Health

Vice squad Donald Trump catching Covid-19 has concentrated minds on what happens if a US president dies in office. Normally, the vice-president will take over — which is why it matters who is on the ballot. In 1972, however, Americans had no idea who would end up president by the end of what should have been Richard Nixon’s second term. Nixon’s vice-president was Spiro Agnew, but he was forced to resign after pleading ‘no contest’ to charges of tax evasion. Nixon then appointed House leader Gerald Ford as vice-president. Ford became president when Nixon himself resigned before he was impeached over the Watergate scandal in August 1974. Ford lost to Jimmy Carter in the 1976 election and so was never elected by the American people in a national election.

How much should we pay to save life? The question is often viewed as distasteful: you can’t put a price on human life. But resources are finite. Even if the only purpose of life was to prolong it for as long as possible, there would be limits to healthcare affordability. So if resources are limited, how can their application be made fairly? And how can this logic be applied in a pandemic? One element when establishing a fair method is to consider life years saved rather than lives saved. This recognises that someone of my age (55), who has already enjoyed two-thirds of his likely life span, should be a lower priority for treatment than a child who has had barely a tenth of theirs.

You have to admit it, Operation Warp Speed is a good moniker. It’s the name for the American interagency programme, initiated by the Trump administration, to produce 300 million doses of a safe vaccine for Covid-19 by January. Who couldn’t get behind this all-hands national effort to defeat the virus and end the pandemic, excitingly named after the faster-than-light space travel in Star Trek? While we wait for clinical trials led by the University of Oxford and AstraZeneca in the UK, America warps ahead. Warp speed allows the Starship Enterprise to put aside the laws of physics. Vaccine development also has its own laws, or rather guides, that describe the way things usually happen.

What have we been witnessing these past few months? A worldwide crisis caused by the arrival of a new virus of exceptional virulence — or a crisis of awareness, in which incomplete information led to a wildly disproportionate reaction? Have lockdowns, face coverings and the rest saved millions of lives worldwide? Or have they had relatively little effect on the course of the pandemic, and ended up causing more harm than good? And why, so far, is Britain not seeing the surge of Covid-19 infections reported in Spain and France? What are we missing? We still know a lot less about Covid-19, and about viruses in general, than you might have been led to believe.

‘Hallo! You was callin’ us about appoint…MENT!’ said the lady at the scanning unit of my local hospital in broken English. Nothing wrong with that. It’s just that when I received a letter bearing the logo of a private company informing me of the details of my forthcoming MRI, I got all excited, anticipating efficiency. Although I was having it done on the NHS, the appointment came through swiftly with no mention of the health service on the paperwork, which raised my expectations. I rang to confirm, but after holding for a while I was told to leave a message and someone would ring me back. A few hours later came the cheery ‘Hallo!

The best way (and with politicians sometimes the only way) to know whether people are aware they’ve made a mistake is seldom to put that question point-blank. A reflexive ‘oh no I didn’t’ kicks in. Do you honestly think, for example, that government ministers are privately confident that as Covid-19 swept the country, hospitals were right to send elderly patients back untested to care homes, even with the limitations to our knowledge at the time? Of course not. But something stupid about British politics appears to constrain them from saying so. Possibly, before trying to persuade us, they have persuaded themselves they were justified; and we all do this to some degree.

Any day now I shall be frogmarched, or at least very firmly escorted, out of a blood donor centre in London. I know this is going to happen because I made the appointment weeks ago and I intend to keep it. But when I signed up to donate my pint of blood to the public good, I was not required to wear a muzzle during my donation. Now I am. I do not intend to do so. I find the idea of donning one of these face-nappies physically repulsive, and dislike the mouthless, submissive appearance they create in all their wearers. I also believe them to be futile. I know the government believes this too, because it was saying so only eight weeks ago, and there has been no great scientific discovery since then. But above all, I am severely distressed by the obligation.

I’m embarrassed every Thursday. I don’t mean to sound ungrateful. The outpouring of love for NHS workers at 8 p.m. each week has been touching. Who wouldn’t want to be clapped and cheered? But quietly among ourselves, many of us in the health service have increasingly felt it’s misplaced. I’ve come to dread it. It makes me wince. The fact is that the NHS is currently letting down thousands upon thousands of patients. When the dust has settled, I fear that we will be responsible for the death or morbidity of countless people. Since the pandemic hit, entire NHS services have completely stopped. I fear that this will have catastrophic consequences for the health of the nation.