Lovely Lisbon and Demonstrating in Norwich

I went to my first conference in nearly two years last month. It was fantastic for many reasons: a chance to get out of the UK; visit a new country and city; meet with colleagues; catch up with developments in the field; and above all be reminded of what we had lost. My word I enjoyed myself. The primary purpose of the trip was to attend the International Association of Providers in AIDS Care’s (IAPAC) Fast-Track Cities 2021 Conference.

To their credit the conference organizers included Covid-19 in the programme. My presentation, which I shared with Corey Prachniak-Rincon, an IAPAC staffer, was on ‘Exploring Legal, Public Policy, and Finance Dimensions of Health Responses.’ The take-home messages were not encouraging, until Covid is on the decline, HIV will not be a priority, even though it (HIV) is not going away. The number of HIV infections continues to rise.

Getting to and from Lisbon was not a joyful experience. There are still virtually no flights from Norwich airport, so I had to take the train to Stansted and fly on Ryanair, a cost cutting, budget airline. Getting to Stansted was not problematic, there is a train from Norwich to the airport that takes just over an hour and a half. The check-in was straight forward, the flight packed and boring. I got into Lisbon at about 19h00 and went straight to the hotel.

Lisbon was so interesting I decided to spend a couple of extra days there. Changing the ticket was not difficult, but I ran into an unexpected problem before flying. I tried and tried to check in online and failed miserably. When I got to the airport, very early, I went to the Ryanair desk to find out what had gone wrong. I was then told I could never have checked in online. I don’t entirely understand why, but I spent two hours more than needed at the airport. Unfortunately Ryanair operates out of Lisbon’s Terminal Two which is threadbare and crowded.

The documentation required to travel included passenger locator forms for both Portuguese and British authorities, Covid vaccination documents and the results of the Covid test. I also took out insurance, with my local travel agent, in case anything went wrong. To the best of my knowledge the only document physically checked was the UK passenger locator form, and that was by the Ryanair staff in Lisbon. I suspect information is shared electronically by all who are interested. I find having to collect and collate all these forms to be extremely stressful. It is also expensive, a disincentive for travel. This is a good thing for the environment but is discriminatory against poorer people. As well as documentation we had to wear face masks from the time of entering to exiting the airports.

Unfortunately, arriving back at Stansted, I discovered that there were no direct trains to Norwich at that time of the evening. I was advised to go from the airport towards London, Bishops Stortford station. From there I got a train to Cambridge, changed to go to Stowmarket, and changed again for the Norwich train. The total journey time was about three hours, so it was not too bad. All the journeys were with Greater Anglia and time, in new and comfortable rolling stock so no complaints.

Lisbon from the castle (October 2021)

Lisbon from the castle (October 2021)

An example of a mosaic from the Mosaic Museum, Lisbon, Portugal

An example of a mosaic from the Mosaic Museum, Lisbon, Portugal (October 2021)

The Castle Ramparts, Lisbon, Portugal (October 2021)

The Castle Ramparts, Lisbon, Portugal (October 2021)

Lisbon is a delightful city. The conference was from Wednesday to Friday, so Saturday and Sunday were spent wandering around. Saturday was spent walking round the old part of the city. On Sunday I did more touristy things, visiting a ceramics museum and the castle at the centre of the city. The castle comprises imposing walls enclosing, probably, two or three acres. It is possible to climb up and walk around on the ramparts. The ascent is rewarded by some amazing views. It was my intention to visit the cathedral. I asked various people for directions and ended up at an imposing cathedral-like building. I walked all the way round looking for a way in, but to no avail. Then I spotted the notice at the door giving the opening times. It is not, wait for it, open on a Sunday, so my guess is it was not the cathedral. Unusually I have included some photographs with this post.

The hotel, in a modern area to the north of the city, was comfortable and had a wonderful roof-top bar, on the 16th floor, that gave a view across the city and out to sea. They had a small menu that included Prego’s, a steak sandwich. This was one of the staples of eating out in Swaziland (Eswatini) in my youth. That was what I had more than once in the five nights there. It was delicious, as well as being something of a blast from the past.

The conference speakers were taken to the ‘Clube de Jornalistas’ for dinner. The building and gardens were magnificent, wonderful high ceiled rooms with wood panelling and sweeping staircases. According to their website

‘You don’t need to be a member of Lisbon’s ‘Clube de Jornalistas’ (‘the Press Club’) to visit this restaurant, and it’s really worth it!’

I concur, I was at a table with a group of, mainly IAPAC, staff and we had a delightful evening of wide-ranging conversations.

It was so nice to be at a conference with colleagues. While I am glad we are going to change the way we do things, in person meetings cannot be totally replaced, and nor should they. This was an attempt at a blended model with online attendance and people able to look at sessions at their convenience. The curse of this will be the requirement to have passwords.

Back in Norwich this has been a period of attending events. Rowan and I are great fans of the Rocky Horror Picture Show and have seen it a few times. A touring production came to our theatre, and we bought tickets. It turned out Rowan’s partner’s dad is also a huge fan and so his parents joined us. We agreed to meet for a pre-performance meal. While sitting in the restaurant Rowan’s phone rang, she glanced at it, saw it was a friend in Durban and declined the call. A few moments later it buzzed with an incoming message. This was to tell her that Durbanite, Jessica Sole was in Norwich to perform in the, yes, the Rocky Horror Show. The Sole family were part of our circle in Durban and Rowan was friends with the two children, one of whom was Jessica. What a small world it is.

Douglas enjoys, and is knowledgeable about, the James Bond franchise and so at the weekend we went to see No Time to Die. The previous evening, we had watched the previous Bond film, Spectre, at home in order, I think, to follow the story. This was pure escapism, and both were highly entertaining. As an aside the cinema we went to charges only £4.99 per ticket for everyone. The act of simply going to a cinema was liberating. The show was popular, but few people wore masks.

Photo of the Gaia at St. Peter Mancroft

The Gaia at St. Peter Mancroft, 30 October 2021

Prior to the film Ailsa and I went into Norwich to join the Climate march, part of a Global Day of Climate Crisis action. It began at the city hall with about 45 minutes of speeches and then the 500+ protesters, and us, marched (straggled would be a better word), though the city streets. It was good to be part of this and see so many people engaged. Unfortunately, I think the majority were older, and while we need to take responsibility for the crisis we are not going to be around to fix it. The previous week we had looked at an amazing representation of the world in St Peter Mancroft, the second largest church in Norwich. I include a picture of this, and one of the marchers at city hall.

Photo of Speakers at the Climate Protest in Norwich in November 2021

Outside City Hall, looking towards the Speakers at the Climate Protest in Norwich (6 November 2021)

There were numerous banners and placards held up by the marchers. They included some for the Socialist Workers’ Party. This evolved from the International Socialists and was formerly established in 1977, my second year at university. I well remember the debates in the Student Union and the battles with other left-wing groups, such as the communists. They never had a significant impact, but it was interesting to see they have survived; indeed, the hard-core supporters still sell the newspaper on Gentleman’s Walk every Saturday. I wonder if this will have any impact, certainly the UK’s Conservative Government seems morally bankrupt and despite COP26 the hopes for real change here seem remote. Unbelievably there are plans for a new coal mine to be opened in the north of the country.

The clock ticks

I was shocked to see it has been over a month since I last posted. I have two countdowns going on in my life. The first, at the end of 2021 I will get my last salary cheque. Apart from a few short ‘student type’ jobs, since 1980 I have always had someone paying me a regular income. The short jobs in Swaziland included working for a school book supplier one holiday, and a week as a ‘hanger round’ at the Central News Agency in Mbabane. In the UK I spent a week packing bulbs (tulips and daffodils) etc. in a warehouse, ironically in the industrial site near where we live. I was fired for being too bolshy. I also spent three summer months as a warehouseman in Her Majesty’s Stationery Office. The second milestone is, in March 2022, on my 66th birthday, I become eligible for a British State pension.

Most young people, certainly those under 40, see people aged 50 to 80 here as an exceptionally fortunate generation. This is true for a high proportion of us. We had access to free university education, jobs, and many will get a state pension that, while not hugely generous, is significant. We were able to travel widely. We only became aware of the appalling damage we have wrought on the world, in terms of over exploitation and environmental damage, as we were doing it.

That is a gloomy way to start this blog, however these milestones lead to introspection. I have been incredibly lucky in terms of my career. My first serious job was as an Overseas Development Institute Fellow posted to the Ministry of Finance and Development Planning in Gaborone, Botswana for two and a half years from 1980 to 1983. I was recruited to the Economic Research Unit, at the then University of Natal, in Durban in 1983, and retired at the end of 2013. During that time apartheid ended, Nelson Mandela was elected president, the university became the University of KwaZulu-Natal, and I established the Health Economics and HIV/AIDS Research Division. In January 2014 I joined the Balsillie School of International Affairs in Waterloo Ontario, appointed by Wilfred Laurier University as the CIGI Chair in Global Health Policy, and this is the post I retire from.

The next few months are reasonably busy. I have been invited to talk at a conference in Lisbon. That will be interesting and fun. Most of my career was spent working on socio-economic causes and consequences of HIV and AIDS. I have been trying to apply these lessons to Covid-19, mainly through writing, but also some analysis. It is writing I enjoy most, at least when I am not procrastinating. I do also enjoy giving presentations. A colleague in Waterloo is organising a series of meetings on the theme ‘After the Pandemic’ through The International Centre for Economic Analysis (ICEA) a non-profit, non-partisan organization for advancement of research in economics and other social sciences. It is an international centre with chapters at Wilfrid Laurier University; the University of Warsaw and the University of Sienna. I am also speaking at the Public Health Conference scheduled from December 3-4, 2021.

There have been several fascinating books on Covid published recently. I wrote an editorial/book review for The African Journal of AIDS Research. The books were Richard Horton’s 2020 book, ‘The COVID-19 Catastrophe: What’s gone wrong and how to stop it happening again’;1 Daniel Halperin’s ‘Facing COVID Without Panic: 12 Common Myths and 12 Lesser Known Facts about the Pandemic: Clearly Explained by an Epidemiologist’.2 Michael Lewis’s 2021 book, ‘The Premonition: A Pandemic Story’,3 Jeremy Farrar’s 2021 ‘Spike: The Virus versus the People. The Inside Story’.4 The story of the Oxford/AstraZeneca vaccine by Sarah Gilbert and Catherine Green, ‘Vaxxers’,5 and Adam Tooze’s ‘Shutdown: How COVID-19 Shook the World’s Economy’.6

Over the same period, I read two 2021 books on Trump’s final year in office, both by Washington Post reporters: ‘I Alone Can Fix It: Donald J. Trump’s Catastrophic Final Year’7 and ‘Nightmare Scenario: Inside the Trump Administration’s Response to the Pandemic That Changed History’8 by Yasmeen Abutaleb and Damian Paletta. What we watched, horrified, and dismayed, is captured and analysed in detail in these pages. The key question is: will Trump be a candidate again in 2024?

I am not just reading; I am also writing. I have been collaborating on a series of Covid-19 and HIV and AIDS articles for the Global Fund Observer. I am writing a couple of other longer articles. It is pleasantly busy, and who knows, perhaps they will have some impact. The memoir I started months ago has been on the backburner. However, I am not the only family member writing.

My cousin Caroline Rodgers, who lives in Cape Town, took part in a University of Cape Town summer school on South African involvement in the 1914 – 1918 Great War. A book resulted. ‘One Hundred Years On Personal Stories of the Great War’ compiled by Kathleen Satchwell and Josephine Frater, it is self-published, the ISBN is 978-0-620-77931-9. Carolyn’s contribution covers her grandfathers’ war experience. The grandfather we share was Fred Hodgson. I never knew him as he died in 1952, 4 years before I was born. He was born in 1890 in Sunderland in England. His family emigrated to Kimberley in 1891, where he grew up. He enlisted at the outbreak of the war and was sent to France. He was commissioned, as an officer, in 1917. He was awarded a Military Cross in 1918 and a few months later received a bar to the MC (for readers unacquainted with military matters: if a medal is given, and the authorities want to award a second a bar is attached to the medal).

I re-joined the gym up the road a couple of months ago. On a conference call, a week or so ago, a colleague said there were three possible outcomes from the lock-down: hunk, chunk or drunk. Walking is something I have been rather good about, managing the magic 10,000 steps almost every day, and quite often getting up to 15,000. Cycling is mostly going to town, to the market, and collecting books from my favourite shop Bookbugs and Dragon Tales. The people who own it are happy to drop books off to our home.

The big events we’re going to live theatre and to London. There was a production of Bedknobs and Broomsticks at the Norwich Theatre Royal. There were not many performances. On the first evening there were lots of empty seats. Douglas was going anyway, so Rowan and I decided to buy tickets at the box office. The story is of three children bombed out of London (their parents are killed). Their host is a trainee witch. It was delightful, but one of the real pleasures was the special effects, a flying bed and an undersea scene, quite remarkable.

Ailsa and I went to London on Saturday 9th October. We met my brother, his family and my sister for lunch. The journey involved two trains with a change at Ely. We had not met for several years, thanks to Covid. Derek and Lynn live in Hout Bay in the Cape, their kids are in London and Manchester, Gill is in London. They had not made it to the UK for more than two years and, given her parents are in their eighties, they were keen to come over, even though it included 10 days in a quarantine hotel near Heathrow. It was good to get together. And that is it for this month.


  1. Richard Horton, ‘The COVID-19-19 Catastrophe: What’s gone wrong and how to stop it happening again’, Polity Press, Cambridge 2020.
  2. Daniel T Halperin, ‘Facing COVID Without Panic: 12 Common Myths and 12 Lesser Known Facts about the Pandemic: Clearly Explained by and Epidemiologist’, ISBN9798663024747 https://www.amazon.com/dp/B08D25GQX6
    Adam Tooze, ‘Shutdown: How COVID-19 Shook the World’s Economy’, Alan Lane, London, 2021
  3. Michael Lewis, ‘The Premonition: A Pandemic Story’, Allen Lane. London, 2021 301 pages
  4. Jeremy Farrar and Anjana Ahuja, ‘Spike: The Virus versus the People’, Profile Books, London, July 2021
  5. Sarah Gilbert and Catherine Green, ‘Vaxxers: The Inside Story of the Oxford AstraZeneca Vaccine the Race Against the Virus’. Hodder and Stoughton, London 2021
  6. Adam Tooze, ‘Shutdown: How COVID-19 Shook the World’s Economy’, Alan Lane, London, 2021
  7. Carol Leonnig and Philip Rucker, ‘I Alone Can Fix It: Donald J. Trump’s Catastrophic Final Year’, Penguin Press, New York, 2021
  8. Yasmeen Abutaleb and Damian Paletta ‘Nightmare Scenario: Inside the Trump Administration’s Response to the Pandemic That Changed History’, Harper Collins, London, 2021

What’s next, I ask?

Welcome to the first of my monthly, meandering blogs, put on my website, and emailed to everyone who signed up to receive my news. Let me begin with a warning, this is not primarily about Covid, so you may wish to take yourself off the list. Obviously, I am still following Covid, but no longer closely, and certainly not enough to write regular posts. Having said that here is something everyone should read – “How the risk of side effects could change with Covid-19 vaccine boosters” – we are all, probably going to offered these soon.

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And, finally, for now

Prepared by Professor Alan Whiteside, OBE, Chair of Global Health Policy, BSIA, Waterloo, Canada & Professor Emeritus, University of KwaZulu-Natal – www.alan-whiteside.com

Introduction

On 4th March in 2020 I started posting a ‘Covid-19’ blog to replace my normal monthly meanderings. It began:

“I am expected to know something about epidemics and pandemics, their causes and consequences. Many friends and colleagues have been asking me about Covid-19.

Here is a quick ‘fact sheet’ as of 4 March – what we know, what we don’t know, and what we need to know. I include hot links. Please feel free to send it on.”

Initially I used red text to indicate where figures or information would change, and bold text to show key points. I managed to keep up a weekly report for over a year. I then reduced it to every two weeks, but gaps increased and I am afraid I lost steam.

More than a month after I previously posted my Covid blog, this is the last. If you are getting it as someone who signed up for the Covid update you might want to ‘unsign’. If you do not, you will continue to receive my monthly personal blog. This is about what I am doing, books I am reading, ideas, and the minutiae of daily life – there is a lot about flights, airports and aircraft. The first of this new series will be posted in a couple of weeks.

As to the reasons for me ending this blog, the main ones are: it was surprisingly time consuming; the situation with regard to the science, numbers and response is increasingly complex; and it was getting too depressing to keep going. There are plenty of other people doing what I was trying to do. Nonetheless there are still areas that are ripe for research and writing. In particular the consequences of the pandemic, its economic, social, psychological and political effects. They are, of course, still unfolding.
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Announcement: The Next and Last Pandemics – The Consequences of COVID-19 and its Impact on the HIV/AIDS Response

The University of the West Indies, HEU, Centre for Health Economics, International AIDS Economic Network (IAEN), and the Pan Caribbean Partnership against HIV and AIDS (PANCAP), invite you to participate in a virtual discussion on “The Next and Last Pandemics – The Consequences of COVID-19 and its Impact on the HIV/AIDS Response”, Wednesday, 21 July 2021 from 9:00 AM – 11:00 AM Eastern Time.

You can register for the virtual discussion by clicking here.

Poster for "The Next and Last Pandemics: The Consequences of COVID-19 and its Impact on the HIV/AIDS Response" virtual discussion

Fatigue

Prepared by Professor Alan Whiteside, OBE, Chair of Global Health Policy, BSIA, Waterloo, Canada & Professor Emeritus, University of KwaZulu-Natal – www.alan-whiteside.com

Introduction

Regular readers will have noticed that it is three weeks since I last posted a blog. I am planning to write one more piece after this and will then end regular posts on Covid-19. I will still blog once a month but it will be a more general article. There are several reasons for this: preparing and writing is time consuming; the situation with regard to the numbers and response is increasingly complex, it might be possible to focus on one continent, but globally the situation is ever more diverse; it has dawned on me how incredibly disruptive and damaging the pandemic is, frankly it is too depressing to keep going; and finally there are many other resources available. Among them is pandem-ic.com:

‘This personal site provides data analytics on the COVID-19 pandemic through the lens of the World Bank country income classification – hence “pandem-ic”.’

It is produced by Philip Schellekens, a Senior Economic Advisor at the World Bank Group, but is a personal blog.1
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Are we winning? Yes and no!

Prepared by Professor Alan Whiteside, OBE, Chair of Global Health Policy, BSIA, Waterloo, Canada & Professor Emeritus, University of KwaZulu-Natal – www.alan-whiteside.com

Introduction

I finished my quarantine in my Waterloo apartment a week ago. I had three days confined in an airport hotel and then 11 more in Waterloo. The government was efficient at checking up on me. Every day I got an automated email with a weblink, and had to complete a form online. There were at least two phone calls and one visit from a private investigator, who had been repurposed as a quarantine inspector, complete with stab proof vest. He came to the door of the apartment, but said he was not allowed to enter it – which somewhat defeats the objective of checking.

The whole of the post-hotel quarantine depends on the honesty of individuals entering Canada. The press has reported, with outrage, of people flying to American airports and crossing the border by road, thus avoiding some of the more intrusive processes. I must be honest and say it was not too bad, though the current lockdown is wearing. Friends made sure I was well supplied with the essentials (food and wine), and so my incarceration went by reasonably quickly. But then I have a large apartment with a great view. I am privileged and I recognise it.

My overarching impression in Ontario is of a province on its knees, and an overwhelming weariness with the whole process. The smiles are becoming fixed, that is when you can see them because people wear masks outside. The problem is the lack of clarity and consistency. As I understand the situation, rules are enforced at the local level. Where I am, it is enforced by Region of Waterloo Public Health. They work closely with Public Health Ontario, the relevant section of the provincial government, which sets policy, and at the national level, with the Federal Ministry of Health. The lockdown is tight; people should only leave their homes for essential reasons, socialising is not allowed, and currently schools are closed. This last regulation has, as in Europe, had an extremely detrimental effect on children and their parents.

A large part of the problem is the Provincial Government, run by the Progressive Conservative Party of Ontario under the leadership of Doug Ford. The world over, conservative governments have reduced public health expenditures and services, and Ontario is no exception. Indeed, Ford was forced into a humiliating climb down when he attempted to announce that the provincial police would enforce his regulations,1 only to have various forces announce the next day that they would not be doing this.2 The numbers in the province are coming down slowly. There is a decent website3 giving data for the province. The citizenry needs clear guidance and, above all, to know the nightmare will end soon, but this is lacking.

The little mall across the road has a security officer at a desk at each entrance. Their task: to ask each customer if they have any Covid symptoms as they enter. It would take a pretty stupid individual to admit to having signs of Covid. I suppose it is important to be seen to be doing something, and this has certainly created employment. Interestingly most of the security officers seem to be recent immigrants from Southeast Asian countries. That probably indicates that these are minimum wage jobs.
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Vaccination: the way ahead

Prepared by Professor Alan Whiteside, OBE, Chair of Global Health Policy, BSIA, Waterloo, Canada & Professor Emeritus, University of KwaZulu-Natal – www.alan-whiteside.com

Introduction

This is being written as I quarantine in my Waterloo apartment. Getting here was surprisingly easy, despite a great deal of bureaucracy. The story began in December 2019 when I travelled from Waterloo to the UK for a year’s sabbatical. I planned a busy year, with visiting fellowships at two German and a British University, and visiting status with two English Universities. It was set to be a full, productive, and fun year. And then Covid-19 arrived, and everything was put on hold. I did not leave Norwich for over a year but making a trip to Canada was increasingly urgent. Travel was not easy, cheap or pleasant.

The first step was getting permission to leave the UK. International travel was not allowed until 17th May, unless the traveller has good reason. There is, of course, a government website. The “Declaration for International Travel” has a drop-down menu of about 10 reasons, from ‘Work’ to ‘Other reasonable excuse – please specify’. I dutifully completed and printed it. No one asked to see it at any point. There were no flights for my preferred route (Norwich, Amsterdam, Toronto) so I booked from Heathrow. There is extensive guidance on travelling to Canada on the Canadian government website. Only four airports accept international flights: Calgary, Montreal, Toronto, and Vancouver. At the moment, there is no recognition in the terms of travel and restrictions of vaccine status. I am fully vaccinated and have a flimsy little record card to prove it. I made photocopies for officials. No one asked or showed an interest.

To enter Canada (and various other countries) a traveller has to have a negative Covid test within three days of boarding. In the UK, private laboratories produce a “Fit to Travel Certificate for SARS CoV-2/Covid-19 Testing”. At a price of course. Also required is an arrival form to allow border officials to track you.

“Speed up your arrival process in Canada and spend less time with border and public health officers. Use ArriveCAN1 to provide mandatory travel information… Help … keep Canadians safe and healthy.”

The aircraft, a Boeing 787 Dreamliner, seats about 250 people. I booked myself in the premium economy section for more room. What a waste of money, there were only 19 passengers! There was a full complement of very bored cabin crew and consequently we had excellent service and some interesting conversations. Clearly, they had time to check the passenger list, halfway through the journey they began addressing me as Professor!

On arrival getting through the Canadian formalities was straightforward. The test is a nasal swab. There was no interest in my vaccination status – but there were a few comments on Canada’s failure to roll out a vaccine. Mind you I was on an empty plane; the next scheduled flight from Manila had 350 passengers. The government requires you to pay for three days’ quarantine in a hotel. My choice was a bog-standard business hotel, where the confinement included three meals brought to the door in large brown paper packets. I understand Pavlov’s dogs better now. Within 24 hours I recognized the rustle from the moment the delivery person exited the lift. There was nothing to get excited about on the menu though.

At Heathrow I bought a couple of bottles of duty-free wine and when I checked into the hotel, I asked for a third. The clerk said that he was glad I asked before he checked me in. He is not allowed to send alcohol to the quarantine rooms! There was no corkscrew in the room and the desk said they had none so here are some tips.
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The Gap Widens

Prepared by Professor Alan Whiteside, OBE, Chair of Global Health Policy, BSIA, Waterloo, Canada & Professor Emeritus, University of KwaZulu-Natal – www.alan-whiteside.com

Introduction

On 2nd May I had my second Covid-19 vaccination. It was my decision to have it earlier than the prescribed 12 weeks to acquire when I travel later in the month. The programme is so efficient, as before. The vaccination centre is in the food court of a major shopping mall in the city. At 4 pm on Sunday I walked in, and 5 minutes later, walked out newly vaccinated. I had the Oxford/AstraZeneca vaccine. It is incredible how rapidly the programme has been scaled up. This probably cannot be maintained so a question is: how often booster shots will be needed? We simply do not know; my guess is it will be annual.

Although I and many readers live in countries where immunisation programmes are moving rapidly, we need to remind ourselves that the Covid-19 pandemic is not over. At the moment there are parts of the world where it seems to be under control: notably the UK and USA. There are places where progress has been and continues to be made: most of Europe falls into this category. Parts of Asia (China and South Korea) and New Zealand and Australia have managed to keep the incidence of Covid-19 cases to exceptionally low levels. Much of South America is in the grip of an expanding pandemic. In Africa, except for South Africa, numbers seem low. The news, though, is dominated by events in India.1

On Saturday, April 17, the world passed three million reported deaths due to Covid-19. The true total of cases and deaths may never be known: cases because many people have no or slight symptoms, and deaths because of under reporting in many countries. Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO) warns the world is

“approaching the highest rate of infection”

so far in the pandemic, and several countries are facing

“a severe crisis, with high transmission and intensive care units overflowing with patients and running short on essential supplies, like oxygen.”2

In addition, there is the question of Covid variants, where are they emerging, how fast, and how should the global community respond?3

The health, social, and economic impact of the pandemic is still to be felt in its true magnitude. The only good news is the speed with which vaccinations are being delivered, although there is unevenness in the pace with which populations are reached, both between and within countries. This is the Matthew effect from the verse in Matthew Chapter 25,

“For unto every one that hath shall be given, and he shall have abundance: but from him that hath not shall be taken away even that which he hath.”4

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Ups and Downs

Prepared by Professor Alan Whiteside, OBE, Chair of Global Health Policy, BSIA, Waterloo, Canada & Professor Emeritus, University of KwaZulu-Natal – www.alan-whiteside.com

Introduction

Spring is well entrenched in Norfolk. The leaves are appearing with great speed, the daffodils are past their best, and it is delightfully warm in the sunshine. Traditionally Spring is a time of regeneration and hopefulness. This is certainly the case in the United Kingdom where the Covid-19 pandemic seems to be under control. The number of new cases has fallen dramatically and has, in turn, been tracked by the decreases in hospitalisations and deaths. As readers of this blog know, although I try to track the global pandemic, I follow events in Canada – particularly Ontario, South Africa, and the UK especially closely.

In my last communique I reported receiving my first AstraZeneca inoculation. This week I am delighted to report that my partner received her second shot. Once again, the location was the food court at the Castle Mall Shopping Centre in the city. The procedure was a model of efficiency, although on a Sunday afternoon, it was quiet. We were in and out in 15 minutes. I asked if they would consider giving me a second dose. I want to be fully protected when I travel in a few weeks. We had an unhurried discussion, and the upshot was that, although they were willing to do the inoculation, we agreed I should wait a couple of weeks. The reason for waiting was that the immunity would be better if there were a longer gap, and, they thought, side effects should be less intense. I cannot praise the NHS and all the voluntary services that are making this happen enough.

The daily UK report on the virus has been of consistent good news. The reported number of new cases, hospitalisations and deaths continue to fall, while the number vaccinated is rising rapidly, including those who have received second doses. This is not the case around the world, the situation in Brazil and India is particularly bleak, not only are the rates going up, but the numbers are extremely high. A quick look at the excess death data gives a sense of bad the epidemic is by country. The New York Times does not seem to have kept their graphs up to date, the Economist has.1 Elsewhere there is cause for cautious optimism, but the price is constant vigilance. The economic, social, and psychological costs remain uncertain. In the UK this uncertainty will continue until the furlough scheme has ended. That will be when we understand how many people have lost their incomes. This will not just be those on furlough but so many small businesses who will either close or may fail.
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