Thoughts from Pontevedra, Galicia, Spain: 9.3.21

 Night’s candles are burnt out, and jocund day stands tiptoe on the misty mountain tops.

Spanish life is not always likeable but it is compellingly loveable.  

- Christopher Howse: 'A Pilgrim in Spain'

Covid 

There's another fine - but UK-biased - review of recent development below.

Cosas de España  

Good News: Spain ranks as one the top 10 countries  of the world for gender equality. I wonder if this is for just 2 of these or for 100+ of them.

Spanish banks are renowned for being both rapacious and inefficient. And not beyond mistakes that always seem to be in their favour. A few months ago, I realised Santander bank - without ever telling me - had started to charge me €12 a month for an account they inherited after purchasing a Galician bank for a pittance. Recently, Santander had started to bombard me with emails on how I could  get free banking by selling my financial soul to them. Irritated by this, I belatedly decided last week to make an appointment to go and close the account. This is how it went:-

- I spend more than half an hour on line trying to get an appointment as a private person (un particular) and eventually accept I can only do this as a business person.

- I get a cita with a gestor called María C. M. O. for yesterday at 11.

- I go to the bank, ask for María but am told there's no one of that name working there.

- I'm asked for my ID and then passed to another person.

- I tell this person why I'm there and she goes off to talk to someone

- She comes back and takes me to a 3rd person

- I tell this person - Carlos - why I'm there and again have to produce my ID

- Carlos advises me of what's left after several months of €12 deductions plus 3 charges

- I ask what the charges are and am told: 1. February's €12, 2. 50% of the March charge, and 3. €6 for the transfer to my main bank.

- I point out that 50% of 12 is 6, not the €9 that's actually cited.

- To my not-very-great surprise, Carlos can't explain this and I decide to let it go. But I tell him I'll take the (free!) cash rather than incur the extortionate charge of €6 for a bank transfer.

12. Carlos goes to get the money and I sign a receipt and leave.

In a perfect world, one would have nothing to do with a Spanish bank but this ain't easy if you live here. Even subsidiaries of foreign banks work - in most cases - to Spanish norms and standards. I say this having been at least 30 years with my British bank, which has - in all this time - never managed to annoy me once. Other than when the voice-recognition technology didn't work well when I was in the UK and had to answer 5-10 security questions before making a transfer to one of my daughters.

Talking  about how things are done in Spain, Lenox Napier of Business Over Tapas cites a report that 12 ex politicians on the boards of 2 energy companies took home €3m last year.

Cousas de Galiza

Bad News: Camino 'pilgrim' numbers in 2020 were 81% down on 2021. For what it's worth, of those that did get to Santiago de Compostela, the profile of the average walker was a male aged 31-45, hailing mostly from Madrid. Though he could have set out from the start of any one of the 40+ caminos now in operation. All authentically dating from many centuries ago, of course.

Talking of the Catholic Church’s ability to make money . . . Lenox cites this report - from a Catholic journal - of the reaction of Spanish bishops to allegations of improper registrations of (tax-free) properties around Spain.

  

Maria's Tsunami: Day 36. 

The UK

A very British comment on the M&H saga: It is not Meghan’s race or Harry’s union with a mixed-race woman that many in this country find insufferable but their evident self-regard and self-pity. In Britain it is a cardinal sin is to take yourself too seriously. We like our public figures low-key, self-deprecating, as humble as fame and fortune allow. It does not do to get too grand, even if you are a duke or duchess. Yet, whether they are demanding privacy while courting publicity, or enjoying the rewards of royal titles while shunning the responsibilities, or blathering about public service while ditching the boring old walkabouts in Rotherham, the behaviour of Harry and Meghan smacks of self-importance.

 

The UK and Brexit 

Regular readers will know Richard North is not Boris Johnson's greatest admirer. Today he says of him: Problems such as these are set to bring the [trading] system crashing down – issues about which Johnson is probably totally unaware, as he burbles about 'goodwill' and 'imagination'. Idiot is too kind a word for this man.

The USA

This article possibly reflects the majority British view of that interview, though it's accepted in the UK that things will be seen very differently in the USA, where the British stereotypical image will be strengthened. But nothing can stop that. Anyway, a wonderful last  paragraph.

Spanish 

Here in Galicia, the  Red Cross  is known as A Cruz Vermello. The latter is sometimes seen as bermello. Both are Gallego versions  of bermejo, which means red. You'll recognise the cognate ‘vermillion’ in English, of course. Over the years, I've twice stayed in  the village of Casabermeja, north of Málaga. Anyway, the word bermejo is said in the RAE dictionary to come from the Latin for 'little worm' - vermicŭlus.

I'm not sure the word caramba is heard as much in Spain as it is in Mexico but, anyway, here's something about it. The word carajo is certainly oft heard up here in Galicia. Or, carallo, as it's rendered in Galego. Click here and here for earlier references of mine to it.

English

Relatedly . . . 'Vermicular'

1. Like a worm in form or movement; vermiform.

2. Denoting or caused by intestinal worms.

Finally

Anyone got advice on how to treat a rug suddenly infested with moth grubs that are rapidly eating it away - after being left alone for 35 years or more?

COVID REVIEW: MD, medical correspondent of Private Eye

Data not dates 

"Data not dates" is the correct approach to managing a pandemic, provided the data is complete, correctly interpreted and consensually obtained. Overall, vaccines are leading to impressive reductions in infections and hospitalisations, but drug companies do not release all their ongoing trial data in real time, which makes it harder for regulators to spot potential problems. Meanwhile NHS records are a treasure trove of real-world data to help understand Long Covid, and much else; but the data must be anonymised and used with consent. 

Much is still unpredictable. Setting staggered provisional dates for reopening the UK, depending on the data, will need continued support for people and industries facing financial ruin. But having spent a year over-promising and under-delivering, Boris Johnson could pull off the reverse if the data improves quicker than anticipated. 

Working model 

The UK vaccine programme continues to deliver, with a single dose of either the Pfizer BioNTech or Oxford AstraZeneca vaccine resulting in substantial reductions in infection, symptomatic illness and hospital admissions after 3 to 4 weeks. Two doses provide even better protection, particularly for the elderly; but for those aged 80 or over in Scotland, a single dose was associated with an 81% reduction in hospital admission risk in the 4th week. This suggests that staggering the doses to cover more people was a good call. Also, older people in Scotland mostly get the AstraZeneca vaccine, which should give Germany, France and Belgium pause for thought. 

Wilful stupidity 

Joy at the success of the Oxford-AZ vaccine is tinged with despair that some EU governments have promoted vaccine scepticism by raising unfounded concerns about it. Germany started it. On 25 January, a German newspaper quoted a minister who claimed it was "only 8% effective in the elderly". President Emmanuel Macron of France then suggested it was second class. On 28 January, Germany said the over-65s should not have the jab because of "insufficient data to assess its efficacy". 

Angela Merkel, 66, has declined it for herself, and Belgium [and Spain] has said it shouldn't be given to over-55s. True, the OAZ trial data for the elderly was scant. But the European Medicines Agency, the WHO and the Medicines and Healthcare products Regulatory Authority (MHRA) said it should be used in all age groups, now backed up by impressive real-world data. Alas, the doubts are hard to reverse and people of all ages in the EU are declining it and demanding the Pfizer vaccine (which was developed in Germany and is manufactured in Germany and Belgium. France's Sanofi vaccine has yet to appear). 

As of 19 February, just 150,000 out of 1.5m doses of the OAZjab had been used in Germany. 

At vaccination centres in Berlin that only give the OAZjab, fewer than 200 people are turning up for the 3,800 daily appointments. Overall, 7% of German and French citizens have been vaccinated compared to 30% of Brits. 

Individual EU countries have always had the power to set the bar of individual vaccine approval wherever they wished, but to see their citizens suffer and die as a result is beyond stupid, particularly when the UK data is looking so good. Meanwhile, Germany and France still have large waves of infection, and Belgium has even higher death rates per capita than the UK. 

Lesson for teachers 

Teachers do not appear to be at higher risk from Covid than other workers not in health and social care. But if we are opening schools next week to full capacity in the new, multi-variant world, we need to make them as safe as possible for everyone. Getting community transmission levels low enough to be controlled by test, trace and isolate is key. Newer generation rapid lateral flow tests with monoclonal antibodies appear more accurate than the lnnova ones we've bought a mountain of.

If we roll out mass testing in schools and elsewhere to those with no symptoms, we will inevitably discover more positive results (including false positives). That may not mean infections are on the rise, or that those who test positive are infectious, just that we are detecting "symptomless positives" we previously didn't. Evaluation is still needed to determine if this does more good than harm. The same is true of children and teachers in masks (and if so, what kind). 

Vitamin D-Day 

Many doctors are taking Vitamin D every day in the hope of reducing the risk or harm of Covid, but the jury is still out. Small, imperfect studies suggest impressive benefits, but better, larger studies find very few. Definitive randomised controlled trials are underway. MD has taken 10 micrograms of Vitamin D every day for years, because it's hard to get enough naturally, especially in winter. I've also had a dose of vaccine. If I somehow still get severe Covid, I'd ask to be included in whatever trials are going on at the time (including extra Vitamin D) 

Missing inquiry 

One thing missing from the 3rd and hopefully final route map out of lockdown was the announcement of a public inquiry. Unless we fully understand what went right, what went wrong and why, we are likely to sleepwalk into the next pandemic. 

The UK has one of the worst mortality rates for Covid. But instead of just blaming politicians, we all - health professionals, managers, scientists, social media companies, tech and data companies, personal protective equipment (PPE) and test providers, ventilation engineers, journalists, broadcasters and citizens - need to consider what we could have done better. The independent global inquiry into the performance of the WHO, and the response of its member states, is due to report in May. A UK inquiry should follow soon afterwards, building on its findings. 

Dial BMJ for Murder 

There are 2 extreme views on the UK's pandemic management and 125,000 deaths. Boris Johnson believes that: "We truly did everything we could, and continue to do everything that we can, to minimise loss of life and to minimise suffering." 

The British Medical Journal - hardly a fringe publication - takes a different view: "Should Covid deaths be seen as 'social murder'? Or failing that, as crimes against humanity, involuntary manslaughter, misconduct in public office or criminal negligence? Politicians must be held to account by any constitutional means necessary." 

According to the BMJ(13 Feb), "social murder" is a wilful refusal by government to address the social determinants and inequities of health, which have led to a disproportionate number of deaths among the poor and marginalised, including BAME communities. Certainly, successive governments have failed to enact the Equality Act, which includes a duty to address socio-economic disadvantage. This is at the heart of much pandemic death and suffering. 

The Sooner the better

Given that the pandemic threat is continuing, we need a rapid interim report before the winter, when the risk will be highest. This happened after the Hillsborough disaster in 1989, allowing life-saving measures to be introduced in stadiums ahead of the next football season, but with the whole truth taking a lot longer to emerge. It would allow the government to acknowledge properly the scale of Covid and non-Covid deaths, loss and harm, and to learn the urgent lessons to prepare us better. Any NHS reforms should also be guided by the inquiry's findings. Meanwhile, a huge wave of pandemic litigation and legislation is building up.

Wave one litigation 

The government is rushing through reforms and contracts under cover of the pandemic, without proper scrutiny, and then trying to keep them secret. Following a Good Law Project challenge, health secretary Matt Hancock has already been found to have acted unlawfully by failing to publish multibillion-pound Covid-19 government contracts within the 30-day period required by law. Hancock has also been asked to refer Centene's takeover of GP services in London serving 500,000 patients for a Care Quality Commission investigation to determine if the private provider is up to the task of taking on such a large chunk of NHS work. 

Open Democracy has just issued a lawsuit over the government's £23m NHS data deal with controversial "spy tech" company Palantir. Data sharing is crucial but the proposed NHS reforms means much of the infrastructure is likely to be managed by big tech firms without public debate or consent. 

A judicial review, meanwhile, is trying to get full disclosure of all documentation and decisions surrounding Cygnus, the government's pandemic preparedness plan. Was it ignored because of austerity cuts? We do not know. 

Legal protection for staff 

NHS staff want indemnity and protection from any litigation pursuant to patient harm, death or denial of treatment during the pandemic because they were doing their best in exceptionally dangerous circumstances, and don't deserve to be hung out to dry for systemic failures. Doctors are also arguing for better whistleblowing protection so they can fulfil their legal duty to raise concerns about dangerous care (the case of a whistleblowing junior doctor has yet to be resolved, but he has carried on serving patients on the pandemic frontline despite having his career ruined for raising concerns about unsafe practices and staffing in intensive care). 

Compensation for harm

Hospitals, meanwhile, face litigation for the many cases where Covid was acquired within their walls. Care homes face litigation for letting the virus in - and may in turn countersue hospitals, the government and NHS England for forcing them to take untested, infected patients. NHS and care home workers are suing the government and employers for lack of testing and inadequate PPE in the face of a known deadly, biological hazard at work. Proving that infection happened in the workplace will be a protracted legal affair. 

Families of those who have suffered or died with non-Covid conditions (eg cancer, stroke, heart disease, learning disabilities) because they couldn't get the care or support they needed during the pandemic are suing GPs, hospitals and care services. Students are suing to recover costs and lost education. Asymptomatic citizens are even suing the government for denying them the right to work because they tested positive for Covid when there is no accepted measure of how a positive test relates to infectiousness. And there will be claims too for alleged vaccine harm, and harms from novel, experimental treatments. 

The legal system, like the NHS, was struggling to cope with demand before Covid, so what should the government do to avoid drowning in litigation? One option is a pandemic amnesty, offering compensation and support to those who have suffered, commensurate to their needs and without a protracted legal battle to prove accountability or negligence. The vast majority of public servants are decent, exhausted and doing their pandemic best. Litigation could be the final straw. 

No jab, no job? 

The issues of mandatory vaccination and vaccine passports are so legally and ethically complex they require far more than a review by Cabinet Office minister Michael Gove. MD is against mandatory vaccination of whole populations but had to have hepatitis B vaccinations to work as a doctor, which is appropriate for anyone who performs or assists at exposure-prone procedures that risk infecting patients. Covid vaccination take-up has been poorest for NHS and care workers, and previous calls for mandatory flu vaccination have been resisted. There will undoubtedly be legal challenges to whatever Gove's group decides. Better to air them at an inquiry. 

'Covid careful' venues 

Proof of vaccination or a negative test is being proposed for entry to a whole host of venues, events and countries, although "zero Covid" cannot be guaranteed (no test is 100% accurate, nor vaccine 100% effective). Some people will cheat on their tests. Can Gove cope with the fall-out?