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the hard and soft science leading our journey

Are we nearly there yet? Not quite, the vaccine is just round the next corner

The growing stream of positive news about the effectiveness of candidate C19 vaccines is indeed phenomenally good news. Yet the journey to the good type of herd immunity based on an immunised population will be long and winding.  and yes we really are nearly there but how nearly is near. With a second RNA vaccine announced to have 95% protection and several others in the pipeline none of which suffer from the same cold-chain logistics challenges in principle, the path to population immunity is clear. Yet there remains an enormous challenge to get sufficient uptake for things to be getting back to normal by this time next year and indeed at all.  As the inventor of the Pfizer vaccine noted 80% must be vaccinated by autumn to beat major outbreaks next winter.  This is a very tall order.  Further, there are huge trust issues among those who are not naturally classical anti-vaxers. Despite the tragically high levels of deaths and risk in the US, a recent poll...

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The vaccine will come eventually but meanwhile much can be done to lower R0 without the powers of a repressive regime

 

Until the completion of an eventual mass vaccination program with either the newly announced vaccine or that and others, China stands out as the only large (of course the largest) country to beat the pandemic. Some have doubted the figures but the success of other large south Asian nations to manage the pandemic suggests their success is real.  New Zealand, a European western-style democracy has also a very good record in delivering eradication but its size and geography make it an exception to any rule. Without the advantages of a small remote island nation with a leader who acted fast and was able to garner a large national consensus, it is instructive to examine the levers China employed to achieve it.  A short article in the Lancet set out the key factors: 

  • speed of action, 
  • use of draconian propaganda (drones equipped with echoing loudspeaker berating non-compliers - the degree to which this actually happened, or was used on social media as a...
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The app is here!

app Oct 12, 2020

Set up your community app now and help your favourite hospitality spots stay fever free - and open - for the long run. 

CREATE YOUR USER ACCOUNT so that you can visit FEVER FREE ZONES

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What on earth are ”symptoms” when you have a stiff upper lip?

Uncategorized Sep 17, 2020

 

We are told that perhaps the most significant challenge mopping up C19 is that up to eight out of ten C19 cases may report no symptoms at all. It all seems so hopeless if we can’t identify C19 then how can we track and trace it, and how can we ever beat it? 

Yet case studies describe ‘asymptomatic’ people who, once diagnosed with C19, recalled some sort of symptoms that they had initially failed to recognise or had dismissed.  

Even before C19, it was standard practice to ignore symptoms. After all, who has time to contemplate being sick? The consequences of having to take time out from work are too significant and who wants to be accused of “Man flu”? So as a nation, we have learned just to keep calm and carry on. We have learned to ignore our bodies until we are laid low by them. 

This mindset existed even before the global pandemic where the individual stakes of admitting symptoms and sickness were considerably less...

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In a nutshell what is Fever Free Zone all about ?

"FeverFreeZone is an initiative that sets out to help us all change and be proactive in being part of the solution to C19 and not part of the problem. FFZ is a membership quality accreditation scheme for responsible businesses who train, are assessed, and are quality assured to adhere to the govt advice regarding C19 measures required in their business sector. In addition, businesses are trained to offer temperature assessment using a clinically recognised contactless thermometer according to a Standard Operating Procedure.  The temperature triggers a status page on the customer’s mobile phone indicating they are “fever free” in which case they get frictionless access to participating businesses, for six hours or else if they are NOT fever free (i.e. the temperature assessment is 37.8 or greater) the app directs them to seek advice from the NHS and if consent is obtained  (potentially) connects directly into the NHS test track and trace workflow....

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Be part of the solution to C19

Uncategorized Sep 01, 2020

I am a  Medical Doctor, Clinical Epidemiologist, Public Health Consultant (experience contact tracing), Health Tech founder. I have become more and more depressed and disappointed by the UK's response to Covid-19.  I realise my life has changed beyond recognition and I want my old one back.  I see the months and even years ahead settling into a yoyoing of less, and then more, social distancing which will keep businesses and our lives partially throttled. I realised that we all need to take individual responsibility for not being part of the problem and indeed being part of the solution. We must be willing to change our way of thinking and change our public behaviour if that is necessary. We must do whatever it takes to irradicate the disease.

As things stand, although I want the partial lockdown limbo to end but fear it appears to be here to stay.

I was so pleased when the UK and the Scottish government announced the bringing back of Test...

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C19 Specific Safety Measures

The UK and Scottish Government guidance around masks and face-coverings was slow to evolve, and so is guidance on body temperature assessment. Scientists still argue about where and how people should wear masks. Now even their biggest initial opponents accept that masks are part of the solution.

Many of us sensed this at the very beginning of the pandemic, and it turns out to be quite hard for scientists and governments to act on common sense which later becomes quite apparent.

There are traditionally two approaches to the development of guidelines for public health and Medicine.

  1. Evidence-based Medicine, where changes are only made based on substantial evidence using rigorous experimental evidence including randomised controlled trials
  2. Precautionary approach, where we take simple, sensible steps in the absence of rigorous experimental evidence and then monitor and modify advice regularly.

In non-pandemic conditions, the Evidence-based approach is the best because it...

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Mopping Up

Uncategorized Sep 01, 2020

Hyperlocal symptom-screening is not only the task of a responsible citizenry, but it also gives us all agency in an increasingly uncertain future.

 

Covid-19 threatens to be with us for some time despite valiant attempts at control through social distancing and hygiene measures.

While one infectious case remains in the community, the threat of an outbreak that will shut down a business, a street and a neighbourhood remain a real and present danger.

As social distancing reduces either through human fatigue or else through government guidance, as it must to open up the economy back up to maintain our way of life, the chances of the epidemic returning are high.

NHS Test Track and Trace (Test and Protect) is a massive part of the solution, but it does not capture those cases which do not get tested, they remain in the community providing embers to rekindle a full lockdown.

It was Napoleon who called the British a Nation of Shopkeepers. Business owners become the Gatekeepers, with a...

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