We are told that Lockdown v3, now renamed Kier 4, in honour of the leader of Her Majesty’s Loyal Opposition and his staunch support for any lunatic measures Her Majesty’s Government may want to implement from time to time, is now in place across large parts of England as winter pressures mount to save lives and protect the NHS. The situation has been further aggravated in recent weeks by the arrival of a new variant of the coronavirus, with a screw loose in its spike protein. A week ago today, a bodged press conference by BlowJob predictably spooked the rest of the world, and with hours the rattle of chains could be heard across the globe as countries drew up their collective drawbridges against la merde anglaise. La solution française turned out to be to use dodgy paperwork based on dud test, the now discredited lateral flow test, but at least it got the truckers trucking. But how fares the outbreak back home?

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.

We should be used to Patti Valley’s scenarios by now, ready to spot them, and take evasive action. Certainly yesterday’s press conference was a classic example, with the scenarios being a barrage of novel speculations on the novel strain of the novel virus. Blowjob did his stuff as a man ordered to play Falstaff while suffering from light concussion, Whitty soldiered on with his weary undertaker act, but Patti was both sublime and supreme as the man with no slides. As the robotic camera stayed fixed on the man, the man averted his gaze to the invisible slides, and intoned a commentary of impending doom. Still the robotic camera stayed fixed on the man; perhaps the robot had picked the moment to take a comfort break. Still no slides. Still the commentary, like Hrry Crpntr doing his Wmbldn commentaries, nothing to see but still the sublime commentary carries on. Dr No never did get to see the slides on the screen during the press conference. Instead, he later downloaded them from here.   

Dr No recently came across a number of reports in the mainstream media suggesting that the median age of those dying from covid–19 was a little higher than the median age for all deaths: 82.4 for covid deaths, against 81.5 for all deaths. Putting aside the inevitable journomonologophobia that gave rise to a swirling word salad of averages, means and medians in the reports, the finding gives rise to the clinically intriguing possibility that the best way for elderly people to live longer in 2020 was not to bother with all that shielding nonsense, but instead get out there and catch the damn thing. On more sober reflection, Dr No wonders if one or more biases may be at work, but let’s for a moment consider that the reported findings are true. If they are, it gives yet more weight to the notion that the burden of covid–19 falls with greatest weight on the very old. If the median (middle value when all are ranged from top to bottom) age for covid deaths is 82.4, then half of all covid deaths occur in those aged 82.4 and over.  

All the people in England today being given the Pfizer BioNTech covid vaccine are necessary guinea pigs. They are guinea pigs because they are participating in the early post marketing surveillance of a vaccine that, at this stage, we know very little about. We will come to just how little we know soon enough, but for now we should note that they are necessary guinea pigs, because, given that an effective vaccine against covid–19 is a common good, the only way we are ever going to know more about the vaccine is by giving it to lots of people. That, bluntly, is how it has to be. But this context, of participating in a mass trial, means that informed consent, always of paramount importance, is, in this particular context, of dominant importance. The distinction here between paramount and dominant, which both mean supreme, is that paramount merely describes a position, whereas dominant adds an element of dominion: that which is dominant is not only above all else, it also rules over all else.

Ballistic is a word lumbered with two somewhat contradictory meanings. When we talk of someone or something ‘going ballistic’ — the colloquial use — we mean that one or thing has reacted explosively, with the focus on the sudden expenditure of energy, rather than what happened next. The more precise scientific use, however, is to describe the characteristic parabolic flight of a missile or other projectile during and after the explosive release of energy that has sent it on its way. This ballistic flight, or trajectory, has some very firmly defined features. It goes up, reaches its summit, or apogee, and then descends, until it hits something. Hard.

Three months after starting at medical school in 1976, along with his revered copy of Gray’s Anatomy, Dr No bought another book that was most definitely not on the official list of recommended reading. Called Limits to Medicine¹, by the theologian and philosopher Ivan Illich — an author said to be “extremely dangerous for people of moderate intelligence” — the book and the ideas it contains are better known as, and better described by, the first part of the subtitle, Medical Nemesis. The central premise is that, in the natural order of things, there are limits to what medicine can achieve, and should attempt; and if these hubristic limits are passed, then Nemesis will strike.