I have been reading about Covid

This is my new toy.

It is a pulse oximeter. It shines a light through my fingertip, senses it, and works out my blood oxygen level and pulse. I read about “Happy hypoxia”, so called because one is oblivious to it- because you feel breathless when you cannot expel CO2, but Covid pneumonia allows you to expel CO2 just not to absorb oxygen properly. So you are slowly starved of oxygen, but don’t realise it. I feel “silent hypoxia” is a better word, despite the loss of alliteration. You breathe more and more rapidly, straining your heart and lungs, but are unaware.

I read about that, and instantly ordered the oximeter. I hope I don’t need it- I may not catch the virus at all. But, unless civilisation breaks down, I should be able to give this particular piece of evidence to a doctor, saying my blood oxygen was below normal (normal is 95-100%) and might get into hospital on time. I also bought a thermometer to assess the severity of any fever.

Does vitamin D deficiency cause cytokine storms? There was some research in Trinity College Dublin, I think saying vitamin D might have something to do with them. A cytokine storm is when your immune cells stop recognising which cells are healthy and which infested with the virus, and start ordering them all to self-destruct, viral and healthy alike. So you drown in pus.

All this stuff is really horrible. Still, as long as you don’t overestimate the probability or severity of risk, it is better to know. Many people catch the virus without being intubated, and may recover completely.

In February I had no idea what a cytokine storm was. Vitamin D deficiency was a suggestion: there is evidence of correlation, and an explanation why vitamin D might be relevant is hypothesised, but the link was not proven (as I understand it). White people should spend more time in the sun. Then I read this. If vitamin D is a platitude cast in the faces of Black, Asian and minority ethnic people, as if this is a simple precaution and you’ll be alright, there is a problem.

I am a pretty straight kind of guy (gal, whatever) and depending on what experience you have of me you might decide to trust what I say here. And, it’s all second hand. I read something, I take it in partially, I remember it partially. I have no expertise, just the lay interest of an intelligent person with a lot of time whose friends may die. Like any other social media, it’s at best a less trustworthy source than Google will find.

I learned of hypoxia first in the New York Times, in an article by a doctor. It’s not peer-reviewed, and the evidence was anecdotal, but I felt it a reasonably prestigious source. You may trust others, and the trust is not wholly objective.

This blog has had views from 199 countries and territories. I would like views from Turkmenistan or Tajikistan, Mauritania, Chad or the DRC, to colour in more of the map, but I got fed up waiting for no.200, so I am celebrating with this header photo.

You may have noticed the pulse indicated in that photo was quite low. I googled, found the scary word Brachycardia, phoned my GP, and the next day (Friday 15th) had an ECG and blood tests. I have a normal sinus rhythm, so no need to worry unless I have sudden dizziness or breathlessness. Thank God for the NHS.

Arguably, I was foolish to buy the oximeter, or foolish to use it before the frightening possible moment when I had been feverish and coughing for a week, and was getting no better. I suppose I could have decided to take my pulse at any point, with or without it, but had not, and my feeling is that the low pulse is a sudden discovery rather than a sudden onset. In the event I may have given myself a fright without any reason. Just because 60 is normal pulse, does not mean that in me, in the absence of other symptoms, 47 is healthy enough. Yet, knowing of it, I am pleased at the ease of getting it checked.

Decent health care

In the US, UK and Australia, right wing governments are bad for your health. It’s not just the Republican party, working to increase the numbers of uninsured Americans and increase costs to the rest, presiding over more “deaths of despair”. It’s British Tories, ending the growth of life expectancy.

British vaccination rates are decreasing because of the Tories. Last month the Prime Minister, BoJo the Clown, pledged to take on the anti-vaxxers, goading social media companies to fight their propaganda.

However people don’t trust social media as a source of health information, and the companies already take action to make anti-vax posts less visible. As so often, Tories seek a good headline rather than action to improve things.

Hard line anti-vaxxers are a tiny minority. Anna Watson, founder of a facebook anti-vax group, talked of their weariness and despair at social media clampdowns. More numerous are the fence-sitters, who have not come to a decision. The responsibility for making health decisions for your children is heavy. Health information has been poor. There are risks in vaccines. Instead of telling people they should vaccinate, it is better to say there are risks in vaccines, but not vaccinating is more risky.

However the biggest group who don’t vaccinate actually believe vaccines are healthy and reasonably safe. They are parents who face barriers to making appointments. GP appointments are harder to get, and fit in to the diary. GPs don’t chase up unvaccinated children.

In 2015, the decline in vaccination rates started along with Tory reforms to the NHS which made way for privatisation along with other harms. They placed some health responsibilities on the increasingly underfunded local authorities, and lost immunisation expertise. They cut the number of health visitors by 25%.

Overstretched parents simply find vaccination too difficult.

Anti-vaxxers may be unreachable. They cherry pick scientific studies, and have a false self image as knowledgeable, like many internet conspiracy groups. Decent health spending and proper organisation preserves herd immunity to disease. An eye-catching pledge to ask social media companies to do what they are already doing does not.

The Chancellor, Sajid Javid, boasted that after no deal Brexit there would be no excise duties to pay on cigarettes and alcohol bought by travellers. It’ll make your cash “go that little bit further,” he said, as if he did not realise how far the pound has sunk against the Euro. At the same time the health secretary planned some work against excessive drinking, the chancellor was undermining him. Deaths of despair are on the rise here too.

In Australia, parents are texted after vaccinations, and can reply with observed side effects. Listening to people’s concerns increases trust in the system.

Vote Labour. Save the NHS. Save the economy from Alexander “fuck business” Johnson. Vote for the chance of a Brexit which won’t damage Britain like Tory Brexit will.

Jeremy Corbyn

To the Pen Green Centre, Corby, to see Jeremy Corbyn, leader of the Labour Party and of Her Majesty’s Loyal Opposition. I had not heard of Pen Green, but it was set up in 1983 and the prototype on which the Children’s Centre network was based, created by Labour, vandalised and vitiated by the Tories. It teaches courses from the first introduction, preparing to work with children, to PhD level: Jacky tells me of a professor of midwifery (?) she knows who left school without qualifications but just kept going once she was encouraged. “It is better to put a fence at the top of the slope than spend money picking up the broken people at the bottom.”

Beth Miller, our candidate, introduced Mr Corbyn. She gets more and more confident, speaking spontaneously, working the crowd. He speaks of the Tory disaster of Northamptonshire County Council, bankrupted by Tory councillors cutting the council tax and contracting out services, with the problem exacerbated by the Tory government cutting the central grant, supported by the county’s Tory MPs.

Jeremy has been round 74 marginal constituencies, targets, this year, getting members involved. He says Labour would end the rote learning and stress on children and teachers, and develop children’s personality through art and music. Education should be a right not a commodity: they would increase corporate taxes for tertiary life-long learning. Labour would support the principle of the NHS against privatisation, looking after the whole person: suicide is the main killer of young men. We would have a proper plan for social care: it is a scandal when people cannot get a care place, so stay in a hospital bed. I note that he does not use the terse, coarse phrase “bed-blocking”. It is a waste when people, mostly women, give up their careers to look after relatives. Rough sleeping has doubled since 2010. He has spoken to rough sleepers, hearing their stories of job loss or relationship breakdown, it could happen to many of us. The empty investment properties in London are a scandal, he would build council houses.

He wants a gentler, kinder Britain. He knows the media is “unkind” to him, attacking because he is determined to change the country for the better.

He wants to hear our ideas for the council, and how we will suffer from the ÂŁ70m cuts in services. I fear for British politics. With the former foreign secretary fomenting hate against Muslim women with mockery, and the Brexit secretary wanting to “unchain Britannia” by ending all workers’ rights or public services, making Margaret Thatcher look like Shirley Williams, my neighbour, who rents privately and whose son lives with her is concerned about the “benefit fraud”, all the people on the estate not working. He says he does not hear such arguments often. The way to get hope is through campaigning, such as the judicial review of the closure of the Corby Urgent Care Centre. Yes.

I need not ask him about trans: he, and many female Labour MPs, have said unequivocally “Trans women are women”.

I fiddle with my camera. “Would you like a photograph?” he asks. Of course I would. You can see how delighted I am. I get depressive about politics, and now feel much better.

I chatted to John Prescott’s son, who is going round with the leader.

Outside, in the warm but not blazing sunshine, a man plays a pan raga, a light, gentle sound.

I put that photo on facebook, and someone wrote, “Well, he looks like a nice guy. Are you going to see him again?” Alas, I did not give him my phone number, nor get his- but the photo has that vibe about it.

Mental health

Normally, the word “Kafkaesque” is too strong for my life. I have not turned into an insect, or been arrested on charges I don’t know, but which could be capital. I am not in the position of the mother who knows the social worker will take her child if she does not give the right answer, but has no idea how to believe what she must say.

Today has not been completely wasted.

Water has been coming into my flat for years, but only when the rain was particularly heavy and the wind in the right direction. Since March it has been coming in most rainy days. I told the letting agent in March, and eventually when I saw him and the landord outside, I invited them in to see the damp patches on the ceiling, the crack which drips along its entire length and the bucket under the light fitting with several pints of water in it. We went up on the flat roof, and saw the guttering on the upper storey was broken.

A few days later I saw a man with a blow-torch applying more sealant to the flat roof. Never accuse the landlord of not spending money. Water is still dripping in, though. Trickling, sometimes, down the light fitting. I called the agent again, and the secretary would see what was happening. She sent a man round.

The man and his son went with me up on the flat roof, where we saw water flowing from the break in the gutter onto some gravel on the flat roof. The son poked around on the gravel for a bit, and the father said the roof should slope a bit, rather than forming puddles like that. It may still be under guarantee. He thought the gutter should be fixed, but could not just come and do any job needing done- he had to provide a report, then a quote, for everything. Next door has water flowing down an inner wall. He left down the metal stairs and I just stood for a bit, thinking I should probably go down again but not really seeing the point.

Today I cycled to Scotstoun to see someone who works for the local mental health services. I had been referred by the woman trying to get me back in employment, then a woman, Ines, had phoned me, and told me I could have a “follow-up” appointment. She had quizzed me in great detail about my suicidal ideation, and I told her those metal steps were my chosen place for the drop, and how I had considered the precise nature of the rope and the knot I would need. I found the detailed quizzing wearing. Today, Bharti was surprised to hear I was suicidal in December, she thought it was in 2009. No, that was when I left the office at lunchtime intending to take my sleeping pills. The thoughts of hanging were around the start of this year. Even as I said it, I was unsure of the point of explaining.

I got the impression that she did not think she could do anything for me, perhaps because of funding, or the particular service she offered, and wanted to create a file record to justify that decision. “You’ve not got any goals,” she said, near the end of the 45 minutes. I reminded her that I had said my goal was to get back to work, as Esther’s minions were liable to take away all my income. I would like my rational self, which tells me to apply for work, and my emotional self which can’t bear to, to be talking to each other and working together. I would like to be able to talk about these things without crying. Near the end I was blurting all sorts of stuff about why I could not trust or respect my GP practice- the first mistake I can forgive, the second carelessness is more troublesome. Was that a mark down against me?

But the day was not completely wasted, because I cycled thirty miles in sunshine, and spent some time in mature woodland with these bluebells.

Big data

File:Google’s First Production Server.jpgWhether I should opt out from the NHS health data sharing scheme is an emotional not a rational decision. I opted out.

I see the point of it. GP and hospital records go to the Health and Social Care Information Centre in Leeds, where they may be analysed to see what health provision works best. “Free text”- what the GP notes about symptoms- would not be sent to HSCIC. Diagnoses, test results and prescriptions would be.

I thought the data would be used for research, but the “Clinical Practice Research Datalink” already gives information to researchers.

My email archive gives a complete record of me, in my real name. Someone has a record of all I have bought at the supermarket in the last three years, and is able to sell that information. My data is out there already. Then again, my GP said she wished they could opt out all their patients, rather than have us opt out individually. She has concerns about the data protection. I have concerns about large Government computer systems, which have made a mess of every new benefit for the last twenty years. But, mainly, I don’t trust them, so I opt out.

Mmm. Do Buzzfeed quizzes record your responses for advertising? What about personality tests?

——————–

I am lying in bed feeling powerlessness and terror, after two things on facebook which remind me of two separate-

I went to the GP to ask about counselling, as recommended by the psychiatrist, and my “while I’m here” was about breathlessness cycling. I have no crushing pain in the centre of my chest, I just get out of breath cycling where I had cycled quite happily last year. She said, well, exercise more, you have exercised less in the winter weather.

File:Charles De Wolf Brownell - Tree and Sailboat, Lyme, Connecticut.jpgSo, yesterday, this started a thought in me: my way is to withdraw. Cycling up that hill, get a bit breathless: stop cycling and moan about it. Then I thought, no, my way is to get the bit between my teeth and battle on despite multiple discouragements, to the end. Like then.
-But that was last century.
(Thoughts of reverting go through my mind. Don’t go there.)

One friend is dying of cancer, palliative care only, one will stay in hospital tonight for tests and fears cancer. Life is a slow tragedy with one end. So-

More exercise could do me good, spiritually: that moment minute or hour when I push on though I want to stop.

———————

-Too low for a racer, too high for a tourer, not much use to anyone really, said the man looking at my bicycle gears. In about 1988. I remembered it, and thought, I am the kind of person who remembers small slights for decades, and tortures herself with them. Then I thought, character revealed in one comment- why was he cycling Lands End to John O’Groats alone, again? Perfect memory for a writer. Being positive takes effort.

Am I the only one who sees others posting things like “stay away from drama and negativity” and worries it is all about me?

I have acquired a meditation stool. So I will still be uncomfortable, bored, distracted or confronted by bits of myself I don’t like in meditation, but my feet won’t go to sleep.

The geese form pairs and fly low, circling over the river, honking constantly, for the joys of Spring.

Correct policies

The presence of a hospital policy or procedure is not a good marker of actual practice.

I was only half listening, but this quote on Radio 4 from a report of the National Audit of Dementia on the treatment of sufferers in the NHS made me take notice. My second thought was, I don’t walk my own talk, and that is a good thing: I realise that something is right, on an intellectual level or in my heart, and I integrate it into my life over time. I am learning and growing. So a new policy may take time to percolate down through an organisation.

I have heard of care homes with two rotas: the one to show the inspection team if they visit, and the actual rota operated, with fewer staff. That is fraud.

In hospitals, there might be a variety of reasons why the documented policies were not implemented. There might be too great an emphasis on getting the paperwork right, or appearing to have the right policies. The policy requirements might be too detailed: they cannot all be known, and workers are too keen to implement the policies they have actually heard of, to guard their own backs.

I think that if there is a description of how a hospital will operate, it should be correct. Spouting words which do not fit reality harms us all. My friend who used to work with the NHS says that if there is a policy, and it is not followed, at least there is a wrong which can be specified, punished or compensated.

It is in this context that I read NHS slogans such as “your health, your choices”.