In the mêlée that is Christmas 2020, Dr No yesterday came across a typical family that is being turned into mincemeat by the latest covid regulations. A typical thirty-sixty-ninety year old children-parents-grandparent family — singular grandparent because only granny is still alive, grandpa having split from this sceptred isle, this fortress built by Nature for herself against infection and the hand of war, from flu back in 2015 — they are spread out across southern England, with the children in London, and the parents and granny living together in Devon. They have adopted the Granny Ultimatum, that granny must be kept safe from covid, whatever the cost. With a heavy heart, they decided, even before the latest tier 4 restrictions were announced, that Christmas 2020 would no longer be a family Christmas. The children would remain in London, and the parents and granny would stay in Devon.

This set Dr No thinking. Once a family adopts the Granny Ultimatum, that granny must be kept safe from covid, which is another way of saying kept alive, whatever the cost, how does they ever unadopt the Granny Ultimatum? If keeping granny safe today is the ultimate aim, how can it ever be the case in the future that keeping granny alive is somehow now no longer the ultimate aim? Any such move could only happen by the unthinkable act of downgrading granny’s importance. By adopting the ultimatum, the family have condemned granny, at whatever the cost, to the hell of a life eternal, forever a prisoner of her families well meant but cruelly misguided intentions.

We could just as well call this the Covid Paradox. Once we adopt the seemingly logical intention to keep granny safe, whatever the cost, we are then trapped in an inescapable tragedy. We have passed through a one way door which admits no return. Lately, Dr No has come to see this as perhaps the most fundamental error in our response to covid, the upsetting of the natural order of life and death. We have forgotten Ecclesiastes 3:1-5:

1 To every thing there is a season, and a time to every purpose under the heaven:
2 A time to be born, and a time to die; a time to plant, and a time to pluck up that which is planted;
3 A time to kill, and a time to heal; a time to break down, and a time to build up;
4 A time to weep, and a time to laugh; a time to mourn, and a time to dance;
5 A time to cast away stones, and a time to gather stones together; a time to embrace, and a time to refrain from embracing

with the last verse included because the second half far from being prescient covid advice, it means instead a time to hold, and a time to let go.

Recall that 75% of those who die are seventy five and over, and getting on for half are eighty five and over, and almost all have co-morbidities. Covid is not a mass cull of the fit and healthy, it is instead a variation on the season at the end of life. Dr No writes this in his early mid sixties, and with many friends in their seventies. Though there are exceptions, the great majority would rather spend their days living life, rather than dodging death. 

When the family’s grandfather died in 2015, he did so peacefully, surrounded by his family. No one really remarked on the flu, or sought to track and trace whoever it was who had given him the flu; instead, it was just something that happened, something to be lived with even as it ushered in death. More importantly, though he died in the cruel harshness of early January, he did so after one of the family’s most joyful Christmases, a celebration of life and togetherness. But that was then, now so long ago. Should the Granny Ultimatum fail, as inevitably one day it must, and granny gets flu this coming January, she will die alone, with no joyous memories of Christmas 2020. And her conscientious doctor, writing her death certificate will, after careful thought and weighing of probabilities, put covid–19 on Part One of the form.


  1. James Robinson Reply

    Supporting your points above (which I agree with), care to comment (or, indeed ‘fact check’) Dr No…

    “The only people who need to be cautious are those who have symptoms. But no more cautious than any other time they have a cold. The chances of somebody WITHOUT SYMPTOMS infecting someone else who then dies are one in 30 MILLION.”

    • James Robinson Reply

      Admittedly not his field, but I believe within the twitter timeline of respected Telegraph and ‘Covid cartoon award winner’, Bob Moran @bobscartoons you’ll find the answers Dr No, as you’ll know what to look for and be able to identity his sources for further scrutiny.

      • dr-no Reply

        James – yes, source confirmed, but he doesn’t give a source! Furthermore, he doesn’t provide/explain his workings even when asked… (never a good sign).

        There’s quite a lot you would need to know to make that assertion: prevalence of asymptomatic infections (unclear, maybe 1/3 of all – but those ‘all cases’ aren’t cases, they are PCR positives, may vary with age, so gets murky very quickly), R number for asymptomatic infections (inherently difficult but not impossible to establish, need to follow up contacts of asymptomatic infections that you didn’t know about because they were asymptomatic…) and only then start thinking about the IFR in this subgroup (final outcome for infected patients infected by people you don’t know about…). The other WOBBLES are the CAPS and one in 30 million, almost half the UK population – odd to be so roundly precise at such a large number.

        • dr-no Reply

          James – have since come across this (Dr Clare Craig is OK) which says much the same in a roundabout way as Dr No’s previous reply – precious little data (because studies are hard to do) but puts a different (but OK – it’s asking a valid question: if we have precious little data, how can we ‘know’?) spin on the matter: Has the Evidence of Asymptomatic Spread of COVID-19 been Significantly Overstated?

          The point is that neither side (asymptomatic cases do/don’t spread covid) can prove their assertions correct, because of the paucity of data.

        • Annie Davenport Turner Reply

          Not the paper I was looking for, but I saw this reference to it today. Reckoning Dr No has seen about this piece of research, but in case not, and if it supports James’ thoughts, here it is.

          • dr-no

            The link (which Dr No has shortened to avoid overflow) is to a possibly agenda riddled American site (Dropdown options: Abortion, Faith, Family etc) but the paper the article is based on is interesting. It’s Chinese, and there may be a bit of tractor production is up (or rather, cases are down) about it, but the key bits for our purposes here are: 300 asymptomatic test positives in cross sectional survey of a population of almost 10m (so very low prevalence), and then no test positives in 1,174 close contacts of those asymptomatic test positives. It looks like the Ct (cycle threshhold) values were quite high, in the mid 30s, so we are in needle fragments in haystacks doesn’t mean you have a sewing machine territory, and that’s probably the biggest weakness of the findings: what exactly was the clinical status of those 300 asymptomatic test positives? If they were outright false positives (not at all inconceivable given ultra low prevalence) or effective false positives (viral debris left over from a some time ago infection), then all the paper shows is that non-infectious people are not infectious. All that said, what the paper doesn’t show is of some circumspect and vague interest: it doesn’t show that asymptomatic spread is rife. But of course the black swan gotcha applies here.

  2. Ed P Reply

    There’s a musical version, but I can’t remember the band.

    Delivering presents tomorrow to front doors. No contact with my grandsons. Xmas day will be not too bad, but Boxing Day I’ll be home alone. How I wish Boris would drop in – I’d punch the swine to the floor, as he’s to my mind redefined Boxing Day as “Punch a Politician Day”!
    If only the spineless MPs (regardless of party), would all rise up and demand Parliamentary action to nip this would-be dictatorship in the bud.
    Still, we can be amused by Hancock impending demise – no-one can make so many idiotic errors about a less-virulent variant (which has been around for months), causing havoc with transport across the water, and then continue to pretend to be a Minister.

  3. Patricia Reply

    It’s rather harsh I think. As a fit and healthy 72 year old granny I would prefer not to die horrid COVID Death or be denied a ventilator due to age

  4. dr-no Reply

    Patricia – and long may you remain a fit healthy 72 year old granny. As you are fit and healthy, and are just under the 75%/75yo threshold, and thirteen years off the 85yo threshold, there is every reason for optimism. If you were to get covid, and become ill enough to need admission, and happened to be under Dr No’s care, you would not die a horrid covid death, and you absolutely would not be denied a ventilator due to age (though they are less used now, so less likely to get one for clinical reasons, not because of age).

  5. dr-no Reply

    dearieme – thank you for solving the mystery of the spelling – Dr No knew it was a French word with accents but couldn’t for the life of him find it. Dr No lazily accepted melley as near enough. In your honour it now stands corrected, in French, in the original post.

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