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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.

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