better still never send one either. In the worst case scenario computers can be replaced but you cannot, neither can your loved ones. Please just Stay Safe.

November 25

“Our health emergency is not yet over, the economic emergency is only just beginning.”With these words the chancellor Rishi Sunak set out the spending review today. The main points of a complex review were;£18bn is to be allocated for testing, PPE and vaccines£3bn for the NHS£2bn to keep transport arteries open£3bn to Local Authorities £250m to help end rough sleepingAltogether public service spending to tackle Covid 19 virus next year will be £55bn.This year a total of £280bn provided “to get our country through the virus.”The OBR (Office of Budget Responsibility) expects the GDP (Gross Domestic Product ) to shrink by 11.3% this year, the biggest decline in more than 300 years.The GDP is expected to grow by 5.5% in 2021 but will not recover to pre-crisis levels until the last quarter of 2022.Borrowing is expected to reach £394bn for the current fiscal year , or 19% of GDP- the highest recorded level of borrowing in peace time.The Chancellor confirmed £3bn for a three year re-start programme to help a million people who have been unemployed for over one year to find jobs.Unemployment is expected to peak at 7.5% in the second quarter of next year. That’s about 2.6 million people.Pay rises for over a million nurses, doctors and others working in the NHS but pay rises paused for the rest of the public sector next year.However the 2.1 million people public sector workers earning less than £24,000 will receive a rise of at least £250. This means the majority of public sector employees will see their pay rise next year.The National Living Wage will rise by 2.2% to £8.91 per hour and extended to those age 25.Spending 0.7% of the national income overseas aid is “difficult to justify ” said the Chancellor and at a time “of unprecedented crisis ” It is being cut to 0.5% in 2021 but with the intention to return to 0.7% when the fiscal situation allows.It is this last issue which has caused most controversy including the resignation of Baroness Sugg a minister at the Foreign Office responsible for Overseas Aid. The Archbishop of Canterbury was very distressed, suggesting it was morally wrong. We should, I feel, keep our promises enshrined in law all the time , in rough times as well as the good times. This tiny cut of 0.2% of our budget represents starvation and death for many children in some third world countries. No matter how poor we are this will not happen here, Today’s other main controversy is the effect of a relaxation of the rules over Christmas, The Chair of my professional association, the BMA, has warned of the risk in the rise of infections after Christmas asking just how much can we tolerate? One issue I have not heard discussed is whether having the schools closed for the holiday will help contain any spread. I think it may be too difficult to quantify. If you end up in Tier 3 you may not see distant loved ones again till Easter if they do not fit into the 3 households for Christmas. Eurostar has seen a 95% reduction in its passengers and they consider they need emergency funding to survive. The do not benefit from the £8m business rates that airports can claim.There is no doubt that almost all the public sector workers have gone above and beyond the call of duty. Although the NHS have been in the headlines, our teachers and police force also deserve special mention. I can understand the frustrations a pay freeze can cause. Most with professional qualifications and the police have a starting salary above £22,000. With the extra payments for those earning under £24k. the most junior staff will receive a small rise.In other news the company De La Rue who print our bank notes are in early stage discussions about the production of Covid 19 immunity certificate. Do you remember the Small Pox ones we used to carry abroad with us ? Apparently they are likely to have a security hologram on to reduce fraud.Businesses claimed some £849m through the Eat out to Help out Scheme and some 160 million meals were purchased at 49,000 different outlets. Do you think this scheme was cost effective. Did you make use of it?The data tonight confirms the trend we have been seeing. The number of new cases testing positive continues to drop and is now 18,213. However because of the lag behind, as I have explained before the daily death rate is going up significantly and today is at 698. Sadly this is going to significantly rise further over the next 10 days. However, hopefully the number of new cases and hospital admissions will continue to drop. There is no detailed hospital data tonight.In the dog circles Crufts is planned to be held in July next year. There have been many grumbles that people who qualified their young dogs for this year’s show will not be able to show them next year as they will no longer be in the correct age class. There was also concern that Crufts with its overseas visitors may have triggered our pandemic, a view that is not supported by surveys. The grumbles have been silenced today by a top judge reporting that a friend of hers who qualified six dogs will not be able to go as she has died of Covid ! It put it all back in perspective.I doubt anyone agrees with everything I report tonight so please send your comments, criticisms or suggestions to discuss .The balance of our lives against our livelihoods is so difficult. I hope we are going about it the right way. We could so easily have a disaster especially if the vaccine programme gets delayed or worse still cancelled. So please each and every one of you play your part, Stay Alert and Say Safe even if it means minimal Christmas festivities, The Health Emergency is for now. The economic emergency is for next year. You need to act now.

November 27

The fall out from the announcements about the new tiers in England to replace the “lockdown” continues at a pace today. What this country needs most of all now is to work with one common purpose to rid us of this virus once and for all. Instead I hear equal and opposite arguments raging everywhere. Almost nobody seems satisfied with the tier they are to be in. Well I am, and we have gone from a tier 1 area to a tier 3 area during the lockdown. Why? because people have become very lax about the rules. Social distancing has been compromised time and time again. Masks, do not provide immunity, that’s for the vaccine in due course. They may protect others if worn consistently and properly, but if taken on and off and stuffed in pockets may actually make you more at risk. The virus particles trapped by the mask then spreading to your hands.Boris Johnson, said today that he understood the frustration we all feel. We just need firm consistent leadership which explains what’s happening in easy to understand jargon free language. The action has been taken because the situation is still out of control across the world. We are not alone in this but there is some good news at last. The R number has now dropped to below1.0 with a range of 0.9 to 1.0. In London, soon to be in tier 2, the numbers of new cases have dropped for the last 6 days and stand at 177.1 per 100k . It looks like we can be confident we hit the peak of the second wave on the 18th November.Of the 119 areas in tier 3, only 8 are still seeing a day by day rise in new cases, all but 1 of them in Kent. The other is Hynburn in the North West.Wales have seen a rise in 16 of its 22 Local Authority areas.Northern Ireland has taken 4 days to reach a majority agreement on the next steps. Their tight lockdown is to continue for the next 2 weeks, with pubs closed for a further period of time. Cafes and hairdressers are allowed to open from next Friday.It is sad to report another Covid fire in an ITU in a hospital in Gujurat in India, where 5 people died and 6 more seriously injured. There have been at least 2 other hospital fires in India and the one in Romania I have previously reported. The police are investigating this last fire. it would be dreadful if it is found to be arson, but I wonder about the the very high use of oxygen in the ITUs and how safety is monitored.Todays statistics show;383,521 Covid 19 tests have been done in the last 24 hours and by tomorrow the number will top 40 million overall. The number testing positive was only 16,022. This represents a 25% drop in the last 7 days . The rate of new cases is also dropping with 193 per 100k of the population.Deaths still lag behind, today, sadly another 521. By the end of next week I hope we see a consistent drop each day and not just for a weekend.We still have over 16,00 in hospital and a further 1,471 admitted on 25th November. 1,456 are being treated on a ventilator.The University at St Andrews is to undertake mass testing of its students before they go home for Christmas. The tests are being undertaken by their own 3rd year medical students, the test results are available in 30 minutes. If a test is positive it will be checked and if still positive the student will isolate at university rather than travel home. This is an imaginative use of medical students and should be applauded.Germany has today become the 5th European country to record over a million positive cases, behind France, Spain, the UK and Italy. It is interesting to note Germany has a much lower number of deaths recorded with only just over 15,000 compared with 50,000 in the UK. I suspect this is because of the different criteria for recording Covid deaths. The UK has a very broad definition of any one who dies with a positive Covid test in the last 28 days. Other countries have a very narrow definition and only attribute it to Covid if there is not a comorbidity they can blame for the death. To illustrate this two patients both in the twilight of their life with advanced cancer; both contract Covid with a positive test and two weeks later both have an expected death. In the UK the death certificate will include Covid whereas in another country only the cancer is recorded.It has been reported that Top Shop is close to collapse and a way to survive is being sought.Just to illustrate the confusion our 4 devolved administrations can cause. Do you know what to do if you think you or someone in your family has caught the virus?In England you should ring NHS111 and do what they tell you. You are expressly told not to ring your GP practice.In Northern Ireland you must ring your GP.In Wales you are told to ring NHS Direct not the GP.In Scotland you are told to self isolate for 7 days. This is the so called United Kingdom. I think we can be united in our desire to be rid of the virus, if nothing else. Which way we do it is of secondary importance. Lets try just following the rules for our area to the letter. If we do then we can continue to turn the tide back. The Spring looks very promising. Meantime we are all ready to tough it out through the winter. Please all stay safe as you do so.

November 30

With the parliamentary vote tomorrow setting into the law the latest tier system on Wednesday, it is of some considerable concern that there a large number of Conservative rebels who feel the steps too draconian. At the same time, the Labour Party have still not announced how they will vote. It would seem if they smell a chance of defeating the Government they will vote against it whereas if the government can still win without their rebels then the opposition will support them. The opposition said they intend hearing medical evidence again before deciding. We do not need party politics at this stage. We need both parties to act in the public interest guided by the science which is pretty clear.There is good evidence now that the lockdown has become effective in its last week. A study from Imperial College suggests the infection rate has dropped by almost 1/3rd in England during lockdown. in London the new case rate has dropped in 30 Boroughs and in 22 of them it has dropped by 20%.Our statistics today are influenced by the weekend still. Only 219,899 tests were done yesterday with only 12,330 being positive in the last 24 hours. That is still at a rate of 164.7 cases per 100k of the population. Despite the Sunday effect 205 deaths were reported in the last 24 hours. The rate at 4.4/100k is not significantly reduced.15,712 people are still in hospital with Covid 19. A further 1,350 people were admitted in the last 24 hours and 1,417 are being treated on a ventilator.Matt Hancock has suggested that the virus is back under control. I think it is, just. However it will not stay under control unless we all play our part in keeping it under control by respecting all the rules and not acting rashly. We must ensure all politicians understand this. You could consider sharing this with him/her on your local web sites.There is slightly disturbing news from Sheffield where the local council have instructed Care homes not to use Rapid Flow tests to test Care home residents, staff and potential visitors, because they show an unacceptable level of false negatives. A study from Oxford University and PHE suggested that PCR tests were the gold standard. Only 77% of positive PCR tests were positive with a lateral flow test. This finding may well have repercussions in the plans to test relatives and if negative allow visits to Care homes again.The new rules in Wales come into effect on Friday. All pubs, restaurants and cafes have to close by 6pm, bingo hall, casinos and skating rinks must close. These actions are necessary because, in contrast to England, rates are rising in 16/22 of Welsh Local Authorities.Police confirm they handed out almost 2,000 fines in the first 12 days of England’s lockdown and a further 133 £10,000 fines for illegal gatherings.Figures from Italy today confirm they still have a major problem. There were 16,377 new cases with 672 deaths.There have been calls for schools to end term early for Christmas and to delay returning in January. I can find no evidence yet that this is on the agenda of any of the 4 devolved administrations.Nicola Sturgeon, speaking at an SNP conference has announced her intention to pay all full time NHS and Social Care workers a one off payment of £500, with no strings attached, as a thank you for their extraordinary service . It is not clear whether this will be tax free. She also announced a £100m fund for people struggling this winter. There is also a one off payment of £100 cash grant to every family whose children receive free school meals.Finally in the Ukraine there is a desperate shortage of oxygen in the hospitals. There is a charity there called “Ours” working at full strength to fund more. They have so far provided 150 more concentrators through crowd funding. Less than half of their hospital beds have access to a piped oxygen supply (in the UK it is virtually 100%), but this is greatly improved since April when there were only 3,500 beds with oxygen compared to 26,000 now.In England at least, I agree with Matt Hancock we have this virus just about back under control. We cannot let up at all if we are to keep it that way. Think very carefully what you are doing over Christmas. Follow all the rules very carefully. Plan creatively but do not get carried away. Next Christmas can be normal but you have to stay alive to see it!Above all support one another and please stay safe. All play your part and stay apart.

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