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The UK government is putting my life at risk…again
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As I write this article, I am entering my fourth period of self-isolation, or as it is now called, quarantine. Since March 1st, I will have spent a full two months isolated from society including my closest family. But this time it’s different: I am entering self-isolation as someone who poses little threat to anyone else, but for whom a period of quarantine could put my health, even my life, at risk.
For those who have not read my fight with Covid-19, you might find my articles on my experience and my views on the government’s reaction to it, of interest: https://www.linkedin.com/in/teixeiradasilva/detail/recent-activity/shares/, or www.allaboutretirementoverseas.com where I have posted a subset of the articles.
The first time I self-isolated was in early March, on returning from a trip to Spain and Portugal. I had heard of a new virus that was spreading rapidly and that the best way to prevent its spread was to avoid contact with others. As a few people on our bus had been a bit sniffly towards the end of the trip, I voluntarily self-isolated. This at a time when the British government had no policy (does it have a coherent one yet?). Luckily I came out of the period fine, with no symptoms and my family also unaffected.
I returned to a cautious lifestyle. This was at a time when the UK government, headed by a truculent Boris Johnson, refused to allow British “independence” and “right to freedom” to be in any way undermined by an unseen enemy. Talk of herd immunity and the withdrawal of testing as something that the government felt was unnecessary to manage the pandemic, were the order of the day.
It was right in the middle of this no-social distancing, know-little-about-this-disease-but-don’t-think-testing-is-of-any-benefit period that I caught Coronavirus. Exactly when Boris Johnson thought that scientific advice was for weaklings. When he would not allow the indomitable British fighting spirit to be suffocated by a microscopic particle. After all, as was often repeated, the country had fought two World Wars, much sterner tests and a sure proof of character.
Boris Johnson’s U-turn after facing his own mortality in a London hospital, which fortunately ended happily with a little help from Portuguese and New Zealand nurses, was too late for many. Too late for the many who were released from hospitals into care homes without testing, too late for those infected by asymptomatic shop personnel and tellers who were infecting hundreds of people a day because no PPE or social distancing rules had been implemented, and too late even for those who had taken their social responsibility seriously by voluntarily isolating to avoid spreading the disease.
When the symptoms began to show, and they were unequivocally Covid-19 symptoms, my second period of 14 days of complete self-isolation began. Despite experiencing around 90% of all the classic Covid-19 symptoms, GPs, the NHS call-in service, and the ambulance service, insisted that staying at home and self-isolating was the best solution. For everyone else, clearly, except the patient. With the medical community living in fear of this unknown monster called Covid-19, the absolute refusal by all in the medical profession to even contemplate a referral to hospital seemed to me to be anathema. In desperation, we even called a private hospital to do some tests, but were rejected on the basis that they were following NHS guidelines! So much for independence…
By the time I had completed my second period of isolation, I was well past infectious. Again, fortunately, the strict rules of hygiene and isolation meant that my family remained safe.
Just when we thought the worst was over and I started to leave the house, undertaking some gentle exercise and exploring the world beyond the bedroom, I suffered something akin to a heart attack (I imagine, having thankfully never had one) or a knife attack (again, gratefully not a victim despite living in dangerous places such as Johannesburg, South Africa and São Paulo, Brasil). Shortness of breath, sharp, repeated pains in my chest, pain like nothing I have experienced before.
Despite classic symptoms of pulmonary embolism, doctors failed to follow NICE guidelines of sending me to hospital within 4 hours, but I did manage to find my way there around a week later. Lucky to be alive, and with severe damage to both lungs, including possible permanent damage, CT scans showed the source of the problem to be a clot in my right leg. My two-week forced isolation due to the disease had cause a DVT (deep vein thrombosis) in my right leg, and part of the clot had broken off and travelled via the heart and lodged in the lungs. Several clots, including a large one in my left lung, now meant blood thinners to give the body time to break down the clots while inhibiting others from forming.
I spent 24 hours in the hospital’s most contagious ward but was, ironically, the only patient not to test positive for Covid-19. My infectious phase had passed, yet because of the risk that I might have been contaminated again, back to self-isolation, for a third time, this time late April and early May.
As my wife is a key worker and as I was self-isolating again due to possible exposure in hospital, the family was finally “entitled” to be tested, months after I had caught Covid and after being in and out of hospital. Thankfully, all negative.
The end of the third period of isolation brought a gentle return to a semblance of “normality” as the UK started to open up its internal market. Debate in UK society moved from health to the economy and in particular the tourism sector. With UK residents desperate to get off the island and put some distance between themselves and the world’s second-worst Covid-19 infested country, there was shock when the UK government decided to impose quarantine on those travellers entering or returning from certain countries. “Unsafe” countries.
Debates about the injustice of a country with a higher infection and death rate placing restrictions on other, safer countries, became the new topic of debate, repeated every 30 minutes on many news channels. The British government, experts in statistical calculations, including methodologies and algorithms used as widely and efficiently as those for A-level results, were able to prove that the UK remained, in terms of ratio of people infected by population, and as long as the period of analysis was carefully selected, a lower risk than anywhere in Europe. After all, the country was an island and its borders were well controlled, with the increase of migrant boats simply the fault of the French who were not controlling outbound traffic.
The British government decided to impose a 14-day quarantine on entrants from many countries, and also reserved the right to, at very short notice, change their advice as to travel from these countries. Three of the main tourist markets, Portugal, which was placed on the blacklist and has never been removed, Spain which was granted a reprieve for a few weeks before being blacklisted, and France, where a scramble to return resulted in obvious breaches to social distancing rules, meant that the top three European holiday destinations became “non grata” in a matter of weeks. Tens of thousands were affected by the decision, travel plans thrown into disarray, unnecessary costs incurred, but most importantly, at apparently no additional benefit in terms of safety.
Just as the government has repeated its mantra of following the science in relation to Covid-19, so too we see that it is following its own, well substantiated advice that it “could be a gamble” to remove a country such as Portugal from the quarantine list despite the fact that hospital admissions in the country are falling, there is a lower number of intensive care patients, fewer deaths and continued high levels of testing.
For reasons I could not avoid, I had to schedule an unplanned trip to Portugal, knowing full well that on my return, I would be facing a 2-week quarantine that could prove dangerous to my health.
If the last time I had been forced, via the disease, to remain immobile and had, as a consequence, developed a DVT and thus multiple pulmonary embolisms, then logically there was now a risk that a second DVT might result, if I was unable to take exercise and was constrained to a limited physical space for another two weeks. There is no way on the government’s online system to declare a medical reason as an exemption to the quarantine.
Unless I am able to find a way to exercise enough in the confines of a single bedroom, then the probability of a recurrence will increase and the risk of a complicated, even fatal, further pulmonary embolism, remains higher than normal. Knowing the fate which awaited me on my return and the potential risks, I decided to see whether this procedure was warranted.
The totally arbitrary nature of the regulations became only too evident as I documented my travels to and from Portugal:
- We left the airport in the UK. On entry to the airport passengers were channelled via a single entrance and a remote temperature check was done. I assume that everyone was within the limits because no one was asked to stop
- There was absolutely no social distancing in the queues for boarding. The boarding line for a Jet2 flight departing to Spain ignored all social distancing rules. A number of passengers were not covering their face with a mask, and the exemption for 12 years olds (which seems both arbitrary and dangerous, given how youngsters can transmit viruses) seemed to extend to a few girls who were in their mid-teens. Neither Jet2 staff nor airport personnel asked any passengers to correct their behaviour and cover up. These are all potential risks leaving the UK and infecting other people in destination countries
- The waiting lounge was quite empty but some people did not wear their masks. Again, no one warned people nor corrected this behaviour
- One of the positive consequences of the Covid-19 pandemic is that the Ryanair “staging” policy, of holding people in groups at several stages of the boarding process, has all but disappeared. So the waiting at the ticket reader, then outside the terminal on the tarmac, then near the stars, then sometimes on the stairs at boarding, has been all but eliminated. Which just goes to prove that the issue is with flight capacity: with a half-full flight, the process is smooth, with a full flight, it is not. Observing the Jet2 boarding procedure, we ensured we were first in line to board our Ryanair flight, and were waved straight through without being in close contact with anyone else
- Once on the plane, which was a little over half-full on the way out and a little less than 50% occupied on the way back, a group of passengers were bunched in the centre of the plane. We were the only passengers wearing masks and visors. Ryanair staff did nothing to admonish people whose masks were not in place or fully covering nose and mouth. We noticed at least two. Cabin crew passed passengers time and again without doing a thing
- On arrival, social distancing went out the window as people flooded the centre aisle and were practically on top of each other. A simply instruction to ask people to remain in their seats and then leave one row at a time, would have eliminated this risk. We made sure we were last off
- Social distancing at Faro airport was better than in the UK, with floor markings clearly setting out where people needed to stand. E-passport stations were out of action. However, borders agency staff did not wear gloves and so any virus particles on passport surfaces could in theory be transmitted from infected surface to another surface. I had come prepared and was wearing gloves. Surprisingly, the Portuguese authorities did not ask for the questionnaire that was requested on the Ryanair site, which was supposedly aimed at aiding trace and track in-destination
- Baggage collection was quite empty, with people moving quickly out towards the exit
- A temperature check was in place and the arrivals area and the taxi and parking areas were all much emptier than usual for this time of year and felt very safe
- The entire week was spent in a private villa with an individual pool and outings were limited to the essential such as shopping, dealing with matters that took me out there in the first place and one trip to a distant beach which we knew was very large and where distancing was possible without any problem
- We did not witness any overcrowding scenes, such as those observed on Devon beaches during recent hot spells, on the beach we visited, nor on any we passed
- Shopping felt about the same as in the UK, with smaller spaces compensated the fact that everyone wore masks and security guards monitored mark usage and enforced anyone not complying. So while in the UK, perhaps shopping aisles are wider and more space to pass, in Portugal, there is a feeling of greater safety as mask usage means less risk of airborne transmission
- We decided not to eat out as we preferred to cook a variety of meals, in particular fish, that are not easily available in the UK. However, we were frankly a little put out by our experience in the “Eat Out to Help Out” scheme in the UK where, despite assurances from the local restaurant that a number of measures were being taken, the ineffectual nature of the table separators, the number of people touching door handles on the way in and out of the restaurant, the lack of use of PPE by children (again, there seems to be no evidence showing that children are any less likely to transmit the virus than other age groups), and the rather basic cleaning of tables after clients left, did not inspire much confidence. Our impression is that restaurants and pubs could well be a source of infection and the government may well have to choose between sacrificing them in order for schools to reopen
- On the way back, social distancing was once again the weak spot of the journey, mainly in the queuing for X-ray machines with a woman with (not so young) children requesting priority treatment and ensuring that all social distancing measures were broken. It is difficult why someone in that situation would not choose to purchase Fast Track for their (and others’) safety. Due to less than 50% flight occupancy, boarding felt safe and passengers observed distancing rules better. Again, we wee first to board which helped us to ensure maximum social distancing
- The return flight was characterised by a much more compliant set of passengers and I did not see anyone without a mask except when eating or drinking
- Passengers were distributed much more evenly than on the outbound flight
- On arrival, buses were limited to 20 people each but the damage, if any, had been done due to the same issue of people crowding the aisles and not respecting social distancing rules. An airline issue that could be easily remedied
- Parents allowing young children to break the minimum distance rule was a recurring feature of the trip, with the added risk that many of the children, due to age, were exempt from wearing a mask. The likelihood that a youngster transmits the virus via airborne particles, given that they are naturally more prone to be speaking excitedly, I would argue is much higher than with an adult
- E-passport stations were operating, but I selected the manual route. Borders staff used gloves to handle identity documents
- Baggage claim and airport concourse were empty and the parking area had few cars
Objectively, after this quick trip, it was impossible to conclude that the UK was a safer location than the Algarve (Faro) province of Portugal. If anything, a few things pointed to it being the other way around. These included the behaviour of people, compliance, and the general lower population density.
The international measure for country comparisons appears to be the rASMRs or relative age-standardised mortality rates. Data from Eurostat and the Office for National Statistics (ONS) shows that for the first half of 2020, the UK had 4 regions among the top 20 worst performing areas, including Brent, Ealing and Enfield, all in greater London, and Thurrock in Essex. Spain and Italy filled the remaining places, with no location in Portugal featuring on the table. England led the rcASMRs (relative cumulative ASMRs) for figures to end May, with a 7.55% and Portugal lagging with -0.91%.
As recently as the 6th August, the ECDC (European Centre for Disease Prevention and Control) reported that the EU and UK have reported around 10% of worldwide Covid-19 cases and around 27% of its deaths. Most of the new cases reported in the EU and UK have come from five countries of which the UK is fourth largest with 8743 cases. Portugal does not feature among the top 5, which are made up by Spain, Romania, France and Germany.
As of August 2nd, Portugal and Sweden reported a decrease of more than 30% in their 14-day incidence of reported cases, albeit remaining above 20 per 100,000 in population. While statistically Portugal remains above the UK when measured by population, the UK remains above all other European countries, except Romania, in the number of deaths per 100,000 in population. To argue that a country is safer than another when the number of people dying is greater, by a factor of around 2.5 times (13.8 in the UK versus 5.2 in Portugal), is not only confusing but also seems to place a higher importance on statistics than on life itself.
Ironically, the region (Midlands) from which I departed in the UK is ranked as stable while the region to which I was travelling (Algarve) reports a decrease in cases. As I write this, the UK has racked up its sixth consecutive day of more than 1,000 new cases.
A study published in the Annals of Internal Medicine by the Guangzhou Center for Disease Control and Prevention, showed that the highest risk of contamination, at just over 10%, occurred in the home, and so it would seem logical that, for example, potentially infected people being able to venture into the garden or even outside, while respecting social distancing, might even help to reduce this probability given what is known about the lower risk of contamination in outside spaces.
I am not naïve enough to believe that this story will sway this government into implementing more objective, fair and sensible measures to manage the Coronavirus pandemic. If the Prime Minister himself has repeatedly failed to accept responsibility for the direct cause and effect of his inaction, hesitation and U-turns, it is not a single article that will sway him from his swashbuckling way of governing. I don’t need to point out that thousands of A-level students in the UK await, indeed expect, a further U-turn (in fact, it happened the day after I wrote the first draft of this article) as the only way to salvage the mess that is the government’s A-level algorithm, developed one speculates with input from the same team that developed the UK’s “world-beating” track and trace system.
The government headed by Johnson must realise that its chaotic, often contradictory management of the entire Covid-19 crisis, has resulted in many unnecessary deaths and hospitalisations. It has also, without exaggerating the point, placed the lives of people like me at risk. Until we see a more coherent and consistent approach, ranging from the fair treatment of destinations to the effective control of the very laws and rules the government implements, it will continue to feel to the average citizen that the government continues to pay Russian Roulette with the health and life of the majority of people in the country.
Given the precautionary measures I have taken, if I or anyone who has come into contact with me gets Covid-19, it will be sheer bad luck. But if I suffer another DVT, responsibility lies squarely on the government’s shoulders.
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