Echoing Rudolf Virchow, frequent bedfellows. The spectrum includes the UK.
A doctor at Shanghai No 10 Hospital said staff had been instructed by the city’s health commission to limit Covid diagnoses. “We are advised to label most cases as respiratory infection,” the doctor said.
“What is certain is that the government can’t afford to treat everyone for free.”
China’s National Healthcare Security Administration said on Saturday that it would fully cover hospitalisation for Covid patients, but continued to exclude complications. Hospitals are also under pressure to reduce medical costs after the national insurance fund was strained by the costs of the sprawling zero-Covid apparatus.
In the eastern city of Hangzhou, Frank Wang, a marketing manager who bought a Covid insurance plan early last year, was refused proof of illness after he developed lung and kidney infections after testing positive for the virus.
“The hospital made it clear that Covid proof is not easy to obtain as the disease diagnosis has been politicised,” said Wang, who paid more than Rmb20,000 for treatment. “That makes patients like me a victim.”
The deserving and the undeserving sick redux; more crony capitalism.
Paul Taylor LRB 2002
The story of the UK is not the whole story of the global pandemic, but it is worth taking a moment to look at the local specifics. We could take as a benchmark the All England Club, which manages Wimbledon. In 2003, having learned from the experience of Sars, Wimbledon began paying around £1.5 million a year to insure against the cost of a pandemic. As a result, when Covid hit, the club trousered cheques totalling £174 million to cover the cost of the cancelled 2020 tournament. That is what competent governance looks like. What would the UK response have looked like if the All England Club had been in charge? What would the Wimbledon number – the death toll assuming competent government – have been?
Instead we are left with:
In other words, the UK is crowded, old, fat, cramped, unequal and much visited, and all of those things increase the impact of Covid.
The following is from Pulse, a magazine that is aimed at GPs. My point is not so much about the specifics but a more general point.
Professor Spector said cases were rising exponentially and people who have only had one vaccine dose should not be complacent.
The UK really does now have a problem and we’ll probably be seeing, in a week, 20,000 cases and by 21st June well in excess of that number,’ he said. ‘Most of these infections are occurring in unvaccinated people. We’re only seeing slight increases in the vaccinated group and most of those in the single vaccinated group,’ he said.
He goes on to say:
Covid is also acting differently now. Its more like a bad cold in this younger population and people don’t realise that and it hasn’t come across in any of the government information.This means that people might think they’ve got some sort of seasonal cold and they still go out to parties and might spread around to six other people and we think this is fuelling a lot of the problem.
The number one symptom is headache, followed by runny nose, sore throat and fever. Not the old classic symptoms. We don’t see loss of smell in the top ten any more, this variant seems to be working slightly differently.
He advised people:
who were feeling unwell to stay at home for a few days, use lateral flow tests with a confirmation PCR test if they get a positive result.
Now comes the boilerplate Orwellian response from the Department of Health and Social Care
[A] spokesperson said: ‘Everyone in England, regardless of whether they are showing symptoms, can now access rapid testing twice a week for free, in line with clinical guidance.
Experts keep the symptoms of Covid-19 under constant review and anyone experiencing the key symptoms – a high temperature, a new continuous cough, or a loss or change to sense of smell or taste – should get a PCR test as soon as possible and immediately self-isolate along with their household.’ [emphasis added]
On September 1, I’m scheduled to teach 170 students in a windowless room. After 12 sessions of 3 hours in the sealed room with 170 people, 50 of them will then disperse back to their 20+ native countries for the holidays. If the producers of Contagion decide on a sequel, I have an idea for their opening scene.
Someone in your family has fallen ill with a respiratory infection that has already killed large numbers. Your small house means that you do not have enough room to quarantine them. Your have little money, and the hospitals are full. You contact the local public health authority.
Not to worry, you are told: A crew will be by shortly to set up a sturdy, well-ventilated, portable, tiny house in your yard. Once installed, your family member will be free to convalesce in comfort. You can deliver home-cooked meals to their door and communicate through open windows — and a trained nurse will be by for regular examinations. And no, there will be no charge for the house.
A fascinating story by Naomi Klein in the Intercept. Seemingly from a time when government knew what government was for.
This is not a dispatch from some future functional United States, one with a government capable of caring for its people in the midst of spiraling economic carnage and a public health emergency. It’s a dispatch from this country’s past, a time eight decades ago when it similarly found itself in the two-fisted grip of an even deeper economic crisis (the Great Depression), and a surging contagious respiratory illness (tuberculosis).
Henry Miller died a few months before I started medical school in Newcastle in 1976. At the time of his death he was VC of the university having been Dean of Medicine and Professor of Neurology. By today’s standards he was a larger than life figure. I like reading what he said about medical education, although with hindsight I think he was wrong about many if not most things. But there was a freshness and sense of spirited independence of mind in his writing that we not longer see in those who run our universities (with some notable exceptions such as Louise Richardson). In the time of COVID we should remember the costs of conformity and patronage.
It would be naive to express surprise at the equanimity with which successive governments have regarded the deteriorating hospital service, since it is in the nature of governments to ignore inconvenient situations until they become scandalous enough to excite powerful public pressure. Nor, perhaps, should one expect patients to be more demanding: their uncomplaining stoicism springs from ignorance and fear rather than fortitude; they are mostly grateful for what they receive and do not know how far it falls short of what is possible. It is less easy to forgive ourselves…..Indeed election as president of a college, a vice chancellor, or a member of the University Grants committee usually spells an inevitable preoccupation with the politically practicable, and insidious identification with central authority, and a change of role from informed critic to uncomfortable apologist.
Originally published in the Lancet, 1966,2, 647-54. (This version from ‘Remembering Henry’, edited by Stephen Lock and Heather Windle).
“I hope the lesson will really be that we can’t afford as a society to create the fire brigade once the house is on fire. We need that fire brigade ready all the time hoping that it never has to be deployed.”
Peter Piot 1
No just in time here. It’s in the statistical tails that dragons lurk and reputations are shattered. Chimes with a quote from Stewart Brand that I posted a short while back.
Education is intellectual infrastructure. So is science. They have very high yield, but delayed payback. Hasty societies that can’t span those delays will lose out over time to societies that can. On the other hand, cultures too hidebound to allow education to advance at infrastructural pace also lose out.
As with HIV, “an epidemic reveals the fault lines in society. The big one this epidemic has revealed is how we treat the elderly. We often park them in pre-mortuary type institutions and give a bit of money and hope it is OK”.
When the tide goes out you see who is not wearing bathing costumes…
Terrific post in the Monday Note from Jean-Louis Gassée. He writes:
This week’s note was sparked by a conversation with a learned engineer friend. He cut through my lamentation that our country lacks the will to send astronauts to the Moon again. ‘It’s not about will, it’s about our changed estimate for the cost of human lives!’.
Jean-Louis then expands on this with details of the various space flight-related accidents, before moving on — as befits a Frenchman— to the legendary 2CV, and the change in safety trade-offs between then and now in car design. Then there is the matter of covid-19, and the calculus advanced societies took the in the not so distant past.
Worth a read in full, and not just for the new acronym (to me, anyway) SWAG (scientific wild-ass guess).
There is lots about covid-19 that I do not understand — the biology and all that. But the NHS and government’s responses are something else. I find it hard not to assume that every statement has an ulterior motive: they are, it seems, strangers to the truth. Here is Bruce Schneier (the security guru as the Economist once called him).
“My problem with contact tracing apps is that they have absolutely no value,” Bruce Schneier, a privacy expert and fellow at the Berkman Klein Center for Internet & Society at Harvard University, told BuzzFeed News. “I’m not even talking about the privacy concerns, I mean the efficacy. Does anybody think this will do something useful? … This is just something governments want to do for the hell of it. To me, it’s just techies doing techie things because they don’t know what else to do.”
I haven’t blogged about this because I thought it was obvious. But from the tweets and emails I have received, it seems not.
It has nothing to do with privacy concerns. The idea that contact tracing can be done with an app, and not human health professionals is just plain dumb.
Testing, testing and more testing, please.
But, as R.H. Tawney once observed, shifts to collective provision are only realised after demonstrations that ‘high individual incomes will not purchase the mass of mankind immunity from cholera, typhus and ignorance’: many elements of the coming future ought to be favourable to the left, though only if they are shaped politically, and if blame – always elusive in the UK’s diffuse system of responsibility – is correctly apportioned.