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Thoughts from Pontevedra, Galicia, Spain

Random thoughts from a Brit in the North West. Sometimes serious, sometimes not. Quite often curmudgeonly.

Thoughts from Pontevedra, Galicia, Spain: 27 March 2021
27 March 2021 @ 11:54

Night’s candles are burnt out, and jocund day stands tiptoe on the misty mountain tops.

Spanish life is not always likeable but it is compellingly loveable.  

- Christopher Howse: 'A Pilgrim in Spain'

Covid 

One or two readers might have noticed that yesterday's Covid Overview wasn’t that of Private Eye's medical correspondent but was, in fact, reportage from the magazine itself. The real Overview is below . . . Sorry for that.

How many permissible deaths? This question is regularly answered by governments in respect of several causes, including road accidents; criminal activities; flu; cancer; obesity-related conditions; mistakes and negligence in the healthcare system; and inadequate resources in the latter. Sooner or later, this will have to be done in respect of Covid. When governments will stop acting as if they can eliminate the virus and so reduce the incidence of death to zero. Of course, they won't tell us their answer but they will, one assumes, remove most or even all of the legally-imposed restrictions and allow people to live and die, as they do in respect of other fatal factors.

After I wrote that paragraph, I read this comment: The UK, alas, is one of the most unequal rich countries where thousands of people die prematurely from all sorts of the avoidable diseases every year. So no surprise we have had so many avoidable deaths from Covid.

See the reference to obesity levels in the Overview

Another question  . . . Why are footballers still allowed to hug and kiss after goals, and managers permitted to shake hands? Do they have some immunity that the rest of us lack?

Something to ponder: Now we're starting Groundhog Year again, we are at least doing so with the benefit of vaccines and much better (though not perfect) testing. In other words, the Russian roulette that is Covid has now had most of the bullets taken from the barrel. However, unless vaccines are made available to the world, the barrel could soon fill up again with variant bullets. So, it's good to see the UK and EU agree on this and have brought the stupid Vaccine War to a quick end. One hopes.

Ooops . . . I spoke too soon. Just seen this.

Cosas de España  

Ever wondered where  CC was buried? We might know one day. When the woke brigade will probably destroy his bones. 

Among the major cases going at snail's pace through the Spanish courts at the moment - at least until such time as the statute of limitations ends it and the accused are released - is one involving an ex senior police officer - José Manuel Villarejo. Because no one in Spain can be kept in jail for more than 4 years(sic) while awaiting trial, he's been released for the moment. The case has been described as one of the most complex and voluminous in memory. So, perhaps I can be forgiven for not understanding what the hell is going  on. I believe it has something to do with corruption in the PP party, before and during the time it was in power. Involving large cash payments from major Spanish companies. And possibly involving the royal family. I'm hoping one day there'll be an Idiot's Guide to it, in Spanish or English. Me dará igual.

Cousas de Galiza

Maria's Tsunami: Days 53&54  

The Way of the World/Quote of the Week

Woke sexuality has descended into incomprehensible jibber jabber. It is entirely disconnected from reality: the reality of philosophical logic, the reality of biology, and the reality of common sense. 

English

The word legacy seems to have taken on a new meaning - previous. As in the legacy media and legacy benefits. A euphemistic use, then. 

Finally  . . . 

The sun has been shining here in Galicia for 2 weeks now. Quite possibly unusually. I blame it on AGW. For which, I can occasionally give some thanks. For small mercies.

THE ARTICLE

1. An Overview: MD, Private Eye:

A nation divided

Britain, as ever, is divided. The rich and mobil want to move on quickly from the pandemic, have already booked two summer holidays (one abroad and one in the UK, just in case) and are chuffed to bits they invested in vaccine companies. Many are breaking the rules already. They aren't remotely interested in a public inquiry, just grateful for the vaccines in more ways than one. Then there are those struggling to move on from the pandemic, either because of grief or long-term medical or economic harm, and they want answers and acknowledgement in an inquiry so we don't repeat 

the same mistakes again. The government, meanwhile, doesn't want anyone to look in great detail at why the UK has suffered 125,000 Covid deaths and counting. Time to move on and upset the nurses ... 

Nurse! The screams . . .

The government has argued since 2010 that it is better to employ more nurses on lower pay than to give existing nurses a decent pay rise. So it's not surprising Boris Johnson is doing so again, even though some of our most experienced nurses have less to spend since the Conservatives came to p0wer. In 2010/I1, the top of the band 5 pay scale for nurses was £27,534, and in 2019/20 it had risen to £30,112. After adjusting for inflation, this represents a 9% real-terms fall. 

Johnson chose to exploit photos of shattered nurses with mask-pocked faces for the "Can you look them in the eyes and tell them you're doing all you can to stop the spread of Covid- I9 poster campaign. So he can't complain if the nursing unions counter with: "Can you look them in the eyes and tell them they' re not worth more than a 1% pay rise?" With around 35,000 NHS nursing vacancies, Johnson is banking on nursing applications going up regardless, both out of inspiration and desperation as alternative jobs disappear. 

However, the key problem in the NHS is staff retention. Many staff go into the job with the best intentions but leave when they are so over-stretched they cannot provide the safe, high quality, compassionate care they envisaged when training. And they are at constant risk of suspension and litigation for mistakes made while working in such an unsafe system. Then there is the Covid risk. A larger pay rise would not change this; but given the levels of exhaustion, post-traumatic stress and long-Covid symptoms staff are suffering, it would at least have acknowledged how valued and vital their work is. 

Teachers first 

All frontline staff should have priority vaccination.. This is not because they are at higher risk of death; it's because they are moving and perhaps spreading around communities to provide essential services that would cease if they went off sick with Covid. 

This applies particularly to teachers. The welfare of children in any society should be paramount. If we foul our nest, we foul our future. Any teacher who catches Covid can't teach, so their students will fall even further behind. We should vaccinate teachers to protect children's education. This would ave the added benefit of a rewarding and reassuring those entering crowded classrooms with poor ventilation and new variants afoot.

Priority Ventilation

Schools must stay Safe to stay open. For an airborne virus, this means keeping the air flowing. In the US, the CDC (Centers for Disease Control and Prevention) has issued detailed guidance guidance for schools and childcare, urging the opening of windows, the use of Portable air cleaners and child-safe fans, and improved building-wide filtration. Heating, ventilation, and air conditioning (HVAC) settings must maximise ventilation to bring as much outdoor air into classrooms as the system will safely allow. 

The aim is to improve air filtration as much as possible without significantly reducing airflow. The use of portable air cleaners with high-efficiency particulate air (HEPA) filters is encouraged wherever possible. Activities, classes and lunches should be outdoors when circumstances allow. 

In the UK, by contrast, filtered, flowing air is not seen as a priority. The typical state-school classroom contains 31 people and has poor ventilation; and teaching periods last up to 2 hours before children and teachers leave for a break. No wonder the chief medical officer for England Chris Whitty is already predicting another surge. 

Test priorities 

THE UK government abandoned community testing at the start of the pandemic but then rebounded by spending £37bn with the aim of providing outsourced "moonshot" testing for the entire population. The Commons public accounts committee verdict is damning: "Despite the unimaginable resources thrown at this project, NHS Test and Trace cannot point to a measurable difference to the progress of the pandemic, and the promise on which this huge expense was justified - avoiding another lockdown - has been broken, twice." Test and Trace must also "wean itself off its persistent reliance on consultants and temPorary staff." 

So why is Test and Trace not delivering when the vaccination programme is? Vaccinations have the massive advantage of using an existing NHS database to trace patients, and tried and tested NHS roll-out programmes used every year for Ru. Test and Trace had to build its own database and employed temporary, outsourced staff who had never done this type of work before. Health secretary Matt Hancock's hubris and faith in technology led him to believe he could build a better app than Apple or Google, and control a highly complex and uncertain operation from the centre. 

The other huge advantage of vaccines is that people generally want one, whereas they don't want to be told they have a positive test, particularly if they have no symptoms, and be ordered to isolate at home for no (or less) money and cough up all their contacts. Many people don't answer the phone, turn their tracing app off or just don't do as they're ordered. The government keeps crowing about how many tests it does - more than any other country - but these make no difference to infection rates if you can't persuade people to do the right thing. This is why Test and Trace should have remained within the NHS and local authorities, where local experts would have stood a better chance of getting a handle on local outbreaks. 

Finally, test results can be hard to interpret. The accuracy of testing changes with disease prevalence. If you do mass testing when infection levels are low, as they are now, you get far more false results. Many - perhaps most - of the positive lateral flow test results in school are currently false, and not always being checked with a more accurate polymerase chain reaction (PCR) test. Even if that is negative, in some schools the entire class bubble is still ordered to isolate at home for IO days. This makes no sense to MD. 

Priority PPE 

In the NHS 77% of staff arc women and yet their personal protective equipment (PPE) was designed for men and doesn't fit or protect women as well, the BMJ reports. Female stalT say that goggles slip, gowns are too long, face shields push against breasts, and respirators don't fit their faces. 

Much of the most protective equipment is designed with Caucasian men in mind so BAME women often fail "fit tests" on two accounts, and have to choose between sharing powered respirators (often in short supply and inadequately cleaned), or wearing items that simply don't fit and let the virus through. Very few feel brave enough to refuse to work when staff levels are so low and patient demand so high. An inquiry is needed to see if this has contributed to staff illness and death from Covid. 

The solution - to design bespoke respirators ind PPE - is more expensive; but 3D printing is already being used to develop personalised respirators from facial scans. Globally, hospitals with the best PPE have had fewer staff deaths and less intra-hospital spread. The government must decide whether personalised PPE is a priority. 

Public fatness 

'Public health has never been a priority in the UK. We have shocking levels of obesity and this as contributed to shocking levels of death when the virus was allowed to spread. Ninety percent of global deaths have occurred in countries with high rates of obesity. No country with high death lies has less than 50% of its population overweight. Vietnam has the lowest Covid death rate in the world and the second lowest level of overweight people; the UK has the third highest death rate in the world and the fourth highest obesity rate. It doesn't prove cause and effect, but it's highly suspicious. 

In the UK, 80% of adults carry excess body fat and so are at high risk of premature death, not just from Covid but diabetes, heart disease, kidney disease and suicide. You name it, obesity increases your risk of it. It should be a priority.



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