Health

How do I know that Britain’s Covid crisis is over? The fakers are back. The hypochondriacs, the psychosomatics, the pseudo-fitters, the attention-seekers and the lonely. They’ve started to return to the acute medical ward where I work. They’ve been gone so long I actually almost missed them. This collection of patients, who take up time and resources inversely proportional to the state of their physical health, simulate symptoms for gain (malingerers), simulate/induce their symptoms for the pleasure of the sick role (Munchausen’s syndrome) or genuinely experience symptoms such as pain, seizures or paralysis in atypical ways with no physically identifiable or treatable cause (now vaguely termed ‘functional disorders’). Members of

Soon, as the rates of coronavirus deaths and infections plummet, we’re likely to focus more on those who suffer what is being called ‘long Covid’ — yet the truth is we know very little about what precisely it is. Long Covid began as a quiet murmur in the background: anecdotal stories about symptoms which extended beyond the predicted 14-day recovery time. There’s no agreed definition, so it’s hard to say how many sufferers there are, but a survey from the Office for National Statistics suggests it affects as many as one in ten of those who have had the virus. As the second wave retreats, the number of people left

Hippocrates prescribed it to allay lassitude, James Bond favoured it as a token of his manliness, and in less indulgent times Gordonstoun school insisted on it: the cold shower. And now it’s having a moment with the wellness brigade. (The very word ‘wellness’ used to send me screaming from the room: a Californian import, I was sure. Then someone pointed out that the word has been in the English lexicon since the 17th century, so that told me.) The proven physical benefits of exposure to cold water are impressive. A boost to the immune system, improved circulation, and a wake-up call to the body’s brown fat, which is apparently A

Is it ethical to lock us down again? This is not a facetious question. Over the past eight months, we have heard a great deal about the policies used to manage the virus, but very little about the ethics. This is a mistake. We should be asking how we can critically and reasonably strike a balance between conflicting values and interests. Yet even now, with so much at stake, this basic question on the ethics of our policies is not being properly asked. When it comes to public health, the ethical balance is simply expressed: how do you achieve a certain public health goal with the fewest restrictions on individual

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

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

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

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

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

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

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

The generational effect of the corona-virus is cunning and baffling. By often being so mild in the young and healthy it turns people into heedless carriers. By often being so lethal in the old and sick, it makes carriers into potential executioners of friends and neighbours. The virus is very dangerous for people who have certain underlying illnesses, which is probably the main reason it is so serious for the elderly. It is almost as if it does not kill people by itself, just worsens other disorders. This is unlike flu, where children are as much at risk as old people. By contrast, in this case, young people in good

So are we all going to die or is it going to fizzle out? In Naples the police drive along streets with loudhailers, warning everyone to keep indoors; in Britain the government declines to close schools, call off sporting fixtures and persuade people out of the pub. Something feels not quite right: either there is huge overreaction or under-reaction to Covid-19. Health Secretary Matt Hancock has not helped calm fears by announcing that the government has been working on a worst-case scenario of 80 per cent of the population catching the virus and 500,000 dying from it. It isn’t easy for the scientists, either. In a fast-developing disease there is,