Tuesday 31 March 2020

Coming Down the Tracks

Mass testing means lower fatality rates from coronavirus because it allows detection of Covid-19 even in patients who suffer few or no symptoms, and who have a much better chance of survival.


The nose and the back of the throat are the two sites where the virus replicates. Swab tests are taken to the pathology lab and used to match the genetic material captured with the genetic code of Covid-19.


Medical staff taking the samples need to wear personal protective equipment including gloves, gowns, masks and face shields.. I was horrified to hear from a friend working as a hospital doctor that they are short of these PPEs. But never mind because Boris Johnson assures us that mass testing for Coronavirus is ‘coming down the track’ and will be taking place ‘as soon as possible’.


As I wrote yesterday, pathology labs in Germany have been conducting about 160,000 coronavirus tests every week. In the UK they average less than half that. And the pathology labs which undertake all this have been undergoing privatisation for over twenty years.


The Tony Blair / Gordon Brown governments reduced the number of hospitals that had their own pathology services and initiated their privatisation. Under the ‘hub and spoke’ model NHS trusts were encouraged into partnerships with private companies.


Pathology Clinitician, Denise Cooke, at Frimley NHS Foundation Trust has said, “The big difference with an NHS-led pathology service is the add-ons you get with it … So you absolutely get a clinically-led service and that is not something you have to contract for or buy, that is just the nature of the beast … On top of that you get all the other things the NHS offers; so there is a very supportive training and education programme … And then there is the ethos of it. The public sector is about doing good for the public, it is about making good use of taxpayers’ money for the public good … I think there is a different ethos in the private sector … I’d say 99.9% of people working in NHS pathology don’t do it for the money – they have some connection with the NHS and what it strives for and its reason for being.”


Here are just a few of the private companies involved today with our pathology labs:


Viapath (Serco) who have been found to overcharge the NHS for diagnostic testing amid allegations of cost-cutting and clinical failings. Senior consultants have claimed that staff cuts and a lack of investment since privatisation have left some laboratories close to disaster. One claimed that Viapath had an “inherent inability… to understand that you cannot cut corners and put cost saving above quality.”


Integrated Pathology Partnerships who were accused by Public Health England of running NHS labs with quality weaknesses. They concluded that: 'A number of working practices, particularly within the laboratory, compromise service quality and potentially patient safety'.


Synlab who were excluded from providing pathology services to Royal Free London and UCLH as the company lied - the company said it was in the process of developing a laboratory close to the two hospitals which would meet the requirements of the tender, but this was not true.


Other private companies involved today in NHS labs are, Alliance Medical, InHealth, Health Services Laboratory, Sodexho, Life Healthcare, The Doctors Laboratory Ltd and Mediscan Diagnostic Services. There are more.


A survey of 103 histopathology departments conducted in 2017 by the Royal College of Pathologists, found that only 3% said they had enough staff to meet the current clinical demand. 45% of departments had to outsource work, while half of the departments were forced to use more expensive temporary workers.


I worry about what is really ‘coming down the tracks’.

Sunday 29 March 2020

German Tests, Johnson in Negotiation


The coronavirus crisis has hit Germany with full force. Infections are increasing rapidly with schools, factories and bars closed across the country. According to data from Johns Hopkins University, there were 13,979 coronavirus infections in Germany on Thursday afternoon, (19 March) more than in any other country except China, Italy, Iran and Spain.


But Germany has only registered 52 deaths (20 March). Neighbouring France, by contrast, reports 243 deaths. Spain has had 803 deaths. The US, the UK and Italy all show case fatality rates significantly higher than Germany.




In Germany there have been a high number of tests with laboratories conducting about 160,000 coronavirus tests every week.


Mass testing means lower fatality rate because it allows detection of Covid-19 even in patients who suffer few or no symptoms, and who have a much better chance of survival.


Experts also point out that Germany now has the chance to prepare for a surge in serious infections, with hospitals across the country expanding intensive care capacity and boosting staff numbers and with a government buying up as much critical equipment as it can.


Meanwhile here in the UK Boris Johnson has set our minds at rest by announcing yesterday ( 21 March) that good stuff is on its way. 


“to give you an idea of what is coming down the track, we’re in negotiations today to buy a so-called antibody test, as simple as a pregnancy test which can tell whether you have had the disease and it’s early days, but if it works as its proponents claim, then we will buy literally hundreds of thousands of these kits as soon as practicable. Because obviously it has the potential to be a total game changer.”


So for the UK it is ‘‘negotiations’. ‘early days’, ‘as soon as practical’ and ‘potential’ game changers.


We have no idea how the Coronavirus epidemic will develop over the coming weeks / months. We can say that since 2012 there have been a 120,000 deaths in the UK due to austerity policies.


Information above comes from a FT article which is is here:

and from the Guardian which is here:


Boris Johnson is neither here nor there, but with his train set in La La land.


Saturday 28 March 2020

Rough Musik


Barcelona residents in Coronavirus lockdown bang pots and pans from their windows and balconies. On 18 March protests were being held across Spain to demand that Felipe VI's father, King Emeritus Juan Carlos I, donate more than 100 million Euros to the public health authorities amid the COVID-19 outbreak, an amount he reportedly received as a donation from the Saudi monarchy.


This comes from a tradition known in this country as ‘Rough Musiking’ - raucous noise used in protest against kings and queens, landlords, tax collectors and other oppressors of the people!


I remember helping organise the banging of drums, bells, cymbals and other percussion instruments outside Westminster Cathedral when Tony Blair was giving a ‘faith’ lecture there.


Who would you like to ‘rough musik’ while we are in our Coronavirus lockdown? Any ideas of who should donate their ill-gotten gains to the NHS?


Watch Barcelona protest 

Friday 27 March 2020

Upward & Downward - a New Science


Boris Johnson speaking on 15 March 2020
We are not, repeating not, closing schools now. The scientific advice is that this could do more harm than good at this time.


Boris Johnson speaking on 16 March 2020
We think it’s much better that we keep schools open for all sorts of reasons.


Boris Johnson speaking on 18 March 2020
We think that now we must apply downward pressure on that upward curve by closing the schools.


Every time Johnson talks about his government policy on Coronavirus he repeats these three words, “The scientific advice.”


What is this newly discovered science of ‘upward / downward curves' children? Put your hand down Johnson. You haven’t a clue.


Thursday 26 March 2020

Wash your hands to 'God Save the Queen'


“The United Kingdom has an enviable reputation for resilience. In a rapidly changing world, we are at the forefront of embracing new opportunities and seeking innovative solutions to emerging problems.” Foreword to Cabinet Office National Risk Register of Civil Emergencies, 2017


In the three years since its publication let us examine the innovative solutions to the most recent ‘emerging problem', the COVID-19, Coronavirus outbreak.


VENTILATORS: These assist respiratory functions, pumping oxygen into the blood for vital organs. They are the main supportive treatment for critical stage COVID-19 patients.


Health Secretary, Matt Hancock said he could not make guarantees that everyone who requires a ventilator will get one, saying: “We don’t make guarantees in healthcare”.


Dr Chaand Nagpaul, Chairman of the British Medical Association says UK’s lack of ventilators “is a result of a decade of under-funding”.


Former NHS trust chairman Roy Lilley has said, “I mean we’ve seen this coming. It’s pretty obvious we were going to need more ventilators and somehow or other, either we’ve been left flat foot and haven’t started to buy them quickly enough or we’ve tried to buy them and they’re just not there.”


HOSPITAL BEDS: Chairman of the British Medical Association, Dr Chaand Nagpaul, said the UK has about “a quarter of the critical care beds that Germany has and that the country’s “starting position unfortunately has been far worse than many other of our European nations”.


Europe is the third biggest manufacturer of hospital beds after New Zealand and the USA. Former NHS trust chairman Roy Lilley said “This is capital equipment and the hospitals won’t have been buying them”. He doubted European producers would sell to the UK now we are leaving the EU.


PROTECTIVE CLOTHING: The Times reports that, “frontline hospital staff fear that doctors and nurses will die because of NHS guidance that they do not need to wear full protective equipment when caring for virus patients.”


TESTING: The World Health Organization has criticised the approach of countries like the UK that are not prioritising testing, with its director General, Tedros Adhanom, saying “you cannot fight a fire blindfolded … test, test, test”. The Guardian reports that a junior doctor in an emergency assessment unit has started a petition called “Test frontline NHS staff for Covid-19 as a priority”, which has so far attracted nearly 700,000 signatures.


The UK government’s chief scientific adviser, Sir Patrick Vallance was asked if the UK should have mass testing on the scale of South Korea which has tested more than 250,000 people out of a population of 51 million, and is bringing infections down. He replied, : “I think we need a big increase in testing. That’s what I’m pushing for very hard.”


PRIVATE HOSPITALS: Spain and Portugal have led the way by requisitioning private hospitals, their equipment and staff. The UK are going to pay £2.5 million a day to ‘buy in’ these facilities.


LOSS OF EARNINGS: In the UK those who have lost their incomes are entitled to £94 a week. The Irish government is giving workers who have lost their incomes the Euro equivalent of £203 a week. The generous UK ‘scheme’ doesn’t even cover the many phony self-employed. Firms like DPD, a delivery company, is insisting that employees who self-isolate will still have to pay the costs of renting vans and equipment. And have I mentioned the homeless? It’s impossible to voluntarily self-isolate if you are sleeping on the street. The state should requisition hotels for the homeless. There they can be be fed, kept warm and offered medical assistance.


CLOSING SCHOOLS: The government’s reason for keeping schools open is that working parents will be deprived of the free childcare they provide. Schools across Europe are closed. In Boris Johnson logic it is better for children to travel to school, mix with each other, come into close contact with dozens of adults and spread the virus.


If Jeremy Corbyn were PM today millions would feel more secure. Even journalists like Robert Peston who spent years attacking him is now making the case for something resembling a socialist response to the crisis.


“ ‘Community organising’ is one of the platitudes frequently offered when someone is bereft of political ideas. It is hard to do and often very dull. This time it is different.” As one Tory minister put it to Peston, these principles imply that Boris Johnson will almost certainly have to oversee a Government that for a good year or maybe longer will look quite socialist. The Minister added, 'We'll find ourselves implementing most of Jeremy Corbyn's programme'.


Wednesday 25 March 2020



Boris Johnson told business leaders yesterday that the effort to manufacture more ventilators could be called “Last Gasp’. Meanwhile the company ready and willing to make millions of them has not received one order from the NHS. What a joker.


The ‘government’ is going to pay over £2.5 million a day to use private hospital beds. Meanwhile the Spanish have requisitioned them. This means the private health companies will make a profit out of the pandemic. Coincidence or planned?


Theatres are ‘advised’ to close but not ordered to. This means they cannot operate insurance cover and many smaller venues and theatre companies will go the wall, but hey a business opportunity for new property development. Coincidence or planned?


The UK is second from bottom in Europe for level of support to ill workers. In France, employees can exercise what is known as “the right of withdrawal” from work by walking off the job if they believe their health and safety are at risk, without having wages docked or facing punishment. In the UK no such luck with just £94.25 a week sick pay.


Meanwhile non-tax payer Richard ‘hold em to Ransom‘ Branson asks for £billions as airline ‘Coronavirus compensation’.


As the Italians say (who are increasingly on strike over all this) BASTA - enough. My Jewish friends would add ‘already’.
Keep well and if you are able to, don’t get upset - organise.


Need more information than you can get from MSN. Here are a few websites/ Facebooks for you. Twitter is also a useful source of information and debate











and this US website



Tuesday 24 March 2020

Cummings is our Cardinal Richelieu


William Hannage, Professor of Epidemiology at Harvard University, says of the UK, “Your house is on fire, and the people whom you have trusted with your care are not trying to put it out ….the UK government has inexplicably chosen to encourage the flames, in the misguided notion that somehow they will be able to control them. I assumed that reports of the UK policy (on Coronavirus) were satire – an example of the wry humour for which the country is famed. But they are all too real.”


This fire is taking place while the Cardinal Richelieu of the Boris Johnson regime, Dominic Cummings, sits at the centre of government policy.


Cummings wrote in a blog in 2016 that he is 'particularly interested in public health and the field of epidemiology … It is already the case that farmers use genomes to make predictions about cows’ properties and behaviour … It is already the case that in vitro fertilisation can select the egg which will be most advantageous with the highest prediction for IQ.’


These are the thoughts and words of Boris Johnson’s senior adviser.


They say judge a man by his friends. Cummings had Andrew Sabisky appointed as his subordinate. A step too far when it emerged that he had made comments in support of eugenics, and the relative intellects of black and white Americans.. He resigned.


But Cummings admits to a strong continuing friendship with Stephen Hsu, a theoretical physicist who is currently searching for an intelligence gene. Even though mainstream science has pretty much scrapped the notion that race has any kind of biological basis long ago, that hasn’t stopped Hsu from trying to link intelligence with race .


So Cummings, Sabisky, Hsu and we must assume Boris Johnson, are eugenicists, believing in the practice of selection of ‘desirable’ traits for the ‘improvement’ of humans.


And today their beliefs lie behind the “Herd’ policy of allowing the Coronavirus to take its course and thereby dictating the outcome of your and my fate.


Anthony Costello, Professor of International Child Health and Director of the University College London Institute for Global Health, questioned the tactics behind the ‘Herd’ policy and argues they are against the policy set down by WHO. He tweeted a series of questions showing scepticism, including: 'Will it impair efforts to restrict the immediate epidemic, and cause more infections and deaths in the near term? He also questioned whether coronavirus causes strong herd immunity or is it more like flu where new strains emerge each year needing repeat vaccines?


We like to criticise China as a totalitarian regime but there the epidemic has been contained after seven weeks of intense national effort, and by NOT following the ‘Herd Eugenicists’.


I am not happy with Cummings and his friends having any say in my possible mortality. Are you?


Monday 23 March 2020

Medics Speak Out


Here are a few comments from leading medical professionals about the Coronavirus crisis.


The chairman of the British Medical Association, Dr Chaand Nagpaul ... "Our starting position unfortunately has been far worse than many other of our European nations – we have about a quarter of the critical care beds that Germany has, as an example, so it’s really critical, it’s really important that we now see transparently what plans the government has to expand that capacity … And one of the most immediate priorities of course is we don’t have enough doctors. Before the outbreak we were 10,000 doctors short, so we’re very worried and the doctors I represent are very concerned that they don’t, for example, have adequate protection.”


Professor John Ashton, a former regional director of public health for north-west England ... “Right at the beginning of February Hong Kong adopted a total approach to this, which is what we should have done five weeks ago ourselves. They took a decision to work to three principles – of responding promptly, staying alert, working in an open and transparent manner … Our lot haven’t been working openly and transparently. They’ve been just dribbling out stuff. The chief medical officer only appeared in public after about two weeks. Then they have had a succession of people bobbing up and disappearing. Public Health England has been almost invisible … Boris Johnson should have convened Cobra himself over a month ago and had regular meetings with the chief medical officer with the evidence. The thing should have been fronted up nationally by one person who could be regarded as the trusted voice and who could have been interrogated regularly. That’s not happened … We have a superficial Prime Minister who has got no grasp of public health … Our lot are behaving like 19th-century colonialists playing a five-day game of cricket ...This virus will find the weak points. You can’t just plan this from an office in Whitehall. It’s pathetic. The government doesn’t seem to understand classic public health. You need to be out and about. You need to get your hands dirty – though preferably gloved and using frequent gel ...The hospitals are full at the moment, A&Es are full, beds are full, intensive care is full … there will not be enough intensive facilities and people will have to be home-nursed … What the government should have been doing over these last weeks, which they’ve thrown away, is to encourage neighbourhoods, communities, supported by the local public health directors and a joined-up NHS … They should have been much clearer, sooner, about making it clear that people shouldn’t be travelling so they could cancel their holidays and get their money back on the insurance. They haven’t done any of that. Who’s going to look after elderly people – stop them having to go out, do their shopping for them? People should have been doing that planning – they should have been pointed in that direction by the government. There’s been no discussion about that at all.”


Dr Richard Horton, Editor The Lancet .... warns that we risk sleepwalking into a hurricane as officials delay their response to an escalating crisis. He said Health Secretary Matt Hancock and Boris Johnson “claim they are following the science, but that is not true … The evidence is clear. We need urgent implementation of social distancing and closure policies. The government is playing roulette with the public. This is a major error.” He goes on to provide perspective. “Coronavirus has saturated the attention of politicians, policy makers, journalists, and even medical journal editors for several months now. There seems to be no end in sight. But while we wrestle with the difference between containment and delay, prospects for a vaccine, and the mental state of an American President who wilfully ignores the advice of his own Centers for Disease Control and Prevention, we should not forget the threat posed by other viruses. We should especially not forget HIV. There have been around 100 000 confirmed cases of coronavirus infection worldwide. Yet please don’t neglect the fact that 38 million people globally are living with HIV, including 1·7 million children under 15 years. 1·7 million people are newly infected with HIV annually. 6000 women aged 15–24 years are infected every week. Coronavirus is reported to have killed fewer than 4000 people so far. Meanwhile, 770 000 people die every year from AIDS-related illnesses. We should certainly take coronavirus very seriously indeed. But we must also put this new pandemic in perspective. So far, we have not.”


Dr. Dominic Pimenta, cardiologist and author ... “The N.H.S. has never been in a worse state going into something like this ... The dominoes have been stacked for 10 years. It wouldn’t have taken much to tip them over.”


Dr. Nick Scriven, former president of The Society for Acute Medicine ... “We’re already at maximum capacity and clearing out beds as best we can.”


Dr. Ganesh Suntharalingam, President of the Intensive Care Society ... “We do have the advantage of a unified health care system, but we’re also starting from further behind the start block than other countries because we historically have fewer intensive care beds per population, and they tend to be more full.”


My friend Dr Irial Eno writes ... "I don’t want to be alarmist or spread panic, but there are some really important things about the coronavirus that the public aren’t not being told, and I fear that as a country we are not acting quick enough and are sleepwalking into a disaster. The following are my opinions but are supplemented by the opinions or experiences of experts in this field.  


Hundreds of scientists have already criticised the government's strategy, with 240 signing an open letter: https://www.ft.com/con…/f3136d0a-663e-11ea-800d-da70cff6e4d3, and hundreds of behavioural scientists have said the issue of 'isolation fatigue' is not a reason to delay urgent isolation measures:  https://sites.google.com/view/covidopenletter/home


It is important to start by saying that for young and healthy people, the virus will most likely be either asymptomatic (you will not feel unwell) or resemble a flu. It is not us who are at risk. It is the older and unwell people in society who will be affected. In these groups, it is not just like the flu. In these age groups the fatality rates (‘FR’, the % of people with the infection who die) are high – data suggests the over 70s have a FR of 8%, whilst in the over 80s it is ~15%; cardiovascular disease leads to a 11% FR, diabetes 7%... i.e. roughly 1 in 10 of those infected across these groups will die.

We appear to be on exactly the same trajectory as Italy. Our cases are increasing exponentially, and we are now at roughly the same caseload when Italy began to quarantine certain areas two weeks ago. Despite the measures they took, which some considered drastic at the time, they are still completely overwhelmed.They do not have the facilities to care for everyone so are having to triage patients in a desperate way: “Patients above 65 or younger with comorbidities are not even assessed by ITU”. Read that again… they are not even being assessed. They are so overwhelmed that people over 65 or with comorbidities (other illnesses) are not even being considered for advanced treatment.

Italy has one of the best healthcare systems in Europe (public healthcare, properly funded!) and as you can see from the above series of tweets they are unable to cope with the situation they are now in.

The World Health Organisation stated yesterday: “Our message to countries continues to be: you must take a comprehensive approach to fight. Not testing alone. Not contact tracing alone. Not quarantine alone. Not social distancing alone. Do it all”. In the UK we are not doing it all, and the WHO have expressed surprise and concern about our government’s approach.

Richard Horton, editor of the Lancet (prestigious medical journal) agrees with many others across the healthcare world in stating in a series of tweets: “The UK’s policy is not evidence-based because it seems to be ignoring the most important evidence from elsewhere”; “What is happening in Italy is real and taking place now. Our government is not preparing us for that reality. We need immediate and assertive social distancing and closure policies. We need to prepare the NHS. This is a serious plea”; and, “The government is playing roulette with the public. This is a major error.”
We need social distancing now. We need drastic measures. Every day that we delay this represents a ~40% increase in the total number of cases. The number of new cases per day in the UK so far reflects this… Thursday 595, yesterday 798, today 1,140. We are right at the start of the epidemic curve and in a strong position to curtail it (see theoretical sketch attached). Without doing anything, numbers of cases will continue to grow rapidly.

Please consider the following individual actions. (Of course, for some of you, these measures will be impossible because of structural societal factors e.g. insecure employment or accommodation. This highlights more than ever the need for much wider social and political change, and we must pay attention to this need from the unfolding crisis):
- Social distancing. Don’t go to events with more than 20 people, avoid crowded places – public transport, pubs etc. This is especially important if you are older or have underlying health conditions, or if you spend time with people in this group.
- Cancel larger events/meetings.
- Do not go and visit elderly/at-risk friends or relatives.
- Try organising within your workplace to see if it’s possible to work from home.
- Stay home if you have any respiratory systems at all (cough, shortness of breath, sore throat, runny nose, sneezing) or fever or general malaise. Don’t let yourself be bullied by bosses or made to feel bad for taking time off. It is not worth the risk.
- Wash your hands a lot, or clean with hand gel if not possible. Especially important before eating/touching your face.
This might all sound over-the-top, and this is not going to be fun, but the better we deal with this now the sooner we can go back to normal. I would so much rather us be extra-cautious now than look back in several months with regret.
There are loads of beautiful acts of community solidarity, and things you can do to help out in your area, such as posting this Viral Kindness card through your neighbour’s doors.

Lastly, please make sure you are getting your information from trustworthy sources. I’ve seen so much quack science recently… false information about the symptoms of the disease, checking if you’ve got it by holding your breath, false treatment advice such as putting garlic cloves up your nose. It can be hard to know where to look if you don’t have a scientific background. Stick to sites such as the NHS for advice. I’m off work for the next few days – if you want to ask any questions I can try to help.
Stay safe, be sensible. Do it for our elders and those most at risk."


Meanwhile Richard Branson wants £3.5 billion to keep Virgin Atlantic ‘healthy’ … You couldn’t make it up.