October 2020

October 1 2020

Just a glimmer of hope from Matt Hancock today. He thinks that there are early signs that recent restrictions were beginning to have an impact, BUT we must not let up, the number of new cases are still rising. Let us all hope and pray that these early signs are real and can be sustained. There have been 6,914 new cases with positive tests in the last 24 hours, just a slight drop for each of the last two days. Similarly the number of deaths officially counted has dropped a little to 59 from 71. This is where the hint comes from but I fear it is equally likely to be just simple day to day variation. If the figures are not being manipulated, at least deaths have not risen for 48 hours.Unfortunately the NHS figures have risen. 2,276 people are now in hospital with Covid , 323 were admitted today. 332, are on a ventilator. This steady rise shows no signs yet of responding to the current restrictions, it does have a few more days to start doing so.There has been a slight easing of regulations in Bolton to bring them into line with the rest of Greater Manchester. The bars , restaurants and pubs are now allowed to provide a table service only but must close by 10pm.Liverpool, Warrington, Hartlepool and Middlesborough have had tighter restrictions in place from today. In these areas there can be no social mixing between households except in parks and outside hospitality areas. The Mayor of Middlesbough has publicly announced his anger about this and vowed to reject them. He is making a political point but it does not help if local leaders do not encourage people to follow the rules. In those areas there are requests to avoid all but essential travel (Going to work and school are considered essential).Overall now some 34% of the total population of the UK are subject to extra restrictions.Infection rates in Turkey and Poland have risen above the threshold of new cases (20 per 100,000) and for passengers returning from those countries, they will have to isolate at home for 14 days if they arrive back in the UK after 4am on Saturday.Ipso Mori believe the R number has dropped to 1.1 across the UK. I have not been able to review how they arrived at this , the figures do not to me seem to support it. If its true that is good news and may also suggest we are perhaps doing better than it appears. I will watch this carefully.Mean while HM The Queen has cancelled all large functions and events both at Buckingham Palace and at Windsor until next year.Schools in Ireland have been affected with 84 positive cases across the country. 4,300 tests have been done to find them.Finally the PM has announced that no evictions will be allowed over the Christmas period.Meanwhile we have a long way to go before Christmas. IF we all pull together, IF we can follow the rules without dissent or disregard. IF we continue to do only essential journeys to work and school, and respect social distancing at all times and following the rules applying in our areas. IF we use face masks or coverings as instructed every time. THEN we still have time to suppress this second wave. Frequent hand washing remains the most basic and the most important measure with frequent sanitizing of work surfaces door handles etc. Remember the brand of bleach that kills all known germs. Covid can kill you or your loved ones.Stay safe everyone.

October 2 2020

Well I doubt if any of you are surprised by the fact that Donald Trump and his First Lady have both tested positive for Covid 19 and are self isolating in the White House. It is reported that today he has only mild symptoms and has been working normally. You will recall when our Prime Minister first became ill he had only minor symptoms but a couple of days later his symptoms were severe and he was admitted to hospital. It remains to be seen how well Mr Trump will get on . He is obese and at aged 74 not a good risk. I of course wish him and his wife a rapid and full recovery. This is a stark reminder that we cannot afford not to take this pandemic seriously. We have seen various act of bravado from the President and sadly this is the consequence. What happens now, about the election in a months time, is anyone’s guess. Everything is in disarray. His opponent is also worried about catching it from him at the ill tempered debate recently.This virus can and does affect anybody, it respects no one, and everyone must follow the rules. The behaviour of the SNP member of parliament who attended parliament when she should have been isolating and then when known to be positive and travelled by train to Scotland, is completely unacceptable I fear her political career is at an end. I wish her a full recovery but what a foolish act from someone who should be leading the way through the pandemic.770 students at Northumberland university have tested positive and are all in quarantine.The media are reminding parents to be careful allowing children to go out doing trick and treat. There should not be more than five people on the doorstep which becomes 6 when someone opens the door to pay up or be tricked. Parents could be find up to £200 for allowing their children to take part in illegal sized groups. There is considerable confusion tonight about figures. The Gov.uk site reports 125 deaths and 13,882 new positive cases. Whereas the Covid 19 dashboard reports 66 deaths in the last 24 hours with 6914 new positive cases. These figures are the most likely and were eventually reported at the end of the BBC 6 O’clock news. They are similar to yesterday. Most of the other statistics today were based on data collected over 2 weeks in the end of September and were not therefore contemporary. The figures reported for hospital activity have not changed from yesterday’s figures, so I have ignored them.Tower Hamlets now has the highest rate of new cases in London at 44 per 100,000. The Local Authority there are urging residents to adopt tougher measures and stop all households mixing even though Central Government have not yet ordered it. In contrast, the Middlesbough Mayor is rejecting the government restrictions and refusing to comply.It is not surprising with today’s news people are very confused. Do not be a trump. It is vital we all do follow the rules I spell out almost every day. The figures just might be plateauing, we might just be getting on top of this second wave despite the efforts of some who should know better. Please all stay safe.

October 3 2020

Truth is very hard to find tonight and a lot of things being reported cannot be verified in the usual way. It did not surprise me at all that Trump was admitted to hospital last night. Compare that with how things went with our Prime Minister when also testing positive. If things continue in the same way he will be in ITU by tomorrow night. Mean while I wonder what his deputy Mr Pense is thinking and how is he preparing if he has to take over?Listening to the doctors and others talking tonight, things just do not sound right. We are told he is in good health, not needing any oxygen and able to work. If that is true what is he doing in hospital? We have been told about his medication, an experimental drug containing antibodies plus Remdesivir which has been shown to shorten the length of the acute illness. No mention of the use of Dexamethazone . We have also been told he no longer has a temperature. Well that will be because has had a regular antipytretic drug such as paracetamol or ibuprofen. I would certainly be concerned if they had not worked! I fear he is more ill than has been admitted to. I also see that a number of others close to him are now testing positive. I suspect the White House is bracing itself for a considerable outbreak similar to those seen in University Halls of residence. Several American friends who are doctors have also expressed concern. I would value their comments tonight if they will share them with us.Saturdays statistics are incomplete due to the weekend effect. They are also hard to find as methods of reporting are changing yet again. It would seem in the UK that figures have been level for a few days. This may however not be real, lets hope it is just not a manipulation of figures to look better than they really are. Although deaths per day are small they have doubled in a week.It’s a long way from over yet. If this can happen in the White House it can happen in any household and it will, if we drop our guard in any way. We have seen how social distancing has been ignored as well as not wearing masks. This must be a wakeup call, I wish all those involved now a speedy recovery.Please be always on your guard, look after your neighbours and friends and stay safe.

October 4 2020

Truth remains in very short supply tonight but slowly, little by little, we can pick holes in the message we are being given and begin to see the truth. I am reproducing in full an open letter to Mr Trump’s attending Physician written by a highly respected doctor friend of mine in the USA today.”Dear Dr. Conley, et al., today’s briefing is not an advance in transparent communication of medical information for a general audience: You said that imaging had findings as expected…. but did not clarify by stating normal or the patient’s previous baseline. That leaves room for a lot of concerned speculation, including the possibility you expected mild or moderate COVID-related pneumonia and found it.You said you started dexamethasone, an IV steroid. This is a significant clinical addition to care, especially when you have already given an experimental therapy under compassionate care provision and a second therapy under emergency use provision (remdesivir). As far as known to medical commentators, remdesivir and the Regeneron antibody therapy have never been tried in one person before.By adding dexamethasone, you have now given everything in the COVID-19 armamentarium to this patient within days of his stated diagnosis date AND you have given an experimental therapy that hasn’t even started phase III trial.And yet we are supposed to think he is doing well and may be about to go home? Yes, home is the White House, which is essentially an elite infirmary, but still.. this is someone who is operating commander in chief and currently having people casting votes for him as president for the next four years. He is implicitly telling us he has four more years in his tires. TODAY.Under questioning, you admitted he had another episode of low blood oxygen, with the only quantification that O2 sat did not fall to LOW 80s — a level at which he would have likely been intubated.This was not a reassuring briefing. This is not transparency.This distinctly looks like a cover your butt with a lot of holes in the undergarment.Even I know that at the least, responsible care is to complete the remdesivir, have the patient stable without fever off all antipyretics, have stable and normal respiration (including O2 saturation and respiratory rate) and cardiac activity without any support and preferably, off the steroids.But I don’t even know why he is on steroids, therefore don’t know what the criterion should be for discontinuance, I don’t know what the chest X-ray or CT show, or what you are watching for inflammatory markers or for kidney or liver function….Please stop lying by omission and vagueness. Or, think more about your wording so it invites the frank possibility of being interpreted as intentional lying.Finally, as you know well, there is little ability to understand context of this disease without knowing the medical history. I hope the doctors at least know exactly when he was tested, with what tests, when the first positive test was obtained, and exactly when he experienced his first symptoms and what they were.We the people, the voters, need to know his medical history, his care in hospital, and the near term plan and prognosis. I know enough as a nonpracticing physician in consult with COVID-savvy friends to know we are already talking about a real mortality rate and a real long-term morbidity in survivors at this point in his course.I have great sorrow for him and his family. I lost a beloved family member to COVID this spring. I have been critically ill myself.However, the president’s legal responsibilities differ, as do yours. You said the truth at the first briefing might have steered the course of the illness in another direction.How? The president is receiving best care. We were all taught in medical school that it isn’t ethical to deceive patients. We give care kindly and honestly.The president deserves that. By the way, so do we.This moment calls for Donald Trump to receive the best possible medical care as a person. This moment calls for the country to receive the medical information its deserves regarding its president — especially given the unprecedented context that we are in the midst of an election.Thank you.”The more normal reaction from doctors is reveal nothing about the personal medical condition at all, claiming confidentiality. However the Public Interest here is so important that I see why both the doctors and Trump himself have spoken out giving differing information.I understand the need to stay positive and optimistic but you cannot tell half truths or lies and expect us to swallow them. I believe he is quite ill and has had an unprecedented set of treatments that have barely been tested yet. no one would do that unless the situation was becoming desperate.I wish him well, I am sure his view of this disease is changing. He joins a growing list of celebrities world wide who have been ill with Covid.Today there is an explanation for the discrepancies in last night’s figures. A whole batch of positive results had not been added until last night. Tonight another batch have been added bringing today’s new positive cases to 12,872. This is roughly twice what we have been used to daily. there were 49 new deaths reported. Remember there are always fewer on Sundays, but it is reassuring that the deaths, although increasing, are not nearly at the same rate as new cases are rising. Israel is under considerable restrictions due to the high number of cases. They have just introduced a new interesting law which forbids people to travel more than 1km from their home in order to demonstrate against anything. It will be very interesting if it helps control demonstrations in the way need to do here.Wish Mr Trump, his wife, and all the others who are testing positive in the White House a full and speedy recovery, For us lesser mortals following the rules and staying safe are a better way of avoiding catching the infection.

October 5 2020

I think I should start with a warning that I can take absolutely no responsibility for the accuracy or otherwise of the figures I posted over the weekend and am posting tonight. it would seem PHE were using and old version of Microsoft excel which was not fit for purpose and could not cope with large files.I started trying to collect figures from the Government’s most reliable source but found the figures were inconsistent and muddled again. They have ben altered several times in the last hour but now seem to be the best we are going to get,Today 12,594 tests have returned positive results ( yesterday 22,961). Today 19 deaths have been recorded compared with 33 reported yesterday.I note that the total number of positive test results has passed half a million in the UK.The basic fundamental errors in PHE’s collection is simply referred to as a glitch ! It makes complete nonsense of the idea we had from the last weeks figures that new cases were beginning to plateau. The figures are rising at a worrying rate. The death rate is going up when looked at weekly but is not as high as feared.The highest number of cases are now in Manchester, with Liverpool a close second, Knowsley is third . Other places being watched carefully are Newcastle on Tyne, Nottingham, Leeds Sheffield and some London boroughs.Paris has introduced tighter regulations today with all bars and pubs closed after 10pm for a fortnight I anticipate the UK may yet have national restrictions in place over half term. France have also banned any gatherings, large parties and public music.Wales is said to be considering quarantine for English people travelling to Wales from the hotspots I mention above. this could prove impossible to enforce and cause chaos.I note a national system of different levels of covid restrictions is being proposed and considered. It is virtually the same as i suggested a week ago. Am I being read in high places now?In the USA the situation with the White house being a source of a major outbreak, must cause concern. The President’s Press Secretary has tested positive tonight as have at least two reporters who attended a briefing. Anyone who has been inside the White House in the last 14 days now needs testing Donald Trump continues to try and persuade us he is not really ill by being driven about last night to show his fans he is well. He does not look or sound well with rambling and repetition in his videos. The White House is also a well equipped near hospital so it is quite possible they will let him go home later but it certainly does not mean he is well again. Steroids in the high doses he is having will give aa burst of energy but as the dose comes down over the next few days we will get a more realistic idea. I do hope he does well and i continue to wish him a speedy recovery. America just cannot afford a crises like his death would cause.”Long Covid” is beginning to attract attention. Many viral infections lead to a prolonged period of post viral malaise or fatigue. Some refer to it as ME (Myalgic Encephalitis). It is commonly seen also in young adult after Glandular fever. it can last many months or in some cases years. People are often unable to work or study. One repot I have seen suggests we may have up to 60,000 cases all ready, if this is true we will have major socio-economic consequences with people off work.Stay out of the hotspots if you can, stay safe and continue to care for one another in the way I know you are all doing

October 6 2020

Dare I be just a little optimistic that tonight’s figures are correct and are not going to be adjusted again until tomorrow? Almost 275 thousand Covid tests have now been done and in the last 24 hours 14,542 were found to be positive.There have been 76 new deaths in the last 24 hours bringing the total number to 42,445.The hospital figures released today are rather worrying being the highest since the 3rd June. 2,833 are now in hospital with 393 in ventilator beds. 496 people were admitted to hospital in the last 24 hours bringing the total of people hospitalised in the pandemic to 144,347. Greater Manchester now has the highest infection rates in the country.It is clear now ,despite earlier being misled, that aa second wave is occurring and is not showing signs of flattening out.Some 4,000 university students are currently infected. Northumbria is reported as having 850 infected students, Sheffield has 500, Nottingham 425, Manchester 362, Queens Belfast 166The continuing ban on school trips spending a night away from home is causing great concern, The Guardian is reporting the potential loss of 15, 000 jobs in that industry alone,So Donald Trump has retreated back to the safety of the White House where he would like us to think he is very well and almost better.The desire to be positive, even upbeat is laudable and is what is needed from a leader, but not in situations like this, Anyone could see in the video he produced that he is struggling to breathe at times and was desperately trying to conceal it. He also used a rail to steady himself at times. He is by no means out of the woods yet and as his steroids are reduced there is always the risk of a relapse.He remains the only patient in the world to have all three of the major treatments available over a period of three days. the experimental antibody treatment is only in stage 1 of trials and only about 6 humans have had the drug so far. Reg-Cov2 is an artificial antibody treatment made by Regeneron. It binds to the surface proteins of the virus so stopping it from attaching to cells of the victim and replicating. The victims immune system can then destroy the virus,Remdesivir, another of his drugs is in short supply, in part because the USA have purchased large stocks. Reuters report a shortage in some European countries especially Holland. The company who market it sell it to wealthy countries for $2,340 a dose but sells it to third world countries at cost price and donates a lot to research programmes. tThank God for our NHS if you need it you will get it for free. But in the USA where many thousands have no health insurance, how can they afford it?Nicola Sturgeon has already hinted of further restrictions to be announced tomorrow and I think we will see more in England and Wales as well. We are late responding to the figures rising now and have no choice. I do not think we can sustain the rule of 6. Watch for tomorrows announcements.I will not bore you by repeating the rules , you all know them but I shall implore you all to follow these and any tighter rules that come this week. I remain upbeat and positive about winning but everyone has to pull together. We need accurate daily sit reps and we need a track and trace system that works and computers that can count. Then together we will overcome. Stay safe every one.

October 7 2020

I have given up trying to get accurate figures for tonight. all my regular sources are showing different figures that are said to give the situation at 4pm on 7th October.There are two figures that are agreed , firstly the total number of tests done in total amounting to 544,275. when I look at the last 24 hours, 3 different figures are quoted 14,162; 14,542 and 28,704,secondly, when I look at deaths the total death figure altogether is agreed as 42,515 but the numbers in the last 24 hours are 146; 76 and 70.Please do not complain if I do not quote the same figures as you find I have done my best!There has been little other news tonight from the White House. !suspect the president has gone to bed for a few days. Here at home I am surprised the Government have not acted today to manage the growing crisis. Perhaps The Prime Minister has had the same problem having accurate accurate statistics to work with. Full marks to Nicola Sturgeon who has taken steps to control things in Scotland. As from Friday all pubs, restaurants and cafes in the central belt of Scotland including Edinburgh and Glasgow are banned from selling alcohol indoors for the next two weeks . In high risk areas all food services are closed except takeaways. snooker, pool and billiards hall have all to be closed again. For more details about the changes in Scotland please refer to local websites.Berlin has also introduced a curfew for the first time in 70 years everywhere is to be closed from 11 pm to 6am and they have a rule of 10.I hope our Government gets on with it. The longer we leave the inevitable tightening of the rules, the more lives that will be lost, and the harder it will be to recover. As far as hospitals are concerned despite saying the dashboard has been updated at 4pm, the only figure to have changed since yesterday is the number now in hospital with Covid 19. It is now 3,145. a significant rise every day now mirroring what we saw in March.I am going to tighten my own set of rules. I am only going out to shop, and do a welfare check on Wendy’s son Alex who is alone and vulnerable. . My group of six has reduced in size. Pubs, clubs and bars are no go areas . The basic rules of masks and hand hygiene can be strengthened and masks cleaned and washed (or thrown away and burnt) more often.Have a look at what you are doing, see what you could do now to pre-empt the next set of rules. Stay safe everyone

October 8 2020

It seems to me we have a stark choice now, it’s a matter of lives versus the economy especially in the hospitality sectors. We can, as a nation, do somethings to help those out of work and with no prospects of work, people can retrain, but no government I know can bring people back from the dead.Figures today seem stable . 17,540 new cases testing positive today with some 254,000 tests being done today. There have been 77 new deaths reported. Even more worrying. the number in hospital is rising steeply and is now reported as 3412. In ventilator beds there are now 442 cases with a total of 609 admissions in the last 24 hours. I note the hospital data was up until 9am today not the usual 4pm. My own view is exactly the same as Professor John Edmunds who has said today that a “circuit breaker lockdown” is required immediately to avoid many more hospitalisation and deaths. Prof. Edmunds said “we must do it now and take the pain now “Apparently the Government intend to take action within 2 weeks however I and many others think we need it now. We must learn not to leave it too late. it seems, the political issues of the Government’s action needing to be ratified by parliament before they can become law. This is difficult We should not have to wait if emergency legislation is required. Surely we can have retrospective confirmation following use of emergency powers,We are also being told via leaks that a national 3 tier lockdown system is to be introduced once parliament approves it sometime next week. Again I believe these need to be in place before this weekend.Our national policy in order of priority must now be to suppress the virus, to support the economy, to support education and the NHS until a vaccine can make us safe.Universities continue to be hit badly . Newcastle now have 1000 plus positive cases and Leeds have 558.Visitors to Italy from the UK will now have to prove they have had a negative test before being allowed in.News about Trump still seems to be scarce. He has not been seen in public today, I presume because they cannot hide his breathlessness. he continues to rant and rave about many issues particularly relating to the Obama era. I think we have no option but wait and see what is going to happen. On debate has been postponed for a week.If the government are not taking action for a week or so and are not allowing local action, its time we took action ourselves. I suggested yesterday we tighten our personal protection. I certainly will not be going to bars pubs or restaurants to eat in or out doors, for the time being. If tighter restriction are held up for a week at current rates there will be 500 more deaths and over 1000 more in hospital. Do not forget, if you are eligible get your seasonal flu jab now.Wash your hands, wear your mask, and change it often. Stay at least 2 metres apart.Keep yourselves and others safe.

October 9 2020

The Chancellor today announced a major change to the Job Support Scheme for workers who would have been left high and dry when furlough ends on November 1.Instead of having to work at least a third of their normal hours to qualify for support from November 1, staff stuck at home can now continue to qualify for cash.And instead of the government paying 22% of wages while employers pay 55%, the government will pay two-thirds of wages – while employers pay nothing at all.But in a major catch, the UK-wide, six-month scheme will only help workers at venues that have been ordered to shut by the government.That throws a lifeline to any pubs and restaurants that are forced to shut in local lockdowns next week. It also helps places that have remained shut since March, including nightclubs and strip clubs.Yet there will be no extra help for venues like pubs that had their opening hours cut back in a local lockdown – or have been crippled by the 10pm curfew across England.Even firms that do qualify will only be able to reclaim the wage cash for their workers from December.And there is nothing new for the self-employed – who must wait until January for a three-month grant worth just 20% of their average profits, up to £1,875.It comes after northern leaders were left furious when plans to shut pubs and restaurants leaked to the media without them having any say.Boris Johnson is set to replace local lockdowns with a new “three-tier” system on Monday that will slap tougher curbs on areas such as Manchester, Newcastle or Liverpool.Remember it will take a full 2 weeks before any tighter measures will be reflected in the daily statistics. As I explained yesterday the longer we leave it the more lives lost and the more suffering from long Covid, but less will have their livelihoods destroyed in the short term.The chancellors offer is good it will help people keep going. we must all help one another keep going.The statistics tonight show 13,864 new positive cases today with 87 deaths registered in the last 24 hours. I remain uncertain about both these figures and those for hospitals. There is no way of verifying them and there will be minor variations on a daily basis. 3,660 people are in hospital with confirmed Covid 19. 436 0f these are on a ventilator (cf 442 yesterday). there were 597 admissions in the last 24 hours compared with 609 yesterday.Whatever the exact figure, its almost immaterial, it is a fact that the number of cases here have doubled in a week Both Germany and France are seeing similar large rises.Only the Czech Republic and the Netherlands have high case rates per 100,00 than the UK according to the Press Association who base their figures on data supplied by the European centre for Disease prevention and Control.In the EK Scotland have begun their extra closures while I write this. Nottingham tops the list in the UK with 760 per 100.000. Liverpool are third at 600 per 100,000,I have no public or printable comments about you know who tonight. but I do know we cannot afford to follow him; we can stay much safer by keeping ourselves away from crowds and following the rules.. keep up to date as they change around the country. Stay safe, protect and support one another,

October 10 2020

Today must be the calm before the storm. It is widely leaked that our Prime Minister will introduce new and tighter restrictions tomorrow with a revamping of the restrictions into a simple tiering system.As of now there have been no daily statistics released today. They often do not reflect the true picture because of being a weekend but it will increase the numbers released tomorrow in support of the action.I am pleased to see my professional body, the British Medical Association, calling tonight for clearer more decisive action, The propose tightening of the rule of 6, to only allow 2 households to mix. They want to see tighter rules on wearing masks in offices and other work spaces unless you are on your own in an office,Remember at all times the objective in these rules is to prevent the virus spreading from one person to another. We do this by staying well apart, at least 2 M when ever possible, by both of us wearing a mask to prevent droplets carrying the virus spreading between us. We know that indoors the concentration of infected droplets is higher and we need to be that much more vigilant, This is why if you meet up with a loved one or friend it is always better to be outside, Regular hand washing and disinfecting surfaces remains important and we should do it continuously. If you are in a household with someone particularly vulnerable or at risk I strongly recommend changing top clothes and foot wear when coming home as well as hand washing. Its very simple the more we can stay apart the less likely there is to be transmission.Politicians in the north seem to be objecting to the lack of financial support rather than the measures them selves. What ever your views on the way this crisis has been managed we have had one of the best system of financial support of any country in the world. We need strong decisive clear action now, It will be at least 14 days after the new restrictions before we see any change in the upward spiral of cases.Stay safe every one I will bring you all the details tomorrow, so stay tuned.

October 11 2020

The delay in announcing the Governments plans to tighten restrictions to deal with the Covid 19 Pandemic, does nothing to demonstrate that the prime minister has a grip on the situation and that effective emergency powers are ready to be announced. He has spent this morning talking with the mayors and other leaders in the major cities in the north which are badly affected. This afternoon he is talking to his cabinet about the plans and will now probably announce them in parliament tomorrow afternoon.Yesterdays figures finally appeared at at about 8.30pm last night. they were entirely predictable. So on Saturday it was 285.015 tests done with 15.166 positive results. There were 81 deaths. 3,837 people were in hospital with 442 on ventilators . a total of 684 new patients had been admitted with Covid.Turning to today and expecting lower figures being a Sunday we are told that 12,872 tests are positive but the total number done has not been recorded. 65 deaths are registered but no other hospital data has been released.There is considerable speculation about the details to be announced particularly with regard to households mixing and restrictions on travel within the UK.I will obviously report the changes when we know them tomorrow. Do not make plans about travel that cannot be changed or cancelled until we know the details.India passed 7 million cases today, mot far behind the USA with 7.7 million cases.It would seem turkey have been misleading us and WHO by only reporting symptomatic cases and have not reported positive cases like the rest of the world. they are to put that right and report all positive cases now.At this point in time only 8% of the British population have been infected. We have to have many many more cases to get anywhere near the herd immunity of at least 70%, and there is no vaccine on the near horizon yet. Remember also that immunity can drop for this disease and people can get reinfected. To use the herd immunity approach advocated by a few, by removing all restrictions, would generate a vast number of excess deaths and the NHS even with the nightingale hospitals would be totally overwhelmed. This approach is totally unrealistic.Prof, van Tam joined the call for urgent action to tighten the rules. He has been a sound , clear and consistent advisor to the government.Remember this virus requires people contact to spread. The less contacts you have the less likely you are to catch it. Please stick to the rules tonight and any additional rules from tomorrow. Stay safe everyone

October 12 2020

i hope many of you have listened to the parliamentary debate following the PM’s statement today. There is a lot to absorb and understand. There will be an address to the nation at 7pm tonight. I have decided to listen to that before posting my daily briefing. I am sorry for delaying it. I will try and publish it by 8.30pm

The Government Chief Medical Officer made it clear this morning that we are in a perilous position. There are now more patients in hospital with Covid that there were when the national lockdown occurred in March. There are now many areas where the rate of rise in the number of cases is increasing rapidly across the country. We were warned that the death toll will be too great to bear if we do not act now and decisively.Limited figures released tonight show 13,972 new positive cases reported today and there are 50 deaths. There are no published figures for health care. Remember Monday’s figures reflect activity on a Sunday.The Prime Minister presented his anticipated three tier system of restrictions to be applied across England, but Scotland Wales and Northern Ireland will only commit to something similar, not necessarily the same rules. We have lost a great chance to bring the nations together, after all it was meant to simplify things.I cannot for the life of me understand why these levels are medium, high and very high. I would have preferred 5 levels with level 0 to mean no restrictions, level 1 meaning mild restrictions, level 2 moderate, level 3 high, level 4 very high, and level 5 maximum. When we get to the easing of restrictions next year we will need a low level for a while. Most of England is placed in level 1 with moderate restrictions which relate to the current rule of 6 meeting indoors or out and a 10pm curfew. Together, of course with the 2 metre rule and face covering, the same rules remain in place as before.A few places such as Greater Manchester and Nottinghamshire have been placed in tier 2 or “high”. Here people will not be allowed to meet in groups of 6 indoors.Only Liverpool City has the highest level 3. This means no social gatherings either indoor or outdoors. The closure of all clubs and bars but not restaurants . additionally casinos, night clubs, gaming clubs and gyms all have to close completely. Further rules may well be introduced as the rules will be reviewed regularly and tailored packages will be developed. People will be asked not to travel to or from high risk areas.The legislation is laid before parliament tomorrow and becomes law from Wednesday.The PM made it clear that schools and universities will remain open in all tiers.Discussions in Parliament covered the whole spectrum of opinions. I am surprised that there are no mandatory restrictions of travel in any of the tiers. Wales have travel restrictions in place already.The opposition leader started by generally supporting the government but ended being critical but not offering any alternative ideas, A lot of discontent remains about the financial support for businesses affected from the opposition benches A lot of my medical colleagues are already saying this is too little too late. They considered much tighter restrictions should have been in place over a week ago, as soon as we saw the way things were going. I have to agree with them.Figures will continue to rise at the same rates for the next two weeks. Only then will the rules begin to take effect and numbers hopefully level out.The R level continues between 1.1 and 1.5 so the number of cases will continue to rise until it goes below 1.0The effectiveness of Track and Trace continues to cause concern and political controversy. The army are to assist in Liverpool and there is a growing campaign to run this locally under Public Health rather that Serco.32 Essex Students have been fined £200 for meeting in groups larger than 6.The Manchester, Harrogate and Sunderland Nightingale hospitals are being made ready for use,If you want to know which tier your postcode is in you can check on Gov.uk or on the Covid app.The Chancellor tonight talked about the financial support with his Job Support Scheme starting as furlough finishes in November. If people cannot work for a week or more they will be paid 2/3rds of their normal salary. There is also a cash grant of up to £3000 per month for businesses forced to close. There is also considerable financial support for local authorities to enforce the local rules.My personal view, is that we are still taking a fire fighting approach. The tiers have not introduced simplicity and when the devolved nations join in, it will be far from clear. Rules within tiers may well be changed. We have not learnt the lessons of the first peak; we act to little too late and with no exit policy at all. Even the CMO says that the tier 3 rules are not tough enough.The position of those who have been shielding remains difficult and clearly needs special care. Dr Harries the deputy CMO is to address these issues tomorrow.Finally, for our schools, a decision has been made to delay the GCSE and A level examinations for 3 weeks. It remains to be seen if they will be able to run them in the usual way.We will get though this, do not be despondent but pull together support one another and stick to the basics as well as following the local rules. Remember the less contact you have with others the less likely you are to catch it. Stay safe everyone.

October 13 2020

Let’s start tonight by trying to understand the rules about travel with the new tier system.As many holidaymakers are set to head off on their half term breaks, the new lockdown rules could mean a change of plans.Each region of England is now in a “tier” – or alert level – which dictates the extent of measures in place for that area.Tiers are allocated depending on levels of Covid-19 infections, meaning neighbouring areas are set to have different restrictions in place – and the tiers are under constant review.So depending on where you live, your reason for travel and your final destination, the rules on travel and holidays could now change from tomorrow (October 14).These are the new rules and guidelines that come into force on Wednesday for each tier level in England:Tier one and tier two rules.The travel restrictions haven’t changed much for those in the lower two alert tiers.They can still travel within high alert level areas to hotels and other guest accommodation, but only do this with people in your household or support bubble.Holidays outside of high alert level areas are also still allowed, but only with people in your household or support bubble.You can still meet people you do not live with in outdoor public spaces, but in groups of six or less – and in England, this limit of 6 includes children of any age. And you’ll still need to follow social distancing rules.Travel to any part of the country subject to higher local COVID alert levels should also be avoided.However the government has been explicit in emphasising how important it is to respect the different rules in Wales, Scotland and Northern Ireland, and to not travel to areas where it would be against legislation to do so in the respective nations.Tier three rules.If you live in an area that is under tier three (very high alert) level restrictions, there are some additional measures in terms of holidays and travel.The government is advising people not to travel in or out of an area if it has been categorised as a very high alert level area – unless it’s for work, education, to access youth services or because of caring responsibilities.So as far as the government measures go, they are now advising people not to go on holiday outside of their lockdown area.However if you are resident in a very high alert level area, you can still travel to hotels and other guest accommodation within the same alert area, but only with people in your household or support bubble.You must not stay overnight with anyone you do not live with from a very high alert level area or visit their home. But you can still meet people you do not live with in outdoor public spaces as long as you are in groups of six or less. In England, this limit of 6 includes children of any age. And you’ll still need to follow social distancing rules.So basically, you can still go on a holiday so long as you stay within your own lockdown area, you only travel and stay with people you live with and you are staying in a hotel or guest accommodation.People who live outside of a tier three area should not travel into one for a holiday.Holidays outside of EnglandThe rules on travelling abroad have been less explicit. The government guidelines advise that holidaymakers should check the entry requirements and rules at their chosen destination – and check the current travel corridor list to see if they will need to self-isolate on return.The devolved nations of Wales, Scotland and Northern Ireland have their own legislation in place which needs to be adhered to at all times while visiting. Many parts of Wales are now locked down to outside visitors, and it is against Welsh law to enter them, with few exceptions. Always check the area you are travelling to for local rules and regulations.Across all tier levels, people are reminded not to travel if they are experiencing any coronavirus symptoms, are self-isolating as a result of coronavirus symptoms, are sharing a household or support bubble with somebody with symptoms, or have been told to self-isolate after being contacted by NHS Test and Trace.This is supposed to have simplified the rules and guidance. I do not see any clarity , in fact I think it is more complex than its ever been. We have been consistently told that the Government have been following the science. I would like to hear an answer to the question when and why did the government reject that approach ? It appears now that the expert medical advice as revealed by the minutes of a meeting of SAGE called for a short sharp full lockdown to pause the spread of the virus. Regular readers will recall I was saying the same thing. Now its too little too late, it will be another two weeks before we see a response to the tiers. Meanwhile, there will be constant adjustment to the tiers; some advisory some mandatory. A few local authorities have resisted and objected to the category their area is allocated to. It seems to me that Greater London will very soon be a tier 2 region and Greater Manchester at tier 3.Look closely at today’s figures. The total number of Covid tests done was 219,074 with 17,234 testing positive. 143 deaths due to Covid have been registered in the last 24 hours. This is the highest jump in deaths for over 4 months.Hospital data for today now shows 4,367 people in hospital, with 507 on ventilators. 655 new cases were admitted in the last 24 hours. Medical knowledge has increased significantly since March, we have some effective techniques to use now to save lives and I would hope the figures will reflect that where patients have been given steroids and other experimental procedures.Having heard that the medical advisors had been asking for a circuit breaker lockdown, Sir Kier Starmer has broken his silence on what his suggestions were to combat the pandemic and publicly agreed with SAGE. I urge you now to talk to your MPs and others of importance in this fight. It should not be a political issue – Lives must come above the economy. A full circuit breaker lockdown would certainly show decisive leadership and simplify things considerably.Some of you have been involved with me in discussions about the role of vitamin D. You will be pleased to hear that a major trial is about to begin to assess the role Vitamin D may have in protecting people from Covid. As a very high percentage of our population are naturally deficient in vitamin D already, particularly in the winter months, it makes sense that having low levels may make the effects of Covid more severe . So you might like to start on a daily oral dose of vitamin D. Discuss with your Pharmacist or GP.Other welcome plans today are that close family members of those in care homes will be trained and treated as key workers so that those in care homes can have a visitor. One relative will be trained to use PPE and this is to be provided. Sadly the government have declined to say when this becomes effective. It’s a bit of progress. Keep up the pressure. We have treated this problem with out any compassion and it must change.Dr Jenny Harries the deputy chief Medical officer is to write to the 2.2 million who were very vulnerable and shielding to say that it is no longer necessary to stay at home indoors. They can venture out safely but they remain very vulnerable and they will be given tailored advice depending on the tier their home is in. Again I am not convinced this simplifies things?We cannot afford to let this pandemic win. We cannot sit back and watch it at work for two more weeks. We can stop it by reducing social contacts and carefully following the rules and helping others do the same. If you are in a position of influence try to influence the way its going, I know the economy will suffer and many will have hardship. Having no money is one thing but having no relatives is much worse and cannot get better over time.Do not despair but stay safe together.

October 14 2020

With almost 20,000 new positive cases of Covid19 in the last 24 hours, does anyone seriously think this is under control and that the three tier system and the 4 governments have got a unified and simplified system ? I doubt it and I personally certainly cannot see how it possibly could. Northern Ireland was the first to go off and do its own thing. Following the advice from SAGE, they have what amounts to a circuit breaker lockdown starting next Monday. All pubs and restaurants are to be closed except for takeaways which can stay open until 11 pm. No alcohol can be sold in supermarkets or off licenses after 8pm.Northern Ireland schools will also close for one week before half term begins so that in effect they are closed for 2 weeks. Those who can, are urged to work from home again whenever possible and there should be no non essential travel in or out of the country and around Northern Ireland.There can be no mass gatherings , no indoor sports, gyms can open but only for individual training only. We are used to bubbles now, they can be up to 10 but only from 2 households. Weddings can take place but without receptions and with a maximum of 25 involved in the service. Funerals can also be conducted but with no pre or post gatherings with up to 25 attending. Places of worship may remain open but face coverings and social distancing is required.Universities can stay open but the maximum teaching possible is to be on line. The current restrictions of different households meeting inside or out continue. Hairdressers and other personal services must close.There is perhaps some greater unity in Northern Ireland than usual as both Arleen Foster and Michelle O’Neil have mothers ill in hospital with Covid 19 infections. I wish them both a speedy recovery and thank their daughters for such prompt action.The First Minister of Wales, having failed to get a reply from Boris Johnson, also took Wales out on a limb today. He announced a ban on anyone in the rest of the UK living in an area of high prevalence of Covid from travelling into Wales. This is the first time there has been any restriction in travelling to or from different nations in the UK. Scotland, says Nicola Sturgeon, is considering their options and are very likely to announce sensible extra precautions very soon.This leaves England, with its confusing tiers, still out on a limb. It is clear now that Manchester have been refusing to cooperate with the government who wanted it in tier 3. Their Labour Mayor has threatened the government with legal action because it is considered the financial compensation is not adequate.Almost every conceivable suggestion has now been made about how to deal with the mess. The Government have little room to manoeuvre. By trying to protect the economy and lives, they are very likely to end up protecting neither. Today’s changes will not bite for 2 weeks so we shall see a continuing deterioration for a while yet. I am not sure that the general public will accept or tolerate this.If you are using the NHS app, you may have received an erroneous message saying your risk level had been raised. This was an error, but was a glitch in an upgrade of its blue tooth technology.An interesting figure from Scotland showed that 180 of the newly positive individuals had recently visited Blackpool.The Head of MI5 gave a press interview today talking about the threat risks to the UK and what hostile states meant. He specifically spoke of the need to protect UK vaccine manufacture and knowledge from those willing to sabotage it.Finally todays figures. 264,713 pcr tests have been done today with the total just short now of 25 million. 19,724 were positive in the last 24 hours. There have been 137 deaths registered. There are now 4,650 people in hospital with 516 in ITU ventilator beds. A total of 680 new admissions occurred today.With almost 20,000 daily cases, just how long are we going to resist the firm circuit breaker approach we need, it has worked well in Israel and other countries. We will perhaps need to use a circuit breaker regularly till we get through the winter and just perhaps a vaccine then will be ready.Meantime do you bit to protect yourself, family and friends. Remember Hands Face and Space. Stay safe everyone.

October 15 2020

As Expected Greater London and Essex have agreed to go into tier 2 or high in the new system. Essex does not include Thurrock or Southend, both of which have higher rates than the the parts of Essex covered by Essex County Council who actually asked the Government to go into the high risk category. This shows the weakness in a localised response. Other areas placed in tier 2 or high today include Elmbridge in Surrey , Barrow in Furness in Cumbria, North East Derbyshire and Evewash.Manchester, lead by the Mayor are refusing the Government plans of putting Manchester into the very high category to join Liverpool. It will be interesting to watch this standoff but I suspect it will go to tier 3.One problem developing is that we are not supposed to travel from one tier to another if the start and finish locations are not in the same tier. Half the population are now in tiers 2 and 3.Statistics for today have not yet been updated on the Gov.uk. web site but have been published for the nations separately for health care. So if my addition is up to scratch 5,857 people are now in hospital with 577 on ventilators.138 people have died in the last 24 hours. As for admissions I only have the England figure at 764 which is higher than the last figure for all 4 nations.It has been suggested tonight that the daily Ministerial briefing should be reinstated as the British public responded to and listened to the situation and that this contributed to our ability to overcome the first wave.I would be very interested in your views. did they influence your behaviour or not? If not. did anything influence you? Do you think they should come back?.I still think a circuit breaker lockdown is inevitable and that we shall have to do it about every six weeks until spring comes and the weather is on our side again. If no vaccine materialises we will be considering a third wave. I was horrified to hear that a Government health minister has denied the concept of herd immunity ever existed. It does not help Covid but by maintaining childhood disease immunisations above 90% most of our population have herd immunity. Trouble is babies are not born with any lasting immunity so we will always need to immunise against Diphtheria, Measles, Whooping cough etc.to maintain herd immunity. It certainly exists!If any of you are risking travelling abroad, Italy has been added to the Quarantine list and Crete has been taken off. If you have a holiday planned for half term think very carefully before you go. Consider the consequences that could happen. Can you afford to lose money or get stuck in quarantine? Do you want to mix that much with others?Many people are very frightened by the current situation, support one another , remember to be kind and supportive. If we do explain and stick to the rules completely, we are going to get through all this. Please only go out if you must, impose a local lockdown on your household Use your spare time to make your house and garden somewhere you like to hang out, not just somewhere you sleep. That will both occupy you and make being at home a pleasant experience. If you save money by not going out spend some on your home so you can enjoy it.Stay safe, remember the basics Hands Face and Space.

October 16 2020

Lancashire has agreed to join Liverpool in tier 3 from 1 minute past midnight on Saturday morning, This came after negotiations between Government and Local Authority agreed a £42 million compensation deal.Manchester, lead by Mayor Andy Burnham, are still refusing to cooperate unless a sufficient compensation package is agreed. The PM says if push comes to shove he will impose it but prefers that the Local Authorities cooperate, Time is short , the situation grave and this cannot be left much longer.I understood the tier system was to simplify and standardize the restrictions in each tier, but already there are differences in the restrictions for Liverpool and those in Lancashire. Gyms and hairdressers for example are allowed to stay open in Lancashire but must close in Liverpool. This makes a complete nonsense of the tier system.The essential requirement now is to prevent the pandemic becoming greater by reducing the R rate back to below 1. It is currently between 1.3 and 1.5 right across the UK. The PM , in his address at the briefing tonight, suggested that it should be quite easy to bring it back to 1, with a thirty percent drop required. I think this was over simplifying the issue to the point it became inaccurate.The PM made it very clear that he did not support a national lockdown or circuit breaker at this time. It would be unfair to businesses in North Norfolk or Cornwall where infection rates were low. He went on to say, however, that if the situation demands it he will act decisively to lock down. Sir Patrick Valance like many of the senior scientists, made it very clear he supported the circuit breaker lock down to save lives.The Prime Minister is trusting that the millions of new rapid saliva tests the government have brought will come on line soon. They are fast, simple and cheap, only taking 15 minutes to get a result. They are shortly to be distributed and trialled. What it does not ensure is that if you find yourself with a positive result you must instantly self isolate.For this disease to spread it requires people to spread from one to another. Which is why staying at home and working from home is best when ever possible. Socialising should be on hold for the time being. Can we all help to show those frightened of technology how to use a basic email system or how to use Zoom or Skype or other social media tools. We were reminded in the briefing that the effects of this pandemic spread far further than the actual effects of Covid itself. There are the indirect health risks of people not having routine cancer checks and follow ups, There are the economic effects on health, the potential loss of education in schools and universities.Sir Patrick Valance posted some very helpful slides at the briefing tonight. If you missed them they will be on the Gov.uk web site by tomorrow. If you do not know the difference between prevalence and incidence you really should look at the slides to help you understand.The data tonight says 304,315 Covid tests were done in the last 24 hours with 15,650 testing positive. There were 136 deaths recorded bringing the 7 day figure 750. Patients in hospital with Covid amounted to 5,311. 580 of these were on ventilators. Another 844 were admitted in the last 24 hours. I am a little suspicious of the hospital data accuracy tonight.Those who enjoy the statistics might like to look at the new experimental web site that is reporting them go tohttps://l.facebook.com/l.php…I notice the PM used the word alas several times in replying to various questions about people meeting and travelling between tiers. It is clear he did not have all the information in his head and I have been forced to making notes to remind me of the details. The rules about crossing from one tier to another to see a love one have become even more difficult. The PM referred people back to the internet for information.Distress is becoming significant among many people I have spoken with and I am sure you are finding the same. We must look after one another in these troubling and confusing times . I like to think the tiers are like gears in a car, we can go up and down the gears easily and we know what to expect of the car in each gear.If the tiers are reducing you to tears please ask for help and stay safe everyone.

October 17 2020

Being a Saturday there is less general news than usual. It seems generally people have welcomed the increase in the numbers of places now in tier 2. The Mayor of Manchester continues to resist the imposition of tier 3 on his city despite government support from Sir Kier Starmer. Meetings continue, I am sure they will have to give in. The longer it takes, the greater the harm it does to the people of Manchester but also in the rest of the country where people cannot accept the idea of further restrictions.The Mayor of Liverpool, as if he does not have enough on his hands, has announced that his brother has died today in an ITU with Covid 19. My condolences to him and his family.Wales have already banned anyone from Northern Ireland from entering Wales. This has been extended to over half of the UK now. Where there are stage 2 or 3 restrictions people cannot travel to Wales. There are however some essential exceptions. The Welsh assembly are to debate a circuit breaker lock down on Monday and are expected to make a statement afterwards. In Europe the usual suspects continue to cause concern, especially the rising death rates and new case rates in Italy and the Netherlands.I understand that a Vatican official living and working in the same residence as the Pope has tested positive and has gone into isolation.Data is scarce tonight. It would seem there have been 150 recorded new deaths in the last 24 hours in the UK and 16,171 new positive tests reported. The hospital data is old but to remind you, 5608 were in hospital when last updated on Thursday 15th October. 592 patients were on ventilators but not updated after yesterday. The daily admissions amounted to 987 but has not been updated since Tuesday 13th October.The data misleads because it says the data has been updated to today when it clearly has not.China is about to start using their vaccine according to reports even though the various trial stages have not been completed. Not something any British medics would be prepared to do.I’m about to do some work on existing recovery plans. If any of you are involved in writing or implementing such a plan I would be very pleased to know about it, so please message or email details to me.Stay at home, stay alert and ensure all your loved ones can stay safe this weekend.

October 18 2020

Again, being a Sunday, only limited data is on the Gov. UK dashboard despite saying it was updated at 4. 30pm today. About 304,000 pcr tests were done in the last 24 hour period with 16,982 people proving positive, each of whom now has by law, to self isolate immediately.Deaths are always under reported on a Sunday but there were 67 deaths reported which is almost double the 35 reported last Sunday. The health data has not been changed for some days now. I reported yesterday that an Aide to the Pope living in the same residence in the Vatican has tested positive. Today we learn that 11 members of the Swiss Guard (The Pope’s body guard) have tested positive as well. I do hope there is not going to be a major outbreak in the Vatican.It must be obvious to everyone that this second spike is far from under control and it is too early to see if the effects of the tier rules have had any effect at all. Germany hit a new record on Saturday with 7,840 new cases compared with our nearly 17,000 today, France has had another 142,900 cases positive in the last 7 days. Even Sweden has introduced some local lockdowns now.We are all aware of the huge number of shop closures this year including many well known names. One study showed 11,000 closures with only 5,119 opening, a net loss of 6,001.Tonight we learn that the Edinburgh Woollen Mill is under very severe pressure and could close.I have been very aware of the impact this is all having on our corporate mental health. Amongst my readers are many in health and other key professions working to support people through this crisis. I am well aware of being in a privileged position living on a secure pension in a large house with plenty of garden to walk in. I did however work for 30 or more years in East London and saw the effects of deprivation in many families. I find it hard to imagine how a single mother with three children under 10, living high up in a Tower block with no employment and no local family can cope with this. The fact that many can keep going is a tribute to the resilience of our Great British spirit of cope and carry on. Those in situations like this must have all the financial and practical help we can give to help them get through. Our government does not have infinite resources and at the end of all this we will have a tremendous national debt again, which will last years. We have only recently cleared debts. from WW2. Many of us will be required to pay more taxes in the years to come and we should do so in a grateful and gracious way. I do believe our government is being as generous as it can and far better than almost any other country. In many countries the cost of hospital care with Covid infection has to be paid for by patient.If any of my readers are upset that they are putting their children to bed hungry because they have no money, please tell me so that I and hopefully others here may find ways of helping. We will get through this best by working together and supporting one another. As an example I have 4 fields doing nothing after our horses were rehomed and local people can now use the fields for dog walking so as to stay isolated. There is to be a simple rota system to stay Covid secure.Now is a good time for you to do an online mental first aid course to help support and assist others in crisis. We will recover as a nation, we did after the far worse 1918 pandemic and we did after both world wars. Few alive today remember the restrictions imposed by the second war and the impact of rationing. It is a good time for our children and young adults to revisit those times. With Remembrance day nearly with us encourage the youngsters to read and watch films about war time conditions and the camaraderie that ensued. We had an enemy we all knew who it was and we were all determined to defeat him.In your immediate locality do you know some one in isolation perhaps not knowing how to use a computer, ipad or even mobile phone. Could you spare some time or send a teenager to help them set up zoom or something similar to help stay in touch with their family. Our local neighbourhood group has helped recently with this . Try it in your neighbourhood please.I have looked to see if there is any data available yet on the impact on Mental Health hospital care. I cannot find any data on the effect of the pandemic on the number of patients sectioned to admit then for care or treatment to hospital. I suspect perhaps less than normal have been admitted compulsorily because of the reluctance to see patients face to face in their own homes. If any one has any data locally I would be interested to know. Under the Covid Act 2020 there are powers to modify the requirements of the 1983 Mental Health Act to enable one doctor rather than 2 to sign papers for compulsory admission. The rules have not changed yet and need to be activated, only if needed.There is a recently published paper about suicide in children during Covid before and after lockdown and also comparing with the same period of time. The numbers collected were fortunately far too small to make any statistical analysis. One figure I saw as important, was that one third of the children were known to child mental health services before they committed suicide. In adults far fewer patients are known to Adult mental health. Another interesting finding was that 25% of those killing themselves had a diagnosis of Autistic Spectrum Disorder or Attention Hyperactivity Deficiency Syndrome. Both of which are known to have a high prevalence of suicide and attempted suicide. Childhood suicide remains very rare; sadly deaths from accidents much more common.Finally on a brighter note we know from lessons of the past that we can and will get through this. Put aside political ideologies and work together helping and supporting one another both practically and when necessary financially.I remember the story of the foot steps in the sand. Two men were trekking across the sand leaving two sets of footsteps. suddenly one set disappeared leaving the man wondering why he had been left alone, The reply was ” I did not leave you I was carrying you!”Whether you are carrying or being carried does not matter. We may change places a few times so stay positive, stay safe, lets get through this in the way we know we can.

October 19 2020

I have today been reminded of this poem whose author is unknown. It has special significance for my many doctor friends who have worked in immediate care as it was often quoted by the acknowledged father of immediate care the late Dr Kenneth Easton. I know his daughter is a regular reader of this daily bulletin so it may well have special meaning for her as well.Don’t QuitWhen Things go wrong as they sometimes will,When the road you’re trudging seems all up hill.When the funds are low and the debts are highAnd you want to smile but have to sigh,When care is pressing you down a bit,Rest if you must but don’t you quit.Life is queer with its twists and turns.As everyone of us sometimes learns ,And many a failure turns about When he might have won had he stuck it out;Don’t give up though the pace seems slow–You may succeed with another blow.Success is failure inside outThe silver tint of the clouds of doubt.And you never can tell how close you are. It my be near when it seems far;So stick to the fight when you’re hardest hit,it’s when things seem worst that you must not quit.Anon.I hope the sentiments expressed here can encourage you and strengthen you as we tackle the Covid pandemic together.

The main news of the day comes from Wales where Adam Price confirms a local firebreak for two weeks from 6pm on Friday. This will affect some 2 million people. it is interesting he chose to find a different term to describe the lockdown, Its a fire break not a circuit breaker. Almost everyone in Wales is asked to stay at home whenever possible. non essential shops are to close. Mr Adams explained the time would be used to build a more resilient test and trace system. he went on to say that “this is a last resort, only to be used in an emergency, but we are now in that emergency. it is time for us as a Nation to come together again , communities, Government and Opposition working together to protect the NHS and save lives. “Support for the move came from the Welsh division of the BMA and from the RCN in Wales. The only exceptions are critical care workers and essential jobs where working from home is impossible. All non essential retail, leisure, hospitality and tourism are to be closed. community centres, libraries and recycling centres will be closed. places of worship will close except for weddings and funerals where there are restrictions in numbers with no wakes or receptions. Child care facilities can stay open. Primary and Specialist schools will reopen normally after half term, Secondary school children in years 7 and 8 will also return after half term but the rest of the secondary school are to learn from home. University students are to be taught on line and students must stay in their university accommodation. Members of different households are forbidden from meeting both indoors and out doors in any settings. The social bubble rules remain the same. It is very important to realise that the effects of this fire break will not show any effects during the first two weeks, Its sole effect is to slow the rate of infection after that.The stand off between the Government and the Mayor of Manchester over financial compensation continues . Sadly it has been announced today that the MP from Bolton South East , Yasmin Qureshi has been admitted to hospital with Covid pneumonia. I wish her a speedy recovery.In London now subject to tier 2 or “high” level restrictions, there have been 10,000 new cases in just one week, however the number of people admitted to hospital is much smaller than in April and only 29 deaths are reported. This reflects that younger people are less likely to be seriously ill and die, but the fear is that over time those infected will bring it home to the elderly and then admission and death rates will rise again dramatically.Northern Ireland are already under a national lockdown now. It is reported that Pandemic Unemployment Payments increased by 15,000 with a total number of claims amounting to 244, 000.The statistical data tonight remains incomplete. A further 18,804 laboratory cases are reported to be positive. I notice a change here normally they report the number of positive tests. As everyone has two swabs taken from nose and throat it is very important to know whether we are counting tests or cases. A further 80 people have died within 28 days of a positive test. There are no new figures for hospital data again. It is not clear to me whether the use of the word cases was careless use of language or a deliberate change.The Nightingale hospital in Harrogate is being made ready again.I have reluctantly decided that I will not conduct prolonged debates with those who post third party propaganda from conspiracy theorists in response to my briefings. I really welcome constructive debate and discussion and I am happy to answer questions or clarify issues. Whether these people believe in a flat earth , are holocaust deniers, or think the pandemic is man made or that it is over now and we can stop worrying and get back to normal, I no longer have time to argue.We will beat this pandemic, we have a tough 6 months ahead “So stick to the fight when you’re hardest hit – It’s when things seem worst that you must not quit!”

October 20, 2020

The Government have finally imposed the highest tier 3 restrictions on Greater Manchester after they failed to find any agreement with Andy Burnham the Mayor and other local political leaders. The changes will take effect from midnight on Thursday. It is not clear just how much financial support the region is likely to receive. It was suggested that there was at least £5million difference between the two sides, which seems a little, talks I am sure will continue to resolve it. The Government would not want to be seen to punishing Manchester, but neither can they afford to be over generous. Whatever your political views about this there is absolutely no doubt that doing nothing was costing lives. Professor Johnathan Van Tam demonstrated this with some very clear statistics about the effects of the pandemic on Manchester hospitals. The population of greater Manchester is very similar to Wales. Wales is just under 3 million and greater Manchester just over 3 million. One word used by all three of the speakers in tonight’s Prime Ministerial briefing was Comply. Comply with the rules, Comply with avoiding unnecessary travel. Comply with the rules about household groups mixing. Comply with wearing of masks and washing hands.Prof Van Tam, now seems to be popularly called JVT, presented a comprehensive sets of slides to support the bleak message he was giving about the seriousness of the situation. If you like a visual representation of the situation they should be available on the Gov. UK web site by tomorrow, They are impressive and worth looking at. The slides that represent the spread of the virus in the form of heat maps are particularly dramatic. JVT demonstrated the spread from the young and middle aged group was now clearly having an effect on the spread of the disease into the elderly age groups. You must remember that the effects in the next two weeks will have occurred because of the situation today. The death rate and hospital admission rates will at least double before any change can be expected. The only way it will change is if each and every one of us complies with all the rules. Studies today show many bend the rules to suit themselves.The hospital admissions have gone from 230 to 620 in 2 weeks. The next 2 weeks will take it to 1200 admissions In Manchester alone.I am sure that over the next few days a financial package that is fair and reasonable will be agreed and that once again all parties will cooperate again. The statistics today show that 21,331 people have tested positive, a rise of 21% in 7 days . Deaths have risen to 241, with 949 in the last 7 days a rise of 65% in a week. Yet again, hospital data has not been released. The R rate across the country is 1.1-1.5 which although less than the natural R of about 3 still means it will spread significantly. We must all comply together to defeat this. We brought R down below 1 before and we can and must do it again.The bottom line, as JVT made clear, is that “we cannot afford to just let our elderly die”. Spain is the latest country to be considering declaring “a state of alarm” to implement a national lockdown and curfew.I want to make sure you understand the facts, I try to stay evidence based in my reports. I believe we can get through this. If you are very worried, talk to others in the same boat. Read and re- read the poem about not quitting. Ignore and delete conspiracy ideas. They have been around for years The current lot join the flat earth society and the holocaust denial groups with their false but well argued non evidence based misinformation. We must not Cry but we must Comply.Stay safe everyone.

October 21 2020

As from 1 minute past midnight on Saturday, South Yorkshire, which consists of 4 boroughs, Barnsley, Doncaster, Rotherham and Sheffield join Liverpool and Manchester in tier 3 or the very high restrictions. It would seem that the negotiations lead by the Mayor of Sheffield, Dan Jarvis, were quite amicable and the government have given them a £41 million deal. The Sheffield Mayor said ” We recognise the gravity of the situation and have taken the responsible route to ensure we save lives and livelihoods and to protect the NHS. Inaction was not an option.”The wrangles with greater Manchester continues from all sides and all shades of opinion. I see and understand both view points but I think on balance the Government has had more support, with many feeling that Manchester were only interested in money, rarely mentioning the sick and dying. I am sure that’s not how they see it. Time will tell on this issue but they have been given the £60 million on offer to support the poorest and those unemployed.In Scotland, Nicola Sturgeon has extended the central belt lockdown for a further week until her planned tier system is announced.The Chancellor, Rishi Sunak, has cancelled the 3 year UK spending review for the rest of this parliament to allow more time to deal with the Covid crisis.It has taken a while tonight to get the Covid dashboard data agreeing with other reports . 26,688 new cases have tested positive. Remember this is now cases not tests. This is a rise of 22% of a week ago and shows how the overall number of new cases is rising. 191 deaths are reported in the last 24 hours which brings the last 7 day total to just over 1000. This figure has risen by nearly 60% compared to a week before . This is perhaps the most worrying. The measures taken in the last week will not have any effect in the next week so we must be prepared for a steep increase in the number of deaths in the week to come. Hospital deaths have again not been updated but to remind you on the 17th October 996 new cases were admitted to hospital in 24 hours bringing the number in hospital to 6,479. On the 17th of October 629 ventilator beds were occupied.There is a glimmer of hope when a survey is suggesting that at long last people are beginning to recognise the rules and to comply with them. We must do all in our powers to encourage and support this.A medical colleague has sent me a very useful research paper summarising what we now know about exactly how the virus is spread. I will read and digest it and share the main findings.Be prepared for more areas to become tier 3; this is not going away. A while ago I warned you not to make plans for half term, I think now I should warn you about Christmas. Travel is likely to be difficult. Large family dinner parties will not be possible. I do not understand about people worrying about not being able to buy small turkeys, some even suggesting large ones should go on a diet. I have always brought a large one and frozen most of it for a treat in the rest of the year. An obvious solution. Thank you all for continuing to comply with the rules. We can and must support those less well off in every way we can. We should also try to protect the vulnerable from false ideas. There are several ways to boil an egg and there are several ways for us to get over the pandemic without resorting to witch’s spells or other crackpot ideas. So remember the most important ways are still Hands, Face, Space with the minimum amount of social contact we can.Keep Calm and Carry on. Stay safe everyone.

October 22 2020

As would be expected three new areas are moved up a tier from 1 to 2 or high. The places are Stoke on Trent, Coventry and Slough. Discussions are continuing about Warrington moving to tier 3. In all these areas the new case rate has been doubling every two weeks.I am hopeful that soon I can report that areas have dropped down a tier. Any guesses who is going to be the first borough to go down.. I think Newcastle might be a candidate. I see 237 university students tested positive there in the last week compared with 749 the previous week and 1,003 the week before that. Well done to the students of Newcastle whose compliance to the rules have seen this dramatic improvement.The Chancellor, Rishi Sunak, has announced a support package for businesses and workers in tier 2. Grants worth up to £2,100 are available for firms in tier 2 , particularly in hospitality and leisure venues. Further grants are available retrospectively for areas already subject to restrictions. The treasury believe around 150,000 businesses are eligible for the grants. The job support scheme which starts on 1st November and replaces the furlough scheme has been made more generous. It is no longer only for those in viable jobs working one third of normal hours it becomes available to those working just 20% of their normal hours.Employers are now required to pay to top up wages at just 5% of unworked hours whereas previously they had to pay 33% of wages for the unworked hours.There is extra help as well for the self employed, who will see the amount covered by grants increase from 20% of their profits to 40% . this means the maximum pay out rises from £1,875 to £3,750. the grant will be paid in two parts, one covering November, December and January and the other will be paid again in February to cover February, March and April. It is estimates that the assistance announced to day amounts to £13 billion for the next 6 months.In the long term the government will have to recoup this money from the taxpayer so I am sure in the years to come we will see significant tax rises for those of us paying taxes. The poorest sections of our community pay little or no taxes and will rightly gain most by the financial support packages.I notice that more people are rightly seeking seasonal flu immunisation this year. It is causing a temporary shortage in some areas. Permission has been given for the vaccine successfully used in the USA for the last few years called “flublock” to be given to those eligible. Please make sure you get yours if you are advised to have it.Further Good news from the Oxford- Astro-Zeneca vaccine team, they report the inoculation is behaving in the desired way and they are now in stage 3 trials. It had been halted for a while to investigate the death of a man in Brazil in the trial. It was found that he had only had the placebo injection and his death was in no way related to the active vaccine.Todays statistics show that 21,242 new people tested positive in the last 24 hours in the UK. the death rate was 189 in the last 7 days, but the week on week figures show a rise of 50.4% from a week previously. Over 1000, deaths have been recorded in the last 7 days. The main concern is that that as more of the elderly and vulnerable begin to be more affected this figure may rise dramatically. By complying to all the rules we can hopefully minimise this risk. The Hospital data is 4 days old.There has been an outbreak amongst workers at a Bernard Matthews turkey plant in Norfolk. 75 members of the afternoon shift have tested positive and 600 other are in isolation.There is zero risk that any turkey, dead or alive, can spread it from a turkey to a human. Your Christmas turkey will be quite safe.Many of you liked and commented on the poem “Don’t Quit” I posted a few days ago. I have now established that it was written by John Greenleaf Whiffier. He was a prolific writer and is best known for the hymn “Dear Lord and Father of Mankind” loved by many.Perhaps we need some of “The simple trust” of verse two of that hymn, that we can and will get through this crisis; and in verse 3 “Take from our lives the strain and stress, and let our ordered lives confess the beauty of Thy peace.” The prayer for our future lives together.as Whittier says Do not Quit but Comply., Stay safe and remember Hands Face and Space,

October 23 2020

Many of the new restrictions come into force this evening. It will be two weeks before we see any real, hopefully, downward trends, if all of us are doing our best to comply. I am watching the situation carefully in Nottingham where there has been a dramatic rise in hospital Covid cases. There are over 200 patients in hospital and they are admitting a new ward full every day. The Queen’s Hospital Nottingham is our nearest major teaching hospital from Boston.On the travel front there are some important changes. As from 4am on Sunday there will be no need for quarantine if arriving in the UK from the Canary islands, the Maldives, Denmark or the Greek Island of Mykonas.If you are leaving the UK and travelling to Germany you will have to self isolate in Germany for 14 days. Denmark has closed its borders to persons travelling from the UK and you may not be permitted to enter. The rules change daily so if you are planning a trip, which is not advised, check regularly to see if it is allowed. The government advice is clear. Stay at home if possible. Do not travel for pleasure.Greece has imposed a night curfew in many places including Athens. Italy registered 19,143 new cases yesterday, up from just over 16 thousand the day before.The statistics show a total of around 34,000 tests processed yesterday with 20,530 testing positive . This relates to a national average infectivity of 180.4 per 100k of the population. There have been 224 new deaths within 28 days of positive Covid testing.There now seems regularly to be a 2-3 day delay on health data but the latest figures released show 7706 people in hospital with 707 on ventilators. The latest daily number admitted was 1056.These figures remain worrying and will go on rising until the measures taken today begin to work. We have no option but to make them work. As the Welsh First Minister said. “We are saving lives not saving Christmas.”One of the fears is that antibodies to Covid 19 may not last very long and so immunity may be lost. Nadin Dories, an MP who has had the infection, has been reported as saying that she no longer has detectable antibodies 12 weeks after her illness. If these results are replicated with others this is disappointing news for those hoping for lasting immunity. It means she could now become re-infected. This has been seen already in a handful of cases.Today’s BMJ reports on a yet un-peer reviewed article from India involving only 460 patients which found that using convalescent serum containing antibodies from a patient recovering with Covid gave no benefit when given to patients with acute disease. According to Trump he considered this a historical breakthrough and it is used a lot in the States. The question science has to answer is did the Americans get better because of this treatment or in spite of it? We now need several larger scale studies to see which is true.Virapro Hand sanitizer has been removed from the Department of Agriculture Biocidal Product Register because of safety concerns and possible side effects. I would urge you all to check and not to use this product any more as it contains Methanol rather than Ethanol. Ethanol is the alcohol in many drinks whereas methanol is poisonous if drunk and can cause allergic skin reactions.The row about free school meals for children continues after Parliament voted not to provide them in the holidays. Marcus Rashford has stepped up his campaign with strong support from Nigella Lawson. Meanwhile Liverpool have spent £300.000 to provide them over half term. In an unusual step Rishi Sunak and three other local Conservative MPs who voted against funding free meals have been banned from using the Mill Public House in his constituency in Doncaster for life. The owner declared he did not want their custom and for 3 days during half term he will deliver 100 freshly cooked meals to 3 food banks in the area.When Nicola Sturgeon was talking to some kids she said “Do not worry. Santa is a key worker and he is safe working hard to be ready for Christmas. He is protecting us so we cannot go and see him this year.”We all remain very grateful for the key workers who have kept this country functioning fairly well through the pandemic but remember each and everyone of us is key to slowing and finally halting the spread of the disease. Be a key worker and stop the spread. Stay safe and stay alert to all the rules.

October 24 2020

The statistics show 340,132 tests were done in the last 24 hours and of these 23,012 were positive. The published data for deaths in the last 24 hours is confusing, with some sources reporting 242, the same as yesterday, and others 174. It may become clearer later this evening which is correct. The fact remains that the death rate is high and does not show any signs of dropping although the rate of rise may be a little down. This would fit with the very slow drop in the national R rate which is now between 1.2 and 1.4 Whereas last week the range was 1.2 to 1.5. This means that for every 10 people infected between 12 and 15 people will catch it from them. We have to get this figure below 1 to stop the pandemic continuing to spread.Today has seen the first full day of the higher restrictions. It is perhaps too early to assess the impact. The decision to stop supermarkets selling goods other than food has provoked a row with many people objecting. I can see both sides of the argument. Things can still be brought on line and should supermarkets be allowed to make more profits when shops selling the non essential hardware and linen are unable to trade. I notice also that Sainsbury’s are trying to enforce the one adult per trolley rule. You are allowed children with you if they cannot be looked after at home. Couples should not shop together any more.If you were in Government and aware of the perilous state of our economy, the considerable hardship millions are living with and at the same time considering the growing pressure on our NHS, what would you recommend to the PM about relaxing some of the social mixing rules over Christmas day and Boxing day ? So a simple yes no question, please respond to it. Would you allow 48 hours relaxion everywhere in England for social gathering, as a gesture of thanks to the public for staying within the rules and sacrificing much of the Christmas traditions? If your answer is yes please add what changes would you make? Political judgements like this are very difficult. London, tonight, is the scene of another demonstration against lockdowns, masks, vaccines and almost every other action to lesson the freedom and liberty of the individual you can think of. Looking at the filmed footage this is largely a crowd of middle aged people. The elderly have stayed away very sensibly and the students also are noticeably not there. They do not want to be wrongly accused again of spreading the virus; again well done to the students. I understand the President of Poland, President Duda, is the latest Head of State to test positive, He is said to be well at present in isolation at home. Also in Quarantine is the President of Bulgaria. the pair had attended a conference together in Tallinn recently. Scotland have announced a new 5 tier plan to be announced to follow the end of the tight restrictions in the central band of the Country. A sensible move in Scotland but very confusing for the UK who wanted one simple universal system.With the very slight drop in the R number there is just a glimmer of hope that the actions taken 2 weeks ago have had a very slight effect and that the actions in the last few days will continue the trend, compliance of the rules is the key requirement. Quitting is not an option. Hands face and Space are the life savers. Mass gatherings without masks are most certainly not. So another question; should the legal right to demonstrate be suspended in the current circumstances and all demonstrations banned? Whatever your view please stay safe.

October 25 2020

Well that little survey last night produced all shades of opinion from strongly no relaxation for Christmas to we may as well anyhow because people will take no notice! There is no right or wrong answer to the question but it does just illustrate how hard it is for our Government to make the right decision at the right time. I was struck by the appeal of the Bishop of Paisley describing relaxation of some of the rules as a “Christmas cease fire”. He compared it to the cease fire on the western front in the first world war when troops cautiously met up in no man’s land for a game of football and to exchange Christmas greetings, only to continue the fighting the next day. My own view is that IF the R rate does not start to rise again and the current measures do begin to show a levelling of the second peak, then it would be reasonable and a great psychological boost if we relaxed the rules on Christmas day so that a nuclear family (that’s parents and children) could meet up to 4 others, normally both sets of grandparents for a family meal at home but not in restaurants or public houses. This would bring the numbers up to 10. The number could be exceeded if there were more than 6 in the nuclear family. Naturally any one with symptoms or recently positive without a negative test would have to be excluded. Every-one involved must be prepared to go into isolation afterwards if someone subsequently became symptomatic. Guests would normally have to travel between homes in private transport.We can never cost a life but I believe the relatively slight risk to increasing the spread would be more than off set by the psychological boost to many thousands of families. I accept that many of our brethren from other faiths have not been able to meet as a family during some of their festivals. Let’s allow them the same relaxations over our Christmas holidays and encourage them all in the same way to celebrate with family meals.There are suggestions today that Baroness Dido Harding should stand down as head of track and trace and have a well earned rest. She is taking the flack for the fact it is not working as well as it should and results of tests take too long. However she cannot be blamed for the large number of inaccurate addresses and contacts being given to them. Please make sure a group you may be in always give accurate and reliable data. Flack is still flying over the Government’s refusal to fund free school meals. As many individuals and food outlets have offered to do it anyhow why should the government do it for half term. Perhaps better they work something out for the longer Christmas and Easter breaks. It is appalling that children are likely to go hungry next week. If its true for you and your family please let me know by PM so we can do everything possible to assist. The Children’s Commissioner described the situation as Dickensian, akin to the situation in Oliver Twist.There is debate in medical and scientific circles that if the quarantine period were to be reduced from 14 days to 7,8 or 10 days there might be better compliance. It is known that many get fed up and go out after a week or so. There is a need for further investigation ; it is thought that 8 days is the maximum incubation period with 5 days the average. 14 days was set originally to give a safety margin in case there were longer incubation periods. I think this would help but would get criticism for the Government changing its mind. It’s not that, it is being lead by science reviewing the evidence and making fresh recommendations.Remember it’s a Sunday and figures will be at their lowest due to the reporting system and some days delay in publishing. 19,970 positive tests were reported today with 151 deaths. Over 340,00 tests were done on Thursday last, not reported since. Similarly the hospital data has not been updated since Thursday 22nd October.In Italy there is a further month of tight restrictions with gyms, pools movie theatres all closed with a curfew on cafes and restaurants closing at 6pm. There is a mandatory requirement for people to wear masks outside their home. Spain has declared a state of emergency which is their term for further tight restrictions. This is the second state of emergency in Spain in this pandemic.We know we can stop this second wave , we did it with the first wave. It requires each and every one of us to influence our families friends and neighbours to stick to the rules all the time and not just when it suits us . Please stay positive and stay safe and seek help if you are desperate.

October 26 2020

Parts of Nottingham are to move to tier 3 on Thursday morning and Warrington is moving to tier 3 on Tuesday. Linked to Warrington is a £1.68 million for track and trace and a further £4.2 million for the Local Authority to support businesses.Boots are set to roll out a new test which will only take 12 minutes to do and get results. Much later when reading the press release we discover it is to cost £120 and can only purchased privately and targeted at those needing a test before air travel.The current rapid rise in cases continues to cause concern. Doncaster Royal Infirmary reports they have 201 positive patients at present, twice the number of 7 days ago. Currently 12.2% of all their inpatients have Covid 19, which is more than they had at the peak of the first wave. Belgium, a country of only 11 million will reach capacity of their ITU beds within 2 weeks if the pandemic continues to grow at the same rate. They already have 1000 patients in ITU beds. The figures here in the UK remain worrying, even though figures on Monday still reflect what happened on a Sunday. 321,113 tests were processed (reported yesterday) with 20, 890 positive tests today. There have been 102 deaths reported today. There are only 9 remaining hospital beds in Lincolnshire.Today I have looked at these figures in a different way. The Governments target is to test 500,000 a day. In the last few days only about 320,000 are being done so there is a lot more to do to reach that target. About 210.5 per 100,000 of the population have tested positive. The admission to hospital rate is 10.6 per 100k of population. The death rate is 1.7 per 100k of the population. I looked at my area in Lincolnshire and the case rate is only 175.8 per 100k of population and Boston only 121/100k.There still seems to be promising results in the trials with the Oxford- Astra-Zenica Vaccine . It is apparently showing a robust immune response even in the elderly. However its still too early to be sure or to know how long immunity will last.Londoners are being asked to ring ahead and book an appointment before going to the A and E departments. They are desperate to keep Covid and non-Covid patients apart and knowing who is coming will make that much easier.There is embarrassment in Wales after confusion about what is and is not an essential non food item you can purchase there. It is now agreed that all pharmaceutical products can be purchased in supermarkets.Bavaria, an area of Germany badly affected, has banned people from leaving home without a valid reason. All schools and kindergartens are closed.Good news from down under, Melbourne has had its first day without a new case for 4 months and from midnight Tuesday the restrictions will be reduced.We still have to work hard to control our pandemic, there are signs that the death rate is lower that the last peak. Staff in ITUs have got better at treating this disease. We have some drug benefits particularly with Dexamethazone. The number of the elderly has been lower but is predicted to rise again in the next few weeks. If that happens we will see many more elderly deaths yet.It is still hands, masks and space that will bring this under control, but it must be everyone all the time. Please do all you can to ensure your family. friends and neighbours understand this. Do not go out unless essential and within the rules. Stay safe everyone.

October 27 2020

The prime Minister is under pressure from many of his own party to explain a clear mechanism for local areas to move up and down the tiers according to the local conditions. I firmly believe that in order to do this he needs to look at it like a car gearbox when you can seamlessly move up or down the gearbox according to conditions. We need a tier 0 where there are no restrictions and everything can function normally. Liverpool is talking about a 4th tier they can move to. Scotland is to have its own tier system.My suggestion is that all tiers are reviewed every 4 weeks ( that allows two generations of infection). If the rate of new positive cases in the area rises by 30% per week and this is sustained for 2 weeks that triggers a rise to the next tier automatically. More important perhaps is the trigger to drop back a tier and relax the rules. This should be a drop of the rate of new cases of 30%, sustained for two weeks. I fully understand that in each locality people need a target to work for. Let’s give them that target of a 30% drop in new cases which brings a reward of lower restrictions.London , now in tier two, has had 13,000 new cases in the last week. Interestingly a few weeks ago the worst affected boroughs were in East London. Now the worst affected boroughs are in the West.In Germany, the number of new infections has risen by 70% in the last week ( that would trigger a tightening of restrictions in my plan). Belgium is also in trouble and considering a full total lockdown.Today’s statistics continue to deteriorate. It is still too early for the current restrictions to have an effect. A total of 261,000 tests were processed in the last 24 hours . The capacity is now 447,000 per day. The government target of 500,000 by the end of the month is still a long way off with only a few days left. 22,885 have tested positive, that is 217.7 per 100k of the population. Deaths always are high on a Tuesday as it includes some from the weekend not previously reported. Today’s deaths are 367, that’s 1.8 per 100k.There are currently 9,199 patients in hospital in the UK to 25th October. 852 are on a ventilator to 26th October. The number of admissions is only accurate to 20th October and is 1,152. I suspect it is already 30% higher than that.Leeds Hospitals now have more cases than at any time in the last wave. 262 beds are occupied with Covid patients and 22 are in intensive care.I had an email from a Russian friend of my late wife, who lives in St Petersburg where dog shows are happening weekly now. They had big problems with the first wave but have very few restrictions now and they found it hard to believe the situation in the UK.Dogs are being trained to detect Covid infections now, the dog will seek you out and the sit and stare at you. Early results are said to be promising.With the recent discussions about whether low levels of vitamin D might increase the susceptibility and severity of Covid 19, I was interested to learn of a drug trial in Italy. They are investigating whether a drug used to treat osteoporosis with the generic name of raloxitene would slow the progress of the disease. It is hoped they can demonstrate that it can block the replication of the virus in human cells.I doubt many of you will be too distressed by a government minister announcing that all trick and treat visits are banned and illegal in tier 3. Play your part, stay apart… This virus can only spread if it can find people to infect . The only way we can control it is to respect all the rules and have minimal contact with others outside the household. It is still hopeful a vaccine will help, but its effects will not be seen for six months so we have to continue using the basic methods of hands face and space. Stay positive and stay safe.

October 28 2020

Today’s miserable weather rather reflects the despondent mood of the country and most of Europe. I find it hard to understand that when an expert says this second wave of cases will be worst than the first that this becomes headline news. This was first talked about months ago when experts were trying to prevent the second wave. I know I have warned about this several times in recent months, it is the pattern pandemics follow and has been seen several times before.A look around the country shows that every London Borough has over the threshold of 100 new cases for 100k. Ealing, Hammersmith and Fulham and Kensington have over 200 new cases per 100k of the population.There are discussions taking place to consider placing West Yorkshire in tier 3.Birmingham hospitals are struggling and elective hospital work has been suspended again. The 3 main hospitals have 294 patients with Covid 19 and 34 are in an ITU bed. Similarly the Airedale hospital in Yorkshire has suspended all elective work.The Manchester Nightingale was expected to take its first patients today. Despite my friend writing to say life in St Petersberg was nearly normal, there are 16 different regions in Russia where the situation is critical with a 90% bed occupancy. In the Urals army medics have been drafted in to assist in hospitals.Heathrow Airport has admitted it lost £1.5 billion in the first 9 months of this year and that passenger numbers between July and September were done by 84% compared with the same period in 2019. Heathrow has lost its place as the busiest airport in Europe. This title is now held by Charles De Galle airport in Paris.The Met. police have indicated that although reported crime dropped between April and June, drug crimes rose by 43%.Here are today’s statistics. Total number of tests processed is 439,541 which is nearing the target of 500k by the end of the month. 280,995 tests were processed in last 24 hours and 24,701 were positive. That’s a new positive rate of 223.5/per100k of population. There have been 310 further deaths . This is equivalent to 1.9 deaths per 100k. A further 1,227 have been admitted to hospital in the last 24hours and that equates to 11.1 per 100k of the population. The number in hospital tonight is about 10,000. Some experts are suggesting this figure could be as high as 50,000 by the end of November.As I have been writing the German Chancellor, Angela Merkel, has announced a circuit breaker type lockdown in Germany. They have similar rapidly rising numbers and as before are a couple of weeks behind us. The details of the lockdown are not fully announced but bars clubs and restaurants are to be closed with tighter restrictions on travel and shopping. I see it almost inevitable that the UK will have to follow Germany in due course.We can all make this so much easier if we do not allow the virus to spread. We have no option now, we must all play our part by staying apart.

October 29 2020

I suspect it is going to be a big problem trying to keep up with the daily changes in the 3 tiers. Soon after I published last night Nottingham decided to bring the rest of the county of Nottinghamshire into tier 3. Today Birmingham are suggesting they will move to tier 3 within days. Oxford will go into tier 2 at 1 minute past midnight on Saturday. Bristol have decided to make a new tier of their own and they call it one plus!Our current tier system in England does not allow for any higher restrictions than in tier 3.We can all see that this is insufficient. We will need much tighter restrictions and our system has to change.I agree with the view expressed by one of our leading scientists, Dr Mike Tildesley, that a national circuit breaker type lockdown will have more effect than putting the whole country in tier 2. As it stands, after this coming weekend in England, 23.9 million of the population will live in tier 2 and in tier 1 there are 23.7million people.Nicola Sturgeon says that from Monday most people in Scotland will be in level 3. That’s the central highly populated band. The rest of the country will be in levels 1 and 2. Remember there are 5 bands or tiers in Scotland. She went on to say we must “dig in and stick with it”. Cafes, pubs and restaurants must close at 6pm. There is a ban on alcohol sales indoors or out. I understand Lanarkshire was very nearly placed at level or tier 4, it is under daily review. Scottish people are advised not to travel unless essential. She went on to say “Its a price we have to pay”. Schools are to remain open in Scotland but university students have been warned they may not be able to go home for Christmas. That is likely to be very unpopular but could be necessary. The React study run by Imperial college is suggesting the R number is running at 2.0 in London. The greatest rate of increase in numbers is in the 55-64 age group whereas in absolute numbers it is the 18-24 age group with the highest numbers.A striking illustration of what we are coping with compares the situation on 1st September with that on 28th October. Patients on ventilators rose from 59 to 788 and the total number in hospital rose from 472 to 8535.Pizza Express report they are closing 73 shops and 1,300 staff are to lose their jobs.By special request I report the situation at the Holy See. There are now 27 confirmed cases. The Pope has halted his public general audiences and is to limit his role over Christmas. He will resume live streaming of his weekly catechism lessons from his library as he did earlier in the year. It would seem the Vatican has followed Italy with its partial lockdown arrangements. The press association report that 175 workers have tested positive in another Norfolk meat factory producing pork products, a further 185 staff have so far tested positive. There is no risk of contaminated meat.As far as international travel is concerned the main changes are that quarantine is now required if returning to the UK from Cyprus and Lithuania.Today’s statistics show a further 280 deaths in the last 24 hours with a further 23,065 positive cases. There are now over 10,000 people in hospital with the disease and on 25th October 1,404 new cases were admitted. The rates of change are also important. Deaths are running at 1.9 per 100k of the population and the admission rate to hospital is 12.8 per 100k. For those testing positive it is 225.9 per 100k.It is going to get worse. But we can and must slow it down. If we do not achieve that in the next 4 weeks we will be in a national if not a global emergency. It requires great effort from every one to stick by the rules and encourage everyone else to do so.Play your part. Share this message: Stay safe and remember Hands, Face and Space, but the greatest of these is space.

October 30 2020

Today there are many news items given a higher priority than this global pandemic of Covid 19. There is a significant earthquake in Turkey and Greece. There is a presidential election in the USA. A senior British politician is suspended from his party. There has been a nasty terrorist murder in France. To name just a few.I could summarise the Covid news by saying it continues to cause severe repercussions. The figures continue to rise and according to SAGE are now approaching the reasonable worst case scenario that was predicted at the beginning of the pandemic using modelling available from earlier pandemic planning. I also warned of 50,000 deaths some months ago. That number is fast approaching and could be exceeded.Russia is reporting waits of up to 10 hours outside a hospital waiting for a bed to become available so they can off load a sick patient. A shocking situation, but also one we have seen here in the past.In France, if you go out you have to carry with you an attestation stating the reason you are out doors. If you do not have it, it’s a fine. There are the usual allowable reasons for being away from home.Warwick University are reported by Sky News to be involved in a study of clusters of new cases being linked to the Eat out to Help out scheme. It seems to suggest that between 8 and 17% are connected. This seems a wide range of confidence limits. I really need to see the full report to assess whether or not this finding is significant.Today’s figures show the testing capacity is at its highest yet– 467,512. It only has one more day to hit 500,000, which was Boris’ target by the end of October. 347,626 tests have been done and 280 deaths recorded.Hospitals had 10,708 inpatients as of 28th October. Ventilator bed occupation is now approaching 1000 at 975 yesterday. 1,404 new patients were admitted on 25th October. This number continues to rise but is not officially released daily any more.I find the rates more helpful. The rate of testing positive is 228.6 per 100k of the population across the country but there is wide variation. The national death rate is now 2.1 per 100k and the hospital admission rate is now 13.5 per 100k of the population . All these figures relate to the United Kingdom and all are going in the wrong direction still.If any one has any local Covid news or insights into its effect at home or at work please feel free to share your information. There are many shades of opinion and many different ideas. There is a great deal of stress and anxiety so I do ask that you do not make personal attacks on people you do not agree with. I am very reluctant to delete posts but if pushed will do so if I see personal attacks.That said, I really appreciate the fact that many of you read and share this. Our thoughts and ideas can help people have a greater understanding and help them appreciate why they must all follow the rules. We must set an example and support one another.Stay safe everyone.

October 31 2020

I suspect many of you will have listened to the Prime Minister confirming the leaks and rumours about the changes. There were no major surprises.The new regulations are national for England and start on 0001 on Thursday and will be replaced by the tier system again on 2nd December, subject to Parliamentary approval on Wednesday. I do not anticipate a problem with that as the PM has full opposition support.So from Thursday you can only leave your home for :-Education Essential work you cannot do at homeExerciseMedical reasons ; to see GP or hospital appointmentsTo avoid harmEssential food ShoppingAs a volunteer helping others.Pubs, Bars and Restaurants to be closed.A single person living at home can still form a support bubble with one other from another home.Those over 60 and especially the very vulnerable need to be extra careful but the shielding restrictions will not be re-imposed.Work places if open must remain Covid secureThe full lists of the regulations will be posted on the Gov. UK web site.Sir Patrick Valance and Prof Chris Witty explained the graphs which demonstrate the precarious position our country is in. The projections into November were particularly worrying. The NHS could be over run before the end of November. The Office for National Statistics confirm there are as many as 50,000 new cases per day now and the rates are going up in all age groups. It is the over sixties which will grow and greatly impact on the NHS with admissions, the requirements for ITU beds and ultimately deaths. Some hospitals have already seen more cases than they did in the first wave.Boris Johnson said that no responsible PM could ignore this new data, we recognise the costs to livelihood, jobs and our mental health. He thanked the nation for putting up with the restrictions. He hopes again to be able to follow a pragmatic local approach again after this one month lockdown to slow the pandemic to protect our NHS from collapse.To help cope with this, the furlough scheme is to be reinstated from Thursday for 4 weeks. The PM said he wanted families to be able to enjoy Christmas together but it remains to be seen what is possible. It certainly will not be anything like normal.He reminded us we re not alone; Belgium, France, Germany and the USA are also in the same worrying state.The PM was optimistic about the future. it will all feel better in the spring. He did not mention vaccines but did praise the new testing system purchased in the millions already so that a test result can be available in 10 minutes. He tells us the Army are being briefed to assist in the role out of the new tests which will be online very soon. I just hope his optimism is justified. The scientists may be despondent about the short term but are much more optimistic in the medium and long term.I believe we can whether the storm of the next month, we all just have to accept what it is and each and every one play our part to reduce the spread, to give real practical help to our families, friends and neighbours and to defeat it. More guidance will follow I am sure. My brother said tonight I could write this report in just 4 words “I told you so”. Yes I did time after time. So without incriminations or arguments lets put politics aside and work in a national common interest. Saying its nor fair or I won’t do it is not an option. Please just follow the rules and stay at home indoors as much as possible. Remember play your part and stay apart.