Day 23 of Coronavirus lockdown

I'm deliberately not rereading my previous posts before writing this one so I don't influence my thoughts. It has been surprisingly difficult to find time to sit down and write an update, but I've just got back from the post office (15 minute queue outside) where I posted a parcel for Stephen and bought two cards for Esther. She isn't expecting many cards on her birthday on 17th as we are still all staying at home so she won't see any friends or colleagues, so I got her one from me and one from the cats. I walked to her house, pushed the lot through the door and left.

Some people are really freaked out by the whole situation. As you walk around, people stand aside so you can keep 2m between you. Or they cross to the other side of the road. Everyone is following the social distancing rules. Some people, particularly the elderly and I assume anybody who has an underlying health issue or is just panicked by the idea of catching the virus is wearing a mask. There is no evidence that masks, other than the top grade surgical masks, stop you from catching the virus. However the WHO are considering changing their advice in the light of growing evidence that wearing a mask stops you from unwittingly infecting others around you if you have the virus asymptomatically. Just another example of the unclear guidelines.

Looking at the trend in deaths, it seems to me that health workers and key workers such as bus drivers, supermarket staff etc who deal with lots of people are the most at risk. They should therefore have the best PPE (personal protection equipment). Ordinary members of the public can make do with scarves or less expensive masks. There seems to be some effect of 'viral load' whereby otherwise fit Doctors and nurses get the infection and then get very ill and sometimes die.

The lockdown thus far seems to have achieved what was intended. There is a compliance level of 90%. We have avoided overloading the NHS. Several new Nightingale hospitals have been built in conference centres etc in areas like London, Manchester where high infection rates are likely, all ready to deal with the intensive care demands. Sadly Boris Johnson got very ill and had to go into intensive care. He is out now and recuperating with his girlfriend, Carrie Simmonds at Chequers. So much hinges on him as a leader and as a positive energy. His approval ratings seem to be really high.

I've read articles about how people have accepted the strict lockdown measures. The government didn't expect so many companies to shut up shop and claim loans to keep afloat. There are more businesses closing their doors and far more workers furloughed or losing their jobs than expected. One estimate puts the cost of the government's job retention schemes at billions of pounds per week.

There has been talk of an 'exit strategy', but people are so convinced by the message that they must stay home in order to protect the NHS and save lives, there is a chance that workers will refuse to go back into the work place. Public opinion seems to be driving government decisions.

A cabinet source said: "We won't be able to lift the lockdown until the public feels ready for it. The Prime Minister's illness has probably added another week to when that point will come, because it's made everyone feel as if they know someone who has come close to losing their life to the virus and it has changed attitudes."

So the timing will be dictated as much by the public's attitudes as by the science otherwise it won't work. To persuade the public the govt need to get a new message across. Instead of talking about 'exit' which has a feel of finality and suddenness about it, Dominic Raab is using terms like 'relaxation' and 'transition'.

Only 717 deaths were recorded yesterday - Easter Monday - as compared to over 900 the day before. This could be due to delayed reporting. Also, deaths in care homes are excluded from the statistics (by international agreement, apart from Belgium who include them). The situation in care homes is getting far worse. Over 100 institutions have had outbreaks in the past 24 hours. Without testing, I think the care home staff are probably bringing it in unwittingly, then the residents catch it and die because they generally don't go to hospital. There has been controversy of late over GPs and others getting elderly people to say that if they get COVID-19 they don't want to go to hospital. Most probably come too high up the frailty scale (1 - 9 with 5 - 9 counting as too frail) to be considered for intervention when resources are scarce.

My feeling is that this virus is here to stay. The best we can do is ensure that the NHS is geared up to cope, and then let the population slowly catch and recover from it. Lets be honest, what is the alternative? If we all stay home, the economy will grind to a halt and we will run out of things. I've been keeping an eye on Sweden, and looking at Mark Handley's graphs, Sweden, with no full lockdown, is showing a similar infection and death curve to Italy, yet Italy imposed lockdown.

I find myself wondering if the full lockdown and consequent impact on the economy is making any difference to the overall progression of the disease. We've done what we needed to do to protect the NHS. There is no way we can all stay indoors until the virus is eradicated because it won't be. We need an exit strategy now.

Meanwhile, the Chinese have allowed the ghastly wet markets to start up again. I do not blame Chinese people per se, but the Chinese government is authoritarian and has the power to stop this, yet they do not. They have caused a world pandemic yet they continue to allow the wet markets from which the virus sprang. I have seen the usual virulent tweets on twitter, blaming Boris Johnson for the deaths of people from Coronavirus. Cheap political point scoring in my opinion. The UK bodies have done what they thought was best at the time, given the advice they had. Some of their choices may not have been the best, though I think it makes little difference overall. In my view, the real culprits in this ghastly worldwide pandemic are the Chinese government. I am no fan of Trump, but why should he not say it like it is - the virus originated in China, they tried to deny it, chastised the Doctor who first raised the alarm in December and who subsequently caught and died from the virus. In my mind they are totally to blame for creating and releasing a worldwide pandemic.