Cassandra Voices

Category: Science

  • ‘Healthy People Do Not Require Genetic Vaccination’

    Editor’s Note: Having previously published Vaccination: A Matter of Trust with Caveats, we now anticipate objections from some readers to an article that may provoke vaccine hesitancy, at a point when rapid rollout to the entire adult population is widely touted as the only path out of interminable lockdowns. The author of this article, Dr. Marcus de Brun, however, is a medical doctor, and prior to his resignation last year– in protest against the government’s handling of the pandemic – a member of the Irish Medical Council. He also holds a first class degree in microbiology from TCD. Thus, we believe it is incumbent on Cassandra Voices as ‘a home for independent voices to inspire new thinking’ to provide this platform for him to articulate fully a public stance that he would not vaccinate a healthy person with any of the four vaccines currently on offer in Ireland. All the more so in a period of crisis, we maintain it is vital to give space to informed arguments that go against the grain. We invite comment and/or rebuttal, and ask if you appreciate this article that you offer a contribution to this publication, either through signing up with us on Patreon or through a single donation Buy Me A Coffee.

     

    Having recently stated publicly that I would ‘not administer a genetic-vaccine to a healthy animal, never mind a ‘healthy human being,’ I have been asked by friends (and foes) to clarify this statement, and will attempt to do so here.

    At present, vaccines produced by four companies (Pfizer, Moderna, Astra Zeneca and Johnson & Johnson) are available on the European market. All four are ‘genetic vaccines’ in that they are composed of synthetic DNA or RNA that is contained within a membrane or shell. In construction and appearance the vaccine is very similar to the SARS-CoV-2 virus responsible for the coronavirus disease known as Covid-19. The vaccine gains entry to human cells by a process that is almost identical to the manner by which a virus generally gains access to host cells. This process is called ‘transfection’.

    Each of these vaccines work by introducing either DNA or RNA into host cells. The genetic material then instructs host cells to make a piece of the coronavirus (the spike protein) that is then released into the blood stream or tissues. There, the spike protein will trigger an immune response. Following this immune response, the vaccinated individual will retain some immunity; they will have antibodies and white cells that can now recognise Covid-19 and attack it before it has a chance to cause a serious infection.

    The AstraZeneca and Johnson & Johnson vaccines are DNA vaccines,[i] which transfect DNA into the Nucleus of host cells. The Pfizer and Moderna Vaccines are RNA vaccines, these transfect their RNA into the cytoplasm of host cells. The difference will be explained later; however, the initial process is the same: human cells take up synthetic viral genes, those genes then direct those cells to begin manufacturing the spike-protein of Covid-19. The cells will then release the nascent spike-protein into the bloodstream or tissues, where it will then function as a ‘traditional vaccine.’

    In essence, the distinction between genetic-vaccines and ‘traditional vaccines’ is that the latter would involve a person being injected with killed or inactive virus or spike-protein, which would then cause our immune systems to mount a response. Each of these novel genetic-vaccines however, insert genetic material into human cells. These synthetic genes then ‘hijack’ those cells or ‘convert’ them to manufacture and release the spike-protein. With a genetic vaccine, pharma does not make the vaccine, our own cells are programmed to do the work instead, a process entirely different from that of a ‘traditional vaccine’.

    Out with the Old…

    For the first time in my medical career of some twenty years, I am presented with the apparent necessity of vaccinating young healthy people with experimental vaccines, against a disease for which they have little or no risk of suffering life-threatening,[ii] or even serious long-term[iii] illness. The vast majority of  ‘vulnerable’ people to whom they might pass Covid-19 have already been either vaccinated or been exposed to the virus.[iv]

    In Ireland according to our Central Statistics Office, during the past 12 months up to the end of January 2021; amongst the entire population of 1-24yr olds, there have been 55,565 PCR confirmed cases of Covid-19. Out of those cases, there has not been a single death recorded; from, by, or associated with Covid-19.[v] It has been reported that a single Covid-related death in this cohort (1-24yrs) did occur in February of this year. However, this has yet to appear in the figures published by the CSO.

    Young nurses, medical staff, care workers, are being pressured into taking a vaccine they probably don’t need themselves, despite residents under their care having been almost all vaccinated already. Now Covid-19 genetic-vaccines are being tested upon children as young as six months old.[vi]

    A Scarcity of Serious Questions? Or a Scarcity of Serious Media?

    The justification for many, if not most, policies during this crisis has largely been based on ‘mortality data’. In contrast, Swedish authorities have enforced relatively few restrictions, nor made masks mandatory. In Ireland, the CSO indicate that 92% of all Covid-related deaths have occurred in those over 65 years of age.[vii]

    In Sweden that cohort of their population is 3.17 times greater Ireland’s. Thus, if we roughly compare the Swedish mortality total (at the time of writing) of 13,262,  to the Irish total of 4588, and if we then multiply the Irish mortality total by 3.17, we arrive at a figure of 14,544, which is significantly higher than the comparable Swedish total.

    We are crudely, but reasonably, comparing ‘like with like’ to reveal glaring potential problems with our own relatively draconian Covid policies. When compared with Sweden, our own version of lockdown seems to have had no benefit in terms of preventing mortality. It might not be unreasonable to assert that our stricter policies may have contributed to a relatively higher mortality. Yet, perhaps the biggest question here is: why are there so few questions being posed in the media in respect of the efficacy of masks, lockdowns or vaccination policies?

    On the rare occasion questions are raised in our national media, it as if an ‘anti-vaxxer’, ‘right-wing loon’, or political extremist is trying to gate crash what might otherwise be a rather sedate and respectable party.

    Pro-Vaxxer

    In the good old days before Covid, in Ireland, and around the world, we only vaccinated those who were vulnerable to, or at risk from a specific disease. We still vaccinate children against an array of illnesses that adults have not been, and are not routinely vaccinated against; Rotavirus and Meningitis B are but two obvious examples. Adults are equally susceptible to infection by either, but they are not as vulnerable to serious illness, and so are not vaccinated. Previously, we only ever vaccinated the vulnerable and those at risk; recently, however, that good science and common sense has been turned on its head.

    It is suggested that we should vaccinate young healthy people who have little if anything to fear from Covid-19. A paediatric genetic-vaccine is expected to be available later this year. It is argued that even though children are generally not susceptible to serious disease, they should be vaccinated in order to protect the vulnerable and achieve ‘herd-immunity.’ In the meantime, the vulnerable have in large part already been either been vaccinated already, exposed or sadly passed away.

    In a recent post on Twitter Michael Levitt, Nobel Laureate and Professor of Biophysics at Stanford University said:

    If getting the disease does not give immunity, how do you think that a vaccine that makes the same spike protein as the virus makes will give immunity?

    It beggars belief that with over a quarter of a million cases of Covid-19 already confirmed in Ireland, [viii] those who have already contracted the virus, are not at least being offered antibody testing prior to being offered (or pressured into taking) a new type of vaccine; novel vaccine that have recognised associated risks, and have not completed all safety trials.

    Between March and June, 2020, 96% of additional deaths related to COVID-19 in Europe occurred in patients aged older than 70 years [ix] We have clearly lost sight of whom we are trying to protect, and what we are trying to protect them from. Presently we have a national obsession with conformity, and an ostensible adherence to guidelines. Despite empirical truths, and substantial contrary evidence, we are being corralled into what increasingly appears to be a specific belief-system surrounding Covid-19, and its threat to the entire population.

    Those who have read George Orwell’s Animal Farm (1945) will be familiar with the threats issued to the hapless animals: ‘Jones the farmer will return, and destroy all of your good work!’ In contemporary parlance, he will return with ‘Long Covid,’[x] and frightening ‘New Variants’ with him.

    https://twitter.com/bergerbell/status/1379143927542947841

    Politicians have applied policies that are in keeping with this notion of ‘universal severity’ in response to a virus where 86% of those infected did not have virus symptoms, such as cough, fever, and loss of taste or smell., according to a UK study from October.[xi] Many of our Covid policies arrive with the benefit of preserving established governments from demonstrations and assemblies calling for policy revisions and or enquiries.

    My own calls for a public enquiry into nursing home deaths, or my pleas on behalf of common sense and natural science, are at best ignored by media. As are those of colleagues who feel and believe as I do, including Limerick GP Dr. Pat Morrissey, and Wexford GP Dr Gerry Waters, who was recently suspended by the Medical Council for refusing to adhere to and promote current public health guidance. Others who have openly spoken out against current policies have been subjected to investigation by the Medical Council, and ongoing vilification by many of our peers. Speaking out returns precious few short term dividends.

    Throughout much of Europe since the outset of the crisis, governments, like our own, are presently controlled by proxy scientific-panels or unelected expert committees. Governments claim to be simply ‘following their scientists advice,’ whilst the scientists insist that they are merely informing the government and not directing government policy. In this apparently blameless political ‘no man’s land’, the stage is perfectly set for blameless political atrocities.

    War of the Words: ‘Genetic vs ‘Traditional’

    Many scientists and physicians prefer to describe most Covid-19 vaccines as ‘gene therapy’. It is a phrase that no doubt serves as much to antagonise proponents, as it does to inform them. However, it is as good a place as anywhere to start.

    Genetic vaccines are certainly not ‘traditional’ vaccines. The licence for their use against Covid-19 throughout Europe was granted under emergency legislation that permits manufacturers to skip phase 4 safety trials that would have otherwise delayed their distribution. Advocates insist that skipping this final phase was absolutely necessary to resolve the current crisis.

    There is much to this argument, and we will not dive into it here. However, one point should be made. There are at least two off-patent (cheap and safe) drugs, Hydroxychloroquine and Ivermectin, that may be effective in treating Covid-19. These drugs are not, however, licensed for use in treating Covid in many Western countries, (particularly the wealthier ones who can afford the novel vaccines).

    https://twitter.com/EvidenceLimited/status/1379400534000594945

    If either, or both, drugs had been licensed, this might have proved an obstacle to the granting of emergency use licences for Covid-19 vaccines. The reason for this is that grounds for emergency licensing of genetic-vaccines are substantially reinforced, as long as there are no other pharmacological treatments available at the time.

    Edward Jenner (1749-1823)

    A Traditional ‘Vaccine’

    In China the practice of inoculation against diseases such as smallpox was established as far back as 200 BC.[xii] It is likely that traditional medicine, tribesmen and ancient civilisations used, or at least inadvertently ‘knew’ something of the benefits of limited exposure to a disease, in order to establish some degree of immunity.

    Our own modern era of the ‘traditional’ vaccine begins when Edward Jenner (1749-1823) noticed that milkmaids appeared to be relatively immune to smallpox, a viral illness that was, in Jenner’s day, responsible for widespread suffering and death.

    Jenner observed that something was being transmitted from the cows to the milkmaids, effectively protecting them against smallpox. Cows contract cowpox. It’s not the same disease as smallpox, but as the respective viruses are so similar, whenever the hands of a milkmaid came into contact with a blister or pox on the udder of a cow infected with cow-pox; the milkmaid would be exposed to this very similar virus.

    In these instances the cowpox virus or ‘pieces’ of it, would enter the milkmaid’s blood stream through a cut or minor abrasion on her hands. The virus would be identified by her immune system as a ‘pathogen’ or disease-causing agent. White cells would attack the cowpox virus, causing it to break apart. Those same white cells would manufacture antibodies; little Y-shaped proteins that will stick to surface-proteins on the virus, and cause it to be directly destroyed, or recognised by other white cells that will mobilise to destroy it.

    All of this complex immunology would of course be occurring within the milkmaid’s blood, whilst she happily milked her cows. She might notice a slight blister, a little pus, or minor swelling around one of the abrasions on her overworked hands. The slight redness might be ignored, and would inevitably fade away. However this localised reaction would have heralded exposure to cowpox. The cowpox antibodies would then persist in her blood, remaining attached to the surface of many of her circulating white blood cells; protecting her or “vaccinating” her against small-pox.

    If the milkmaid should later come into contact with smallpox, those newly formed cowpox antibodies would be ready to mount an early and more efficient immune response. Her antibodies to the cowpox virus could attach to the smallpox virus, recruit other white cells – killer t-cells etc – onto the scene, and mount a pre-emptive response. This would be fast enough to eradicate the smallpox infection before it had an opportunity to spread and cause severe illness or death. It was Jenner’s genius that ultimately brought this reality to light.

    Jenner collected some of the pus that oozed from the udders of cows infected with cowpox. He swirled it about in a drop of water, placed it in a glass vial and then offered it to the world as the prevention for small-pox. Half a century later Louis Pasteur coined the phrase ‘vaccination’ after vacca, the Latin for cow. The paradigm in respect of human medicine and public health had shifted forever.

    Louis Pasteur.

    Perhaps the real hero of the vaccination story was an eight-year-old boy by the name of James Phipps, the son of Jenner’s gardener. On May 14th 1796, Jenner made a small incision into James’s arm, and rubbed in a drop of his magical ‘pus-paste’, making little James the first to be given a vaccine in the modern sense.

    Thankfully, little James proved immune to the various small-pox ‘exposures’ and challenges that Jenner then came up with. At the time small-pox was responsible for almost 10% of annual deaths in England. Jenner sent his results in a paper to the Royal Society for publication, but his paper was ignored.

    Having had the audacity to suggest pus from an infected cow’s udder, as a cure for smallpox, Jenner was at first dismissed as an eccentric by his peers. Yet, rather than disappearing into obscurity, he persisted. He vaccinated a further twenty-three people, and having seen little James survive, he even included his own eleven-month old son Robert, in this first ever vaccine trial.

    At that stage the medical establishment found it impossible to ignore his findings, which soon attracted widespread interest amongst the medical fraternity. However, it was not until 1840, some forty-four-years after his first attempt to publish his results, that the British Government began offering Jenner’s vaccination, free of charge, to the general public.

    The same but different

    Since Jenner’s day, ‘traditional vaccines’ have functioned in precisely the same way. Pharmaceutical companies take a virus or bacterium, they break it up, kill it, or leave it intact but render it weaker or ineffective ‘the same but different.’ They then take the bug (or pieces of the bug), swish them around in a little drop of water, add in a few elements that act as preservatives and immune-stimulants; then we doctors inject those pieces into people, thereby preventing many from succumbing to various infective diseases. The vaccination exposes us to a bug or pieces of a bug causing our immune system to generate antibodies and white blood cells that will persist in our circulation and be ready to launch a pre-emptive strike against the bug or a similar bug if it is encountered again: we have, in essence, become immune.

    So what is different about genetic-vaccines? Well here’s where the story becomes a little nuanced. Let’s try to put it in terms we might relate to.

    To begin with we must remind ourselves that: all living things are composed of cells, which is perhaps the most basic tenet of biology.

    Image of a recreated 1918 influenza virus.

    Viruses are not considered ‘living things’, because they are not ‘cells’ and neither are they made up of cells. They are formally referred to as ‘obligate intracellular parasites.’ They only become ‘alive;’ and can only replicate, after entering host cells, at which point they replicate or multiply within host cells. Once inside a cell the virus hijacks the cell’s own processes for making things that the cell needs for itself. The infected cell then becomes a virus factory, it swells with new virus particles, until it bursts, dies, and releases its payload of new virions into the bloodstream, or fluid outside of the cell membrane.

    It is only when a virus is outside the cell, within the blood stream or tissues, that it might be recognised by white cells or antibodies, and become the subject of an immune response. When a virus is inside one of our cells, there are some discrete ways this cell can let other cells know that it has become infected; there are means by which the immune system detects that one of our own cells has a virus inside it. However, these are comparatively slow, indefinite and uncertain processes and will not be discussed here. The major and most important way the immune system clears viruses is by getting at them before they get inside our cells.

    Once a virus is inside a cell, for the most part, it is hidden from the immune system. This point will be crucial to understanding the distinction between a genetic vaccine, and a traditional vaccine.

    All Cells Look a Little, or a Lot, Like a Fried Egg:

    Under a microscope, all cells appear a little like fried eggs. Almost all of them have the same basic plan, the yellow yolk being the nucleus; the white of the egg, the ‘cytoplasm;’ and the outer margin of the fried egg (the crispy brown edge) being the ‘cell membrane’ or wall surrounding the cell. To learn the basics of how genetic vaccines work, we need only refer to this analogy, but we must understand our ‘egg’ a little better before we put the toast on.

    The yellow yolk, or nucleus, contains all of our DNA. To understand what DNA looks like, imagine your fly, not the one buzzing at the window, but the zip on your trousers. It is composed of two sides or strands that are linked together when your zipper is up, and separated when your zipper is down.

    DNA is like an extremely long length of closed zip. Imagine this super long ‘zip’ coiled into individual space-saving packages, like neat balls of wool. Each of these little packages is called a chromosome and (with the exception of sperm cells and egg cells) the nucleus of each of our cells contains forty-six of these little balls of wool; twenty-three from mum, and twenty-three from dad.

    All forty-six are packed into the nucleus, the yellow yolk of our analogous egg. When we, or one of our cells, needs something; a protein, a hormone, a replacement part etc., the information to make what the cell needs (the recipe for all of life’s necessities) is coded for in that length of closed zip, our DNA.

    Each of the ‘teeth’ along the length of the zip strands, represent a single letter of the genetic code. An entire message may contain many letters, or teeth, along a specific length or piece of the zip. The lengths of zip that contain messages (or recipes) are called our ‘genes.’

    The ‘message’ within a gene is like a recipe in a cookbook. It contains a coded instruction for how to make the protein, enzyme etc., or whatever it is that the cell wants or needs. The DNA code is in the nucleus, and the basic ingredients are located in the cytoplasm, and it is in the cytoplasm (the egg-white) where the item required is assembled and manufactured. The raw materials for manufacture get into the cytoplasm, when they are absorbed across the cell membrane (the crispy brown bit at the edge of our fried egg). These raw materials are the amino-acids, sugars and vitamins etc., that we receive in our diet.

    To kick off the process, when a cell needs to make something, a signal is sent from the white of the egg (the cytoplasm) into the nucleus. That signal makes its way to the ball of wool or chromosome that contains the particular recipe, or code for the ingredients that will make up whatever is needed by the cell. When the signal reaches the chromosome containing the particular recipe or gene, the ball of wool is loosened slightly, and a relatively small length of closed zip (or DNA containing that recipe), is unzipped. One side of the opened zip is then copied into a piece of mRNA.

    That copy of one side of the unzipped zip is called messenger RNA. In most textbooks it (the mRNA) looks exactly as I have described it: a single side of a zip. This messenger RNA then exits through pores in the nucleus.  It enters the white of the egg, where this mRNA ‘recipe’ is then read or translated, and whatever it is the cell needs can now be manufactured within the cytoplasm or the white of the egg.

    The Ribosome

    When the strand of messenger RNA leaves the nucleus and enters the cytoplasm it is immediately found by a fascinating little cytoplasmic protein called a ‘ribosome’. The ribosome attaches to the mRNA. It then slides along this single strand of zip, and as it does so, ‘reads’ the code, and then makes a little strand, like a bead of pearls (a polypeptide). That strand of polypeptide then curls and folds itself into a little ball or blob; and this little blob of protein, is the very thing that the cell was looking for in the first place.

    It might be a structural protein, an enzyme, a building block, a replacement part, or whatever. When the ribosome slides along the piece of mRNA it makes this new little string that will ultimately fold upon itself to become the required product. This wonderful orchestral process is as ancient as life itself and is called ‘translation.’

    It is one of the rare occasions when jargon makes sense, for the little piece of mRNA, has indeed been ‘translated’ into a protein or ‘final product’ by the ribosome. The cell has now manufactured the thing that it needs, and after a few translations, the mRNA then degrades. No more ribosomes can attach to it, and no further product can be manufactured from it. If the cell wants another product it must send another message into the nucleus and call for another mRNA copy to be made in the nucleus and sent into the cytoplasm. It is a beautifully organised process, integral not simply to human life but to all life on the planet.

    How Does a Genetic-Vaccine Work?

    If you got all of that, you have grasped some of the fundamentals of cell biology and we are now able to ask: how does a genetic vaccine work?

    Most of us have seen an image or an artist’s impression of what a coronavirus looks like. A little ball, covered in spikes, like a medieval weapon swung from the end of a chain. Inside this little ball are the virus’s own genes. These genes are in the form of strands of RNA; the same type of RNA that is made in the nucleus of our cells, and sent into the cytoplasm for the manufacture of all ‘things’ that the cell needs.

    SARS-CoV-2

    The main difference between the RNA strands within a coronavirus, and those that naturally emerge from the nucleus of our own cells, is that coronavirus RNA does not code for ‘things’ that our cells might need. On the contrary, it codes for pieces that make up the coronavirus itself.

    When a coronavirus binds to the outside of one of the cells in our respiratory tract, it releases its RNA into those cells – into the white of the egg – and there, instead of making proteins that are needed by our cells, our ribosomes attach to their viral RNA and begin to manufacture (or translate) proteins that make up the physical structure of the virus. The host cell has now becomes a virus-making factory; the cytoplasm swells with viral particles; the cell bursts, and thousands of new viruses (virions) are released into the bloodstream, or the fluid that lies outside of the cell membrane.

    A genetic vaccine looks like, and functions, in almost exactly the same manner as the coronavirus itself. If a genetic vaccine could be visualised, it would look like a little sphere that encapsulates a piece of viral RNA or DNA (depending on which of the four vaccines we are considering). The role of the sphere is to protect the RNA or DNA inside the vaccine, and, most importantly, to bind it to human cells in a manner that will allow the piece of RNA or DNA to enter host cells at the site where the ‘vaccine’ is injected.

    For an RNA containing vaccine (Pfizer & Moderna) once the vaccine RNA gets inside our cells, our ribosomes attach and translate the RNA into a piece of the virus (one of the spike proteins). The host cell will then swell with spike proteins, and release them into the blood stream or body fluids outside the cell. There, the spike-protein will trigger the same immune response that Jenner and the traditional vaccines make use of.

    For DNA vaccines (Johnson & Johnson, AstraZeneca) the vaccine-DNA makes its way into the nucleus of our cells where it begins working (and is treated the same as our own DNA). It is copied into a piece of mRNA that will then travel into the cytoplasm and be translated by ribosomes into spike-proteins. Because genetic vaccines cannot infect cells, the process whereby a genetic-vaccine enters host cells is referred to as ‘transfection’.

    It is only after the transfected host cell releases spike-protein into the blood stream that our genetic-vaccine begins working in the ‘traditional’ way. In reality, it is the cellular process for the manufacture of things which has been hijacked, and the ‘traditional vaccine’ is being made inside one’s own cells. The ‘vaccine’ is released into our blood stream in the same way that a cell infected with a virus releases new virus into the blood stream or tissues.

    The final result might be the same, however, where a genetic-vaccine is different is in its mechanism it operates inside cells at a level of intimacy that Jenner could never have imagined. Because DNA vaccines enter the nucleus of our cells, and are treated as our own DNA, they come with a risk of damaging our own DNA, causing mutations, including, potentially, cancer. The potential is indeed an established fact. It is no less established than the fact that there is a link between smoking and cancer.

    Consider when a piece of synthetic DNA comes within intimate proximity of a relatively enormous coiled ball of DNA that is dynamically unwinding and unravelling in response to the daily activities of the cell. Is there a chance that this relatively small piece of synthetic DNA might become incorporated into or interfere with the normal function of our own DNA? Before Covid, the answer was an emphatic yes. However of late, the mere suggestion will undoubtedly be treated as something of a ‘conspiracy theory’.

    It is for this and other reasons that genetic-vaccines have not been previously licensed for use in humans prior to the current crisis. Thus, a 2013 paper[xiii] published in Germs, the respected Journal of Infectious Diseases lists the established disadvantages of DNA vaccines.

    Crossing the Rubicon

    At this point the reason critics refer to current Covid-19 vaccines as ‘gene therapy’ should not be too difficult to understand. It is important to bear in mind that as the cellular process of translation can be hijacked to produce a ‘vaccine’, it can also be hijacked to produce a myriad of other potential pharmaceutical therapies.

    Very limited forms of gene therapy are available in the treatment of terminal cancers. However, pharmaceutical companies have not been able to market this form of medicine, outside of the laboratory, on human populations.[xiv] A cynic might reasonably argue that companies are exploiting the current crisis in order to expedite safety trials and open the market for ‘gene-therapy’.

    There is nothing new here, this type of therapy, whereby patients are administered the gene for a missing or desired product, has been in development for several decades. The major difficulty for pharmaceutical companies has been how to get it out of the laboratory and past the paralysis of safety trials. It is certainly easy to see that if our cells are programmed to make and release spike-proteins, they can also be programmed to release other kinds of proteins, drugs and potential therapies directly into the human blood stream or tissues.[xv] Getting this type of therapy past regulators, and avoiding meaningful debate, has, (for better or worse), clearly been accomplished within the context of the current crisis.

    From a simple economic perspective, if human cells can be programmed to take on the role of manufacturing the ‘drug’, numerous difficulties in respect of production, costs, delivery, and even safety trials, are relatively easily overcome. The paradigm shift that resulted from Jenner’s development of vaccination could pale into insignificance compared to the potential game changer of genetic-vaccine.

    Ah go on. You’ll be grand!

    If, indeed, these vaccines are going to protect people from Covid-19, and they come with the added benefit of paving the way for novel therapies, why are people like me getting our proverbial knickers in a twist?

    Again the answer is not that complicated. The cellular process of ‘translation’ that is being ‘hijacked’ by the relevant pharmaceutical companies, does not belong to them, to our respiratory cells, or even human cells. As mentioned already, it is a process that belongs to ALL cells, in ALL species. In essence it ‘belongs’ to all living things in Nature.

    If anything happens to go wrong, the consequences are not limited to human beings, as the process being ‘hijacked’ is not exclusive to us. It ‘belongs’ to all life on Earth. The consequence of error, may extend further than a little nausea or swelling at the injection site.[xvi] Potential consequences extend to all cells that utilize the same process, and come in contact with the manufactured DNA or RNA.

    DNA or RNA? Red or White?

    Whilst the potential for either of the two available DNA vaccines to integrate into, or damage, human DNA is well established; there is an argument being made that this cannot possibly occur with the two available RNA vaccines.

    Generally speaking within our cells once RNA is copied or made in the nucleus it moves into the cytoplasm. It does not travel backwards. RNA does not move back inside the nucleus and incorporate into our DNA. However, the key words here are: ‘generally speaking.’

    Nature (generally speaking) blocks this possibility because the copied RNA that exits the nucleus, is different to DNA. It is an RNA copy of the DNA, the RNA cannot bind or interact with DNA. In the first instance RNA is a single stranded copy of one side of the zip. In the second instance the ‘teeth’ on the newly copied RNA are slightly different. They are tweaked with a sugar molecule called ribose, they are ‘ribosylated’ and therefore cannot readily recombine with DNA. (The ‘R’ in RNA simply means Ribosylated Nucleic Acid.)

    The RNA does indeed code for the same message that is contained within the DNA, but the teeth, or the letters of the RNA code, are slightly different. RNA does not travel backwards and interfere with DNA. Generally speaking they are incompatible, and cannot interfere with each other. Therefore, when the vaccine makers insist that the pieces of RNA that they have transfected into our cells do not interact with our DNA; well, they aren’t spoofing. It doesn’t normally happen that RNA interferes with DNA.

    So that’s what it says on the tin. However, there are two points that must be considered before we take this claim at face value. The first is a question of ‘precedence’ and the second is a question of scale.

    Does it happen in humans and in Nature that RNA can travel backwards into the nucleus and interfere with or incorporate into DNA? The simple answer to this question is a definite yes! RNA can and does travel backwards to incorporate itself into our DNA. This retrograde move, (where RNA sequences become incorporated into DNA) is called reverse-transcription. The reason for the use of ‘retro’ in the word retrovirus, is because retroviruses, and many other viruses, make use of reverse-transcription, converting RNA into DNA that will then integrate into our own DNA.

    HIV and HTLV (a human virus that causes t-cell leukaemia) are examples of viral infections, where RNA is converted backwards into DNA which then ‘interferes’ with our own DNA inside the nucleus of our cells. These viruses contain RNA, and they also carry an enzyme called ‘reverse transcriptase’. This enzyme converts RNA backwards into DNA. Retroviruses and other viruses (such as Hepatitis B) introduce the reverse-transcriptase enzyme into our cells when they infect them.[xvii] Furthermore, our own cells normally produce and use this enzyme (reverse transcriptase) inside the nucleus, where it has some ‘house-keeping’ roles in maintaining our own DNA.[xviii]

    Perhaps even more interesting is the fact that within the human genome some 8% of our DNA is composed of DNA that was originally viral RNA. Infections with RNA viruses whose genes have since become permanently incorporated into our own DNA. These sequences are called ‘Human Endogenous Retroviral Sequences’ or HERVS.[xix] Many of them persist within our genome because they may code for proteins or things that are likely to be of some benefit to us; genes brought into our genome from outside the cell, via the natural, dynamic interaction between viruses, retroviruses and human DNA.

    Many more of these endogenous retroviral (originally RNA) sequences are mysteriously redundant, and science is yet to learn of their function in sickness or in health. The fact remains that they are present; been present for countless millennia; may be integral to our evolution as a species; and are certainly with us ‘until death do us part.’ They should serve to remind us that there is a long established history of communication between viral and human genetics; an interaction that we should attempt to understand before it is blindly manipulated.

    Interconnectedness

    Too often viruses are portrayed as static structures, distinct from our own genetic material and distinct from one another. This is quite simply a rather primitive concept, the same kind of thinking that removes human beings and the consequence of our actions from Nature. It is part of the reason we remain largely incapable of seeing and appreciating the vast web of interconnectedness that dependently joins us to whales, rain forests, and even viruses.

    We depend upon viruses for our genetics, as we depend upon yeast for our beer. Often viruses depend upon each other to cause infection. In certain instances, if a particular virus is missing something, a part or component (without which it is defective or deficient), the missing part is supplied by another helper-virus. There are helper-viruses, and there is an entire family of viruses (dependoviruses) that are entirely dependent upon assistance from helper-viruses. For example, in Humans, Hepatitis D virus is activated, only in the presence of Hepatitis B virus. Essentially, in order to function, the D-virus ‘borrows’ some missing parts from the B virus.

    In short, viruses are not ‘monogamous recluses’: interacting with each other; helping each other; interacting with our genetic material within the cytoplasm and within the nucleus. It does not matters if that genetic material has come from the nucleus of our own cells, or been synthesized in the labs at Johnson and Johnson.[xx]

    A Question of Scale

    There is no such thing as a ‘perfect process’. Do something for the first time and you might do it right,  do it right enough times, and you will eventually do it wrong. 

    When vaccine RNA or DNA hijacks a natural cellular processes and transforms the cell to vaccine or spike-protein production; how many times does this ‘event’ occur in the tissue of the person who has thus been vaccinated? Thousands, or several thousands of times? How many times has it occurred when several billion people are vaccinated? I don’t know the answer to this question. However, when a process is repeated billions of times, mistakes are no longer ‘possible’, they are inevitable. Such mistakes or mutations are not only inevitable but are essential, lying at the heart of evolution itself.

    The End is Nigh?

    There is certainly a mountain of spin and delusion on either side of the ‘genetic-vaccine’ or ‘gene-therapy’ debate, and we must keep matters in perspective. Genetic modification is here to stay, for better or for worse. The argument in respect of unforeseen genetic consequence to ourselves and/or other species is an old one. It began with ‘Dolly’ the sheep, and has raged for some time around the desirability of genetically modified foods.

    Ironically, the introduction of synthetic genes into vegetables, created something of an international furore, yet the transfection of synthetic genes into millions of regular human beings has created far less controversy. Debate or discussion on the subject of genetic modification or therapy, its necessity, utility, or potential harm, is long overdue; although perhaps it might be a case of too little, too late.

    Today, many of the foods we eat have been genetically modified to some degree. Genetically modified food is, however, met with and processed by the acid and digestive enzymes in our guts. The synthetic genes in GM products do not (as far as we know) enter our cells, they do not attempt to manipulate our own cellular or genetic processes.

    There is clearly an urgent need to revisit this debate in light of these new vaccines. The battle may have been lost in respect of GM crops, but there is a reasonable argument to be advanced this time round as ‘human genetic processes’ are being tampered with, rather than sheep, beetroot or soya beans.

    The Right Hashtag?

    In recent years discourse and protest have become strangely predictable, organised around or stimulated by whatever happens to be trending on social media. It seems the right hashtag hasn’t been developed for ‘debate’ in respect of current pandemic policy, even as that policy extends into the function of our own cells.

    How many people in Ireland, or around the world, know how a Covid vaccine work? How many clinicians are aware for that matter? When debate does erupt in relatively small pockets around the country it is hijacked by extremists or dismissed as being organised and attended by extremists. Social media appears to be moderating our behaviour to a greater degree than even genetics.

    The health of our society depends far more on constructing a more honest and happier version of ourselves. We need to re-evaluate materialism, define happiness, reduce consumption, eat less (or no) meat, take plastics out of our food chain and ecosystems, restore and preserve habitats, protect and understand a biodiversity upon which we are entirely dependent. All of this, and more, is not contingent on genetic modification, no more than it is dependent on us getting to Mars.

    Therefore, for the reasons I have outlined, I would not inject a healthy animal with an experimental genetic-vaccine, never mind a healthy human being.

    [i] Jonathan Corum and Carl Zimmer, ‘How the Oxford-AstraZeneca Vaccine Works,’ New York Times, March 22nd, 2020,  https://www.nytimes.com/interactive/2020/health/oxford-astrazeneca-covid-19-vaccine.html

    [ii] Smriti Mallapaty, ‘The coronavirus is most deadly if you are older and male — new data reveal the risks’ August 28th, 2020, https://www.nature.com/articles/d41586-020-02483-2

    [iii] Adam W. Gaffney, ‘We need to start thinking more critically — and speaking more cautiously — about long Covid’ Statnews, March 22nd, 2021, https://www.statnews.com/2021/03/22/we-need-to-start-thinking-more-critically-speaking-cautiously-long-covid/

    [iv] Conor Pope, Vivienne Clarke, ‘Vaccination rollout in nursing homes almost complete, HSE says,’ February 12th, 2020, Irish Times, https://www.irishtimes.com/news/health/vaccination-rollout-in-nursing-homes-almost-complete-hse-says-1.4483250

    [v] CSO. https://www.cso.ie/en/releasesandpublications/ep/p-covid19/covid-                                                19informationhub/health/covid-19deathsandcasesstatistics/

    [vi] Moderna Announces First Participants Dosed in Phase 2/3 Study of COVID-19 Vaccine Candidate in Pediatric Population https://investors.modernatx.com/news-releases/news-release-details/moderna-announces-first-participants-dosed-phase-23-study-0

    [vii] CSO. https://www.cso.ie/en/releasesandpublications/ep/p-covid19/covid-                                                19informationhub/health/covid-19deathsandcasesstatistics/

    [viii] https://www.google.com/search?client=firefox-b-d&q=covid+deaths+ireland

    [ix] ‘Immune evasion means we need a new COVID-19 social contract’, The Lancet, February 18th, 2021, https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(21)00036-0/fulltext

    [x] Jeremy Divine, ‘The Dubious Origins of Long Covid’, Wall Street Journal, March 22nd, 2021,  https://www.wsj.com/articles/the-dubious-origins-of-long-covid-11616452583

    [xi] Angela Betsaida B. Laguipo, ‘86 percent of the UK’s COVID-19 patients have no symptoms,’ News Medical Life Sciences, October 9th, 2020, https://www.news-medical.net/news/20201009/86-percent-of-the-UKs-COVID-19-patients-have-no-symptoms.aspx

    [xii] The History of Vaccines, Chinese Smallpox Inoculation, https://www.historyofvaccines.org/content/early-chinese-inoculation

    [xiii] Germs. 2013 Mar; 3(1): 26–35. Published online 2013 Mar 1. doi: 10.11599/germs.2013.1034/

    [xiv] Kristina Fiore, ‘Want to Know More About mRNA Before Your COVID Jab?’ Medpage Today, December 3rd, 2020, https://www.medpagetoday.com/infectiousdisease/covid19/89998

    [xv] Nature Reviews Drug Discovery volume 17, pages261–279(2018)

    [xvi] Nicola Davis, ‘Covid vaccine side-effects: what are they, who gets them and why?’ The Guardian, March 18th, 2021, https://www.theguardian.com/world/2021/mar/18/covid-vaccine-side-effects-what-are-they-who-gets-them-and-why

    [xvii] Medical Microbiology. 4th edition (Chapter 62).Galveston (TX): University of Texas Medical Branch at Galveston; 1996.

    [xviii] Proc Natl Acad Sci U S A. 1986 Apr; 83(8): 2531–2535.
    doi: 10.1073/pnas.83.8.2531, https://www.nature.com/articles/1205081

    [xix] PMCID: PMC7139688 PMID: 32155827 Human Endogenous Retroviruses (HERVs): Shaping the Innate Immune Response in Cancers.

    [xx] Knipe, David M.; Howley, Peter M. (2007). Fields Virology (5th ed.). Lippincott Williams & Wilkins. pp. 126–7.

     

     

  • Covid-19 in Ireland: Landfall

    In August of last year I wrote an article pointing to the impending consequence of the Irish government’s rolling lockdown policy, ‘The Perfect Storm’[i] gathering on the horizon over the country. By that I meant a significant second wave of Covid-19 – to hit this winter. I made that prediction based on the following factors:

    An elevated number of potential viral hosts, which is a consequence of suppression of natural-immunity.

    Increased life of the virus in the external environment due to decreased daylight

    Raised levels of social anxiety and subsequent susceptibility to illness/infection

    Continued persistence of the virus at low levels within Irish society

    The ‘storm’ made landfall at the start of January, leading to the imposition of an extreme lockdown for the third time – with children denied their constitutional right to an education –  amid renewed fears the hospital system would be overwhelmed, as many elderly in care homes passed away once again.

    Sadly, this ‘third’ wave actually commenced in week 48 of 2020 (22/11/2020), while the country was still under Level 5 Lockdown restrictions, according to a report by the HSPC.[ii]

    Could additional deaths have been averted if the Taoiseach had not sought ‘a meaningful Christmas’; or if NEPHT’s advice had been followed to the letter – permitting house visits rather than opening restaurants and gastropubs[iii] at the start of December? Based on the HSPC report that seems doubtful. And I would question whether most Irish people would have willingly foregone sociability throughout the depths of winter – there was certainly no political clamour to cancel Christmas – having endured near-constant lockdown since March. But you never know.

    Furthermore, without a Christmas spending spree many indigenous retailers and restaurateurs might have been forced out of business – to the unrestrained joy of Jeff Bezos, Tescos and the rest.

    But in Ireland, as ever, we desperately need someone to blame third time round; anyone other than NPHET that has managed to preserve a reputation for scientific insight despite the damage it is doing to the country. So, instead of questioning the government’s response, youngsters – who may have availed of a brief chink of light to socialize – are scapegoated.

    Other than that we find talk of selfish immigrants returning home over Christmas to see loved ones. And now attacks on those who escaped the overwhelming doom and gloom for a post-Christmas break. Yet, whatever one’s thoughts on the sustainability of flying, it is notable that just 1% of cases since the pandemic began have been traced to travel abroad.

    Lockdown Policy

    In the midst of any crisis scientific arguments compete to establish the best way forward. In the case of Covid-19 in Ireland ‘the argument’ has been remarkably one-sided. Discussions in the media are generally over the severity of lockdowns to be employed – this hitherto unheard of public health intervention with enormous collateral damage, which has somehow been normalised.

    From the outset I have been convinced that the Irish government at the prompting of the WHO – along with most other Western governments – adopted an erroneous approach, based on a flawed epidemiological assessment, which led Leo Varadkar to suggest there could be a staggering 85,000 deaths[iv] in Ireland.

    Virtually alone in Europe, the Swedish health authorities (relatively free of political interference) stood apart, refusing to lockdown in March, 2020. I would argue that this softer approach has been to the benefit of the vast majority of people living there – and may even lead to a lower death toll in the end – compared to the trauma of lockdowns experienced by citizens in most other European countries.

    Notably, during the first wave almost 92% of confirmed deaths from Covid-19 in Ireland were among over sixty-five-year-olds,[v] and when this Irish cohort is compared to Sweden’s considerably older population a very different picture emerges; in contrast to the usual truck of ‘deaths per capita’ and ‘deaths per million.’

    Hats off to the impressively organised states of Norway and Finland, where Covid-19 mortality has remained very low indeed, but vigorous track and trace strategy operating in these countries have proved ineffective elsewhere; even Germany is floundering this winter, having been locked down for months.

    Revealingly, in March 2020 the Director-General of the Norwegian Institute for Public Health Camilla Stoltenberg[vi] recommended that her government should keep schools open – as in Sweden – and was advocating last June for a softer approach in the likely event of a second wave.

    Now, as the death toll from Covid-19 in Ireland steadily converges with Sweden’s – especially when adjusted for the relative age of each population – it remains to be seen whether much-vaunted, but still experimental, vaccines will significantly alter the respective death tolls.

    I maintain that a policy of keeping the Irish population under rolling lockdowns until the whole population is vaccinated will have a worse impact on the nation’s long-term health than any mortality or morbidity that may be avoided.

    Zero Covid Utopianism

    The frankly bizarre ‘option’ of Zero Covid-19 that has been grasped by some on the left, and the right, in Ireland is a form of Utopianism. It ignores the virtual impossibility of eradicating an aerosol, sub-microscopic pathogen such as Covid-19 from Ireland. Moreover, we remain one of the most globalized societies in the world with over half-a-million foreign born resident in the country[vii] and an Irish-born diaspora of three million;[viii] rely on international trade for most commodities; besides having a porous border to the North.

    Moreover, New Zealand and Australia are currently enjoying summer, when respiratory viruses retreat. This seasonal effect is enhanced by a depleted ozone layer over the Southern Hemisphere – causing the world’s highest rate of skin cancers[ix] – which elevates the level of UV light that destroys viruses. Both countries are also insulated from the rest of the world by vast oceans and an uninhabited landmass. Even still, outbreaks occurred in New Zealand and Melbourne last winter, prompting draconian responses.

    Notably, however, the maximum number of cases that Melbourne – with a population almost the size of Ireland’s – experienced in a single day was just seven hundred, and it required an extreme 112-day lockdown[x] – and/or the arrival of spring before an apparent elimination. In contrast, case numbers in Ireland have exceeded eight thousand in a single day.

    Covid-19: Southern Dreaming

    A Zero-Covid approach assumes the island of Ireland is sealed hermetically. Good luck with telling the DUP that they have to follow the rules of the South! And ‘success’ would presumably give way to a permanent state of siege against the viral dangers posed by the outside world.

    At this point even New Zealand’s Prime Minister Jacinda Arden has had enough, acknowledging the long-term impossibility of pursuing Zero Covid she recently said: ‘Our goal has to be though, to get the management of Covid-19 to a similar place as we do seasonally, with the flu. It won’t be a disease that we will see simply disappear after one round of vaccine.’[xi]

    Comparing Ireland to East Asian countries may also be inappropriate as, Wuhan apart, no single country in that region has experienced a significant outbreak. Notably, Japan, which has avoided locking down throughout the crisis experienced forty times as many flu and pneumonia deaths during that period. This suggests other factors – East Asia has been the geographic origin of several modern coronavirus epidemics – may be inhibiting the spread of Covid-19 there.[xii]

    Yet this message has not trickled either left or downwards into popular opinion as the Irish Times continues to print articles in support of ‘the plan’.[xiii]

    ‘Zero Covid’ is as much a vote-winner, as a zero tolerance for crime or any other virtuous objective, but it’s political claptrap from an taxidermized left and a neoconservative right, furnished by scientists that seemingly have no conception of biological realities.

    Reality Bites

    The success of any institution might be summed up by the notion that it is only as good as its ability to predict the future. Throughout human history we have had two powerful methods of prediction: science and religion. If not religion, we might define this in terms of ‘faith,’ or an ‘unscientific’ belief system of some kind or other.

    If the Romans, the Egyptians, the Spartans, or the Native Americans, had done a ‘better’ job predicting the future, the world would be a different place. Thus, the success or persistence of any individual, nation, or civilisation, is based on an ability to reliably predict the future. Our faith in science is strengthened solely by this condition, and undermined when predictions go awry.

    Galileo Galilei, 1636 portrait by Justus Sustermans.

    Galileo’s prognostications in respect of the Earth and the Sun led him into conflict with the dominant powers of his day. The accuracy of his predictions disturbed the established cosmic order, as any heresy does. The predictions of Einstein had a similar effect on Newtonian Physics, and now Quantum Mechanics has become the sacred cow. Final judgements on the success or otherwise of policies are, of course, made through the prism of hindsight.

    Two Schools of Thought

    At present around the world there are two broad scientific schools[xiv] of thought in respect of how to respond to Covid-19. On one side there is a dominant view: that we are in the midst of a once-in-a-lifetime crisis, where humanity is dealing with a virus that will kill, and perhaps permanently incapacitate, many millions more than it has already done; and that the correct response for any government should be to impose a lockdown and mandate masks until the ‘scientific cavalry’ arrive, carrying their novel genetic vaccinations as shields to save the day.

    On the other side there are the conspiracy theorists, Covid-deniers, and a minority of scientists who consider most most masks in use to be ineffective, and who argue that restrictions and lockdowns cause more harm than good. These scientists have advocated protecting the vulnerable and permitting an equilibrium of natural immunity to emerge within the non-vulnerable majority as the least harmful way forward.

    The question for ordinary people and politicians, then, is where does the truth lie? Or, more accurately, who is correctly predicting the future?

    When the dust settles in a few years, perhaps we’ll see that the truth lies somewhere in the middle. An appreciation of a middle way, or synthesis, is evident in Sweden’s chief epidemiologist Anders Tegnell’s acknowledgement in June that mistakes were made in the first wave.[xv]  Such concessions to human fallibility seem to be the preserve of Scandinavian leaders. This may explain why increased restrictions have been introduced in Sweden during their second wave, though its government has refrained from imposing a lockdown, and the emphasis is still on personal responsibility.

    By the start of February, without a lockdown, Sweden appears to be sitting pretty with the death toll falling precipitously during the month of January, suggesting a herd immunity threshold may have been reached.

    [An earlier version of this article read: “surveys indicate that at least forty percent of the [Swedish] population now have antibodies to the virus,[xvi]” We have sought corroboration from Sebastian Rushworth MD @sebrushworth, having been advised that this claim is unreliable]

    Likewise, there are positive signs that India has now reached a herd immunity threshold,[xviii] without recourse to vaccines.

    Benefit of Hindsight

    Last April I resigned my position on the Irish Medical Council to the shock of family, friends and former colleagues. I did so because I believed a catastrophe was immanent, and that hundreds of nursing home residents would die as a consequence of political ineptitude and mass hysteria. As it transpired, 62% of deaths in Ireland occurred in this setting during the first wave of the pandemic, the second highest proportion in the world.[xix]

    I take no comfort that my fears were realised, and have since also resigned as a contracted employee of the HSE. I could no longer, in good conscience, enforce guidelines upon staff and patients I do not consider either efficacious or ethical.

    I would argue that a failure to conduct a proper inquiry into the decision-making that led to this carnage has led to avoidable mortality in this second wave in the care home setting. Any enquiry would surely have highlighted the inadequacy of safety protocols in these settings, and the absence of real expertise on NPHET.

    Before my small Covid-19 rebellion, in March 2020, I circulated a paper on the response to Covid called The Mismanagement of Covid-19 in Ireland. Its premise was (and remains) quite simple: that Covid-19 is a viral illness with a mortality confined to a relatively small and manageable subset of our population.[xx]

    I argued that Ireland’s gross demographic – the youngest population in Europe – is (and was) the key to navigating a safe path through the crisis. With a relatively low population of over sixty-fives – approximately 650,000 – this amounted to a manageable population of those truly vulnerable.

    I also noted how, unlike during influenza pandemics of the past, children and young adults were not dying of this disease, and that the vast majority of adults without serious underlying conditions were also relatively (if not entirely) immune to significant consequence.

    Long Covid

    A current cause for concern with Covid-19, which may be deterring our governments from permitting younger people from resuming their lives is so-called ‘Long Covid,’ or Covid ‘Long Haulers’ as this is referred to in the U.S..

    This is a condition that appears to fit within the category of a post-viral syndrome, or post-viral fatigue;[xxi] which is ‘a sense of tiredness and weakness that lingers after a person has fought off a viral infection. It can arise even after common infections, such as the flu.’

    In October one of the leading advocates for Long Covid patients, and a firm advocate of draconian policies, Oxford University’s Professor Trish Greenhalgh clarified that Long Covid is only very rarely a long-term affliction:

    The reviews we’ve done seem to suggest that whilst a tiny minority of people, perhaps one per cent of everyone who gets Covid-19, are still ill six months later, and whilst about a third of people aren’t better at three weeks, most people whose condition drags on are going to get better, slowly but steadily, between three weeks and three months.[xxii]

    But a paper from 2017 gives an idea of the pre-existing scale of chronic and post-viral fatigue syndrome in the U.K.:

    Fatigue is a symptom of a number of diseases—anaemia, depression, chronic infection, cancer, autoimmune disorders and thyroid disorders among them. But no apparent cause can be found for a state of extreme and disabling exhaustion that has acquired a number of names, the most generally accepted worldwide being chronic fatigue syndrome (CFS). In the UK, where it is (often incorrectly) known as ME (myalgic encephalomyelitis), 150 000 people are said to be affected. Other terms used for the condition are postviral fatigue syndrome (PVFS) and chronic fatigue and immune dysfunction syndrome (CFIDS).[xxiii]

    So, we can conclude that Long Covid is hardly a new phenomenon, and while the pandemic is likely to create an additional burden on health services, the extent of the problem needs to be put in context: perhaps one percent of sufferers are still ill after six months.

    Moreover, the impact of Covid-19 is significant heightened by environmental factors such as air quality[xxiv] and poor nutrition. I would argue, therefore, that the threat of Long Covid is insufficient grounds for closing universities and denying young people the chance of a social life beyond walking the block.

    Indeed, the obesity pandemic that leads to a wide range of morbidities is a far greater challenge to this nation’s health, and a crucial indicator of an individual’s risk of severe case of Covid-19 .[xxv] Yet there has been no serious attempt since the Covid-19 pandemic began to address how Ireland fails to adopt international best practice for addressing obesity.[xxvi]

    Seasonality

    In my March paper I also observed that Covid-19 is a member of the coronavirus family responsible for many common colds,[xxvii] and that such viruses are seasonal, in that they are eliminated especially by increasing UV light (and the population’s tendency to retreat indoors). These were hardly earth-shattering revelations, and have been noted by many other doctors and scientists around the globe.

    I also compared the population of over sixty-five-year-olds in Ireland, to the equivalent cohort in the U.K., noting there are roughly twenty-times the number of over sixty-five in the UK (while the overall population is less than ten times that number); so I assumed U.K. mortality would be in the region of twenty times that of Ireland’s.

    In this respect, Ireland has performed significantly better than the U.K., but other factors such as population density and an elevated risk of severe disease among BAME groups[xxviii], may account for the  higher relative death toll there. It should also be emphasised that the U.K. has almost the highest rate of mortality in the world.

    ICU Capacity at the beginning of the pandemic.

    Like many other doctors and scientists, I argued that in the absence of a proven cure or vaccine at that time for Covid-19, humanity is (or was) very much operating at the whim of nature. Thus, without a cure we were (and to a certain extent still are) subjected to natural forces, as I assumed this virus would spread widely through the population. All we could do, then, was ‘flatten the curve,’ protect the vulnerable, and await a safe vaccine.

    At the outset of the crisis that was the mantra behind which the public united. Flattening the curve would reduce the rate at which the vulnerable would present for treatments in hospitals. This would protect the system form being overwhelmed, bringing an increased chance of survival for those badly afflicted.

    ‘Protect the NHS’ from collapse was a similar cry across the water. That made sense at the outset of the crisis. The reiteration of these ‘priorities’ might now illicit a yawn, as our national health authorities did not use the flattened time and space to increase ICU capacity substantially, which brings the ‘necessity’ of recurring lockdowns.

    Hysteria

    Since March of last year events have taken a strange turn. With fear and hysteria at the helm politicians lost their nerves. The mantra shifted from ‘flatten the curve’, to ‘protect everyone from this deadly disease,’ despite it becoming clear that the infection fatality rate (IFR) is considerably lower than the 0.9% assumed initially. Now a paper on the WHO website states that the infection fatality rate for the disease is less than 0.2% ‘in most locations.’[xxix]

    Perversely, children have become the focus of inordinate efforts; locked indoors, locked out of school and forced into wearing masks. We have insisted upon protecting them from a disease that has not caused a single child death in Ireland throughout the entire crisis.[xxx]

    Troublingly, when Covid-19 panic gripped the nation, politicians and mainstream media listened only to the scientific ‘authorities’ that fed the hysteria and justified everything from political incompetence to profligate expenditure. Hospitals were emptied in preparation for an approaching ‘tsunami’ of illness, as tens of thousands of deaths were incorrectly predicted by politicians and esteemed professors, all of whom continue to profess, and have even grown in esteem.

    Covid patients were dumped from hospitals into Nursing Homes, and tests were withheld from residents lest they run short for the healthy-hysterical. The vulnerable were not only abandoned, but too many of them were crushed in the stampede.

    Thus, there is the shocking case of a resident in a Meath care home discovered to have had a maggot-infested a wound.[xxxi] What began as a campaign to protect the vulnerable, had turned into nothing short of a manslaughter machine.

    At the End of the Day

    The natural endpoint for viral infection in respect of many viral pathogens is of course ‘herd immunity.’ This is the point where a sufficient proportion of a population have been exposed to and develop full or partial immunity to a particular pathogen, such that its rate of reproduction is below 1 most of the time.

    With insufficient hosts, a virus can no longer spread easily. This is not full elimination but an endemic equilibrium within the population, with a certain annual death toll tolerated – such as is the case with influenza, which kills up to a thousand people a year in Ireland, despite the availability of a vaccine.

    This natural evolution, or pathogenesis, is also helped along by the seasonal shift from spring to summer. Increasing daylight reduces the level of viral particles, and people spend more time out of doors, or ventilate their living spaces in warmer conditions. This is how nature brings an end to seasonal colds and flus. Yet curiously this basic piece of natural science was largely ignored in March. Talk of UV light became highly politicised and thence poisoned.

    The Swedes

    Sweden provided a template for a country acting within the bounds of common sense and science. From the outset health authorities there endeavoured to protect a vulnerable aged cohort, leading to a natural-immunity developing within the population. In permitting this to occur they also took the precaution of doubling ICU capacity[xxxii] which, like Ireland’s, had been among the lowest in Europe when the pandemic began.

    Comparison between Sweden and Ireland cannot be made on a like-for-like basis, any more than the Irish can be compared to any other national group; however, some relevant comparisons can be drawn in respect of population demographics.

    Sweden has twice Ireland’s population, but 3.2 times the number of over sixty-five-years-olds. Ireland has not quite experienced just over a third of Sweden’s mortality (11,815 v 3,418); but while Ireland’s death rate from Covid-19 has been steadily increasing over the month of January, Sweden’s has flattened to point where, according to the WHO, Sweden’s death toll has been in single figures since the start of February, while Ireland has been experiencing daily deaths over one hundred.

    Source: WHO

    There may be a further uptick in Covid deaths in Sweden once schools reopen – and even a third wave – but the hopeful signs are that the country is now reaching a herd immunity threshold – one that has brought less suffering overall when compared to other jurisdictions.

    A similar comparison can be drawn between Sweden and most other European states, implying, in most situations, that mortality is not significantly reduced by lockdown policies. Yet invariably whenever one reads about Sweden in mainstream Irish media[xxxiii] comparisons are only drawn with best-in-class Scandinavian neighbours, where lockdowns have also been, for the most part, avoided.

    Lockdowns are likely to increase mortality through missed cancer screenings, dysfunctional health services, serious mental health impacts, besides the ‘shadow-pandemic’ of domestic violence that has occurred under lockdown.

    The writing on the wall?

    What of the good people on the opposite side of the Swedish argument? It is fair to say that lockdowns can flatten the curve. This is apparent if we compare mortality graphs on the Euromomo website that tracks excess deaths across Europe. It shows that Sweden did not see the same kind of spike on their graph of mortality during the first wave as in other countries that locked down, but experienced a steady decline, which in July led the New York Times to state prematurely that ‘Sweden Has Become the World’s Cautionary Tale’[xxxiv]

    Source: Euromomo.

    The question is whether the short-term benefits of lockdowns in terms of averted-deaths are worth the cost? Or, were lockdowns necessary, and will they ultimately translate into lives being saved rather than simply deferring deaths? Perhaps the truth lies in the middle of these arguments but I know which side I lean.

    Lockdowns do not prevent deaths, but slow the rate of infection and mortality. They can only ease the burden on hospital or tertiary care services. The purpose of lockdown should be to insure that the sick can access the best treatment available, and should not be ‘a primary means of controlling the virus’[xxxv] according to leading authorities in the WHO, as we are experiencing in Ireland.

    Although the mortality figures in Ireland still lag behind Sweden’s I suspect this is deferred mortality and does not represent patients who have been cured or saved. The curve has been flattened. Thus far, lockdown policies have had the beneficial effect of decreasing mortality by less than 20% compared to Sweden’s when adjusted for our respective age profiles. In my view, however, what may simply be deferred mortality, cannot justify the burden of lockdowns on the wider population.

    Only when the crisis has passed, and with the benefit of hindsight, will it be possible to determine if the Swedes broadly got things right. Although, it is more appropriate in the context of a disease that has killed thousands of people – and caused suffering to most of the rest of the population – to state that some countries will have managed it better than others. For sure, no one will have got everything ‘right’.

    Assuming vaccines do not represent a panacea, if it transpires that most Irish mortality is confined to the nursing home sector, and that all lockdowns accomplish is to preserve a larger number of potential hosts for successive seasonal resurgences then the pandemic will have been a more painful and long-running saga in Ireland than it might otherwise have been.

    [i] Marcus de Brun, ‘The Perfect Storm’, Cassandra Voices, August 19th, 2020, https://cassandravoices.com/science-environment/covid-19-the-perfect-storm/

    [ii] Epidemiology of COVID-19Outbreaks/Clustersin IrelandWeekly Report Prepared by HPSC on25thJanuary 2021, https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/surveillance/covid-19outbreaksclustersinireland/COVID-19%20Weekly%20Outbreak%20Report_Week032021_25012021_WebVersion_final.pdf

    [iii] Digital Desk Staff, ‘Opening hospitality will mean limiting Christmas gatherings, Nphet warns’, November 26th, 2020, Extra.ie, https://www.breakingnews.ie/ireland/nphet-strongly-opposed-to-parts-of-governments-lockdown-exit-plan-1042387.html

    [iv] ‘Up to 85,000 Irish people could die from coronavirus in worst-case scenario, Taoiseach indicates, as three more diagnosed’ John Downing, Eilish O’Regan and Gabija Gataveckaite, Irish Independent, March 9th, 2020, https://www.independent.ie/world-news/coronavirus/up-to-85000-irish-people-could-die-from-coronavirus-in-worst-case-scenario-taoiseach-indicates-as-three-more-diagnosed-39029363.html

    [v] COVID-19 Deaths and Cases, Central Statistics Office, https://www.cso.ie/en/releasesandpublications/br/b-cdc/covid-19deathsandcases/

    [vi] ‘Norwegian health chief: we advised against closing schools’, 10 June, 2020, Unherd, https://unherd.com/thepost/norwegian-health-chief-we-advised-against-closing-schools/

    [vii] ‘Census of Population 2016 – Profile 7 Migration and Diversity’, https://www.cso.ie/en/releasesandpublications/ep/p-cp7md/p7md/p7anii/

    [viii] Ciara Kenny, ‘ The global Irish: Where do they live?’, February 4th, 2015, Irish Times, https://www.irishtimes.com/life-and-style/generation-emigration/the-global-irish-where-do-they-live-1.2089347?mode=sample&auth-failed=1&pw-origin=https%3A%2F%2Fwww.irishtimes.com%2Flife-and-style%2Fgeneration-emigration%2Fthe-global-irish-where-do-they-live-1.2089347

    [ix] American Institute of Cancer Research, Skin cancer statistics, https://www.wcrf.org/dietandcancer/cancer-trends/skin-cancer-statistics

    [x] Phil Mercer, ‘Covid: Melbourne’s hard-won success after a marathon lockdown’, 26th of October, BBC, https://www.bbc.com/news/world-australia-54654646

    [xi] Luke Malpass, ‘Jacinda Ardern declares 2021 ‘the year of the vaccine’’, January 21st, 2021, Stuff, https://www.stuff.co.nz/national/politics/124012148/jacinda-ardern-declares-2021-the-year-of-the-vaccine

    [xii] Ramesh Thakur, ‘The West should envy Japan’s COVID-19 response’ January 10th, 2021, Japan Times,  https://www.japantimes.co.jp/opinion/2021/01/10/commentary/japan-commentary/west-japan-coronavirus-response/

    [xiii] Gabriel Scally: It is essential Ireland tightens borders in fight against Covid-19, January 30th, 2020, Irish Times, https://www.irishtimes.com/opinion/gabriel-scally-it-is-essential-ireland-tightens-borders-in-fight-against-covid-19-1.4471283

    [xiv] Sarah Bosley, ‘Covid UK: scientists at loggerheads over approach to new restrictions’, September 22nd, 2020, The Guardian, https://www.theguardian.com/science/2020/sep/22/scientists-disagree-over-targeted-versus-nationwide-measures-to-tackle-covid

    [xv] Rafaela Lindeberg, ‘Man Behind Sweden’s Controversial Virus Strategy Admits Mistakes’, Bloomberg, June 3rd, 2020,  https://www.bloomberg.com/news/articles/2020-06-03/man-behind-sweden-s-virus-strategy-says-he-got-some-things-wrong

    [xvi] Sebastian Rushworth M.D., ‘Here’s a graph they don’t want you to see’, 25th of January, 2021, https://sebastianrushworth.com/2021/01/25/heres-a-graph-they-dont-want-you-to-see/

    [xvii] Sheena Cruickshank  ‘A new study suggests coronavirus antibodies fade over time – but how concerned should we be?’ October 27th, 2020, The Conversation, https://theconversation.com/a-new-study-suggests-coronavirus-antibodies-fade-over-time-but-how-concerned-should-we-be-148957

    [xviii] Amy Kazmin, ‘India’s tumbling Covid cases raises question: Is the pandemic burning itself out?’ February 1st, 2021, Irish Times, https://www.irishtimes.com/news/world/asia-pacific/india-s-tumbling-covid-cases-raises-question-is-the-pandemic-burning-itself-out-1.4472406?mode=amp

    [xix] Fergal Bowers, ‘High percentage of virus deaths in Ireland’s care homes highlighted in comparison report

    [xx] Mismanagement of Covid in Ireland’ May 27th, RTE, https://www.rte.ie/news/coronavirus/2020/0527/1143036-covid-deaths-ireland/

    [xxi] ‘What to know about post-viral syndrome’ Medical News Today, https://www.medicalnewstoday.com/articles/326619

    [xxii] Jennifer Rigby, ‘Why long Covid can be really grim, but is rarer than you think’, October 3rd, 2020 The Telegraph, https://www.telegraph.co.uk/global-health/science-and-disease/long-covid-can-really-grim-rarer-think/

    [xxiii] Postviral Fatigue Syndrome, Science Direct, https://www.sciencedirect.com/topics/medicine-and-dentistry/postviral-fatigue-syndrome

    [xxiv] Matt Cole et al, ‘Air pollution exposure linked to higher COVID-19 cases and deaths – new study’, July 13th, 2020, The Conversation, https://theconversation.com/air-pollution-exposure-linked-to-higher-covid-19-cases-and-deaths-new-study-141620

    [xxv] Meredith Wadman, ‘Why COVID-19 is more deadly in people with obesity—even if they’re young’, September 8th, 2020, https://www.sciencemag.org/news/2020/09/why-covid-19-more-deadly-people-obesity-even-if-theyre-young

    [xxvi] Shauna Bowers, ‘Irish policies to tackle obesity ‘fall behind international best practice’ – report’, November 9th, 2020, Irish Times, https://www.irishtimes.com/news/health/irish-policies-to-tackle-obesity-fall-behind-international-best-practice-report-1.4403921?mode=sample&auth-failed=1&pw-origin=https%3A%2F%2Fwww.irishtimes.com%2Fnews%2Fhealth%2Firish-policies-to-tackle-obesity-fall-behind-international-best-practice-report-1.4403921

    [xxvii] Anthony King, ‘Coronavirus family now a prime suspect in previous pandemics,’ February 4th, 2020, Irish Times, https://www.irishtimes.com/news/science/coronavirus-family-now-a-prime-suspect-in-previous-pandemics-1.4463053

    [xxviii] Tom Kirby, ‘Evidence mounts on the disproportionate effect of COVID-19 on ethnic minorities’, The Lancet, May 8th, 2020, https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30228-9/fulltext

    [xxix] Infection fatality rate of COVID-19 inferred from seroprevalence data

    John P A Ioannidis, WHO, September 13th, 2020, https://www.who.int/bulletin/volumes/99/1/20-265892/en/

    [xxx] (According to the CSO there have been 20,402 confirmed cases of Covid amongst the age group 0-24yrs, during the period from Feb 2020 to December 2020 and not a single recorded death in Ireland. https://www.cso.ie/en/releasesandpublications/br/b-cdc/covid-19deathsandcasesseries18/

    [xxxi] Simon Carswell, ‘Widow ‘outraged’ by footage of husband’s facial wound’, August 26th, 2020, Irish Times, https://www.irishtimes.com/news/health/widow-outraged-by-footage-of-husband-s-facial-wound-1.4338831?mode=sample&auth-failed=1&pw-origin=https%3A%2F%2Fwww.irishtimes.com%2Fnews%2Fhealth%2Fwidow-outraged-by-footage-of-husband-s-facial-wound-1.4338831

    [xxxii] Emma Lofgren, ‘’The biggest challenge of our time’: How Sweden doubled intensive care capacity amid Covid-19 pandemic’, June 23rd, 2020, The Local, https://www.thelocal.com/20200623/how-sweden-doubled-intensive-care-capacity-to-treat-coronavirus-patients

    [xxxiii] Suzanne Cahill, ‘Coronavirus lockdowns are still a step too far for Sweden’, February 3rd, 2021, Irish Times,  https://www.irishtimes.com/opinion/coronavirus-lockdowns-are-still-a-step-too-far-for-sweden-1.4473119?mode=sample&auth-failed=1&pw-origin=https%3A%2F%2Fwww.irishtimes.com%2Fopinion%2Fcoronavirus-lockdowns-are-still-a-step-too-far-for-sweden-1.4473119

    [xxxiv] https://www.nytimes.com/2020/07/07/business/sweden-economy-coronavirus.html

    [xxxv] Michelle Doyle, ‘WHO doctor says lockdowns should not be main coronavirus defence’, October 12th, 2020, ABC, https://www.abc.net.au/news/2020-10-12/world-health-organization-coronavirus-lockdown-advice/12753688

  • Covid-19: Questioning the Three Mantras

    The three mantra for this pandemic in Ireland are: wash your hands; socially distance; and wear a mask. Stated repetitively with suitable gravitas the guidelines have been internalised by most of the population. Fears around the spread of the ‘deadly’ virus are even driving people to police one another. The valley of the squinting windows is alive and well.

    But what are the inherent costs to these three injunctions? And why shouldn’t we keep measures in place when this pandemic abates, as has recently been argued?

    Throughout this pandemic we have witnessed very little meaningful scientific debate in Ireland. Irish experts are drawn from a small circle of academics, some with vested interests, supporting the government’s highly successful publicity campaign. In other countries, in contrast, there are heated public debates between scientists as to whether to adopt a dominant approach of blanket policies, or one of shielding elderly populations.

    But in Ireland Nobel laureates and professors from prestigious universities around the world are routinely dismissed with smart quips by gullible journalists. But let us examine the three mantras in a dispassionate way that acknowledges each of their adverse impacts.

    Wash Your Hands

    The first injunction to ‘wash your hands’ is sound advice, which unless you are living on another planet you will be aware of by now. Do we always follow this injunction? Probably not. Are we all dying of ghastly flesh eating infections or coughing up great globules of blood stained mucus? No we are not. Why? Because very few of the billions of micro-organisms with which we share our bodies are actually pathogenic.

    We have existed as a species for approximately a quarter of a million years, and as part of the great evolutionary flow of life for over four and half billion years. In that time adaptation to adversity has been the rule; hence homo sapiens is now thriving, sadly often to the detriment of the rest of the natural world.

    In the advanced economies at least, most of us are now almost invincible until old age. Thus, over the past two hundred years improved nutrition, housing and sanitation have brought life expectancy up to almost eighty years in many countries.

    Medical science, including antibiotics and vaccines, has contributed to this longevity, but not to the extent some of us doctors would have you believe. The authors of The Changing Body: Health, Nutrition and Human Development in the Western World since 1700 (Floud et al., Cambridge, 2011) state:

    it would be easy to exaggerate the importance of scientific medicine when one considers that much of the decline in the mortality associated with infectious diseases predated the introduction of effective medical measures to deal with it

    So yes washing your hands regularly is a good idea. Soap and water should be the principle means, not the bactericidal or viricidal gels we now find on entering every shop or building, some of which are to be avoided – especially the 52 sanitation products the Department of Education has told schools to refrain from using.

    Our skin harbours myriad micro-organisms – that form a part of the human microbiome – all vying for space to live, raise a family and grow old peacefully in a quiet stable neighbourhood. They generally live harmoniously with us in what is referred to as a state of homeostatic balance.

    What happens when we kill off all the good micro-organisms, repeatedly, just in case there is a bad micro-organism on our skin? First, these agents damage our skin’s protective oil barrier, and kill micro-organisms with which we live symbiotically, contributing to our health and wellbeing.

    These ‘good’ bacteria and other microorganisms are easily replaced by ones that are resistant to the effects of the gels, and who can then run amok when given the chance.

    Prior to this pandemic, excessive hygiene measures against infections has given rise to the hygiene hypothesis, according to which ‘the decreasing incidence of infections in western countries and more recently in developing countries is at the origin of the increasing incidence of both autoimmune and allergic diseases.’ So let us be on our guard against excessive hygiene.

    “Social” Distancing

    Hannah Arendt in 1933.

    The second part of the mantra and perhaps the most dystopian is the injunction to distance ourselves socially. It recalls Hannah Arendt’s warning in The Origins of Totalitarianism (1951) that ‘The evidence of Hitler’s as well as Stalin’s dictatorship points clearly to the fact that isolation of atomized individuals provides not only the mass basis for totalitarian rule, but is carried through to the top of the whole structure.’

    This “safe” distance is anywhere from the depth of the average grave – two metres – to imprisoning ourselves in our homes and limiting the number of fellow humans we allow to enter that space, which is no one from another household under current ‘Level 5’ Irish regulations; or previously an arbitrary number such as six, a figure no doubt chosen after repeatedly employing the reading of the runes technique.

    Not seeing anyone at all would be ideal, but the illuminati could not depend on the imbecilic general public abiding by their lofty standards, or reverting to having sex online to limit the spread of the virus, and so some meagre concessions have been made to human frailty, with the advent of support bubbles.

    Yet social isolation is a potential pathway to madness and a lonely death. We are social creatures and in solitary confinement few can flourish. A Screen New Deal is a recipe for Surveillance Capitalism, and enrichment of the billionaire class. Human touch brings emotional balance and better health.

    A person may be technically alive but is he or she really living without conversing directly with others, dancing, or otherwise demonstrating his love and empathy? We are not avatars in a complex, visually stunning computer game. We are connected physical beings. Those connections extend back into the past, embrace the present, and reach forward into an unknown future.

    It is impossible to tell whether the shocking spate of domestic homicides and suicides that occurred in the last week of October in Ireland, just as stricter measures were introduced, are the product of isolation, but the UN has described the worldwide increase in domestic abuse as a ‘shadow pandemic’ alongside Covid-19.

    Irish incidents include a murder-suicide in Cork involving a father and two sons; the apparent murder of a mother and her two children in Dublin; and the death by suicide of a Dublin nurse along with the death of her young baby through asphyxiation.

    Moving forward, we just have no idea what effect the injunction to “socially” distance – and the attendant loss of touch will have on us – a very tactile people.

    Recall that in shaking hands we make character judgements based on grip and duration; we embrace and kiss those we love with warmth and energy, and those we like with fleeting touching cheeks; we cup the faces of babies and ruffle the hair of cute children – especially if they possess more than us.

    We are now ordered to stop doing all of that, but for how long? Is there any evidence to suggest ‘the virus’ passes from one healthy person to another when we hug? Hasn’t common sense always dictated that we avoid hugging when we are under the weather?

    In this precarious age, however, it is necessary to assume we are guilty of being ‘asymptomatic’ into what seems like an interminable future, and either hug with extreme caution, or not at all. I fear these tactile behaviours will disappear altogether given Covid-19 is very unlikely to vanish.

    Mandatory Masks

    The third and final of the government’s mantras is perhaps the most pernicious: the mandating of masks. It has infantilised the population and turned people into part-time police officers.

    We’ve heard Irish and other experts overturn forty years of science, allowing celebrity doctors to demonstrate to the Irish public, with a cheeky Charlie smile, that masks will prevent contagions. In fact, the only masks that offer real protection are N95 masks or similar respirators. The popular cloth masks are of little more than symbolic value in preventing contagion.

    Instructively, in Norway, which has had among the lowest incidence of Covid-19 in Europe, but where case numbers have increased in recent weeks, the latest national measures do not include a requirement to wear masks in public, although this option is left open to municipal authorities in the event of high infection levels.

    Yet in Ireland journalists and ‘social influencers’ have accepted as self-evident that masks are a form of panacea; failing to recongise that approach is not backed by experimental data, and is in fact the lowest form of evidence.

    Now armed with the received wisdom – mumbling ‘I follow the science’ – righteous members of the public are on the lookout for slackers, and woe betide anyone not wearing a mask when shopping or travelling on public transport; it has reached a point of such absurdity that some even wear them while alone in their cars.

    But you might ask: what is the cost apart from mild to medium, or even extreme, discomfort, depending on how long it has to be worn? And as most of us don’t have to wear them other than when we enter shops then what of it?

    Masks hide our faces so that we have difficulty recognising and communicating with each other. Indeed, our brains have evolved to recognise faces. We see faces in clouds, bushes and cracked tiling, a phenomena called pareidolia. I have yet to hear of such an occurrence where the face is obscured by a mask.

    Pareidolia

    Our face has a remarkable forty-two muscles and is the site from which we deliver most of our body language. Ask a mother of a new born to stare at her child without changing her facial expression for more than a few moments and the baby will become distressed and cry. This is how hardwired our need is to read faces.

    Facial coverings – called surgical masks for good reason – are useful in clinical settings to prevent bacteria, hair, skin cells and mucus from falling into open wounds, but hardly when worn by unruly schoolchildren in class. The best reason to wear one now is simply to make people comfortable who believe they confer protection.

    Asians, have worn masks for various cultural and environmental reasons, including non-medical ones, for decades. In Japan people who feel ‘under the weather’ wear them to be polite.

    But there is no reliable scientific evidence to support widespread use, as Professor Carl Heneghan of Oxford University pointed out to the Dáil Committee on Covid-19 Response. There have only been three registered trials on the use of masks in the community: one in Denmark, one in Guinea Bissau and one in India – but none have reported outcomes so far.

    Now let us for a moment indulge in that age old technique of the thought experiment. Viruses are measured in nanometres. If we looked at the material from which most of these facial coverings are made under an electron microscope we would see more holes than material.

    A virus leaving your mouth, journeying out into the big bad world, is like a football passing through your front door. The football could hit the door frame and bounce back, but this is unlikely. The pseudo-scientific argument is that the virus travels first class in a large globule of spit and this globule gets jammed in the doorway, “proving” the efficacy of masks.

    Ahh, but wait a minute, mask are often worn for hours by kids and cashiers in shops, so what about all the other graduating viruses and their globular carriages? I doubt they are all just clinging for dear life on to the mask for fear of upsetting the Irish expert.

    Instead the globule eventually evaporates, after all it is mostly water vapour, the front of the mask dries and the viruses, being virtually weightless, just waft off on their merciless way.

    Other Approaches

    Now when I hear the mantra ‘wash your hands, social distance and wear a mask,’ I consider: are we running the risk of undermining our society to preserve some cherished scientific authority? We are supposed to be entering the second wave of a pandemic, yet while hospitals in countries such as Italy are under severe pressure – as was the case last February – few Europeans countries are now showing excess deaths. Yet the doomsday models that were wildly inaccurate last time around are being revisited.

    Excess mortality in Europe source since 2017: https://www.euromomo.eu/graphs-and-maps/#excess-mortality

    Shouldn’t our health authorities, especially in Ireland – which has had among the most stringent measures in the world throughout the pandemic – also be conscious of maintaining our humanity, and recognising the huge value – in terms of our health and wellbeing – of being able to gather, kiss, hug, talk, sing and laugh with abandon, without fear of breaking the law? We especially need to explain to our children that the world they currently live through is not going in a normal phase.

    In preventing infections with a respiratory disease such as Covid-19, we might look back on what the great American polymath and Founding Father Benjamin Franklin once observed:

    From many years’ observations on myself and others, I am persuaded we are on a wrong scent in supposing moist or cold air, the cause of that disorder we call a cold. Some unknown quality in the air may perhaps produce colds, as in the influenza, but generally, I apprehend they are the effect of too full living in proportion to our exercise.

    Franklin observed  a connection between succumbing to an infectious disease and poor dietary choices (“too full living”) and a lack of physical exercise that contributes to obesity, which we know significantly increases the likelihood of death from Covid-19.

    He also had the following to say on the benefits of being outside into the fresh air:

    I hope that after, having discovered the benefit of fresh and cool air applied to the sick, people will begin to suspect that possibly it may do no harm to the well. I have long been satisfied from observation, that besides the general colds now termed influenza (which may possibly spread by contagion, as well as by a particular quality of the air), people often catch cold from one another when shut up together in close rooms, coaches, et cetera, and when sitting near and conversing so as to breathe in each other’s transpiration, the disorder being in a certain state.

    During this pandemic, and moving forward, we should thus be addressing a pre-existing obesity pandemic that is being exacerbated by some of the current restrictions on sports especially. Franklin also seemed to have recognised the importance of adequate ventilation in buildings.

    Image (c) Daniele Idini

    Thus addressing the underlying conditions exacerbating the Covid-19 pandemic may prove to be the optimum response, as the editor of The Lancet Richard Horton has argued:

    we must confront the fact that we are taking a far too narrow approach to managing this outbreak of a new coronavirus. We have viewed the cause of this crisis as an infectious disease. All of our interventions have focused on cutting lines of viral transmission, thereby controlling the spread of the pathogen. The “science” that has guided governments has been driven mostly by epidemic modellers and infectious disease specialists, who understandably frame the present health emergency in centuries-old terms of plague. But what we have learned so far tells us that the story of COVID-19 is not so simple. Two categories of disease are interacting within specific populations—infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and an array of non-communicable diseases (NCDs). These conditions are clustering within social groups according to patterns of inequality deeply embedded in our societies. The aggregation of these diseases on a background of social and economic disparity exacerbates the adverse effects of each separate disease. COVID-19 is not a pandemic. It is a syndemic. The syndemic nature of the threat we face means that a more nuanced approach is needed if we are to protect the health of our communities.

  • The Bonds that Hold Society Together

    I am a father, a husband, a son, a friend, a doctor, an athlete, a traveller, a student and a citizen. Although just one person, I nonetheless occupy many nodes in the complex networks that make up society. These extend into the past, traverse the present and reach towards the future.

    Over the past few months I have been deprived or diminished in many of these roles. Had I been asked if I wanted to relinquish the responsibilities inherent to these roles I would have declined, but I may have wanted to increase my responsibilities in some areas.

    I am just one person in a vast network of people whose lives have contracted in the past six months. This makes me consider the extent of the wastage across society.

    Why? Policies were adopted by an unelected government on the erroneous advice of experts listening to other experts, who predicted an enormous death toll from Covid-19 that has not come about anywhere on the globe. These same experts are now doubling down on initial errors and inflicting incalculable harm on the delicate fabric of society.

    I don’t think these experts took into account people like a patient of mine, eighty-five-year-old Joe, who was married to Mary for sixty-years. They were forced to separate, partly because of her dementia when she had to go into a care home, but then because of public health restrictions. Mary resides in a nursing home and Joe visits every day, but the last time he held her hand was on their sixtieth wedding anniversary in March.

    Previously Joe would cry when recounting his visits to Mary. Then he realised that if he spoke to her about their early days he could bring her back to life; at least for an hour or two. This stanched his tears. He was happy to have a small piece of the woman he married return to him.

    His last such conversation was in March. Until recently he was still visiting her and looking and waving at a woman who didn’t recognise him. If the day was bright and sunny all he’d see was his reflection in the window. Joe managed to see Mary this week; to hold her hand and speak to her, but unfortunately she was unconscious. She stayed that way until she died a few days later.

    The experts never asked Joe how he and Mary would like to live out their last days, nor sought the opinion of the thousands of elderly people whose children live abroad and who had planned perhaps their last trips to a wedding, a graduation or a funeral. Instead a paternalistic decision was taken, after a shameless use of the national media for propaganda purposes, inculcating a fear of imminent death in the elderly if they did not comply with the rules.

    Yes Covid-19 is a very dangerous illness for an elderly person, with a mortality rate of perhaps ten percent for over seventies, but at a certain point people should be allowed to make informed choices about how they want to spend their last days.

    The past is being separated from the present and the future, as grandchildren now avoid grandparents for fear of being harbingers of contagion and death.

    Perhaps most egregious of all is the passing away of a generation deprived of family and friends in the final moments of life. No last words of forgiveness, reconciliation, gratitude or love can be expressed. Such pronouncements on death beds have always nourished the generations to come.

    As a people we traditionally celebrate death in a very communal way. We wake our dead. We toast their memory. We keep them alive in stories. We form processions to accompany their coffins to the church and the graveyard, where we huddle against wind and rain to say our final goodbyes. Then we gather for soup and sandwiches as a family, making sure to thank all those who have remembered. How dare they take this away from people indefinitely.

    Our bonds are being ripped asunder. Our young in schools are now sitting in alienating environments, their every move regimented.

    For anyone in university, the experience of academia will not be much better than watching a documentary on YouTube. The vital experiences of college life that sustain us for a lifetime are rarely found in books, but are the product of societies, sporting events and the parties that bring lasting bonds of friendship. These are all human connections that come about through proximity and touch.

    What of this year’s Leaving Cert cohort? Students have been deprived of completing their fourteen years of school in a way so many generations before them have done. They are deprived of rites of passage that include the exams themselves, the celebration of results, and then on to the debs. Little wonder nearly 50% of the class of 2020 have reported high levels of depression or anxiety.

    And what of the many small businesses, run by the parents of those young people that have been told to pull down their shutters? Who are these people that have the right to tell someone to cease trading and potentially permanently damage sources of livelihoods, and the future prosperity of their families?

    Severing social threads by ending sporting activities, indefinitely shutting pubs and restaurants and restricting travel has already taken many formative experiences away from young people, while future encounters may well be tainted indefinitely by a fear of contagion.

    And as to the future, are we supposed to believe the oxymoronic slogan of staying together by staying apart. How can this fortify social bonds?

    They have instilled fear and paranoia where once there was social capital, infantilising the population with lockdowns.

    This is a population that had grown restive about injustices and was developing a growing awareness and intolerance of homelessness, poverty, inequality, sexism, environmental damage and racism. Now the only of most politicians seems to be to keep their jobs, while maintaining social distancing, wearing face masks and eschewing all forms of human contact and connectivity.

    To what end? To protect the vulnerable or the health service? The hypocrisy of this is astounding. Since when has an Irish government dramatically altered our society in such a short space of time to protect the vulnerable, or our health service?

    Why can’t they admit they got it wrong – that they over-reacted and panicked when the initial grossly erroneous estimates were published? Instead they continue in the same vein. Isn’t it clear by now that the damage that has been caused, and will be caused, is far greater than any perceived health crisis.

    Perhaps buried within their spuriously scientific reasoning is the fact that politically this crisis was fortuitous. It came at a time when the electorate had rejected the current government, and become radicalised and deserved a second election, but where are the opposition now?

    They should end these arbitrary rules, lockdowns, based on specious and selective use of science purveyed by celebrity scientists. They should listen to international experts and use international data to inform decisions and stop preventing people, young and old, from leading meaningful lives.

  • Seal the Deal

    it is difficult enough for the fishermen to make a living but because of inaction with seal culls, they are now suffering very seriously … What is needed is to dramatically reduce the amount of seals in our water in the same way as we have to reduce our deer population … There is no nice way to do this – the hard core facts are we need a seal cull and we need it immediately and nothing less will be sufficient.
    Michael Healy-Rae, T.D. for Kerry, February, 2019.

    I have rarely agreed with Michael Healy-Rae’s, or others from his Kerry dynasty, views on anything, but the colourful manner in which they impart their message has always brought a smile.

    I respect their support for the people of Kerry, while disliking a partisan style which pits one part of the country against another. They are undoubted masters of public relations and gaining valuable media coverage, delivering messages in a way that seemingly makes them loved in Kerry, if not by the Dublin medja.

    This time, however, it’s personal. Healy-Rae has attacked friends of mine, having called for their death in the usual lurid language.

    Among the dive community a petition to stop licences being granted to cull seal colonies along the coast was quickly arranged. Within days it garnered 5,000 signatories, a number which is still climbing, as divers voice their anger at the prospect of an attack on one of the most popular of Ireland’s coastline animal communities.

    Dalkey Days

    I spent my teenage years bringing groups of children out to meet the seal colony on Dalkey Island. Snorkel camps run weekly during the summer months out of Dun Laoghaire always culminated with a much loved boat trip to Dalkey Island to swim among the resident seals.

    Some of the first underwater images I took with a disposable underwater film camera were of these playful sea creatures interacting with children from around south county Dublin. It was always hard to determine who was more playful the children or the seals, who seemed to have a number of games they liked to play, including hide and seek, tag and their constant favourite of fin chomping without being seen.

    The playful nature of seals reminds any snorkeler of a dog looking for affection from its owner. So listening to news stories where people are saying the best solution to the problems afflicting the fishing community is to take a high powered rifle to these playful creatures filled me with rage and frustration around the management of our coast, and what the future holds for it.

    Of course it is a complex issue replicated across the world and our history, where human appetites come into direct competition with other predators in the natural world.

    The Grey Seal 

    The Grey Seal – one of the two seal species found along our coastline – holds an auspicious distinction of being the first animal to be protected by law against hunting back in 1903.

    By that time the Grey Seal had become nearly extinct in Irish waters, having been hunted for both their meat and fur. Now, thanks to conservation efforts their numbers are estimated to have reached over five thousand around Irish waters, with nearly 300,000 worldwide.

    Although this sounds like a fair number, they are actually fewer in number than the African Elephant, another endangered species more wildly known for being at risk of extinction. With Ireland home to just over one per cent of the worldwide Grey Seal population, we have a great opportunity to help conserve this incredible marine animal for future generations.

    Hunter Gatherers

    The fishing industry has been under threat for as long as I can remember from all sides. In a way it is the last remaining among the hunter-gatherer professions, so it’s easy to understand why the call for seals to be culled has come from this quarter.

    Fishing quotas introduced at a European level can seem deeply unfair to those who support their family from fishing. Catches often have to be thrown back into the water on account of it being a species which cannot be sold due to quotas. On the other hand, the playful seal does not have these caps inflicted on it, and is able to hunt for fish to its heart’s content.

    Technological advances have allowed super trawlers to travel thousands of miles to hoover up fish stocks, with implications for small scale fisheries. The recent restaurant closures due to the Covid restrictions has seen a collapse in demand in local markets for their produce.

    Like so many business, fishermen are facing a very difficult year while the playful seal watches on, oblivious to the stresses of running a business in the era of Covid-19.

    This is not a new battle between two communities, with the fisherman receiving enough support in the 1960s and the 1970s to allow culls of seal colonies. Yet it is all too easy to blame the fishermen for cruelty, while ignoring the methods required to provide affordable fish for supper.

    Joy and Wonder

    As a diver, meeting a seal under water brings great joy and wonder, although on rare occurrences seals take a dislike to the bubble trail divers surround themselves with. Ironically, it’s easier to encounter a seal on a snorkel and held breath, as they don’t perceive a threat from the diver’s bubbles.

    Seals are wrapped up in Irish mythology and lore, with stories of the ‘Selky featuring prominently among most coastal communities.  A Selky is a shape-shifting seal that comes ashore and is transformed into a beautiful woman.

    Lucky fishermen could win themselves a wife by capturing the seal skin and hiding it from the Selky. If the captured Selky found her skin only then would she be able to return to her underwater lair, leaving the fisherman alone and holding the baby!!

    Anyone who has heard the melodic calls of the seals around Dalkey island can well understand why such myths sprang into existence. Seals provide a human tone that could easily deceive the ear. In protecting them around our coastline we are also preserving a part of our own cultural inheritance, as these tales would mean very little we were to drive this species from our waters again.

    Quite recently, while bringing an open water diver on a final dive for their open water course we had the pleasure of being joined on the dive by a playful Grey Seal. The seal stayed with us for over five minutes and watching my student’s eyes I could tell this magical encounter would stay with him for the rest of his life. Hopefully through this interaction a new diver also became a new guardian and advocate of the seal population.

    Farmers Replacing Hunters

    Sandycove in Dublin, beside Dun Laoghaire, like Dalkey Island is home to multiple seals colonies, but with the welcome new cycle lanes divers can no longer park cars near this space, meaning these interactions are frustratingly difficult to avail of. Hopefully a resolution can be found, as divers cannot transport equipment without a vehicle.

    Almost every diver includes stories of encounters with seals among their favourite dives, so it is easy to see why a petition to save the seals would garner such support from within the dive community in such a short time.

    Every year I make a point of revisiting the seal colonies on Dalkey island to see how these friends from my teenage years are getting along. In the last few years I have been delighted to observe the population increasing with nearly forty Grey Seals counted this year.

    If you haven’t had the pleasure of spending time on Dalkey Island yet I again highly recommend it in these pandemic times. It offers an opportunity to see wild animals in their natural habitat while exploring a nature reserve, without leaving the confines of the county.

    In this time of rampant extinction events the playful Grey Seal communities in Ireland stand out as an example of how, with the right steps taken by our political leaders, we can preserve species from extinction. It is also a clear sign that once steps are taken continued care is needed to ensure these creatures survive and thrive.

    The grandfather of scuba diving Jacques Yves said: ‘We must plant the sea and herd its animals using the sea as farmers instead of hunters. That is what civilization is all about – farming replacing hunting.’

    Perhaps other ways to earn a living from the sea may in time become available to fishing communities, and a compulsion to hunt in a destructive manner will decline.

    Hopefully steps can be taken so that a balance can be struck between fishing communities and the seal communities that co-exist along our incredible coastline.

    If you believe in preserving these seal communities that have so recently come back from extinction along our coast please sign the petition by clicking here.

    All Images by Dan Mc Auley, read more of his articles on Ireland’s marine life here.

  • Covid-19 in Ireland: Elusive Facts

    No facts without Judgment

    Facts alone are wanted in life. Plant nothing else, and root out everything else. You can only form the minds of reasoning animals upon Facts: nothing else will ever be of any service to them.
    Mr Gradgrind from Charles Dickens’s Hard Times (1854).

    These are facts the heart can feel; yet they call for careful study before they become clear to the intellect.
    Albert Camus, The Myth of Sisyphus (1955).

    The philosopher Alasdair MacIntyre wrote that ‘facts, like telescopes and wigs for gentlemen, were a seventeenth-century invention.’ The term is derived from the Latin ‘factum,’ meaning ‘a deed, an action and sometimes in scholastic Latin an event or occasion.’ MacIntyre was not dismissing the importance of gleaning evidence from sources, or deriving conclusions from scientific studies, but asserting that no fact is ever ‘independent of judgment.’[i]

    Over the course of the current pandemic, as a recent opinion piece in the British Medical Journal puts it:

    uncontested facts—things that are ascertainable, reproducible, transferable and predictable—tend to be elusive. Most decisions must be based on information that is flawed (imperfectly measured, with missing data), uncertain (contested, perhaps with low sensitivity or specificity), proximate (relating to something one stage removed from the real phenomenon of interest) or sparse (only available for some aspects of the problem).

    Similarly, the historian E. H. Carr considered facts to be ‘like fish on the fishmonger’s slab. The historian collects them, takes them home and cooks and serves them.’ Thus partisan outlooks have always coloured understandings of historic events. Carr recalls: ‘Our picture of Greece in the 5th century BC is defective not primarily because so many of the bits have been accidentally lost, but because it is, by and large, the picture formed by a tiny group of people in the city of Athens.’

    Journalists and editors in writing ‘the first rough draft of history’ therefore make judgments in determining facts. Unsurprisingly, during a global pandemic Covid-19 deaths and diagnoses are given greater factual weight than the equivalent statistics for heart disease, cancer or influenza. This is quite apart from deaths in developing countries from tuberculosis, AIDS and malaria, which are set to double this year in part owing to the intense focus on Covid-19 – particularly in Africa which by mid-August had experienced just 23,000 deaths from Covid-19.

    Any journalist’s judgment in determining facts is not necessarily a product of sinister machinations, but orthodoxies and received opinions are easily enshrined in news organisations that are patronised, or owned outright, by vested interests, which throughout history have ‘manufactured’ consent.

    Moreover, as Noam Chomsky put it in a famous interview with Andrew Marr, there is ‘a filtering system’ that starts in kindergarten which ‘selects for obedience and subordination.’ Chomsky intimates that most journalists that rise to the top of major news organisations are conformists, including Marr.

    The pandemic has exposed the fragility of contemporary journalism in the era of the Internet, which, arguably, has exhibited over-deference to scientific authority, even where those authorities have proffered accounts that have proved wildly inaccurate, or contradictory. This passivity seems to be a feature of what Nick Davies has described as ‘churnalism’, whereby journalists become passive processors of ‘unchecked, second-hand material, much of it contrived by PR to serve a political or commercial interest.’

    Fake News

    In the Internet era we have witnessed an onslaught of so-called ‘fake news,’ which are accounts departing from journalistic convention that enter the realm of fiction and outright distortion.

    This is not, however, entirely novel. It is axiomatic that truth is the first casualty of war, a metaphor constantly applied to this pandemic. Journalists embedded in power structures have long spun outright falsehoods. We need only cast our mind back to uncritical coverage of claims around Weapons of the Mass Destruction prior to the invasion of Iraq in 2003, or the misleading accounts of Cuba in the U.S. press.

    Nonetheless, in this context such claims have become more outrageous, and even comical, with social media – Facebook in particular – acting as a conduit for misinformation from non-mainstream outlets, granting individuals unprecedented platforms to project fears, fantasies and delusions that are often manipulated by shadowy agencies, such as Cambridge Analytica.

    An apparent antidote to fake news has arrived in the form of fact-checking websites. While these may succeed in exposing outright falsehoods – which is undoubtedly important in an era of climate change – we should also examine which facts are being checked and also, why there are discrepancies in mainstream accounts. The funding for such sites also merits scrutiny. The facts do not speak for themselves.

    #CoronaVirusFacts Alliance

    In March this year the Irish online news website, www.thejournal.ie announced it had ‘joined a worldwide project of factcheckers debunking claims about Covid-19.’ According to their report: ‘This project, called the #CoronaVirusFacts Alliance, comprises more than 100 factcheckers around the world and it is the largest collaborative factchecking project ever,’

    That global alliance was launched in January by the Poynter Institute:

    when the spread of the virus was restricted to China but already causing rampant misinformation globally. The World Health Organization now classifies this issue as an infodemic — and the Alliance is on the front lines in the fight against it.

    This global response is in line with a war-gaming exercise for a global pandemic (coincidentally a fictional coronavirus: Coronavirus Associated Pulmonary Syndrome) called Event 201 organised by The Johns Hopkins Center for Health Security in partnership with the World Economic Forum and the Bill and Melinda Gates Foundation. In this exercise where no one has immunity from that virus, the model predicts the pandemic will only end when 80 percent of the world’s population has been infected, which takes 18 months and results in 65 million deaths.

    The participants addressed the issue of disinformation and misinformation from ‘state sponsored groups’ and specifically pointed to the importance of ‘fact-checking efforts.’

    Notably, the Poynter Institute has received charitable donations from the Bill and Melinda Gates Foundation of $382,000 in 2015, earmarked for improving ‘the accuracy in worldwide media of claims related to global health and development.’ The organisation now receives donations from, among others, Facebook, Google News Initiative and climate-change denying Charles Koch.

    Died ‘From’ or ‘With’?

    Most of www.thejournal.ie’s investigations into online claims result in slam dunks, where obvious fake news is dismissed. This may indeed be in the public interest; although it is questionable how many people actually believe claims such as that children are going to be taught how to masturbate as part of their education, or that Bill Gates briefed the CIA in 2005 on a vaccine against religious fanatics. This latter claim, interestingly, was also debunked on other fact-checking sites, demonstrating that www.thejournal.ie is a small cog in a global campaign.

    More relevantly to Ireland, in carrying out its fact-checking remit www.journal.ie has bolstered the Irish government’s emphasis on the serious danger posed by Covid-19 to all age groups. Consolidating government messaging during a pandemic may be considered a civic duty, but it can also over-simplify “elusive” facts that merit revisiting.

    On July 24th, Radio DJ Niall Boylan’s tweet from July 14th claiming just eight people under the age of sixty-five had died from Covid-19 became the subject of a fact-checking inquiry.

    The relevant fact checker, Rónán Duffy, recalled that the Health Protection Surveillance Centre had recorded a total of 1,763 deaths related to Covid-19, of which 113 related to people under the age of 65. Duffy thus concluded that ‘At the time that Boylan shared the original tweet on 14 July, the number of Covid-19 deaths among people under 65 was 113, not eight’

    In response to a request for clarification, however, Boylan said he specifically used the term ‘from Covid-19,′ not ‘with Covid-19′. He went on to argue that it was important to distinguish deaths among people with and without underlying health conditions, ‘in other words people who had died from coronavirus.’ He claimed the figure of eight people was a direct quote from a statement made by Independent T.D. Michael McNamara, who said at a sitting of the Special Committee on Covid-19 that only eight of those under the age of sixty-five who died did not have an underlying condition.

    Duffy concluded the claim was ‘misleading because it omits crucial details that may lead to readers forming an incorrect conclusion.’

    Boylan’s tweet may indeed have been unsatisfactory, but the original death toll was itself a simplification: a bald statistic that omitted to mention that the vast majority of those who died were afflicted with underlying conditions. Perhaps some of these were patients would have succumbed to a respiratory infection in an ‘ordinary’ year, considering influenza or pneumonia are the cause of up to a thousand deaths a year in Ireland.

    A Covid-19 infection may not have been the primary cause of death; or an infection could have accelerated by a short time that mortality. Any death comes as a shock to those left behind, and all reasonable efforts should be undertaken to preserve life, but it is not uncommon for patients weakened by long-term illness to succumb to respiratory infections, such as Covid-19, rather than the chronic degenerative disease to which the cause of death is ordinarily ascribed. Members of the public unacquainted with medical science may not be aware of this. According to one G.P. consulted in researching this article attributing cause of death is never an exact science.

    A more thorough fact-checking exercise might examine the nature of comorbidities or underlying conditions. Conditions are described in papers, but a loose definition can easily yield to wild claims around the number of those in the Irish population who are at risk of death from the virus.

    https://twitter.com/DonnellyStephen/status/1303632455107260422

    Yet a recent article in Nature emphasises that age is by by far the strongest predictor of an infected person’s risk of dying :

    For every 1,000 people infected with the coronavirus who are under the age of 50, almost none will die. For people in their fifties and early sixties, about five will die — more men than women. The risk then climbs steeply as the years accrue.

    The suggestion that 1.5 million among an Irish population of less than five million that is the youngest in the E.U. are susceptible to death from Covid-19 is a wild exaggeration.

    All 1,777 deaths?

    In another recent article Fact Checker claimed: “the virus was a factor in all 1,777 deaths.”

    Yet HIQA reported in July:

    Excess mortality was found to be 1,072 (95% CI: 851 to 1,290) between 11 March 2020 and 16 June 2020 inclusive. The officially reported number of COVID-19 deaths for the same period was 1,709. Therefore, the estimated excess mortality is less than the officially reported COVID-19-related mortality by 637 cases.

    Similarly in the U.K. Dr Jason Oke of the Centre of Evidence-Based Medicine in Oxford has found that almost one third of Covid-19 deaths in July and August were ‘primarily caused by other conditions’. There is therefore significant doubt over whether the virus was the primary factor in all 1,777 of these deaths.

    Also, the coroner’s office was not conducting post-mortems on suspected cases and testing was pulled from the entire care home sector for three weeks at the height of the pandemic, meaning in many cases doctors were making educated guesses that Covid-19 was the cause of death.

    Then CMO Tony Houlihan also acknowledged: ‘Clinically, the “index of suspicion” for the disease would be “a good deal higher” than would normally be the case for flu.’

    RTÉ’s Feargal Bowers

    The Irish public service broadcaster RTÉ says that ‘nine out of ten people in Ireland say RTÉ has been their main media source for accessing information on Covid-19.’ The broadcaster recently launched an initiative against fake news entitled: ‘The truth matters at RTÉ – here’s why,’ claiming:

    Now that society is grappling with the challenges of a pandemic, and the inescapable anxiety that comes with it, the potential for manipulation of the facts is huge.

    But RTÉ has at times provided an unreliable account of the danger posed by Covid-19 to the Irish public. Throughout the pandemic RTÉ’s health correspondent Feargal Bowers has pointed to the exceptional danger posed by Covid-19, which fits within what Nancy Tomes has called the “killer germ genre of journalism”.[ii]

    Bower’s describes a Grim Reaper that is redolent of the character of Death from Ingmar Bergman’s Seventh Seal:

    This virus could visit any of us, at any time, in our homes, or in work.

    It does not make an appointment.                                                        

    Going outside involves a certain roll of the dice.

    Inside you may also encounter this intruder.

    Like any lottery, there are things people can do to improve their chances.

    And hold onto the most valuable prize of all – your life.

    In fact, we are dealing with a virus with an infection fatality rate below 1% according to Nature magazine, or ‘possibly as low as 0.2% or 0.3%,’ according to Lone Simonsen, a professor of population health sciences at Roskilde University in Denmark who has worked at the CDC and National Institutes of Health in the U.S.; others such as Professor Johan Gisecke, a member of the WHO’s Strategic and Technical Advisory Group for Infectious Hazards (STAG-IH) previously suggested a figure as low as 0.1%. The IFR has varied from region to region, with New York, Madrid, London and Lombardy particularly badly hit, but in Africa, as indicated, the IFR appears to be exceptionally low.

    With better treatments – especially the use of the generic drug Dexamethasone – and protection of vulnerable groups, chances of survival have improved since the early stages of the pandemic. This seems evident from the relatively low death toll currently witnessed across Europe, including in Ireland, despite rising case numbers. Many of us also harbour T-cell immunity from other coronaviruses, as we will see.

    Yet Bowers has continued to make factually incorrect claims in a succession of articles, including on September 5th, which stated: ‘The World Health Organization says data to date suggests 80% of Covid-19 infections are mild or asymptomatic, 15% are severe infection, requiring oxygen and 5% are critical, requiring ventilation.’

    Ventilators are now used sparingly in the treatment of Covid-19, and large orders were cancelled in April.

    Remarkably, Bowers seems to have copy and pasted that information from a WHO Situation Report from March 6th, stating ‘data to date suggest that 80% of infections are mild or asymptomatic, 15% are severe infection, requiring oxygen and 5% are critical infections, requiring ventilation.’[iii]

    The continued use of data from March undermines RTÉ’s credibility and should be a source of embarrassment.

    IFR or CFR?

    In a widely circulated tweet at the height of the pandemic then Minister for Health and current Minister for Higher Education, Simon Harris confounded the Case Fatality Rate (CFR), which is the percentage of deaths from diagnosed cases, with the Infection Fatality Rate (IFR), which is the percentage who die after contracting the virus. This surely elevated fears around the ‘deadly’ virus.

    More recently Fianna Fáil TD Cathal Crowe displayed the same confusion when he called a TikTok video ‘almost treasonous’ and ‘only a step or two away from being culpable for manslaughter.’

    He added:

    And at a time when those who contract Covid – there’s a fatality rate at the moment in this country of 6.2% of those who contract Covid – I think their actions in trying to draw the Covid virus onto themselves and pass it onto others, I think it’s only a step or two away from being culpable for manslaughter.

    Reference to the CFR may give the impression the virus is more lethal than we now know it is. Raising alarm bells may serve a short term end of confining people to their homes, but will ultimately only lead to distrust as reliable scientific information is now easily accessible.

    A similar caution should apply to emphasis by the current Minister for Health Stephen Donnelly on so-called ‘Long Covid.’ In June the UK’s Covid Symptom Study indicated that ‘one in ten people may still have symptoms after three weeks, and some may suffer for months.’ But the study fails to distinguish between asymptomatic and symptomatic cases, implying this is a reference to only confirmed symptomatic cases. Anecdotally, one Dublin GP consulted said he had not encountered a single case in his practice.

    Long Covid appears to fit into the category of a post-viral syndrome, or post-viral fatigue which ‘refers to a sense of tiredness and weakness that lingers after a person has fought off a viral infection. It can arise even after common infections, such as the flu.’ The prevalence at this stage is unclear.

    Mortality Projections

    The medical historian Mark Honigsbaum writes: ‘by alerting us to new sources of infection and framing particular behaviours as “risky,” it is medical science – and the science of epidemiology in particular – that is often the source of … irrational and often prejudicial judgments … knowledge is constantly giving birth to new fears and anxieties.’[iv]

    Epidemiology cannot be an exact science as it projects into an uncertain future. Michael Levitt has claimed that epidemiologists see their function, ‘not as getting things correct, but as preventing an epidemic. So therefore if they say it is 100-times worse than it’s going to be, then it’s ok.’ This approach may explain why a senior Irish health official told the Sunday Business Post in March that ‘1.9 million could be infected and become sick with the new coronavirus.’

    But crying wolf with claims that prove wildly inaccurate over the course of a long pandemic cannot easily be repeated. It corrodes trust in scientific authority, which is an important consideration in an era of climate change.

    Among the scientists that have risen to prominence over the course of the pandemic is Professor Sam McConkey. On March 11th he predicted ‘there could be between 80,000 and 120,000 deaths in Ireland from coronavirus.’ McConkey has not been adequately held to account for the inaccuracy of this prediction, yet his projections continue to be circulated:

    https://twitter.com/AodhanORiordain/status/1305613309752864771

    The main go-to-man among Irish scientists for the Irish media has been Trinity Professor of Immunology Luke O’Neill. On June 22nd he claimed that Ireland would have had 28,000 deaths if there hadn’t been a lockdown.

    Yet in a long Twitter thread data analyst David W. Higgins provided a compelling argument that mortalities peaked prior to the nationwide lockdown at the end of March.

    Higgins recalls the country went into lockdown in two stages. ‘The “first measures” were on March 12th with school closures, social distancing and a ban on large gatherings …. Then on March 28th, we began the ‘full lockdown,’ with non-essential workplaces shut and the 2km rule.’

    Higgins worked from the assumption that symptoms manifest after five days, and that deaths, on average, occur after twenty. He calculated that ‘the March 28th lockdown should have led to a peak in deaths taking place over 20 days later, any date after April 17th,’ which he said is ‘pretty much what the headline data shows. April 20th saw the largest number of new deaths.’

    ‘However’, he added, ‘we know that the date of death being announced is several days *after* the death actually took place,’ which, he reckoned, was typically about two days. Therefore, ‘the peak is more likely around April 15th.’

    ‘The problem is’ he said ‘that’s 2 days before the March 28th “full lockdown” should have had an effect.’ His conclusion was that ‘the full lockdown wasn’t the main cause for peak deaths!’, the implications of this were ‘profound’ he argued. He argued that ‘the social distancing alone (between March 12th and 28th) was the main driver of #FlattenTheCurve.’

    Based on Higgins’s assessment, the laws introduced on March 12th provided sufficient space for hospitals to handle a surge in cases that could have led to avoidable deaths from hospitals being overstretched. One may question O’Higgins’s assessment, but at least he has crunched the numbers, unlike O’Neill it would appear, who has offered no proof for his claim.

    Forming Memories…

    Another scientist to have gained a platform has been, Dr Tomás Ryan, a Trinity colleague of O’Neill’s, who is widely touted as an expert authority on this pandemic, despite being a neuroscientist, with no publications listed on Google Scholar related to contagious diseases or public health. Nor does he have a medical background. A recent paper, from June 2020 is entitled: ‘Memory: It’s Not a Lie if You Believe It.’

    Ryan has been among the leading advocates of ‘Zero Covid’ Ireland, dedicated to ‘Crushing the Curve’, a global initiative of the Wellcome Trust that also supported Ryan’s thesis work. Ryan has written a number of articles for both the Sunday Business Post and the Irish Times, which does not appear to mount a paywall for his contributions.

    Advocating a suppression of the virus in ‘the paper of record’ on June 10th, Ryan claimed that a strategy of ‘living with the virus,’ would involve:

    a cycle of successive lockdowns [which] would need to continue four to seven times until we reach a stage of herd immunity, with at least 60 per cent of the population infected. The health cost of this approach would be about 50,000 deaths.

    Ryan makes no reference to any study on which he bases this mortality claim. He seems to be referring to the epidemiological assessment of Imperial College’s Niall Ferguson, the methodology of which has come in for serious criticism. In March Ferguson’s ‘best case outcome’ for the U.S. was a death toll of 1.1 million, rising to 2.2 million in a worst case scenario.

    On March 17th, 2020, Mark Landler and Stephen Castle in the New York Times wrote: ‘It wasn’t so much the numbers themselves, frightening though they were, as who reported them: Imperial College London.’ Due to the professor’s WHO ties, the authors noted, Imperial was ‘treated as a sort of gold standard, its mathematical models feeding directly into government policies.’ Yet despite a chaotic response from the Federal authorities, the U.S. death toll from Covid-19 remains below two hundred thousand, with daily deaths decreasing according to the New York Times.

    Contrary to Ryan’s stark warning, Ireland has registered just over fifty deaths, as of September 20th, since the start of July.

    A More Nuanced Approach

    One-sided reporting of ‘facts’ around Covid-19 in Ireland is consistent with a concerted global effort emphasising the unprecedented danger posed by Covid-19. This account is predicated on the assumption that a reliable vaccine is the only way to bring the pandemic under control.

    As mentioned, however, the pessimistic projections of Professor Niall Ferguson and others have proved unfounded, and recently the WHO’s Mike Ryan warned there is no guarantee that a vaccine will ever be found.

    This leaves us in a position of zugzwang, a term which Emeritus Professor of Public Health at Edinburgh University Raj Bhopal borrows from the game of chess, meaning when the obligation to make a move in one’s turn leaves one in a serious, often decisive, disadvantage. He concludes:

    The balance between the damage caused by COVID-19 and that caused by lockdowns needs quantifying. Public debate, including on population immunity, informed by epidemiological data, is now urgent.

    Hearteningly, after a relatively heavy death toll in the spring, having avoided lockdown, Sweden’s case numbers have remained below the European average throughout September – lower even than its high-performing Scandinavian neighbour Norway.

    This supports an hypothesis that a herd immunity threshold could lie at around 10-20%, ‘considerably lower than the minimum coverage needed to interrupt transmission by random vaccination,’ according to the University of Strathclyde’s Professor Gabriela M. Gomes et al. Professor Sunetra Gupta’s group at Oxford University have put the figure as low as 10%.

    The scale of pre-existing immunity to Covid-19 is discussed in a recent article in the British Medical Journal. The authors remind us that the ‘research offers a powerful reminder that very little in immunology is cut and dried.’ Yet there has been little debate on the crucial question of herd or population immunity in the Irish media. This would involve an age-targeted strategy that takes account of the significant health impacts of lockdowns, especially on younger age groups.

    We are now beginning to witness the emergence of a recognisably left-wing opposition to lockdowns as herd immunity ceases to be a dirty word; while Bill Gates has acknowledged: ‘the initial vaccine won’t be ideal in terms of its effectiveness against sickness and transmission. It may not have a long duration.’

    Lack of ICU Capacity

    Facts around Covid-19 remain keenly contested among scientists. It may well be that the extreme precaution advocated by the Irish government is indeed justified, but it is incumbent on the Irish media to validate carefully all claims, and permit frank debate to occur. Politicians can be forgiven for erring in not giving an accurate picture at the height of a pandemic, but more honest conversations are necessary as we move forward. It is incumbent on journalists to hold politicians, and scientists, to account.

    Unfortunately Ireland’s dysfunctional system of public health creates additional risks that discourages any change in approach, and perhaps explains an apparent faith in a reliable vaccine being produced.

    At the start of the pandemic Ireland had half the number of ICU beds and staffing compared to other E.U. countries. By the start of May, however, according to Feargal Bowers (who presumably can be relied on in this instance) there were 417 units; but by the start of June, that figure was 381; July 252; August 276. At the start of September it was 356. But, as of mid-September the number of ICU beds open and staffed is 278. Under questioning from Michael McNamara in the Dáil, Taoiseach Micheál Martin said that just twenty-three had been added since the start of the pandemic.

    The pandemic has compounded a pre-existing health crisis, with 700,000 awaiting medical appointments by the end of May. Now restraints due to the pandemic are accelerating the highest rate of obesity in the E.U., with one in four adults falling into this category. But a recent study warns that any vaccine may not work effectively on someone who is obese.

    Under-resourcing of the health system might best explain the ultra-cautious and draconian approach adopted by the Irish government, which is increasingly out of step with most its European partners, where social life has been permitted to resume under restrictions.

    Feature Image: Daniele Idini

    [i] MacIntyre, Whose Justice: Which Rationality?, University of Notre Dame Press, Indiana, 1988, p.357.

    [ii] Mark Honigsbaum, The Pandemic Century: One Hundred Years of Panic, Hysteria and Hubris, C Hurst, London, 2020, p.75.

    [iii] Coronavirus disease 2019 (COVID-19)Situation Report –46, March 6th, 2020,
    https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200306-sitrep-46-covid-19.pdf?sfvrsn=96b04adf_4

    [iv] Mark Honnigsbaum, The Pandemic Century: One Hundred Years of Panic, Hysteria and Hubris, C Hurst, London, 2020, p.viii.

  • ‘This is science which should go on trial’

    A zoom panel discussion organised by Lindau, which included two other Nobel-prize winning scientists, provided Stanford biophysicist and Nobel Laureate Michael Levitt with a platform to vent his fury over the global scientific community’s flawed response to the Covid-19 pandemic, as he saw it.

    In particular, he condemned Imperial College’s Neil Ferguson for failing to respond to his emails at the height of the crisis. He said that a flawed response had caused hundreds of billions of dollars’ worth of suffering and damage, that had disproportionately affected a younger generation, and which would not substantially alter the ultimate death toll.

    Levitt began by saying (at 11.41 in the video below):

    One thing that strikes me is that once the virus moved from the China-Korea phase is how totally inadequate science structure is for real time science. People are insisting on refereed reports. No one wants to share anything. The scientists are more panicked and scared by reality than anybody else. The august organisations like Lindau, The Royal Society, The National Academy of Science, have been totally silent … As a group, scientists have failed the younger generation.

    ‘There should have been a committee formed’, he said, ‘either by the Nobel Foundation, by Lindau, by the Royal Society, or the National Academy of Science in the middle of February.’

    He continued:

    The worst opposition I got was from very, very prominent scientists, who were so scared that the non-scientists would break quarantine and infect them. There was total panic, and the fact is that almost all the science we were hearing from organisations like the World Health Organisation, was wrong. We had Facebook censoring WHO-contrary views. This has been a disgraceful situation for science … We should have been talking to one another ..

    Over the course of the pandemic, he said he was releasing reports openly, but all he go back was abuse. Nonetheless, he argued, everything he said in the first six weeks was true, but that ‘for political reasons, we as scientists, let our views be corrupted.’

    He argued that ‘the data had very clear things to say. Nobody said to me: ‘let me check your numbers’. They all just said: ‘stop talking like that’.’

    Levitt reserved particularly harsh comments for epidemiologists who he said:

    see their job, not as getting things correct, but as preventing an epidemic. So therefore if they say it is 100-times worse than it’s going to be, then it’s ok. Their mistake was that we listened to them. They said the same thing for Ebola, they said the same thing for Bird Flu, no one shut down for them. We should never have listened to the epidemiologists. They have caused hundreds of billions of dollars’ worth of suffering and damage, mainly on the younger generation. This is going to be a tragedy. It’s going to make 9/11 look like a baby story. This is much, much worse. I am not against lockdown, I am against stupid lockdown, without considering the full picture, i.e. not just combating a virus, that is exactly as dangerous as flu, but also avoiding the economic damage, that every country has caused itself except Sweden. We have really, really failed as a group. There have been smart people in Sweden, and that’s about it. Germany is getting reinfected because they cut down too strongly. You know the level of stupidity that has been going on here has been amazing, and it just required a little bit of discussion of smart people. I am not saying I am right, but I would like people to contra me on the details.

    He says that ‘simple logical assumptions’ such as the infection fatality rate ‘got discussed so slowly and so late,’ while, ‘we circled the wagons against this, and it really, really hurt us.’

    Imperial College’s Neil Ferguson.

    Neil Ferguson, he said, ignored his emails, and that the problem did not simply lie with a lack of communication with the public, but that scientists refused to listen to people not in their fields.

    Now he said:

    Scientists are getting away scot-free for causing billions of dollars’ worth of damage and this is something that cannot be allowed to happen. It’s not just the World Health Organisation. Ferguson wanted Sweden to lockdown, got Britain to lockdown, and when the numbers become normal, exactly what you would expect without lockdown. He then says, ah it’s because of lockdown. This is terrible science. This is science which should go on trial. Scientists cannot cause damage like this and refuse to listen. I really, really tried hard to get them to at least discuss this with me. In the end I said something I never say: whatever. Just leave me alone, go ahead and die. And the fact is that epidemiology and modelling has been a disgrace. They have not looked at the data. They have been wrong at every turn. We are going to see that although coronavirus is a different disease, the net impact of death is going to be very similar to severe flu and it’s going to be that way without lockdown.

    Levitt reserved praise for Sweden:

    Sweden is the only country that has done the right thing by heading for what they consider to be herd immunity. It occurs at 15%, not at 80%, another error that the epidemiologists made. Sweden is going to end up with about 600 deaths per million.

    https://vimeo.com/433350887/33bbbe4090

  • The State of Irish Agriculture

    On April 30th, acting Minister for Agriculture Michael Creed defended Ireland’s agricultural sector,[i]  claiming we are the second most food secure country in the world. What Creed seems to have been referring to was an Irish independent article from October 2019, saying Ireland had moved from first place to second in a Global Food Security Index.[ii]

    In so doing, Ireland had been overtaken by Singapore, a micro state that imports over 90% of its food. You might ask, how is it possible that this island of concrete was adjudged to be the most food secure place on the planet?

    Singapore, ‘the world’s most food secure country’.

    On closer examination, it seems this “research” had been sponsored by Corteva Agriscience, one of the largest producers of pesticides in the world, and now a subsidiary of DowDupont after a merger with Dow Chemical, (the corporation responsible for the Bhopal Disaster in India 1984). Such vested interests cannot be trusted as a reliable source in assessing the food security of nation states.

    The fact that Singapore is ranked highest in a food security index sponsored by an agri-chemical multinational should come as no surprise, as these chemicals are much more likely to figure in industrially produced food systems, traded on a global market, rather than localized, subsistence food systems.

    It also comes as no mystery to find the Irish independent presenting this highly dubious study as fact. That newspaper has historically represented the interests of the comprador, or broker capitalist class in Ireland; that revolving door between agribusiness, finance and politics, servicing the multinationals that have located in Ireland.

    Moreover, Micheal Creed has a track record of presenting erroneous research to the Dáil regarding emissions from Ireland’s fast-expanding dairy sector.[iii]

    Food security in this scenario equates to commodities being traded on a global market with minimal restrictions. The evaluation is predicated on current availability, price and diversity of food consumed – regardless of productive factors or supply chain interference. It takes no account of the environmental or social consequences of this supply line, or any risks lying further down the line, whether a hard Brexit, a global pandemic, or that the global food system has eroded a quarter of all arable topsoil on the planet since the 1950s.[iv]

    Despite supposedly being number two in the world in terms of food security, Ireland now imports the majority of its potatoes and nearly all its wheat flour; the main staple carbohydrates of the people of Ireland.

    The Teagasc Consensus

    A large part of the belief in distortions like these can be attributed to the neoliberal religion of free trade, which is engrained as a belief system in a great number of Irish farmers.

    Over the course of the twentieth century, the adaptation of new and increasingly expensive inputs into agriculture have been sold as ‘progress’ to farmers. Numerous chemicals and pharmaceutical companies, including SmithKline, Pfizer, Merck, Schering Plough and Roche located their manufacturing facilities in Ireland during the 1960s and 70s, availing of lax or non-existent environmental regulation and lower labour costs. They stayed because of an attractive corporate tax regimes and unrestricted interference in Ireland’s educational system. By the turn of the twenty-first century they accounted for nearly seventy percent of global pharmaceutical output.[v]

    These multinationals have helped the Irish state to adopt an increasingly intensive, highly specialized monoculture agricultural system, geared towards the export market.

    Traditionally, farmers have gone along with this because of the developmental rhetoric and of course, generous EU subsidies.

    Also crucial to manufacturing consent has been the educational apparatus of Teagasc, the state research centre for agriculture. Teagasc uses science selectively to the end of export intensification.

    Connected to the revolving door between chemical and pharmaceutical multinationals located in Ireland, Teagasc and other state educational institutions have effectively locked farmers into an unsustainable, high-input agricultural model, based on the latest bio-technological ‘fixes’ formulated by the agri-chemical industry.

    The end result is scientistic rather than scientific, meaning science is adopted in a cosmetic manner, to provide technical short-term fixes within a strictly liberalised market paradigm.

    A truly scientific approach, which is essential in the face of irreversible climate change, requires rigorous philosophical as well as technical inquiry, taking into account all of the parts involved in a system and their effects. This is a thorny path to embark upon, especially when multinational interests are threatened.

    Irish state education, and Teagasc in particular, indoctrinates a free market ideology into young people. This includes the Law of Comparative Advantage, which involves specialization in one industry over others, for the purposes of international trade. This is the central tenet of the state’s agricultural policies, and the cornerstone of Teagasc’s educational institutions.

    The Law of Comparative Advantage has long been subjected to criticism from other schools of thought such as Development Economics: most notably the Singer-Prebisch thesis, which demonstrates that the terms of trade between countries producing primary products deteriorates over time, relative to countries producing manufactured goods.

    Notably, this economic ‘Law’, was formulated by British Economist David Ricardo in 1817, when the Spanish colonies in the Americas were in the process of becoming independent republics. Spain’s loss was Britain’s opportunity, as ‘free’ trade doctrines became the rationale for unequal exchange between the global North and the global South, then as now, keeping wealth flows disproportionately northwards.

    Now in the former British colony of Ireland the main farmers’ lobby, the IFA, maintains the consensus around globally traded commodities, successfully convincing many smaller farmers that their interests are joined to large scale beef and dairy producers.

    Just recently the IFA managed to compel acting Minister Creed to continue with live exports to Turkey, Algeria and Libya as a way of stabilizing prices.[vi]

    Yet many farmers are discovering that they have given away too much autonomy to the IFA and their political patrons in Fine Gael. Some small farmers broke away from the IFA to form the Beef Plan Movement, which challenged export monopolies from 2018, but the Movement seems to have dissipated.

    Now some disillusioned farmers are beginning to see the EU’s CAP as the source of their problems, and are calling for an ‘Eirexit’.[vii]  However, while free trade agreements in the EU and other consumer markets are a vehicle for the current model, the driver has long been the Irish State.

    Source of the Problem

    With many farmers now in grave financial difficulties, it has become apparent that the source of our agricultural difficulties lies in international free trade arrangements, European or otherwise, being used by the State and accepted without question by farmers’ lobbies in the name of ‘progress’.

    There was nothing inevitable about European integration pushing Ireland so far past its ecological carrying capacity in terms of agriculture: it came from the Irish state’s pursuit of European integration and other free trade arrangements.

    During the 1970s and 1980s, the Irish State pushed to clear wildlife from farms, even if the financial incentives came from EU grants. It is the Irish State which continues to push for export intensification through its Food Harvest 2020 and Foodwise 2025 schemes, seeking markets far beyond the EU. Ireland is now the second largest exporter of infant formula in the world, its largest market being China.[viii]

    A food system that is so integrated into global market chains has brought increased levels of monoculture specialisation in beef and dairy, severely diminishing the diversity of food produced [ix],  and depending not only on chemical inputs ,which pollute our environment and destroy biodiversity, but also on imported animal feedstuffs.

    The dairy industry has grown by 27% [x] in just five years and continues to expand, far exceeding the carrying capacity of the grassland it relies on. Due to homogenization, the supply chain of pretty much all Irish butter and non-organic dairy produce contains on palm kernels, and genetically modified, Roundup-Ready soya and corn.

    This amounts to an appropriation of land, labour and water resources from the global South, causing deforestation in tropical rainforests, erosion of topsoil which takes thousands of years to form; as well leading to the extinction of animal and plant species.

    The successive crises that these policies have led to in Ireland have been misrepresented as ‘fodder’ crises. They are in fact over-intensification crises, arising from destructive free trade policies which have pushed the island of Ireland past its agricultural carrying capacity.

    These are a reoccurring themes in Irish history. The difference between today’s and the crises of the eighteenth and nineteenth century is that Ireland is no longer bottom of the economic hierarchy in the global economic system. As a result, the environmental burden can be externalised to peripheral parts of the world, especially through feed imports.

    Inside Ireland’s largest milking machine. Henry Clarke (wikicommons).

    A New Way Forward

    The progress of the so-called ‘Green Revolution’ in agriculture from the 1940s is beginning to unravel. Short term bio-engineering fixes are spiralling out of control. A continuous stream of newly engineered GM crops – which can withstand higher concentrations of agri-chemicals – are being rolled out in response to new herbicide resistance in weeds which make the existing chemical concentration of previous GM varieties ineffective. The result is higher doses of chemicals in our food chain and mass extinction of pollinating insects and soil microorganisms.

    The limits and consequences of the industrial model of agriculture is now evident from a food security standpoint as well as in terms of the environment. The science behind our agriculture needs to involve a whole systems approach that takes into account all of the ecological consequences of globalized food production, and which places soil conservation and renewal at its core.

    At present, this is missing entirely from Teagasc’s educational apparatus as the current food production model is not circular, but extractive: heavily dependent on imported inputs which cause deforestation, topsoil degradation and extinction of species in other parts of the world, as well as wreaking havoc on biodiversity and water quality within Ireland.

    In the wake of Covid-19, a future roadmap is in the hands of whoever dares to seize the moment. The epidemic has occurred in the wake of years of environmental campaigning and the farm to fork strategy [xi],  which has been pushed through at European level. This  reflects a growing recognition of the limitations of the global industrial food model at the highest levels of political power.

    This crisis of international capitalism is a real opportunity for small producers to adopt more localized regenerative agricultural systems, which are embedded in community and work with natural ecosystems instead of attempting to dominate them. In these kinds of systems, farmers and communities of farmers produce foodstuffs suitable to their bio-regions, sequestering carbon in the soil.

    These kinds of systems generate their own inputs, freeing farmers from the clutches of the agri-chemical industry. In this kind of scenario, farmers produce a healthy diversity of food for their communities, instead of monoculture commodities for cargo ships.

    In order to achieve this, however, we require a complete overhaul of deep-seated beliefs about farming which have been perpetuated by state propaganda, the educational apparatus, and the media.

    The United Nations Food and Agriculture Organization now recognises agri-ecology as the way forward for developing food security in the face of climate change. We must fight State policies which prevent a regenerative agriculture. Not only is this achievable, it is essential.

    [i] VideoParliament Ireland,  Deputy Holly Cairns – speech from 30 Apr, YouTube, 2020 https://www.youtube.com/watch?v=8PrwuHgRxPM&feature=youtu.be&fbclid=IwAR16-ozAjJzFY_iF2fWI8jr0yu0ydOZCdse5vJxvXkavGEltsHoOMAZAM2g

    [ii] Margaret Donnelly, ‘Deputy Holly Cairns – speech from 30 Apr 2020’, Irish Independent, October 16th, 2018, https://www.independent.ie/business/farming/news/world-news/ireland-slips-to-second-in-the-world-for-food-security-37425858.html

    [iii] Press Release, ‘An Taisce has called on Minister Creed to retract misleading Dáil statements on rising dairy emissions’, 25th of June, 2018, https://www.antaisce.org/articles/an-taisce-has-called-on-minister-creed-to-retract-misleading-d%C3%A1il-statements-on-rising

    [iv] Chris Arsenault, ‘Only 60 Years of Farming Left If Soil Degradation Continues’, Scientific American, December 5th, 2014, https://www.scientificamerican.com/article/only-60-years-of-farming-left-if-soil-degradation-continues/.

    [v] Robert Allen, No Global: The people of Ireland versus the multinationals, Pluto Press, Dublin, 2004, p.4

    [vi] Untitled, ‘MINISTER CREED MUST ENSURE THAT LIVE EXPORTS TO ALGERIA CONTINUE’, IFA, May 10th, 2020, https://www.ifa.ie/minister-creed-must-ensure-that-live-exports-to-algeria-continue/#.XrgyI2hKg2w

    [vii] Irish Freedom Party, ‘Irish Farmers are Strangled by EU Regulations | Frank Shinnock at Irexit Cork’, March 4th, 2019, https://www.youtube.com/watch?v=rp41yqAWkzQ&t=1115s

    [viii] Stephen Cadogan, ‘ The origin is green — China is now Ireland’s second most important market for dairy exports’, Irish Examiner, November 15th, 2018, https://www.irishexaminer.com/breakingnews/farming/the-origin-is-green-china-is-now-irelands-second-most-important-market-for-dairy-exports-885402.html

    [ix] Conor Finnerty, ‘Only 1% of Irish farms grow vegetables, the lowest in the EU’, AgriLand, October 22nd, 2016, https://www.agriland.ie/farming-news/only-1-of-irish-farms-grow-vegetables-the-lowest-in-the-eu/

    [x] Ibid, Press Release, An Taisce.

    [xi] Untitled, ‘Farm 2 Fork and Biodiversity Strategies Hold Firm on Real Targets’, Arc2020, May 20th, 2020, https://www.arc2020.eu/farm-2-fork-and-biodiversity-strategies-hold-firm-on-real-targets/

  • Review: Notes from an Apocalypse

    ‘We are alive in a time of worst-case scenarios. The world we have inherited seems exhausted, destined for an absolute and final unravelling’. So begins Mark O’Connell’s journey into our ever-darkening future.

    There are, he notes darkly, fascists in the streets and in the palaces, while around us ‘the weather has gone uncanny, volatile, malevolent’. The last remaining truth, O’Connell proposes, ‘is the supreme fiction of money, and we are up to our necks in a rising sludge of decomposing facts. For those who wish to read them, and for those who do not, the cryptic but insistent signs of apocalypse are all around’.

    The faint splattering sound that reechoes throughout ‘Notes from an Apocalypse’ is that of the shit hitting the metaphorical fan.

    ‘Listen. Attune your ear to the general discord, and you will hear the cracking of the ice caps, the rising of the waters, the sinister whisper of the near future. Is it not a terrible time to be having children, and therefore, in the end, to be alive?’, O’Connell muses.

    Familiar Journey

    The journey is a familiar one, in every sense. My mind flows back to early 2003, my first-born still an infant then, her future an unknown country. Out of the fog of broken sleep and newfound joys and terrors, I began, for the first time in my adult life, to look into the future. Not days and weeks, but years and decades.

    What I found staring back was every bit as chilling as O’Connell’s more recent epiphany, and it has, to a lesser or greater degree, haunted my waking hours every day since then. As he points out, once you’ve become a parent, ‘whether it happens by choice or by chance, is that it is one of only very few events in life that are entirely irreversible. Once you’re in, existentially speaking, you’re in’.

    This being the case, the next question effectively writes itself: How are we supposed to live, ‘given the distinct possibility that our species, our civilization, might already be doomed?’ While he may have lost hope, O’Connell certainly hasn’t lost his dark sense of humour, describing the curious feeling of being sick to death of the end of days. ‘I’m sick, in particular, of climate change. Is it possible to be terrified and bored at the same time?’, he wonders aloud.

    Back in the good old days of the Cold War, the spectre of global annihilation was never far away. And while the risks were all-too-real, in reality it was always a binary proposition: either we would have a total nuclear war or nothing at all would happen. And, with luck, cooler heads would prevail and catastrophe would be avoided.

    O’Connell notes that we civilians were pleasantly blameless, either way, mere bystanders ‘whose role was limited to cowering in terror, maybe holding the occasional placard, partaking here and there in a chant if called upon to do so’. In classical eschatology, the apocalypse, whether religious or secular, would be delivered in a blinding thunderbolt, ‘a sudden intercession of divine or technological power’.

    The very real doom that encircles us is altogether more banal, more insidious and one in which we are both helpless bystanders and active, albeit unwitting, participants. To be alive today, to live in a prosperous modern society is to be an integral part of the very linear system of consumption, expansion and disposal that is fast destroying the natural world and the very basis for our current prosperity and all future prospects for every generation that succeeds us.

    Image: Daniele Idini

    Footprint

    O’Connell acknowledges the thin irony that his own gloomy travelogue entailed vast emissions of the very carbon that is burning down the world. ‘My footprint is as broad and deep and indelible as my guilt… I myself am the apocalypse of which I speak. That is the prophesy of this book’.

    That ‘Notes from an Apocalypse’ should be published in the midst of the first global pandemic of the Internet Age seems grimly apposite, life in imitation of art as the confident certainties of our world unravel in unpredictable, non-linear ways.

    O’Connell vividly describes his growing obsession with the imminent collapse of civilisation. He sees himself as being obsessed with the future, ‘an obsession that manifested as an inability to conceive of there being any kind of future at all…my journalistic objectivity, a fragile edifice to begin with, was under considerable strain’, he adds.

    Many people seek to escape their demons. In this trade, that’s not so easy. ‘It is both a privilege and a curse of being a writer that throwing yourself into your work so often involves immersing yourself deeper into the exact anxieties and obsessions other people throw themselves into their work to avoid’.

    The book, O’Connell accepts, probably was initially conceived as a form of therapy, though he admits to what he calls a more perverse motivation: ‘I was anxious about the apocalyptic tenor of our time, it is true, but I was also intrigued. These were dark days, no question, but they were also interesting ones: wildly and inexorably interesting. I was drawn toward the thing that frightened me, the thing that threatened to tear everything apart, myself included’.

    This gave him the impetus to embark on a series of what he describes as perverse pilgrimages ‘to those places where the shadows of the future fall most darkly across the present’. Nor is the overtly religious framing accidental. ‘If I could be said to have had a faith in those days, it was anxiety—the faith in the uncertainty and darkness of the future’.

    O’Connell’s research took him into many dark places; he describes being unable to click on links in his computer’s browser ‘for fear that what I gained in knowledge I would lose in sanity—my online existence was saturated in a sense of end-time urgency’.

    In other circumstances you could reasonably infer that the author was in reality experiencing what is for all intents clinical depression, the key difference being that the auguries of catastrophe which he was consulting are not the product of his fevered imagination, but are a painfully accurate reflection of the world as it stands.

    ‘Preppers’

    Avoiding the sensible options of pouring his energies into what might be seen as more constructive channels, O’Connell ‘set out towards the darkness itself’. And where better to start than with the weird US sub-culture called ‘preppers’. This group consists almost exclusively of middle aged and older white males with an unnatural interest in dried food, assault rifles and racism.

    O’Connell is merciless in his depiction: ‘as a group, preppers were involved in the ongoing maintenance of a shared escapist fantasy about the return to an imagined version of the American frontier—to an ideal of the rugged and self-reliant white man, providing for himself and his family, surviving against the odds in a hostile wilderness’.

    In seeking to rekindle some imaginary frontier spirit, what preppers are in fact doing, he adds, is ‘creating the necessary conditions for a return to the cleansing violence of the nation’s colonial past … In fact, you couldn’t even properly call it crypto-fascism: it was really just good old-fashioned original-style fascism’. The National Geographic’s TV channel ran a series for three years called Doomsday Preppers; O’Connell gorged on many hours of it on YouTube as part of his research. While ostensibly about gearing up for post-apocalyptic survival, he believes the show ‘is in fact a reality TV psychodrama about masculinity in crisis’.

    Preppers, he concludes, ‘are not preparing for their fears: they are preparing for their fantasies. The collapse of civilization means a return to modes of masculinity our culture no longer has much use for’.

    While disagreeing with them in almost every regard, O’Connell admits to relating to the ‘distributed matrix of unease from which the certainty of collapse grew. I, too, with my pessimism, my intimate imagination of the world’s unravelling, had driven my own wife, if not to despair itself, then to somewhere in its vast and crumbling exurbs’.

    I can certainly attest to the strain that burdening yourself with documenting the slow, agonising death of the world imposes both on you as an individual and on your long-suffering spouse and family.

    O’Connell’s perverse pilgrimage takes him to the wilds of South Dakota where, for a price, you can buy a bunker with all the mod cons. This bug-out fantasy is being marketed and sold with the characteristic exuberance of the U.S. real estate industry. ‘This was a new entry into the apocalyptic imaginary: bankers and hedge-fund managers, tanned and relaxed, taking the collapse of civilization as an opportunity to spend some time on the links, while a heavily armed private police force roamed the perimeters in search of intruders. All of this was a logical extension of the gated community. It was a logical extension of capitalism itself’.

    At its cold heart, this amounts to the haves battening down the hatches against the have-nots, unequal to the bitter end. Unlike the old anti-nuclear war slogan, it appears that all men will not in fact be cremated equal. And nowhere is this inequality more apparent than in New Zealand, now the world’s favourite end-of-the-world bolthole for the excessively rich.

    ‘Everyone was always saying these days that it was easier to imagine the end of the world than the end of capitalism. Everyone was always saying it, in my view, because it was obviously true’, O’Connell continues. ‘The perception, paranoid or otherwise, that billionaires were preparing for a coming collapse seemed a literal manifestation of this axiom. Those who were saved, in the end, would be those who could afford the premium of salvation’.

    Image: Daniele Idini

    Backup Planet

    Next, O’Connell tagged along with the space colonisation enthusiasts, most notably oddball billionaire Elon Musk, who described Mars as our ‘backup planet…just in case something goes wrong with Earth’. Similar to doomsday preppers with their bags of dried food, ‘Mars colonisation is apocalyptic scenario as escapist fantasy’.

    What he describes as a narrative of exit is, O’Connell argues, fundamentally male, a yearning for escape ‘as a means towards the nobility of self-determination’. The world, our world, urgently needs attention, care, rehabilitation, yet the ultra-rich techno-fantasists are instead writing it off, dreaming of new empty spaces to subjugate, to colonise, to shape in their image, without state or societal oversight, a darkly Utopian fantasy played out on the blank canvas of the cosmos.

    ‘The politics of exit are pursued, according to cultural critic Sarah Sharma at the expense of a politics of care. ‘Care, she writes, is that which responds to the uncompromisingly tethered nature of human dependency and the contingency of life, the mutual precariousness of the human condition’. To repudiate the Earth is to reject the imperative of care.

    It goes without saying that the escapist daydreams of the wealthy elites envisage salvation only for the tiny handful; the mass of humanity will, it seems, be consigned to burn, fight and starve amid the smouldering wreckage of a plundered biosphere that has been asset-stripped to the bone.

    The intuition that many of the global 0.001 percenters actually seriously believe this stuff makes sense of a circle I have long struggled to square: how can tycoons and titans so blithely ignore the ever-encroaching ecological consequences of the profitable destruction they are orchestrating? Surely they too have kids, they must ultimately breathe the same air and drink the same water as the rest of us? Well, apparently not.

    The colonial mindset that saw groups of determined Europeans and later, Americans, set out to conquer, subdue and enslave every country on Earth they encountered that was incapable of fighting them off is alive and well, and the age of gunboat colonialism has been replaced by the more subtle but equally effective economic colonialism.

    East India Company

    Today, as before, ultra-cheap goods, minerals and raw materials flood out of the global South through trade channels controlled by powerful transnational corporations whose monopolies are operated every bit as ruthlessly as the East India Company, which enjoyed a royal charter giving it permission to ‘wage war’ and, at its peak, had its own army numbering 260,000 troops, twice the size of the then British army.

    The rape, pillage and plunder of the Earth has as a project been underway in earnest for centuries, but it is those of us alive in the 21st century and without tickets to Mars, who are about to reap the whirlwind.

    As O’Connell notes, capitalism, ‘which exists and thrives through expansion of its own frontiers, through a relentless force of deterritorialization, is running out of frontiers; running out of boundaries to obliterate, nature to exploit’. The legacy of what he terms its monomaniacal pursuit of cheap resources is a ‘devastated planet that soon may be unliveable for vast numbers of its inhabitants’.

    Just quite how soon and for just how many was to become clearer even as I was reading ‘Notes from an Apocalypse’. It came in the publication of a new peer-reviewed study using data from UN population projections and a 3ºC global warming scenario in line with current scientific projections.

    While we think of ourselves as a highly adaptable species, filling niches from the high Arctic to the tropical jungles, in reality, most human populations are concentrated into narrow ‘climate bands’ in areas where the average surface temperature is in the range of 11–15ºC.

    An average global surface temperature rise of 3ºC in the coming decades would leave some three billion people in areas with average temperatures as hot as the Sahara desert is today. Wide tracts of India, Australia, Africa, South America and the Middle East will, in just a matter of decades, be essentially uninhabitable for humans and most animals.

    Consider the impact of 2-3 million refugees fleeing the aftermath of conflict in the Middle East and how the impact of these desperate migrants strained the EU almost to breaking point. Now, multiply that not by 100, but by 1,000 and suddenly the idea of escaping to establish a colony on a barren neighbouring planet no longer seems quite so insane.

    Back on planet Earth, the Arctic is burning. ‘That there were wildfires in the Arctic Circle felt like the most important fact in the world. This was a thing we should never not be thinking about, talking about… the subtext of every news headline now, of every push notification, was that we were completely and irrevocably fucked’.

    Image: Daniele Idini

    An Island Apart?

    O’Connell, who is Dublin-based, recalls sharing office space with an ecologist, who told him people often ask her how Ireland will fare with climate change. Overall, and relative to so many other countries, actually pretty well, is the short, but entirely incomplete answer.

    ‘What would it even mean, after all, to be fine in the context of a drowning world, a world on fire? We were a small island, with nine hundred miles of coastline and an army that would by itself be effectively useless against any kind of invasion. We would be relying, she said, on the goodwill of other countries whose people were starving, drowning, burning. We would not be fine’.

    O’Connell’s meditation returns time and again to his own son, from whom he feels he is keeping a secret. ‘Just as I want him to continue believing in Santa Claus for as long as possible, I want to defer the knowledge that he has been born into a dying world. I want to ward it off like a malediction’.

    He outlines the complex denialism both he and his wife engage in to shelter their son and his newly born sister from true knowledge of the world as it is. ‘There are times when it seems that we are protecting him, and protecting ourselves, from a much deeper and more troubling truth: that the world is no place for a child, no place to have taken an innocent person against their will’.

    O’Connell strikes a universal chord by observing that becoming a parent means having a radically increased stake in the future. Being responsible for a person who must live in the place and time normally inhabited only by your deepest fears means ‘I no longer feel the definitive force of pessimism as a philosophy…life no longer seems to afford me the luxury of submitting to the comfort of despair’.

    In what may be a rich irony, O’Connell professes to having lost his taste for cosmic nihilism: ‘Lately I have been glad to be alive in this time, if only because there is no other time in which it’s possible to be alive’.

    While it might seem glib in the extreme to be seeking out teachable moments from the imminent collapse of the biosphere and the extirpation of our species among countless others, what does perhaps emerge from his journey is a deeper, visceral understanding of what it truly means to have been alive in the first place.

    Notes from an Apocalypse: A Personal Journey to the End of the World and Back by Mark O’Connell, Granta, London, 2020.

    Featuring images by Daniele Idini from a series taken on Mount Etna, Crateri Silvestri, Sicily in 2019.
    https://www.instagram.com/idinidaniele/
    https://danieleidiniphoto.blogspot.com/

  • Diary of Pandemic Doctor: Nursing Home Chaos

    It’s Saturday morning and I stand exhausted in line for my weekly shop, having left home without breakfast to get ahead of the despondency that might otherwise keep me indoors all day, despite the incongruent sunshine. I know at heart I am mostly there in hopes of some semblance of normal human contact. The phone rings as I wait. I answer to the now familiar voice of the coroner detailing the latest coronavirus-related death at the nursing home where I work as a doctor. My mind races through the expanding catalogue of names residing in the hastily fashioned ‘COVID wing’ and fixes upon her sunken face and heaving chest.

    Last I saw her, rendered unrecognisable behind sheets of dehumanising plastic, she clutched at my hand with her failing limbs and begged me not to leave. But in every room, each now unadorned with the usual ersatz trappings of home and identity one finds in nursing homes – photographs, homespun blankets, love letters from grandchildren – fellow residents lie awaiting their rushed assessments. Oxygen saturations, pulse and respiratory rate, a survey of existing co-morbidities, and finally resuscitation and transfer status to be revisited and revised: who might possibly be saved by hospital transfer, and whose last comfort would be the inevitable cocktail of morphine and midazolam, slipped quietly under the skin at intervals until death arrives.

    I have some forty patients to see before resuming my main function back at the practice in the afternoon. There I will take calls from many of those caring for the residents and triage their symptoms, almost inevitably caused by the virus that has taken hold in this seemingly forgotten corner of society.

    Across the hall, the atmosphere is suddenly lifted by the wit and humour of a ninety-odd year-old who has somehow escaped the dementia and delirium that pervades here. Unlike his fellow residents, this is a man who never wears his breakfast and is more recognisable to me in crisp shirt and tie, top button fastened. When we first met some months ago I doubted his cognition on hearing him shouting instructions to ‘Alexa’ across the room, but it turns out that I was the one that was out of touch. I look at his records – not for resuscitation, not for transfer. Despite his joviality, the oxygen levels already look poor. Given that it is still early on in the course of his infection, it is only a matter of time before he will crash and be gone.

    As the nation scrambled to prepare itself for the deluge of demand on ventilators, this was the kind of man who was never to have been deemed eligible. Yet in spite of the full newspaper spread photos of busy intensive care units, I know there is room for him, and that he has the will to live. Despite his age, were he to defy the admittedly poor odds, he has a quality of life to return to. We embark on the conversation that echoes a distant role-play from medical training which treads gently but directly on taboo. How is it you wish to die, and what interventions might be acceptable or worthwhile to try to prevent that?

    I tell him I feel he should at least consider a hospital assessment, and he accuses me of looking for the remaining half of the president’s cheque that he had promised to his doctor following his last successful visit to hospital some months previously. The next time I am at the home he is no longer there and I hope to God I have made the right decision in encouraging him to leave.

    On and on it goes, as the moisture accumulates under my mask and the goggles steam over. The delicate exercise of balance between connection and scientific detachment as I pass from room to room. Gaping mouths and vacant faces paint a poor prognosis, but even the most frail have surprised us to somehow come out the other side of this infection. To what quality of life, one may well ask. Does dementia provide some sweet oblivion to the horror of all of this? It is an ugly and brutalising process, despite best efforts from nurses and carers.

    Almost entirely recruited en masse from India, these are the compassionate and cheerful bearers of what society now refuses, at poor return to themselves. Let’s not forget that it is a business after all. Living on site in groups of eight or ten, they are simultaneously the protectors of residents and also the vectors by which many will now die. Left to their own devices by a distracted state and a self-preserving management structure (inevitably homegrown), they continued over recent months to meet their duties without full awareness or being properly equipped, and so the virus spread its wings to envelope the entire campus.

    Care facilities always tell a story with their decor. I remember a private hospital from training where a self-playing grand piano sat in the lobby. It was possibly the last place in the country I would recommend anyone actually falling ill. This centre is steeped in a dubious faux-heritage atmosphere of fake mahogany and red carpets. At one point there was even a Leeson Street nightclub type velvet cordon rope placed outside the entrance. Perhaps more than anything else these finishes are there to assuage the guilt families inevitably feel as they break a certain human code by consigning a loved one to an institution. Such is the society we have organised for ourselves. But in this situation the contrast between decor and reality is one of the utmost dissonance; all is well, while everything is falling apart.

    The airwaves and print media are bursting with opinion, analysis and occasional outrage as the crisis unfolds and consumes the institutionalised elderly. The great and the good understand and discuss, sounding wise and all-knowing. But week after week we are alone. Where is the calvary? Where are the boots on the ground? Who is going to help?

    I cease to sleep. I withdraw from friends and family, unable to explain how this has all come to affect me. On the telephone, I struggle to contain the emotion of the distressed families who have been kept away from their loved ones for months at this stage. Meanwhile, the underclass of cleaners, carers, assistants and nurses struggle on, now considered heroes without capes, but shorter staffed and more at risk than ever. Simultaneously caring for and infecting those they seek to serve.

    I break the rules and cross the city from odd to even postcode to visit my widowed mother at a remove. The atmosphere is a languid scene of early summer as dogs are walked and the dividends of lockdown are embraced. Garden parties are heard over walls and milestones of self-development and Zoom yoga classes are considered. It’s a different world. But perhaps it always was. On leaving I check my phone and see another two missed calls from the coroner.

    This is the third in a series of diaries written by different doctors confronting aspects of the Covid-19 Pandemic. If you are interested in contributing an entry drop us a line to admin@cassandravoices.com. Anonymity is guaranteed.