Life in the Time of Corona

This post covers January 2020 until, possibly, now ... It is the time of Corona. It almost harks back to Gabriel Garcia Marquez and the idea of magical reality, where everyday life is carried on beneath the the all-enveloping veil of an existence beyond reason.

January began with both Pauline and I having curious dry non-productive coughs that lasted for about three weeks. During the time my art class started up. Otherwise there was a general tidying up of accounts . It had been the first year on pension and with all our trips I knew I had overspent but factoring the need for the car repairs in December made the overspend a little painful! The rest of the month was quite uneventful. It was time to buy new slippers before I tripped and I discovered a new online retailer of retro dresses and petticoats that I immediately squandered money on! By and large life was continuing as it had been for the previous year. In the wider world there were rumblings about a new virus affecting Wuhan in China.

Come February and life was to change for me ... towards the end of January I had received a letter from the NHS about a further appointment for 3rd Feb in respect of the basal cell carcinoma on my nose that was diagnosed the previous June. I was then telephoned by the Dermatology Department and Kent and Canterbury Hospital to say I was now at the head of the list for minor surgery - how about the Feb 5th? There was clearly a mix-up but we resolved that I would go on the 3rd and my op would be deferred until the 12th. This was good because I had been invited to the 'Ladies who Lunch' group from Dover DC to meet for brunch on the 8th. It was good meeting up with Alison, Emma-Jane, April, Kathy and June again and I was 'incorporated' for further meetings!

Pauline took me to the hospital on the day of the op and after a 40 minute delay I was seen. In the interim another patient and his wife were complaining about a mix-up they had and the wife was writing down all the names of the staff! (As a result, after my treatment I contacted PALS to compliment the Dermatology Dept.)

Dr Jabramoski, who had seen me at the previous consultations, undertook the operation. The worst part was when anaesthetic was injected into the base of the nostril - it was extraordinarily painful. Everyone was really nice during the course of the op. I left with a large bandage over my nose and a dental cotton roll up the nostril. I took paracetamol when home, just to take the edge off the pain, which was really quite slight. After three days I was able to take the dressing off. I was surprised at the extent of the incision.

 

I had to apply vaseline two or three times a day to the scar and after 7 days went back to have the stitches removed. Dr Jabramoski stopped by to check his handiwork and the nurse removing the stitches said I was lucky to have him as he was a very good surgeon, which pleased me. Since then I have bought some bio-oil and scar reduction serum (Boots) which I apply 2-3 times daily , massaging the whole site including the flap which is still quite enlarged as of 02/05. At the end of April I received my discharge letter, the histology showing that the whole carcinoma had been removed. I was at first a little shy of taking photos of Nikki for flickr, but I've never been particularly vain about my looks and now  am not fussed. The main issue I have making sure that any blemish cover (Dermablend etc.) works under flash and doesn't draw the eye.

As my op was the day before art, I missed that and then it was half-term, so it was two weeks after the surgery before I re-attended and I was surprised that I had to point out the scar to my tutor (he's an artist ... and meant to be observant!)

Now to COVID-19. There had been news about a novel virus causing pneumonia-like symptoms in January. The wider reference was to something no worse than 'flu. As we went through February it was clear that it was not at all like 'flu, By the end of January it had spread from China  to South Korea, Japan, Thailand and Singapore. It was not until March 11 that it was formally declared a pandemic, although from the way the news developed I had taken that view a week previously. In response to a thread started in 'Just Class' by Pamela, I posted the following on 14 March in response to the briefings being given by UK Govt:

"Ever the sceptic, I fear that for the UK (I have my ideas about the US, but there's an ocean between us) the evidence is mounting that we are being hoodwinked by 'behaviourial scientists' at the behest of a government that has social engineering as its mammon. The dictum would be 'if we can convince people this is the right path, it is, whatever the outcome'. So, the idea of herd immunity ... let the virus sweep slowly across the wider community picking out the vulnerable (those who rapidly die through sepsis as their own bodies lose auto-immune control) while the rest pick up an assumed acquired immunity (something unknown in this case). (I cannot help but think of sociobiology and eugenics when I consider this). Now, we are expected not to even report symptoms of COVID-19 if it does not amount to a serious personal health issue. That will result in there being no useful information being gained about the sub-clinical spread of this disease. This seems nonsense in this age of data-acquisition on everything, but of course, 'sub-clinical' provides no obvious commercial outcomes.
At first I thought the UK government's 'nuanced' approach was good, but once the disease development (the well-known exponential) was clearly occurring in all circumstances, I found myself questioning why the UK should approach things differently and it did not take long for me to support the more universal 'lock-down' approach.

That said, the pandemic is and will continue to disrupt our lives for many months. It will cause heartache and distress for many people, taking lives and livelihoods. It will harm society, but if tackled in a truly humanitarian way, society will grow through the experience of this."

Herd Immunity - If in an epidemic the majority of the population has either suffered from a viral infection and has developed immunity or has been vaccinated, then the chance for the disease to find the minority of those uninfected/unvaccinated will reduce to zero over time, depending on the longevity of the virus outside of a host. Scientists have argued that the term is a misnomer in that 'herd immunity' applies to those that are immune, whereas those that are protected gain from the 'herd effect', which seems logical to me. The proportion of any population that needs to be immune for the herd effect to occur must depend on the infection mechanics - affected organs, incubation time, multiplication rate, auto-immune reactions and dispersal. The main point, however, is the assumption that immunity will occur.

At the time - 13th March - Patrick Vallance proposed this (and I have my suspicions that it may have been promoted so as not to contradict political advice), there was no hard evidence of immunity, or how long it might last for. It seemed to me to be a highly dangerous and reckless approach. Furthermore, Patrick Vallance stated that 60% of the population would need to get COVID-19 for 'herd immunity' to take effect. (A month earlier a "senior member of the government" told the ITV journalist Robert Peston that "If there is a pandemic, the peak will be March, April, May" and, further, that "the risk is 60% of the population getting it. With a mortality rate of perhaps just over 1%, we are looking at not far off 500,000 deaths." - source, Wikipedia) This seems to tie in with what Neil Ferguson of Imperial was saying, so I suspect that the modelling Ferguson had done had been available for some while and that accounts for Vallance's 60% figure.

Updated Section (12/05)

The basic reproduction number (rate of transmission) (R0) of COVID-19 has been put at 2-3, which with 60% immunity reduces the effective reproduction number R to between 0.8 and 1.2. However, as knowledge about COVID-19 increases, so it seems does its R0 value. One estimate is that R0 is nearer 5.7 which requires 82% immunity to take the R figure to 1 [ R = R0 x, where x is the % susceptibility].

Even while R0 was regarded as 2 - 3, it was the 500,000 deaths that made Johnson suddenly drop 'herd immunity'. Now, if a 1% mortality rate of 60% of the population results in 500,000 deaths, for 82% this would rise to over 680,000.

Clearly, the original advice was the wrong advice at the wrong time.

Now, while 'lockdown' may be easing, it appears that the virus is re-appearing in Wuhan where it is intended to antigen test the entire population of 11 million in ten days.

Another matter which continues to annoy me is the lack of tracing early on and I wonder whether this is because the Govt was still partly wedded, philosophically, to the idea of letting the virus run riot through the population to achieve the unholy grail of herd immunity. Now, in May, vaccine work is well underway and a drug used in speeding recovery in Ebola outbreaks - remdesivir - may have application for COVID-19. It can only be better than the disinfectant or hydroxychloroquine as promoted by the POTUS.

This week the issue of asymptomatic (i.e. sub-clinical) COVID-19 is coming to the fore as there is the ability to mass test for the virus antigens. It is thought that this could be 40-50% of the population. Now, if immunity is conferred through asymptomatic COVID-19, then the 60% figure is getting close and the pressure to reduce social isolation is sensible, but there is still too little known about the quality of any immunity and there is widespread talk of 2nd and 3rd waves. It would seem that both China and Singapore have experienced such. And what if R0 is 5.7? Untimely or careless  cessation of controls could cause a far greater chaos.

Doubtless, I shall return to this, but how has the pandemic affected me?

Concerns about exposure to COVID-19 began in earnest in early Feb when I was asked about risk at my dentist. By March 15th I was concerned about shopping so ordered a delivery from Ocado. The earliest slot was a week later (usually it is 24 hours). That was the last online order I was able to make. Panic buying of loo paper started in early Feb in Hong Kong and by early March (reports from the 4th) people across the UK were rushing to buy loo paper, pasta and rice. Later it became eggs, flour and instant yeast as people started home baking under social isolation (lockdown). Now, on 2nd May, baking goods remain in short supply. I found two online suppliers of organic bread flour at 70% more than my usual supplier!

The country, the world, is in deep crisis both in terms of health and economy. The inequality that we all know of but ignore is being exposed by the disease. Will the world look the same after COVID-19? There is evidence that pollution has decreased and wildlife is more active as there are less people and less vehicles about which should add weight to conservation concerns. POTUS is frantically trying to blame anyone but himself for the virus; currently he has his eyes set on China (he has already blamed WHO for being China-centric). Anything or anybody to help him get re-elected. The simple fact is that in January WHO stated it was a zoonose. It is believed to have been contracted via the wet market in Wuhan, possibly from pangolin, although the coronavirus appears related to one occurring in bats. If Trump loses, there is a chance that politicians may consider less harmful ways to benefit their electorate. I may write on zoonoses later.
 
Pauline came to stay at the cottage mid-March, but has been going back to her flat for post and so has taken on the role of shopping. Since mid-March I have been out 3 times, twice to the farm shop as I needed compost for the greenhouse plants.

All our trips up to October have been cancelled or postponed. We are booked for W Ireland next year, and we have made a booking for Dartmoor in October when social isolation should have eased. Pamela and I are skyping, sometimes with Amanda and we've also skyped with Gia and Penny which has been very nice. My art classes are back up and running using Zoom. We had virtually no rain in April so I spent a lot of time in the garden getting things under control again and have plenty of veg growing in the greenhouse and also outside. I even managed to get the old swing seat back into operation although mice wrecked the soft furnishings which had to be replaced. I dress about every other day, primarily to give my face a rest inbetween times and have been buying things in the sales. Most of the non-food things I usually buy are available but sometimes with a slight delay. Annoyingly, a wig I ordered was lost by the courier but the wig supplier replaced it. I bought some hair clippers and am cutting my own hair for the time being.

TG matters: I tend to keep well away from all the 'trans' debates. It is no different from when I left the Angels with internecine warfare between different egos, but with the rise of the right wing in Europe, I may write something on that.