On this day in 2020

Extract from the upcoming book,

‘Coronavirus–2020 Vision

A complete diary and events of the COVID-19 pandemic.’

- Keith Wright.

?KeithWright2021

TUESDAY 21ST APRIL 2020

Facts and figures.

823 deaths in the UK overnight.

70 in Scotland. (985 in total).

25 in Wales. (609).

9 in Northern Ireland. (203)

778 in England. (15,607).

17,337 total deaths in the UK.

535,342 tests done in the UK.

129,044 positive cases in total.

4,301 new cases.

17,681 are currently in hospital.

‘Ghost deaths.’

A note on indirect deaths. In earlier entries, Professor Chris Whitty mentions this phenomenon, this data takes longer to come through, but there are reports, for example, of 2,700 cancers missed each week due to fear of COVID-19. Scanning has been suspended some time, and doctors’ surgeries are 50% down on attendance. This lack of medical care, which would have otherwise taken place, but for the virus's existence, is the indirect consequence of COVID-19 and just as responsible for those deaths as catching the damned thing.

The ONS (Office of National Statistics) have published their weekly figures today. Remember, these figures relate to those COVID-19 deaths which have occurred outside of the hospital, in care homes, hospices, and people’s homes. It includes any reference to COVID-19 as a cause on the death certificate.

The figures show that for the week up to the 10th April 2020, there were an additional 1,662 deaths.

The previous week’s figures up to the 3rd April 2020 were 406 deaths outside of hospitals.

What do the ONS figures mean?

It shows an increase in deaths, as expected.

Statisticians state that this is a 41% increase in England and Wales on the official government figures for this period up to 10th April.

The real disparity of reported deaths up to the 10th of April is:

The government reported 10,260 deaths in hospitals in England and the ONS (including non-hospital reports) 12,516 deaths. This is a disparity of 2,256. 22% of the total reported.

The government death figures (hospitals only) for yesterday was 16,509.

These additional ONS, non-hospital deaths, makes the actual figure 18,765.

If the true figure of all COVID-19 deaths at 41% was extrapolated and added to the UK figure, instead of 17,337 it would total 23,274.

If added at the lowest existing percentage 22% of the total UK figure, it would be: 20,139

This is estimated as there is a lag in the ONS figures. There are still eleven days of non-hospital numbers to be added to catch up to today. These could be as high as an additional 3-4000 deaths. It suggests that we are, even at this stage, well over the twenty-thousand mark that was ‘hoped-for’ at the start of the virus last month, at best being circa 23,000 deaths overall.

Scandal.

Authors note–retrospective insertion–Further scrutiny of the complex data that the ONS submit has shown that for the week up to the 10th April 2020, there were 18,500 deaths of any cause. This is 8,000 more deaths for this one week than averaged over previous years. Deaths in care homes quadrupled that week, also.

Two-thirds of these extra 8,000 did not have COVID-19 recorded on their death certificates. Interestingly, there is a much higher reported death rate of flu and pneumonia amongst the 8,000 even outside the flu season. Are these ‘flu’ deaths COVID-19, or is it just a coincidence that flu and pneumonia deaths are much higher?

In a previous entry, I mentioned my views on Doctor’s reticence to diagnose COVID-19 as a cause of death, and these figures only strengthen my opinion. This additional data is not included in my conservative estimates above.

The Financial Times have one model, which suggests that today's correct figure for all deaths is not 17,000 but 41,000. This would be a catastrophic figure at this stage and would imply our strategy to deal with coronavirus has been completely awry in this country.

Why does this matter? I think it matters that as far as possible, every person that has passed away because of this terrible virus is acknowledged as such. Every number is a person, with a family and loved ones. It is their truth we are recognizing.

Daily news.

The trials of Hercules.

At the Jenner Institute at Oxford, the manufacturing of the potential vaccine will begin ahead of the trials finishing so that we could hit the ground running. If it is successful, there would be a global demand for billions of them. They hope to have a million ready by September.

In other interviews, Matt Hancock has said he will ‘invest in manufacturing capability,’ so if either of these vaccines safely works, we can make it available for the British people as soon as possible.

How does the vaccine propose to work?

Scientists have taken the DNA from the spike on the virus's surface and put it into a harmless virus. The harmless virus is from chimpanzees and is a cold virus modified to be safe for us. It is a carrier primarily to deliver the DNA and alert antibodies. This is the vaccine. Once injected it starts to enter cells, which then begin to produce the coronavirus spike protein. This prompts the immune system to provide antibodies and activate killer T cells, which should then recognize the coronavirus in the future and destroy it.

Professor Sarah Gilbert from the Jenner Institute team at Oxford said that she hoped up to 500 people would be part of the trial by the middle of May 2020. It is to be a ‘randomised control trial,’ and half the people would get a different vaccine or another placebo. The trial will take place in Oxford and Southampton, with three other sites added later.

An urgent appeal has gone out asking for volunteers to take part. They are being offered ‘up to ￡625.’ This does not seem a lot of money. People coming forward should be aged 18 to 55 and in good health.

The first person to be injected with the vaccine in the trials was microbiologist Elisa Granato.

The vaccine seems miraculous and ingenious, doesn’t it? An incredible testimony to the progress in medical science, whether it works or not, is another matter.

The government says they ‘are throwing everything at it.’ In other words, doing everything to facilitate the successful outcome of the project. Let’s hope and pray that it is successful.

More than 70 vaccines are in development around the world, but the UK, alongside the USA and China, will be the only ones doing human trials.

Authors note: To demonstrate how difficult this is likely to be, I will re-iterate that there are no vaccines available for any of the coronaviruses which exist in the world today.

To add to this note of caution, the Chinese have discovered that the virus has already mutated 33 times. A mutation is where a cell changes its make-up over time. It is this mutation that may explain why it has been more deadly in certain parts of the world. All viruses mutate, particularly RNA viruses like corona, it is expected, and is not always a bad thing that they do as this often leads to a weaker infection with an RNA virus. Researchers from Zhejiang University headed by Professor Li Lanjuan are making the claim that the pathogens have changed several times.

 (A pathogen is a biological agent that causes disease to its host. The term is used for agents that disrupt the normal physiology of a molecular animal or plant).

According to Professor Lanjuan, the deadliest mutations in the patients were in those from Europe. Milder strains were found in those in the United States. This disparity in the types of viruses shows how diverse the coronavirus and COVID-19 viral strains are.

21st century old Etonians.

Parliament is gearing up to re-start this week. For the first time in history, it is to be run virtually; up to 120 members of Parliament will be using the video-conferencing facility called ‘Zoom.’ At the same time, a maximum of 50 MPs will be allowed into the main debating room itself.

New measures will include large screens lining the chamber walls, hazard tape marking safe social distances. Only about two hours of proceedings will be held this way, with the rest taking place with the slimmed-down number of MP’s permitted to attend in person. Sitting days will be limited to Mondays, Tuesdays, and Wednesdays during the pandemic.

Foreign Secretary Dominic Raab is standing in for Boris Johnson for prime minister’s question time tomorrow, while he continues his recovery at Chequers.

One hundred scientists–two different questions.

One hundred scientists and medical experts are calling for face masks to be worn by members of the public when outside. The response is a concern that this could leave a shortage of masks for health workers. I mentioned this previously in the diary that the reasoning for people not wearing masks in the west had a political and practical slant to it. There is a pay-off.

The issue isn’t whether it would be helpful to avoid the spread of the disease, it is whether it can practically be done, and these are two different questions.

Prime Minister Boris Johnson has started to re-establish contact with world leaders and has had calls with the Queen and President Trump today.

Trump card.

During his daily briefing, Trump announces that he is halting immigration via the green card system for 60 days, initially. He says this is to protect American worker's jobs as he continues to ‘open up America.’

The USA total COVID-19 deaths rose above 45,000 today, doubling in the last week.

Author's note. Hydroxychloroquine mentioned by the President in earlier entries as being an excellent treatment sadly has no benefit and causes a possibly higher risk of death. The drug is usually used to treat malaria and lupus and rheumatoid arthritis. Dr Jeremy Falk, a pulmonary specialist at Cedars-Sinai Medical Centre in Los Angeles, said that they were using it on everyone originally, but now it is much more careful.

In one study, 28% of those given hydroxychloroquine and standard care died.

22% of patients who were given hydroxychloroquine and antibiotic azithromycin died.

Only 11% of those receiving standard care alone died.

 President Trump had declared hydroxychloroquine as a ‘game-changer.’ He said he was basing his comments on ‘common-sense.’ My view is that a lot of the problem here is the style of presentation, which is often style over substance with the President. However, I have to agree that if I were dying and there was nothing else other than that, I would have it.

5 pm Press Briefing – Matt Hancock, Secretary of State for Health.

There have been 8,331 offers to the government to supply PPE from countries around the world.

The government is now working with 159 UK manufacturers in PPE.

Some good news and some hope; what we already knew is confirmed by Mr Hancock that the UK is at the forefront of a global effort to create a vaccine. Two major projects are ‘live’ to discover a vaccine and are making positive progress. These are at Oxford University and Imperial University.

The government is supporting these by giving ￡2.5m to Imperial to support phase 2 and phase 3 of their trials.

The Imperial College London team has been testing its vaccine on animals since February 2020, and clinical trials are expected to start in June 2020.

They are giving ￡20m to the Oxford project who are working with the MHRA. The MHRA is the Medicines and Healthcare products Regulatory Agency. There is some hope with this project as it will commence human trials this coming Thursday, 23rd April 2020. To get to this stage would typically take years, not weeks.

Professor Van Tam showed some slides. He commented that new cases are still high (4301), and this is still a ‘dangerous’ time.

Peaky.

Hospital cases: London has peaked and is on a decline, but the rest of the country has not. They appear to be plateauing, but we are not yet out of danger.

Another week's figures have emerged from the ONS, and the UK line for ‘all cases’ on the graph is more visible from the cluster where it was previously hiding. As predicted, its trajectory is now above Spain, whereas the longstanding UK ‘hospitals only’ line is not.

Home testing kits will be sent out shortly to care homes and the NHS, hugely increasing returns. There will also be a mobile testing unit traveling around rather than the previous ill-fated system we have been adopting; expecting people to travel significant distances to go to a testing station. These new tests will pick up asymptomatic carriers. This test is not for ‘screening’ as people could be tested negative on one day and then contract coronavirus the following day.

Face masks came up once again. They continue to keep reviewing their worth. The scientists will change their advice if necessary. SAGE has discussed the matter today and will advise ministers. There was a further emphasis on not depriving PPE to health workers.

Authors note: As mentioned pretty early in this diary, I cannot help but be a little cynical about what is happening here. You do not need to be a Professor to understand that if you cough or sneeze while wearing a mask on a tube train, or in a shop, there will be less chance of infecting others if you are wearing a face mask, or covering of any kind, just on the expulsion of droplets alone. Why do surgeons wear masks?

I feel confident this is more about the concern over PPE becoming scarcer if they condone it. The paradox is that while ever this continues, and people do not wear masks in crowded places, it perpetuates more infections, casualties, and deaths, which creates the need for health workers to look after us, who in turn need PPE and face masks.

Shed.

We are learning more about the coronavirus. Some patients, begin to shed the virus even before they have any symptoms. Some, of course, are totally asymptomatic and shed the virus. They are carriers. The difficulty comes in understanding just how infectious these people are compared to those who have symptoms. It seems likely that those with symptoms, coughing, and sneezing would spread the disease more than others.

Visitors to the country through airports was raised at the briefing. Port of entry screening is a problem.

Authors note: I think the answer given to this is an example of science driving decisions, but not necessarily in the right way. I will explain what I mean. According to the scientists, we as a country are not checking temperatures or doing other screening at ports and airports because a flight usually is no more than 12 hours long. The incubation period for the coronavirus is anything up to 14 days. It is typically 5 days when there is no point in doing screening as those in the incubation period would not be detected having a temperature.

The science makes sense, doesn’t it? But how defeatists is this approach? What about those who are travelling that have symptoms? Some at least would be identified. Why aren’t people quarantined when they arrive? Or, if necessary, close the damned airport and ports?

In Australia, all persons entering the country are quarantined for two weeks, and the government authorities take you to the hotel themselves to make sure it happens. Here you just go straight home or to visit your family hordes.

Even during the bubonic plague, there was an understanding of the benefit of quarantining. The word ‘quarantine’ itself originates from this time in medieval Venice.

Venice was a gateway for the bubonic plague, and the city asked ships to stay for 40 days on an island called ‘quaranta giorni.’ This activity became known as ‘quarantine.’

Family life.

No ‘quiz night’ tonight. One of Jackie’s kids has decided they are having a ‘date night.’ It may take place tomorrow instead. But why not have the date night…oh it doesn’t matter.

Quote of the day:

‘It is difficult to say what is impossible, for the dream of yesterday is the hope of today and the reality of tomorrow.’ – Robert H. Goddard.

?KeithWright2021

‘Coronavirus–2020 Vision

The complete diary and events of the COVID-19 pandemic.’

- Keith Wright.

This day-by-day factual and complete account of events throughout the coronavirus pandemic, written as it happened, gives an incredible insight into what life was like during this tragic and historic pandemic in the United Kingdom and worldwide.

It includes facts and figures, government initiatives, news events, moving individual accounts, and the horrific consequences, as they happened each day.

There is also a daily, personal slant on what life was like for the author and his family during what threatened to be an apocalyptic event.

It reveals all humanity in its idiocy, compassion, and brilliance; the key elements, significant dates, statistics, human stories, tragedies, government strategies, the twists and turns, the humour, and the obtuse.

The coronavirus will define this generation and identify these times, like other rare global historical events such as the bubonic plague and the World Wars.

This book is something to show your children and grandchildren when they ask you what it was like during such a frightening time. It can also be used as a point of reference for historians, commentators, and educators. It is also merely for posterity.

Were you alive? Do you recall it? Do you remember our Prime Minister almost died with Covid-19? Remember, the Queen saying ‘we’ll meet again’ during lockdown? Surely you recollect the EU conducting ‘an act of hostility' towards the UK to get their hands on our vaccines? The thirty police officers fined for having a haircut, or the first man in the world to be vaccinated being called William Shakespeare from Stratford Upon Avon!

The whole world was plunged into chaos, with death, suffering and economic disaster. How did we cope? How did all of this happen? According to Keith’s wife, Jackie, it was ‘all because a man ate a bat.’

Keith Wright previously worked in leading Corporate Investigations for a global pharmacy retailer. He has worked on major Crisis Management Incidents alongside senior executives impacting across the world of pharmaceutical product management.

Critically acclaimed crime novelist, and former CID detective, Wright moves from fiction to a factual account of arguably the most historic natural event to blight humanity in modern times.

He has four children and lives in Nottingham, England, with his wife, Jackie.

All rights reserved ?Keith Wright 2021

Copyright?KeithWright 2021

If you are affected by any issues raised in the book contact:

The Samaritans or check local charities.

All information believed correct at the time of writing.

Diary entries gathered from an array of publicly available visual, audio and written sources and merged

to give a holistic and creative editorial view.

Glossary and source lists are available at the end of the book.

This book is dedicated to those who have lost their lives and the extraordinary bravery of front-line NHS staff, key workers, carers, and everyone who, in their own way, have contributed to help others. We are grateful, and we thank you, wholeheartedly.

Authors note.

My mother's first husband was killed in World War 2. His name was Arthur Smith. When I spoke with her about it, which, with hindsight, was too infrequently, she said he wasn't a fighter; he was a gentle, kind man, thrown into a hell with which he would struggle to adapt. He was an infantryman who died doing his duty for others, near Geel in Belgium, pushing through from the D-Day landings in 1944.

I use this as a loose analogy for our NHS heroes in the front line. These people are not emergency workers such as the police who are used to conflict and danger, nor are they like firefighters physically battling a fire and saving lives. These are people who have a caring disposition. (Not that the police and firefighters, don't care, bearing in mind that they risk their lives on a daily basis, but you see the point I am making).

 NHS front-line workers are sensitive to the human condition and understand the nuances of helping another human being survive illness and injury. They are also people who have now seen the effects of COVID-19 and the nightmare conditions it engenders. Every fibre of their being is focussed on kindness and caring. Yet they have to find peculiar courage. The courage to risk their own lives and possibly even their families lives to treat others every day. Not only do they have to wear a surgical mask, but they have to display the mask of quiet reassurance, professionalism, and positivity, despite their fears. They have to fight with decisions like holding a hand of an infected dying patient when your COVID instinct dictates you surely must not do this.

Dear reader, this is real courage. I hope they are well looked after once this is all resolved, and they receive counselling to help them recover from this incredibly traumatic time.

BEFORE WE START THE DIARY. WHAT WAS IT ALL ABOUT?

As I begin this diary, this is merely what is known as I make the entry; our knowledge will grow over the months and years.

 Coronavirus is a respiratory virus discovered in 2019. In lay-person terms, it causes the lungs to clog up, inhibiting the oxygen supply to the blood, and eventually causing organ failure. Its potency is in how virulently contagious it is. Coronavirus is the virus that leads to the disease COVID-19.

It is believed to be a zoonotic illness, meaning it jumped species to infect humans. Researchers believe the most likely source is the Rhinolophus sinicus, otherwise known as the horseshoe bat which was consumed having been purchased from a ‘wet market’ in Hubei Province, China.

COVID-19 was originally known as 2019-nCoV. It stood for the year of its discovery - 2019, the fact that it was a new (novel) virus (n), and it came from the Corona Virus family (CoV).

 The name was changed to COVID-19 when it became a pandemic. The World Health Organisation had to allocate a name for the disease that did not relate to a person; a group of persons, an animal, a geographic location, was pronounceable, and relatable. Beyond this, the formal name for the virus given by the International Committee on Taxonomy of Viruses called it the 'severe acute respiratory syndrome coronavirus 2' or SARS-CoV-2, because it is related to the virus that caused the outbreak of SARS in 2003. For the avoidance of doubt, it will be referred to by the name everyone uses; COVID-19 or ‘Covid.’

Early analysis of the virus suggests that two main strains exist, designated L and S. The L strain appears to be more prevalent (70% of cases); however, it is the S strain that is the ancestral version. L strain appears to be the most aggressive and spreads quickly. It should be noted that this is a new virus to humanity, and we are starting from absolute scratch in our understanding of it. Even as knowledge grows, the chances of mutation are possible, if not probable, and suddenly all bets can be off.

 The coronavirus is transferable by hand to mouth from surfaces or contact and close proximity with someone affected. As with all such viruses, droplets, contact, or airborne particles also spread it. It causes a continual dry cough, breathing difficulties, and some aches and pains. Latterly we discovered a loss of taste and smell was also a major symptom. It is a mild-to-moderate condition for 80 percent of those who catch it. However, older people and those with underlying illnesses are at a much higher risk of death. As the disease progresses, we see more and more younger able-bodied people in intensive care and dying because of the virus. The World Health Organisation state that 3% of those contracting it will die. There is no cure and no vaccine.

The virus uses its outer prongs to lock on to a living cell. It then inserts its genetic material (RNA – Ribonucleic acid) into the cell. Once inside, it hijacks the machinery of the nucleus of the cell to make numerous copies of itself. It then destroys the cell, and the copies burst out and spread, to do the same thing to multiple other living cells and so the cycle continues, with the virus growing and multiplying exponentially.

The incubation period in a human can be anything from 0 to 15 days. Some people are asymptomatic and are oblivious to having caught it. Most people's immune system mounts an appropriate response, and they begin to feel better after around 5-7 days after a debilitating flu-like illness. In some people, the immune system goes into overdrive and starts attacking the lungs and other organs and the coronavirus. Infection can cause pneumonia, breathing difficulties, and further organ damage. In others, the immune system cannot cope, and they die. Some can appear to have overcome it and then deteriorate rapidly and die in a day, often with hypoxia – lack of oxygen. Some have been in a coma for 60 plus days, yet still, survive, but forever scarred and impaired.

It is reported that the first case of the disease was presented by a 55-year-old man in Hubei Province, China, on 17th November 2019. It spread and was located in Wuhan Province, China, a month later, in December 2019.

Other theories have emerged around the virus' origins:

• The eating of a diseased bat (or Pangolin) at a wet market. (This seems initially to be the most likely. ‘Pangolin and chips please, no vinegar.’).
• A leak or intentional dispersal from the biological warfare lab in Wuhan, China.
• It began in a region south of Wuhan as early as September 2019. Cambridge scientists are exploring the September theory by tracing pathogens. Humans could have carried this earlier outbreak well before it mutated into a more lethal form.
• Others suggest that traces of feces in Italy’s sewerage show the virus earlier than it began in China in the summer of 2019. This was later corroborated by research into blood samples of cancer patients taken in early October 2019 which had COVID-19 antibodies present, which means they would have had the disease in September 2019.

Regardless of the exact trigger point, the coronavirus was initially thought to have arrived in the United Kingdom on 28th February 2020, and the first confirmed case being on 31st February 2020. In August 2020, samples by the University of Nottingham discovered that the earliest person to contract and then die with the virus was a 75-year-old woman from Nottinghamshire who tested positive on 21st February 2020.

It is now understood that a traveller returning from South Korea on 28th February 2020 most likely caught the virus in Nottingham rather than Korea as first assumed. Professor John Ball, one author of the study, said ‘there was widespread community transmission of coronavirus’ in Nottingham in early February 2020.

In the UK, we have the National Health Service (NHS). This means that medical care is free at the point of need for all its citizens. The working population pay for this service through their taxes. Each country around the world has different healthcare systems, some insurance-based. The NHS does not have any added complications around whether someone can afford to pay for their care through insurance coverage or otherwise.

Key players in the management of this crisis in the United Kingdom are:

Boris Johnson; Prime Minister,

Matt Hancock; the Health Secretary of State,

Dominic Raab; the Foreign & Commonwealth Secretary of State (deputising for the P.M.),

Rishi Sunak; The Chancellor of the Exchequer,

Professor Sir Patrick Vallance; the Chief Scientific Advisor and chair of SAGE (Scientific Advisory Group for Emergencies),

Professor Chris Whitty; the Chief Medical officer for Public Health England,

Professor Jonathan Van-Tam; Deputy Chief Medical Officer for Public Health England.

The virus has caused tens of millions of infections and millions of deaths worldwide, creating a global lock-down and an almost dystopian planet of death and deserted streets, never experienced in modern history. Some describe it as an apocalyptic disease. The fabric of society is changed with people told not to socialise and to stay at home. These changes have a massive effect on our way of life, the economy, and family interaction. What will life be like when we come blinking out of our homes in months or years ahead, assuming we survive, into a new world that is changed forever?

Our hope is for a vaccine, yet this is impossible for many months, probably years, if at all. Sadly, the world has been unable to develop a vaccine for any of the previous coronavirus such as SARS, (or even the common cold, which is part of the coronavirus family), so it would be remarkable if they do so with this one.

Immunity after the disease is unclear. There is nothing to suggest that previous sufferers have immunity, nor for how long it will last if they do. There is even the danger of those recovering from COVID-19 gaining, something known as 'enhanced immunity.' This relatively unknown syndrome happens with Denghi fever, which means you get the disease far worse the second time.

I start this diary uncertain whether I will be alive to finish it or sustain it if I become one of the coronavirus victims. Will I be too ill to continue? Will I die? Things change day-to-day, and suddenly the future is more uncertain than ever before in my lifetime.

No one would have believed, a matter of a few short weeks ago, the changes that this vicious, dangerous pandemic would bring to our lives: the deaths, the uncertainty, the trauma, the separation, and the loss.

This book is intended to bear witness, record statistics, collate news articles, personal stories, front-line accounts, precis government briefings, and offer an intimate view of family life during this historic and tragic period in the year 2020 and beyond.

Release date July 2021.

?KeithWright2021