It Mainly Affects the Elderly

Update to this blog post. My Mum’s care home has decided to go into ‘lock down’. I am glad I have done my research because I know they are doing the right thing and I absolutely back them up 100%.

It means my mum will be as safe as possible but it also means I do not know when I will see her again.

My heart is breaking.

Yesterday I hoped that the government would announce stringent measures to curtail the spread of coronavirus . I had my doubts due to my own experiences and others’. Apparently that was the containment phase.

The tone of the press conference was very adult and sombre and I found that reassuring. I was also pleased that they have changed advice so that people with mild symptoms should now self isolate. However, that advice should surely have come sooner and the measures they are going to take are extremely limited.  They are banning school trips and recommend elderly not to go on cruises. This, they say is the ‘delay’ phase.

According to the WHO“Covid-19 is a new virus to which no one has immunity. That means more people are susceptible to infection, and some will suffer severe disease.” We can see this translated into graphs where the unhindered contagion rate of this novel coronavirus is extremely rapid and often exponential.

In order to delay the numbers catching it, you have to create inflection in that exponential growth. The evidence from countries already dealing with it is that social distancing measures affect the growth in this way, slowing down the contagion rate. (See the graph in this article) The lesson from those afflicted countries tell us to intervene with social distancing (and other) measures sooner rather than later and every day counts. In the briefing they gave weak measures compared to other countries and said they think it is better to do social distancing at a later stage.

They mentioned flattening the curvein the briefing yesterday in order to not overwhelm health services. However, this means we have to slow contagion rates. The limited methods they are going to use do not correlate with this aim. I felt confused.

In a sleepless night tweet, I wrote “I think I might be at the Shock Doctrine stage where you start feeling child like. I did find the conference reassuring to some extent. ….Then I compared to known data and strategies that have worked + compared to Macron’s speech.  They aren’t doing what’s needed are they.”

This chart summarises the interventions by various countries:

countries response to cv

Our govt says it is listening to scientists. Macron also says they are listening to scientists. Why are our interventions so much more minimal compared to France and all the countries on this list?

Part of the answer comes from looking at their thinking. Our government is basing its protocols on ‘herd immunity’. In other words, let people catch the virus to build immunity. However, herd immunity is normally done via vaccinating a critical proportion of the population so that those who cannot have the vaccine (e.g. they may be too young or have medical conditions) are protected. Herd immunity as a health protocol in a pandemic is a novel protocol. In effect, we are being experimented on:

From the IndependentAccording to Professor Woolhouse, as coronavirus is a viral infection that causes an antibody response “we would expect” herd immunity to occur. However, as the coronavirus is “not well-studied” as of yet, “we don’t know how protective the antibody response is long-term, we don’t know how long it lasts, we don’t know any of these things”.

It appears to me that there is a massive contradiction in what they want to do (flatten the curve) and the way they are going about it (mass contagion). My tweet this morning

To achieve herd immunity without a vaccine, you need to let the virus sweep through a population.To flatten the curve, delay the peak and prevent overwhelm of health services you have to delay contagion.

The govt say they want to do both. #contradiction”

My diary story:

I have felt mildly unwell for a few days and have been in contact with someone who caught the bug from friend who travelled from Gran Canaria (see previous blog post ) . So I decided to self isolate this week. The main reason is that there was no information about mild coronavirus symptoms. I am in a position where I can self isolate reasonably easily.

So I was pleased when they specifically said yesterday that people with a new cough even without fever should self isolate for 7 days.

However, the government are not going to start social distancing measures. Their thinking behind this is herd immunity. Herd immunity normally applies to populations where enough are vaccinated which will protect those that can’t be vaccinated. In this case, there is not a vaccine so, the protocol of increasing herd immunity is to allow the disease to sweep through the population. The weakest will die. So with vaccination, the weakest are protected with herd immunity but in a pandemic, the weakest will most likely die. That means the elderly and those with underlying health conditions.

Let me tell you about a conversation I had with the manager of my mum’s care home. Even though my mum is very well physically, I like to be prepared and I had an ‘end of life’ meeting with the lead carer a few months back. When people die, their organs shut down and this can clearly be painful and so a syringe driver (with various pain meds) is often used during this phase. So this week, I asked how would she be kept comfortable in a care home situation if she as dying of interstitial pneumonia. (I was told they would keep residents in the home if they had the virus). I did not want her to have a frightening death, choking on fluid in the lung. The manager compassionately and clearly explained that there are drugs to dry up the phlegm and prevent choking so that death can still be peaceful.

I probably wouldn’t be able to be with her and the care home staff are under enormous risk themselves. I asked her what would happen if the care home had to be quarantined? She said they have discussed among themselves who would be willing to stay. She said she would because she is very fit and well.

So when Boris Johnson and his crew decide to experiment on us all, it is conversations like this that we are likely to be having. It is carers deciding amongst themselves who would most likely survive and be able to stay with elderly people – some of whom will be dying. We will learn how our loved ones will be kept free from pain and we will have to come to terms with probably not being by their side if they die with the virus.

The other thing that struck me (in my 4am sleepless state) is that the logistics of the care home in that situation would be massive.

We have been given no indication of how the logistics of managing the most afflicted. People don’t just drop down dead, they require care and attendance while they die. People in our communities who are ill but not dying need attendance too. Surely there should be more communication, mobilisation and resources to help with this?

Maybe it will come but why did they not mention that it is forthcoming?

So this weekend, I will think about a letter to leave at the home in case Mum gets terminally ill with the virus and in case I cannot get there. She won’t understand the letter because she has dementia but she will feel the love if someone reads it to her.

Think about that maybe next time someone says “it mainly affects the elderly”.