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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: 20.7.21    
20 July 2021 @ 08:21

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'

Note: I’ve been posting my blog in 3 places in the last year, including here. I’ve now reduced this to 2 and, in the near future, will be confining posts to one site on Wordpress. This is the link, if you want to start using it now.  Maybe sign up for email receipt, as this helps me understand my readership.

Cosas de España/Galiza  

How to get your Covid passport here in Spain

A few extracts from the article on the siesta I cited yesterday, pertinent to the crazy Spanish horario:-.

- A light lunch and a heavy evening meal: To a certain extent, this is catching on in Spain, mainly in big cities where it takes too long to get home and back and where opening hours for offices and shops tend to be longer, frequently all day, meaning midday breaks are taken in shifts and cannot afford to be more than an hour or two for this reason.

- In bigger towns and cities, and in tourist-heavy areas, the midday shutdown might only be from 14.00 to 16.00, if at all, but in smaller towns, it can be from 13.00 to 17.30, whether or not there is any practical need to do so, whether or not there is any practical need to do so.

- For some time now, various economists, health experts, sociologists and politicians have been calling for a more northern European-style work schedule, since not returning home until night-time makes the work-life balance extremely difficult, especially for families, and even with an extended break in the middle of the day, it is tiring for employees to be starting work at around 09.00 and not finishing until 20.30.

- Whilst it is often argued that the long lunch break and siesta are a 'Spanish tradition', they are more a habit than part of a custom or culture, and it is just as likely that future generations will adapt to a light lunch and early finish in the same way other nations have done, since practical considerations, like having to travel a longer distance to get to work, forced them to alter their routine. The pandemic and opening restrictions thrust similar changes on Spain.

An interesting map from a local paper, in an article informing us of the growing importance of the Pontevedra port of Marín to the world's drug barons:-

[Go here to see the foto I'm not allowed to post here]

I set off for the kilometre walk to my pilates class at 8.30 yesterday but had to return to my car to get my reserve mask there. But no mask. No problem, I thought, as I knew I'd pass 3 farmacias en route to the sports centre. As I did, plus another 2 within sight. All closed. As was a 6th I detoured to. All in vain, since - even when one of them opened at 9 - I had to wait behind one of those customers who regards a chat with the pharmacist as essential to their good health. By the time I got a mask, it was too late to finish the walk to the venue and join the class. So, I had a coffee, read the local and national papers before walking back to my car, parked at the bottom of my hill across the river.

En route, I passed a young woman remonstrating with her 3 year old for dropping her little umbrella. ¿Que pasa, coño? she shouted at the child. Which is roughly equivalent to What happened, arsehole? Only worse It might be hard to believe but, to motherland speakers of Spanish, c**t is a term of endearment. South Americans are generally much less vulgar, eschewing the palabrotas so common here in Spain.

As I sat outside the café, I twice enjoyed one of my little pleasures - seeing cars arrive at the top of a side road where the single direction of traffic was changed at least a year ago. Resulting in a 6-point U-turn back to whence they came. I suspect that the culpability lies with their satnavs(GPSs).

[Go here to see the foto I'm not allowed to post here]

In the UK, temperatures this week are in the high 30s, leading the Met Office to issue its first ever Extreme Heat warning. Here in Pontevedra it was 37/38 on Friday and Saturday but only 21 for the first 2 days of my daughter's visit from Madrid. But it might rise to 25 today, when the sun finally clears the persistent low cloud/mist by early afternoon. I feel a bit sorry for the vacationers from the capital and the South. They surely didn't expect the sought-after coolness to be this cool, even if they were aware of the capriciousness of our Atlantic seaboard climate.

The UK

A couple of heavy-ish articles:-

1. As we see a spike in non-Covid related deaths - a result of reduced general healthcare services offered by the NHS - we will eventually reach a situation where dealing with Covid indirectly becomes a more important cause of death that the disease itself – if we are not already there. More here.

2. From a British doctor who is an NHS respiratory consultant and works across a number of hospitals: I work in an NHS Covid ward – and I feel so angry. But it's hard to summarise exactly why I feel so angry. See the article below.

The Way of the World

For those seriously interested in the dialogue around transgenderism - The Sex Deracination gambit.

Spanish

Una siesta sentimental - A euphemism, I believe.

Finally  . . .

The recent British Open golf championship was won by a young American called Collin Morikawa. So, an extra L compared with my forename. But not here in Spain, where it's rendered Colin in the press. Which is a tad ironic, as when I give my name to receptionists and bureaucrats here, they usually write it as Collin. As my first surname, by the way. Since David is my first forename.

 

Note: If you’ve landed here looking for info on Galicia or Pontevedra, try here

THE ARTICLE  

I work in an NHS Covid ward – and I feel so angry. 

It is hard to summarise exactly why I feel so angry. While the third wave is clearly under way, things are definitely different this time around. For the equivalent case numbers, hospitalisations are far lower, and people overall are less unwell. Vaccines have made the difference.

Many of our admissions have not been vaccinated, however. Some want to achieve “natural immunity”; it is unclear whether they realise that the only way to do this is to get the disease instead. Another wants “to see some real data”, as if all the information assessed by the regulatory authorities before approval, and the clear real-world data about the reduction in cases, is somehow fabricated. Someone’s friend got some side-effects from the vaccine so she didn’t have it; guess which one of them ended up in hospital. Most of these people have the decency to look sheepish, or to describe themselves as “one of those idiots”.

Not all, mind: some remain defiant as they are wheeled off to intensive care, and their families deny that Covid itself exists even as their relative is placed on a ventilator.

How can you even begin to have a conversation with that as a starting point?

Conversely, well over half of our Covid admissions have been vaccinated. These patients are a mix of ages, and are less unwell than they used to be, for the most part; very few need admission to intensive care after vaccination. The vaccination clearly works, but is not 100% effective in all people. This much we knew.

There are other problems brewing now. Our paediatricians are seeing a rapid increase in cases of RSV, a seasonal virus that in severe cases causes respiratory distress in children. Children have been mingling much less recently and immunity has dropped, so cases are rocketing. Conversations have already begun about how we are going to share vital equipment – ventilators, Cpap machines – between adults needing it for Covid and children for RSV.

On top of this, other respiratory viruses are starting to rise again in adults. We are starting to see cases of flu, parainfluenza and others that have been almost entirely absent for months. This creates a huge headache as we try to isolate different cohorts from one another. Two cohorts were hard enough – Covid and non-Covid – but now that we have different Covid variants and patients with other respiratory viruses to isolate from one another, we are rapidly running out of side rooms and space in the hospital to do so.

It is hard not to watch the steeply rising curve of daily cases with horror. It is obvious that we are not even near the peak. Current predictions seem to be that this will not occur until later in August, or September. The number of cases we have in hospital is doubling every 14 days or so. At the current rates, that suggests we will need to open new wards and restart our Cpap unit in a couple of weeks. Just the thought makes me feel tired.

We are all still exhausted. Levels of unhappiness among staff are high; I know several consultants who have gone off work with stress and many others who are receiving treatment for mental illness. Planning childcare is a nightmare on the shifting sands of unexpected isolations in children and their caregivers, and this increases the strain. Interestingly, I have sensed an increasing openness and willingness to discuss mental health that has long been lacking for doctors and perhaps this is one small silver lining.

Meanwhile, however, our junior doctors are so close to the edge that minor events regularly bring them to tears. Their training has been hugely disrupted through this, and they have high anxiety levels about the future. The most junior were fast-tracked through to qualification last year and have never worked in a hospital without Covid. They have missed out on so much of the camaraderie, shared experiences, nights out and human contact that formed my coping mechanisms during my first few nervous months as a doctor. No wonder they are struggling. I want to tell them that this is not normal, that it won’t always be like this, but reality bites: it may well be.

We are undoubtedly in for a horrendous winter that is likely to surpass any previous years in terms of the complexity and intensity of work over a prolonged period. The burden of long Covid and patients left broken and damaged after severe Covid infections is not decreasing and will need to be provided for alongside everything else. Vaccines have clearly weakened the link between cases and hospitalisations, with people not getting as ill as they were before, but if cases hit 200,000 a day even a small proportion of these could bring hospitals to their knees. Meanwhile, we are also about to allow all the other respiratory viruses to again flourish in a population whose immunity will be relatively depressed by 18 months’ reduced exposure to them.

In this context, it is hard not to feel undermined by the relaxing of all restrictions. Any pretence of “data not dates” or “following the science” is nonsense; why not hold on a bit longer? I appreciate that we will all have to “learn to live with Covid”, but surely we must continue to mitigate risk, and opening up in the face of exponentially rising case numbers is idiotic. We have to learn to live with the risk of getting run over; that doesn’t mean that we cross the road in front of an articulated lorry. Surely we can at least wait until the curve of new cases is flattish, not steepening, and hospitalisations are not rising? And give a few hundred thousand more vaccinations while we’re waiting?

For the most part, I think that the patients I see have been following the rules. But if people are allowed to do something, they will. And this is what makes me most angry. When rules are relaxed, people will quite reasonably relax their behaviour. Urging caution thereafter is as nonsensical as asking people to “stay alert”. This is a pernicious, contagious, invisible virus that a person can spread for days before they even know they have it. I have met tens, if not hundreds, of careful, cautious, law-abiding people who have been infected despite following the rules. All that the current verbal gymnastics can do is to shift the blame away from those in power – who have access to a wealth of data, the whole picture – on to ordinary people who don’t have the information to make an informed decision. We need to be given simple, clear, safe rules to follow, however unpalatable that may be. It is craven and disingenuous to do otherwise.

Meanwhile, the mood in the hospital is one of weary resignation. We watch the unfolding case numbers with horror and try to carry on as usual. It is hard to escape the feeling that, once again, we will be bearing the brunt of our leaders’ mistakes. 



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