Day 7

Monday, March 9th

I wake up this morning to find that the Lead Employer would like sick notes for our ‘enforced’ self-isolation. I physically have not received an email about this but have heard about it from my colleagues on our group chat…I am not sure about the logistics of this as we are not allowed out of the house and as the GP cannot see us they may not be able to provide a retrospective sick note. I have sent a message to the twitter world asking the opinions of GP colleagues. I await their response. One of my colleagues on the #SelfIsolating WhatsApp group said that they contacted their GP and informed them that they have moved within the last month…literally two roads away from his previous address…however as they are not in the catchment area anymore they should sign up with another GP….as you can imagine my colleague is really frustrated and now has no GP…not ideal!! I cannot understand why the Lead Employer are requesting this….However, on reflection, I actually think this will all be ok..as this is unprecedented times and no one knows what to do…I believe our own specialties will support us through this…I guess the managers have been asked a question…to which they do not know the answer to currently…so it’s a general ‘stick with what we know’ answer. I have rung my GP and they are “considering” my request…Interestingly another colleague on the WhatsApp group has had a similar experience to me…This is all very silly. Another colleague (different profession) on the group chat has told us about an e-roster system that seems to have acknowledged the issue and updated their system so that, if an employee has reported an absence related to Coronavirus, the person affected is searched on the e-roster and the dates checked for that individual. This is all very sensible and I cannot understand why another department cannot follow a similar path. Another colleague on the group chat has just contacted to say, they spoke to a friend who is GP – and they think we should insist it’s an occupational health issue. If we get a stick note its sort of us agreeing that we are sick when we aren’t. Ultimately, we got exposed by following a policy. Literally just another ping on the Groupchat….someone is also in transition between GPs….so feels that occupational health may need to step in…and in their case…they have had to cancel a holiday and in order to get their money back (talking of £1000s), they will need a medical note!! Someone has looked at their GP practice website to look at getting a sick note…only to find the following statement, “A group of GP practices has banned walk-in appointments to try to stop COVID-19 spread..” meaning that they may struggle to register for a GP…anyhow that would have to be after the isolation period…

My Groupchat buddies have been having a conversation on how this self-isolation experience has been affecting them…It seems that to them, sleep discipline is not what it used to be. I have to admit, I normally get up at 0515Hrs every morning…now its 0830hrs…Obviously, this will all have to change when I get back to work…and to those who think I am on a holiday…I can definitely confirm I am certainly not…. This is a mentally draining process especially with the uncertainty presented to us by bureaucracy we work in… I think this whole affair is becoming very tiring….PING…another message on the group chat… I think someone wanted to lighten the atmosphere… and posted up https://twitter.com/DickKingSmith/status/1235850734882545664 Basically it is a Gila monster dancing to a Hall and Oates track…with the comment, Monday delirium has set in…very funny…I tried to put an academic side to the message by informing my fellow WhatsAppers that Exenatide is a synthetic form of a protein found in the saliva of the Gila monster that mimics the action of glucagon-like peptide-1, an incretin important in glucose homeostasis and deficient in patients with diabetes mellitus https://www.telegraph.co.uk/news/uknews/1550871/L. I inform them that Ely Lilly tried to prevent other drug companies from discussing the relationship between Exenatide and Gila Monster saliva as Ely Lilly (the product license holder at the time) felt that potential users of this medicine might not like the idea of using something sourced from the spit of a Gila Monster!. The original sender of the tweet naturally, “Jesus – I was only posting a video of a lizard strutting like a boss to a tune”…To which I reply…”Once a Pharmacist, always a Pharmacist”….Meanwhile, a caring parent has sent a ‘care package’ to them (WhatsApp Groupee) but it needs signing for…and guess what! They cannot sign for it! You couldn’t write this!! The conversation turns to feelings of whether the public is in denial with what’s going on or whether we are not being given all the information on this subject. I can imagine this is quite difficult for the authorities…especially as so much is still as yet unknown…The pings are coming in thick and fast….One person suggests that we stick together as a group with regards to sick notes…They too feel that it is an occupational health issue and since our self-isolation was related to occupational exposure, our self-isolation leave should be treated as such! Surely only our employer can confirm that we have been asked to self-isolate…as mentioned earlier. How can a GP be expected to know whether a request is a valid claim? Would we have to send copies of the texts from PHE, or emails from our place of work?

I wondered if the self-isolated nurses are experiencing a similar issue…I am not in their group but one of the doctors are…They comment that the nurses seem very quiet on the sick note matter and so it may not be an issue to them….I ask if they could ask the nurses about this issue…They reply back saying that they think we should try and sort us out first before causing a mass calling into the Occupational Health department…additionally she did not wish to cause panic within the nurses on this matter…..I suggest that they may be text someone privately, someone who is level headed…to which they agree….Meanwhile..

PING….another message…Three British skiers have been hospitalized in Austria with coronavirus after contracting the ‘most aggressive strain’ in Italy.. https://www.dailymail.co.uk/news/article-8091313/British-skiers-hospitalized-Austria-coronavirus.html …

PING…A friend of one of the WhatsApp Groupee has sent them a board game to ease the boredom…called Pandemic https://boardgamegeek.com/boardgame/30549/pandemic Only thing is that it is for 2+ players…not helpful for a self-isolatee…I suggest that we could play a multiplayer game via FaceTime or Google Hangout…. No response though…maybe people are not in the mood for this… especially with what has been going on this morning….Meanwhile back to the GP sicknote issue…One of the group members contacted someone from the BMA about the subject…who replied back saying, “Sicknote is ridiculous, especially as in any other circumstance if occupational health tells you not to come into work, then you don’t produce a sick note”….hopefully the BMA can help us with this situation. It’s interesting I have had no reply as yet to my twitter request that had the BMA

Dealing with this has taken me around 1.5 hours….30 min for breakfast…my usual nutribullet, checking emails and updating myself on current affairs of the world….Talking of which….Currently, on the BBC News website, https://www.bbc.co.uk/news/live/world-51796781 The death toll in Italy has jumped by 133 from yesterday and the number in the US has exceeded 500…In Iran, the death toll is 237. 319 people have now been tested positive in the UK…up from 273 yesterday https://twitter.com/DHSCgovuk/status/1237015402028335105?s=20 ….Meanwhile, a cruise ship rejected by Thailand and Malaysia will dock in Singapore tomorrow. The France England Six Nations rugby match has been cancelled, the Indian Wells ATP 1000 tournament has been cancelled, British Airways and Easyjet have cancelled Northern Italy flights, meanwhile, a Pakistani man has sued his ex-wife over coronavirus accusation. The man who recently returned from China had to spend two weeks under medical observation on a court order but was found to be healthy…He claimed his ex-wife wanted to prevent him from meeting the couple’s minor son who lives with his mother. She said she feared that her child could get the infection from his father…. These are clearly challenging times…The Olympic torch lighting ceremony in Greece before travelling to Tokyo will now take place without spectators….Considering the cancellation or postponement of various sports events, I am surprised that our son Euan who will be playing at a British Tour on Wednesday is still scheduled to play. It is a public event hosted by the Lawn Tennis Association…Although the culture secretary Oliver Dowden has said that sporting events in Britain are unlikely to be affected by coronavirus in the immediate future…He stated “I was at Twickenham [for England v Wales] with the Prime Minister [on Saturday],” he said. “There was a huge crowd of people there. There is no reason why people should not be going to those events. It is very premature to be talking about things like that.” …adding that the advice was based on the current guidance issued by medical experts… Apparently the Chief Medical Officer had briefed sporting bodies last week and that they (the government) will follow their advice https://www.bbc.co.uk/sport/51777154 …I guess with what’s going on internationally we will have to wait and see what happens….The game between Paris Sait Germain and Borussia Dortmund will be played behind closed doors https://www.bbc.co.uk/sport/football/51800667

Ok….Home exercise time…kettlebells and dumb-bells out and insanity video on youtube…. I think these sessions have been keeping my sanity

Meanwhile, I have just come across this website, https://criticalcarenorthampton.com/2020/03/08/covid-19-your-one-stop-resource/ Hosted by the Critical care group in Northampton, it aims to provide information from a single resource, as up to date as possible, on everything to do with Coronavirus. From personal experience, there is a lot of information out there, and I have spent hours trawling the web, reading news stories and hearing one thing, then another contradicting the first! For me, it complements the advice given by the Royal College of Anaesthetists (RCoA) https://rcoa.ac.uk/safety-standards-quality/guidance-resources/coronavirus-covid-19

Meanwhile…latest update from the BBC at 1415hrs, Coronavirus: UK to remain in ‘containment’ phase of response https://www.bbc.co.uk/news/uk-51796072 and that measures to delay the virus’s spread with “social distancing” measures will not be introduced yet, ministers said….I cannot understand this position considering the exponential rise in positive cases…I get that most cases will be mild…but then what about our elderly with multiple co-morbidities. The issue is that it is not being contained. It is already out there. We are apparently two weeks behind where Italy is currently, so why not learn from the lessons?…although this was updated at around 1800hrs with the government suggesting that people who show “even minor” signs of respiratory tract infections or a fever will soon be told to self-isolate in an effort to tackle the coronavirus outbreak. The UK government’s chief medical adviser said the change in advice could happen within the next 10 to 14 days https://www.bbc.co.uk/news/uk-51807781 People will be asked self-isolate for seven days after showing mild symptoms under the new approach…So, as far as we are concerned, the government has now confirmed that “containment” the first phase of the government’s four-part plan…The other phases are described here https://www.gov.uk/government/publications/coronavirus-action-plan/coronavirus-action-plan-a-guide-to-what-you-can-expect-across-the-uk The phases include, “delay phase”, “research phase”, “mitigate phase’. In summary, the government page describes these phases as follows,

The overall phases of our plan to respond to COVID-19 are:

• Contain: detect early cases, follow up close contacts, and prevent the disease from taking hold in this country for as long as is reasonably possible
• Delay: slow the spread in this country, if it does take hold, lowering the peak impact and pushing it away from the winter season. This is Social Distancing…i.e. “keep your distance”. In this case, keep yourself greater than 2m apart.
• Research: better understand the virus and the actions that will lessen its effect on the UK population; innovate responses including diagnostics, drugs, and vaccines; use the evidence to inform the development of the most effective models of care
• Mitigate: provide the best care possible for people who become ill, support hospitals to maintain essential services and ensure ongoing support for people ill in the community to minimise the overall impact of the disease on society, public services and on the economy

I do find the ‘research’ phase strange. Surely with the data from the WHO and from the experience internationally, research should be higher in the itinerary. Anyhow…containment includes adequate hand washing…and if anyone wants a decent run down into what to do, try the following….that is if you are into rock/ indie but Foals new music video is just 20second clips of handwashing techniques. https://www.youtube.com/watch?v=jNFwQLRHS8U&feature=youtu.be Some feel that the government should be doing more. Tory minister Rory Stewart says the Government should immediately close schools, stating Boris Johnson’s response to the coronavirus outbreak was ‘half-hearted.’ But then there are those sticking with the Government on this and feel that further intervention will pander to the alarmist…what challenging times.

Unfortunately, two more deaths were reported today attributed to coronavirus…Both patients, who were in hospital in Wolverhampton and Epsom respectively, were in their 70s and had underlying health conditions…Thoughts are with their families. This takes the number of deaths to four….

Back to the group chat and #SicknoteGate….one of the guys has contacted one of the consultants who with all the ICU team have been legends…about the sick note issue…and they said that they will kindly assist with this…they are also going to kindly write a supportive note so the individual who had to cancel their holiday because of this can get their money back…meanwhile the BMA has got back to one of the team…They clarified that we should not need sick notes…It has nothing to do with statutory sick pay…as this is word for word from NHS England’s guide for trusts regarding COVID-19…”“Ensure that any member of staff, including bank staff and sub-contractors, who has to be physically present at an NHS facility to carry out their duties, receives full pay for any period in which they are required to self-isolate as a result of public health advice.”…which just shows that the powers at be dealing with our issue are not au fait with what NHS England is requesting…..It turns out one of the team has now got a sick note from their GP….however as a group we decide, for solidarity, we would have a stronger case if we stuck together…

Time for an interlude…someone pings through a GIF of an office worker using origami skills to convert a piece of toilet roll…or kitchen role plus elastic bands into a mask…quite clever really…we joke about whether this was one of the reasons why people were panic buying toilet paper….We have never really understood this…some people on the phone this morning (Radio 5Live) said that people were preparing for a period of self-isolation if needed…They didn’t wish to run out of toilet paper…I personally think this is not just about using it to wipe bottoms but as a cheaper form of Kleenex….The conversation moves to discuss the length of time we have been on our phones recently…especially since last Wednesday….We have sent 2500 messages on our group…sent emails and been on multiple forms of social media…. My son commented that I have been on the phone longer than he has…My iPhone stats tell me that my usage has gone up by 201% since last week…this is madness…What would I have done if I did not have access to this technology….reminded me of the experiences of someone who had to self-isolate 20 years ago for other reasons https://www.bbc.co.uk/news/uk-northern-ireland-51719029. She had no access to technology…I can only imagine what she must have gone through…what is happening here? I feel an ethnographical study coming trying to examine this phenomenon…We as a group are sharing solace with each other…What will it be like once the self-isolation is over next week…There are some who spend a lot of time on the group chat while there are some who do not…It would be interesting to study what individuals hope to gain from the conversation?… Do te people who do not interact as much have other sources to seek help from? It seems that those with families living with them are beginning to get used to the current situation….There is a ping on my twitter account…relating to #sicknotegate …It was published in the GP newsletter, Pulse, that coronavirus patients can now call 111 to get a confirmation instead of a GP sick note http://www.pulsetoday.co.uk/clinical/clinical-specialties/infectious-diseases/coronavirus-patients-can-call-111-to-get-email-confirmation-instead-of-gp-sick-note/20040268.article However, considering Ann told me yesterday that 111 has said not to contact them and go through the website…contradicting advice?? Who knows

2100hrs…just about to go to bed…thought I would have a look at any updates…I see that Italy has gone on complete lockdown https://www.bbc.co.uk/news/world-europe-51810673 and is extending its strict coronavirus quarantine measures, which include a ban on public gatherings, to the entire country. Italy’s coronavirus death toll jumped today by 97 to 463. It is the worst-hit country after China. Meanwhile, in Israel, everyone arriving in Israel will be required to self-quarantine for 14 days to prevent the spread of coronavirus, https://www.bbc.co.uk/news/world-middle-east-51809818

2107Hrs… Italy suspends all sport in Italy until April! https://twitter.com/SkySportsNews/status/1237122504642174976 Now what does this mean for Serie A? Or the Champions League? Juventus, Atalanta, and Napoli are still in the competition and then the UEFA cup too. Madrid have shut all schools https://www.bloomberg.com/news/articles/2020-03-09/spain-says-coronavirus-cases-almost-doubled-overnight-to-999 so wondered if the Liverpool game will go-ahead..Although I have just been pinged on the group chat by a fellow Liverpool fan to say that Italian teams will be allowed to play international matches but fans cannot travel.

The topic on the group chat goes back to toilet rolls..people are sorting out their shopping…Asda is out of Shades toilet rolls….why??? Why so many rolls…one points out that people will want to build a fortress out of the rolls…This takes me back to my childhood where I suggested that people could make cannonballs out of toilet rolls and then play battlefields…alternatively I thought this was entrepreneurial by owners or arcades, https://www.devonlive.com/news/devon-news/coronavirus-loo-nacy-devon-arcade-3929707 where a Devon arcade puts toilet rolls and hand sanitiser in grabber machines …absolutely hilarious. There have been many funny photos sent as well…

On the Twitterverse, and football shirt of the day? Grasshoppers away shirt (Swiss challenge league).

Anyhow after a rapidly changing day…I bid you Bonne Nuit!