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A very thoughtful post from Dr Caroline Hoffbrand, a GP.
“My thoughts on what the messages from government mean. It sounds vague but that’s partly because people are all in different situations, and because to someone extent people can do what’s right for them and their families within reason. Many countries have allowed people to use their own judgment rather than impose laws about lockdown.
We don’t know what a perfect plan for the UK looks like as we are in uncharted waters. Both for bringing in lockdown and for lifting it. The virus quite possibly follows the same pattern whatever restrictions or none are in place. Death rates reflect a multitude of factors including age, population density, air quality, weight, diabetes, race, genetics, vitamin D levels and no doubt factors yet to be defined.
Comparisons with other countries are hard to make as so many factors are variable including genetics which can affect how immune systems function. People keep bringing up New Zealand but it’s an almost nonsensical comparison given its small population, low population density, and isolation from the rest of the world. Just think how many Brits travelled abroad and how many tourists to the UK there were from December to March. Our international population travelling to visit family and for holidays at Xmas and half term is literally like stirring the world with a massive wooden spoon centred on London!
Some people are clamoring for tighter restrictions like in some other countries, but at the same time are vociferously against things such as ID cards, mandatory registration of change of address, or mandatory tracking of your movements which those countries use.
So what do today’s modifications to lockdown mean? I agree ‘Be alert’ seems an odd slogan. We have to be alert for unattended packages on the Tube. I think I would have gone for ‘Be sensible’.
Roughly translated it means we need to use common sense, pragmatism and learn to live with uncertainty.
It means keep your distance. There won’t be sports events, pubs, restaurants, theaters, weddings and shopping centers for now but maybe it’s ok to visit a friend outdoors.
And a few more people can go back to work.
If you compare this to your normal number of interactions with people it remains vastly reduced. No crowded tube to work, walking through city centre crowds, busy offices and hot desking, lunch in a pub, dinner in a restaurant then a concert or club but it’s ok to meet a friend for a walk.
It means that we have to stop seeing everyone as the enemy and recognize that of course it would be nice if this endless Bank Holiday paid for by the government/tax payer/our children’s economic future could continue but realistically it can’t.
Lockdown has achieved what it set out to do and last months’ social media hysteria about rationing of ventilators, old people left to die because of lack of beds etc has not come to pass. We flattened the curve and did not run out of hospital beds or ventilators, or oxygen. It was tight in places at times but the NHS was not overwhelmed and no one died as a sacrifice to rationing of care.
Lockdown affects people differently and vast swathes of the country live in tiny, unpleasant accommodations with no out door space. Many people will not survive financially, physically or mentally if things don’t start to ease up.
It means we have to start getting more of the NHS moving again. Not all, not like it was, but looking at how we can get operations done for example, as many people are suffering in pain while they wait. Some are waiting for heart operations which means that their current cardiac function is not good making them more at risk of complications of COVID-19 or other infections than they would be once the heart is fixed. These are difficult balancing considerations.
It means staying home not mixing in society is creating a new pathology, a hysteria that sees the outside world as life-threatening and everyone else as the enemy. There was always a risk if you step out the front door that you would be at risk from vehicles, nogoodniks, diseases, your own clumsiness and poor choices. There was never a cast-iron guarantee if you stepped outside the door that you would make it home alive and well. Granted this is on a whole new scale.
It means we are happy to clap NHS workers but are unwilling to do our bit (teachers refusing to go back to work at all even if adaptations are brought in like overseas and despite the evidence that children don’t seem to be dangerous vectors after all). Plenty of people have continued working throughout and not just NHS and carers: drivers, mechanics, builders, plumbers, electricians, gardeners, supermarket and grocery staff. There are people picking crops, cooking in the places you are getting take aways from etc etc so it has never been 100% lockdown.
You are scared? We’re all scared. We have to learn to live with an extra element of fear now. But we have to live. For those without added risks, it’s time to put a toe in the water. Not yet time for a swim!
It’s time to ease it a little bit more. A few more people mixing with a few more people.
But be sensible (alert does seem an odd word) wash your hands after going shopping or filling up the car or visiting your parents. Many people are already doing garden visits but taking their own refreshments etc
It’s also a reality that different parts of the country are in different parts of the curve. London was hit early and new cases are reducing but other places are not there yet. Geographical variations could be an option but doesn’t seem to be being suggested (beyond the four ‘nations’)
Stop expecting cast-iron guarantees. There are none. Stop thinking that there ever was one course of action the government / country could have taken that would have meant no one got sick and no one would die. There never was. Every death is awful and dying a lonely, maybe painful or breathless death in hospital separated from loved ones has brought previously unimaginable levels of suffering to the dying and those close to them.
Could things have been done differently? Undoubtedly. Might the outcomes have been different? Maybe. We are not through this pandemic yet. It’s far too early to draw conclusions. Countries that appear not to have been badly hit may just be earlier on the curve. Death rates? We will never know for sure because in the UK we have not tested in the community and testing is still patchy. Where I work in Hendon, like other parts of NW London, was hit early. Colleagues clearly had it but before testing for HCWs (health care workers) was brought in, huge numbers of our patients have clearly had it and no doubt many more who didn’t call us. None have been tested so don’t count in the stats.
Unless the scientists can develop a reliable antibody test and we test the entire nation apart from those who had a positive test, we won’t know how many people had it and what the 30,000+ fatalities represents. Even the death certification is unreliable as many deaths that occurred in the community early on only mentioned COVID-19 if it was suspected and it may have been listed as a cause based on clinical suspicion rather than a test, so again unreliable.
Anyway dear friends, take a deep breath as we move onwards. Try not to let your fears rule your head and your heart. Try to find some perspective and some balance. Be sensible, pragmatic, and imaginative. Be safe and don’t get swept up in hysteria.”
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Dave
Moira And Dave
“I know that you believe you understand what you think I said, but I'm not sure you realize that what you heard is not what I meant.”
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