Warning: mostly not about Covid-19, but On Operations and Lockdowns

This is not a Covid-19 communique but rather a standard blog post. Don’t feel you have to read on. The reason for the change in emphasis this week is that Covid-19 events simply passed me by. The explanation is that I was engaged with the National Health Service (NHS), finally having elective surgery for an umbilical hernia. It has been a long road to get here, I am relieved to have it sorted.

I have always considered myself fit (but overweight), playing squash, touch rugby and running. A few years ago, I noticed I was developing bulge in my belly button. It was confirmed as an umbilical hernia. All the sources of advice: doctors and the internet recommend these occurrences need to be dealt with, and that means surgery. Two years ago, I arranged to have the hernia operation in Durban. It could have been a day surgery but, stupidly, I decided to spend the night after the operation in the hospital. It was that or go back to the flat. The surgery was straightforward, the hospital experience was not great. Unbelievably the morning began, at 05h30 am, with inappropriately cheerful nurses. I was on a men’s ward where all had more serious conditions and concerns, and felt somewhat fraudulent.

The original surgeon gave me options for the repair. I selected stitching rather than putting in a mesh. This was a mistake, as I realised, when the bulge reappeared some months later. This time I did more homework and consulted with medical professionals in Waterloo, Norwich, and Durban (as well as qualified friends). The consensus was it had to be redone, but with a mesh. In addition, I learnt I would have to wait at least a year before a surgeon would even consider reopening the wound.

Covid-19 meant that, after arriving in Norwich in December 2019, I have not travelled outside the UK or even on a plane for 14 months. (I am seriously tempted to go for a flying lesson as soon as it is permitted just to get in the air!) This in turn necessitated arranging to have the surgery in Norfolk. I began the process and expected to have to wait for at least a year. As it happens it was quicker than that, but my word it became a complicated process, and it has been an insight into the amazing NHS and how they function in time of crisis.

The centre for these surgeries in Norfolk is the James Paget Hospital. This is in Gorleston on the Norfolk coast, about 50 minutes (or 30 miles) away. The process involved visits for assessments, an MRI scan, a Covid test and other ancillary events. The surgery was originally scheduled for January 2021. However, the government unwisely relaxed restrictions in England at Christmas, and the number of cases soared. On 8th January 2021, they peaked at 68,192 up from just 12,386 on 12th December 2020. The hospital called me to say, regrettably, the surgery would be postponed. I expected this!

I was quite happy to wait, after all it was elective, and not urgent. The next, and unexpected development was the hospital called and offered me a date, at a private hospital in Colchester, some 60 miles away. One of the ways the NHS is trying to manage their waiting list is to outsource some procedures to the private sector. I declined the option and eventually heard from the local surgeon who said that the surgery could be scheduled for 2nd March. As an aside the number of new Covid-19 cases across the UK on that day was 6,411.

On the day, I had to get to the hospital by 7 am. Ailsa drove me down and dropped me off. I checked in to the day procedure ward and was wheeled into the theatre at 11 am. I had hoped it would be earlier. This delay was entirely my fault. When we got up, just before 5 am, I had a cup of tea with milk in it. Note to self: read the instructions carefully and follow them! I could have had water or black tea; it was the milk that was the issue!

Apart from extra hygiene precautions and wearing masks, the part of the hospital I was in appeared to be functioning normally. There is a separate terribly busy Covid section. The biggest obvious difference is visitors are not allowed at all. This makes for a very much quieter environment. The day procedure centre was active, but not manic and the nursing staff were caring, professional and calm. Everything went smoothly and, after passing urine, (a non-negotiable apparently) I was discharged in the evening. I left with a ‘goody bag’ of everything I needed for post-operative self-care.

My ‘N’ for hernia operations is now 2. The first was an incision while this second was done laparoscopically, through five places on my stomach. I had to take a few painkillers, far fewer than prescribed. Generally, I have been fine although getting up and lying down have been challenging. In addition, I was given about 10 preloaded syringes with blood thinning medication, to inject into my stomach. Not a pleasant process. I have been really impressed by the standard of service in the NHS despite the Covid-19 crisis. This also needs to be seen against the backdrop of a public sector pay freeze except for nurses, who have been offered a derisory 1%. They are furious, feeling it as a slap in the face, and I quite understand. I recognize the need for fiscal conservatism to pay for the Covid-19 response. It has cost billions, not just care costs, but also keeping families and supporting the furlough programme so people have jobs to return to. This stingy pay offer to core staff stinks.

I have taken several lessons from this experience. The first is to read and follow instructions carefully. Second is that the health service is amazing. Even when it is under immense pressure, people are seen and treated. At the same time as this was going on, the government is rolling out a vaccination campaign. I was able to go online and book both the appointments I need, the first on 12th March and the second three months later. My hub is the Food Court, in the currently shuttered, Castle Mall Shopping Centre in Norwich.

I do have a few quibbles though. The main one is about ‘joined-up’ thinking. The provision of a decent health system is part of the social contract, but the major challenge faced by humankind is climate change. I have been taken aback by the use of resources in the health service, much of which probably can’t be recycled. I was given 14 disposable syringes, each in separate plastic wrapping. It may be that there are no options! However the instructions and pamphlets were on recycled paper.

I have talked before about how fortunate I feel we are. We have a home, an income, and a family close at hand. The children are coping with this as well as anyone. My extended family are all OK, although no one is very happy. In addition to that, our environment is changing in two significant ways. First with regard to Covid-19, the numbers are falling, and the vaccination programme is working very well. Second, there are signs of spring. I can see the first leaves beginning to bud on the rose bushes and today we spotted blossom on the trees in the neighbour’s garden. It is still chilly but there are signs of spring.

This good fortune was brought home to me when we walked to a local shop to get some essentials and the Observer newspaper. The rule is only one person from a household should go in and so I waited outside. There is a ‘security guard’ at the entrance to make sure people wear masks and sanitise their hands. I think he is from Norwich. I started chatting with him and this is his story: he worked on cruise ships out of Fort Lauderdale in Florida and was also paid as an American Football Player. I know this may come as a shock to readers of this blog, but there is a league in the UK and Norwich has a team which he was part of before going off adventuring. He said he played in Australia, before going on to join a team in Vladivostok in Eastern Russia. Covid put an end to this, and I think he was lucky to get back to Norwich. I would never have known any of this. What a story. The next instalment will be interesting, and I am looking forward to it. End of personal stuff, some COVID-19 coverage next.

Continue reading

Covid-19 Watch: Back and Forth, Up and Down: A Deadly Dance

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 year marked the first time since 1992 that I was not involved in the International AIDS Conference, organised by the Geneva-based International AIDS Society (IAS). It was scheduled to be held in Oakland, San Francisco, and would have attracted up to 25,000 delegates. I would have been amongst them. I was on the IAS Governing Council for 12 years, the last four as Treasurer, so my heart went out to the staff, executive and Governing Council. This will have been a blow. However, there was a swift pivot and the virtual meeting included a great deal of material on Covid. I watched online presentations and will refer to some. It is clunky, but will improve. One panel, highlighted below: “COVID beyond the health”.

This week it is time to reflect on the Covid-19 numbers and how they have changed over the past few months. There have been significant changes in the ‘hotspots’, however the global trend is, tragically, upwards. The two clear messages are: there needs to be constant vigilance against the introduction of new cases, which has been seen in New Zealand and Australia, as well as outbreaks in some European countries; the second is the rate of spread can be exceptionally rapid.
Continue reading

Covid-19 Continues

For the past two months I have not written my usual personal blog for my website. There is a reason for this, the Covid-19 pandemic. Covid-19 is the greatest global challenge I have seen. It could be outstripped by a climate catastrophe, but for now it is all consuming. Given the work I have done on HIV and AIDS I am supposed to know a bit about pandemic diseases. It is worth remembering that like AIDS, Covid-19 is a retrovirus that transferred across the species barrier into humans. AIDS was recognised as a new disease in 1981. There were scares with SARS, Ebola, Zika and MERS, but none developed into a major pandemic.

In four short months Covid-19 has claimed over 250,000 lives and infected more than 3,500,000 million people. I began posting a weekly communique on Covid-19 to share what we know and need to know. This replaced the personal monthly blog I have written for more than 10 years. You have, along with several other hundred people, signed up for the communique and now you are getting this additional piece, so please feel free to delete it.

I originally wrote the monthly offering because I had something to say and share. It was just two sides of an A4 sheet when printed, and the reason was to keep the price of postage down.

“Ah ha”, I hear, “But it is on the website and sent electronically, so what is this postage business?”

Well, several of my elderly relatives are either self-confessed luddites or just lack technological skills, and don’t have email, so it was printed and posted to them. Yes, in an envelope with stamps on.

Continue reading

Family and Travel

March should mark the end of winter in England. There are clear signs that spring is approaching. Some of the trees are covered with blossom. The daffodils in our garden are almost all in full bloom. However, despite the signs that nature is stirring, the weather has been rotten. We experienced periods of sustained strong winds and rain for nearly two weeks at the end of February. The western part of the country has had flood after flood, houses and homes have been wrecked. I find it quite confusing to see car roofs protruding from the middle of floods, surely you can drive a car out of harm’s way.

Of course, the serious floods over the past fifteen or so years meant defenses have been built, and in many cases they have worked. It could have been so much worse. The problem is that there are just too many houses built in vulnerable places (unbelievably on floodplains), and the nature of these storms is that they are ever more intense, a month’s rain in 24 hours. Yes, global warming is real, and it is affecting us in the UK in clear and measurable ways.

I had been organising a lunch in London with our extended family in mid-February. It turned out to be the wildest and windiest weekend of the month and public transport was greatly disrupted. As my sister and her husband are not youthful, canceling the gathering seemed appropriate, and indeed this turned out to be prescient. Fortunately, we made the call to postpone before I finalised the restaurant booking.

My brother, Derek, was passing through London for a day on his way back from the United States to Cape Town, and so we decided to have a smaller lunch the following weekend, on Saturday, 22 February. The plan was for Douglas and I to take the train down to London and meet up with the family at a restaurant they had booked near Notting Hill Gate. This was a central location and gave easy access to and from Heathrow for Derek as he had a limited amount of time.

Continue reading

The end is nigh

It is many years since I included a ‘round robin’ in with Christmas cards and this, lazily, also constitutes my blog post for December. There is a good reason this year. I have significant news and don’t want to leave people out, or have to write it in all the cards I send.

You may recall in January 2014 I joined the Balsillie School in Waterloo, Ontario as a full time member of faculty. It is complicated appointment. My salary is paid by Wilfrid Laurier University, but I work at the Balsillie School of International Affairs. Here I was, according to my letter of appointment, employed to teach two courses per year, and carry out the other responsibilities of a senior academic, including researching, writing and publishing.

About two years ago the University unilaterally, and with very little consultation, decided to change the conditions of service. They were, of course, made less favourable for academics. Of particular concern was the doubling of our teaching commitment. I came here because I had not, in 30 years as an academic, taught (two years of teaching one course at the University of Natal on Southern African Development in 1984 and 1985 had receded to a distant memory). I wanted to see what it would be like to work with and teach MA and PhD students. The idea of supervising a thesis from start to finish was intriguing, and I am happy to report that I did manage to do that with one student.

This new demand regarding teaching made staying in Waterloo problematic in the long term. I neither had courses prepared, nor much guidance on what to do. In addition to more teaching being mandatory my academic cohort was assured, when we signed up in 2012 and 2013, there would be research money available to us, without too many hoops to leap through. This promise evaporated like the dew in the Kalahari in January, although it was not entirely the fault of the university but rather the shocking behaviour of one of the other ‘partners’. In addition to this moving the goalposts, a part of the university bureaucracy was irrational to me. I have every intention of writing about this in due course.

Continue reading

Frying in Norfolk

Anyone who denies climate change, and more specifically, global warming, is seriously wrong. At the end of August we had record temperatures in Norwich. Fortunately it cooled down in the evenings so sleeping has not been too difficult. However, this summer the rowan tree in the front garden died from a mixture of disease and heat stress. Ailsa has been using the water from the rain butts to keep some of her favourite plants alive, but it is an uphill battle. It presents a dismal picture and I really wonder what the next 10 to 20 years will hold. I am increasingly aware of my contribution to this crisis, particularly through flying, but I do not consider myself to be a flamboyant consumer of other things.

Having said that, I have to begin this blog by reflecting on my travelling over the past month. My final class in Waterloo was on 30th July. I had to complete the marking and submit the marks by 8th August. I was able to do this, and almost all of the students should have been pleased with the outcome. The temperatures and humidity gradually rose in Waterloo, and I was glad to be heading for Norwich. I did not realise how hot Norwich was going to be.

I travelled over on Sunday 11th August, flying via Amsterdam. Toronto to Amsterdam is not all that long, just 7½ hours. This is not long enough to take a sleeping pill, so I sat and watched the film ‘Red Joan’. This was about a British woman who became a Soviet spy in the 1940s and 50s. Oddly I was reading a book called ‘And Is There Honey Still For Tea?’, by Peter Murphy, set in the same time period and covering the same topics. It is hard to believe how much skullduggery there was going on then. I guess it is still happening, with electronic surveillance playing an ever-increasing role.

Continue reading

Pollen and polling

In my blog, posted at the end of March, I described the surgery I underwent in Durban. I also talked about going out a couple of times, with friends, to a really delightful little bakery/pizza restaurant in the neighbourhood. It does not even have a liquor licence; and this does tend to mean the evening is cheaper as one takes one’s own wine. Among those friends was Jurgen Brauninger and his family. I wrote in that blog:

‘On a personal level it is interesting to see my cohort, friends and colleagues ageing into their 60s, for the most part with grace and dignity. It is however a shock to us all – but, as I said to one friend, ‘it is better than the alternative’.’

Within two weeks of these dinners we learned, out of the blue, that Jurgen was not well. He was suffering from pancreatic and liver cancer, and was having difficulty in eating. After various consultations he was scheduled for urgent surgery to ease pressure on his duodenum. While this was not a cure, it was expected to improve the quality of his life. The surgery was carried out on 26 April (by the same surgeon who did my hernia); Jurgen did not recover and died on 6 May.

I want to pay tribute to a dear friend and colleague, a talented musician, but above all a devoted family man. I know Tania, Hannah and Brigitte will be torn apart by grief. Sitting in Canada I have felt very distant, but no less sad. I wish I had deep and meaningful forethoughts about this but I don’t, I just know I will miss him enormously. Andrew Marvell’s lines “But at my back I always hear, Time’s wingéd chariot hurrying near”, were not written about death; they do seem very apt though.

The Brauningers lived a few houses up the road from us in Manor Gardens. Their children were similar ages to Rowan and Douglas. We celebrated many milestones together; Brigitte did the most amazing Easter lunches for the university crowd and others. The families went away together for a number of short holidays in the province. Everyone enjoying each other’s company, even braaing under umbrellas during a heavy rainstorm. Their home was an original ‘wood and iron’ house, this is one of the first Durban houses and relatively few are left standing. Jurgen, I and Ullie, one of his friends, purchased the house next door when it came on the market, in order to preserve it and the jungle of a garden for a little bit longer. Jurgen and Brigitte had just moved a few kilometers to a more modern house and were planning their retirement when this devastating event occurred. This has been a deeply sad time.

Continue reading

Autumn and Spring Showers

The month of April began in the Cape and ended in Canada via Norwich. In the first week we ran the scientific writing course in Stellenbosch in the Cape. There were 19 participants from across Africa. Tim Quinlan did most of the teaching and the event was excellent. We are beginning to see results in submitted and published manuscripts from earlier years. I hope the project will be renewed, but if it is not then we have achieved a great deal. As my travel was from the southern to the northern hemisphere, I experienced autumn one day and spring the next. In England the daffodils have bloomed and are past their best. In Canada, or at least in this part, they have yet to blossom and it is still decidedly chilly.

Of course visiting Cape Town is also a chance to see family. My brother and sister-in-law were away but I caught up with my aunt, various cousins and a niece for Sunday lunch. I felt that I had not talked properly to niece Sarah, and she was good enough to join me for lunch on the Monday before I flew back to the UK. We walked across from the City Lodge to a new restaurant right next door. It was good to have a decent conversation and catch up with family news. Because the flight from Cape Town is so late (after 11 pm), I only watched one film: The Great Buster, a biopic of filmmaker and comedian Buster Keaton. He was one of the few stars who transitioned successfully from silent films to sound. It was not demanding so was good to watch in the small hours.

I had a relatively short spell in England. My sister came up from London for Easter and her birthday. We went to a show at the Norwich Playhouse, where Rowan works. It was an amateur production of A Sound of Music. It was outstanding. There were a few wrong notes, but not many at all. The set was imaginative and the acting most impressive. I think amateur productions can be excellent because people really throw their hearts into the show.

Continue reading

More Climate Change

February in England was mild and dry, in my view clear evidence of environmental change. It is five minutes to midnight on the Doomsday clock. It is not surprising the birds and insects are reacting to this warm spell (between 5 and 10°C above seasonal averages). There was a robin singing its little heart out, on a tree with bare branches, yesterday evening. Robins are not shy, but it was unique to see this bird so clearly silhouetted against the very blue sky. We are not taking the urgent and dramatic actions needed to address what we are doing to our natural world. I fluctuate between optimism and despair.

It was an interesting month from the productivity point of view. I managed to complete and submit two pieces of work: an article and a book chapter. More importantly I did something long overdue that will, hopefully, improve my efficiency. Sometimes as I write I think to myself ‘I have said this before, but where?’ Over a morning I made a list of everything I had published, or drafted, since the beginning of 2016. This included the table of contents, a list of figures, tables and maps, and an abstract. My memory may be bad, but at least now I know where to look. I also listed ideas I have had and not properly developed, these could be revisited and turned into articles.

The month began with a visit to the Robert Bosch United World College in Freiburg in southern Germany. The founding headmaster of the college was the head at Waterford for many years. Indeed, I was the first governor to interview him in 1998. This was at a time when we were desperately looking for a new head. What had happened is we had appointed a man who turned out to be a disaster and who, fortunately, served only one contract. He was probably a good educationalist, but he did not have a grasp of finances. Because the reporting was not adequate, by the time the Governing Council realised what was going on, the school was deep in the red. We were lucky to get a couple from the UK to come and act in the Principal’s role while we went head hunting. Then we were lucky to get Laurence!

Laurence Nodder and his wife Debbie took up the position in 1998 and stayed for close to 15 years. He was then invited to establish the new United World College in Freiburg. That meant supervising building work, some new and some conversions of existing buildings, as well as recruiting staff and students. This was challenging, even in efficient Germany. As I saw walking around the college, they have done a remarkable job. I felt very lucky that Laurence invited me to come and give a public lecture to the school and community.

Continue reading

“January brings the snow: makes your feet and fingers glow”

(Title: Michael Flanders and Donald Swann’s ‘A Song of the Weather’)

The first half of January was exceptionally warm for winter. We are told not to ‘cherry pick’ weather events to argue global warming is real. When they come one after the other, however, the evidence seems to be stacking up. The weather maps showed high pressure over the UK and to the south, so the fronts seem to be further north than usual. Scotland got a battering. Sadly the potential advent of Scottish independence won’t help that situation – weather is bigger than politics.

The rest of the month saw a few hard frosts, grey days and wind and rain, as well as some gloriously sunny spells. Even in the depths of winter the sun shining through the window can be warm enough to warm the south facing rooms. We have wood / coal burning stoves in the living areas and I must admit to getting a great deal of pleasure in laying and lighting the fire: paper, kindling larger pieces of wood and the coal. If I do it right we use 10 kg of coal for four fires. It warms both the room and the house very nicely.

If January weather was not enough to keep us depressed, the all-consuming topic in the UK is Brexit. Theresa May presented her deal to Parliament in mid-January, and it was soundly defeated. In fact the margin was astonishing: MPs voted by 432 votes to 202 to reject the deal. Labour leader Jeremy Corbyn immediately tabled a vote of no confidence, which, unsurprisingly was not passed. If it had been it would have led to a general election.

The problem is both the Conservative and Labour parties are both deeply divided on leaving the EU and the deal, so there is no consensus. An election would not help, unless the smaller parties did really well, which is unlikely. It is all a terrible mess. There have been, in past few days, more votes in Parliament and the situation is even more uncertain at the end of January.

The papers, or at least the ones I read, are full of commentary on the rise of the right in global politics. This is clearly happening, but just as worrying is the growth of incompetence in leadership. The events of the past few months in the USA seem to epitomise this. When this is combined with the lack of vision I worry even more.

“A politician thinks of the next election. A statesman, of the next generation.”

I knew the quote and I was writing this letter I decided to see where it was from. The answer is James Freeman Clarke (April 4, 1810 – June 8, 1888) an American theologian and author. There do not seem to be any great works by him but lots of very good quotes.

Continue reading