World's Ends

By Paul Chaplin

The Coronavirus crisis uniquely offers dramatic insights into psychology: individual, crowd and political. As a Certified CBT Practitioner, and former barrister and solicitor, with his unique life experience, Paul offers his own insights on this world-changing crisis. Blowing suddenly from the East, a world crisis which has convulsed and transformed Britain. A pandemic crisis, for which the UK Government had no Plan.
Or Did It?
See examined for the first time how the UK Government had a SARS-Cov pandemic Plan in place since 2011 ready to deal with 250,000 covid deaths and avoid closing down the country.
And see, too, the documents showing how, in three short weeks of February and March 2020, the UK Government UK ditched that careful Plan, and Locked down instead.
Did the Government follow the science? Or were Focus Groups used to decide what the science should say?
Read how the UK Government paid for professional psychologists' advice on how most to threaten the UK population with death messages and how the use of death forecasts, invented in days, were deliberately used to create Coronaphobia.
See how the UK Government suppressed the existing SARS-Cov research and models, created over 10 years by experts, so you could not check its new terror messaging and then read for yourself the hidden (but not secret) UK Government documents, and the court papers documenting legal challenges, which claim the Government lied about the science.
This best-selling CBT author now details how we can each cope with the psychological pressures induced by mass-media stories, statistics of doom, the reality of isolation and social distancing. By offering CBT insights and practical exercises, Paul shows how to extract individual comfort and peace from a time of crisis. It is by focusing on the reality of You in the now, with clarity and understanding, that the new worlds formed by the coronavirus crisis can best be lived.
By using the techniques and exercises in this book, You can learn not just to live with isolation, but gain distinct benefits from it. You can learn how physical social distancing can actually bring you closer. And save for those very few who have sadly succumbed, whether of or with this virus, the journey of You has not ended. It now treads unexpected paths. This book is a guide to navigating hope in your lived reality, by realising the Power of You.

• Language: English
• Publisher: G2 Entertainment
• Release date: Jun 26, 2020
• ISBN: 9781782813323

Book preview

INTRODUCTION

Dedication

To all those who perish, despite our efforts,

and because of them.

Kindness, Clarity and Hope

This is a book about Kindness, Clarity and Hope.

In a world’s end, we can strive to keep the quality of kindness safe. For ourselves and for others. We recognise that kindness in the Thursday clap for the NHS, care and key workers.

Kindness is not a thing. It is a set of techniques of thought, leading to practices of deed. We do as we think, and we can think more kindly. Kindness is not a function of weakness. It comes as a practice of thought and action only through strength.

Strength in turn is founded in clarity. To see matters as they are in reality. In CBT terms, to assess your reality directly, rather than through a fog of fear. Your reality is never the same as mine. But our explanations of our separate reality can bind us together with strength, when those explanations have clarity.

Clarity in turn prospers hope. It is difficult for hope to emerge from blindness. Hope is not some airy fairy will ‘o the wisp. Hope is not a longing for certainty: that is in fact pessimism. Hope is an expectation of opportunity.

From this covid crisis emerge so many potential opportunities that no single book could encompass even a tiny fraction of them. The societal response to covid itself provides so many opportunities that were unimaginable when we celebrated new year 2020.

Fear

Fear is not something we are born with. It’s a response to stimulus that we are conditioned to. Babies and toddlers don’t have fear. They learn it.

Conditioned responses can’t be un-learnt. But they can be overcome. The natural process for overcoming fear – for crowding it out of our consciousness – is anxiety.

That’s why you tense yourself up, tightening the screw in your nerves, muscles and mind, before you jump off a high diving board. Or taste food you’re not sure about. Or watch media headlines about coronavirus.

Living with fears is not a problem. There are events and circumstances that we are right to fear, and fear can help us avoid them. But it is anxiety which allows us to live at all. Anxiety and the inexorable natural soothing which always rises to match it: if we allow it.

The Anxiety-Soothing Cycle

My last book I Want To Love But… Realising the power of You, uncovered and explored the working out in our minds, emotions and life of this natural healing cycle, with us from birth. The core concept:

THE ANXIETY-SOOTHING DANCE IS A

LEARNING EXPERIENCE IN SELF-BALANCING

Illustration

As this Rhythm of Anxiety < > Soothing happens, over and over again, another layer of magic emerges:

Baby-You is LEARNING to Self-Soothe the Anxieties.

Baby is Realising the Power of You.

Baby experiences that power as a learning process (in Geek-Speak a Heuristic): by having repeated the Rhythm of Anxiety < > Soothing.

I see this Learning Rhythm of Anxieties-Action < > Soothings-Reaction, as something profound and beautiful. We are all born like this. It is a gift from nature. The ultimate blessing from god, or a higher power, if that’s how your philosophy works for you.

The Anxiety-Soothing Rhythm is Perfection Born in You

I hope you can share this sense of wonder with me. It is a true Gift: we don’t need to do anything to deserve it. It’s not a reward for anything. It is, quite literally, the Birth right of all of us. This is the gift of growth for you, me and all of us. And we are all born with this Perfect gift. You were born being Perfection.

Geek Speak: human-kind’s natural nascent mechanism for survival & growth is Heuristic Homeostasis.

Our individual psychological problems come from interference in the Anxiety-Soothing dynamic.

Later, I’ll be unwrapping all this for you, summarising the much more detailed explanations in I Want To Love But… realising the power of You.

The Slices of Personality

Another key concept in I Want To Love But… realising the power of You, is how our personality is formed in a dynamic of 5 Slices:

5 SLICES OF LIFE:

Illustration

The key concept here is dynamic harmony: not equality.

The 5 Slices are a way of understanding how the Anxiety-Soothing dynamic, and our individual interference patterns and habits, manifest themselves in our personality: and in our life choices.

Again, later, I’ll be unwrapping all this for you, summarising the much more detailed explanations in I Want To Love But… Realising The Power Of You.

Fear and Deprivation

From a CBT perspective, the CVD crisis is hitting two hot buttons of the human psyche: fear and deprivation.

Fear:

•Fear of infection, illness and death: for oneself, and loved ones;

•Fears arising in the course of living in lockdown;

•Fears from the results of lockdown: for jobs, business, relationships;

•A special type of fear: Armageddon Fear , of the sort not seen since the Cuban Missile Crisis.

Armageddon Fear concerns the end of the world as we know it. This seems not to be a fear that we are psychologically equipped by ordinary life to handle.

A crucial CBT insight is that we all are equipped by ordinary life experience to handle Armageddon Fear. In fact, we deal with this sort of fear all the time in our ordinary individual lives. So, we do have the psychological and emotional tools to deal with Armageddon Fear. The hope is that this book will help to explain how, and bring comfort through that.

Deprivation:

•Loss of life and loved ones (although that is not in any way novel to covid);

•Loss of liberty in lockdown;

•Economic loss, now and later.

CBT can’t restore health, or life or a job or a business. But CBT, at its core, is about helping us to think and feel better about bad stuff: whatever that bad stuff is and wherever it comes from.

A Spectrum of Humility

I try to keep this book as free as possible of source notes. Firstly, given my own cognitive difficulties with memory, trying to assemble source referenced materials is a Frankenstein monster I would rather not have to tackle.

Secondly, I am a cognitive scientist and an emotional artist. My job as a writer is to communicate, not argue.

I’ve provided an internet citation for every article and paper quoted, so you can go look them up for yourself.

Clarity best comes from balance. Referencing a spectrum of views provides stability: would you rather the table for your thoughts and feelings be supported by one leg, or many?

Terminology and Tone

A note on terminology. We know the Frankenstein’s monster we are talking about:

•Acute respiratory syndrome coronavirus 2 (SARS-CoV-2);

•COVID-19 (the official designation of the disease which can be caused by coronavirus).

This isn’t a virology textbook. So I will refer to covid, corona, C-19 and so on in different ways, depending on context.

A note on tone. Because I’d like you to enjoy reading this book, I follow the style of my last one. I sometimes try to keep things light, even when dealing with things that are heavy. The context in which this book is offered to the reader could hardly be more weighted.

I myself am in a high-risk Covid infection category. I’m of an age where the risk ratios suddenly skew upwards. Worse than that, I suffer from irreversible auto-immune disease. I have for many years. It has a disabling effect upon every aspect of the body’s functions, from digestive disorders to sleep apnoea.

One result is having narrowed, and narrowing brain arteries (vasculitis). That starves oxygen to the brain and kills off entire brain cell areas. I’ve had enough MRI scans to have seen it in black and white.

So I suffer from cognitive deficits, particularly memory. That’s a pretty severe handicap in writing. So I have to do it in jigsaw bits and then have editorial assistance to put the pieces together.

It tends to slow down writing when you’re trying to remember a word (names are really poorly held in the cognitively injured memory banks). But there’s the wonders of spell and grammar checkers, encyclopaedias and thesaurus works. Sometimes, it’s like following a maze: you know the idea of the word you’re looking for, but you can’t remember the word. So you go rooting for words around that idea which you can remember. And eventually (with luck) you come across the actual word. Which somehow seems unfamiliar, once you’ve found it.

The mechanical task of writing is made difficult by the effects of auto-immune on muscle tissue and nerve conductivity from the brain. You want to type the letter p, but your brain sends your fingers to the wrong key. Some days it’s too painful to even type at all. And then you’re plugging in the speech recognition software. But I find it even harder to recall words when speaking, so that sets the whole thing backwards.

I’m not great with antibiotics, so pneumonia (which is bacterial infection that settles on cells killed by your antibodies fighting a virus) is best avoided. Although thank the god of tobacco that I’m a pipe smoker: now that scientists are reporting a mysterious protective effect of nicotine against C-19.

Shooting the Messenger

This book is composed of two sorts of words: mine, and many others. If, as you read, you decide that you would prefer to ignore all of mine, and consider only the others, that’s your privilege.

If there be any degree of offence which arises from me showing you documents and ideas that you may not have seen before, then no words of mine can address that dynamic.

I have had an unusual life. I talk about it openly and in detail in the Strange Days chapter of I Want To Love But. If you want to do a journalistic muck-racking exercise, there’s your first source.

I am no Galileo. If you want to insist on a flat-earth philosophy, that’s fine. If you want to put pressure on me to recant my own views, I’ll happily oblige. Because I understand that the messenger’s views are ultimately irrelevant. The message is composed of the thoughts of thousands of others, representing the work and thoughts of millions.

~

I have taken a laboratory standard serological test for covid antibodies. I’m negative.

So, if anyone is on the Titanic UK, heading towards the covid iceberg without a lifeboat, it is I. Lockdown and social distancing don’t remove the iceberg. At most, they (supposedly) simply slow the sailing speed.

With kindness, clarity and hope: see you on the other side of the iceberg.

CHAPTER 1

END TIMES

It feels like the end of worlds. Certainly, it is difficult, with any degree of realism, to imagine that the worlds we have known in our collective lifetimes will ever be the same again.

Maybe it really didn’t have to be this way. Maybe Professor Ferguson and the lockdown lobby were wrong all along, and various US States, Sweden and leading epidemiologists, were right.

It’s too late for the worlds we knew, now. The social, economic, psychological and spiritual damage is done. What this book and CBT as a practice, is about, is dealing with that psychological and spiritual damage.

To undertake that necessary work of repair on the human psyche, as with any structure, we must understand where exactly the cracks are, and what the dynamic of the subsidence is.

There come into being in the world all the time unpleasant circumstances, for which there was no alternative scenario in reality. CBT looks at how we can best think and feel in a situation which is involuntary and non-optional.

Then there are circumstances which are brought about by acts of human will.

Human beings react very differently to each of these. CBT is reactive to which of these circumstances we are confronted by. There are different lessons and techniques for differing circumstances.

So, it’s important to be in a position to distinguish between inevitability and fallibility. A well-developed human trait is to seek to turn the voluntary into the involuntary: I had to do it because. We don’t accept that at face value from a domestic partner who is abusing us, even if we feel limited in our practical range of choices. No more should we accept at face value justifications for abuse (of our civic rights and freedoms) by our governmental partner in society.

Necessity or choice: this is the divided landscape in which CBT, and society in general must consider its responses.

It would be easy to write a book which accepts uncritically the face value justifications of certain governments for their actions, and inactions. To offer bromides of self-help to those feeling helpless in the face of inevitable adversity.

But that would be to discharge only half of the responsibility to which is subject any person who accepts the place of counselling others.

The main news media has not, with some exceptions, discharged its responsibility, in this time of crisis, of comprehensively informing the public. Instead, an editorial line has been taken that the public are scared and want to carry on feeling like that, so give them what they want.

At this unique time, these two big ideas rest concurrently in the consciousness of readers:

THREE -QUARTERS OF BRITS DON’T WANT TO LIFT THE LOCKDOWN

By James Wood, 2 May 2020, Mail Online

A new YouGov poll of 3152 adults has revealed that 77 per cent would like to see the lockdown continue while just 15 per cent are opposed to the move.

Some 46 per cent of those surveyed said they would ‘strongly support’ the decision to extend the lockdown while 31 per cent said they would ‘somewhat support’ an extension. Just 8 per cent said they did not know.

When restrictions are eased experts will monitor how different parts of the country are complying and may put individual towns and cities back on lockdown if the re-infection rate, or R, creeps above 1 again.

YouGov asked 3152 British adults: The next government lockdown review is on May 7th. Would you support or oppose extending the current lockdown beyond 7th May?

https://www.dailymail.co.uk/news/article-8279221/Commuters-told-check-temperatures-leaving-home-individual-towns-cities-lockdown.html

Naturally, if you deprive any decision-making person of the information needed to choose between available alternatives, you get a certain answer.

If the only alternative to lockdown is death, then it is not surprising that few knowingly choose suicide. If the alternative to lockdown always was living with a viral pathogen which is harmless to over 95% of the population, then the answer would be different.

But people believe what they believe, mainly because they believe it. Facts of reality in the world enter upon the thinking of some people, but by no means all.

Kindness necessitates having the clarity to understand whether an individual or group is choosing belief or knowledge as the fulcrum of a world view. It is not for me to weigh in judgment which type of view you hold to. My responsibility is to help you, if I can, to think and feel better about yourself and your world, taking that view as your guiding principle.

It does, of course, enhance your ability to enjoy your life if you can, or can come to, perceive as a fictional problem, that which another views as a real problem. So long as the problem is, in the world of reality, merely fictional. If that is a real scorpion, you are best not standing on it. If it is an illusory threat, then you are best served by recognising its unreality.

I therefore take pains in this book to present to the reader a selection of information, much of which, although publicly accessible, remains outside mainstream media coverage.

You are entitled to dismiss utterly all views except that promoted by Govt UK since 23 March 2020 (being the opposite of what Govt UK) promoted previously.

You can take any of these views:

•CVD is lethal to anyone, of any age and disposition;

•The lethality of CVD is directly related to age and pre-existent conditions;

•CVD acts differently to other coronavirus, and its societal mortality impact is materially different to other coronavirus;

•CVD acts differently to other coronavirus, but its societal mortality impact is not materially different to other coronavirus;

•CVD acts differently to other coronavirus, and its societal mortality impact is materially different to other coronavirus, and there are significant and fundamental steps society can take to minimise those;

•CVD acts differently to other coronavirus, and its societal mortality impact is materially different to other coronavirus, but there are minimal steps society can take to minimise those;

•CVD acts differently to other coronavirus, and its societal mortality impact is materially different to other coronavirus, but there is nothing we can actually do about that;

•CVD acts differently to other coronavirus, by the same degree that all coronavirus effects differ to each other, and always have done, so there is no need to do anything except apply ordinary common sense;

•Lockdown policy is common sense, and any other view is nonsense;

•Lockdown policy is common sense, and its practice is correct;

•Lockdown policy is common sense, but its practice is any or all of: (a) contrary to the science which is supposed to support it (b) contradictory (c) nonsensical;

•Lockdown is socially, medically, economically, psychologically and spiritually harmful, but it is a price that has to be paid, for viral defence;

•Lockdown is socially, medically, economically, psychologically and spiritually harmful, and is too high a price for viral defence;

•Lockdown is socially, medically, economically, psychologically and spiritually harmful and has no to low defensive role against viral infection;

•Lockdown is socially, medically, economically, psychologically and spiritually harmful and makes viral infection worse by prolonging it in an immunologically weakened population;

•Voluntary social distancing is wise, but legal lockdown is not;

•Social distancing is scientifically pointless when it comes to dealing with an airborne virus;

•You acknowledge you are suffering from Coronaphobia, but there’s nothing you can do about that;

•You acknowledge you are suffering from Coronaphobia, and you wish you could feel differently.

This is a vast range of views. In historical hindsight, we will be able to know which of these views had the weight of empirical truth beneath it. For now, it is the duty of anyone who assumes responsibility for commenting upon this landscape and counselling individuals who must live within it, to represent and react to them all.

One world which has disappeared is the consensus of opinion about societal fundamentals. What strikes me about that opinion poll cited above is the near 50/50 split amongst the country. One side looks relatively monolithic (Lockdown extenders). The other side less so. But the fact of that divide is obvious.

The last occasion we saw this sort of societal divide was with Brexit. But that was just politics. Yet nobody, not even the most ardent Brexiteer or Europhile, viewed the contest as being significant in life and death.

This divide is different. It is fundamentally about the perception of living or dying. The presentation of spectrum of views is thereby made, not merely a matter of enhancing interest in reading, but requisite to the discharge of duty in writing about such serious matters.

What do I personally believe? The answer is that I try not to believe in anything which has knowable reality. I am a cognitive scientist. My job is to understand how different people see reality, to appreciate those vision dynamics, and then to provide neuro-linguistic techniques for helping people to think and feel better about themselves, with the visions they each have.

The tectonic plates of UK opinion are shifting, as this Chapter is written. The fault lines, and political difficulty of trying to stand like a colossus on both sides, are brilliantly encapsulated in this recent opinion article:

IS EVIDENCE RISING THAT LOCKDOWN COULD BE A DEADLY MISTAKE?

By Sherelle Jacobs, 2 May 2020, Daily Telegraph

So concludes another surreal week of watching a government-by-focus-group pretend to follow the science. In particular, the Government overlooked two vital pieces of evidence that raise frightening questions about the impact of its draconian lockdown strategy – and whether lockdown was ever even necessary.

First is the latest ONS data, which suggests that lockdown could be killing people insofar as people who are suffering from non-Covid diseases and conditions may not be seeking help. Figures for Week 16 (up to April 17) showed 11,854 excess deaths in Week 16 (compared with the five year average) – but just 8,758 were Covid-related. Are these other 3,096 non-Covid excess deaths anything to do with the fact that urgent referrals by GPs for cancer tests, and chemotherapy appointments have plummeted? Could it be that thousands of seriously ill people are not seeking treatment because they are following the Government’s petrifying instructions to Stay At Home to deadly effect?

The figures also show that out of 7,316 deaths in care homes up to Week 16, just 2,050 were Covid-related. HC One, the UK’s biggest care home provider, has revealed that while the death rate among its 17,500 residents is around three times that of last year, just half of these additional deaths are directly linked to Covid-19. What is going on? It is quite right that stamping out coronavirus in care homes should be top priority. But a twin investigation into the non-Covid deaths ripping through care homes should also be launched as a matter of urgency.

Not least because, the proportion of non-Covid excess deaths could be even higher; it is worth remembering that Covid-related deaths include people who die with Covid, as well as people who die of it, and some deaths are being registered as coronavirus-related when the presence of Covid-19 is suspected rather than proven via a test.

Some may counter that, lockdown or no lockdown, coronavirus was always going to swallow up NHS resources at the cost of non-Covid patients. But given the growing concern among GPs and hospital doctors about missing non-Covid-19 patients, one cannot help but wonder whether the scale of lockdown and its relentless Stay At Home messaging has had a detrimental impact on patient attitudes.

The second major development that the Government failed to act on this week was the international community’s belated realisation that Sweden’s strategy may be working.

The penny has finally dropped at the WHO, which on Wednesday hailed Sweden as the model for the new normal. Its top emergencies expert, Dr Mike Ryan said: What it has done differently is it has very much relied on its relationship with its citizenry and the ability and willingness of its citizens to implement self-distancing and self-regulate… In that sense, they have implemented public policy through that partnership with the population.

The more time goes on, the more Sweden looks like a success story, in glaring contrast with the UK. Sweden has suffered fewer proportionate deaths than Britain. Its government believes that Covid-19 deaths peaked on 8 April. And, vitally, Stockholm believes it is weeks away from herd immunity; although it is not yet proven that the normal principles of herd immunity apply to this virus, early studies have shown promise, in which case Sweden is in a much stronger long-term position than lockdown countries.

One would think that rising evidence, which may suggest that a) lockdown is harmful and b) coronavirus can be managed perfectly sensibly without lockdown, the Government would be determined to ease restrictions.

But there is a severe political obstacle to following the science. Downing Street has proved debilitatingly successful at government by focus group. The polls show huge support for the Government’s approach – particularly in the North East and the West Midlands. Read the regional papers in Red Wall towns, and you get a spine-tingling sense of just how in-sync Downing Street’s pro-lockdown messaging is with the views of millions of ordinary people.

The Editorial Comment in Thursday’s edition of the Black Country’s Express & Star perfectly encapsulated the political power of No 10’s strategy: Every extra lockdown day means more jobs lost, more businesses going under more damage. This is the dilemma. Yet, in reality, until we can have confidence that we are safe from a disastrous coronavirus counterattack, we have little choice but to dig in and carry on.

And there we have it in a nutshell. When Boris Johnson assembled a coronavirus War Cabinet in March and vowed we’re going to beat this thing, the war analogy stuck; when No 10 ran Stay At Home – the most chillingly penetrating advertising campaign since Don’t Die of Ignorance when aids hysteria gripped the world – millions became convinced by lockdown.

Now – perhaps understandably in light of how the crisis was sold to them – the same people expect victory at any cost. They are hesitant about easing restrictions. And they expect that a second wave can – and – must be stopped.

Yes, Boris Johnson has promised to release plans for easing lockdown next week. But they are unlikely to go far enough. The Government cannot follow the science because it is trapped by its own success.

https://www.telegraph.co.uk/politics/2020/05/01/evidence-rising-britains-lockdown-could-deadly-mistake/

I was sent this entertaining meme:

As we enter the next 3 weeks of lockdown here is a summary of the advice:

1. You MUST NOT leave the house for any reason, but if you have a reason, you can leave the house.

2. Masks are useless at protecting you against the virus, but you may have to wear one because it can save lives, but they may not work, but they may be mandatory, but maybe not.

3. Shops are closed, except those shops that are open.

4. You must not go to work but you can get another job and go to work.

5. You should not go to the Drs or to the hospital unless you have to go there, unless you are too poorly to go there.

6. This virus can kill people, but don’t be scared of it. It can only kill those people who are vulnerable or those people who are not vulnerable people. It’s possible to contain and control it, sometimes, except that sometimes it actually leads to a global disaster.

7. Gloves won’t help, but they can still help so wear them sometimes or not.

8. STAY HOME, but it’s important to go out.

9. There is no shortage of groceries in the supermarkets, but there are many things missing. Sometimes you won’t need loo rolls but you should buy some just in case you need some.

10. The virus has no effect on children except those children it affects.

11. Animals are not affected, but there is still a cat that tested positive in Belgium in February when no one had been tested, plus a few tigers here and there…

12. Stay 2 metres away from tigers (see point 11).

13. You will have many symptoms if your get the virus, but you can also get symptoms without getting the virus, get the virus without having any symptoms or be contagious without having symptoms, or be non-contagious with symptoms...

14. To help protect yourself you should eat well and exercise, but eat whatever you have on hand as it’s better not to go out shopping.

15. It’s important to get fresh air but don’t go to parks but go for a walk. But don’t sit down, except if you are old, but not for too long or if you are pregnant or if you’re not old or pregnant but need to sit down. If you do sit down don’t eat your picnic.

16. Don’t visit old people but you have to take care of the old people and bring them food and medication.

17. If you’re sick, you can go out when you are better but anyone else in your house can’t go out when you are better unless they need to go out.

18. You can get restaurant food delivered to the house. These deliveries are safe. But groceries you bring back to your house have to be decontaminated outside for 3 hours including Pizza.

19. You can’t see your older mother or grandmother, but they can take a taxi and meet an older taxi driver.

20. You are safe if you maintain the safe social distance when out but you can’t go out with friends or strangers at the safe social distance.

21. The virus remains active on different surfaces for two hours ... or four hours... six hours... I mean days, not hours... But it needs a damp environment. Or a cold environment that is warm and dry... in the air, as long as the air is not plastic.

22. Schools are closed so you need to home educate your children, unless you can send them to school because you’re not at home. If you are at home you can home educate your children using various portals and virtual class rooms, unless you have poor internet, or more than one child and only one computer, or you are working from home. Baking cakes can be considered maths, science or art. If you are home educating you can include household chores to be education. If you are home educating you can start drinking at 10am.

23. If you’re not home educating kids, you can start drinking at 10am.

24. The number of corona related deaths will be announced daily but we don’t know how many people are infected as they are only testing those who are almost dead to find out if that’s what they will die of… the people who die of corona who aren’t counted won’t be counted.

25. You should stay in locked down until the virus stops infecting people but it will only stop infecting people if we all get infected so it’s important we get infected and some don’t get infected.

26. You can join your neighbours for a street party and turn your music up for an outside disco and your neighbours won’t call the police. People in another street are allowed to call the police about your music.

27. No business will go under due to Coronavirus except those businesses that will have already gone under.

After the Prime Ministerial broadcast of 10 May 2020, you can read this meme in a rainbow of confused colours. Let us provide a firm foundation for the rest of this book, by seeking some clarity about covid.

CHAPTER 2

COVID CLARITY

Kindness comes from clarity, not confusion.

Clarity requires a consideration of all views within a spectrum of reality. That which is real is rational. Because only that which is rational can be shared in human consciousness.

Herr Hegel, meet Herr Jung. I can’t share with you the feelings of love that I feel. You can sense those feelings within me, by reference to your own feelings. I can appreciate that you too, feel love: but your love is not the same as mine.

The CBT approach here is orientation. There is nothing more dangerous to personal well-being than unexamined ideas. Ideas trigger feelings. In order to optimise your own state of feelings, you need to examine your ideas.

One easy way of getting you to reflect upon your ideas is to ask hypothetically that you explain them to a kindly visitor from Mars. Our Martian visitor is interested in what you think, but has no interest in persuading you to change what you think. If they have CBT on Mars, the visitor may well be interested in helping you to modify how you feel about what you think.

So, let’s hit the Skype button and talk this one through.

Terms

Importantly, let’s first define our terms. We need to be talking about the same thing in the same terns, otherwise it’s not a conversation, it’s a confusion.

This will take a few pages. The scientific information is not complicated. Anyone with general education up to GCSE / O Level (age 16 for non-English readers) can understand it. The super-long taxonomic and clinical words are off-putting. But get past them to the context and meaning and it’s plain sailing. I use Wikipedia references, where available, to demonstrate the accessibility of the information.

The Virus

Betacoronaviruses (β-CoVs or Beta-CoVs) are one of four genera (Alpha-,Beta-,Gamma-, and Delta-) of coronaviruses. It is in the subfamily Orthocoronavirinae in the family Coronaviridae, of the order Nidovirales. They are enveloped, positive-sense, single-stranded RNA viruses of zoonotic origin. The coronavirus genera are each composed of varying viral lineages with the betacoronavirus genus containing four such lineages: A, B, C, D. In older literature, this genus is also known as group 2 coronaviruses.

The Beta-CoVs of the greatest clinical importance concerning humans are OC43 (which can cause the common cold) and HKU1 of the A lineage, SARS-CoV and SARS-CoV-2 (which causes the disease COVID-19) of the B lineage, and MERS-CoV of the C lineage. MERS-CoV is the first betacoronavirus belonging to lineage C that is known to infect humans. The Alphacoronavirus and Betacoronavirus genera descend from the bat gene pool.

https://en.wikipedia.org/wiki/Betacoronavirus

So the primary subject matter of the debate between the two case is: SARS-CoV-2 (which causes the disease COVID-19) of the B lineage.

Phylogenetics and taxonomy

SARS-CoV-2 belongs to the broad family of viruses known as coronaviruses. It is a positive-sense single-stranded RNA (+ssRNA) virus, with a single linear RNA segment. Other coronaviruses are capable of causing illnesses ranging from the common cold to more severe diseases such as Middle East respiratory syndrome (MERS, fatality rate ~34%). It is the seventh known coronavirus to infect people, after 229E, NL63, OC43, HKU1, MERS-CoV, and the original SARS-CoV.[

Like the SARS-related coronavirus strain implicated in the 2003 SARS outbreak, SARS-CoV-2 is a member of the subgenus Sarbecovirus (beta-CoV lineage B). Its RNA sequence is approximately 30,000 bases in length. SARS-CoV-2 is unique among known betacoronaviruses in its incorporation of a polybasic cleavage site, a characteristic known to increase pathogenicity and transmissibility in other viruses.

With a sufficient number of sequenced genomes, it is possible to reconstruct a phylogenetic tree of the mutation history of a family of viruses. By 12 January 2020, five genomes of SARS-CoV-2 had been isolated from Wuhan and reported by the Chinese Center for Disease Control and Prevention (CCDC) and other institutions; the number of genomes increased to 42 by 30 January 2020. A phylogenetic analysis of those samples showed they were highly related with at most seven mutations relative to a common ancestor, implying that the first human infection occurred in November or December 2019. As of 27 March 2020, 1,495 SARS-CoV-2 genomes sampled on six continents were publicly available.

On 11 February 2020, the ICTV announced that according to existing rules that compute hierarchical relationships among coronaviruses on the basis of five conserved sequences of nucleic acids, the differences between what was then called 2019-nCoV and the virus strain from the 2003 SARS outbreak were insufficient to make them separate viral species. Therefore, they identified 2019-nCoV as a strain of Severe acute respiratory syndrome-related coronavirus.

https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndrome_coronavirus_2

Six species of human coronaviruses are known, with one species subdivided into two different strains, making seven strains of human coronaviruses altogether. Four of these coronaviruses continually circulate in the human population and produce the generally mild symptoms of the common cold in adults and children worldwide: -OC43, -HKU1, HCoV-229E, -NL63. These coronaviruses cause about 15% of common colds, while 40 to 50% of colds are caused by rhinoviruses. The four mild coronaviruses have a seasonal incidence occurring in the winter months in temperate climates. There is no preference towards a particular season in tropical climates.

Four human coronaviruses produce symptoms that are generally mild:

1. Human coronavirus OC43 (HCoV-OC43), β-CoV

2. Human coronavirus HKU1 (HCoV-HKU1), β-CoV

3. Human coronavirus 229E (HCoV-229E), α-CoV

4. Human coronavirus NL63 (HCoV-NL63), α-CoV

Three human coronaviruses produce symptoms that are potentially severe:

1. Middle East respiratory syndrome-related coronavirus (MERSCoV), β-CoV

2. Severe acute respiratory syndrome coronavirus (SARS-CoV), β-CoV

3. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), β-CoV

https://en.wikipedia.org/wiki/Coronavirus

All scientists in the relevant fields agree that:

•Relevant scientific disciplines for understanding the nature and effect of Betacoronaviruses include: micro-biology; virology; epidemiology; acute clinical medicine disciplines, and geriatric medicine disciplines;

•These scientific disciplines have a comprehensive understanding of the nature and effect of Betacoronaviruses, such that it was catalogued in medical literature existing as at (say) 1 January 2019;

•The Betacoronavirus SARS-CoV-2 emerged into the world sometime in late 2019;

•The origin of SARS-CoV-2 is somewhat disputed. But it makes no difference to our ability to understand its virological / clinical effects;

•These scientific disciplines were able to garner a comprehensive understanding of the nature and effect of SARS-CoV-2 by the end of January 2020;

•Understanding of clinical effects and treatment took a little longer. But doctors worldwide now have best treatment options for covid sufferers. The majority of those infected, with serious symptoms, survive.

Illustration

The Coronaviridae

Coronavirus disease was first recognised in humans in the 1930s, with the first virus (HCoV-229E) isolated in 1965.

Subsequently, three further CoVs were identified in humans (HCoV-NL63, HCoVOC43 and HCoV-HKU1).

These viruses are endemic in humans and, after rhinoviruses, are an important cause of the common cold, with outbreaks occurring throughout the year, but more frequently in winter and spring in temperate climates. While adults generally experience mild cold symptoms, among individuals with asthma/COPD exacerbations may occur. Infection may be more severe in infants and young children, causing tracheolaryngobronchitis (croup), bronchitis and pneumonia.

In November 2002 an outbreak of serious acute respiratory syndrome (SARS) was found to be due to a fourth, highly pathogenic, coronavirus the SARS coronavirus. The disease originated in China and subsequently spread to Vietnam, Hong Kong, Taiwan, Singapore and Canada. Between its first and last appearance, 8096 cases were reported to the World Health Organisation (WHO) with 711 deaths, giving a case fatality rate (CFR) of 9.6%. In affected countries, outbreaks were contained by vigorous identification of cases and enforced quarantining of contact. In Taiwan, where an outbreak followed return of an infected traveller returning from Guandong, China, 671 cases were identified and 131,132 people were quarantined The last case from this episode was reported in July 2003, although three small laboratory associated outbreaks have occurred since then involving 11 patients. The causative virus, the betacoronavirus, SARS CoV, has not been circulating in humans since.

A fifth coronavirus was identified in 2012 the UK following hospital admission of a patient with a SARS like illness. Middle East Respiratory Syndrome (MERS) CoV has resulted in a limited number of outbreaks, mostly in Saudi Arabia and other middle eastern countries. Human to human transmission of this disease has, to date, been limited to close contacts of affected cases in households or healthcare settings. The CFR in this disease exceeds 30%

https://www.fpm.org.uk/blog/covid-19-sars-cov-2-pandemic/

Microbiology of Viruses

All agree upon these elementary matters of microbiology:

A micron (µm) is a unit of measure in the metric system equal to 1 millionth of a meter in length (about 39 millionths of an inch). The average cross-section of a human hair is 50 microns. The human eye cannot see anything smaller than 40 microns in size.

The average diameter of a coronavirus particle (a virion) is around 80-125 nanometres (nm) = 0.125 µm.

The average coronavirus virion is, in size, approximately 1/800th the size of a cross-section of human hair.

Humans Are Viral Beings

Nearly 10 percent of the human genome is made of bits of virus DNA. For the most part, this viral DNA is not harmful. In some cases, scientists are finding, it actually has a beneficial impact.

When viruses infect us, they can embed small chunks of their genetic material in our DNA. Although infrequent, the incorporation of this material into the human genome has been occurring for millions of years. As a result of this ongoing process, viral genetic material comprises nearly 10 percent of the modern human genome. Over time, the vast majority of viral invaders populating our genome have mutated to the point that they no longer lead to active infections. But, as scientists funded by the National Institutes of Health have demonstrated, they are not entirely dormant.

Sometimes, these stowaway sequences of viral genes, called endogenous retroviruses (ERVs), can contribute to the onset of diseases such as cancer. They can also make their hosts susceptible to infections from other viruses. However, scientists have identified numerous cases of viral hitchhikers bestowing crucial benefits to their human hosts -- from protection against disease to shaping important aspects of human evolution, such as the ability to digest starch.

https://www.sciencedaily.com/releases/2016/11/161128151050.htm

This data point also factors into the data points of: Acquired Immunity; Heterologous Immunity; and Cytokine Storm.

Pathogenic Defence

We all have an immune System. A vast array of defences against viral infection.

The relevant point, for present purposes, is that you can successfully fight off a virus, without using antibodies. Your first-line pathogenic defence sees off most invaders (including SARS-CoV-2).

So, you don’t produce antibodies, because you don’t need them.

It’s only after 1-3 weeks of your immune System, trying but failing to eradicate the virus, that you produce antibodies. Then they have a go.

This is enormous implications for Testing. In summary:

Illustration

Antibodies

These are produced by the human target of the virus. The mechanisms are well-known to science, but too complex to summarise here. The key data points are:

•You produce trillions of antibodies, all the time;

•You can be infected by a coronavirus and be symptomatic or asymptomatic, and: (i) produce antibodies detectable as targeted at that specific Virion; or (ii) not produce antibodies detectable as targeted at that specific Virion;

•In either case, you can still have Acquired Immunity (from that specific virus, or by Heterologous Immunity).

However, your production of antibodies declines when you reach old-age. Just like the rest of your body, you get progressively worse at doing it. Which is, of course, another reason why the elderly are more vulnerable to viral infections and the chain-effect mortality they can trigger.

Other Anti-Viral defences

Viruses enter the host through skin and mucosal surfaces that happen to be colonized by communities of thousands of microorganisms collectively known as the commensal microbiota, where bacteria have a role in the modulation of the immune system and maintaining homeostasis. These bacteria are necessary for the development of the immune system and to prevent the adhesion and colonization of bacterial pathogens and parasites. However, the interactions between the commensal microbiota and viruses are not clear. The microbiota could confer protection against viral infection by priming the immune response to avoid infection, with some bacterial species being required to increase the antiviral response. On the other hand, it could also help to promote viral evasion of certain viruses by direct and indirect mechanisms, with the presence of the microbiota increasing infection and viruses using LPS and surface polysaccharides from bacteria to trigger immunosuppressive pathways.

https://www.frontiersin.org/articles/10.3389/fcimb.2019.00256/full

To simplify:

•A flu or covid virion gets up your nose;

•That triggers your body’s own innate bacterial defence system;

•That’s a completely different system to your antibody system;

•Trying to test for anti-viral bacterial activation is extremely difficult (for obvious reasons).

Cytokine Storm

The following is a useful summary.

Diseases such as covid-19 and influenza can be fatal due to an overreaction of the body’s immune system called a cytokine storm.

Cytokines are small proteins released by many different cells in the body, including those of the immune system where they coordinate the body’s response against infection and trigger inflammation. The name ‘cytokine’ is derived from the Greek words for cell (cyto) and movement (kinos).

Sometimes the body’s response to infection can go into overdrive. For example, when SARS -CoV-2 – the virus behind the covid-19 pandemic – enters the lungs, it triggers an immune response, attracting immune cells to the region to attack the virus, resulting in localised inflammation. But in some patients, excessive or uncontrolled levels of cytokines are released which then activate more immune cells, resulting in hyperinflammation. This can seriously harm or even kill the patient.

Cytokine storms are a common complication not only of covid-19 and flu but of other respiratory diseases caused by coronaviruses such as SARS and MERS. They are also associated with non-infectious diseases such as multiple sclerosis and pancreatitis.

The phenomenon became more widely known after the 2005 outbreak of the avian H5N1 influenza virus, also known as bird flu, when the high fatality rate was linked to an out-of-control cytokine response. Cytokine storms might explain why some people have a severe reaction to coronaviruses while others only experience mild symptoms. They could also be the reason why younger people are less affected, as their immune systems are less developed and so produce lower levels of inflammation-driving cytokines.

In 2006, six healthy young men were left in intensive care with multiple organ failure as a result of an out-of-control cytokine immune response during a preclinical trial of a new kind of drug. This reaction happened just 90 minutes after receiving a dose of the drug.

https://www.newscientist.com/term/cytokine-storm/#ixzz6LYQnS7ky

Acquired Immunity

To a viral pathogen:

•Renders an individual Non-Susceptible to that specific pathogen (you don’t catch the same flu twice);

•By Heterologous Immunity (Cross Immunity), can render that individual Non-Susceptible to genetic variants of that pathogen.

The existence of Heterologous Immunity is well-established in scientific literature. Choosing just 3 examples from a vast corpus:

•Mathews JD, Chesson JM, McCaw JM, McVernon J. Understanding influenza transmission, immunity and pandemic threats. Influenza Other Respir Viruses. 2009;3(4):143-149. doi:10.1111/j.1750-2659.2009.00089.x

•Welsh RM, Che JW, Brehm MA, Selin LK. Heterologous immunity between viruses. Immunol Rev. 2010;235(1):244-266. doi:10.1111/j.0105-2896.2010.00897.x

•Souquette A, Thomas PG. Past Life and Future Effects-How Heterologous Infections Alter Immunity to Influenza Viruses. Front Immunol. 2018;9:1071. Published 2018 May 22. doi:10.3389/fimmu.2018.01071

Heterologous Immunity is well-established to act as Acquired Immunity, as between (for example) one influenza virus and another. As a 2009 study comments:

Abstract The current pandemic threat can be best understood within an ecological framework that takes account of the history of past pandemics caused by influenza A, the relationships between pandemic and seasonal spread of influenza viruses, and the importance of immunity and behavioural responses in human populations.

Isolated populations without recent exposure to seasonal influenza seem more susceptible to new pandemic viruses, and much collateral evidence suggests that this is due to immunity directed against epitopes shared between pandemic and previously circulating strains of inter-pandemic influenza A virus.

In the highly connected modern world, most populations are regularly exposed to non-pandemic viruses, which can even boost immunity without causing influenza symptoms. Such naturally-induced immunity helps to explain the low attack-rates of seasonal influenza, as well as the moderate attack-rates in many urbanized populations affected by 1918–1919 and later pandemics.

The effectiveness of immunity, even against seasonal influenza, diminishes over time because of antigenic drift in circulating viruses and waning of post-exposure immune responses. Epidemiological evidence suggests that cross-protection against a new pandemic strain could fade even faster. Nevertheless, partial protection, even of short duration, induced by prior seasonal influenza or vaccination against it, could provide important protection in the early stages of a new pandemic.

•Mathews JD, Chesson JM, McCaw JM, McVernon J. Understanding influenza transmission, immunity and pandemic threats. Influenza Other Respir Viruses . 2009;3(4):143-149. doi:10.1111/j.1750-2659.2009.00089.x

It is difficult to specify in advance, in relation to a new (novel) viral pathogen, whether extant Acquired Immunity in respect of another viral pathogen (within the same genus of pathogens, as the novel virus):

•Provides Heterologous Immunity;

•To what extent in the population.

It is easier (but still challenging) to investigate those matters retrospectively.

Anyone who tells you that previous exposure to flu of various kinds cannot give you cross-immunity to covid, as disguising a guess, as knowledge. They don’t know. Past experience strongly suggests that there should be some degree of cross-immunity. What degree (say in percentage terms) nobody knows right now. Eventually, science will give us an approximate range of probability. But it is almost certainly not a zero probability.

Transmission:

You emit billions of virions when you are infectious. Each of you. All of us. You emit them by breathing. Also by coughing and sneezing, but people tend not to cough and sneeze at or on each other.

Virions emitted inside mucocsal droplets from sneezes and ‘wet’ coughs have very limited transmission distance. Virions emitted by breathing out, or coughing out, are aerosolised. Those virus particles travel in the air.

The following is clear. Its importance is obvious, so I reproduce the paper in the Appendices Library at C1.

AEROSOL AND SURFACE STABILITY OF HCOV-19 (SARS-COV-2) COMPARED TO SARS-COV-1

10 March 2020

Abstract HCoV-19 (SARS-2) has caused >88,000 reported illnesses with a current case-fatality ratio of ~2%. Here, we investigate the stability of viable HCoV-19 on surfaces and in aerosols in comparison with SARS-CoV-1. Overall, stability is very similar between HCoV-19 and SARS-CoV-1. We found that viable virus could be detected in aerosols up to 3 hours post aerosolization, up to 4 hours on copper, up to 24 hours on cardboard and up to 2-3 days on plastic and stainless steel. HCoV-19 and SARS-CoV-1 exhibited similar half-lives in aerosols, with median estimates around 2.7 hours. Both viruses show relatively long viability on stainless steel and polypropylene compared to copper or cardboard: the median half-life estimate for HCoV-19 is around 13 hours on steel and around 16 hours on polypropylene. Our results indicate that aerosol and fomite transmission of HCoV-19 is plausible, as the virus can remain viable in aerosols for multiple hours and on surfaces up to days.

Useful further information:

Airborne Precautions.

Authors: Ather B1, Edemekong PF2.

During aerosolization, the microorganisms that are less than 5 microns in size float in the air. Sometimes, the microorganisms may be contained in dust particles that are present in the air.

Once the droplets that contains microorganisms have been formed, they are then dispersed via air currents to varying distances and can be inhaled by susceptible hosts.

The infected aerosolized particles often remain suspended in the air currents and may travel considerable distances, although many particles will drop off within the vicinity. As the distance travelled of the aerosol particle increases, the risk of infection starts to drop. Airborne precautions necessitate the prevention of infections and use of available interventions in healthcare facilities to prevent the transmission of airborne particles. The airborne particles often remain suspended in the facility air environment and with air currents move along to different parts of the institution where there is a potential of them being inhaled by other patients. The airborne particles may remain localized to the room or move depending on the airflow.

•StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 17 Feb 2020.

Testing for Antibodies

This is different to testing for the active virus itself by nose / throat swabs. Instead, the domain of the inquiry is whether any individual has been exposed to SARS-CoV-2, or any other BCV.

You are not testing for the virus. You are testing for the antibodies. This is wherein lies the apparently insuperable difficulties and limits of testing.

Example:

HSV1 is the herpes virus which causes cold sores. It is colloquially termed the kissing disease. It is part of the family of Herpesviruses (from the Greek for creeping). Readers will be familiar with cold sores. Around 80%-90% of European and US persons test positive for HSV1 antibodies. This is of no great importance to people. Lots of kids have it. The reason it is of no importance is: it is transmissible only while an open sore is present; it is capable of control by well-known anti-virals.

There exist a gold standard laboratory test for HSV1 antibodies. It is correct within 95% certainty.

HSV2 is the herpes virus which causes genital herpes. It is widespread in the USA. In the UK, approximately 0.5 million people are presently infected. This is the nasty cousin of HSV1. It’s nastiness is produced by 2 factors: (1) it can be immensely painful; (ii) it is transmissible even in the absence of sores. The virions lodge in nerve bundles and emit more virions in what is called viral shedding. Viral shedding occurs intermittently. It can be daily (for a period), monthly, weekly. Anti-virals can reduce the rate of shedding by a factor of 95%. But after 12-18 months of anti-viral usage, the virus can acquire immunity.

Here is the point: in the absence of symptoms it is virtually impossible to test effectively for HSV2 antibodies. That is why the American Center for Disease Control standard guidance to doctors is not to test, because the chances of false positive result are 50%. The reason why the false positive rate is so high, is that the antibody reaction caused by HSV2 is not sufficiently dissimilar to the antibody reaction caused by HSV1.

To oversimplify by analogy, for the purposes of explanation: Both HSV1 and HSV2 are cats. But they are invisible cats. You can only see where they have been by collecting cat fir samples left behind on the sofa. They are different breeds of cats (a Tabby and a Persian). But their hairs are so similar, that when you put them under a microscope it is very difficult to tell them apart.

Back to coronavirus. We carry inside us an antibody zoo of trillions of antibodies of different types, and different (and overlapping) antibody systems which organise anti-viral defence.

To oversimplify by analogy for the purposes of explanation: the 7 known human coronaviruses are all Breeds of Dog. There are:

•Varieties of Toy Dogs (the common cold): which can give you a nasty nip, but in the absence of other complications, is rarely fatal;

•Varieties of Terriers (influenzas): which can trigger fatal complications in the frail elderly, but the under 65 fit and healthy find the bite anything from mildly annoying (if they even notice it) to 10 days in bed;

•Varieties of Alsatians (SARs): which can definitely bite you to death, if you are already frail elderly, or if you have a weak heart, but the under 65 fit and healthy find the bite anything from mildly annoying (if they even notice it) to 10 days in bed;

•Rottweilers (MERS): 33% bite fatality. They go for main veins, with very powerful jaws.

All of these Breeds are mutations from a common genetic ancestor. They are Dogs, not Cats. SARS-CoV-2 is a dog. It is not a cat or a bat.

The trouble with testing is that all these dog breeds are invisible. All you can test is the response of the human body to having been bitten. If your femoral artery is bitten through, it’s a safe bet that little Terrier jaws didn’t do that. But when your wound-response systems react to bites, the response is similar to all bites.

This is all complicated by the fact that human coronaviruses have been around as long as we have: just like dogs. We are so used to them, that we have Systemic Immunity, Acquired Antibody Immunity, and Heterologous Antibody Immunity. And a dog is a dog. There are different breeds, but what they genetically have in common genetically is way bigger than what distinguishes them.

So, we have the SARS-CoV Alsatian breed. Long Coat (SARS-CoV) and Short Coat (SARS-CoV-2). And various Terrier breeds of influenza.

We:

•Know that Acquired Immunity to one Breed, provides immunity to that same Breed (for a year to 2 years);

•Have enough clinical experience of SARS-CoV-2 to be robustly certain that these established rules of immunity apply to it;

•Know that Acquired Immunity to one Breed, can provide immunity, or partial immunity, to another Breed;

•That everyone carries around a rolled-up newspaper (innate bacterial systems with anti-viral properties).

We don’t know:

•Exactly how that immunity is manifested in the immune system (antibodies; plus the whole array of anti-viral strategies we deploy), in response to any particular Sub-Breed (as compared with any other Sub-Breed);

•How to test for Heterologous Immunity;

•How to test for Bacterial Immunity (the effectiveness of the rolled-up newspaper).

The result of all of the above, and its corollaries, is that it’s really hard to formulate a test which works:

•In the absence of symptoms;

•After a time when any symptomatic immune response (if there was one) has dissipated.

As with Herpesviruses, you tend to end up with lots of false positives:

•There is genetic similarity of the variations of attacking Breeds;

•So the anti-body and immune system repertoire works in similar and dissimilar-but-overlapping ways, in response to all Dog attacks.

You also end up with lots of false negatives, due to:

•Acquired Immunity, which is present to the virion, but not to the test;

•Heterologous Immunity which sees off the virion, but does not present to the test;

•Bacterial anti-viral systems, which don’t present to the test;

•Low / No antibody count, which does not present to the test.

Ventilators

A ventilator is life support machinery, in the Intensive Care Unit of a hospital. The patient is placed by drugs in an artificial coma. The machinery then takes over the operation of the lungs.

Ventilators play a limited role in acute clinical care for the geriatric population. This is well-established clinical medicine knowledge and practice. Here are some examples (1996 and 2004) from the clinical literature:

THE OUTCOME OF PROLONGED MECHANICAL VENTILATION IN ELDERLY PATIENTS: ARE THE EFFORTS WORTHWHILE?

Authors AREND J. MEINDERS, JOHANNES G. VAN DER HOEVEN, AREND E. MEINDERS

Age and Ageing, Volume 25, Issue 5, September 1996, Pages 353–356 https://doi.org/10.1093/ageing/25.5.353

1 September 1996

Abstract

We studied the outcome of prolonged (> 3 days) mechanical ventilation in 181 patients aged 70 and over and determined the risk factors for in-hospital mortality. The overall in-hospital mortality for the entire study group was 57.5%. The previous medical history did not influence the final outcome. Shock during the intensive care unit (ICU) stay and an admission diagnosis of cardiac arrest were independently correlated with in-hospital mortality. We conclude that the prognosis for patients aged 70 and over who need prolonged mechanical ventilation is mainly dependent on the acute health status and the occurrence of complications during the ICU admission

INTENSIVE CARE AND INVASIVE VENTILATION IN