Predicting Covid-19 deaths in UK

The total deaths recorded in the UK to date (28 March 2020) is 1,228, an increase of 209 since yesterday. The Health Minister is predicting that a final total of 20-25,000 deaths will be a good outcome. Taking today as Week 0, I have applied a little maths to the figures released so far, and the accelerating rate of change. This will not of course go on without limit, or the whole population would be eliminated. This might be a good outcome for Extinction Rebellion, but it is not the ideal outcome for the rest of humanity, and I for one would like to see a few more summers. I am therefore presenting this forecast based on the limited and ever-changing information we have at the moment, here and in other countries.

Projection of possible total deaths in UK

As we now know, Covid-19 is highly infectious, and dangerous because people are infective at all stages, both before they show symptoms and for some time afterwards. It is particularly dangerous for elderly men with pre-existing health problems, which makes me take it seriously as I try to avoid any contact with the world outside my home.

This prediction is based on a final death figure of twice the best case figure, i.e. 50,000. The rate of increase is exponential at the beginning: it will rise to a peak, and then begin to level off as the number of immune people rises and the rate of infection tails away. It assumes no vaccine over the next few months, and that the infection will not abruptly stop from the release of a miracle cure, nor die from warmer weather. Although very provisional, these data suggest the magic peak will occur in 3-4 weeks time, when the rate may be as high as 2,000 deaths/day.

The good news for most people is, in two months, it may all be over, except for small pockets of residual outbreaks. The majority of people should be able to return to work or schooling in one month's time, especially if they can be shown to be immune. The bad news is for people like me, who will continue to be at risk until it is completely eliminated, or until a vaccine or good treatment is produced. But at least there should be a huge surplus of ventilators and intensive care beds available by that stage.

Filling the day

We have been in self-isolation for only five days. It has passed quickly so far, though we haven't done much. Ann is young and healthy, and God willing will come through this well. Indeed, we do speculate that she may already have been exposed in January when we were in Singapore, and she had very severe flu-like symptoms with high temperature and dry cough. We were in a hotel, and she thought she was dying and couldn't move for three day. Of course, no one suspected CV-19, and the doctor she saw put it down to standard flu. But now, we wonder, could she have been an early victim?

Unfortunately, I am not young nor particularly healthy. We read stories of those with terminal respiratory failure feeling that their lungs are bursting, unable to breath, and it does take me back to my childhood days of asthma, when I used to gasp for breath during an attack. Inhalers were in their primitive infancy and my only treatment was a hand-held glass bulb nebuliser. This contained isoprenaline which gave some relief; only now, with my drug safety-hat on, do I read of the epidemic of deaths in asthmatics associated with this drug in the 1950's. Modern treatments, with bronchodilators and inhaled steroids, didn't come into use until the 1960's, by which time I had outgrown my childhood asthma. Now it has returned, probably secondary to other illness and medications. It would be ironic for me to die from CV-19, having survived everything else, so Ann is desperate to keep me from getting infected with it. No one is allowed to come into the house. I am not allowed contact with anyone. Even Ann has stopped going out, relying on what we have in the cupboard and what Mary-Anne can bring round and leave at the door.

Edwin wants to come round to collect his computer, to work from Andre's apartment in Cambridge. Ann told him we'll leave the computer in the saloon ready for him, but he won't be allowed in the house. He was a bit annoyed, but had to agree as the alternative was no computer. He won't be allowed to walk the dogs, or even see them: Ann says she will lock them upstairs to stop them barking their noisy greeting and jumping up him.

I still walk the dogs each day, combining my daily allowance of exercise with taking them out. It is a cold north wind today, so I only take them once round the playing fields opposite. The whole village is like a ghost town: I do not meet even another dog walker, and not a car moves along the road. The only sound is the cold wind in the trees; the only movement the rooks flapping hard above the trees to move slowly against it.  I have a slight cough, but it is not a dry cough so I must be OK, and welcome the phlegm as a sign of just an innocent cold. We measure our temperatures each day with the comment, "It's 36.6, we're still alive, so we should get through the day!" On Thursday, we stood at the door with countless others ready to applaud for the NHS. We felt self-conscious, and wondered if we should be the first or only ones in Hundon, but in the far distance, we gradually heard a ripple of applause in which we joined, then people started whooping and sounding horns and whistles. We are a tiny village, but clearly we stand apart united, determined to beat the bugger.

Ann is doing more housework than ever, cleaning cupboards and polishing till everything glows. I am not allowed to help with ironing, washing, even clearing the dishes away, as she says it gives her something to do. I think she should write: she always has such deep insights into situations and people and relationships. Everyone shares their worries or problems with her, and she always comes up with supportive advice backed by sound common sense. It is no wonder she is so good at Tarot reading. Her poetry is penetrating, arresting and deadly in its aim. If she ever does write a novel, I know it will be brilliant, and we would all queue to buy it, though hopefully I would get a signed complimentary copy! My only fear is, I know she would write about people she knows, and I suspect I would read myself into every bad character or deed, though I know she would deny it vehemently with the comment, "It's not all about you!" But it will be a book worth reading.

American Gothic and Wagner

Virus

 Vivid illness, you've got my number
 I know you're not far off
 Retreat is all I can muster, as
 Ubiquitous, you stalk me with calm intent
 Surrounded by beauty, I fight you with solitude

Betsy Marston

In common with millions of others we are sitting out CV-19 for the duration. When the first World War started, people were telling each other, "It'll be over by Christmas." Now, Trump has pronounced, "It'll be over by Easter." Easter is two weeks away, but London and New York are still on the accelerating slopes of the plague, so they are going to have to reach their peaks very rapidly to meet the president's schedule.

Meanwhile, we sit enjoying the sunlight, doing some gardening and enjoying the early spring sunshine. Mary-Anne came round yesterday to bring some shopping; she left it on the table on the patio, and talked to us through the open window. She took a picture of us, saying we reminded her of Grant Wood's American Gothic. We are so fortunate to have each other; so many people must be forced to sit this out alone.

Sitting out CV-19

The Hundon Gazette came yesterday. It had a large poster we have put in the window warning visitors to keep away, and has collated a list of local volunteers offering to help those in need. It is so good to be reminded that the world is not all evil, but there is also goodness fighting the darkness. Even so, the usual naysayers immediately swung into action decrying these actions, and saying the Gazette should not have been delivered because it risked bringing infection into people's home. Well just burn the thing, I say, if you're frightened to touch it!

In common with many others, we are reading or writing; or watching television, Netflix, and old videos while awaiting the figures of doom announced as the deaths mount round the world. Nine years ago, we started to watch The Ring, or Der Ring des Nibelungen to give it the full title, staring Bryn Terfel as Wotan, broadcast live at the Arts Theatre Cinema in Bury. We could only see the first two because of prior commitments on the second weekend, but later Ann treated me to the DVD set.
It is based on characters from the Norse sagas, and as potent a story as Tolkien's, depicting as it does the forging of the ring symbolising power made from the theft of the Rhinegold, then the repeated wars to possess the power. Last night we watched the first, Das Rheingold, and were transported into that other world. For a while we could leave our own worries or fears as we were swept away from this earth, such is the power of the music, the sets, the characters and the story.

The Last Sight of England

A Last View of England?

Just when I have time to spare, and am getting stronger and more able to take on some voluntary work, I am barred from doing so. However, once a medic always a medic. I remain a qualified doctor and still on the Medical Register, so even though I can no longer offer face-to-face support, I will be glad to do so by phone or email.

On a beautiful spring day, I worked in the garden. This afternoon I thought to take the dogs, not to Clare, but just through the empty sports field opposite to post some letters for Ann. But then the rumours started that even local, solitary dog walks are to be banned, so I chose instead to take a last longer walk round the outskirts of Hundon, through the fields past the church, then back via the postbox. The whole village is deserted; I only saw two cars and not a soul I needed to dodge.

At the top of the hill, I overlooked the village church and a few houses (Hundon is a very small village) and was reminded of Ford Madox Brown's title, The Last of England. If we are soon to be banned completely even from a local dog walk, then this may be the last view I have of our Suffolk hills and fields, if not for ever, certainly for some time.  I am in the older age group, and carry many risk factors should I become CV-positive, so I have a deep personal interest in staying isolated.

Whatever happens, it is certain that nothing will be the same once the pandemic has past. Many will die, many firms and businesses will be gone, and many people will lose their jobs. There will be unemployment, and shortages in unexpected areas from supply chain disruption. The huge input of finance from the Bank of England will ameliorate some of the worst, but will probably lead to inflation and shock increases in the bank rate. But at least, once it is past, we can get out to enjoy what is left of England.

Light a candle for Mothers' Day

Happy Mothers' Day. 

To all our hardworking wives and mothers, our hearts go out to you. You unstintingly work through the year to support us and sustain us, both physically and mentally. Today is the one day when we try to thank you and remind ourselves how important you all are in our lives, but it has cruelly been snatched away.

A Candle to Mothers Everywhere

Ann and I had booked a Mothers' Day meal at the Swan, but last night it was closed by government decree and all such meals are no more. After the letter of despair by Nick, the manager, he followed it up by offering all the food they had bought in for sale at the rear window: eggs, veggies, beer (bring your own jug) and wines. It must be heartbreaking for him and the staff. If they begin to offer takeaway meals, we have vowed to have some regularly to continue supporting a vital community service (i.e. the local pubs).

Tonight, in celebration of Ann and mothers everywhere, I intend to light a candle at the window at 7.00pm. It will burn as a light of hope in this time of darkness, and I urge you all everywhere, young or old, to do the same - let us remember their part in our lives, and let us strive to banish the blackness of the curtain that is falling upon us.

Picnic in the forest

Today being clear and sunlit, we started our semi-quarantine, driving to Epping Forest forest for a picnic in the car, a vast stretch of dense woodland nearly twenty kilometres long. It is the Spring Solstice, when all the world is equal, as much in daylight hours as it is now in fighting a common enemy. Epping Forest is dark, ancient and foreboding. It reflects the mood of the moment, seeming to be scarcely touched by man; there are scattered dark pools and swampy bogs hidden in unsuspected corners. It seems to manage with minimal help from the forestry commission: many of its largest and oldest trees were allowed to fall at Nature's hand in the last gale and lie where they snapped through, great jagged upthrusting half-trunks with the rest of the trunk crashing and splintering smaller neighbours with its crown and side arms making the paths difficult to find or walk through.

The forest is written with history from its oldest roots. Unlike many newly created woodlands, it is one of England's primeval forests, dating back to pre-Neolithic times. It is the scene of countless murders and unlawful burials, including more than thirty murders by the Kray brothers' gang alone, and more recently the "Babes in the Wood" murders. Even highway men such as Dick Turpin had their hideouts here, to ambush wealthy coaches on the road from London to Newmarket for the races. Surrounded by the creaking trees and rustling wind we ate our sandwiches and took a glass of wine. Then, getting out to walk the dogs, Ann found a wallet ground into the mud behind the car! It lacked any identification, but was distinctly creepy, knowing the history and reputation of the place.

Wallet found in Epping Forest

Our world ends tonight

Friday 20th March 2020 will be recorded in English history as the ending of the world. This morning, I had the last of my routine appointments at the dermo clinic to read the patch tests; the consultant confirmed mine was the last routine appointment for the foreseeable future, as everything was cancelled from next week to prepare for the great plague.

We came home via the Long Melford garden centre for Ann to buy a few pieces. I walked the dogs then waited at the car; she came out with just two take-away cups of coffee, the last before the cafe closes. This afternoon Ann went for her hair appointment - this also will be the last. Again, I stayed clear of people, walking the dog, and waiting in the carpark of the Swan. Ann went to the restaurant section as the bar was unusually full for an afternoon, with all the regulars taking a last drink. Nick the manager had a long face, fearing what was coming. In the Clare Facebook page, they write:

We would just like to say thank you to all our customers for your continued support, it really has meant so much to us. An even bigger thank you to our team who have been with us from day one. You have been the best team we could of ever asked for and it has been a real pleasure to work with you. We are not sure what the future holds now but we wish you all the very best and hope you all stay safe. Best wishes Nik and Victoria.

Ann bought two drinks and brought them out so we could take them in the car. Then home to indefinite isolation.

On this day, too, Northwick Park Hospital announced it was full beyond capacity due to CV. This is the hospital I visited before Christmas to examine and report on their Phase I unit before we signed them up to run a clinical trial. Now they may need to requisition the unit and send all the study patients home.

This has been handled so badly. It could have been anticipated that people would stock pile when told they may have to go into blanket isolation for weeks at a time. The government should have brought in powers of rationing at the outset.

Now to shut everything, every shop, bar, restaurant, gym... and every pub! So many people out of work, so many places will never reopen. It is crazy - the majority of younger people will only have mild infection; many may not even know they've had CV. Is this the best way? I don't know, but one has to assume the government is selecting the best of bad options based on best advice.

Because it's only the older ones who will suffer and block the NHS, perhaps it would have been more sensible to confine us to barracks and leave the rest of society to carry on. We who are most at risk would respond willingly and sensibly to keep isolated. We have no wish to die or take up intensive care beds. Perhaps the rest of society could have carried on and kept the country running. We will never know what the alternatives might have done, but maybe then no one would have even thought to stockpile.