Pandemics and travels

It has been an inordinately long time since I last posted to my website. A lot has happened. In early July I travelled from Durban to Cape Town for a few days, seeing friends and staying with Derek and Lynn (my brother and wife). On Sunday 10th July I flew from Cape Town back to Norwich via Amsterdam. By Thursday I had a scratchy throat, headache, cough, and a metallic taste in my mouth. A day later I tested positive for Covid-19. The virus I had written so much about got me! I was not seriously ill, but it was not pleasant. I am convinced I was infected in an airport or on a plane.

I was due to travel to Montreal for the International AIDS Economics Network (IAEN) meeting ahead of the International AIDS Conference on Monday 25th July. Although I do not believe I was infectious, travelling seemed unwise. I was very relieved to consistently test negative in the days before I flew. At one point I thought my attendance was in doubt which would have been difficult for my colleagues as we were co-organising a meeting.

Covid-19 is a horrible disease. I had two vaccinations and a booster, but it did not stop me getting the virus. At no point did I feel my life was threatened, and indeed the new, essential, bit of medical kit, a pulse oximeter, indicated that my blood oxygen levels remained high. I was lucky I think, but the cough is taking ages to disappear. It is still annoying, especially at night. Thank heavens for the vaccinations. Interestingly, at the conference, when I revealed I had just had Covid, more than half the people I was speaking to said, “oh so have I”. It seems there has been a pandemic wave which, because it did not kill or hospitalise most people, has not been recorded or noted. Interestingly the other members of the household in the UK remained well! The conference may well have been a super-spreader event.

My reflection, having had the disease, is that it is probably impossible to avoid infection. Certainly, international travel, airplanes and airports mean one is very likely to be exposed, despite wearing masks (which was not mandatory for passengers on the flight to Europe). However, if people have been vaccinated, they should not get seriously ill. It can be treated with a range of drugs. A friend I saw at the conference, who took the medicine, warned that this seems to lead to a rebound positive test a few days later. I really hope vaccinations plus infection will ensure a degree of immunity for a decent time, but I don’t know if this will be the case.

It is over two decades since the first meeting of the IAEN was convened in Durban and I was involved from the very beginning. The Network generally held two-day meetings ahead of the International AIDS Society’s biannual AIDS Conference. In 2020 a virtual meeting was held in conjunction with the San Francisco conference. In Montreal we had a ‘hybrid’ meeting, as they are now called, with a mix of in person and virtual presentations.

Our meeting faced a number of challenges. In the past we raised sponsorship for scholarships and partnered with local academic establishments to save money on room hire. We were not able to do either this year. In addition, many potential participants from the developing world were unable to obtain visas in time for the meeting, indeed the senior Canadian government minister who was expected to attend did not. We suspect he knew he would be heckled and did not want the confrontation or the bad press that would follow. This lack of support was covered in the Canadian press, not that it will make any difference. Despite all this we were delighted to have 60 people in the room and present a full programme of research.

Montreal is a delightful city and I enjoy it, although we did not have very much time for sightseeing. Initially I stayed in the hotel my colleague booked us into. I won’t name it here though. It is a family hotel, run by Taiwanese immigrants, right on the edge of the red-light area. There is a hard to find door on the street that leads up to the reception area and then there were two floors of rooms. These were adequate but in need of renovation and redecoration. The reception was not staffed all the time, not that it made much difference since most people who appeared behind the desk did not speak very much English. I had to resort to the standard English practice when faced with this: speaking loudly, slowly and clearly and using mime. As I left one midday there was a couple checking in, without luggage. This led me to speculate that the rooms may be let for periods of less than a night. I found an unopened package of condoms on the floor next to my bed which tended to confirm this supposition.

I had been unable to get accommodation in this cheap hotel for the entire period, so ended up moving to an anonymous, but very standard, Travel lodge style hotel. This was nearer the conference centre, so it suited me. This hotel even had a gym, an amenity I would have used religiously until quite recently, indeed I found it marginally worrying that I did not feel guilty about it. Mind you the ‘Palais de Congress’ is a vast building, as a result I had no difficulty in managing my 10,000 steps per day. Unfortunately, I also kept up my wine intake.

This blog was partly written on the train from Montreal to Toronto, a journey of just under six hours. The train was late! I ended up in a carriage with two Chinese families in the seats in front of me. One mother was travelling with two children, about five and two. She brought their own food, and it was interesting watching the littlest one using chopsticks, she had about as much skill as I do. Obviously, this is a skill which has to be learnt rapidly. She spent a happy half an hour playing with her facemask and then moved on to sticky sweets! The journey is not particularly interesting, scenic, or fast! But trains are comfortable and environmentally friendly and the connection to Kitchener is good.

It was fantastic to connect with so many old friends and colleagues. One I only bumped into on the last day. Mitchell Warren heads up AVAC. I first met him when he was starting his career in Durban. I was able to tell him that I thought of him and his family frequently in Durban, my walk to the Glenwood Bakery takes me past the house they lived in. He was amused and pleased to learn this. The South African contingent was sizable and very present. I was told there were over 30 Swazis there, but I only met one. In the past we would have organised a meeting of Swazi researchers, but I failed to do this, largely I think because of travel and not being very well.

We did however manage to publish a special issue of the African Journal of AIDS Research on ‘AIDS in the Time of COVID’. This was thanks to superhuman efforts by the editorial team in Grahamstown, and the fact that authors and reviewers were responsive to the deadlines. Inevitably a few articles simply did not make it, so we will mop them up with a special section in the next issue, assuming, of course, that they get through the peer review process. I was delighted that we were able to produce such a timely issue with the support of UNAIDS. Even more pleasing is the fact that it is open access, anyone can look at it and download the articles, including anyone who reads this blog!

Jubilees and a Slow Start to Summer

A month ago, I wrote that we were waiting on tenterhooks for the swifts to return, and to see if there were any takers for the nest boxes we had installed. I am delighted to say that the birds arrived a couple of days after the post was published, although there have been no obvious takers for the ‘accommodation’ we are providing. Unfortunately, the swift box that plays swift calls developed a fault. I don’t want to attract swifts with laryngitis, so it was sent off for repair, but that meant we lost a couple of weeks. The sound of swifts is like lost souls wheeling and shrieking overhead, but the sight of them makes up for the sound.

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Funerals, Memorials and Spring

We are waiting on tenterhooks for the swifts to return to Norwich. In summer 2021, we had six nest boxes installed, under the eaves, on the side of the house. It was too late for that breeding season, so we will only learn if the birds find them attractive in the next few weeks. We are told to encourage them by playing recordings of swifts calling. The conservationists warn that it may take a couple of years before birds choose to nest in our boxes.

The story of swifts is a counterpoint to sadness I have experienced over the last weeks. In early May we attended the funeral service of Joan Watts (3 June 1926 to 8 April 2022). A long life and, as the person who took the service told us, a happy and good one. We knew her as the sister of Arthur Duffield, whom Ailsa had befriended as part of her bereavement support network. Arthur died two years ago. He was a widower and as neither he nor his sister had children, that direct lineage ends. Joan lived and managed on her own, amazing considering she had a leg amputated.

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‘Love Light’ and ‘Love Life’. Reflections on Retirement

The heading for this posting is taken from a festival held in Norwich in mid-February and my own admonition to myself. It has been a while since I last posted anything on my website, it was at the beginning of January I see. Confusingly quite a lot has happened, but at the same time it seems as though not very much has. Perhaps a sign of the times.

I am coming to the end of my second month of retirement. It is challenging. One of my wise friends wrote to me saying there were three things to be aware of with this changing status. The first is a dramatic decline in income. This is certainly true. That is not to say that I don’t have enough, I do, but instead of, in economic terms, drawing from the flow I may need to dip into the stock. Some argue good planning means the cheque for one’s funeral should bounce because there are insufficient funds. Sadly, I think this is not a feasible option. Gene Perret, a Hollywood screenwriter, said:

“Retirement: it is nice to be out of the rat race, but you have to learn to get along with less cheese.”

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Of Birds and Viruses

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.

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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.

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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.

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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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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.

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Covid-19 Watch: Green Shoots!

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

There had been no rain in Norwich for six weeks and the garden was looking decidedly wilted. Finally, on Sunday night, the heavens opened, and to the accompaniment of thunder and lightning, sheets of rain fell. The lawn had been brown and within 24 hours was transformed into a green swath. The rain butts filled within a few days as showers continued to march across East Anglia. It was a reminder that nature is beyond our control, and Covid-19 is a reminder that it can turn on us. Zoonotic events like the one that gave us SARS-Cov-2 are becoming more frequent. We must both prevent them through better stewardship, and be prepared for them. The Wall Street Journal has an interesting analysis: ‘A deadly coronavirus was inevitable. Why was no one ready?’ the subheading: ‘Scientists warned of a pandemic for decades, yet when Covid-19 arrived, the world had few resources and little understanding’. The authors conclude withdrawal of support to the Atlanta based Centers for Disease Control meant early warnings mechanisms were lost.1

In general, the epidemic is beginning to become more predictable and there are a growing number of countries where daily cases have peaked and are now falling. This includes South Africa, the subject of this week’s guest contribution, where the number of new cases peaked towards the end of July. Across much of Europe the daily number of new cases was declining but some countries, notably Spain, France and the Netherlands have, over the past week, reported increases. Boris Johnson’s government has imposed quarantines on people arriving from certain countries, the footnote sets out the complex governance in the UK.2 Wales, Scotland and Northern Ireland have different rules and regulations regarding gathering and could, but don’t yet, have different quarantines.

In this blog I wanted to make some predictions about the future. It is time to think about where we are going and how long this may take. I am aware that this is inadvisable, after all Sir Arthur Conan Doyle’s Sherlock Holmes said: “It is a capital mistake to theorize before one has data. Insensibly one begins to twist facts to suit theories, instead of theories to suit facts”.3 In addition, I am aware that this week’s offering is becoming too long, so I will hold that over for a week.
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