Geneva, 13 March, 2021

I saw a news item about how the p*ndemic has run unchecked in a hot and sandy country that I had the mixed fortune to visit quite some years ago. At the time, I was working as a field surgeon for the International Committee of the Red Cross. One of the organisation’s neutral and impartial visiting cards was to host a surgical seminar about treating war wounds. We knew that this could open the door for “humanitarian” access in particularly difficult contexts. So, instead of heading to a field hospital – and long before we knew about powerpoint – a long and dusty drive took me to BBDland with a travel pack of videos and photographic slides (remember them?) I was to facilitate an exchange of ideas and experiences with BBDland’s military surgeons. The seminar had been given the go-ahead by the Big Bad Dictator himself. 

We already knew that BBDland’s political elite and army were the only people who had access to the country’s health care system. Before leaving Geneva, I was advised against raising this issue. As a preliminary to the seminar, I met my surgical counterparts at the rather plush Central Military Hospital. I feared a me-against-them atmosphere for the days to come. This fear proved groundless; they were all charming and welcoming. Many had trained in Europe and North America and were now starved of contact with international colleagues. I am sure I could have discussed the inequity of BBDland’s health care with them. The only time a shadow passed over their faces was when any allusion to BBD was made.

The seminar itself was to be held in a modern, but barely used, conference centre. On arrival, I was surprised to see TV cameras at the door and realised that the ministry of information was going to squeeze as much positive PR for BBD out of this. The cameras rolled as I walked through the main door. Cheers went up. The Red Cross doctor had just walked over a massive and intricate floor mosaic that depicted the smiling face of the President of the USA with blood dribbling from his teeth. “Bush is a killer” the caption read. I hadn’t seen that one coming. One of my colleagues plucked up courage to say very quietly “We’re sorry!” I hoped there would no further political interference in our modest collegiate event. Like, yeah!

In the auditorium, I positioned the slide projector in the middle of the floor, carefully placed my slides in the carousel (reversed and upside down!) and clankity-clicked through them all in a quick trial run. Ready to go! The place started to fill. Not only were the surgeons present but also two hundred or so other doctors and nurses all in full uniform. Suddenly, the chatter stopped. Everyone took a seat and kept their eyes on the floor. The fear was palpable. I was told that the brother of BBD, the Minister of the Interior (a man known to have much blood on his hands) was about to arrive. He had decided to open the seminar. Could this ruin the whole event?

The doors crashed open. Fifty men charged in with AK47s at the ready. Immaculate uniforms and distinctive red berets signified an elite guard; they were checking the security of the place before the arrival of B-BBD. One of them clearly didn’t like the look of the slide projector with its long lens pointing up towards the podium. He unplugged it, picked the whole thing up and marched off. I watched in horror as my slides fell out on to the carpet one by one. I moved to pick them up. Unwise. In a language I didn’t know I was told to sit still; the command was quite understandable in tone and kalashni-gesture. 

B-BBD swept in surrounded by flunkies. He neither smiled nor asked to meet me. He made a one-minute speech and then left. The red berets eventually left too; the last of them walked out backwards AKs still at the ready. After some minutes there were audible sighs but the chatter was subdued. Nobody wanted to tell me what B-BBD had said.

I followed the trail of slides that led to the discarded projector. Later than expected, we kicked off the seminar that happily proved to be congenial and informative for both sides. I later heard that the whole exercise did eventually open some doors for ICRC colleagues to visit prisoners and gain access to some displaced people. And so the “humanitarian” world turns.

BBD, B-BBD and the whole regime have long gone leaving only a poor, chaotic and dangerous country with no public health infrastructure. I often wonder what became of my surgical friends there. It is difficult to see how, in 2021, such a country will gather the necessary c*vid-19 data and the resources needed for a structured vaccination programme. It is also difficult to see how such a country being behind the vaccination curve will avoid a “natural” evolution of the p*ndemic with high case numbers and associated mortality. Such a country is also likely to become a source of further variants of the virus. I really hope I am wrong on this. Whatever, there is little doubt that this p*ndemic has on a global basis brought into stark relief the difference between the haves and the have-nots.

Another desert landscape! Isn’t the Perseverance landing on Mars just great? Isn’t this news so welcome when all we currently hear about is the vaccine – variant race against time and how this will determine the relaxation of social distancing measures? (And the postponed 2020 Olympic games in Japan will go ahead this year but without spectators.)

One of the great paradoxes of our time must be that the same country that has harnessed the power of science to put a vehicle on another planet elected and nearly re-elected a President who, during the c*vid-19 p*ndemic, refused to grasp even the most fundamental tenets of public health science. The same President whose Twitter and Facebook accounts were closed. 

So, you may be wondering by now what links the p*ndemic, the daily news, propaganda, science and technology (largely American), the US President and why I have written “c*vid” and  “p*ndemic.” It’s all about those algorithms that support the social media giants allowing them to promote or suppress posts that contain certain words. I have it on authority from someone who knows about these things that it’s quite possible some sneaky algorithm is suppressing the reach of posts and messages that contain the words “c*vid” and “p*ndemic” the idea being to foil the conspiracy theorists and the anti-vaxxers. Inevitably, I believe this is the reason why, up to now, these C*VID Chronicles have not gone viral. Ha!

On a lighter note, we are now beginning to see TV series that were produced in the time of c*vid-19. Social distancing rules dictated that for some series, all involved had to live in an isolation “bubble.” And so I recommend Channel 4’s Great Pottery Throwdown. During the making of this series the contestants, presenters and experts alike became great friends. I’ve never had a burning interest in pottery but this eclectic bunch produce a wide variety of truly beautiful stuff. There is something genuine and human about this series. What grips me through the enthusiasm, laughter and tears is how the different pottery challenges bring the potters’ lives to the fore and reveal such close bonds within the group. 

The sun is shining. Spring is in the air. My wife and I are heading out to play golf. In our traditional and deadly serious competition that runs throughout the season, the score is 6 games each! 

Go well. Be wise.

Geneva, 14 February, 2021

There is a basic principle of pharmacology: that the only difference between a drug and a poison is the dose. What better example than botulinum toxin. This bacterial poison causes botulism by paralysing muscles and is said to be the most toxic of all toxins. In tiny injected doses it is… you’ve got it…. botox! Now, it was said that in his day, the roguish Saddam Hussein had hidden in his sand-pit of mass destruction 1,000 litres of botulinum toxin. This was enough, according to one report, to kill the whole human population assuming that the contents of this microbial hobble-bubble could somehow be distributed throughout the whole human population. 

Last week I took a stroll with a friend who is steeped in public health matters. We agreed that if we view the virus responsible for COVID-19 from its biological / evolutionary perspective, it is truly remarkable. This little tooled-up single strand of RNA, unlike botulinum toxin, has worked out its own distribution mechanism to poison the whole human population – and could still achieve this – by using…. da-da-daah… humans! Brilliant! That then got us thinking about what the total biomass of this virus might be. Would it fill a swimming pool? Or would it fill a beer glass? By surprising coincidence, I heard the following day that BBC science had set two scientists independantly the task of making precisely this calculation; one concluded a wine glass and the other a shot glass. Yes, were you to take all the viruses that are currently doing their pandemic round-the-world cruise, you could put them in a glass, swirl them around, sniff them and then take a sip. (Don’t try this at home.) This little tinker clearly out-does botulinum toxin on every front.

Staying with matters of the virus’s spread…. The Chinese authorities eventually permitted an international team from WHO access to Wuhan, the presumed site of origin of the COVID-19 coronavirus, on 14 January. Three weeks later the team is back in Geneva. Wow! That was quick! Their rather predictable, politically convenient but quite possibly correct conclusion is that the source of the virus was an unidentified animal or animals and that a leak from a laboratory is “extremely unlikely.” However, implying that laboratory leaks of important pathogenic organisms are “extremely rare” points a lack of historical perspective. Have Sverdlovsk, Janet Parker and the UK’s foot and mouth outbreak been forgotten? A good read on all this with its political implications was published yesterday by my full-of-common-sense friend Filippa Lentzos in the Bulletin of the Atomic Scientists. Filippa picks apart the WHO team’s report, points out that the WHO hierarchy may not agree with it and lays bare the political stakes.   

As if to muddy the waters, a study, published last week in the European Journal of Epidemiology, concluded that the virus responsible for COVID 19 might have been circulating in France early in November 2019. It cites the findings of an earlier report that the virus could have been circulating in Italy in September 2019. All this of course will bring a smile to the test tube of any Chinese virologist. Could it be, though, that the virus was already on the wing in autumn of 2019 and one variant was first identified in Wuhan? I can just see the WHO from our balcony here in Geneva. Perhaps I should brave the snow, cross town and knock on the institution’s front door with a “Oi! Whats going on ‘ere then?” But then I have to remind myself that when it comes to a subject such as this, the political tactics and media scoops play out over days whilst reliable science takes months if not years but will, in the end, arrive at something resembling the truth.

Otherwise the COVID-19 news is dominated by uncertainties relating variants and vaccines. To what extent do the different vaccines reduce transmission of the virus and its UK, South African and Brazilian variants? Will the different COVID-19 vaccines be as effective (in terms or reducing severe infections) against the variants? If not, will the second vaccine dose make a difference? Can different vaccinations be used for the first and second dose? In relation to these variants, does the protective effect of the different vaccines vary according to age of the person being vaccinated? If your country plans to issue “vaccination certificates,” will they be worthless-until-proven-otherwise with the arrival of a new variant? Our best scientists will answer these questions and more over the months to come, but the cold reality is dawning; we will be playing variant – vaccine catch-up for rest of 2021 and maybe for years to come. On this, I realise my opinion is no more welcome than a vocal vegan at a Trump rally. 

Geneva, 11 February, 2021

I caught Geneva Lux, the town’s light festival, just before its twenty-one installations were taken down. It was a cold, wet night and this was night-time viewing. There were few pedestrians about. A sign of the times was the number of food delivery bikes braving the rain-slick streets. Head down and struggling to keep my iPhone dry, enthusiasm was some way off but took a step closer when I found “L’Envol” in the Parc des Bastions.

Well done, Geneva, for rolling out public beautiful stuff in the era of COVID-19. On the outer wall of the Old Town, Chris Plant’s slow-colour-pulsating “Portal Harmonic” hypnotised a small crowd; me included.

My favourite lights had me enthralled and wandering around in small circles right outside Tiffany’s. “Hivernales Népenthèses” is Sophie Guyot’s take on a species of tropical insect-eating flower. I love the way these elegant boulder-based standing lamps have been orientated towards the luxurious premises of the famous jeweller.

The pandemic news gets no better. In the countries that have instigated distancing measures, the case numbers and mortality data are not falling as fast as expected. Even with the roll out of effective vaccines, the numbers will not suddenly drop to zero. The hard truth is that the shape of an epidemic curve dictates that the total number of cases will eventually be double of what we have recorded to date.

Different scientific institutions are getting a handle on the full implications of the different variants of the COVID-19 coronavirus and, importantly, how effective the different vaccines may be against these variants. This spontaneous generation of variants gives a new sense of urgency to vaccination campaigns. Political spats about availability of vaccines are unsurprising. Currently, the EU claims Astra Zeneca is not fulfilling it’s contract to supply its vaccine in sufficient quantity as European countries face a difficult and delayed roll-out. The WHO points out that vaccine availability must be fair and reach countries without developed public health infrastructure. This is not unreasonable; the people in these countries could act as sources of yet more variants that carry the potential to overcome a vaccine and spread to other countries. Meanwhile, Switzerland seems to be going about its vaccination programme calmly and efficiently. I have registered for my jab; it should be three to four weeks away.

It may be all too obvious, but the longer this pandemic runs, the more severe will be the long term impact. It is inevitable that COVID-19 related studies, reports and enquiries will occupy our news cycles and concerns for years to come. I would hope that the WHO has already foreseen a major and apolitical lessons learnt review that is orientated around preventing and managing future pandemics. Such a review would be incomplete without something conclusive about the origins of this virus, how the pandemic affected poor people disproportionately in most countries and how effective or ineffective different countries’ strategies proved to be. I predict a continued academic commentary about the interface of politics and the pandemic especially in the USA. With respect to the development, distribution and delivery of the vaccines, we will hear much more of governmental and corporate wins and losses. I make no predictions about the economic impact of the pandemic nor how it will be recorded other than it will be profound and long lasting. Another long running source of research will be the impact on the education and mental health of children who have missed so much school time and the accompanying social interactions. COVID-19 will have a long, long tail.

Closer to home…. I’m not really a great TV watcher but the pandemic has changed my habits. I never thought I would spend so much time watching Netflix. My impression is that you have to kiss a lot of frogs before one proves to be… well…. a prince. “Call My Agent” (prince) is a French production about actors and their agents finding themselves embroiled in all shades of gallic mischief. It is thoroughly entertaining. By contrast, Bridgerton (frog) is the TV streaming giant’s current smash; this is surprising. Lavish sets, exuberant costumes and a wondrously knee-taking cast make the first few episodes just watchable. However, we abandoned it as the story-line failed to get out of its lame first gear and whole episodes were dominated by the era’s lack of sex education for young ladies and scenes that could easily pass as raunchy Kleenex ads. Yeuch! (Sorry… s(p)oiler alert!)

Hoping my readers are well, safe and as happy as possible under the circs.