I have officially been retired since Saturday 1st January, or perhaps, to be pedantic, since midnight on 31st December 2021. I must confess to feeling a little uncertain as to what the future holds. There needs to be a plan, budget, and cash flow projection, all but the first can be done quickly. The Covid crisis has made planning difficult. I really want to do some travelling, but it is hard to book tickets with any confidence. This is changing slowly though. It is hard to believe that the world began this seismic shift just two years ago. I became aware of this new disease in January 2020. I had no idea how rapidly and far it would spread, or the incredible disruption it would cause. More on this later.
One thing I am really enjoying is the birdlife in the garden in Norwich. I did not realise how having a cat and a dog reduced the visits from the birds, even though they (the cat and dog) were not hunters and chasers. Both have been gone for over two years. While they are greatly missed, there are some benefits in terms of the other creatures we are seeing. The most common visitors are blackbirds, up to 15 at peak, all squabbling individuals. Second are blue tits who feed from the hanging feeders. The other regulars are gold finches, magpies, robins, dunnocks and the occasional jay. The pigeons are ubiquitous, they are large bullies and, in my eyes, don’t count. Sadly, although there are delicate doves in the suburb, we are not on their feeding route.
To encourage the birds, we have bird feeders; spread seed on the garden every morning; and have fat balls hanging on the bushes and on the ground (in metal cages). To my amusement a couple of the blackbirds try to act like hummingbirds. They attempt to hover in front of the feeders, flapping and pecking furiously. They do not have any comparative advantage in this activity. We are not surprised to see the squirrels getting chubby, despite having to get the food through the mesh.
About once a week a sparrowhawk makes a pass over the suburb, much to the alarm of the rest of the gang. Today, though, it was perched in a tall tree at the end of the garden waiting for the food to be spread. Perhaps it saw this as a breakfast buffet, not the seed but the birds! It was spotted because of the unusual behaviour of the blackbirds; they were perched nervously in one of the bushes, unwilling to go down to the ground.
I won’t turn into a ‘twitcher’, but I love seeing and hearing the birds. Just one more bird related observation. While the garden has a rich variety of birds, there are sparrows and starlings living on our road, perhaps 200 yards away. They do not ever seem to come to our end. Are we in the ‘better’ or ‘worse’ neighbourhood? Is there no space for them in the micro-environment? I would love to see sparrows in our hedges, they are such cheerful little creatures.
In 2013 I left Durban, cleared out my office and kept some papers and books, shipping them to Canada. After 30 years it was a herculean task. Earlier this year I did the same for my office and my flat in Waterloo, this time shipping boxes to Norwich. Over the next few weeks, I will go through my home office and attempt to rationalise it. The criteria: will I ever read this again? If the answer is no it can go. There are whole canons of papers and books that have little relevance now. The best place to donate books of all types is Oxfam. They seem to sort out and deliver to places where most obscure material can be sold or recycled, and this includes academic material.
The books are relatively easy to deal with. As I work though my office it is apparent that papers and reports will be more problematic. I have a considerable stack of these too, and they can be kept or recycled. There is also the question of confidentiality, some are sensitive and should be destroyed rather than put in a wastepaper bin. At the end of this process, which might take another month, since I am doing it in phases, I will need to deep clean and perhaps refit. And then there are still the CDs to be sorted out, and there must be 200+ of these.
Covid: an incomplete update (4th January 2022)
This month marks an important anniversary of the pandemic. It has been two years since it emerged and swept across the world. In March 2020 I began blogging on Covid-19. The first blog stated:
“I am expected to know something about epidemics and pandemics, and 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”.
The blog was initially published every week then in 2021 less frequently. By the middle of 2021 I was unable to keep going. The reasons for ending it were:
“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.”
The last blog was on 11th August 2021. Before Christmas I sat down to write an update but did not get very far, so let me try again.
The numbers and epidemiology
There are excellent, accessible data websites.1 As of 4th January there had been 292,567,808 cases and 5,449,575 deaths globally. There had been 9,214,046,229 vaccine doses administered. At the end of 2021 and in early 2022 the number of new cases had risen from about 5 million per week to over 10 million. At the peak, a year ago, there were just over 100,000 deaths per week, currently there are about 42,000. Vaccination rate stands at over 250 million per week.
The top three countries on 4th January were the US with 56,191,733 cases and 827,749 deaths; United Kingdom with 13,497,515 cases and 149,367 deaths; and France with 6,667,511 cases and 89,573 deaths. The OECD countries dominate the pandemic. In Africa, South Africa leads the pack at 3,475,512 cases and 91,312 deaths. In South America Argentina has the most cases, 5,739,326 and deaths, 117,245. In Asia it is India that leads with 34,960,261 cases and 482,017 deaths. China – where this all began has recorded 115,597 cases and 4,849 deaths, with new outbreaks being reported over the past few days. The Chinese data seem remarkably low.
The take home message is that waves of infection are inevitable and seemingly unstoppable. The UK is in its third (or possibly fourth wave), the USA is in the third major wave. In South Africa, at the beginning of January, the Cabinet stated:
“All indicators suggest the country may have passed the peak of the fourth wave at a national level.”2
However, these are waves of infections, the numbers of hospitalisations and deaths, while following the same pattern with lags, are very much lower. There is consensus that prevention messages have been heard and populations have adopted and maintained these without governments necessarily forcing them to do so. Vaccinations have given a measure of immunity, although these have not been made available equitably. In addition, the idea of herd immunity seems to have come back into play in some settings, simply because so many people have been infected. The surge may appear contradictory, but it can be primarily attributed to Omicron. The fall in illness and death is due to vaccination and advances in medicine.
Over the past two months a new variant has come to dominate. Omicron, as it is officially named, was first identified in Southern Africa. It spread with amazing rapidity across the world and quickly overtook Delta as the dominant strain. There is much that is not known about this variant and scientists are generally unwilling to commit themselves. Early indications are that it is very much more infectious than any other variant. It seems consequent illness is generally mild. The problem is that if under normal circumstances 100 people are infected and five percent need medical attention, only 5 patients need care. With Omicron, 1,000 people are infected and only one percent need care, that is 10 patients. Nonetheless there is cautious optimism that the Covid crisis will be over soon.
The incredible advances in science meant vaccines had been developed within the first year and could be rolled out in the second year. There was not just one vaccine, but three from the OECD countries (Oxford-AstraZeneca, Pfizer, and Moderna), two from China and one from Russia. Progress continues with potential additional vaccines being developed and being trialled. Existing ones are being improved. There may be new variants but there is optimism that vaccination will keep pace with this. Vaccines are however highly political at many levels.
There has been a great deal of coverage on the inequity of vaccine distribution and administration. The wealthy countries were able to make vaccinations available to most of their populations very quickly. In many poorer countries governments have been unable to acquire the necessary doses, despite numerous grandiose sounding proclamations about ‘leaving no one behind’.
The consensus is that three doses are required to provide immunity. Originally two doses of most vaccines were prescribed, then a booster dose was added. It would be more honest to simply say it is a three-dose course. What we do not know is how quickly the immunity will decay.
“Now Sir Andrew, the head of Britain’s vaccine body, has warned that fourth Covid jabs should not be offered until there is more evidence they are effective, as he said giving boosters to the whole population every six months was “not sustainable”.”3
I believe Covid will be like with a shot needed every year.
A challenge in the OECD countries is vaccine hesitancy, people who are not willing to be vaccinated. Some news programmes have featured doctors expressing frustration. To paraphrase:
“Of course we will treat everyone who needs it, but when you have a Covid patient who has not been vaccinated and now says they wish they had, then we wonder.”
All the evidence is that vaccination makes a huge difference and prevents adverse outcomes, data can be found in the footnoted article.4 However vaccination alone will not halt the pandemic. It might happen that, where resources are scarce, access will be rationed by willingness of people to come forward. It makes some sense but is probably impossible to operationalise for equity and ethical reasons.
At the beginning of the pandemic there were no drugs specifically available for Covid. This is not surprising as the disease was new. Initially some drugs were repurposed, some successfully. By January 2022 the New York Times reported there were 33 drugs: one with FDA approval, seven widely, and five with promising evidence. One potential bottleneck is that drugs must go through an approval process which may differ from country to country. One of the advantages of the European Union is centralised drug approval.6 Vaccines will mean fewer people are infected, develop serious illness, need hospitalisation and die of Covid. Drugs mean some can be treated at home and won’t need in-patient care while, for those unlucky enough to be admitted, the prognosis is much better.
Since Covid appeared I have warned of the economic, social, psychological and political effects. They are still unfolding and need more time and space if I am to do them justice. I can talk from the OECD perspective. The 5th January was the first day of the new school term in the UK. The news has been dominated by the fears of educationalists that they will not be able to provide education because of staff absences. The National Health Service (NHS) is in a similar position as so many staff are absent. These people are generally not sick but have had a positive Covid test or been in close contact with an infected person.
It is not just the public sector that is facing these challenges. British commuters have been warned that staff absences mean services on many trains to and from London (and other cities) have been cancelled.
“Around 8,000 flights were cancelled worldwide between Christmas Eve and Boxing Day – approximately 3,000 of which were due to go to or from the US.”7
“Public sector leaders have been asked to prepare for “worst case scenarios” of 10%, 20% and 25% absence rates, the Cabinet Office said.”8
The ‘Consequences of Covid’ may be the research project I take up in retirement. It needs people I can work with, and ideally some funding for them. If anyone has ideas let us talk.
We should not underestimate the divisiveness of this issue. The BBC reported French MPs as saying they received death threats when they debated a Covid-19 pass. The law would require people to show proof of vaccination to access public venues and transport.
“On Sunday Agnès Firmin Le Bodo of the centre-right Agir party tweeted an email she received containing graphic threats to kill her over her support for the vaccination pass. “Our democracy is in danger,” wrote Ms Firmin Le Bodo, who is also a pharmacist and vaccinates people against Covid.”9
What to watch out for10
Increasingly the discourse is that we cannot eliminate Covid so will have to learn to live with it. Despite the astonishingly high case rates reported in a number of countries at the moment, it is generally believed they will not turn into unmanageable hospitalisation and death rates. I am prepared to stick my neck out and predict that in OECD countries the pandemic will be under control by the end of 2022. There may be continued restrictions to life such as facemasks on public transport, but these will be limited and not too invasive. The situation in poorer countries will probably be more Covid, but the demographics will remain protective.
The rules change and it may be for political reasons. The advisors in England have been keen to stress they ‘advise’ not instruct. It is up to the government to set rules and make decisions. At the moment in England a person must self-isolate if they develop symptoms or receive a positive test result. The period has been reduced from ten to seven days. Two negative lateral flow tests (LFTs) are required to end self-isolation.11 We need to monitor the restriction of liberty and not be afraid to challenge it, but as David Spiegelhalter and Anthony Masters said in an Observer column “beware of people who use the line: ‘I have done my own research’.”12
Above all we need to ask how to help those who have been disadvantaged by the events of the past two years, this includes material and mental impact. Along with the climate crisis, Covid shows it can not be business as usual.
- https://coronavirus.jhu.edu/map.html and https://ourworldindata.org/coronavirus
- The Telegraph, ‘Vaccine expert says jabs will need to be restricted’, 4th January 2022 http://m.email3.telegraph.co.uk/nl/jsp/m.jsp
- New York Times, Coronavirus Drug and Treatment Tracker, accessed 3rd January 2022 https://www.nytimes.com/interactive/2020/science/coronavirus-drugs-treatments.html
- Although this blog is primarily about Covid this is yet another reason to rue the day the referendum voted for Brexit. It is painful to realise how much the UK lost.
- Nature, COMMENT, “Two years of COVID-19 in Africa: lessons for the world”, 03 January 2022 https://www.nature.com/articles/d41586-021-03821-8
- BBC News, ‘What are the Covid self-isolation rules now?’ 31 December 2021 https://www.bbc.co.uk/news/explainers-54239922
- David Spiegelhalter and Anthony Masters, “Can you capture the complex reality of the pandemic with numbers? Well we tried…”. The Observer 2nd January 2022