September 4 2020
I think it is time I tried to bring you an update on the Covid 19 pandemic as I feel we are reaching an important stage in our journey together with this disease. What happens in the next few weeks will be critical.At the beginning of the Covid pandemic , modelling suggested that in a full blown pandemic the UK could expect around 50,000 deaths in the first 20 weeks of the pandemic. The latest figure for the total number of deaths is now at 41,537. As you will be aware getting an acceptable working definition of a Covid death has proved very difficult as every country has been doing it in a different way. For a while the UK figures were inflated by about 5000 but now the 4 countries of the UK report a covid death as any death in a patient with Covid 19 whose test was positive in the last 28 days.Unfortunately life is becoming much more complex with each country doing there own thing. Some local “lockdowns” are being organised locally whereas other are imposed centrally. Things are changing on a daily basis. This makes it almost impossible to report to you what is happening where, as it could well change on a daily basis. I can only suggest you monitor very carefully the arrangements local to where you live and work on a daily basis. Using local media or web sites.It is difficult to get an accurate and reliable situation with the track and trace arrangements. I have found it best to not believe any report completely as there is a great deal of hype and political pressure to massage figures to suit the agenda of the day. If 80% are being adequately followed up then I think that is a reasonable return. We should not expect to get 100%. If you have personal experiences of track and trace, please share it with me.At the beginning of the pandemic the medical experts spoke largely with one voice and their advice was respected. Sadly, as various pressures have built up they have given in to media pressure and broken ranks. We have lost the authoritive voices guiding us and politicians are increasingly going their own way, and we receive conflicting advice.The uncertainty in the air has fuelled the conspiracy theories and the anti-vaccination brigade. Hardly a day goes by without venomous emails being share all over facebook causing a lot of distress and fear. Illegal demonstrations and gatherings are putting our police force at risk and frightening the vulnerable who do not know what to think. Sadly political point scoring has returned. We have lost the political will of the various parties to work together for the common good.The good news is that the number of daily deaths has often dropped into single figures on some days with an average of just 10 a day. Currently I belied there are 743 people in hospital and 76 require ventilation. There are still 124 admissions a day and this is climbing up again steadily for last 2 weeks or so.Many of the deaths we have seen so far have been in the elderly with pre-existing conditions. There are many less cases in the elderly now, because many have already died and many more are still shielding to one degree or another. Cases being seen today are therefore in a younger mobile population who are less careful about following social distancing and cooperating with the various rules. It is this reason the death rate has dropped because in the younger adults and middle aged it is much less virulent, is often asymptomatic and rarely causes death. It does not mean it is going away. Indeed it is sitting waiting to get hold and bring a second wave of infections in November we could still see a new peak even worse than the first. Please do not make any fixed plans for Christmas as they may well be wrecked. Always have a quiet plan B at home ready.I recognise the need to try and get the economy up and running again. There is tremendous pressure to do so on our politicians but it must be balanced against risks. I personally feel that lives must still come first. The economy will recover when we have a safe effective reliable vaccine. Although there has been great progress it is unlikely to be available in the UK this year. I note with interest that Russia have produced a vaccine already. In a country that uses Novichok I do not think we can rely on the propaganda from there yet. We do know that the balance and checks being put in place here will ensure our vaccines are as safe as possible.On the subject of vaccine please make sure your children and grandchildren do not miss out on routine immunisations. Many were put off in the summer. Now is the time to bring them up to date. Everyone who is eligible to have seasonal flu vaccine should have a shot this year. We must ensure we do not have a winter pandemic this year of flu as well.Most of you are aware of the medical controversies about face masks. We are now obliged to wear them in shops and on public transport. School children are being asked to wear them some of the time at school.We know that a fit child is extremely unlikely to be seriously ill or die with Covid. Being a teacher puts you at no more risk than the average worker. There are two types of masks generally being used at the moment, disposable ones and other that can be washed and reused. Are you sending children to school at the moment? If so please share your experiences. How many masks do they get through in a day? I have used a mask since being a young medical student. I was taught to handle a new mask only after disinfecting my hands, handling it by the strings only and pinching the nose once. If I accidentally touched it, or it got damp it had to be removed by the strings only and placed in a bin to be burnt. A new one should then be used. With reuseable masks, removal is the same but they should be placed in a large plastic bag and sealed ready to be washed later. I reckon a child could easily use 6-10 masks in a school day. Are they ? I doubt it very much. One mask all day, taken on and off, regularly adjusted, and when off stuffed in a pocket or school bag until next required. Why is nobody talking about this? These children are getting little protection and may well be at extra risk especially when wearing them out side school.When I have been out and about, I have seen countless examples of the nose not covered, worn around the chin or on the head like sun glasses. Others have had holes in to drink through a straw or smoke a cigarette. The final straw, while waiting in line to go into a shop was when a young man behind me realised he had forgotten his mask and was asking around to see if any one had a spare. A lady came out of the shop and said oh you can have mine. I have only worn it 20 minutes. He gratefully accepted and wore it in the shop! Just how much understanding was there for both parties. I am afraid if we are going to use masks we need a massive public education programme. The possible psychological benefit of masks is nullified if they are abused.I have now finished a large piece of work I was commissioned to do and can come back to trying to help my friends stay safe. My advice means stay safe, lay low, do not travel too much, be prepared to change plans. You may well have to self isolate if travelling abroad. Watch the daily updates but do not go unless essential if you do not want to have to quarantine. Do not travel too far from home unless essential. Stick to all the rules about gathering in social bubbles avoid crowds and remember the basics about distances and handwashing. Do please post your stories. but I do not want the conspiracy theories repeated. I have had to take a lot of criticism from some, for posting like this
September 5 2020
A much shorter comment today, I do apologise for the length of yesterday’s comments. I was amazed how many of you read it right through. There was such a lot to comment on. The Times have reported that statistics from PHE are alleged to show that 2/3rds of new cases are in people under 40 years old , so that means 1/3rd are over 40. In an attempt to confuse you they go on to say 20% are in the over 50s which means 80% are under 50 years old and 3% are over 80 years old. 1/3rd is about 33% and 2/3rds is about 67%. What they also do not remind you is how many individuals there are in each class. there are many more individuals aged over 40 compared to the over 80s. There are no absolute numbers presented So making sense of this is much more difficult than we realise. The only reliable figures are those quoted as a number per 100,000. Concern is now raised if the count locally is above 20 new cases per 100,000. Leeds is the latest city to cause concern today and it is now on the official watch list. Leeds has one of the highest student number in the UK and thousands are set to return from all over the Country to Leeds in the next couple of weeks. Whilst they, themselves may not be much at risk they could have a lot of asymptomatic infections. When a student goes home at half term, like goldilocks they go to see granny and the risk of spread all over the country returns. A great deal of work is being done to ensure testing and tracing and quarantine arrangements for students. Most lectures can be done on line and the same with tutorials but lab work poses much more of a challenge. 7 people have been fined a maximum £10,000 fines for organising illegal raves. you can be fined £100 for not wearing a mask and up to £3400 for repeat offences Portugal a country of only 10 million people compared with 62 million in the UK have 486 cases reported in one day. The highest figure since May. This will cause concern and restrictions are bound to follow. My advice is not to go on holiday there. Have a chat with students ensure they understand the rules and that they have a generous supply of masks to take to university. begin to plan now for when they return home and how they interact with the family. Please all stay safe I enjoy reading your comments and experiences.
September 6 2020
The statistics for today, being a Sunday, you will remember, are often artificially low due to reporting issues at weekends . 756 people are reported in UK Hospitals with covid 19. sixty nine of these are requiring a ventilator. Only two deaths have been reported in the last 24 hours. There were 124 new cases admitted today. Based on the testing programme 1813 tested positive yesterday and 1940 on Friday. These figures continue to cause concern. The average number of new cases per day in August was only about 1000It is the younger adults who are now most at risk. They tend to take more risks, perhaps believing they are less likely to die of the disease rather that their older relatives. Now is the time for these people to accept the responsibility they have to help contain the pandemic and prevent a second wave. They have to take responsibility for their actions. There will be significant risks of asymptomatic carriers continuing at work and the going home to more vulnerable parents and grandparents.The track and trace programmes is being effective to detect local outbreaks in places of work and strict local measures can be in place quickly. Bolton is the latest town to find quite severe restrictions imposed where the case rate has risen to 99 cases per 100,000. There can no longer be a mixing of different households . you can only use public transport if essential apart from education and essential work. All the recent relaxations have been re-imposed in Bolton.The shocking events in Birmingham seen last night demonstrates the disregard for official guidance. This time of year we are used to seeing this mob behaviour in the silly season. I accept this may prove to be a hate crime or terrorism, but the crowds should not be there in the first place.My personal view about masks is that they offer only a very little protection to others because of the ridiculous way they are being worn .Whether we like it or not there are now laws we should respect, and wear them as correctly as possible. They may then have limited benefit for others I have had considerable arguments with some about compulsion, and interfering with civil liberty. We all wear seat belts in the car, and in aircraft. We accept non smoking in restaurants, we respect red lights when driving. Lets be adult about this and respect the rules. If they could be worn properly (and they should be.)Then I do believe they help to remind us all about the pandemic . They remind us to frequently sanitize our hands and to remember social distancing.I checked the status of Heathrow Airport today, not that I am planning any travels! Subject to the usual exceptions anyone over the age of 11 must wear a mask anywhere inside the airport. They say there is no reason to arrive any earlier than you usually are required to . All passengers are required to complete an online passenger locator form 48 hours before returning. Recent additions to the Quarantine lists are the Czech Republic, Jamaica, Switzerland, Austria, Croatia, Trinidad and Tobago. If you must travel it is vital to check the status of the country you are going to daily .Stay safe, wear a mask correctly and keep your distances. As our Politicians have said we have a public duty to do this to protect our loved ones and get through these exceptionally difficult times
September 7 2020
My rising concerns have not lessened in any way today. The daily number of new positive cases remains high at 2948 only a little less than yesterdays figure of 2988. There would appear to have been 4 more deaths in England 756 people are in hospital with 124 new admissions today. The increasing numbers have also arrived in rural Lincolnshire where two different schools have been closed with infections in the school community. Lincoln, our capital city has a rising rate of infections reported at 36.3 per 100,000 compared to a national figure of below twenty. In absolute numbers the figure is still very low. I have about 1 in1000 chance of randomly catching it now. Not being a gambler I would not risk much money at 1000 to one !A very worrying outbreak is reported in a hospital in Northern Ireland where 14 patients and 17 staff have tested positive, a total of 56 people are in quarantine and there have been 4 deaths. The outbreak is centered around a haematology ward where most of the patients will be vulnerable and at high risk. I welcome the announcement of an independent investigation as there would seem to have been a severe breach of barrier nursing. I shall be interested in the findings so we all learn from any shortcomings.If you have been or are planning a holiday on 7 Greek islands (Lesbos, Tinos, Serifos, Mykonos, Crete, Santorini and Zakynthos ) and live in England you have until 4 am on Wednesday to avoid being caught for 14 days quarantine. If in Scotland the whole of Greece is on the red or quarantine risk already.Nearly 20% of Scotland is involved in tighter rules and regulations following rising figures in the Glasgow and West Dumbarton Area. Caerphilly has a local lockdown announced tonight as well.Check your local rules daily. Stay safe and really encourage everyone to be public spirited. Pull no punches when explaining to youngster the need for all of us to play our part. No body wants a national lockdown but I can see a 10 pm lockdown being introduced with some exemptions for key staff.. I wonder if school and their PTA’s ( parent teacher associations) can recommend curfews to keep local children off the streets. We have to get it over to them all that catching Covid and taking it home to grandma may just kill her.Stay apart, and save lives
September 8 2020
I resumed my daily reports when I realised there was trouble ahead . We continue to see most worrying signs of an imminent rapid rise in new cases leading on to a second peak in the next few weeks. Today Prof Van Tam spoke publicly for the first time to express similar concerns. The public must start taking coronavirus “very seriously again” after people “relaxed too much” over the summer, England’s deputy Chief Medical Officer has warned.Professor Jonathan Van Tam said the recent surge in infections was of “great concern” and the UK faced “a bumpy ride over the next few months” if cases continued to rise.His comments came after figures showing that the UK’s coronavirus infection rate had surpassed 20 cases in 100,000 people — the level at which the Government considers imposing quarantine restrictions on foreign countries.Although the rise in UK cases has mainly been in young people, Prof Van Tam said, similar outbreaks in EU countries had later spread into more vulnerable populations.“It’s all very well saying that hospital admissions and deaths are at a very low level in the UK, which is true, but if you look further into the European Union you can see that where case numbers rise initially in the younger parts of the population they do, in turn, filter through and start to give elevated rates of disease and hospital admissions in the older age groups and we know that that then becomes a serious public health problem.”“That’s my concern, that if we don’t get on top of this, if people don’t start to take this seriously again, then there is a risk that that’s where we end up.”To my mind its not just a risk it is a certainty. We must act now to prevent it but it’s probably too late but we can still reduce the impact.New cases testing positive today are at 2420. At first sight this sounds better until you realise that for some reason the figures from Northern Ireland have not been included. 30 deaths are a lot higher, but may reflect the low numbers over the week end with a catch up in reporting today. The situation in hospitals is stable.With schools back for only a week or so over 60 have had to close either completely or partially. Most have had to close down a bubble or year group due to 2 or more cases in staff or children.Bolton seems to be the hotspot in England and tonight there are further restrictions with pubs and restaurants closed. Next step will be back to full lockdown conditions and a night time curfew.Birmingham has a case ratee of 62.4 per 100.000 population compared with only 28.1 the previous week. I am surprised there are not already tight restrictions there but they will be needed. There is an asylum centre in Egbaston with a serious outbreak among staff and residents involving 56 people.Spain and France are about 2 weeks ahead of the UK, but we continue to follow the experiences of other countries and the lessons of history which tell us what is coming.Those of us still claiming to be middle aged are stuck in the middle, trying to protect ourselves and our parents whilst trying to contain teenagers desperate to get out. I welcome any suggestions as to how to contain them. I do wonder if in stead of losing pocket money for misbehaviour the new rule might be a 9pm curfew, or confiscation of clothes they will wear to go out !Good luck with your teenagers, set them a great example, stay at home, stay apart, use a fresh mask and above all stay 2 metres apart. Stay safe!
September 9 2020
Interestingly following my decision to return to daily reports the Prime Minister and his top medical and scientific advisors turned out for a 4pm media briefing today.Todays statistics showed 2659 more new cases testing positive , so still remaining at a high level, there were also 8 new deaths reported which remains around the current daily average.After discussions in Cabinet and with senior police officers the new arrangements are mandatory whereas in England at least they were mostly only advisory.So we now have a new rule of six. We must not meet in groups of more than 6 people whether indoors or the garden or the park. This replaces the earlier guidelines of more than 3 households or 30 people. There are exceptions for weddings and funerals when up to thirty can gather but remain socially distanced. So can organised team events. If your household group is more than 6 you can obviously still be together. In Covid secure venues the groups of six must not mix and the venue is required by law to collect track and trace details and hold them for at least 21 days. You can be fined £100 for breaking the 6 rule and it can double every further offence up to £3200. Special Marshalls are going to be employed to help enforce this rule in public places. There will be Fines for hospitality owners who break the rules about maintaining Covid secure venues and collecting track and trace data.The Basics still remain the most important measure every one of us can and must remember. Frequent hand washing with soap for at least 20 seconds or cleaned with an alcohol based had sanitizer. The use of face coverings on public transport and in shops and other public buildings and other places in confined space and where distancing is not possible. For simplicity Boris reduced this to “Hands Face and Space”. I think he is thinking of new words for the children’s rhyme “Hands Knees and……..There were some very interesting slides shown tonight which broke down the Covid cases by age group and demonstrated that with children under 14 there was only a very slight rise in numbers but at the age of 17-18 the number of new cases was increasing steadily. All the other age groups were showing a rise but the highest rise was in the 20-30 age group followed by the 30-50 year olds with the elderly 70 plus only showing a small rise. The figures were mirror in the graphs of those testing positive by age group. They are yet to be published but I will try and post them tomorrow.These figures justify the belief that for the younger school, children going to school is relatively safe. They are Covid secure and maintain good distances. Older teenagers show an increasing risk, not so much at School which is controlled and is covid secure but what they do in groups away from school and home. Covid Marshalls will be on the look outThe next age group at greatest risk are adults, tending to deliberately break the rules believing they are not at risk. These graphs clearly say they are, they are pitting our whole nation at risk. The law must be tough on this group who refuse to disperse. The best advice is still to stay at home. Find and develop some family hobbies that can be done at home. Collecting information about local history on computers is one such project I know one family are doing and learning a lot about their home town.There are interesting plans in the pipeline to be able to do simple very rapid tests that could give a result in 10 minutes. This could mean that in the future people could be tested individually before attending a theatre, only being admitted if negative. The same could be done at conferences and lectures as well as cinemas It is a long term goal to do this for sports events and even work places. It was claimed that the UK has already done more tests than anywhere else in Europe. I have no way of checking that but they are planning to be able to test 500.000 people a day by the end of October.We were assured today, and I know from experience it is true, that the pause in the vaccine trial being led by Oxford University is routine whilst an episode in one of the patients involved is independently assess to ensure it is not a significant side effect. Hopefully this pause will only take a few days. There are some 200 vaccine studies going on around the world. 6 other trials in the UK are advancing well and there are 4 different classes . the recovery trial of drugs run from the UK first showed that certain drugs did not work, and the demonstrated that dexamethazone makes a significant difference to the recovery of Covid patients in hospital requiring oxygen, Some 500 other drugs are under investigation including antivirals.We are in for a very difficult winter. If you have symptoms or are told to, get a test. Make sure you get a flu jab if eligible, make no plans for Christmas. Perhaps slowly ensure a 2 weeks supply of food. If unable to get to the shops but please no panic buying. Find things to do as a family entertainment as they did in Victorian times. Remember the rule of 6 and hands face and space . we can and will come through this but the Nation requires us to work together and in harmony. Please keep politics out of comments, stay kind to everyone especially those anxious or worried about a loved one.
September 10 2020
These are the two graphs released which show the prevalence of positive Covid cases by age group and the recent changes. It is surely clear to everyone where the problem cases now are occurring. The governments genuine attempts to explain and control and reverse this trend have been ridiculed by many in the media and on facebook. I agree there was not complete clarity and the Government promised more detail at a briefing tomorrow. Actions taken today will not show any effect for at least two weeks. The effects, if any, of opening schools have not shown themselves yet and will not do for another week or so. Reducing the number we can socialise with to six from Monday will not show its effect until the end of September. We are promised a full list of exemptions in more detail tomorrow at another briefing. I am still confused a little about a group of 6 friends in the pub. It would seem there can be different interpretations about this. The simple way round it is not to go to the pub at all. Sadly we cannot expect people to behave properly after a couple of drinks. I am sure we are facing early closure of pubs again and possibly a curfew.Figures released today continue to be of concern. There have been 14 deaths in the UK in all areas in the last 24 hours and 2919 new cases testing positive. There some other fairly interesting statistics released that show of 320 Local Authorities , 210 that’s (65%) have a rate below 20 per 100,000. This of course means the rest , 102 or 35% have more than 20 positive cases per 100000 We have quite simply to decide as a nation whether we want to risk lives to protect jobs, boost our economy or face years in recession but with a few thousand more of our loved ones still alive. A stark choice, go too far in one direction and we will pull back, try the other direction and again we will be pulled back. Try both directions and we risk the worst of both . At least we can be as sure as possible that our school kids can be as safe as possible. As for the rest of us careful organisation and planning means we do not need to become hermits but we can tread very carefully and get out of this with as little damage as possible. It will end, either when 90% of the living population have been infected or they have been vaccinated. how long immunity will last remains to be seen. we may need annual vaccinations, we just do not know. a government ( any government) has to be positive they want the public to back them. Borris can be very optimistic at times, I fear he is, with 10 minute test for everyone before going to the theatre. There is not technology or infrastructure to achieve this infrastructure even in sight.So continue to think Hands Face and Space but stay alert and encourage everyone to do the same. Together we can stand but devided we will fall.
September 11 2020
Just in case anyone still has a doubt that we have an impending crisis on our hands: The number of new positive test cases of Covid 19 has risen again to 3,539 with the number of deaths variously reported as 9 or 6. Still low, we will see that rise in 10-14 days. How many of you can tell me the difference between Great Britain and the United Kingdom? This is another problem with statistics, sometimes the figures relate to one and sometimes to the other. In the Greater Manchester area seven of the ten Local Authorities are now in the red or watch list because of a rise in the number of cases per 100,000 of the population. Remember we have been running at less than 20 across the country until the last two weeks. Bolton has the highest rate at 160.7. They are followed by Tameside and Salford both with rates in the 80s. Oldham, Rochdale and Manchester are both in the 70s and Bury in the 60s. Local restrictions are already in place in the Manchester area.Today Birmingham is back in the news for all the wrong reasons. The figures are rising significantly across the area and new measures are in place now banning any mixing of households. The Birmingham figures are also showing a rise in numbers in older categories and predictably they are more seriously ill.While writing this I hear Scotland have responded to rising figures in Lanarkshire ( heard it on the radio news).You will recall from April that the R number (reproduction number) is important in assessing the speed of spread of new cases. SAGE have announced that the average R number across the UK is now 1.2. This points to increasing numbers in the coming days. Just to remind you an R number of 1 means that one infected patient will infect on average one other person. If the R number is 2 then one person infects two and if it is 4 then 1 infects 4, and we are in big trouble. So far in this pandemic in the UK the figure has not gone above 3. Today’s figure of 1.2 means that 5 people will infect 6 or 10 people will infect 12 more. There have been several comments in discussion about blaming the problem on teenagers. That is certainly not my stance as I blame the virus! I might agree that human behaviour does not always do the right thing and that alcohol can disinhibit and cause rules to be broken. Please ask your teenagers to tell us what they think we should do now. We need to listen to them and not condemn them. They are our future. The stark choices are not easy, I do not know the answer! For many thousands finding enough money to live on is a priority. Can those who have small surpluses find ways of giving some employment to those that are becoming desperate and depressed, even if only a few hours a week. Its easy to say close the pubs and restaurants, but thousands will lose their livelihood. If it becomes necessary I am sure it will happen, but are we ready as a nation to pick up those who lose heart with no income?For now, think long and hard what ever your age. keep safe , help other to stay safe and help everyone by setting the best possible example. Remember Hands Face and Mask. Only go out to work, school or shop unless an emergency or doing other key tasks.
September 12 2020
Lets start tonight with a little good news. The Oxford /Astra Zenica vaccine trial has permission to resume. The independent review committee and the MHRA ( Medicines and Health Care products Regulatory Agency ) have given a green light to resume the trial, one of the 18,000 volunteers who were given the vaccine had become ill. The conclusion is that it was nothing whatever to do with the trial. The process to gain approval is very thorough with a series of stages. The vaccine has been tested on ferrets, mice, monkeys and humans. When and if it gets through all the hoops and becomes generally available it should be as safe as say tetanus toxoid vaccine. The number of new cases reported today (normally lower at weekends) is 3,497 and there were 9 deaths in the UK. I was interested but not surprised at the numbers who thought Great Britain and the United Kingdom were the same thing.New rules come into force on Monday in many parts of the UK. In England gathering of more than six unless all in one household becomes illegal. There are exemptions for work and education where there are Covid Secure bubbles.I was interested to note that the London Borough of Redbridge has been placed on the watch list. It has the highest infection rate of all the London boroughs at 36 cases per 100,000 of the population . there have been 110 new cases in Redbridge in seven days, I did note that a former colleague who is now the DPH said most of the cases were in the South and North of the Borough. South Woodford is not so badly affected but all my friends there must be extremely careful and think twice before mixing socially at all.I am encouraged by some good debates in discussion although there are some extreme ideas and some would bring back flogging!Please get the views of your young people and encourage their contribution. Remain very vigilant set excellent examples and remember Hands Face and Space.
September 13 2020
The Last Night of the Proms last night was compelling viewing for a very large number of us. It was quite unique without the promenaders, but the spirit of unity and strength shown in the traditional songs sung only by the choir ,as well as the brilliant rendition of the “Lark Ascending” by Nicola Benedetti was exactly what the British Public need at this time. A reminder that we can rule the waves , we can ascend above the troubles of Covid. We are not alone, we are all in this together. We need much more of this positive encouragement, and less of the scaremongering seen in several newspaper headlines this morning.Let’s make a plea to the media that they move away from the idea that bad news sells newspapers and in the interests of national unity report the news factually but in a positive way to encourage us. As a fictitious example suppose 20 people who work in the same firm have died in a week from Covid and the remaining 480 employees are isolated at home. You can bet your life the heading will be “20 dead as factory closes”. If it is instead reported a “factory has had to close with 480 isolating at home after an outbreak of Covid which has taken 20 lives” we would all feel less depressed and threatened. Both reports are accurate. We need many more boosts like the concert last night.Remember the rule of 6 becomes law at midnight tonight. In England it has been clarified that that number includes all children even babes in arms. Scotland does not count children under 11 years old. Wales does not count children under 11.Just in case you are planning to organise a rave and ignore the rules, I remind you a 19 year old has just been fined £10.000 for having 50 people in his home in Nottingham.Things are even worse in France with 10,000 new cases on Saturday (three times more than in the UK) and the Czech Republic with a total population of only 10.7 million, has seen over a 1,000 new cases every day for the last 5 days.Here in the UK 3,330 lab confirmed cases of Covid have been reported today. Remember its Sunday and the weekend effect makes it artificially lower. There have been 5 more deaths reported.Now people are listening to the warnings, hospitals are being geared up again to cope with the levels of work seen in March-May. The Nightingale wards are being prepared again. I think the first week in November will show a rise in hospital cases.I think it prudent to advise cancelling any plans for Halloween, Divali, and Bonfire night. Christmas plans are also at risk and certainly it will not be normal.If you have the symptoms of Covid get a test. The advice has slightly changed. In Great Britain do not go to your GP or local hospital get advice on line or call 111. In Wales where NHS111 is not available ring NHS direct on 08454647. If you live in Northern Ireland you should call your GP. This is what happens when Devolution confounds the issues.Stay positive. encourage one another, and support each other. Remember the Hands Face and Space slogan, to my mind the greatest of these is Space. Stay your 2 metres apart. Remember this is the Land of Hope and Glory and long may it be so.
September 14 2020
Each year from mid – September onwards, every general practice sees a large number of children under the age if 11 with a snotty nose ( please excuse the technical language) and a fever. They will see others with a raging sore throat and a fever. If you look in the mouth you can see a very red throat. Compare it with someone else’s throat if necessary, and you may feel little marble like glands under their lower jaw and down the neck. These children have a tonsilitis. Children who are just unwell with a temperature and feeling rotten have probably got seasonal influenza, but just could have Covid 19.The point I am making is that we have now got a great log jam of people wanting to be tested and stories of people travelling the length of the country. We have been told that 25% of those seeking test do not really need them. Families are being told to stay at home for 14 days because a child has a snotty nose and cannot be tested.For 40 years in practice I sorted out sick children and easily came to a clinical diagnosis. To sort out this log jam, I suggest the following. Because children under 11 are only extremely rarely catching Covid 19 we could safely say that to require a test they should have either a fever or a new cough. AND they do NOT have a snotty nose nor a sorethroat. We know that a snotty nose and a sorethroat are NOT symptoms of covid 19 or for that matter seasonal influenza. They do not for now require testing. Children under 11 will not volunteer a loss of taste or smell unless they are groomed.The decision about whether a child is well enough to go to school should be made by parents in the way they have always done. My advice would be if they were febrile on a school morning they should not go to school.I assume that a sample of the swabs now being taken are being screened also for winter endemic influenza A , so that we will all be aware if that is causing illness.I strongly recommend that NHS 111 changes its protocol so that before considering a child under 11 needs a test and their family isolated . They should have a new cough, or a fever, or loss of smell and taste AND DO NOT have snotty nose or a very sore red throat.This will clear the back log quickly and ensure those most at risk are tested first. I wonder what the positive test rate is in the under 11s? I bet its less than I in 1000The figures remain very worrying. It is unlikely we can avoid a second wave of disease. The rate of increase in new cases is very similar to the rate we saw in March. Several other countries are heading for serious problems.Israel is the first country to declare a second full lockdown from this coming Friday. Israel only has a population of 9 million but has seen 4,000 new cases in a single day. All Schools hotels and shopping centres must close. Supermarkets, pharmacies and restaurants can only open to do home deliveries. People are not allowed to go more than 500M from their homes except to travel to work.We could be facing this again in a few weeks if we do not act now. The new rule of 6 must be kept vigorously if we are to stand a chance. I am still keen for a teenager to give me their views on this. Remember what we do today will take at least two weeks to take effect.It is so important that we maintain and boost our corporate morale. We can get through this, if we stick together. We must all set excellent examples and follow very carefully the guidelines to help protect others. To protect ourselves, staying at home apart from essential journeys to school, work and shopping. We do not need to go to restaurants or pubs for a while longer. Start a family hobby. Collecting photographs from the internet of a topic of interest like birds and animals or historic buildings could help educate as we learn. Working on a family history or a history of your village or town is great fun. There is a lot to find on line! Even learn a foreign language together on line.I still remember the Last Night of the Proms being an amazing rallying call. Remember the rule of 6 and Hands Face and Space. Working together we can rule the waves. If we waive the rules then we put thousands more lives at risk.
September 15 2020
I have had a frustrating day with no telephones and only very intermittent broadband. I will make this email shorter than usual in the hope I can post it before I lose the link.There are now 972 people in hospital with Covid 19 of which 106 are now on ventilators. 141 new cases were admitted in the last 24hours. There have been 27 deaths reported in the last 24 hours and for several days now the number of new cases is over 3,000. It was 3,105. I fear this is the beginning of the rise in hospital admissions 10 days or so since the rise in cases was first reported.Looking around the country Bolton remains England’s hotspot and the Royal Bolton Hospital has seen a rise in daily hospital admissions. They report they are seeing middle aged men being admitted some quite seriously ill. My old hunting ground of Redbridge is where a number of readers live, there have been 74 per 100,000 new cases, and is the hotspot of Greater London. Neighbouring Walthamstow reports 41 per 100,000. In Boston in rural Lincolnshire, the risks are much less at only 7 per 100,000How has the rule of 6 begun to work in your area, do you have concerns? We have politicians now urging us to report neighbours who are breaking the rule to the police. Have you done this? or would you do so if you saw the law being broken? Do you have any other ideas as to how to maintain the rules without having to damage relationships with neighbours.I was pleased to have comments from teenagers explaining they are confused. I have the greatest of sympathy for them. One of my reasons for writing this is to try and present complex issues both simply and in an accurate way.Snotty nosed children are set to cause major problems with the economy if they cannot go to school, cannot get tested and parents have to stay at home. I do not believe our public health colleagues have any idea of the problems of children with colds. Historically GPs have sorted these out and parents knew when a child was fit for school. The current guidance is stupid. Parents are calling 111 because they have been told to. They are told not to see GPs. Then because they have a fever they must have a test and there are none available. It is simple, snotty nosed children under 12 will not have Covid 19. A study in the USA found no children with a double diagnosis. Put pressure on anyone that will listen; that a child with a streaming nose does not have Covid 19 and can go to school safely as soon as is well enough. Testing can be done later if necessary. This simple step would remove 25% of the back log. Stay safe, I hope I can post this now. Please encourage every one to follow the rules.
September 16 2020
I have a rather fragile telephone line and internet tonight, so back in business! I remain very concerned, if we do not get much better cooperation immediately we are heading for a real crisis. Christmas will mean nothing this year and many will succumb to this disease before then unless every one takes action now. The number of new daily positive tests has risen to almost 4,000 a day. The daily death rate although still low has doubled to 20 in the last 24 hours . The number in hospital is now 901 some 70% higher than a couple of weeks ago and a similar rise in the number on a ventilator to 115 in the last 24 hours. This number has doubled recently. We are most fearful of a rise in cases of people over the age of 80. It remains low but has doubled in the last 2 days, exactly as predicted. The hospital cases are rising and our elderly are back in the firing line.We are following the pattern seen in France and Spain with the development of the second wave only about 10 days behind. I was pleased to see the UK did not make the top 10 of countries for the number of cases. Then I realised it was cases not deaths or cases per 100,000 of the population. Many counties have a much higher population than the UK. In terms of deaths we are certainly in the top 5.Politically today seems to have been quiet with quite a lot of posturing about the inadequacies of track and trace, especially the number of adults off work because children are off school and unable to be tested. With the end of the furlough scheme those of us still able to work or on a secure pension may have to do our best to help family and friends rapidly running out of money.The picture is gloomy right across England with 184 of the 315 local authorities reporting a rise in cases. The only Authority to report no cases was Babergh. The PM has not denied the reports that a curfew is about to be imposed after 10pm, I am sure it will happen, and will be easier to police. Additionally I hope public places where people congregate will also be closed. Places like the Sea Shore, National Trust properties and public parks. I realise the impact on the hospitality sector but all lives matter and there seems little alternative.Meanwhile if everyone plays exactly by the rules we can minimise the second wave and reduce the mortality. Please remember Hands Face and Space, Do more than remembering please practise it as well. We should all be helping one another. We must fight a common enemy and remain united.
September 17 2020
Well the restrictions expected last night, have arrived today and I am sure this is only the beginning . There will need to be more across the UK very soon. About 1-5 million people are affected by today’s announcement about NE England. The areas involved are; Northumberland, Newcastle, Sunderland, North and South Tyneside, Gateshead and County Durham. In these areas people are banned from socialising anywhere outside their own household or social bubble. Leisure and entertainment venues are to close at 10pm and cannot open before 5am. Only table service will be allowed in bars and restaurants.A further 23 areas are being watched very carefully and some like Bolton already have significant restrictions. Bolton still has the highest case rate at 204.1 per 100,000 of the population. At least a dozen other areas have rates of over 100 per 100,000.It is really difficult to predict where will be hit next. It could be almost anywhere. The WHO has spoken today about their rising concerns. They consider that this second wave is already having a greater impact than in March. In the last week over 300,000 new cases have been reported to WHO. The UK is 5th in the list of new cases with 35,000 new cases in 2 weeks.The effect on hospitals is already clear, almost one thousand people are in hospital (988) and 124 of these are on a ventilator. There were 134 new admissions in the last 24 hours. The rules about flights to and from different countries are changing daily. My advice is to avoid flying unless absolutely necessary. Add a very recent negative test to your passport and ticket. Be prepared to be stopped from entry into some countries, and for 2 weeks quarantine on return.What does this mean for us all ? It means we are now in a mess! I listened to Baroness Dido Harding today when she said ” No one was expecting to see such a big rise in demand”(for tests). Why on earth not? Ask any GP or junior school teacher and they tell you that about two weeks into the autumn term hundreds of thousands of children develop a cold with a streaming nose and a low grade temperature. The one symptom Covid patients do not seem to have is a snotty nose. We could reduce the back log of tests dramatically if some one in authority says that children with snotty noses do not need a test and can continue at school without a test when they are well enough. I was pleased to see a video on line from other doctors making the same suggestion that I am.University students due to return to college are not children, and should be intelligent enough to understand the problem of spread, they must be responsible and self impose a degree of social isolation. They can and must wear masks when required and can measure 2m or 6ft 3 inches. The rest of us can, and now must, do the same. If you do not understand the rules ask someone who does. Please do not just ignore them. It is now time critical; a higher percentage of our elderly are back at risk. Christmas as we know it is very much at risk. If the general public do not listen we will have restrictions across the four nations lasting for many months. The second wave could last 15 to 20 weeks if it follows the pattern of previous pandemics and that is what I expect. Stay Safe and remember Hands Face and Space.
September 18 2020
As you know I try hard to be positive in my reports, I firmly believe we can get through this crisis but I cannot stress enough what a critical point we are at now. I think the vast majority of you realise the problems. We have differences in emphasis about the gravity of the situation which will depend on where we are. Some of you want more then anything to save lives. Others want to save the economy , others the livelihoods of the many, about to have no job and no money. Some want to keep school education going at all costs. Others want a total lockdown from now till Christmas.Amongst all of this there are thousands of experts wanting to have their say . Many have lost confidence in our official expert advisors. Politicians are squabbling amongst themselves. On top of all this we still have a country to run, Brexit to deal with and trade deals to sign.The hard facts are that we are now well on the way to a second peak of cases as we saw in March with the first peak. Past historical data, and with what we have seen to date, this wave is likely to be bigger than the last, with many more cases. The number of new cases is now doubling every 7-8 days. There were 4,322 new cases in the last 24 hours. Over a thousand are now in hospital and 127 have been put on ventilators. This later figure is worrying as we found in the first peak we could use a technique called CPAP effectively to avoid ventilation in some cases. Also the drug dexamethazone proved very useful. Despite both these advances the numbers continue to rise steadily. There was to start with, a view that many of the new cases were less severe because it was affecting a younger age group with less co-morbidities. The average age of admission is going up as inevitably more of our vulnerable elderly are exposed.The government have reacted swiftly in many areas of the country to ensure it does not get out of control. Yesterday brought tight new restrictions in the NE of England. Today similar restrictions are placed on Lancashire, Merseyside and Warrington. 17 council areas now have 10 pm curfews on night life. People are advised not to go on holiday with others unless in the same support bubble. Further restrictions are in place in Bradford, Kirklees and Calderdale. The Office for National Statistics have announced they are concerned about rises of cases in Greater London where the Mayor has announced there will be no firework display on New Year’s Eve.A new term has been introduced tonight. The government are considering a “Circuit Breaker”. The idea is a short two week lockdown to largely prevent any spread and slow the pandemic right down. It would work like this. Consider 100 people with new confirmed Covid on the first day. As things stand now with an R number of 1.4. It would mean a week later there would be 140 new cases and a week later there would be 196 more cases. With a really severe lockdown with schools and business closed, no public transport apart from emergency and key workers and no one travelling more than 1 Km from their home, most shops closed and life paused for many of us. We would then have the best chance of stopping the spread in the way I have just illustrated.I am sure the experts are considering this very carefully. It may be more effective than a longer lockdown and may have less unintended side effects on our livelihood and our economy. To be effective it means 100% compliance. We cannot afford for this not to work.I was delighted by the posting from young Jodie who gave us a very mature view of the crisis from her 6th form. Even more delighted by her school emailing all the pupils telling them they must wear masks. We can all learn from this. Do not tolerate bad practice whether its at work or home, in school or shops, or at the local park.I am certain we shall see something like the “circuit breaker”. We have been warned and must be ready for it; but no panic buying please! Believe our lives and those we love, depend on each and every one of us, doing their utmost to prevent the spread of Covid 19. I am not scaremongering as I was accused yesterday. The facts are grim but we can and will get through this. The PM once said “I will do whatever it takes” and so must we, no matter how unpalatable.
September 19 2020
I think all of you will have been appalled by the behaviour of a few hundred demonstrators in Trafalgar Square this afternoon. No civilised society should have to tolerate any violent gatherings like this. You are very welcome to believe in conspiracy theories and as an adult to refuse vaccination. You are not allowed to impose your views on others in a threatening way. The Law of the land still allows you to protest IF you are attending an organised and Covid secure demonstration and abide by the rules. Our police force are one of the most tolerant in the world but patience is wearing thin. I am sure if not arrested today the demonstrators will be picked up on the basis of photographic evidence in the next few days. This way the police can avoid much of the violence. There was no respect for social distancing and in this new crisis we are in, you have to disperse if told to do so.Today there are calls for tough action nationally now and it would seem Keir Starmer, Nicola Sturgeon and London’s Mayor Kahn and Prof. Neil Ferguson all agree we should have a full national lock down now. Boris is under enormous pressure, he is dammed if he does and dammed if he does not. He was criticised at the first wave for leaving it too late. The economic implications are tremendous and perhaps catastrophic for millions of people. I think there may be a decision to use a “circuit breaker ” approach of the type I described yesterday. I think we will hear tomorrow or Monday what the cabinet decision will be.I am glad to see my GP colleagues beginning to speak out about the problems of snotty nosed children. Most parents, teachers and GPs know a snotty nosed child when they see one. They know the difference between it and possible Covid19. Patients with Covid can have a wide range of symptoms or non at all. The one symptom they never have is a snotty nose. GPs and their staff would have been perfectly capable of handling this problem but someone in their wisdom decided General Practice should not be involved in diagnosing Covid at all. Patients, who though they might have the disease, were explicitly told not to see their Doctor. Instead they saw completely non trained people recruited from SERCO. It’s no wonder we are in a mess with the wrong people being sent for tests.Today’s figures provide little grounds for hope that we can avoid the inevitable. Remember today being Saturday there are often reporting problems at the weekend and the true figures are underestimated. There have been 4,422 new people with a positive test recorded in the 24hrs up till 4pm today. There have been 27 deaths . There are now 138 people on a ventilator and 134 new cases were admitted. You must remember there is a 10-14 delay after catching the virus before you may or may not show symptoms, need hospital admission, need ventilating and possibly dying of the disease . We will see a further big jump in hospital admissions and deaths in a weeks time.If I were involved in making a decision I would do it in the next 48 hours with a Circuit breaker lockdown for three weeks. I do not think we can afford to wait till half term as several have suggested. We may find it necessary to act to protect the majority from a wilful minority. It would not surprise me if short term jail sentences are imposed through new legislation for deliberate interference and obstruction of social distancing by demonstrators and ignoring instructions to disperse.For now carry on doing your best, look out for each other. Only go out if essential . Take steps you need to to cope with a new lockdown. It is like winter, it cannot be stopped.
September 20 2020
Tonight’s report can be shorter being a Sunday. There is little to add today. You all know about the tipping point we hover at. I told you the bad news last night but sadly there is no real improvement in sight, because on a Sunday data is always under-reported.3,899 new positive cases were reported today with 18 new deaths. I was suspicious of the hospital data being offered as the hospital admission rate had been exactly the same now for the last 4 days. I investigated and found not every one of the devolved nations releases a daily figure, this means the figure is only updated when all 4 nations report a figure on the same day. Wales still reports suspect cases whereas the rest report positive test cases only. I found another source for the data but as yet these figures are not verified. They suggest the total number in hospital in England is 866, with 153 new admissions today in England only. These figures are broken down by region, 269 in Hospital in the NW, 190 in the Midlands, 152 in the NE and in Yorkshire , 134 in London 73 in the SE and 35 in the East of England.The law has been tightened today. If you test positive or are told by track and trace that you must isolate yourself and stay at home, then failure to do so can result in fines of up to £10,000. This rule comes into force tomorrow week, but if it affects you, isolate at once do not wait till tomorrow.We will get the most reliable daily figures on Tuesday when it is widely speculated that the Prime Minister will speak to the nation. Whether we will see a Circuit Breaker or a full national lockdown, I do not know but I do know each and every one of us can and must play apart and do what it takes.I think perhaps the slogan needs to be altered again. I would like to see it say Space Space Space as I think the 2M rule is now much more important than Hands and Face, but please do not forget the Hands and Face routine they remain very important to getting safely through the pandemic.
September 21 2020
Many of you I am sure, like me. listened to Prof. Chris Whitty and Sir Patrick Valence at their 11 am briefing to the Nation today. It was refreshing to see they were allowed out on their own without a political minder. That may have been an astute move by the PM to allow us to hear the bad news as it is and not wrapped in political hype and propaganda. If you have been reading my daily reports nothing that was said today will have been a surprise. You have read it all here in the last week. I think these two gentlemen have both charisma and credibility in their presentations. It is possible that some who won’t be told what to do by a politician will respect the professional opinions of two very astute men. It was spelt out very clearly. if unchecked we will have 50,000 new cases per day by mid October and 200 deaths per day by mid November. This is based on cases doubling at the present rate of every seven/eight days. It assumes also an R rate of about 1.2-1.4 which is the current estimate.Spain and France are a few weeks ahead of us . The European Centre for Disease control confirms this And the graphs shown this morning illustrated it clearly.I understand COBRA will meet at 9am tomorrow, followed at lunchtime by the PM making a statement before the House. I think he will address the Nation either Tuesday late afternoon or Wednesday. I am sure there will be quite drastic action taken quickly, there are a range of options none of them very palatable, and none any government would want to impose. We have one last chance to listen to the scientists. If we do react properly and swiftly we can reduce the rate of doubling of new cases and reduce the R rate. If we do not do it promptly and voluntarily it will be imposed. We know from March and April that it works. We have absolutely no choice. The socio economic impact will be huge. We have been promised they will do whatever it takes to get through this and I am sure we will. Listen to our experts please.4,368 new cases reported today with 11 deaths reported. remember the weekend effect is still seen on Mondays, The hospital data has not been released again . And the web site says it will not be updated until 9th October. Tomorrow we will hit 400,000 cases in the pandemic.Stay at home if you can, only go out if you must. Wash your hands frequently, and sanitize regularly Wear your mask in public places outside your home, Respect the social distancing and stick to your local rules. There will soon be big fines for not doing so.
September 22 2020
Well, after a lot of speculation we now have the news we were expecting. Boris addressed Parliament after this Morning’s COBRA meeting. He is due to broadcast a message to us all at 8pm tonight. I have posted this early so that if there are any new developments I can post again this evening.Firstly we are urged to work from home again, only traveling to work if we must. Work places must be as Covid secure as possible. Appropriate PPE must be used if appropriate.From Thursday all restaurants pubs and bars must close by 10pm . last orders for food will be 9pm to ensure they can close by 10pm. You must wear face coverings to go into these premises and can only remove masks when eating or drinking in a seated position. It will be a table service only and you must provide a name and contact name for everybody for track and trace.The existing rule about 6 people gathering still applies generally but in the many areas where there are already stiffer lockdown restrictions the stiffer rules will continue to apply. This is particularly true of Northern Ireland.The Prime Minister warned us to expect these tough measures will be in place for at least 6 months, Although this sounds dreadful at least we know where we are. We can knuckle down and get on with it. We know that Christmas will be like nothing ever before and that we will be lucky to celebrate Easter.There will only be a maximum of 15 people allowed to attend a wedding, but 30 can attend a funeral including staff.The wearing of masks has been extended and in addition to wearing them on public transport, and shops they must also be worn in a taxi or private hire car and any other indoor premises such as doctors’ surgeries and banks.There is to be a pause in opening up of spectator sports, exhibitions and sports clubs.Businesses can now be fined up to £10,000 for not complying. Individuals can be fined £200 for a first offence of not wearing a mask. So its time to ensure you have plenty and always keep some on your person or in the car.For those of you that endured shielding, this is not being re-imposed except in local lockdown. If you are medically very vulnerable it is probably wise to partially shield but allow yourself a little more freedom to go out safelyThere will not be any major dogs show this year or early next year. Crufts 2021 will be at risk.Up to 30 million of you are already under tighter local restrictions. These are very likely to be widened at the first hint of a problem.Unless these new regulations change everyone’s behaviour, if the R number does not come down and admissions to hospital and the deaths do not start to fall, much tougher regulations are ready. Remember unchecked we could have Covid death every 8.5 minutes by mid NovemberA new phrase is used today “Shelter the Economy”. This is vital for our future mental health and financial well being but for the time being saving lives take precedence over everything. Remember if you take a risk, you put other lives at risk as well as your own.
The PM spoke in parliament at lunchtime and many of us have debated what he said ever since. Tonight at 8pm he addressed all of us individually. He came over as a really concerned Prime Minister doing his best to balance all the conflicting demands he has on him at present. I do not think I have seen him speak in such a way before.He reminded us we can do this, as we have done it before in the Spring. He went onto say this is the biggest crisis to hit the world in his life time. We live in a great and freedom loving nation and we can do this and restore our freedoms if we all pull together.The virus is just as virulent as it was ,we see what’s happened in Spain and France. You will all want your government to be Robust and Proportionate. Your risks are not your own, your cough could be the next person’s death bell. Some people say we should just lock up our elderly and vulnerable; but that will be neither practical nor desirable and the virus will still get through to themStrong action now is like a stitch in time. Working together must be our united strategy. Most medical and scientific colleagues are certain things will be much better in the spring. Mainly because the virus is less virulent in the summer, Hopefully we will have fixed track and trace and have an effective vaccine by then.The statistics were not available earlier. But the daily death rate has risen to 37 There were 4,926 new cases testing positive, taking the cummulative figure to over 400,000. In the USA the death rate topped 200,000 today.Another rule tonight I missed earlier was that staff working in shops must now wear face covering.If we do not rapidly see the benefits of these measures and everybody’s compliance, the Government will bring even tougher measures.”Humanity will win” said a very concerned Prime Minister, “the fight is by no means over. Now is the time to dig in and work together. There will be great times ahead Share the spirit of togetherness in these dark days.
September 23 2020
Here are some extracts from a major paper I have been writing recently which gives more detail on the Spanish flu epidemic of 1918-19 and the swine flu issues of 2009. I hope this clarifies the facts “2.4 1918-1919 Spanish FluIn 1918, during the last year of World War One a devastating epidemic hit the United States. The most reliable evidence suggests some 675,000 Americans lost their life. It significantly impacted on the efforts of America at the end of the world war. Much information about the epidemic was never published because of wartime censorship. However, Spain, which had been neutral during the war published freely with massive newspaper coverage. This is how it became known as the Spanish Flu pandemic, when in fact the initial spread from America through their troops arriving in Europe was probably the truth. There is no full consensus on where it began, but it would seem that an outbreak in Haskell Co in Kansas in February 1918 was the most likely. Less than a year earlier the USA had joined the war and was scrambling to mobilise and train hundreds of thousands of young men who were crowded into hastily built camps all over the Continent. As the soldiers travelled from home to camp and then from camp to camp,It would seem a few soldiers on leave brought the infection to Camp Fuston, a perfect location for very rapid spread through the community. The military policy of frequent transfers of soldiers from one camp to another did not help. Within weeks it was spread to a dozen or more other camps and then into the community. In America, influenza was not a reportable disease like TB or Cholera and most victims only had a mild illness to start with. All deaths were recorded locally so Washington had little idea of the size of the epidemic. There are numerous images of a vast influenza ward created at camp Fuston. This was perhaps the first example of an enormous ward built to hold victims of the Pandemic. The huge Nightingale Hospitals prepared in England for COVID-19 and the hospitals built rapidly in China were used to contain cases in the same way. Most of what is known about the Pandemic was from places that kept good local records. We know from such records that 1,000 workers at the Ford Motor Company were infected and 500 inmates of San Quentin prison. Because at this stage the illness was generally mild, it attracted little attention and much of the general public had little or no knowledge about it. This was the first wave in the USA, it did not just go away. It went to Europe on troopships and started the ravage of Europe at the port of Brest. As the troops dis-embarked they joined the Expeditionary Forces and flu quickly engulfed the armies of France, Great Britain, Italy, Austria, and Germany. If soldiers went on leave, they took the disease with them and it soon had a hold on the civilian population as well. In the midst of a war no country wanted to advertise their plight with the pandemic and war time censorship suppressed much of the news only reporting how badly the enemy were faring. Newspapers reported the Germans were catching it because they were hungry and exhausted. One American newspaper reported falsely ‘No Influenza in our Army.’In June 1918, the influenza hit Spain which was not involved in the war. There was extensive uncensored news coverage and many people thought it had started there and so it became known as Spanish Flu. One of the early casualties was the King of Spain. The Americans were happy they did not have the blame.Something changed in August 1918, a second wave of infections was beginning. The first cases of the second wave occurred in a vast Navy barracks in Boston, called Commonwealth Pier. On the 27th August two sailors reported sick. The next day eight more and on the third day 58 reported sick with influenza. The barracks held some 7,000 sailors all closely confined. It soon also spread out of the camp into the surrounding civilian population. It spread to the soldiers at Camp Devens where huge numbers lived in very crowded conditions.This was an excellent illustration of the exponential growth of case numbers in an uncontrolled epidemic The Reproduction number or R as we now know it was extremely high.This was very much more severe, and soon several hundred flu deaths a week were being seen in Boston’s civilian population. A naval physician wrote an article in the Journal of the American Medical Association alerting doctors across the country to the severe and rapidly spreading epidemic. He warned it would engulf all of America and by the publication date of 28th September it was already becoming true.At the same time as devastating the USA, this new more virulent strain was devastating countries all over the world. Every continent was affected in turn as the disease spread rapidly. The death rate was far higher than normally expected for typical influenza but not as high as previous pandemics of plague or cholera. In the first wave the majority of Influenza deaths occurred in the very young and the very old. In the second wave there were far fewer deaths in the elderly, but teens and young adults were badly hit. The reasons for this are still not clear. Remember in 1918 we had not met a virus, they were yet to be identified, the germ theory was well established as was the practice of disinfecting everything. Bacteria were quite well understood now. The local newspapers in England carried large adverts for ‘Jeyes Fluid’ to disinfect everything. They were describing the causal micro-organism as Bacillus influenzae. Hand washing and sanitisation was heavily promoted. Face masks were encouraged for the general public in public places and medical care staff wore them. Schools were closed and opened again on a local basis as each town became engulfed in the pandemic. The local Medical Officer of Health was a key person in decision making.In the United Kingdom the first death was recorded in May 1918. According to a report in 1919 by Sir Arthur Newsholme for the Royal Society of Medicine, the disease spread like wildfire in crowded troop transporters and munitions factories as well as on buses and trains. In 1918 he had also written ‘A Memorandum For Public Use’ that advised people to stay at home if they were sick and to avoid large gatherings. It is alleged this memorandum was buried by the Government. There was no centrally imposed lockdown although many theatres, dance halls, cinemas and churches were closed in some places for months. Pubs which were already subject to war time restrictions on opening hours mostly stayed open. The Football League and the FA Cup had been cancelled for the war but there was no effort to cancel other matches or to limit crowds. Regional competitions and women’s football continued throughout the pandemic. Some towns used widespread disinfecting methods with sprays, others did not. Many people wore ‘anti-germ masks’ at work and when out and about. Hospitals became overwhelmed and medical students were brought in to help. Medical and Nursing staff worked flat out but they had no drugs to help and no antibiotics yet to help with pneumonia complications. Experiences in the UK confirmed the American findings that the second wave of influenza was far more severe than the first. The third and fourth waves were again both less severe and smaller in numbers. A notable feature of this pandemic in the UK was the emergence of fake news and conspiracy theories. The general level of ignorance about healthy lifestyles was considerable. Some factories relaxed the rules about smoking at work in the belief that cigarettes would help prevent infection. In one Commons debate an MP asked, ‘Is it a fact that, a sure preventative against influenza is cocoa taken three times a day’. Public health leaflets warned that ‘coughs and sneezes spread diseases. In November 1918, the News of the World advised its readers to ‘wash inside the nose with soap and water each night and morning; force yourself to sneeze, then breathe deeply. Do not wear a muffler; take sharp walks regularly and walk home from work; eat plenty of porridge’.The final death toll in Britain is now estimated at 228,000 with a quarter of the total population infected with the influenza virus, including the then Prime Minister David Lloyd George. Children enjoy rhymes and just as ‘Ring a Ring of Roses’ reflected on an earlier plague pandemic so in 1918 they were singing:‘I had a little bird.Its name was EnzaI opened the windowAnd in -flu-enza. ‘………. Anon
and on Swine Flu”2.11 Swine Flu 2009The 2009 swine flu pandemic was a global influenza pandemic that lasted for about 19 months from January 2009 to August 2010 and was the second of two pandemic’s involving (H1N1 influenza virus) the first being the 1918 to 1920 Spanish flu pandemic. First detected in Mexico in April 2009, the virus appeared to be a new strain of H1N1, which resulted from a previous triple reassortment of bird, swine and human flu viruses further combined with the Eurasian pig flu virus. This led to the term swine flu (WHO 7 Jul 2009 press conference). It is estimated the actual number of cases worldwide which ranged from asymptomatic and mild cases to critical illness and death was as high as 700 million. At the time, the lower value of 700 million is more than the 500 million people estimated to have been infected by the Spanish flu pandemic. (WHO 6 Aug 2010). The number of laboratories confirmed deaths reported to the WHO was 18,449 but this 2009 H 1N1 flu pandemic is estimated to have actually caused about 284 thousand. A follow up study done in September 2010 revealed that the risk of serious illness resulting from the 2009 H1N1 flu was no higher than that of the yearly seasonal flu foot comparison WHO estimates about 250,000 to 500,000 people die of seasonal flu annually.The disease rapidly achieved global presence spreading initially from Mexico in April 2009 it reached the UK via returning UK holidaymakers from Mexico and the first case was confirmed on 27 April 2009. The WHO declared the H1N1 outbreak a pandemic on 11 June 2009. The number of UK cases peaked at about 110,000 in the last week of July and the younger age group 11 to 15-year olds were primarily the highest infection group.Cases declined during the summer months down to about 3,000 and rose again to 84000 in the October of that year, falling from November onwards. Upon the virus being identified in April 2009 the UK quickly invoked their influenza Pandemic plan and the response which was led at the governmental level by the Department of Health supported by the Health Protection Agency nationally, regionally, and locally.
I imagine most of you have spent the day thinking about and discussing the Government’s plan for the next six months. How are you going to keep your self, your family and other loved ones safe?Most will be assessing their financial position and questioning what help will be coming. It seems to me that opinions on the media are roughly equally divided, with half saying its too much and half saying not enough. That probably means it is about right for now. Tighter measures can be kept in reserve if the public still will not accept that we now need to have and follow very unpalatable rules. There are so many different agendas to juggle.One significant move tonight is that the chancellor is to unveil an “economic master plan” tomorrow. This hopefully will ease the financial burden on those worse affected, we shall see.Tonight the statistics released show 4,926 new positive cases today. 37 deaths reported today. The NHS data is more difficult but it would seem there are now 1,319 in hospital with confirmed Covid 19 and 211 of these on a ventilator. The number of admissions per day are no longer published by the Government and the NHS have reported the statistics once a month with a considerable delay. As from yesterday they are supposed to be publishing them daily again. Go and look at this site and see if you can make any logical sense out of how they are being counted. There are some figures worth looking at , consider England alone between 11 Sept. and 20th September, admissions rose daily from 135-237. The worst region being the NE and Yorkshire which rose from 30 to 67. The best area, the South West, went from 3 admissions to 8 in the same 9 days.I continue to do my best to answer your questions but admit I got a bit inundated with them this morning. There will be more clarity over the next week. For all of us it’s listen and do our part and follow the rules. Do your best to help others do the same without being hurt and stay safe.
September 23 2020
As expected today the Chancellor has been explaining his furlough replacement scheme. the existing furlough scheme will end on 30th October and the new scheme called the Job Support Scheme will start the nest day.The Chancellor said that he would be nurturing the economy but we have to accept the fact that not all businesses are viable and some will cease . No scheme can save everyone, and those in unsustainable jobs will have to reconsider their options.The new job support scheme will only support those who are working one third of full time and earning normal wages for that time. These people will then receive 2/3rds of their pay for the hours lost. providing that their job is considered viable in the long term and only covers small and medium sized businesses.There is some further support for the self employed. They will get a grant of 20% of their average monthly profits, from November to January 2021. this up to a maximum payment of £1875There is still more short term help for businesses trying to survive with “Bounce Back Loans” enabling companies to pay as they grow for up to 10 years.Self assessment tax payments can be further deferred. There can be deferred payments on VAT . VAT on the hospitality industry will stay at 5% until next March.I am by no means a financial advisor and want to stay with health issues. I am not certain I have managed to capture the financial small print and I apologise in advance. Please check everything I have said tonight before taking action. It seems very complex.What is certain is the profound difficulties many will face in the months to come. Despite what seems to be quite generous help. Please all support one another as best you can as they say in Tescos “we are all in this together.”In other news , 2 Covid outbreaks in different Halls of Residence in Glasgow University have resulted in 120 positive cases. There is dismay that they must isolate where they are and not go home. There is further discussion more generally that students may be asked to stay at university over the Christmas break and not return to their families. I can see the wisdom in this approach but ignores the psychological and mental health consequences and I cannot believe that could be enforceable.The mirror headlines a report from Japan that face shields may not be as safe and effective at first thought. I have only seen a resume so far but was not impressed with the science behind it. I will watch this but not change general advice yet.The EU have highlighted 7 Counties of concern. they are Spain Romania, Bulgaria, Croatia, Hungry, Czech Republic and Malta. Because the UK has left the EU we are not included but certainly would be if still a member.As I write this, today’s statistics have still not been released, so I cannot give them to you. If they appear later I will post them. I do not suspect any good news.Stay safe everyone.
September 25 2020
Figures are available now from gov.uk so I will start with them tonight. The total number of people testing positive since the out break occurred is 423,236 with a further 6,634 being tested positive today. This is a considerable rise on yesterdays figure. New deaths reported yesterday also continue to rise to 40 and the total deaths to 41,936.There are now 1,618 people in hospital with this disease and 228 are on ventilators. In the last 24 hours, 266 new cases were admitted, which means so far 138,358 have been admitted to hospital. There are no figures available from Scotland tonight, apparently there has been a power outage there.I do notice other people such as Sky News are reporting slightly different figures but broadly the same . Sky do not have figures for Scotland either.Staying with Scotland I was impressed to hear Nicola Sturgeon today addressing students and making it very clear to them the outbreaks in Glasgow are not their fault and that they are not to blame. She said very clearly how sorry she was that they had been blamed personally.The Mayor of London, Sadiq Khan, has called for a ban on households visiting in London in the same way as it is already banned in Scotland and Wales, as well as the towns in the NE and elsewhere in England. The number of cases in London has already put the capital on the watch list, as they are seen to be rising steadily. This could affect another 9.5 million people in London. There are already 15 million people affected by the ban on different households gathering. The Mayor argues that is is inevitable so should happen now rather than later in the hope more lives can be saved rather than livelihoods badly affected. A stark choice either way.The conspiracy theorists still try to tell me this is all made up and that the problem does not exist. Just speak to and support anyone you know who has worked in an acute hospital or care home, or ambulance service. How many of us have knowledge of the loss of a loved one? I attended a virtual funeral yesterday.I trust those of you severely affected by being unable to work have been able to understand the financial situation for you in the next six months. I know of an airline pilot who is now an undertaker, an opera singer who is now a van driver delivering, and others who have become carers. Do feel free to share your experiences in the discussions.I have a great number of friends in the emergency services and with this morning’s dreadful news from Croydon it brings to 3 the number of sudden deaths of blue light workers in London alone this week. When we run away and shelter from disaster they will be running towards it.For now stay at home if you can; wear a face mask or covering if out in a public place like shops, banks, surgeries and public transport. The regular hand washing and sanitising is extremely important and so is the two metre rule. In a further week or so we may see the results of our efforts and figures just might begin to plateau. Look after one another and stay safe all of you.
September 26 2020
Weekend results are always un reliable and figures for Saturdays, Sundays and Mondays are always lower as fewer cases are reported on those days. There are also problems with the gov.uk web site giving slightly different figures to the NHS site tonight.6,874 new cases with positive tests (6,041 on NHS) today with 34 deaths (NHS 35) . 1,616 patients are now in hospital and 243 are on ventilators. These figures are both higher than the day before without considering the weekend. There have been 266 new cases admitted to hospital. Around the world some 32.5 million people have now contracted the virus. Compare that with the 1918 Spanish flu pandemic when some 50 million people died of the disease, and you will realise we have not seen anything much yet ! Doing nothing could give that situation again if left unchecked. This is why we must all do everything in our powers to stop this pandemic; doing what ever it takes.The growing crisis is worrying especially for the freshers who have only just arrived. I worked for a few years as a University Medical Officer and know how many students, when they arrive at university can hardly make a cup of tea. Part of the early university experience is learning how to survive. To lock them in a single room for 2 weeks is going to greatly affect their mental health. Urgent decisions to solve these difficulties are required before parents start arriving in the middle of the night to smuggle them home.The new App released yesterday has run into problems with a missing code to allow positive results to be added. Hopefully this can be fixed quickly.The Press Association using PHE data say that Burnley is still a hot spot with 228 new cases or 256.4 per 100,000 of the population. Next is Liverpool with 243 /100.000 then Knowsley at 242 per 100,000. Other areas with high rates are Newcastle Upon Tyne ,Pendle, Sunderland, Halton. and Sefton. All have shown a sharp spike in results in the last 7 days.Places of interest to me are, Redbridge with 60 cases per hundred thousand, the highest rate in Greater London ,and good old Boston where the wind has blown so strongly all weekend the virus has blown away. We now have only 11.4 cases per 100,000. I ventured out to a garden centre for lunch today. Excellent arrangements in place to keep us safe and I could not fault their Covid compliance. I also stocked up with fruit and vegetables and fresh eggs, much better and even cheaper than the supermarket.I have run out of different ways of reminding you of the rules. Regular readers know them off by heart. I am very glad the police have closed down today’s big demonstration as they refused to remain socially distanced.Stay safe, look after one another.
September 27 2020
Wales seems to be the place in the news tonight. Cardiff, Swansea and now Llanelli have had further restrictions over the weekend with three further places, Neath Port Talbot, Torfaen and the Vale of Glamorgan. 60% of the Welsh population have enhanced restrictions now.There were 362 new cases in Wales reported in the last 24 hours but no new deaths.Scotland has seen 344 new positive cases in the last 24 hours. 172 of these were in Greater Glasgow and Clyde, 52 in Lanarkshire and 40 in Lothian There was one death recorded in Scotland, 105 people are in hospital with 12 in an ITU.For the UK as a whole 6,041 new cases have been recorded with 35 deaths in the last 24 hours. A total of 1,727 are in hospital with 262 people on ventilators. I do not trust the daily admissions figure as it remained unchanged since yesterday’s report.There continues to be a lot of debate about the plight of students, particularly those who have only just arrived having gone through the problems with place allocations as well. Prince Charles has voiced his concern as well as many politicians. What do you think should happen? Should the term be abandoned and students go home? Is that even feasible? Should they effectively be locked in their student accommodation or allowed to go home to their family? Does one answer fit all students ? What about fees, should they be in part or all refunded for this year ?Let’s discuss this. Have you got a son or daughter at University? If so give us a first hand report on how they are doing. Are there any students reading this? If so, tell us how life is treating you please.Just a reminder to make sure that if you are eligible you get your free seasonal flu vaccine from you doctor’s surgery. It’s more important than ever we prevent an epidemic of flu this winter on top of everything else. While you are thinking about immunisations please check your children or grandchildren have not missed any booster or primary immunisations because of the pandemic. Please endeavour to get them brought up to date as soon as possible. Your GPs and Health Visitors can tell you what’s been missed. Vaccine for Covid is progressing well and we can be hopeful a safe and effective one will be available by Easter next year. In the meantime we must all continue to be very strict with the Face, Mask, Space drill we know well. I was pleased to see the police congratulating a crowd that dispersed quietly and quickly when the pubs closed last night. We need to see that everywhere now.Keep safe.
September 28 2020
I thought it might be useful to summarise the rules that now apply as a minimum across the UK. There are many areas particularly in Wales, Scotland and North East England where the rules have been tightened. Please check your local requirements. The rule of 6 has a number of qualifications now and locally can be changed at any time, but in the following situations the rule does not apply:-For work, or the provision of voluntary or charitable servicesRegistered childcare, education or trainingSupervised activities provided for children, including wraparound care, youth groups and activities, and children’s playgroupsProviding support to a vulnerable personProviding emergency assistance, and to avoid injury or illness or to escape risk of harmYou may take an animal to a vetFor arrangements where children do not live in the same household as both their parentsFulfilling a legal obligation such as attending court or jury serviceWeddings and civil partnership ceremonies and receptions – from 28 September, up to 15 people, in a public placeFunerals – up to 30 people. From 28 September, this does not include wakes (which are subject to the rule of 6), other than for religious ceremonial purposesOrganised outdoor sport or licensed outdoor physical activity, and supervised sporting activity (indoors or outdoors) for under-18s. Organised indoor sport or exercise classes can take place in larger numbers, provided groups of more than 6 do not mix. Organised indoor team sports for disabled people can take place in any number.Eite sporting competition and trainingSupport groups up to 15 – formally organised groups to provide mutual aid, therapy or any other form of support. This includes support to victims of crime, recovering addicts, new parents, people with long-term illnesses, those facing issues relating to their sexuality or gender, and those who have suffered bereavement.Protests – if organised in compliance with COVID-19 Secure guidance. All individuals must be socially distanced.Where a group includes someone covered by one of these exemptions, they are not counted as part of the gatherings limit. This means, for example, that a tradesperson can go into a household of six without breaching the limit if they are there for work.Does this mean that no more than six people can be in a pub, restaurant or place of worship at once?Venues following COVID-19 Secure guidelines can host more than 6 people in total, but no one should visit in a group of greater than 6 (unless you are all from the same household or support bubble). When you visit one of these places, such as a pub, shop, leisure venue, restaurant or place of worship you should:Follow the limits on the number of other people you should meet with as a group (it will be illegal to be in a group of more than six from outside of your household or support bubble). If your household and/or support bubble is larger than 6 people, this is your largest permitted group and you cannot meet as a group with any additional people.Avoid mingling with anyone outside the group you are with, even if you see other people you know.Provide your contact details to the organiser so that you can be contacted if needed by the NHS Test and Trace programme.Wear a face covering (except for when eating and drinking).The consequence of breaking isolation rules can lead to severe financial penalties. Falsely naming someone as a contact of yours to force them into self -isolation for 14 days unnecessarily can result in a fine of £1,000. Failure to self-isolate when told to do so can also result in a fine of £1,000, whereas deliberate and reckless breeching of isolation rules with intent to infect others carries a fine of £4,000.Venues like Pubs and restaurants who break the rules, by playing loud music or allowing dancing, serving at the bar or not enforcing social distancing can be fined up to £10,000.Tonight, Liverpool is the latest town to face further tough restrictions. Tonight some 8,000 school children and at least 350 teachers and other staff are self- isolating at home. There were 1254 new cases confirmed in the last 7 days, compare that to 50 in a week in August and 14 in a week in July. Liverpool has displaced Bolton as the place of greatest risk with 242 cases per 100,000 of the population.As you know there was a discrepancy in the statistics last night, one reason I have found was that the lower figures were for the 24 hrs up to 9am on Sunday whereas the figure I used was released at 4pm. I usually use figures released at 4pm but I have the same problem again tonight. Most are yesterday’s figures offered again as todays. To avoid confusion, I will check them again later tonight but if not accurate I do not want to share them as they will not be helpful.There is no doubt we have a crisis . It’s still too early to tell if the new measures are working yet. Stick rigidly to the rules and we have a chance to lessen the impact. Please all stay safe.
September 29 2020
Today we have seen the Prime Minister stumble over some of the local lock down rules he has imposed recently. It is becoming increasingly difficult to understand the rules applying to any location at any point in time. It is not helped by the devolved nations imposing their own local rules on top of UK rules. It should not be impossible to review all the existing rules and group them so that the lockdown measures are graded. So my suggestion to the UK Governments is as follows: Grade 0 would mean no Covid rules apply anywhere. Grade 1 would cover the basic rules applying in England at the moment, where there are no local lockdowns. Grade 2 would be where there are restrictions of groups of 6 meeting indoors. Grade 3 restricts gathering outside as well. Grade 4 as in some parts of Wales, with restrictions on travel as well and people unable to travel across area borders without good reason. Grade 5, we have yet to see, which will involve severe generalised restrictions on meeting anyone any where and all but essential travel banned. This is yet to happen in the UK. Masks and social distances would apply from grade 1 upwards.As I feared reporting gets back to some normality on a Tuesday so the figures rise to more realistic levels, It would seem that 71 deaths have been recorded up to 4pm today. This takes the UK deaths above 42,000 and more significantly the global deaths to over 1 million. It is a sobering thought that whilst trying to recover from the ravages of the first world war, the world lost 50 times that number with 50 million dead from Spanish influenza. Back to the Black Death it was an estimated 200 million deaths. We will never see another black death pandemic as the causative organism is a bacteria , not a virus, and we have antibiotics that can cure it quickly. There are still a few cases in the world each year very promptly dealt with.I can find no reliable national hospital data again tonight. From reviewing the reports locally, there is a slow but steady increase in hospital beds occupied and the use of ventilators . The daily death rate although still low has doubled. We will see these figures rise considerably yet, even before any benefit from tighter rules are seen.I was thinking about holidays and the last time I had one and would I even want to go at present? I found a helpful report from the Telegraph to assist us. So are you allowed to go on holiday?If you live in England you can still go on holiday even if you live inside an area with local restrictions. The holiday must be outside the area of local restrictions or abroad. BUT there must be no indoor socialising except with members of your own household or support bubble. However, it is permitted to stay in a hotel or bed and breakfast with another household if you avoid sharing rooms with people you do not live with and do not socialise with them in restaurants and bars. You are also advised not to share a caravan or share a private vehicle to travel to and from the holiday location. In Wales which has the most draconian rules in the UK, the country is divided into geographical areas which residents are not allowed to leave except for essential reasons which do not include a holiday. You are not allowed to travel to take a holiday even if already booked and paid for before the restrictions. Furthermore if and when you cancel you are unlikely to be able to get your money back.In Scotland there are no specific legal bans on travel over and above the national rules on social distancing and meeting. Nicola Sturgeon has asked the people of Scotland not to book overseas holidays for half term.Then if you are going abroad the rules about travel and quarantine on return and possibly also on arrival need to be understood carefully and checked the day before departure.Is it surprising Boris got it wrong? I personally would not bother with trying to have a holiday, it’s too complex and liable to sudden change. Staying at home, staying apart from other households and relaxing are much more attractive .
September 30 2020
A Prime Minister’s briefing was called tonight because of the crisis point we are now at. The Prime Minister supported by his Chief Medical Officer and Chief Scientific Officer brought the country up to date with the situation.The bottom line was that nothing was changing today, but the country is not yet responding to the restrictions imposed 2 weeks ago. The scientists were very clear the pandemic is not yet under control. The number of new cases are still going up, the number of deaths are going up, the number of people hospitalised are going up and the numbers of ventilators in use is rising. Thanks to the extraordinary expansion in the NHS in March there is still plenty of capacity. There are the Nightingale hospitals ready for use and some 32 ,000 ventilators available. It is most important you remember the NHS is open for business and that you should ensure you seek prompt treatment and attend for scans and screening tests now whilst there is still plenty of capacity.The Prime Minister paid tribute to the students whose University life had been severely disrupted. He promised them that he would ensure they were able to be at home for Christmas. He went on to say that the testing was on course to have 500,000 tests available every day. There are now some 4 months reserve stores of PPE in place with some 32 billion items.He continued that “some people want to give up and let the pandemic take its course, but I profoundly disagree. We are not going to give up, we are going to fight it. The public want us to fight it. If we do that we can save thousands of lives”. An effective vaccine is on the horizon. 14 million have downloaded the NHS App and we should all do that if possible. No matter how frustrated we are, the only way of dealing with it is to fight and for everyone to comply strictly with the rules.Prof. Chris Whitty reinforced all he was explaining with a series of 8 graphic images and finally an animation to show how the second wave has hit some areas in the North East, North West, Scotland and the Midlands harder than areas like rural Suffolk.The Prime Minister stressed that the government would step in and act quickly if the situation deteriorated. He was pressed by the media to indicate a threshold at which a tighter lock down would be enforced, he would not be drawn, but at least twice the scientists repeated the situation is still all going in the wrong direction. We were again reminded that the scientists advise on the action to be taken but the politicians make the decision and authorise the actions. I got the feeling there was a hint of tension tonight. But Boris is adamant he wants the British public to hear and understand about the crisis and pull together, sticking to the rules, and bring the problem back under control. He is of course right, it can still be done, but human nature being the way it is, there is little sign yet.The fact there are to be more official briefings is proof of the concern about the critical position. If the figures do not plateau or drop in the next 7 days I am sure there will be a much stricter imposition of rules with a lockdown, locally or even nationally.In other news the Royal Glamorgan Hospital has an outbreak with 82 people affected and 8 deaths recorded. The hospital has effectively gone into isolation and its A and E is closed. All work has ceased.In parliament, after a partial concession to those who want to debate further rule changes, the Government agreed they would debate any future changes if there was time to do so and so the Covid Emergency Powers were renewed for 6 months with a huge majority.I remain suspicious of figures quoted tonight. The BBC, Gov.uk. And Sky all having different figures. For instance, exactly the same number of deaths are reported at 71, compared to yesterday. There were 7,108 new positive cases today. 2252 are now in hospital but the number admitted to hospital has not changed for a few days. To summarise, it’s all going in the wrong direction. The outcome is in the balance. It’s situation critical. The situation is political, lives must come before the economy. You have one week only to change things round. With 95% compliance with every rule we can. It makes sense, you and everyone else must use their common sense. Please all stay safe.