Category Archives: medical

current affairs, medical, thoughts

On Vaccine Logistics

Let’s think first about flu vaccination – not the vaccine itself but the logistics involved to get a needle stuck in my arm.

It is very tempting to ridicule the NHS and the UK government for failures to supply sufficient vaccines – especially flu vaccine – in sufficient quantity, and on time, when the requirements are apparently well understood. And indeed there have been supply failures in recent years. However it is salutary to consider the complexities of the logistics involved.

Somewhere around 30 million doses of vaccine have to be manufactured, packaged and shipped. Those 30 million are split between six different vaccines, made by five different companies. And there are tens of thousands of shipping endpoints (almost 10,000 GP practices in England alone, plus pharmacies, hospitals, …), all with differing requirements.

30 million doses can’t be manufactured, packed and shipped in the twinkling of a politician’s brain. It takes time, and the NHS isn’t the only customer of the manufacturers. So the supply from manufacturer to NHS warehouse will be phased; so the final shipping to the endpoint will also likely be phased. Which means at any time a given vaccine may not be available at every outlet, even if they did get their requirements correct the first time.

Keep in mind too that these vaccines are temperature sensitive and must be held in refrigerated storage at all times. That too complicates the distribution.

All of that is before one even thinks about the GP identifying, and calling those eligible for vaccination, and making enough clinic time (space, appointments, clinicians) available to actually stick needles in arms. Oh and chasing up those who don’t respond.

I know from experience of logistics at a much simpler level it is almost impossible to get this 100% correct every single time — hard though one might try! It’s almost inevitable that on this scale things will go wrong; and the further back in the chain the problem occurs the bigger the knock on effect out at the clinic.

(Incidentally it’s the same with supermarkets and getting things like loo roll on the shelves. Don’t just blame people for panic buying – although, yes, they do – but think about the logistics and supply chain involved.)

Amazingly this works the vast majority of times in developed countries. For instance, the UK currently has among the highest national coverage of flu vaccine in the world, vaccinating around 75% of the over-65s against flu every year; most countries either do worse or have no vaccination programmes for older people. But in places where the infrastructure and healthcare systems are more fragile, things break down quite quickly.

Now let’s extend this to vaccine(s) for Covid-19.

First of all let’s say that all of the above logistics still apply, but things get worse …

We don’t yet have a vaccine (or vaccines), so as yet we have no clue how many of what we are trying to deploy, or where, or how.

We don’t know if the vaccine(s) will require refrigerated storage, or actual cold storage. If cold storage (ie. freezer temperatures) is required – and this seems likely for many of the vaccines currently being trialled – this hugely complicates the distribution chain (and makes it pretty much impossible in developing countries).

How many shots of vaccine are required to provide immunity? Will just a single shot be enough? Or will patients need a booster (or two, or three, …). Again it looks as is many of the potential vaccines will need a booster shot after a few weeks. That doesn’t just double the amount of vaccine required; it doubles everything right down to ensuring patients get their booster.

And who is eligible for the vaccine? And when? Government is likely to plan on getting the vaccine to the most important people (eg. healthcare workers, food supply people) first, followed by vulnerable groups, and then everyone else. Ultimately they will want to catch everyone (barring the small number of nay-sayers): that’s 60+ million in England alone, with potentially two shots of vaccine – so four or five times the flu programme.

That’s a potential 120+ million doses of vaccine for England alone together with a huge amount of distribution and a great deal of clinical effort. That deployment will take time; maybe as much as an elapsed year! By which time the first recipients may need repeat vaccination if the immunity decays, as it well may.

All of that is before we even think about … How effective the vaccine(s) are (no vaccine is 100% effective). How many vaccines are available. Are particular vaccines (in)appropriate for particular groups of patients. How do we handle the case where the first vaccine available is followed up by one which is much more effective? – Do we revaccinate the first recipients now, or later, or not at all? What advertising campaign, or other incentives (maybe even legislation?), do we need to ensure the vast majority of people get vaccinated?

Of course, we don’t yet have a vaccine to deploy. The front runners are all still in Phase III trials which are unlikely to complete until at least the end of this year. Even if one (or more) of the candidate vaccines looks really good, it is very unlikely we’ll see an emergency approval much before next Spring. And then there may be the question of how that affects other ongoing trials.

Now you can be pretty sure that there will be people in the Department of Health and the NHS sweating blood to try to work all this out, now, even before we have a vaccine. And however well they do their job you can be sure they will get some of it wrong – because the problem is just too complex and contains too many risks and pitfalls. It isn’t at all easy, and it’s human nature to complain when things don’t work perfectly, but it helps to try to see the bigger picture.

So … (a) cut the healthcare system some slack when things don’t work 100% every time, but (b) do call the government to account if it’s their policies which cause the failures, and (c) don’t pin all your hopes on a Covid-19 vaccine being available to everyone (anyone?) real soon.

Further Reading

  1. Derek Lowe; “The Vaccine Tightrope”; Science Translational Medicine; 21 October 2020; https://blogs.sciencemag.org/pipeline/archives/2020/10/21/the-vaccine-tightrope
  2. David Salisbury; “If you’re pinning your hopes on a Covid vaccine, here’s a dose of realism”; Guardian; 21 October 2020; https://www.theguardian.com/commentisfree/2020/oct/21/covid-vaccine-immunisation-protection
  3. Jeremy Farrar; “Let’s get real. No vaccine will work as if by magic, returning us to ‘normal’”; Guardian; 6 September 2020; https://www.theguardian.com/commentisfree/2020/sep/06/lets-get-real-no-vaccine-will-work-as-if-by-magic-returning-us-to-normal
  4. Derek Lowe; “Cold Chain (And Colder Chain) Distribution”; Science Translational Medicine; 31 August 2020; https://blogs.sciencemag.org/pipeline/archives/2020/08/31/cold-chain-and-colder-chain-distribution
  5. Derek Lowe; “Preparing For the Vaccine Results”; Science Translational Medicine; 25 August 2020; https://blogs.sciencemag.org/pipeline/archives/2020/08/25/preparing-for-the-vaccine-results
  6. Megan Scudellari; “How the pandemic might play out in 2021 and beyond”; Nature; 5 August 2020; https://www.nature.com/articles/d41586-020-02278-5
amusements, environment, history, links, medical, science

Monthly Links

Once more unto the breach, dear comrades, to bring you this month’s selection of links to items you may have missed the first time round. And an e-glass of e-ale to anyone who can knit the links into a coat of mail!

Science, Technology, Natural World

Let’s begin with another look at why wasps are so annoying, but yet so useful.

Oh and for anyone wanting to scare their visitors, you can buy a roughly five times life-size model of an Asian Giant Hornet (aka. “murder hornet”).

If you never understood why mathematics is so fascinating, take a look at odd perfect numbers. [LONG READ]

And changing topic again, scientists think they’ve found phosphine gas in Venus’ upper atmosphere, and say this could be a sign of life (albeit microbial life). Meanwhile Derek Lowe explains about phosphine but remains somewhat sceptical of the latest results.

Health, Medicine

The logistics around distribution of any vaccine (well any drug really) are complex, especially when one gets into the realm of Cold Chain Distribution.

But then we need to keep our feet in the real world as no vaccine will work by magic and return us to normality.

Girls: have you ever needed to pee standing up and envied us men our flexible hose? If so, the Shewee may be your friend.

Environment

Rewilding as an environment improvement method is taking time to get going, but not if one maverick Devon farmer has anything to do with it.

Social Sciences, Business, Law

So who thinks Scottish bank notes are legal tender in England? Spoiler: they aren’t! And what is legal tender anyway?

History, Archaeology, Anthropology

There’s some new archaeology at Pompeii which is uncovering more of its past.

Medieval sermons were one of the most effective and wide-reaching forms of propaganda, but that only works if they are in the vernacular. [LONG READ]

The people of medieval Europe were devoted to their dogs. [LONG READ]

Transport until the early part of the 20th century was largely dependent on the horse: either being ridden or pulling a wagon of some description. Here’s a look at horse transport in Victorian times.

Lifestyle, Personal Development, Beliefs

Oliver Burkeman, writing his last regular column for the Guardian, talks about his eight secrets for a fulfilled life.

If you’re dreading a long, dark winter lockdown, then maybe the Norwegians have something for you.

So what does your cat mean by “miaow”? A Japanese vet is apparently earning a fortune telling people what their cats are saying. Personally I thought we had a fairly good idea!

Shock, Horror, Humour, Wow!

Magawa, an African giant pouched rat, has been awarded a gold medal for his work detecting landmines in Cambodia. I must say he’s a rather handsome animal, and well deserving of his apparently upcoming retirement.

And finally, what is the connexion between frozen shit and narcissists’ eyebrows? Yes, of course, it’s this year’s Ig Nobel prizes.

arts, history, links, medical, science

Monthly Links

It’s been quiet round here recently. Nevertheless we’ve been collecting our usual list of links to items you missed the first time. And this month we have an edition packed with some good (long) reads …

Science, Technology, Natural World

Astronomer Martin Rees looks at how we’ve discovered that the universe is much bigger and weirder than anyone thought … [£££] [LONG READ]

… or as our favourite theoretical physicist, Katie Mack, points out: space is big and our planet a tiny porthole, looking over a cosmic sea.

Whoops! We didn’t see it coming and it nearly got us. [£££]

Flat Earthers’ “science” may be wrong, but they aren’t entirely stupid.

Now to more mundane matters … here are two articles, one from the Conversation the other from the Guardian, on how vets identified Coronavirus in a cat.

A few weeks back, when the weather was nicely tropical, Diamond Geezer took a look at the technical definition of a heatwave – and it isn’t as simple as you might think.

Really tiny, but really cute: Leaf Sheep,
apparently the only animal that can photosynthesise.

The Somali Sengi (a species of elephant shrew) is a really cool critter: it mates for life, can race around at 30km/h and sucks up ants with its trunk-like nose – and having been thought extinct ecologists have recently rediscovered it in Djibouti.

Health, Medicine

A view from inside the NHS on what it was like trying to cope with a sudden deluge of Covid-19 patients. [LONG READ]

Covid-19 is here for the long haul: here’s how scientists predict the pandemic might play out over the next months and years.

Ed Yong looks at the totally non-intuitive complexity of the immune system, and why trying to understand it is so important. [LONG READ]

Here’s one doctor who avoids soap (except for hand-washing) and says we’re showering all wrong.

[TRIGGER WARNING] Unlike in animals, we know that around 25% of all pregnancies end in an early miscarriage, but do we really understand why? [£££] [LONG READ]

Then again, we’ve only just discovered that human sperm swim differently than we thought they did.

Social Sciences, Business, Law

For two decades scientists and officials played pandemic war games, but they didn’t factor in the effects of a Donald Trump. [LONG READ]

Be concerned; be very concerned. A lawyer looks at the government’s current review of Judicial Review.

History, Archaeology, Anthropology

Pace Richard Dawkins, it is suggested that humans aren’t inherently selfish, but hardwired to work together. (Until the ship gets overcrowded that is.)

The origins of modern humans get more complex with every new twist of DNA analysed. I have to ask whether we’re actually sure that Homo sapiens, Neanderthals, Denisovans, H. erectus (and maybe others) aren’t actually just one species with some very well-defined sub-species. [LONG READ]

Archaeologists believe they’ve found the source of Stonehenge’s giant sarsen stones.

It turns out that our medieval friends had a thing about sex with demons. [LONG READ]

And now to almost modern demons of a different kind. Here’s an old article about a potentially huge explosion lurking in a wreck off the Kent coast. [LONG READ]

London

Archaeologists have uncovered the lost medieval Great Sacristy of Westminster Abbey.

The history and workings of the Port of London in Tudor times. [LONG READ]

On the dissolution of London’s monasteries.

And another piece from The History of London on the building of Regents Canal.

A short history of the London Hackney Coach and the Horse Cab.

Food, Drink

At long last someone is waking up to the ideas that dieting per se doesn’t work and that we all have different food and metabolic requirements.

Lifestyle, Personal Development, Beliefs

There’s a Zoroastrian centre not far from here, so I’ve always wondered what they’re about. Here’s a look into the very closed world of a strange religion. [LONG READ]

Here are nine common myths about naturism which are totally wrong.

Postcrossing has been around for a while. It’s an interesting idea involving swapping postcards with unknown people around the world as a way of building global friendship.

Shock, Horror, Humour, Wow!

And finally … Only the Japanese could invent a public toilet with transparent walls. They’re quite pretty really.

arts, history, links, medical, natural history, science

Monthly Interesting Links

Once again we come to our monthly collection of links to items you missed the first time round and which you’ll find interesting. This month we have a well packed collection (lots of science and lots of history), so it’s straight in the deep end.

Science, Technology, Natural World

Astronomers still think there’s a large planet out beyond Pluto, so of course they’re still hunting for it (artist’s impression above).

So when you have this new vaccine how are you going to package it? Pharmaceutical Chemist Derek Lowe takes a look.

Many plants have stingers (think, stinging nettles), and it seems they have achieved optimal pointiness. [£££]

Oh dear! It seems likely the world’s smallest dinosaur is a lizard. [£££]

Ornithologists are revealing the long-distance travels and longevity of British birds.

Scientists still don’t know how birds navigate, though it is likely magnetic and they’re narrowing down the options.

30 years ago Red Kites were reintroduced to the Chilterns to the west of London, and this has proven to be a huge conservation success. (I’m 30 miles east of the release area, and in suburban London, and I now regularly see Red Kites over this area.)

Where have all our swifts gone? Are they on the Grand Tour?

There’s a growing realisation that old paintings can provide valuable information about agriculture both livestock and arable. [£££]

Here’s a brief look at the chemistry of cat allergies, catnip and cat pee.

Health, Medicine

How on Earth do you do surgery in the weightlessness of space without having bits of body floating around?

I find this hard to believe, but seemingly damaged human lungs can be revived for transplant by connecting them to a pig. [£££]

Researchers are worried that a new swine flu identified in China has pandemic potential.

Researchers are also looking at the potential for using magic mushrooms to help ex-soldiers overcome trauma.

Art, Literature, Language

Where are the bones of Hans Holbein? Jonathan Jones went looking, but we still don’t know. [LONG READ]

An astronomer has finally(?) pinpointed the exact date and time of Vermeer’s “View of Delft” (above).

The British Library has acquired an important archive of Mervyn Peake‘s original illustrations, preliminary drawings and unpublished early works (example below).

History, Archaeology, Anthropology

Archaeologists have uncovered stone tools which they believe show that humans occupied the Americas around 33,000 years ago – that’s over 10,000 years earlier than previously thought.

Work on the UK’s HS2 rail link has unearthed the skeleton of a possible iron age murder victim.

Drinking games have a long history. Michael Fontaine, in History Today, takes a look.

So how old is the Cerne Abbas Giant (right)? New archaeological thinking by the National Trust suggests it is not prehistoric.

Our favourite medieval historian, Dr Eleanor Janega, takes a look at colonialism, imperialism, and the perils of ignoring medieval history. [LONG READ]

Going Medieval also take a brief look at the medieval obsession with the Moon.

A look at the symbolism of the medieval haircut. Scissors or sword, Sir?

Coming closer to our time, apparently Georgian London was a haven for sexual diseases.

Even closer to home, a look at what happened on the morning of the first nuclear test in 1945. [LONG READ]

And almost up to date, the purrrplexing story of the British Museum cats.

ARCHI is a UK archaeological site containing old maps (largely Victorian, it seems) which you can overlay on the current map to see what was there before we were.

London

Here are two pieces from the History of London on the area to the east of the Tower of London. First, the St Katherine’s area, and second the development of the area around Stepney.

Going Medieval (again) introduces us to the magnificent Agas Map of London (it’s detailed and zoomable!) as well as the lfe of medieval and early modern cities. [LONG READ]

Lifestyle, Personal Development, Beliefs

And finally for this month … Dungeness is one of my favourite places and the late Derek Jarman’s cottage and garden (thankfully saved for the nation) is an absolute delight (below). Now there’s an exhibition about Jarman’s garden at the Garden Museum in London.

environment, history, links, medical, natural history, science

Monthly Links

Here are our links to items you may have missed in the last month. There’s a lot this month, so let’s dive in.

Incidentally [£££] indicates the article may be behind a paywall, although most of these sites do offer a limited number of free articles so don’t ignore them.

Science, Technology, Natural World

First off, here’s an old article from New Scientist in which Roger Penrose asks What is Reality? [£££]

However there’s a warning that we should beware of Theories of Everything. [£££]

Meanwhile scientists have calculated the most likely number of alien civilisations we could contact. [Spoiler: it isn’t 42.]

Maybe the search for extraterrestrial life is why the Americans are embarking on another round of major upgrades to their U-2 spy plane. [£££]

But back to Earth … Researchers have used camera traps to complete a thorough survey of the inhabitants of African rainforest.

Surprisingly in this day and age we still don’t fully understand where eels come from. [£££]

Ecologists have tracked the astonishing migration of one particular European Cuckoo.

Equally astonishing, scientists have managed to record and translate the sounds made by honeybee queens.

After which we shouldn’t really be surprised that crows are aware of different human languages.

Health, Medicine

So out of the crow’s nest and into the fire … What you always thought you knew about why males are the taller sex is probably wrong.

It seems there is growing evidence that we should be taking seriously the potential of psychedelic drugs to treat depression. Well I’d certainly be up for trying it.

Tick-borne Lyme Disease can develop into a debilitating chronic condition. [£££] [LONG READ]

Have you ever wondered how medical students are trained to do those intimate examinations?

Environment

There’s a movement to establish fast-growing mini-forests to help fight the climate crisis.

Barn Owls are one of our most iconic species, and the good news is that they’re growing in numbers thnks to human help.

Here’s just one example of the huge amount of rarer elements in old computers which we need to recycle.

We’re used to places like Iceland using geothermal energy, but now there’s a plan to heat some UK homes using warm water from flooded mines.

History, Archaeology, Anthropology

Archaeologists have found clues to the earliest known bow-and-arrow hunting outside Africa.

DNA from the 5,200-year-old Newgrange passage tomb in Ireland hints at ancient royal incest.

And DNA is also being used to provide clues about the origins of the Dead Sea Scrolls.

On health and safety in the ancient world – or maybe the lack of it!

Religious iconography always was about marketing and PR.

The Medievals had notions about the ideal shape of women which curiously don’t coincide with our modern ideals. [LONG READ]

But then the Medievals lived in a world without police, and it wasn’t quite a brutal as one might think.

Archaeologists think they’ve found London’s earliest theatre, the Red Lion.

If we thought Medievals had odd ideas, then Enlightened Man (in 17th and 18th centuries) was in many ways stranger; shaving and periwigs were the least of it. [LONG READ]

London

On the first few hundred years of Westminster Abbey. [LONG READ]

From Tudor times Protestants have been intermittently persecuted in mainland Europe, and escaped to Britain. Here’s a piece on the history of the Huguenots in London. [LONG READ]

Lifestyle, Personal Development, Beliefs

Is it OK for your kids to see you naked? Here’s an uptight American article which nonetheless concludes it is OK, as we all know.

history, links, medical, science

Monthly Links

And so at the end of another month we come to our regular collection of links to items you may have missed …

Science, Technology, Natural World

Extraterrestrials. What is believable, and how would we know? [£££££]

Meanwhile on this earth we have Vespa mandarinia, the Asian Giant Hornet, aka. the “Murder Hornet”. But just how dangerous is it? TL;DR: Very if you’re a honeybee.

I never cease to like the (small) variety of wasps in this country and what they get up to.

Still with the hymenoptera, the humble bumblebee has a clever trick to get plants to flower.

Health, Medicine

When is a llama not a llama? When it’s a unicorn!

So why is it that clinical trials of (new) drugs are so complicated and expensive? [LONG READ]

For a long, long time sunshine has been seen as having healing powers.

Researchers, almost accidentally, have found a microbe which completely stops the malaria parasite.

[TRIGGER WARNING] Having had four miscarriages, journalist Jennie Agg wanted to understand why it happened and why it is never talked about. [LONG READ]

Sexuality

Dr Eleanor Janega has some sexual fun over on Going Medieval. Here she is on:
•  No Nut November [LONG READ]
•  Dildos and Penance
•  “Alpha Men” and poorly disguised misogyny

Social Sciences, Business, Law

Have you ever wondered how the heights on Low Bridge signs are calculated? Diamond Geezer investigates.

Art, Literature, Language

Dutch researchers have been trying to extract the secrets from Vermeer’s “Girl with a Pearl Earring”

History, Archaeology, Anthropology

Mexico has too many mammoths – or at least bits of mammoths.

OK, so here’s another series from Going Medieval:
•  On chronicles versus journalism, and ruling versus governing.
•  On the King’s two bodies and modern myth making.
•  On the Lusty Month of May.

London

Diamond Geezer (again) discovers the interesting history of his local Tesco supermarket. What’s the history of your local supermarket’s site? Three near me: the iconic Hoover building, an old cinema and the site of a former gasworks!

And one more from Diamond Geezer … this time he’s been finding out the correct names for the different parts of a London bus stop.

Food, Drink

Apparently coconut oil isn’t all it’s cracked up to be. Colour me surprised! [£££££]

Lifestyle, Personal Development, Beliefs

And finally … Pity the poor curators who are having to spend lockdown in places like Hampton Court Palace!

history, links, medical, natural history, science

Monthly Links

In the middle of these interesting times we’re living in, we bring you a diversion by way of our round-up of links to items you may have missed this month. And I promise it is Coronavirus-free.

Science, Technology, Natural World

The Rainfall Rescue Project are looking for (online) volunteers to help transcribe old rainfall records from the handwritten sheets, so they are digitised and useable for in depth research.

We thought we understood it, but rock samples brought back by the Apollo moon missions are reopening debate about how the moon formed. [£££££]

It seems that people who get lost in the wild follow strange but predictable paths. [£££££]

Dust is often not what you think, especially in museums.

A brief look at five dinosaurs which, once upon a time, roamed the British Isles.

The smallest known dinosaur skull has been found in a piece of amber.

Crows understand death, at least death of a fellow crow, but can we work out what they’re actually thinking?

Now, while we’re all in solitary confinement, is a good time to take up birdwatching: there’s a surprising number of birds go past your window and they’re not all sparrows and pigeons.

If they share a vase, daffodils kill other cut flowers. Here’s why.

Health, Medicine

Copper is great at killing off microbes (it’s been used in horticulture and viniculture for centuries) and yet in a medical context the more inert stainless steel is preferred.

A small number of women are born with the rare MRKH Syndrome, where they lack a vagina and possibly other internal reproductive organs.

We all know about tree rings giving information about the growth of the tree, but it seems our teeth also document our life’s stresses.

Environment

A small Japanese village is leading the way into our carbon-neutral future, but it ain’t easy.

The Guardian gives us fifty simple ways to make life greener. [LONG READ]

Social Sciences, Business, Law

Many of us like to belief we have free thought uninfluenced by others; but can we ever be a truly independent thinker?

Art, Literature, Language

Aubrey Beardsley is one of many artists whose has work been suppressed for obscenity, and is the subject of a new exhibition at Tate Britain (assuming museums are ever allowed to reopen). [LONG READ]

History, Archaeology, Anthropology

A new study reports that a supposedly important collection of Dead Sea Scroll fragments are all fakes.

Archaeologists suggest that a collection of bones found in Kent church likely to be of 7th-century saint

Drake’s Island in Plymouth Sound is to be opened up and get its first visitors in 30 years.

London

London blogger Diamond Geezer takes a look at the genesis of London numbered postal districts.

Lifestyle, Personal Development

And finally … Should ladies’ loos provide female urinals, and would they be an answer to the queues for the loos?

Take care, everyone, and stay safe!

medical, personal, ramblings

Horrible Times 1

2 Comments

Over the last weekend I started writing what I hope may become an occasional series of comment/diary entries emanating from the current mess known as Coronavirus. Here’s what I wrote on Sunday (lightly edited).

Sunday 15 March 2020 – Ides of March

This Coronavirus (Covid-19) is getting a grip of everyone. It looks like we’re in for a long haul, and a very messy one. Few of us trust the government’s strategy, which is at total odds with what the rest of the world are doing (except for the USA, and President Trump is an even bigger moron that Boris Johnson). The strategy may protect the over-70s for a bit, meanwhile it will rip through the rest of the population. Then the over-70s will succumb as soon as the restrictions come off, creating a second (and third etc.) wave before we’re near to having any treatment or vaccination options – don’t expect those within a year. Anyway it is now much too late; the genii is out of the bottle and in my estimation has been since probably mid-December (because the first case is now thought to have been in mid-November, but not recognised for what it was). So we needed to impose draconian social distancing measures very early, like back at New Year, if we really were to nip this in the bud.

I’ve already cancelled one of our doctor’s patient group events for this week, and my meeting the same morning with the Practice Manager. More will doubtless follow over the next few days. Others organising events I’m involved with as far ahead as mid-May are discussing cancelling them too.

Unfortunately I’m also minded to cancel my fortnightly massage sessions: not only because it’s a risk to me but also because my masseuse is newly pregnant and others working in the same practice are at significantly high risk. That makes me really sad as I enjoy the massage sessions and the chat, and it does help keep my back going. But we need to consider others in this as well as ourselves.

Amongst all this I’m really frightened and depressed. I’m almost 70 and with diabetes, obesity and sleep apnoea so I’m in a high risk category for serious complications if I do get Covid-19. And if I do I fear that it will kill me – either because my immune system is too compromised or because the hospitals won’t be able to cope and I’ll be a low priority for treatment.

I know the chances of me succumbing to this are relatively small, but that doesn’t make it any less frightening. So I feel my best hope is not to get this and be around long enough for either a good treatment or a vaccine.

But then I’m worried too that Noreen will fall ill. She’s not far behind me in age and she does have a long-term hereditary condition, although that doesn’t seem to affect either her immune system or lungs. Indeed her immune system, hitherto, has been so good it keeps many things under: she’s a Typhoid Mary. If Noreen does fall off her perch before me I know I shall be absolutely sunk: not because I can’t do what has to be done (although that may not be easy) but mentally; the depression will be completely overwhelming. Equally I know Noreen will struggle without me.

But what can we do? Both of us being risk averse as we are we’re inclined to behave as if we’re over 70, and self-isolate as much as we possibly can. Luckily we can (for now, at least) get grocery deliveries – not ideal but OK – and we have the reserves we built up against Brexit to help.

Even before all this I was beginning to feel my mortality and realising that I likely have only a few more years. The thought of not being here leaves me feeling deeply sad and almost terminally helpless. I’m starting to understand how, in his last years, my father just gave up the will to keep going.

It’s also interesting to start to really appreciate how frightening in must have been for people during the Black Death of 1348-9, the Plague of 1665, and the Spanish Flu of 1918-19; especially given that they really didn’t understand how any of this worked and what they could do to mitigate the diseases. In that sense at least we stand half a chance.

Please stay safe everyone!

beliefs, freedom of speech, medical, sexuality, thoughts

Sex is Binary

About three weeks ago there was an article in Wall Street Journal [paywall] under the headline:

The Dangerous Denial of Sex

The first half of the article crystallised what I’ve been thinking for a while: that although there are rare instances of intersex individuals, to insist that biological sex is a spectrum is erroneous. Supplanting biological sex with a subjective and fluid “gender identity” arrived at “by the whim of the owner” (my deliberately slightly irreverent words) is unrealistic and impractical. To quote just one paragraph of the article:

There is a difference … between the statements that there are only two sexes (true) and that everyone can be neatly categorized as either male or female (false). The existence of only two sexes does not mean sex is never ambiguous. But intersex individuals are extremely rare, and they are neither a third sex nor proof that sex is a “spectrum” or a “social construct”. Not everyone needs to be discretely assignable to one or the other sex in order for biological sex to be functionally binary.

From here on I dislike the tone of the article which to me sounds very right-wing, misogynistic and derogatory. Added to which I’m far from convinced the authors’ arguments follow logically.

That is not to deny (a) that some individuals’ biological sex is ambiguous, nor (b) that some individuals may self-identify to a different gender than their biological sex. While I will admit to not fully understanding this (cis-hetero male privilege and all that), it seems to me that the disconnect between an individual’s biological sex and their gender identity begins in some way as a psychological process. My gut feeling is that the medicalisation of this to sex reassignment is not sufficiently controlled or counselled (especially in adolescents), and is thus somewhat dangerous – as the quoted article goes on to imply.

This is also not to deny the psychological stresses that those affected go through in coming to terms with their situation, leading up to gender-reassignment, and that they encounter during transition – this latter is something I’ve witnessed in a work context and which was quite disconcerting even to a completely uninvolved bystander.

So basically I’d say: by all means gender identify however you please, but in the vast majority (not all) of cases biological (anatomical) sex is binary, not a social construct. Yes, gender reassignment surgery is possible, and some require it. However it is not something I’m personally comfortable with – just as I’m not comfortable with IVF etc.

As with so many other things, while I may not agree with you or be comfortable with your views, I would defend and support anyone’s right to gender identify however they wish. It’s your life, not mine.

Of course, YMMV.

arts, environment, history, links, medical, science

Monthly Links

Once more (where is this year going; it’s already the end of February?) we bring you our monthly bumper bundle of links to items you will wish you hadn’t already missed. I’m ignoring Coronavirus per se for the simple reason that everything is moving too fast. Here goes …

Science, Technology, Natural World

One of our favourite physicists introduces the top 10 most important effects in physics.

Here’s an interesting idea about measurement: forget feet and meters there’s as more fundamental measurement for earthlings.

Anyone who is active in science, especially chemistry, will love The Pocket Chemist.

Male-male competition, and sometimes female preferences, have helped fashion the flashiest adornments. [LONG READ]

Health, Medicine

Do drugs deteriorate? Why are their use-by dates important?

Facemasks. Do they actually do any good against flu, coronavirus or pollution?

What can the medical profession do to help your back pain? It seems there’s not a lot in their toolkit which is of much help.

Retinal migraines are rare, but what are they like?

We all have left-right asymmetry (internally), but how do bodies map this out? [LONG READ]

And another biological conundrum … how do body parts grow to the right size? [LONG READ]

Apparently girls are beginning puberty a year earlier than they were 50 years ago.

Sexuality

Katherine Rowland talked to 120 women about their sex lives and desires.

As if we need an excuse, here are five ways to have more sex with your partner.

Here’s a review of Kate Lister’s new book A Curious History of Sex. I found it interesting and amusing. [Disclosure: I helped crowdfund it.]

An interesting look at parenting in a polyamorous relationship. There’s no evidence it’s any worse for children than any other style of relationship.

Meet some of Britain’s sex-positive influencers. [LONG READ]

Environment

Estate owners across UK are queueing up to reintroduce beavers.

Art, Literature, Language

Anglo-Saxon charters and place-names are an often-overlooked source of folklore and popular belief.

A portrait, long thought to be of Louis XIV’s son, turns out to be a late-17th century Lord Mayor of London.

History, Archaeology, Anthropology

The records of the High Court of Chivalry (which still exists) reveal quite a lot about the life of 14th cetury soldiers.

The British Library has digitised a 15th century children’s guide to manners: Pyke notte thy nostrellys.

Archaeologists have uncovered the remains of the mysterious 14th century Bek’s Chapel, lost at the time of the Civil War.

Four secret societies whch operated in the London’s shadows.

A brief hiostory of the (somewhat disreputable) East India Company.

The vast collection of King George III’s military maps are now available online.

London

A secret passageway has been discovered in the Place of Westminster.

The V&A Museum of Childhood at Bethnal Green is to close in May for two years for a £13m revamp.

Lifestyle, Personal Development

Want to rewire your brain for clearer, calmer thinking? The case for Transcendental Meditation.

And finally … Women share their stories of celebrating their body hair.

We’ll have more next month!