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31 things I learned in May 2021

1: According to a Survation poll, almost a quarter of people who vote Conservative think Boris Johnson is lying when he denies saying that he would rather “bodies pile up in their thousands” than impose a lockdown.

I really struggle with understanding the cognitive dissonance required to simultaneously believe that (a) the Prime Minister is openly lying to the public and Parliament with the support of his ministers and MPs; (b) the Prime Minister thinks that thousands of British citizens dying is the preferred one of any two options in Government; and (c) the Prime Minister and his party are the best people to lead the country.

I don’t understand politics.

2: Dominic Raab, a man who studied law at Cambridge, is on the Sunday morning shows hawking the line that “there’s no separate body or individual that has power over [the Prime Minister]. That’s why we have elections.”

He must know that this is constitutionally illiterate, yet he’s choosing to say it anyway because—presumably—he values the pursuit of power over truth.

I don’t understand politics.

3: According to Laura Kuenssberg, “Politicians, even really honest ones, regularly say things they don’t quite believe. The public knows this. We don’t expect our politicians to be angels.”

What is the point of public service if not to speak the truth and honestly strive to do what you think is right for the electorate you serve?

I don’t understand politics.

4: On 22 February, the Prime Minister told Parliament “that the contracts [for procurement of PPE] are there on the record for everybody to see.” In fact, many of the contracts had not yet been published: for example, this one wasn’t published until 8 March. It seems that rather than the Prime Minister simply correcting the record, his inability to admit straightforward errors means we now have to debate whether the original—obviously incorrect—statement was misleading.

I don’t understand politics.

5: “Used to walking and having more time to slowly take in the landscape, travelers found that the railroad bombarded such perceptual openness, producing a sort of exhaustion; in fact, an 1862 medical journal described the experience in these terms: ‘The rapidity and variety of the impressions necessarily fatigue both the eye and the brain.’”

I don’t understand politics… but that has very little to do with this.

6: A failure of diplomacy so great that it involves threats of cut electricity supplies and the deployment of Navy ships with machine guns against one of our nearest neighbours is thought to boost the electoral prospects of the political party responsible (“A cynic would be forgiven for thinking the PM won’t believe his luck that his robust response to perceived French aggression is leading the news just as Britons go the ballot box.”)

I don’t understand politics.

7: “May 7th was a bleak day for Sir Keir Starmer, who took over as Labour leader a year ago from the hard-left Jeremy Corbyn after the party’s worst election performance since 1935.The campaign was overshadowed by allegations that Mr Johnson had improperly sought donations to refurbish his flat. Labour’s candidate, Paul Williams, was a family doctor who has worked in clinics during the pandemic, which has hit the town hard, and witnessed the government’s early missteps in managing it. None of that mattered much.

“Voters think Mr Johnson a better candidate for prime minister than Sir Keir by 40% to 24%, according to BMG Research, a pollster. He enjoys particularly high support among Brexiteers and those with fewer qualifications. His faltering response to the pandemic, and an often-chaotic turnover of personnel in Downing Street, left Tory MPs in despair, but he will survive in office for as long as they believe he is their best chance at re-election.”

A party in power for 11 years, a Government mired in scandal, and a set of leaders who have gifted us one of the world’s highest covid-19 death rate, result in a record by-election swing in a constituency which has never previously supported the governing party. It’s an unbelievable achievement for the Conservative party, a miserable failure for the opposition, and further proof (as if any were required) that…

I don’t understand politics.

8: “Think about that common, and distinctly modern, Shakespearean truism also found in children’s stories, self-help books, and everyday advice: “To thine own self be true.” We are urged not only to discover that real, authentic version of who we are, but to remain faithful to it at all costs. It leaves little room for having more than one self, despite the many contexts we find ourselves in that draw on our different sides and different strengths. Advice to be true to some essentialized version of your self runs the risk of discouraging change and flexibility.”

9: “Medicine has the authority to label one man’s complaint a legitimate illness, to declare a second man sick though he himself does not complain, and to refuse a third social recognition of his pain, his disability, and even his death. It is medicine which stamps some pain as ‘merely subjective,’ some impairment as malingering, and some deaths—though not others—as suicide. The judge determines what is legal and who is guilty. The priest declares what is holy and who has broken a taboo. The physician decides what is a symptom and who is sick.”

10: In the editor’s letter in the latest Wired, Greg Williams talks about how Apple’s “business model happens to coincide with both governmental and consumer appetites for increased privacy.”

I think he’s wrong: in the UK context, it doesn’t feel to me like there is much governmental appetite for increased privacy. From voter identification, to sharing location history in the covid-19 app, to backdoors in encryption technologies, to calls to prevent anonymous publishing on social media, it feels as though the government is suspicious of the motivations of those who value privacy.

11: I’m on a bit of a Kishi Bashi phase at the moment.

12: “The Queen was leaning over a man injured by an IRA bomb, asking him how much sight he retained. ‘Not a lot’, said the Duke, ‘judging by that tie.’”

13: I learned how Pete Adlington designed the cover for Kazuo Ishiguro’s Klara and The Sun.

14: “It is impossible to read these pages without bemoaning that, in the nation’s worst crisis since 1945, Britons are governed by someone so obviously unsuited to the job. Over the past year, the man who urged the nation to ‘take back control’ refused to take decisions and sought to displace responsibility wherever possible (‘we are following the science’). In his masterly recent portrait of Johnson in the Guardian, Edward Docx describes the prime minister as a clown whose rise to power was built on persuading the audience to collude in the secret that all human endeavour is no more than a complicated joke. Johnson, on receiving bad news in his daily meetings, tends to keep his head bowed. He then looks up quickly, his eyes darting around the room, to find someone to join him in a rueful smirk. The NHS needs more ventilators? Let’s call it ‘Operation Last Gasp’. The temperament behind that humour guided the country on its bleakly circular trajectory.”

15: “Moving on, as a concept, is for stupid people, because any sensible person knows grief is a long-term project. I refuse to rush. The pain that is thrust upon us let no man slow or speed or fix.”

16: Motherland is one of those comedies which divides Wendy and me: I think it’s brilliant, while Wendy is less keen.

17: Almost third of people in Newcastle have worked from home. I’m surprised it’s that high, even considering the pandemic.

18: “The education secretary Gavin Williamson just said: ‘The record number of people taking up science and engineering demonstrates that many are already starting to pivot away from dead-end courses that leave young people with nothing but debt.’

“He’s genuinely gleeful about people not studying art. That’s what it means to the people in power, and that heinous attitude trickles down through every facet of society.

“We are now decades after the YBAs, half a century after Jackson Pollock and a hundred years after Duchamp’s urinal, and public perception of art still hasn’t moved on. People still look at a drip painting or a Rothko and think ‘I could do that’. Art is frozen in the past, in a world where the more a painting looks like a photo the better it is, and that’s been done on purpose.”

19: FiP played The Tibbs’s cover of Santa Baby this morning. I like my music eclectic, but Christmas tunes with breakfast in May is pushing it.

20: I learned about jury nullification, and the principle that “jurors should aim to strike a balance between following their own sense of justice and respecting the accumulated cultural knowledge represented by the law.”

21: I read a bit about how to approach pronouns in the workplace, but it didn’t help me understand the person whose email signature has “she/them” listed in place of the more usual “he/him”, “she/her” or “they/them” combinations.

22: “The [Chernobyl] disaster is both history and myth: it has been exhaustively investigated, yet the basic facts have still not been established. The death toll, for example, has been fixed at just two from the explosions themselves and a further 29 from radiation sickness during the three months afterwards: close to Soviet reports at the time, and far short of the thousands claimed by Western media and intelligence sources. But the long-term figure can only be guessed at. The United Nations’ estimate in 2005 of four thousand deaths is at the low end of a spectrum which extends, in Greenpeace International’s estimate, to ninety thousand. Assessments of the present and future risk continue to diverge. According to Igor Gramotkyn, the current director of the Chernobyl power plant, the site will be a no-go area for at least 20,000 years; other sources think it may be habitable in three centuries, and observe that populations of wolves, bears, beavers and otters are already thriving. By 2000 3.5 million Ukrainians were claiming state benefits as radiation sufferers; yet dozens of elderly former residents have returned to live (and die) in the exclusion zone, and the World Health Organisation has determined that radioactivity-related mutations and birth defects are statistically insignificant.”

23: “Green Man Authority” is a thing.

24: It’s been an exceptionally wet May… so far. It’s sunny today, though.

25: “A precondition for reading good books is not reading bad ones.”

While the span of a lifetime makes this true in a longitudinal sense, I’m not sure I wholly agree with this as a philosophy: in books, as in life, I think a varied diet is important. Junk food is fine sometimes, and bad books can be fun.

26: Gordon Brown’s government is the only one in British history not to have included anyone who went to Eton.

27: It’s easy to forget, but important to remember, the net positive impact of the internet during the COVID-19 pandemic.

28: Preparing for an appraisal after the most challenging year of my career to date has proven to be a surprisingly emotional process.

At a time when I’m frankly exhausted, it’s making me sit alone in a room while I drag up raw memories of unacceptable interpersonal behaviour, frustration with being left repeatedly in invidious positions, working under enormous pressure to unrealistic expectations, the realisation that I’ve had fewer sets of consecutive weekends off in the last year than I have fingers on one hand, the weird psychological instability caused by people insisting that fiction is fact, and much more unpleasantness besides.

In recent years, I’ve grown to be a bit of a secret fan of appraisals, supporting (as they do) reflection on practice and future plans. But this year, I’ve found the process of preparing for the meeting really quite traumatic. Rather than helping me reflect and learn and spot connections, it’s made me brood and relive events that I could not control and that were bad enough to live through just once, thanks.

For some, this must be the experience every year. And, for all the benefit it brings, I don’t think that’s worth it.

I think we need to do medical appraisals better, in a way that is perhaps more like counselling, and doesn’t involve sitting alone revisiting traumas in an unsupported way.

29: It’s depressing to see how widely this completely fictional April Fool’s interview with Eric Carle in The Paris Review came to be reported as fact in so many of his obituaries: “My publisher and I fought bitterly over the stomachache scene in The Very Hungry Caterpillar. The caterpillar, you’ll recall, feasts on cake, ice cream, salami, pie, cheese, sausage, and so on. After this banquet I intended for him to proceed immediately to his metamorphosis, but my publisher insisted that he suffer an episode of nausea first—that some punishment follow his supposed overeating. This disgusted me. It ran entirely contrary to the message of the book. The caterpillar is, after all, very hungry, as sometimes we all are. He has recognized an immense appetite within him and has indulged it, and the experience transforms him, betters him. Including the punitive stomachache ruined the effect … I don’t recognize childhood obesity. No one should. I see children doing what they like, which is eating, and doing it without the shame or remorse later drilled into them by Judeo-Christian ethics.”

30: Duncan Stephen has written a great blog post about why content is more important than technology, and I’m simultaneously delighted by his clear explanation and depressed that it is necessary. I’m fed up of having arguments in the public health world where people excitedly say that they give people information X through medium Y, but want to spend more time tinkering with Y than actually making X both technically accurate and practically useful. And that’s before we even get to the question of whether Y is better than long-standing medium Z from the point of view of the end user, even if Y is more cost-efficient (and whizzy) than Z.

31: Eighteen months of daily lessons is enough… for now.

This post was filed under: Posts delayed by 12 months, Things I've learned.

30 things I learned in April 2021

1: I’m a bit obsessed with Max Richter’s 2012 recomposition of Vivaldi’s Four Seasons at the moment. Particularly, and unseasonably, Winter 1.

2: “In 1989, Shell Oil announced it was redesigning a $3-billion North Sea natural gas platform that it had been developing for years. The reason it gave: Sea levels were going to rise as a result of global warming.

“The original design called for the platform to sit 30 meters above the ocean’s surface, but the company decided to raise it by a meter or two.”

3: The economic generational divide in the UK is something that has played on my mind a lot over the years. It was one of my early pitches for inclusion in the CMO’s annual report, but as the health impacts are mostly in the future, it wasn’t something that was readily visible in surveillance data as yet.

We’re sailing toward an unprecedented crisis, with the burden of paying for the health and social care of the unusually large number of people born from the mid-40s to the early-60s likely to result in an unprecedented liability on those of working age: it’s simple maths.

Yet the same simple maths precludes an easy fix: there isn’t a democratic mandate for rationalising the approach as the median age of voters in the UK is 53.

This Propsect article gives a good overview of recent developments in how this has played out.

During the pandemic, 88 per cent of covid-related job losses affected Britons aged 35 and under, while employment among the more vulnerable over-50s rose.

It takes an average of 19 years to save for the deposit on a first home compared with three years in the 1980s.

“Deaths of despair” (those from suicide and addiction) strike each successive generation at a younger age, and their numbers are increasing. The proportion of young people with diagnosed mental health problems is roughly equivalent to the proportion of over-65s who are millionaires: one in five.

I think it is inevitable that this will lead to social unrest. It is surely impossible to avoid while choices such as triple-locking the basic state pension paid to millionaires while funding cuts mean that student leave university an average of £50,000 in debt. But social unrest only adds to our list of problems.

I have no idea how we can fix any of this. Even if older voters (and politicians) can be persuaded to propose and support politics against their immediate best interests, those very cuts might end up making this generation less healthy and (paradoxically) more costly: four in five aren’t millionaires, and even those who are don’t necessarily have liquid assets.

It’s hard not to imagine that this, along with privacy and climate change, will prove to be one of the dominant long-term societal challenges of the first half of the 21st century.

4: Murder in outer space would be a legally knotty affair.

5: On top of the Scottish independence referendum which looks near inevitable in the next few years, an Irish unity referendum—guaranteed by the Good Friday Agreement—also looks highly likely.

6: It sometimes feels like we’re in an extremely turbulent political period, but on one measure it is remarkably stable: in my lifetime, there have only been handovers between Prime Ministers from different parties twice (John Major to Tony Blair and Gordon Brown to David Cameron). We haven’t had a similarly stable period in this regard since the 1700s.

7: “During one of those recurring leak panics, somebody in Whitehall revealed to a journalist that a cabinet minister was lying. In the uproar that followed, a civil servant was challenged to confirm that she owed unconditional loyalty to her minister. But she demurred. ‘At the end of the day, I answer to the little lady at the end of the Mall.’”

8: “‘Everyone has the right to realise their full potential.’ Quite apart from the now common inflation of the quasi-legal language of ‘rights’, there is a curious emptiness to this claim. It seeks to be at once egalitarian, relativist and positive. ‘Everyone’ has this right; no one can say what another’s ‘full potential’ might be; ‘realising’ it, whatever it is, on this universal scale will be a good thing. Yet has anyone ever realised their full potential? Could it be that in realising my potential, I might get in the way of you realising yours? And what if my potential is to become the most successful mass murderer in history?”

9: “I don’t have remorse and won’t acknowledge failure,” said President Macron in March. I don’t think I’ve ever heard a senior politician sound more like a DSM-5 entry.

10: “In 1937, the 16-year-old Philip walked through German streets for his sister’s funeral as onlookers gave Nazi salutes. His grandson Harry, meanwhile, married a biracial American actor, moved to California, and launched a podcast.

“The 20th century was a hell of a ride, and one in which men’s expectations for their lives changed as dramatically as women’s. No one encapsulated that quite as strangely, or as remarkably, as a man who lived for nearly a century himself.”

11: Jonathan Rothwell’s blog post about the London mayoral election has sent me into a bit of a spiral of thought. “It does rub me the wrong way that there appears to be so little choice—and when there is more than just a binary choice between two ancient political parties, neither of whom appear to have your best interests at heart, the machinery of national politics is willing to snatch even that away.”

It makes me worry that I’m part of the problem. I have no desire at all to get involved in politics: I struggle to imagine anything worse than spending my time having to constantly defend my basic interpretation of reality. It makes me think of heart-sink meetings with anti-vaccine councillors. I completely understand the importance of having those conversations and explaining the science to people who are making local policy decisions, but I it isn’t something I’ve ever enjoyed. The idea of a professional life that involves a lot of that is unappealing. Adding a layer of party politics, in which one has to defend positions one personally finds indefensible simply because it is the ‘party line’, just makes the prospect even grimmer.

And yet: does this not make me part of the problem? If I’m not willing to engage, why should anyone else bother? Are people who enjoy party politics really the people we want making decisions on our behalf? Shouldn’t we all engage more for the good of society? Is “I don’t want to” just a selfish whinge? How can things improve if we leave politics only to those who can be bothered? Aren’t decisions made by those who show up?

12: Work has brought a surprising amount of discussion of stevedores recently, which is a delightful crossword word.

13: It feels like there must be a story behind the placement of this sign.

14: Last week, the MHRA and DCMO used some excellent slides from the Winton Centre for Risk and Evidence Communication (David Spiegelhalter’s stomping ground) to illustrate the risk of serious harm associated with receiving the AstraZencia covid vaccine.

This got me thinking: how does the risk of the vaccine itself compare with the risk of participating in the programme as a whole? In particular—given that most people live “within 10 miles” of a vaccination centre—how does it compare with a 20-mile round trip by car?

After much searching through evidence, my boring conclusion is that they’re focusing on absolutely the right bit of the programme, and the risk of serious harm associated with the journey is orders of magnitude smaller and probably negligible, even at this scale of rollout.

I should have known better than to doubt them!

15: The last Routemasters have run in passenger service.

16: From Concretopia, I learned about Cumbernauld town centre, one of Britain’s most hated buildings. I’m amazed I haven’t come across it before.

17: Derwent Reservoir is spectacular in the spring sunshine.

And as though to prove that it’s spring, here are some ducklings.

18: People often talk to me about books, because they know I’m interested in reading and they follow me on places like Goodreads. I find these conversations difficult, never quite knowing what to say or how to say it. I had a moment of stunning clarity this week when talking to a colleague about this: their suggestion was that it’s easier to write about books because books themselves are written-word.

I think there’s something in that. I’ve always been useless at dictating because speaking isn’t the same as writing, and they need different parts of my brain. In the days when I did clinics, I was far faster at typing my own clinic letters than dictating for a secretary.

For the same reason, I got more confident at public speaking when I stopped trying to write presentations out and relied on freely talking around the key points instead. And, probably for the same reason, I find it hard when I phone a company and they ask for a security word (or whatever) that I’m used to typing instead.

So why wouldn’t the same apply to talking about books?

This conversation came back to me this morning as I read Courier Weekly: “One of the best parts about reading a book is getting to talk about it with other people.” Mmm, maybe not.

19: Fran Lebowitz says that “your bad habits will kill you, but your good habits won’t save you.” It’s possibly the most accurate public health aphorism I’ve ever heard.

20: The news that some teams want to play in a new football competition is dominating the papers and bulletins to an extraordinary extent—and no matter how much I read about it, I’m continue to struggle to understand what the problem is, mostly because I’m not really familiar with how football competitions work at the moment (and struggle to care).

21: I’m still a promising thirty-something.

22: The Government has changed its mind about holding daily televised press briefings, seemingly for reasons which were perfectly obvious from the start. I’m sure that spending 13 times more on refurbish a room for these cancelled briefings than on helping 15,000 displaced Commonwealth citizens affected by a volcanic eruption is entirely justifiable.

23: “If it occurred to the home secretary, Priti Patel, or the minister for ‘immigration compliance’, Chris Philp, that an army barracks wasn’t the best place for refugees who might well have been detained and tortured in such places, it didn’t trouble them for long. Nor did they see any problem with housing four hundred men in 28-bed dormitories with two toilets and two showers in the middle of a pandemic.”

24: That Yes Minister bit about who reads which newspaper is older than I realised.

25: “The prime minister was careless with the facts and too willing to gloss over the complexities of Northern Ireland in his rush to ‘get Brexit done.’ He applied a reckless ‘have your cake and eat it’ approach to an area where the cake had already been painstakingly shared. The irresponsibility is astonishing, and it is not as if the prime minister was not warned.”

26: One needn’t be a doctor to become one of the US’s Top Doctors.

27: “On Monday, three major news organisations – the BBC, ITV News and the Daily Mail – did something unprecedented in recent times. Despite the PM’s outright denial on camera, all three reported that sources familiar with the conversations had heard Mr Boris Johnson say, last autumn, that he would rather see ‘bodies pile high’ than take England into a third lockdown.”

For all the hand-wringing about President Trump’s destruction of any form of trust in Government communications, it seems no lessons have been applied to the UK government. When the judgement of the UK media is to disbelieve statements from the Prime Minister’s spokesperson and from his own mouth, we’re in a bit of a sorry (if entirely predictable) state. And, just like Trump, the liar remains popular with the public.

28: Starbucks has on the wall of one of its branches the claim that 99% of its coffee is ‘sourced ethically.’ I’ve been slightly reeling ever since I saw it: Who decided that acting unethically 1% of the time was boast-worthy behaviour? It seems like an active admission of guilt, which obviously doesn’t come as a surprise with that chain, but it still seems amazing that some corporate communications team signed it off. I half expect to see a ‘we’re proud to intentionally overcharge just 1 in every 100 customers’ sign in the next branch I venture into, or perhaps ‘99% of our baristas are paid in full.’ Baffling.

29: The Dixons brand of electronics stores is about to disappear for good, a little over fourteen years after I wrote that Dixons was “to stop selling anything. To anyone. Ever.” You heard it here first.

30: I have seen film posters with the line “in virtual cinemas now”—and I’m really not sure what that means. I thought it probably just meant available to stream, but then an ad for Truman & Tennessee said “in virtual cinemas and on demand now – book now” which seemed to rule that out.

This post was filed under: Posts delayed by 12 months, Things I've learned.

31 things I learned in March 2021

1: “The NHS is ponderous, idiotic and wildly inefficient, and anyone who condemns it for being so is missing the point. Photosynthesis, after billions of years of evolution, has an efficiency of perhaps 5 per cent. People and their organizations are not so simple. Calls to reduce healthcare inefficiency should be treated with contempt unless they are detailed, specific and achievable.”

2: Annie in Michael Jackson’s Smooth Criminal is a resuscitation dummy.

3: “The author is not a very good person to quiz about a book. I try to avoid talking to authors about their books. I’ve been writing here in Britain for decades now, and I have no idea which of my author friends has ever read me or not, because there’s an understanding that you just don’t mention such things. It’s not polite conversation.”

4: “You are the result of a very complicated puzzle, consisting of thousands and thousands of pieces, and you’re only half-assembled.”

5: The national curriculum is blamed for primary school lessons being filled with jargon and acronyms.

6: Hotter summers mean wine has more alcohol by volume due to “the build-up of sugar in grapes, which yeast converts to ethanol.” And ABV labelling has wide tolerances, which means that “a wine with 12.5% ABV on the label could be anything between 11% and 14% in reality.”

I was surprised by the wide tolerance on alcohol labelling, but I really shouldn’t have been.

When I did my ready meals research a decade ago, I was surprised at the wide tolerance on nutritional labelling, which makes anything other than broad-brush calorie counting utterly pointless.

At that time, there was a legal tolerance of +/-20% in calorie labelling, meaning that someone could stick rigidly within their (say) 1500kcal daily target according to the packaging and still be a couple of Mars bars over their target.

Yet even that is an overstatement of accuracy: the tolerance of 20% could in fact be applied to the unprepared ingredients rather than the product as sold, so food could in fact be way more than +/-20% by the time they reached our stomachs.

So it really would be impossible for anyone to count calories accurately, just as it now seems it’s pretty hard for people to monitor their alcohol intake with precision.

7: “Good doctors (and good nurses) are self-effacing, humble, endlessly patient, full of common sense, constitutionally incapable of boredom. However, eminent and influential doctors – ‘key opinion leaders’ – are usually vain, arrogant, impatient and ambitious.”

8: There’s a special exemption to the rules for carrying liquids in hand luggage for pesto.

9: “No 10 introduced a new and innovative form of avoiding difficult questions yesterday, with the Downing Street spokesman telling journalists that the PM would address the royal news at the coronavirus press conference, only for the PM to show up and say he did not want to comment.”

10: “England’s test and trace programme failed to make a ‘measurable difference’ to the spread of the pandemic despite an outlay of £23bn, an ‘unimaginable’ level of expenditure, a parliamentary spending watchdog has claimed.”

11: The British people have “widespread admiration and affection” for Boris Johnson. It’s baffling to me that someone as respected as Allegra Stratton would chose to take a job where she’s having to debase herself with nonsense like that.

12: Airlines have their own trademarked scents: for example, ‘Calm’ for Delta, ‘Landing’ for United and ‘Ocean Citron’ for Alaska Airlines. Verizon has a trademarked ‘flowery musk’.

13: A book I thought was rubbish has been made into a film the NME thinks is rubbish. I think I’ll give that one a miss.

14: Some English schools think it appropriate to use a teaching resource “that tells girls their role is to be ‘receiver-responders’ in their relationships with men, that discourages the use of contraception, and tells young gay and lesbian people that there is no way for them to marry or express their love for another person”. And the Government’s response is that “it is for schools to decide which resources they choose to support the teaching of RSHE”.

15: “The Covid-19 pandemic has been like a barium meal for the body politic—and what it has revealed about the innards of our society has been far from pretty. To start with, it has shown how basic public services have been hollowed out by a decade of austerity, leaving the country ill-prepared for a crisis and those dependent on such services exposed.”

16: “Environmental resource economist Marshall Burke says there is a proven link between poor air quality and premature deaths linked to breathing that air. ‘With this in mind,’ he said, ‘a natural—if admittedly strange—question is whether the lives saved from this reduction in pollution caused by economic disruption from COVID-19 exceeds the death toll from the virus itself. Even under very conservative assumptions, I think the answer is a clear ‘yes.’’ At just two months of reduction in pollution levels he says it likely saved the lives of 4,000 children under five and 73,000 adults over 70 in China alone.”

17: Yo-Yo Ma gave an impromptu performance after receiving his second dose of the covid-19 vaccine.

18: Counting isn’t always helpful. I’ve been frustrated recently by a circular conversation about covid-19 “outbreaks”. I’m often asked to enumerate the current number of “outbreaks”: but defining individual “outbreaks” in the context of widespread community transmission is fairly arbitrary. Cases generally have multiple sites of possible disease acquisition, and may pass on their illness in a number of settings. There isn’t a point source to eliminate, nor is the disease rare enough to identify with a high degree of confidence chains of transmission.

So the only logical response is to ask why someone wants the figure, so that I can help them define the measure that best answers their question: the measure will be different, for example, if one is interested in pressure on the public health response, than it would be if one is interested in a proxy measure of the number of sites of community transmission. The answer, repeatedly, seems to be “the reason for the measure is not your concern, just count them!”

And it feels like the only two possible responses to that are 🤬 or 🤷‍♂️.

19: Laughter is important. I laugh a lot, especially at work. This is something I never really realised about myself until it was pointed out to me: I am someone whose first reaction to corporate nonsense is most likely to be belly-laughter, with frustration only tending to set in later. I often revel in the absurdity of the world of work, and I know I need a break when I stop seeing the silliness in the world.

20: I was thoroughly depressed today to see adverts up around Newcastle telling men not to ask women for directions and to cross the street to avoid walking near women.

This is such a tangled web of a situation. It is horrific to hear of the violent attacks that people inflict on other people. It’s horrendous that women live in fear every day. It’s awful that many men live with similar fears but are unable to express them. It’s upsetting that people’s level of fear—high or low—is often divorced from the statistical risk they face. It’s hard to explain the lack of focus on male/male violence, which some experience as victim blaming or as men being expendable.

Most of all, it’s regrettable that fear stemming from inhumane violence is allowed to drive a wedge between us and make all of us a little less human as a result.

21: What’s the point of London City Airport? I’ve used it a couple of times and—it seems— liked it more than Jonathan, but it is hard to argue that perhaps it’s an idea whose time has passed.

22: In my experience, most people who work in health—and especially in public health—have a deep-seated passion and drive to do the right thing for patients or populations. Opinions on what “the right thing” is vary, of course, and that can be a source of profound disagreement.

Today I was reminded that some don’t share that passion: some have a natural focus on processes, not people. And those are important people to have around because processes are important, and—from the perspective of the patient-focussed people—robust processes support good outcomes for patients.

Nevertheless, the cognitive load of talking things over with someone who approaches their work from such a different angle is high, and it’s hard not to give into a cognitive bias that nags away suggesting that the other person just doesn’t get it… particularly when they are in a more senior role.

23: Times New Roman appears on the face of some luxury watches.

24: In what may be a new world record, the National Institute for Health Protection has been abolished before it even existed, replaced by the UK Health Protection Security Agency.

25: Some days, my job appears to involve making YouTube videos at home. Does this mean I’m an influencer now?

26: “If you are moved by a rapper that you listen to on YouTube, it’s really not a big deal. You shouldn’t have to apologise for it in literary environments. The same is true if you love a classical poet. It isn’t the case that you need to approach lauded works on bended knee. The pool of influence you draw from does not have to meet the approval of an academy or an institution, or be bound by the parameters of a genre, sub-genre or ‘movement’. Listen to everything. Read as much as you can. Try to stay present and connected with whatever you’re engaging with when you’re engaging with it.”

27: “We should not be afraid to note some potentially positive side effects of the epidemic. One of the lasting symbols of the epidemic is passengers trapped in quarantine on large cruise ships. Good riddance to the obscenity of such ships say I, though we have to be careful that travel to lone islands or other resorts will not once again become the exclusive privilege of the rich few, as it was decades ago with flying. Amusement parks are turning into ghost towns—perfect, I cannot imagine a more boring and stupid place than Disneyland. Car production is seriously affected—good, this may compel us to think about alternatives to our obsession with individual vehicles. The list can go on.”

28: “The technology to construct modern skyscrapers existed long before the skyscraper became modern; the problem was the number of stairs. Stepping would have replaced office work as the office workers’ chief activity. Once the lift had released time into tall buildings it made its way into shorter ones, where more important than its production of time is its ability to render marginalised sections of society publicly visible.”

29: Here’s some advice that has become commonplace: don’t sleep with your phone next to your bed. Picking up a screen first thing in the morning it not good for anyone’s mental health, but some people need a phone by the bed for emergencies. There’s no need to use the alarm on it, though.

I started using my phone as my alarm clock when I first got a Blackberry, which required daily charging and even came with a ‘nightstand’ dock which turned it into a bedside clock. I stopped about a decade ago, when I realised how much I valued a couple of minutes of allowing myself to wake up without that sort of input: we got a clock radio instead.

These days, I’m woken by FiP on our Sonos system, because in 2019 the feverish radio chatter about Brexit became too much to handle first thing. At first, the timechecks being an hour ahead made it a little more… alarming! Though we ended up enjoying it so much, we now listen in the kitchen in the morning too. Contrary to common speculation about immersion in other languages, I can confirm that our French hasn’t improved.

30: This thoughtful reflection on the Oprah/Meghan interview is worth reading. Possibly more so than the interview itself.

31: Richard Wilson, the former Cabinet Secretary, says that one method of dealing with the initial stages of a crisis is to announce a COBRA meeting for later in the day, giving the impression of seizing control while allowing time to gather information and get ducks lined up. This is, more or less, the same approach I’ve long used to scheduling Incident Management Team meetings at work.

This post was filed under: Posts delayed by 12 months, Things I've learned.

28 things I learned in February 2021

1: Lego streets have become worse for pedestrians and cyclists over the years, not least as cars and roads have widened at the expense of footpaths. But things are looking up.

2: I have long believed that TV detector vans were essentially distractors for more basic modes of TV detection such as looking through windows, but I was wrong: they had proper kit in them which could detect TVs and support applications for search warrants.

3: It might be time for those who peer review papers for publication to rebel.

4: One of the fundamental principles in outbreak management, and in incident management, is having clear lines of accountability. If I’m managing a multiagency outbreak, I have a little spiel on the topic that I give at the start of each incident management meeting, accountability for decisions is clearly documented in minutes and a section on “legal considerations” appears on every agenda for good measure.

And yet, when it comes to the national response, “we have not been able to identify who [in the Department of Health and Social Care] was accountable for major decisions, particularly where PPE is concerned.”

5: I walked past this van and thought: “What on earth is futsal?”

I inevitably ended up perusing the Wikipedia entry, and—having got a few paragraphs down—GCSE Spanish lessons, which often seemed to mention futsal, came flooding back.

6: There’s a line in Shuggie Bain about the smell of static electricity from TV screens, something I haven’t thought about in years. It reminded me of the unique power of olfactory memories.

7: Denis Norden, presenter of It’ll Be Alright on the Night, was the person who came up with the title Auntie’s Bloomers for the rival BBC show.

8: “The physician’s duty is not to stave off death or return patients to their old lives, but to take into our arms a patient and family whose lives have disintegrated and work until they can stand back up and face, and make sense of, their own existence.” It’s a few years since I read Kalanithi’s book; this blog post reminded me of the emotional experience.

9: Some people are making their own homemade covid vaccines. I wouldn’t recommend it, but it is a curious reminder of the full range of human responses to the offer of vaccines, from outright refusal to desperate home-brewing.

10: With knowledge of the treacherous frozen slush to come, it’s sometimes difficult to feel positive about snow. Yet there is something particularly beautiful about a fresh fall, and especially about the wintery quality of light it brings.

11: “A No 10 spokesman said: ‘Going on holiday is currently illegal.’”

There are moments when a simple sentence can just tip over into crystallising a bunch of feelings into something more like thoughts, and this Government line has proven to be one of those for me.

By nature, I’m quite libertarian: I don’t really like forcing anyone to do anything. This is quite an unusual proclivity in my specialty of health protection, but one which is shared (to a greater or lesser extent) by most of my immediate colleagues. I think better results are generally achieved through persuasion than through force, though of course a public health emergency like a pandemic is always going to require a multifaceted approach.

A little over a year ago, I was nothing short of astonished when returnees from China were (to all intents and purposes) forced to quarantine at Arrowe Park hospital: I remember suggesting in conversation with colleagues that this would turn out to be a “resignation issue” for the Secretary of State. Of course, I said, we should offer people supported quarantine. Of course, we should ask all returnees to quarantine at home at the very least. But of course we can’t force people. I was wrong.

So much has happened since then, much of it to my mind ethically questionable: do we really have informed consent from all care home residents for routine covid swabbing? If not, is it really in the best interests of each individual? Are we really sure we haven’t slipped into making “best interests” decisions on behalf of populations rather than individuals?—a slippery slope indeed.

We all now live under a level of legal restriction unprecedented in modern times, perhaps concordant with an unprecedented emergency. More than a hundred thousand people have died.

And yet: there is still something which sits discomfortingly about governments using on-the-hoof extreme restrictions as opposed to established ‘emergency’ approaches such as the Civil Contingencies Act. This is even more true in an era of populism and governments who have a history of riding roughshod over constitutional convention and legal limits on executive power.

Will we really find it simple to put the genie back in the bottle?

12: I know I’ve said it already, but would you look at the quality of the light?!

13: Both this podcast episode and this book make, in passing, a very clear argument about emissions being by far the most important ecological consideration of our times, and both, in passing, unflatteringly compare with the impact of most recycling. I’m really pleased to see clear communication on this, instead of a plethora of actions referred to as ‘sustainable this’ or ‘green that’ in a way that treats every action as roughly equal. I was also pleased to see that carbon offsetting, which I do all the time, is more effective than I imagined it to be!

14: When standing before the 1777 marble statue of Armand-Thomas Hue at the Frick Collection in New York, “try as you might, you absolutely will not be able to meet his eyes. I wonder if this was Jean-Antoine Houdon’s subtle aim, as it ultimately says more about his subject and is almost more of an artistic accomplishment than what he managed with Madame His—and also because it’s what most of us spend our lives actually doing.”

15: There are tens of roads named “Bow Street” in the UK, but it seems that the BBC considers the best way of writing about a Bow Street in Wales is through reference to one of the Bow Streets in London. It’s not hard to see why coverage like this is often judged to be inappropriately London-centric.

16: Copying and pasting between Apple devices is built-in.

17: Richard Smith reckons there have been 20 re-organisations of the NHS since 1999… and he ought to know. I haven’t even tried to keep count.

18: Energy efficiency ratings for household appliances are changing.

19: On hope so much depends.

20: The Government has broken the law again.

21: How Daft Punk’s robot outfits were made.

22: Daft Punk have split. 😱

23: Spectacularly failing to learn a lesson from promising a Christmas easing of restrictions a month in advance, the Government has chosen to make itself a hostage to fortune once again by promising an easing of restrictions even more than a month in advance.

24: “Every love story is a potential grief story. If not at first, then later. If not for one, then for the other. Sometimes for both.”

25: “It will pass. All the epidemics of the past have passed. Nobody is yet clear about the effect this will have on our lives, how disruptive it will be, how much it will cost each of us. Perhaps we will review some assumptions about the free market: even the most strenuous defenders of the total freedom of the market today cry out: “The State should help us! In times of difficulty, it becomes clear that collaborating is better than competing. My secret hope is that this will be our conclusion from the current crisis. Problems are best solved together. Humankind can survive only if we work together.”

26: “Nothing can deceive like a document.”

27: Pigs can play computer games.

28: Brexit means Brexit “Your parcel is delayed due to a Brexit related disruption. We are adjusting delivery plans as quickly as possible.”

This post was filed under: Posts delayed by 12 months, Things I've learned.

31 things I learned in January 2021

1: The chai tea latte from Starbucks isn’t too bad.

2: I’ve found a new affection for Instagram: I left last year, but have drifted back over the Christmas period.

3: People used to wonder where birds went in winter.

4: It is, in fact, possible for the Government to announce a lockdown and publish the associated guidance simultaneously. Small successes are worth celebrating, especially 42 weeks after the Prime Minister said his Government would turn the tide on covid in 12 weeks and “send coronavirus packing”.

5: “I’m completely fed up. He just can’t lead and this can’t go on.”

6: I learned about the Dogger Bank wind farm.

7: I’ve never really thought about the ethics of architecture before, but there are some interesting and current questions in the field. Is it okay to design spaces for prolonged solitary confinement? Is it okay to design airports in the age of climate change? Is it okay to design waiting rooms when more humane technological solutions exist?

8: It’s instructive to look at how Tony Blair, who now pops up from time to time to offer the Government advice on pandemic management, reflected on his own management of a potential pandemic in his ‘risible’ autobiography:

During the run up to the election, we nearly had a vast panic over the approaching ‘flu pandemic’. There is a whole PhD thesis to be written about the ‘pandemics’ which never arise. In this case, the WHO had issued a report claiming there would be 500,000-700,000 deaths across the world. The old First World War flu statistics were rolled out, everyone went into general panic and any particular cases drew astonishing headlines of impending doom. Anyone who caught a cold thought they were part of a worldwide disaster.

I’m afraid I tried to do the minimum we could we the minimum expenditure. I understood the risk, but it just didn’t seem to me that the ‘pan-panic’ was quite justified. And in those situations, everyone is so risk-averse that, unless you take care, you end up spending a fortune to thwart a crisis that never actually materialises.

However, the reaction of the system is perfectly understandable. The first time you don’t bother is the time when the wolf is actually in the village, so you have to steer a path, taking precautions and be ready to ramp it up if it looks like this time it’s really happening. But oh, the endless meetings and hype of it all!

Is doing the bare minimum really that different to the current Government’s initial approach? Isn’t the lesson of history that we should hit potential pandemics hard and early? Or, has been quipped, is the real lesson from history that we never learn from history?

9: Publishers often tell readers that ebooks are the future; but when they want they books reviewed in the hallowed pages of The TLS, they still send hardbacks.

10: More than a month on, I’ve still not seen a better briefing on covid vaccines than Rupert Beale’s.

11: “Act like you’ve got covid” means “cycle seven miles from home”. That’s a round of charades I’m not winning.

12: “Everything will be confiscated—welcome to the Brexit, sir. I’m sorry.” Truckers’ butties have become headline news.

13: 2021 is a census year: with most students working online, it strikes me that University towns might be about to discover that they have smaller than expected official populations, which could cause trouble for the next decade.

14: In professional work, I’m a stickler for keeping writing concise. Only yesterday, I moaned to colleagues that a draft internal guideline had more than doubled in length with very little additional useful content, but a whole lot more waffle. We all know the Mark Twain quip that “I didn’t have time to write a short letter, so I wrote a long one instead”, but it wasn’t until I read this article by former Court of Appeal judge Robin Jacob that I considered that work pressures might result in baggier writing. I’m sure this is true for my own work too; I’d just never connected the two before.

15: One of the challenges with trying to use the law to control an outbreak is that the law often comes to define the limits of the response. For example, laws requiring self-isolation will necessarily tightly define those who are required to self-isolate (say, people with known identified contact with an infectious person). However, there may be very good reasons for asking people outside of that group to self-isolate (say, people likely to have had contact with an infectious person, but without certainty). If systems are then built solely around requiring isolation, with the necessary barriers around it to prevent those who should not be required to isolate from being contacted, then it can become very practically difficult to ask people to isolate, even though this may be a key control measure in a given outbreak.

For example, if an app were to be built to allow people to ‘check in’ to venues, it would be difficult to conclusively prove that any two people in that venue had been in close contact, and it may therefore be legally challenging to require them to self-isolate. However, if ten people have been in the same venue at the same time and nine of them were infectious, it would be perfectly reasonable to ask the tenth to self-isolate on the basis that they may well be at high risk of contracting the disease.

If the app is built only to meet the needs only of the legislation and not of broader public health management of complex situations, it may turn out to be considerably less good than just keeping a written log of customer details to which judgement can be applied.

16: “St Uncumber: A medieval saint to whom people, especially women, used to pray to relieve them of their spouses. She was a Portuguese princess who didn’t want to get married. Her father found her a husband. She prayed to become unattractive and her prayer was answered. She grew a beard, which naturally put off the suitor. Her father had her crucified as a result. She’s depicted in King Henry VII’s chapel in Westminster Abbey, with long hair and a full beard.”

17: The Aston Villa football team is based in Aaron, near Birmingham. I have spent the last 35 years thinking it was a London-based team. My knowledge of football (and English geography) really is woeful.

18: “The only ‘world-beating’ element in our lives is the virus, and we’d benefit from a discourse that came clean about it.”

19: Matt Hancock, proponent of the Government’s “act like you’ve got covid” guidance—an act which includes playing rugby in a park—is self-isolating now that he’s a contact of someone who had covid. It’s an odd state of affairs when “acting like you’ve got covid” includes being out in public and in close contact with others, while acting like you are a contact of a covid case means self-isolating.

20: J R Pole once said that every president makes his predecessor look good. Today, we hope that’s not true.

21: “Works of art were until the early twentieth century typically displayed in ‘period rooms’ furnished to match the era of their creation.”

22: More than I ever wanted to know about those little built-in battery testers that always used to appear on AAs, but seem to have disappeared.

23: “One morning in 2002, while walking his daughter to school, forensic psychiatrist Dr Richard Taylor ran into an ex-patient, who waved to him cheerily. Years earlier, the man, a talented musician, had beaten his father to death during a psychotic episode, then set fire to his body before sticking a meat thermometer into his stomach (‘To see if he was done’). Taylor had assessed him in custody. He was ‘incredibly disturbed and violent’, he says. But having undergone years of treatment, the man had been freed under close supervision. ‘Who was that, Daddy?’ asked Taylor’s five-year-old daughter, as they walked on. ‘Oh, just someone I used to work with,’ he told her.” (from The Week magazine)

24: The commonest cause of fire in UK hospitals is arson, at least according to the fire safety mandatory training which has been frustrating Wendy this afternoon.

25: Marie Curie, the only scientist ever to have won Nobel Prizes in two different sciences, “was married in a civil ceremony wearing a dark blue outfit that she subsequently adapted and wore for years as a lab coat.”

26: 315 days after we were told that keeping the number of covid deaths “below 20,000” would be “a good outcome”, the number of deaths has passed 100,000: almost a third more than the number of British civilians who died in the First and Second World Wars combined. The UK now has a higher coronavirus death rate per million people than any other country.

27: Sometimes, something I read makes me feel regretful through association with and on behalf of medical colleagues who I’ve never met. It’s a strange feeling. This is one of those times:

Every medical staff member we met along the way has asked my wife how she’s doing, not just once but on every occasion they’ve crossed paths with her. She’s spent a lot of time telling them she’s fine. None of them ever did get around to asking me the same question.

I am being OK; I want to make that clear. I think that, by now, I’m getting it down pat. But am I OK?

Not yet.

28: “We have throughout followed scientific advice and done everything we can to minimise disease and suffering throughout the country.” Of course “we” did.

29: It’s a year since we set up our Incident Co-ordination Centre for ‘Wuhan novel coronavirus’ response at work, and I’ve learned that—as in life—some years in health protection can be substantially more challenging than others.

30: “Despite his own serious brush with the virus, Boris Johnson never approached it with the appropriate humility. He never mustered that consistency of purpose that was, among other things, a precondition for clear public messaging. He never sought to bring in from the cold rivals, such as former health secretary Jeremy Hunt, who publicly engaged with the detailed dilemmas in a way he did not. Nor did he fully transcend his instinctive individualism, and summon a spirit of truly shared endeavour in the face of a shared threat. He continued to take a truculent stance to the likes of the teaching unions, who governments find difficult in ordinary times, but whom a creative leader could have turned into partners in this rare moment of national crisis. The requisite command and resolve was not there—and Britain is counting the cost in lives.”

31: Many of the organisations involved in the covid response are corporate members of the Plain English Campaign. Avoiding jargon is a key part of good communication in incident response. Yet my inbox is now full of emails talking about “two-week sprints”, “playbooks”, “taskforces”, “canvases” and more besides. Management-speak seems to have taken over to an alarming extent. I despair.

This post was filed under: Posts delayed by 12 months, Things I've learned.

31 things I learned in December 2020

1: The national lockdown unlocks tomorrow, so the time feels right for another deeply ill-advised prediction with potential to make me look like an idiot when you read this next year.

Here in Tier 3 country, the “great unlock” means that non-essential retail is to re-open. That is, people are going to be able to take public transport into their nearest city centre or shopping centre, and spend spend spend in poorly ventilated indoor spaces where the main control measures are stickers on floors. Indeed, Councils are planning to string up their regular Christmas lights to really draw in the crowds. This seems to be because it is assumed that the transmission risk associated with retail remains consistent even during winter weather and with Christmas crowds, which seems deeply unlikely to me.

On top of that, the Government is lifting lockdown at a point where the country is still seeing more than 14,000 new covid cases per day, which means we have a large pool of people ready to act as sources of infection: the 14,000 only counts confirmed infection, there will be many additional people each day with undetected infection because they are asymptomatic or choose not to be tested.

It’s hard to see any outcome other than case numbers bouncing up rapidly over the next three weeks: and with case numbers getting towards / as high as / even higher than the numbers immediately before the latest lockdown, it’s hard to see how the planned lifting of restrictions over Christmas can possibly go ahead… but it’s also impossible to see how, politically, this is something on which the Government can reverse ferret.

Even without the lockdown and tiering decisions, the Government boxing themselves into a decision a month ahead of time looks crazy to me: it may have been more prudent to announce conditional principles backed up by work with retailers and the travel sector to guarantee refunds for cancelled travel plans if the relaxation can’t proceed.

Though, perhaps with a larger dose of optimism than realism, Wendy’s Christmas flights to Northern Ireland are already booked.

2: From this book, I learned that it was only in 1938 that an Act of Parliament required every local authority to provide a fire service. If you’d asked me to guess, I’d probably have said it became a requirement after the Great Fire of London, putting me about three centuries out

3: Instagram has had a big impact on the design of luxury watches.

4: One can now take music grade exams, up to grade five, in DJing.

5: “Today’s Conservative Party has evolved into a nasty party, which has given us a government of inexperienced and incompetent ministers at a time when the coronavirus pandemic increases the necessity for strong and able leadership.”

6: “Johnson often compares himself to Pericles on the grounds that they both enjoy good speeches, democratic engagement, big infrastructure and fame. But Pericles built the Parthenon, not the Emirates Cable Car.”

7: The first autopsy in the New World occurred in 1533 “when the Catholic Church ordered an autopsy on the conjoined infant twins Joana and Melchiora, who had died eight days after birth. The goal was to determine if the children shared a soul; the priest baptized them both separately as a matter of precaution as he was not sure whether they represented two bodies and two souls or only one.” The conclusion? Two.

8: The vaccination programme has begun.

9: “In the pandemic we hear figures every day of the numbers of death, but death, if not denied, is unfamiliar. Even in these days of the pandemic death is not much in our everyday lives, and when it does come it is largely hidden. We rarely see people dying; we don’t see corpses. In contrast, in 19th century England death was present almost every day. It was dreaded and feared but utterly familiar.”

10: I never previously realised that octopuses are so interesting. And they have beaks!

11: The Prime Minister who, a year ago, offered the electorate an “absolute guarantee” of securing a trade deal with the European Union by the end of 2020 says it is “very, very likely” that he will break his promise. Even if we ignore the bluster and accept that it’s pretty likely that a deal will be done in the end, it’s hard not to see this posturing as deeply damaging to trust in politics.

12: Dominic Cummings is a joke.

13: How to escape from Titanic.

14: It didn’t have to be this bad.

15: I’ve never before clocked the (obvious) fact that bone china isn’t vegan or vegetarian friendly. I wonder if there’s a vegan crockery alternative to William Edwards for First Class passengers on British Airways?

16: On my rainy walk to work this morning, a group of 12- or 13-year-old boys ran past me with their teachers (or perhaps coaches) riding bikes alongside. As the stragglers slowed to a walk, one of the faster kids aggressively shouted, “Come on you lazy bastards, get moving!” Something about this scene jarred with me, but I couldn’t quite put my finger on what.

I think it may be something to do with rarely hearing this sort of hectoring in everyday life. Had I been one of the stragglers at that age—quite likely, if I hadn’t found an excuse to get out of running in the first place—this would have been the least effective strategy to get me moving faster, and perhaps the most likely to make me roll my eyes and snigger.

It also made me wonder whose behaviour the shouty child was modelling. Perhaps it’s a sports thing. I’ve chaired three outbreak control team meetings for elite sports teams in the past week, and I don’t think I’ve felt as culturally out of my depth since working at the Department of Health around Glyndebourne time.

17: If you asked me to name words that typically follow “agile” then “lighthouse” would not previously have featured among my answers. Yet the phrase “agile lighthouse” has been crowbarred into my vocabulary by people involved in the covid response who seem to speak a different version of English to me, and searching online reveals that it is genuine management speak.

18: It’s hard to disagree with Dominic Cummings’s assessment that “Issues of existential importance are largely ignored and our political systems incentivise politicians to focus more on Twitter and gossip-column stories about their dogs.”

It’s equally hard to ignore the profound pathos of that statement given that less than a year ago, he was hubristically describing the Government as having “a significant majority and little need to worry about short-term unpopularity.”

Cummings is possibly the only man in Britain who needed to spend time in Government to appreciate that people who dedicated their lives to winning regular public popularity contests are people who dislike being disliked—and Alexander “Boris” de Pfeffel Johnson dislikes it more than most. It’s hard to conceive a more fundamental misjudgement of character than assuming this Prime Minister to be one who wouldn’t worry about short-term unpopularity in pursuit of more noble goals.

19: With the number of new confirmed covid-19 cases in the UK each day now similar to that at the introduction of the November lockdown, the planned lifting of restrictions over Christmas is cancelled. But, please guv’, it’s nothing to do with the Government’s decision-making, it’s all to do with a new variant of the virus.

20: In quite possibly the most bizarre bit of Government messaging to date, the Secretary of State for Health is urging everyone to “act like they have the virus” while imploring them to continue attending school, workplaces (if they can’t work remotely), take outdoor exercise in public spaces, visit essential retailers, and more besides—all of which are not allowed nor remotely sensible for people who have covid. Marr really ought to have asked, “Would you be sitting here in my studio if you had the virus?”

21: Napoleon, it is claimed, “directed Bourrienne to leave all letters unopened for three weeks, and then observed with satisfaction how large a part of the correspondence had thus disposed of itself and no longer required an answer.”

22: “The government has consistently throughout this year been ahead of the curve in terms of proactive measures with regards to coronavirus.” I’m not sure to which curve the Home Secretary refers; presumably not the curve which, to date, shows that more than twice as many UK residents have died of or with covid-19 than voted for her at the last election.

23: There are seven kinds of gift… or maybe more.

24: “In the 1960s, NASA went to huge expense to contain possible pathogens from the Moon” but the measures were so disastrously poor that the effort would have had little effect. This is a great story: particular highlights are the choice to base control measures on spread of Yersinia pestis and that “NASA’s plans stipulated that quarantine at the LRL could be broken in the event of a medical emergency. Ironically, if a lunar microbe made an astronaut really sick, that astronaut would be removed from quarantine.”

25: “Even on the darkest nights there is hope in the new dawn.”

26: I’m currently really enjoying The Heart’s Invisible Furies. The novel (at least as far as I’ve read) has vignettes from Cyril Avery’s life aged 7, 14, 21 and so on, every seven years. This has made Wendy and me reflect on how this structure would reflect our own lives: both of us have collected five vignettes so far; each vignette would see us living in a different house, each at a different school or workplace. We’d both have few recurring characters outside family—though we’ve been together for the most recent three vignettes of each other’s stories.

27: “If you tell Facebook not to collect location information from your iPhone, then it doesn’t, right? Wrong.” The fact that Facebook collects oodles of data on users is hardly news, but now and again, something like this pops up and it feels so egregious that it almost lends credibility to the conspiracy theorists.

28: There’s a direct line of succession from the Acorn processor in the BBC Micro which sat in the corner at school to the ARM (Acorn RISC Machine) processor in the iPhone I’m typing this on.

29: The iOS Reminders app has got much more fully featured since I last used it (around iOS 5).

30: A Government which claims to be keen on parliamentary sovereignty is ramming legislation through without time for proper parliamentary scrutiny and then shutting the doors on the House of Commons for an extra week. Her Majesty’s Most Loyal Opposition is supporting the Government in implementing legislation it disagrees with, because it is unable to figure out a better approach. And in the world of 2020, all of this feels like par for the (lamentable) course.

31: At the stroke of 11pm, the Government’s actions stripped me of more freedoms and opportunities than at any other moment in my life so far.

Instead of having free pick of the job market across 28 countries, I’m limited to one. Instead of having the automatic right to live in any of 28 countries, I’m limited to one. No longer can I travel at will or whim across Europe; and no longer will I be guaranteed a lack of roaming charges.

Brexit is regrettable for much bigger reasons than those that affect me directly—not least friends born in other EU countries who have dedicated their lives to the NHS now being made to feel like second-class citizens (if even ‘citizens’ at all)—but when Government rhetoric is all about victory and celebration, it feels like tonight’s a night for self-indulgent melancholy.

This post was filed under: Posts delayed by 12 months, Things I've learned.

30 things I learned in November 2020

1: I’ve managed to keep a series of posts on my blog running for a year rather than giving up after about a month.

2: William Barr is someone we may be hearing more about in the coming days.

3: I recently read Lawrence Douglas’s Will He Go? and the first 24 hours after the polls closed in the US presidential election have been just as mad as he predicted. But I wasn’t convinced by Douglas’s arguments on the abolition of the Electoral College, and Ian Frazier’s piece in the New York Review which I read this morning strengthened my view. (I also realised this morning how mad the dating of New York Review issues is: it’s more than two weeks before the cover date and I’m reading a printed copy in Newcastle!)

4: Airline seatbelts are quite interesting.

5: A large survey of English adults conducted in May by researchers in Oxford found that “almost half think covid-19 may have been deliberately engineered by China against ‘the West’. Between a fifth and a quarter are ready to blame Jews, Muslims or Bill Gates, or to give credence to the idea that ‘the elite have created the virus in order to establish a one-world government’; 21 per cent believe – a little, moderately, a lot or definitely – that 5G is to blame, about the same number who think it is ‘an alien weapon to destroy humanity.’”

Once I’d recovered from the pain of that revelation, the same article delivered a good belly-laugh: “There’s a danger that in writing about QAnon – a social phenomenon not just in the US but in Britain, Germany and many other countries, and endorsed by a number of Republican candidates – you make it sound more interesting and mysterious than it is. It is interesting, but in the way hitting yourself in the face with a hammer is interesting: novel, painful and incredibly stupid.”

6: Channel 4 is seizing on US electoral chaos to advertise the availability of The West Wing on their streaming service, and even just seeing the trailers makes me feel a bit warm and fuzzy.

7: “There are huge opportunities for using data science to improve the quality, safety and efficiency of care. These opportunities are being needlessly neglected through a lack of clear career paths, and a historic failure to harness existing best practice into a commons of knowledge. But there is a vast skilled workforce that could, through use of open methods and structured support from the NHS, rapidly deliver an explosion in high-quality, verifiable, shared analytics.”

Disastrous data management, and a critically poor understanding of the relationship between population level data and individual clinical care, is one of the as-yet untold stories of the failure of covid-19 control in England. I hope we learn from that, and build upon those lessons to do everything Goldacre and co suggest.

8: Some of the best books of 2020 don’t actually exist.

9: Amazon has only just launched in Sweden. It didn’t go well, with the retail giant encountering problems both serious and trivial. “For reasons known only to Amazon itself, the Argentine rather than the Swedish flag was placed next to the word Sweden on the site’s country picker. Then there were the disastrous automatic translations that saw a cat-themed hairbrush described using the Swedish slang for ‘vagina’ (clearly the result of a direct translation of ‘pussy’), a children’s puzzle featuring yellow rapeseed flowers described as having a ‘sexual assault flower motif’, and football shirts labeled as ‘child sex attack shirt’.”

It all reminded me a little of this (which surely counts as pre-historic in internet terms).

10 : “The PM is given to expansive rhetoric and ‘Moonshot’ ambitions; if mere words could defeat a pandemic and conceal the tearing up of a treaty, he would be carried shoulder high up Whitehall.”

11: Mass testing for covid-19 is now well underway in Liverpool, but questions remain about the effectiveness of the assessment of the pilot. “The Department of Health is being incredibly secretive about how this pilot is going to be evaluated. There’s a National Screening Committee which we’ve had in the UK for 20 years, and they’ve been sidelined from this. There’s a big concern that we’re not going to learn what we should because we don’t know what studies are being done alongside it, and the right scientists haven’t been involved … We still have public health teams who are underfunded to do track and trace, and people have been saying for six months that’s the way to control things on a national scale. There’s a cost effectiveness question here, and it’s not a case of mass testing or nothing. It’s this or some of the other alternatives.”

12: There was a time, not that long ago, when politicians disagreed civilly, and leaders clarified misconceptions about their opponents and worked to raise the tone of public discourse.

13: Paul Flynn’s interview with Sarah Jessica Parker in the latest Happy Reader made me reflect on the differences in our responses to Tony Soprano and Carrie Bradshaw, and contemplate the everyday sexism those responses perhaps reveal. As Parker and Flynn point out, why are Soprano’s murders downplayed and yet Bradshaw’s profligate spending on fashion overplayed in popular notions of those characters?

14: Once upon a time, computer mice with built-in telephones were a thing.

15: “Most sex between giraffes is homosexual: in one study, same-sex male mounting counted for 94 per cent of all sexual behaviour observed.”

16: Reading about how dismissive rudeness was at least part of the underlying cause of the downfall of Lee Cain and Dominic Cummings. In some ways, it feels like a repeat of the same mistakes Fiona Hill and Nick Timothy were perceived to have made. Civility in seniority is perhaps an under-rated quality among those making the appointments.

17: In an order confirmation email, fashion and homeware retailer Next says “we are working incredibly hard to get your items to you.” They apparently underestimate my credulousness.

18: This book taught me that the Olympic torch relay is an entirely modern creation, a Nazi idea introduced for the 1936 Olympics in Berlin.

19:  I find it hard to disagree that “the pandemic has brutally exposed a centre that has control over the country’s resources but does not know what’s happening on the ground.”

20: The Home Secretary has engaged in “forceful expression, including some occasions of shouting and swearing” which left some Civil Servants upset. The implication of the Prime Minister judging her not to have broken the Ministerial Code is that this was not “intimidating or insulting behaviour that makes an individual feel uncomfortable.” Which either means the Prime Minister doesn’t believe shouting and swearing to be intimidating or insulting, or that he doesn’t believe those who claim to have been upset, or that he doesn’t believe the Home Secretary engaged in the behaviour described. The Government’s statement isn’t clear on which of these is the case.

21: While pondering whether I should send an email at work today, I caught myself reflecting on Marcus Aurelius and Meditations. This is completely ridiculous, embarrassingly knobbish, surprisingly frequent and really quite helpful, all at the same time.

22: Some big wotsits were towed out of the Port of Tyne this afternoon. I assume they were bits of oil rigs, but don’t really know.

23: This book taught me the depressing word hemoclysm (coined by an American, so no ‘a’ or ‘æ’).

24: For a few years, while I was contributing to some guidelines, NICE used to invite me to their annual conference as a guest. One of the most memorable presentations in the years I attended was one on the extraordinary results of getting GPs to opportunistically remind older people not to sleep with their bedroom windows open: something that was commonly advised decades ago but which led to many older people sleeping in rooms which were unhealthily cold. A simple clarification in this DHSC campaign could have saved lives; I worry that the lack of one may do the opposite.

25: Twenty-six fire have broken out on buses in Rome this year alone. “The most dramatic incident occurred in the early hours of Saturday when an out-of-service bus burst into flames in the Aurelio neighbourhood. As the driver leapt to safety the heat melted the brakes, sending the bus rolling down a shopping street, torching six parked cars and four mopeds as it passed, causing a shop front to disintegrate in the heat and the windows of ground-floor apartments to explode. The bus, which was purchased seven years ago, eventually careered into a line of dustbins, setting them on fire as it slowed to a halt.”

26: I’ve never really thought about what happens to sailors when shipping companies collapse. It turns out it’s complicated and distressing.

27: I’ve never given a lot of thought to the logic of art restoration, but this article made me think about it. “Over a hundred years ago, the United States Army began looking into turning the Statue of Liberty back to her original copper color. ‘As might be expected, when the Statue of Liberty turned green people in positions of authority wondered what to do,’ writes Frazier. ‘In 1906, New York newspapers printed stories saying that the Statue was soon to be painted. The public did not like the idea.’ In the end, nothing was done. Change was accepted, and we let her green skin stay. And like a word moving through years, shifting its meaning, she continues to change, ever so slightly.”

28: It’s the first frost of the season, and the first day I’ve felt the need to don gloves for the walk to work.

29: This is a fantastic review of the human biological impact of space flight. In summary: it’s complicated.

30: Some people feel so strongly that face masks are unsafe that they scrawl messages on walls. I’m not sure what specific harms concern the author(s).

This post was filed under: Posts delayed by 12 months, Things I've learned.

31 things I learned in October 2020

1: I learned about Usutu virus.

2: Donald Trump, who only allows people who have tested negative for covid-19 to be in close proximity, has tested positive for covid-19, underlining the fallacy of relying on other people’s negative test results as the sole protective measure against infection. Meanwhile, Boris Johnson presses on with his moonshot project to provide mass testing so that we can all rely on other people’s negative test results as the sole protective measure against infection. A negative test is only as good as the testing technology—and even if the technology were magically perfect, it still only reflects the moment the test was taken.

3: I’m no fan of spiders (to say the least), but even I found this short article about the venom of funnel web spiders surprising and interesting. The thesis is that the venom is only deadly because it’s not had enough time not to be.

4: Nadia’s story.

5: “It wasn’t only independence-minded Scots who noticed that their country was handling its own coronavirus crisis confidently and – after some horrible early mistakes, principally to do with care homes – more effectively than England. Mark Drakeford, first minister of Wales, confirmed the growing recognition that decisions made in England were made for England, and that ‘home nations’ could and should stand on their own feet (‘we now have a three-nation approach from Wales, Scotland and Northern Ireland’). Meanwhile, back in London, nobody tried to claim: ‘We are all in this together’ – the slogan used in the aftermath of the 2008 financial crisis and defaced by the monstrous unfairnesses of ‘austerity’. This moment will pass. Covid-19 will gradually disappear from newspaper front pages, and Johnson will return to being a ‘British’ prime minister. And yet the union will never be the same again. A saucy genie of empowerment has escaped from the bottle.”

6: “Shaming is a major and necessary form of social control in any public health emergency. We shame people who cough without covering their mouths or who do not wear masks or do not wear condoms – and we should.” I’m not entirely sure I agree, but this provoked some thoughts.

7: Some people are much braver than me when it comes to getting involved in home renovations!

8: “There appears to be a very deliberate policy to break things up and create an instability in the system. They are doing things they don’t need to do to effect the changes they want. I don’t think it’s all 4D chess plotted out, some of it is instinctive — how they’re treating people in particular. They don’t really care about the consequences or relish them. There is an awful lot of chaos and short-termism. It’s about who they trust and who is on side — it’s a very Trumpian approach.”

9: “Mandela used to tell people a little parable. Imagine that the sun and the wind are contending to see who can get a traveller to take off his blanket. The wind blows hard, aggressively. But the traveller only pulls the blanket tighter around him. Then the sun starts to shine, first gently, and then more intensely. The traveller relaxes his blanket, and eventually he takes it off. So that, he said, is how a leader has to operate: forget about the strike-back mentality, and forge a future of warmth and partnership.”

The combination of extreme pressure and tiredness which characterises the experience of most people in public health at the moment means that warranted frustration—and perhaps grief—is often expressed in a manner that looks a lot like anger. This article helped me to reflect on and unpick some of the true underlying emotions, which aren’t really anger at all… in most cases.

10: “In two years, thousands of tourists and space enthusiasts could be gathering in the far north of Scotland to watch an unlikely event, the inaugural flight of a rocket blasting off from a peat bog usually grazed by deer and sheep.” Only a year away by the time this post is published… or not.

11: “Fellow feeling is the greatest of all human attributes. And even though it is lacking in the world’s most powerful human, and in his desire to be exceptional he does not seek to become the wounded people of his country, we can still spare a thought for his condition with benevolent sympathy — even if we then take time to criticise him properly too.”

12: “The Prime Minister has today set out how the government will further simplify and standardise local rules by introducing a three tiered system of local covid Alert Levels in England” and it’s time for another bold and ill-advised prediction from me. Ill-advised because by the time this is published, you’ll know if it’s come true, and I might look like an idiot.

The plan which the Government has announced is scientifically illiterate. Tiers appear to be allocated mostly on the basis of the number of cases in a given area, yet the speed of spread is far more important. An area which has only 10 cases today will have nearly 500 cases within six weeks if the case numbers are growing by 10% per day. An area which has 100 cases today will have only fewer than 250 cases within six weeks if case numbers are growing by only 2% per day.

Restricting only areas with high case numbers is folly. The oft-repeated argument that it’s “unfair” to impose restrictions on areas with low proportions of the population infected is based on a misunderstanding of mathematics.

The fact that the measures at each tier are only aimed at slowing the spread, and won’t be introduced until an area has a high number of cases—regardless of the speed of spread—means that I’m certain we’ll end up with an England-wide lockdown within weeks. It’ll be “stay at home” again, but with schools allowed to remain open this time. I think the Government will be slow to admit the error of the Tier system, so we may well see a new Tier 4 (local “stay at home”) unveiled before then.

And while I’m on a roll… basing restrictions on incident cases is acting far too late. The impact of restrictions takes at least an incubation period to come into effect. Introducing restrictions only when the case numbers are causing the NHS to reach breaking point is damning services to fail. I think Nightingale Hospitals will be taking patients within the month. Probably not covid patients, because that never made much sense as a strategy, but non-covid patients will be admitted to free up beds for the covid surge.

13: “This is the moment where we enter the next phase. It’s going to be really hard to stomach, it’s going to go on for some time, and if people don’t follow the rules then we may have to go further still. People in all areas of the country should be under no illusion, we are back to where we were in March, this is going to be shit and it may get shitter yet.”

14: Like an Italian schoolboy, I’ve learned about Giacomo Leopardi. I think he had exactly the opposite perspective to me on many things.

15: “You should all be writing about the PPE shortage. About a too-late response from a useless and distracted government who never thought for a minute they’d end up governing anything. Whose only thought about state was how to dismantle it as fast as possible. Who thought it was all going to be such a blast, being in power, making lots of money for themselves and their pals.

“You should be writing about how many people have died and are going to die in this country because of this government’s rank carelessness. They’re saying twenty thousand deaths will be good. Good!

“Get them writing. About how the hedgefunders have made billions already out of what’s happening. Billions going into their accounts from other people’s losses, while nurses and doctors and cleaners have to wear binliners. Binliners. A government treating them like rubbish. The NHS is not happy to let people die. That’s the difference between them and this government, happy to count the heads of their so-called herd, like we’re cattle, like they think they own us and have the right to send thousands of us to slaughter to keep the money coming in. Peevish. Too focused on their infantile Brexit obsession to accept offers of help and equipment from our neighbours.

“Write about how the people who’ve never been properly valued are all holding this country together. The health workers and the everydayers, the deliverers, the postmen and women, the people working the factories, the supermarkets, the ones holding all our lives in their hands. Write about that. The mighty Etonians brought low one more time and the meek revealed as the real might after all.”

16: “Everyone knows what you do in the bathroom, but you still close the door. In other words, your info may not be a secret, but it should remain private” by default.

17: Readwise reminded me of this lesson from a book I read some years ago: “Can you assess the danger a criminal poses by examining only what he does on an ordinary day? Can we understand health without considering wild diseases and epidemics? Indeed the normal is often irrelevant. Almost everything in social life is produced by rare but consequential shocks and jumps.”

18: I recently finished reading Ali Smith’s Summer, the extraordinary finale to her seasonal quartet. This article in the London Review of Books made me realise how much more there is to the whole series than I derived on my casual read. Maybe a series to revisit at some point.

19: I’m distinctly average.

20: “Johnson used his press conference on 9 September to dangle some hopeful news. The government, he revealed, had a plan for mass testing – a “moonshot” attempt to make quick, simple tests available at scale by next year.

“As more details of the “moonshot” emerged, the more absurd it seemed. Leaked documents revealed the plan to roll out between 6-10 million rapid tests per day at a cost of £100bn – a figure so high that some sceptics thought it was a typo.

“Roche, one company manufacturing the tests, estimated in early September that it would be able to make 80 million units a month only by the end of the year. Even then, the company’s entire global monthly manufacturing capacity would serve the UK’s moonshot for less than a fortnight.

“The plans have little basis in reality. If experience is any guide, the idea that this government could competently keep track of millions more test results every day is little short of farcical.”

21: With rumination, people can make very precisely cutting comments: “On the very rare occasion Linda Barker is on television now, when I do see her, she’s still very bouncy, and I just don’t think she earned the bounce.”

22: I learned about a famous photograph of the corium “elephant’s foot” at Chernobyl.

23: There are times when, even after all this time, Trump’s attacks on the fundamentals of democracy retain the power to shock: “I’ve been complaining very strongly about the ballots. And the ballots are a disaster. Get rid of the ballots and…we’ll have a very peaceful. There won’t be a transfer. Frankly, there’ll be a continuation.”

24: Less than half of the population knows the three cardinal symptoms of covid-19 infection, and fewer than a fifth of those advised to self-isolate actually follow the rules according to the Covid-19 Rapid Survey of Adherence to Interventions and Responses study. I’m surprised more by the former than the latter: for many, a lack of support makes full self-isolation a unviable, and “best efforts” are worthwhile anyway.

25: The Government chose to outsource NHS Test and Trace to Serco, who then themselves outsourced it to many other companies. There is a strong suspicion that the Government does not know even how many companies are now involved, let alone who they are.

According to Bernard Jenkin, who somehow manages to avoid mentioning outsourcing or any private company in his analysis, “there is a spaghetti of command and control at the top, which is incapable of coherent analysis, assessment, planning and delivery.”

One of the dominant narratives about the UK Government response to covid-19 is that the UK was well prepared, but for the “wrong kind of pandemic”.

A command and control structure is required for any pandemic: indeed, it’s probably the keystone. The plan wasn’t for “spaghetti”. The plan wasn’t for the Government to set up a Joint Biosecurity Centre nor a Covid Task Force nor to abolish the single national organisation providing health protection expertise.

Spaghetti doesn’t just appear. It doesn’t grow on trees. Ignoring the long-standing plan, outsourcing to countless private companies, creating public organisations on the fly, abolishing established players half way through, and sprinkling people with no relevant qualifications or expertise at the top; it all adds up to a Government spaghetti recipe of which even Nigella would be proud.

26: “In 40 years of reporting and broadcasting about politics, daily and most weekends, I’ve never known a time when rational, mature leadership has been more needed and yet been so wretchedly absent. Is it too much to ask our leaders to treat people as adults, and to grow up themselves?

Of course, it is possible that this crisis might have been handled worse. But, if I’m being perfectly honest, I can’t immediately see how that might have been accomplished.”

27: HM Government’s top-line advice for people who are in a large indoor shopping centre and feel that they have symptoms of covid-19 appears to be to whip out one’s mobile and book a test—not to immediately self-isolate. This is a surprising approach to controlling spread of a respiratory virus.

28: “For London, 2020 was just about the worst possible time to confront a global pandemic. The UK, which has always prided itself on being one of the most stable democracies in the world, was already uncertain about its future with an untested new government and a prime minister who many even in his own party considered ill qualified for the job. Despite all his bluster and attempts at Churchillian rhetoric, Boris Johnson has done nothing to dispel those doubts. Far from offering decisive, effective leadership, he and his ministers and advisors have spread confusion and eroded public trust – with disastrous consequences.”

29: “When you tell Chrome to wipe private data about you, it spares two websites from the purge: Google and YouTube.”

30: “We’re all mired in vague unarticulated anxiety right now, and tidying provides you with a strong foundation to ask questions of yourself: ‘What’s important to me right now? How do I want to live?’” I feel a very strong desire to write something snarky about this quote… but then I think there may be some truth to it.

31: It turns out that a year of hindsight wasn’t needed to assess item 12 on this list: patients are arriving at Nightingale hospitals and lockdown is back. Unless, of course, I just did a Cummings and retrospectively edited my predictions to fit.

This post was filed under: Posts delayed by 12 months, Things I've learned, .

30 things I learned in September 2020

1: “We’re not repeating history, just the parts that sucked.”

2: Reminded of Ogden Nash’s observation that “Candy / Is dandy / But liquor / Is quicker,” and his later regretful postscript that “Nothing makes me sicker / Than liquor / And candy / Is too expandy.”

3: Artificial banana flavours are usually based on a type of banana which is no longer commonly sold, which is why banana flavour generally doesn’t taste like banana. It’s all the same to me, as I don’t really enjoy either.

4: The Economist says Donald Trump is very likely to challenge the result of the US presidential election. By the time this blog post is published, you’ll have the benefit of hindsight in knowing whether that prediction comes true. As I write this on a bright and windy September morning in Bangor, it feels depressingly hard not to assume—despite the statistical modelling—that Trump won’t somehow win the election without any legal challenge. It’s noticeable how much tighter the odds are at the bookies than in the press: William Hill is offering the same 10/11 odds for both Trump and Biden wins, while The Economist’s tracker has Biden on an 85% chance of winning.

5: Kindles collect more data than you would think.

6: “The pandemic will end. But in India, Tunisia and Peru, there are signs the surveillance will not.”

7: “There needs to be an agreement with our European friends by the time of the European Council on 15 October if it’s going to be in force by the end of the year. There is no sense in thinking about timelines that go beyond that point. If we can’t agree by then, then I do not see that there will be a free-trade agreement between us, and we should both accept that and move on.”

8: Maps in journalism are hard.

9: “Giraffe populations have decreased by 30 percent over the past three decades. Only 111,000 individuals remain. There are at least four African elephants for every giraffe.”

10: “The ‘Moonshot’ scheme is better understood as a benign version of President Trump’s wall: a populist symbol of intent and determination, designed to mobilise public support and confidence, with little or no chance of being completed. It is surely no accident that the plan leaked on the very day that Johnson urged the country to behave with greater responsibility, limited gatherings to six and reminded people to wash their hands, wear masks and observe social distancing. After the stick, this was a carrot-shaped moonshot.”

11: Elisabeth Blik is a leading “image sleuth” in biomedical research. Who knew that was a thing?!

12: London’s bridges really are falling down. “Hammersmith Bridge is an apt metaphor for all the ways the country has changed after a decade of economic austerity, years of political wars over Brexit, and months of lockdown to combat the pandemic, the last of which has decimated already-stressed public finances.”

13: Her Majesty’s Theatre is in a sorry state:

14: “Everyone has been in a meeting where the most vocal and confident person in the room clearly doesn’t know what they’re talking about. But the most harmful meetings are the ones where that’s happening and the group can’t even recognize it.” I wonder to what extent this problem plagues Government decision-making?

15: A refreshingly clear account of what went wrong with GCSE and A-Level results this summer.

16: I’m reading Lorna Arnold’s account of the accident at Windscale in 1957 at the moment. The opening chapter portrays a small localised part of a national organisation that is undergoing a massive politically driven restructure, which cannot recruit enough professional expert staff to replace those it is losing, let alone to support the enforced expansion. Arnold says, “Windscale was over-worked and under-manned with inadequate research support, but it was a well-run site with hard-working and dedicated staff. They tackled their problems tenaciously, overcame formidable difficulties and met the demands made on them.” The whole section feels like it could be lifted from the inevitable covid-19 inquiry.

17: “The problem with the fall of a democracy is that it doesn’t simply happen, like a rain shower or a thunderstorm. It unfolds, like the slow and steady warming of the climate. Liberties aren’t eliminated, they are restricted and violated – until they erode. Rights aren’t abolished, they are undermined and trampled – until they become privileges. Truths aren’t buried, they are mocked and twisted – until everyone has their own. A democracy doesn’t stumble and fall; it slides into decline.”

18: The Prime Minister, who pledged in April that he would not “throw away all the effort and sacrifice of the British people and risk a second major outbreak” of covid-19 acknowledges that the UK is “now seeing a second wave” of covid-19.

19: Ruth Bader Ginsburg has died. She was inspirational in so many ways. Her career-long elucidation of how the whole of society is harmed by discrimination on the basis of sex is a message which is feels still hasn’t been fully absorbed across US and UK society even in 2020.

20: A month ago, I was very sceptical… but Streaks has proven remarkably at convincing me to remember to do important but mundane everyday tasks that I otherwise frequently forget (like flossing).

21: The Government’s peri-peri-ometer is rising back to “hot”.

22: Everyone was in the office, then out, then in, then out. Just one more cycle left before we get to shake it all about, do the hokey-cokey and turn around.

23: It’s 21 years—22 by the time this is published—since I registered my first domain name.

24: It’s not so long ago that Wendy first came across (and was appalled by) Fanny Craddock, thanks to a repeat of her Christmas series, so I read this profile with amusement. (“Her appearance got more striking each year, and by the time of that Christmas series—presented without Johnnie—she resembled a psychedelic Cruella de Vil, her face heavily powdered, her eyebrows plucked and redrawn an inch above her eyes, her hair decorated with large pink ribbons. She was—and still is—magnificently watchable, partly because she’s so elusive; she switches from ingratiating smiles to impatient scowls so quickly that one can’t tell what she’s thinking or feeling, whether she wants to embrace her viewers or rap their knuckles.”)

25: Subscription shoes are (almost) a thing now: when this post goes live in twelve months’ time, they should have launched.

26: The jabot is back in fashion. Apparently.

27: Since Pret launched takeaway coffees by subscription, their shops have been rammed and I’ve had to join a long queue to buy my lunch. The staff in my local shop have been not-so-quietly grumbling about the amount of money the store is losing as a result. It’s hard to know whether a reverse ferret might be coming, or whether this is a “first month” effect (given that the first month is free).

28: “Of systemic action adopted in England for the pre- vention of the importation of infectious diseases, the system of quarantine (in the commonly received sense of that term) performs an extremely small part.” Only written 143 years ago.

29: American presidential debates rarely change election outcomes.

30: FTP is dying.

This post was filed under: Posts delayed by 12 months, Things I've learned, .

31 things I learned in August 2020

1: “Just like the world needs small companies, it also needs large ones. There are things small companies simply can’t do. I don’t care how good an entrepreneur you are, you’re not going to build an all-fiber Boeing 787 in your garage. [But] we should scrutinize all large institutions, whether they’re companies, government agencies, or non-profits. [Amazon’s] responsibility is to make sure we pass such scrutiny with flying colors.”

2: Life in the United Kingdom: A Guide for New Residents, published on behalf of the Home Office, ‘approved by ministers’ and retailing at £12.99, is ‘the only official handbook on which the Life in the UK test is based’. Last week the Historical Association published an open letter – signed so far by more than 350 historians – pointing out that the handbook is ‘fundamentally misleading and in places demonstrably false’.” I remember a lot of fuss about this when the test and guide were first launched, but as the noise had subsided I unthinkingly assumed that it had just been quietly and gradually fixed. It seems that’s not true. I’ve tried three online practice tests and, while the content did seem a little like a pub quiz, I did pass all three, which clearly makes me a better citizen than the New Statesman team.

3: Covid has converted a lot of people to online food shopping, my parents included. It will be interesting to see whether the days of the trolley are over for good, or whether people will return to supermarkets in the future.

4: “All roads lead back to Barnard Castle mate. That’s what f**ked it.”

5: I still look young enough to have my ID checked when ordering alcohol…at least at Yo Sushi.

6: The commandments are not consistently numbered: in both Judaism and Protestantism, the seventh commandment is “thou shalt not commit adultery,” but that’s the sixth commandment in Catholicism. (And only 21 years late, I finally get the “joke” about the ordering of commandments in the first episode of The West Wing.)

7: I’ve been in two notable public toilets (!) in the last couple of days, which seem to me to be making steps towards greater inclusivity. One, in Geneva, had a tampon dispenser in the men’s. The other, in London, was a single combined facility for all genders and abilities (with individual cubicles including accessible facilities and baby changing spaces all off a central hand-washing atrium).

8: Major Harold Hering was sacked for asking a sensible question.

9: A load of genes have been renamed with an eye on how Microsoft Excel processes their names.

10: From a delightfully odd piece of writing in the FT by Judy Joo, I learned of Hugh Hefner’s “FU pea”.

11: Anything can be a temporary roundabout if it tries hard enough.

12: Alice Wickenden’s essay in the Summer 2020 edition of the Brixton Review of Books (not online) was moving and powerful. It made me think in detail for the first time about the particular and awful trauma of being raped by a friend and working out how to live with that.

13: New desk, new office, same job.

14: Some days are just exhausting.

15: In 2012, the Conservative mantra was to “streamline existing health improvement and protection bodies” into a single agency. In 2020, Conservatives complain that “instead of having an organisation that is constantly on alert for pandemics you have an organisation that has been concentrating on prevention of ill-health.”

16: “PHE employs some of the best, brightest and most hardworking clinicians and experts we have. There are simply not enough of them, which can partly be explained by the steady reduction in funding over the last seven years. We should not scapegoat PHE for the failures in the system in which they are but one cog.”

17: It’s possible for the Government to mess up A-Level grades more than anyone expected, despite having the Scottish experience to learn from in advance.

18: “Ministers cut PHE’s budget from £397.9m in 2015 to just under £300m this year and cut the public health grant that local councils in England receive by 22% over the same period.”

19: I’m less good at leaving work at a reasonable hour now that I work in a building that opens 24/7 rather than one that slings me out at 7pm.

20: “The virions in the surface waters of any smallish sea handily outnumber all the stars in all the skies that science could ever speak of.”

21: A conductor’s “baton has to be a certain length based on how tall the person is. Ideally it’s balanced, it should sit on the finger, so when you go to make a gesture the stick moves in a coordinated fashion. A great baton is one you don’t really feel.”

22: “At the end of June, the navy announced that the marines were getting new uniforms, which the Times described as ‘hi-tech’ because the material includes a small amount of spandex.”

23: “A typical microwave oven consumes more electricity powering its digital clock than it does heating food.” And ours isn’t even set to the right time.

24: “It can now safely be said, as his first term in the White House draws toward closure, that Donald Trump’s party is the very definition of a cult of personality. It stands for no special ideal. It possesses no organizing principle. It represents no detailed vision for governing.”

25: Perhaps a year ago, I had a very stimulating conversation with a friend and colleague about unconscious bias in medical education. It made me realise that it was something to which I hadn’t given enough thought, and I’ve been thinking about it quite a bit since. I’ve made a few changes in response to stuff I’ve read on the topic, the most noticed of which has been soliciting anonymous feedback via my work email signature—an idea I brazenly purloined from a friend who works in tech but who struggled with essentially the same question. I initially used Admonymous, but then moved to a custom-made single-question survey using my employer’s survey platform after (probably needlessly) worrying myself about information governance. Now, I seem to be reading more and more about the importance of curiosity in making accurate assessments about the world, like this article by Sanne Blauw. And really, failure to interpret the world accurately is at the heart of unconscious bias. So now I’m musing on how I can be more curious, which seems hard in the time-pressured conditions everyone in healthcare recognises. Food for thought.

26: Just like many smart watches today, the first digital watches didn’t have enough power to continuously display the time.

27: Eighteen months after my first visit to the Sagrada Família, this David Cerqueiro profile of Etsuro Sotoo—a sculptor who has worked on the building for more than four decades—gave me a slightly different appreciation for it.

28: Perfect Crime is the longest running play in New York’s history, performed eight times a week since 1987. Catherine Russell (who sounds a bit of a character) has played the lead in all but four performances.

29: “In a typical shopping trip, 60-80% of the time is spent in ineffective wandering, as customers deviate from a path that would be the shortest route to obtain the goods they purchase.”

30: Forensic botany is a thing. I know it features endlessly in the Sherlock Holmes books, but I didn’t know it happened in real life.

31: “We are going to die, and that makes us the lucky ones. Most people are never going to die because they are never going to be born. The potential people who could have been here in my place but who will in fact never see the light of day outnumber the sand grains of Arabia. Certainly those unborn ghosts include greater poets than Keats, scientists greater than Newton. We know this because the set of possible people allowed by our DNA so massively exceeds the set of actual people. In the teeth of these stupefying odds it is you and I, in our ordinariness, that are here. We privileged few, who won the lottery of birth against all odds, how dare we whine at our inevitable return to that prior state from which the vast majority have never stirred?”

This post was filed under: Posts delayed by 12 months, Things I've learned.

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