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| The 18 hair-pin bends on the road from Udunuwara to Mahiyangana, Sri Lanka |
Dean Martin - Oldies
https://youtu.be/tIEw7u3qCyU
Dr.
Fauci – Accomplishments
New Migraine drug
https://www.dailymail.co.uk/health/article-8262383/Wonder-drug-help-misery-migraines.html
For those who are inclined to be apologists for the UK
approach to deal with Covid: please read this article from the Financial Times:
When Dr Richard Horton turns up for our Zoom lunch, I feel a pang of
disappointment. I am at home but attired for a real-life work meeting: black
frock, inoffensive earrings and a dab of make-up. The editor-in-chief of The
Lancet, the prestigious British medical journal founded in 1823, “arrives” in a
black hoodie. He has apparently forgotten his light-hearted promise to wear a
jacket, though happily remembered that we are dining together. “Look, I’ve got
my lunch,” he says proudly, thrusting a brown paper bag towards the camera. He
offers to wait until mine is delivered. I am not surprised that our loose
sartorial agreement has crumbled in the face of his to-do list.
It was The Lancet that, in January, first published clinical
reports of a mystery pneumonia from Wuhan. Since then, a trickle of papers on
Covid-19 has become a torrent of crucial, freely accessible information helping
to shape the public health response in real time. That has landed the
58-year-old with an arguably more important secondary role: critic-in-chief of
the UK government’s handling of the Covid-19 outbreak. Since February, he has
accused ministers and their advisers of failing to see the coming storm,
keeping up a barrage of criticism in The Lancet, in newspapers and on
television. The UK response to the pandemic, he told the BBC on March 26, is a
“national scandal”. I go to the heart of the matter: does the government have
blood on its hands? “I’m not going to use those words, but I do believe lives
could have been saved had we acted earlier,” he says. “If we had used February
to scale up capacity for testing and contact tracing, and to begin surge
capacity for intensive-care bed use, it’s absolutely clear we would have saved
lives and saved the NHS. Even if it wasn’t the extreme lockdown we see now, we
should have been reducing social mixing and winding down economic activity,
like promoting working from home and physical distancing, so that we started to
cut the lines of transmission.” We are speaking against the backdrop of an increasingly
rancorous debate over the UK’s response.
He has despaired at how the science and politics of this
pandemic have been handled at every turn: from the lack of testing at the
beginning to what he says is the “charade” of the daily press conferences and
the “strategic failure” of the government to plan adequately. He, along with
others, has demanded transparency on the opaque epidemiological models that
shaped the UK’s originally laissez-faire response, which included floating the
idea of “herd immunity”. I have delegated the catering at my end to my
17-year-old daughter Rosa. She settles on an Italian via Just Eat. The doorbell
rings; a few minutes later, she serves me four slices of Hawaiian pizza and
waves hello to my interviewee.
Horton and I briefly discuss how unsettling the pandemic is
for children. Horton is sitting in a study with the obligatory bookshelf in the
background. He unpacks his lunch and angles his camera down to flaunt a
carefully arranged Mediterranean feast. His spicy meze platter comprises
chicken, homemade tzatziki and hummus, baba ganoush and fresh chilli sauce. I
can’t help feeling a little jealous. Horton has to be one of Britain’s
longest-serving editors. He joined The Lancet in 1990 and was appointed
editor-in-chief five years later, aged just 33.
He makes no apology for being overtly political. “Some of
the great advances, like the 19th-century sanitary movement and the birth of
the NHS, were not technical accomplishments but political struggles. The idea
you can strip out politics from medicine or health is historically ignorant.
The medical establishment should be much more politicised, not less, in
attacking issues like health inequalities and poor access to care.” Notably,
one of his idols is Michael Marmot, a London-based academic who has pioneered
the study of how social inequality affects health. The idea you can strip out
politics from medicine or health is historically ignorant It was studying
physiology and medicine at the University of Birmingham that first opened Horton’s
eyes to how other people lived. “I can remember as a student going into
high-rise flats where the carpets were soaked with urine,” he says. “The
bathrooms were completely unsanitary, the kitchens were loaded with unwashed
dishes and cutlery, and everywhere was dirt. I’d never seen anything like it
before.” After a middle-class upbringing he only discovered in his forties that
he was adopted, that his birth father was Norwegian and that he had five
half-siblings: “It was a shock. I went from being an only child to having this
enormous family. Being half-English and half-Norwegian changed the centre of
gravity of who I thought I was and I’ve been having a love affair with Norway
ever since.”
Horton has been labelled a left-winger by his critics. He rejects
the tag, saying he has voted Conservative, Labour, Liberal Democrat and Green.
His philosophy is, however, faithful to the spirit of Lancet founder Thomas
Wakley, a surgeon and social reformer once described as an “honest denouncer of
invidious distinctions betwixt the rich and the poor”. Wakley named the journal
after a surgical instrument and a type of window: it was meant to symbolise
piercing corruption and letting the light in. Accordingly, Horton has shone the
light of The Lancet on a range of political causes: he has praised the climate
protest group Extinction Rebellion, urging healthcare workers to join
non-violent protest; he published an emotively worded letter in support of the
people of Gaza penned by a geneticist in Italy later accused of having
anti-Semitic sympathies; and he ran a study claiming that civilian deaths
related to the Iraq war had been undercounted. None has made him the most
popular man in the room. Dr Michael Fitzpatrick, a GP and former Lancet
columnist, described Horton to me as “very personable and easy to deal with,
but a bit of a showboater and a pariah in the medical establishment”. In truth,
Horton has never been forgiven for publishing a 1998 paper by Andrew Wakefield
that raised unfounded doubts about the safety of the measles, mumps and rubella
(MMR) childhood vaccine. Despite years of controversy, the paper wasn’t fully
retracted until 2010, after the General Medical Council ruled Wakefield had
been dishonest (he was later struck off). The uncertainty caused childhood
vaccination rates to plummet and energised the anti-vaccination movement.
The MMR debacle became one of the biggest ongoing calamities
in public health. “There’s no escaping the serious damage that was done,”
Fitzpatrick tells me. “He [Horton] wasn’t apologetic enough about what
happened.” Does Horton regret what happened with MMR? “I’d be mad not to, but I
can’t simply retract papers I don’t like. There has to be due process [via the
GMC tribunal].” Has he ever come close to being sacked? “I don’t know,” he
smiles. “You’d have to ask my publishers. All good editors get fired
eventually.” It is time to change the subject.
We have a pandemic to discuss. When we meet, the shortage of
personal protective equipment among health workers is dominating media
coverage. Hospital trusts have threatened whistleblowers with disciplinary
action; Horton has offered to act as conduit for their dispatches from the
pandemic front line: “Workers have been bullied and forced to see patients who
clearly have or are suspected of having Covid-19 without PPE. When they raise
concerns, they are belittled or threatened. It’s horrifying to see the lack of
concern by some NHS management.” War zones, one doctor told him, are better
prepared than the world’s sixth-largest economy.
The NHS was left playing catch-up, Horton says, because the
government either ignored or did not act on information in a timely manner. The
first paper suggesting the existence of a new contagious virus appeared in The
Lancet on January 24. Horton now wants to know why that chilling assessment was
seemingly passed over in Whitehall. “Why wasn’t that paper read by the
Scientific Advisory Group for Emergencies, or the New and Emerging Respiratory
Virus Threats Advisory Group, or NHS England, or the chief medical officer or
the chief scientific adviser?” he asks. “We had all of these committees and all
of these offices and all of these organisations, but somehow they didn’t
connect. We’ve had the biggest science policy failure in a generation.”
He dismisses the idea that such a devastating outbreak could
only have been predicted with hindsight: “How can it be hindsight? It’s there
in black and white on January 24, written in a paper from China, telling
people, ‘Please act now, this is urgent, there’s a crisis.’ ” A week later,
another Lancet paper warned that, since the virus was no longer contained in
Wuhan, and that “self-sustaining outbreaks in major cities globally could
become inevitable . . . Preparedness plans and mitigation interventions should
be readied for quick deployment globally.” Blue Kitchen Mediterranean Cuisine
177c Priory Road, London N8 8NB Hot and spicy marinated chicken meze platter
(free-range chicken, fresh organic chilli sauce, tzatziki, baba ganoush,
hummus) £9.50 Highland Spring water Wood Oven Pizza 391 Kilburn High Rd, London
NW6 7QE, via Just Eat Tropicana pizza £7.99 Extra black olives 80p Service
charge 50p Total £18.79 Horton’s combative public persona conceals a personal
struggle: in 2018, he was diagnosed with advanced melanoma. His experience as
an NHS patient adds to his sense of outrage at the pressures facing health
workers. “I don’t think I’ve ever been in an institution where people have been
so genuinely kind and thoughtful,” he says. “That’s why I’m so angry that we
didn’t act sooner. I’m angry because I know how good the NHS can be.
Politicians and policymakers and scientists let down the NHS and its staff. And
that’s unforgivable.” The government is clearly rattled by such criticism.
A Sunday Times article entitled “Coronavirus: 38 days when
Britain sleepwalked into disaster”, published last weekend, drew a lengthy
rebuttal from the Department of Health and Social Care. The rebuttal includes a
quote from Horton on January 23 calling for “caution” and accusing the media of
“escalating anxiety by talking of a killer virus” to dismiss the idea that a
scientific consensus around a coming pandemic was building in late January.
The quote originated, he clarifies, from a tweet urging
caution on lurid coverage rather than government policy. Besides, the World
Health Organization declared a public-health emergency on January 30. “I do
think it’s a misrepresentation, absolutely,” he says. “Between January 24 and
31, there was daily mounting evidence and concern that this was tipping into a
pandemic.” Meanwhile, the scientific community is desperate to second-guess
what the virus will do next. “We are already seeing it’s got the potential to
come back,” he says, noting China’s uptick in cases. “That’s very worrying
indeed, and it’s why we need a vaccine as quickly as possible. “But there’s
still a vast amount to learn. Why did the outbreak take off so dramatically in
Italy but not Germany? Testing is one possibility, but we don’t know for sure.
Testing is absolutely crucial, and if we’re going to get out of these lockdowns
we definitely need to scale up our capacity.”
Western countries have fared poorly in their coronavirus response compared to
Asian countries, he thinks, because they saw the threat through the lens of
influenza. China and Hong Kong feared a rerun of Sars, a much deadlier illness,
and clamped down quickly. The cognitive bias, he says, has cost us dearly.
Horton also worries about complacency setting in once this pandemic has run its
course: “It would be very dangerous to say this is our 1918 [Spanish flu
pandemic], and to think these things only come around once a century. The
conditions still exist in countries for zoonotic diseases [which jump the
species barrier from animals to humans] to develop. We’ve had five or six of
them in the last 20-30 years.
This is the big one for now but there might be an even
bigger one to come.” I wake up and think I’ve got to make the most of every
day, because I don’t know how many I will have Rosa brings a coffee cupcake,
but we have moved on to talking about Horton’s cancer and it seems
disrespectful to eat it. It was his 19-year-old daughter Isobel, from Horton’s
marriage to paediatrician Ingrid Wolfe, who urged her father to get a mole on
his right temple checked out. Since his diagnosis, Horton has undergone surgery
three times and is left with scars and an uncertain prognosis. He is now on
immunotherapy. Every day is “the toss of a coin”. Therapy soothed his darkest
moments: “I thought I didn’t have very long to live, maybe weeks or months . .
. It was extraordinarily helpful to be able to sit in a room with someone who
is on your side and be able to say anything.” Solace now comes in the form of
books — currently The Birth of Biopolitics by Michel Foucault, on how
governments exercise power over the lives of their citizens — and a nightly
glass of Lagavulin whisky. He is still nervous about touching his face because
he fears to find cancer has returned.
But for now he feels — and looks — strong: “I wake up and
think I’ve got to make the most of every day, because I don’t know how many I
will have.” He will push for a public inquiry into the coronavirus pandemic,
and for the WHO to be strengthened, not weakened. The inaction that followed
the WHO’s emergency declaration, he clarifies, was down to member states and
not to China, to whom he says the world should be grateful to for its warnings
and containment efforts. That attitude might surprise those in the medical
profession who criticised China’s initial response to the outbreak.
But the idea that China should pay reparations for the
resulting economic losses is, he says, ridiculous, and he calls Donald Trump’s
decision to suspend WHO funding a “crime against humanity”. He is now writing a
book about why, despite the warning signs, the Covid-19 pandemic caught the
world by surprise. Meanwhile, that formidable to-do list leaves no time to
answer his critics: “You said earlier that people think I’m a pariah. Maybe in
previous years that might have upset me. But now? I really don’t care what
people think of me. If I’m not here in six months or a year . . . f*** them.
Seriously.” Anjana Ahuja is an FT science commentator Follow @FTLifeArts on
Twitter to find out about our latest stories first. Listen to our podcast,
Culture Call, where FT editors and special guests discuss life and art in the
time of coronavirus. Subscribe on Apple, Spotify, or wherever you listen.
Kumara
I received this from Dujeepa (Singapore)
Truth, wisdom, learning, and good
sense—these are worth paying for, but too valuable for you to sell.
Proverbs 23:
