Anyone who knows me well would probably describe me as having an upbeat, sunny disposition, devoid of cynicism. But, even my sunny-side-of-the-street personality is being tested at the moment. I am not by nature an anxious person which, given my circumstances, is undoubtedly a good thing, but Coronavirus is just beginning to fray my nerves a little.
Within my lifetime there have been a number of pandemics. In 1968 there was “Hong-Kong” flu (H3N2) which had a CFR (Case-Fatality Rate) of 0.1% and killed somewhere between 1 and 3 million people globally. More recently, there has been SARS (Severe Acute respiratory syndrome) and MERS (Middle East respiratory syndrome), both of which, incidentally, are Coronaviruses (SARS-CoV and MERS-CoV) and have higher CFRs of 10% and 36% respectively. Unlike influenza, which spreads relatively evenly and rapidly within a population, Coronaviruses, including Covid-19, seem to spread in clusters, making them theoretically easier to contain. Indeed, both SARS and MERS were bought under control before they went global. Which begs the question, what’s gone wrong with Corvid-19?
With SARS (2002 and 2004) and MERS (2012), there was certainly a degree of anxiety and wariness as we watched the spread of the diseases from afar, but since they didn’t make inroads into the UK there was little of the hysteria we are beginning to see today. I don’t remember the panic-buying of toilet-rolls or hand-sanitizer during those outbreaks. Nor were 95% of news bulletins devoted to the subject. Corvid-19 is different because, right at the start, China reacted slowly to the threat. The first known victim of the new disease was identified on the 1st December 2019, in Wuhan, the state capital of Hubei Province. A Wuhan hospital notified the local centre for disease control and prevention (CDC) and health commissions on 27 December 2019. Unverified documents appeared on the internet and on the 31st December, Wuhan CDC acknowledged that there was a cluster of pneumonia cases that appeared to have originated at the local seafood market. Beijing was notified and by 8th January, a new strain of Coronavirus had been identified, shortly followed by the complete genome sequence being published on an open-access database. I say the Chinese reacted slowly to the threat, but it is hard to imagine many other governments responding any faster. Nevertheless, the genie was out of the bottle.
The world watched with a degree of awe as China went about trying to stuff the genie back in it’s bottle. No-one could fail to be impressed when a brand new 1000 bed hospital was built in just 10 days. Draconian measures were put in place to try and contain the virus. Rolling news reports showed deserted city streets and checkpoints guarded by face-mask wearing soldiers. Even so, pockets of the disease began appearing throughout mainland China and then, further afield. The first cases in the UK were among people who had recently travelled from China. Then a cluster of infected people occurred in Northern Italy, and many of those people had had no obvious links to, or contact with, China at all. Governments throughout Europe began to react in earnest, albeit slowly, cherry-picking the science to suit cultural and political expedience.
In the USA, the toddler in the White House reacted with his customary good grace and forensic grasp of epidemiology, by first declaring it fake-news and then assigning blame. He declared his administration was doing “an incredible job”, and that one day the virus “was going to disappear”. He has also helpfully labelled Corvid-19 the “foreign virus”, and members of his administration/creche have started calling it the “Wuhan Coronavirus” because nothing is more conducive to international cooperation than a touch of xenophobia.
Here in the UK, Boris Johnson, a man with a well-documented casual attitude to facts, has been trying to reassure the nation that everything is under control and that science-based strategies are being enacted. This might even be true. The recently maligned ‘experts’ seem to be back in favour. Few people would deny the expertise and experience of Professor Chris Whitty, the chief medical officer, a man Johnson seems to be listening to.
Unfortunately, we can assume that just about every national government is taking advice from their scientific advisors and chief medical officers, but the strategies derived and the conclusions drawn seem wildly contradictory. Schools should be closed to restrict the spread of infection. Schools should remain open so children aren’t left in the care of vulnerable grandparents. Sporting events should be banned or postponed so as to reduce the number of large crowds gathering. Sporting events should go ahead because otherwise, those crowds will get together in more enclosed spaces, like pubs, to watch games being played behind closed doors on TV. Don’t panic-buy or hoard goods. Make sure you have enough food and medication in case you need to self-isolate. On the island of Ireland schools will be closed in one place, but a few hundred metres down the road, and across an invisible border, they will remain open. Labels such as ‘the containment phase’ and the ‘delaying stage’ give the impression of an orderly progression which, in reality, is largely illusional.
Eventually, patterns will emerge that will identify the most effective strategies to manage the outbreaks, and those strategies, through sheer Darwinian selection, will become the established protocols. Eventually, a vaccine will be developed. Eventually.
In the meantime, we all have to manage as best we can.
I am sure it is meant to be reassuring when reporters and politicians tell us that the vast majority of people who contract Coronavirus will recover fully. Every time a death is reported the caveat ‘he had underlying health issues’ is added. It is beginning to feel that instead of listing the various conditions that constitute being vulnerable, they could simply say, “like Stephen Deal of Carshalton, Surrey”.
We already had in place fairly strict hygiene protocols because it would be almost suicidal not to have them when you live with a tracheotomy. Gloves and plastic aprons are to hand, water used to clean the stoma is sterilised. Seeing the way the wind was blowing, Polly initiated more stringent hand-washing protocols, carers and visitors are politely reminded to wash their hands before entering my room, and outdoor coats are left in the hallway. Earlier this month Polly and a couple of my care team had heavy colds, the carers stayed off work and I didn’t see Polly for several days.
Even though we try to control my immediate environment as best we can, Corvid-19 is still impacting our lives, just as it is virtually everybody in the country, one way or another. Some hospitals and specialist centres of the kind where Polly works have closed their doors to non-clinical outside staff. Others are bound to follow suit. Since Polly is essentially self-employed, this has an immediate and possibly long-term financial impact. We’ll be okay, but we will be eating into our rainy-day money, and it’s rained quite heavily over the last few years. At present, the government is holding off on closing schools, but if that changes it will seriously affect Sam’s GCSE prospects. Much has been made of the possibilities for home-schooling in this online age if schools are closed. While this is certainly a possible solution for Sam’s academic subjects, he attends a performing arts school. Acting and dance make up a large part of his curriculum; subjects that don’t lend themselves to learning via Skype. Matty, who is reading history at university, will hopefully fare better because much of his studying can be done via the web. He tells me that from Monday, all lectures will be given online.
Even as I have been writing this post, the situation has been evolving. In direct contradiction of government advice, virtually all sporting events, both domestic and international, have been cancelled or postponed by their organisational bodies. Football, Rugby Union, Rugby League, Formula 1, the London marathon, Boxing, Golf, Tennis, Horse Racing, Cycling and Darts have all been affected. Several major film premieres have been delayed, including the latest James Bond and MCU blockbuster, Black Widow.
There appears to be a growing dissatisfaction with the UK government’s handling of the crisis, despite its insistence that they are following scientific advice. The notion of ‘herd immunity’ has come in for particular criticism.
WHO spokeswoman Dr Harris told BBC Radio 4’s Today: “We don’t know enough about the science of this virus, it hasn’t been in our population for long enough for us to know what it does in immunological terms.
“Every virus functions differently in your body and stimulates a different immunological profile. We can talk theories, but at the moment we are really facing a situation where we have got to look at action.”
It seems apparent that more drastic measures will be implemented over the next few days.
Being firmly in the ‘at risk’ category of the population, I greatly appreciate the efforts and sacrifices people are making. Ultimately, whatever measures are imposed on us ‘top-down’ by government, it is how we all behave at a grass-roots community level that will protect the vulnerable who, after all, are our parents, our grandparents, our colleagues and our friends. And Stephen Deal of Carshalton, Surrey.
N.B. While writing this post I have been reading around the subject of Coronaviruses and pandemics. I have relied on trusted sources, including the BBC, the Guardian, the Washington Post, NHS 111, and WHO. Even so, some of the information appears contradictory regarding CFR statistics and categories of pandemics. If I have made any factual errors I apologise. Please contact me via the comments page if you identify anything that should be corrected.