I wrote in a previous post about Koch’s postulates. To recap,
whether you get an infection or not, depends on 3 things:
Host vulnerability – if you are immunocompromised (for
Virulence of the organism – if you get Ebola as
opposed to a mild cold
Dose of organism – if you have a huge dose of an
innocuous infective organism you are more likely to become ill than if it is only
1 bacterium or virus.
I may seem like a bitter old git,
but I have serious reservations about all the praise for NHS workers. I see how
people are clapping and join them unreservedly in praising how front-line NHS
workers are going to work every day facing fears and genuinely risking their
lives to save patients in the present Covid-19 crisis. It is what the NHS
and the wonderful people in it signed up for, are committed to, and execute
with kindness and empathy.
I’ve been a consultant
neurosurgeon for 34 years in the NHS and have had the privilege of working
beside the finest nurses, porters and ground staff any system could offer.
Virology half-understood, pseudoscience and and maybe a little hope:
Coronaviruses are interesting.
They have the biggest genome of any RNA viruses in their nucleocapsid (the envelope with the RNA in). There
are three proteins – S- or spike protein which makes up the spikey part on the
outside, M protein which makes up the outer membrane and N protein which
encloses the nucleocapsid inside.
The virus spreads in two ways. It can
force replication of its own RNA and the new virus particles exit the cell emerging
into the extracellular space to infect other cells.
I realise most of it isn’t rocket
science, but as a neurosurgeon, I’m used to looking at figures of outcomes and
mortality. I’m puzzled.
In January last year the winter
mortality in the UK was just about 1500 deaths per day. The daily death rate
fell to around 1200 by 31 March 2019. The cause of the excess
deaths (1500 – 1200 = 300) was due to an increase in respiratory infections,
mainly in the elderly.
I have not seen the current daily
death rates for this year, but it remains unclear to me whether the figures
given out for Covid-19 are to be included in the normal daily death rate or
whether they are on top of the known seasonal excess winter death rates.
So, we’ve hit the 1K mark for
deaths. The PM says it’s going to get worse. We know this already. If we all
behave and don’t touch anyone else, we may keep the deaths to a minimum but not
before the death rate peaks.
Seems to me there is some pretty
flawed thinking about who is at risk. Front-line NHS workers I suspect are among
those who are most exposed to the Covid-19 virus. The Government is wanting to
test them because… because what?
The average doctor in ITU whether
he has PPE or not, may or may not have the virus at any one point in time.
It has come to my attention…
That’s the way all unpleasant missives begin, after all, isn’t
Look people, there seem to be a lot of you who still don’t
understand what we are facing here. If the epidemic peaks badly like in Italy,
the mortality will quadruple. All the intensive care facilities will be taken
up (average stay is about 8 days in ITU). Infected people will not get
treatment and more and more will die.
We bandy figures around like 1% mortality but in Italy, the
mortality over all is over 8% because as facilities get used up there are more
people dying at home without ventilatory support.
A nineteenth century traveler called Charles Kinglake published his travelogue of a journey across the Mediterranean
and Middle east (Eothen). I had to study it for ‘O’ levels. At the time I
couldn’t understand why there were frequent references to plague and weird superstitions
about things like: if you have a cold you can’t catch plague. He thought he was
lucky to get a bad head-cold on his journey. Maybe I understand him a little
It seems to me that even when
confronted by facts and scientific truths we still cling to foolish
superstitions in the hope that hope will save us.
I watched GOT from Season 1 to
the very end. I loved it. The acting was mostly brilliant, the storyline even better
than the books and the characters were fleshed-out, realistic and engaging.
Many fans seem to be displeased
with the ending and for my part there were elements of the ending I didn’t
like. I felt Jon Snow became a whimp towards the end. The great swordsman, the
driving force behind so much in the story just fizzled out as if no one in the
7 Kingdoms felt he deserved better than banishment to the far north.
have a view of Donald Trump. I know I have mine. Meghan Markle has expressed
her views during Trump’s presidential campaign. Can’t say I can identify any
difference of opinion between mine and hers.
This is the
first US president that I can recall who is blustering, tactless, full of
himself and well, downright a president of whom the USA should be ashamed. His
failure to act on climate change, his views on women and equality and human
rights have all come under scrutiny in the press and it all fosters a view of a
man who should never had got to power, but money speaks, I guess.
This girl has been castigated and disenfranchised because
she left the UK to go to the IS. At the time she was 15 years of age. When she
entered the refugee camp in Syria, she was heavily pregnant, and she now has a
Much controversy surrounds the mother and child. Many seem
to think that she is a Muslim Jihadist and allowing her to return to the UK
poses a threat to our security.
My initial reaction was that it serves her right because the
faction she left the UK to join is without doubt, by western standards, evil.