Category: London Calling

I’m sure weekends like this used to be pretty normal… in the before times. But I’m out of practice, and I’m totally knackered.

Dawnise found-out on Facebook post that a neighbor of ours from Seattle was moving to London. She arrived (and made the aforementioned Facebook post) earlier this week. She got settled into temp housing, got a clear COVID test, and we had her around for Saturday brunch. I made brioche french toast and we sat and caught up for a couple hours. It was fantastic.

Saturday night we caught the DLR to a “do-over” birthday party for a friend, at a gastro pub in east London, along the Thames. They had arranged a room – food, drinks, and more people than we’d been in one place with in quite a while. At some point, somehow, Dawnise and another extroverted friend ended up chatting with a group of very well dressed folks who turned out to be quite interesting. Two were musicians, one in media, and the last a bit of a serial entrepreneur.

This morning we got up, made breakfast, and caught an early afternoon train to Guildford, to meet up with friends and former colleagues we haven’t seen in far too long. We spent the afternoon chatting, eating and drinking with friends with better weather than we had any right to hope for. We got a ride back to the station, fortuitously arrived just in time to catch an express train back to London, and got home just on time to feed and medicate the diabetic cat.

Tomorrow we’ve got tickets for a play we were scheduled to see just before the theaters were closed, with friends who’ve since moved back to the US.

Put a fork in me. I’m done.

But also, more of this, please-and-thank-you.

After two weeks of insulin, Oscar had a follow-up to check his fructosamine levels. The good news was that the levels had fallen several hundred points, into a range the vet considers “healthy.” He’d also lost a bit of weight, at a rate the vet also considered healthy. Barring acute events or observable change in behavior, he’ll goes back in three months to test again.

So the 7am/7pm feeding and injection regime is “the new normal.”

Cats, it turns out, are much better at knowing when they’re hungry than they are at knowing what time it is – so Ivan generally starts demanding food a couple hours before it’s time to be fed.

That’s far less irritating in the afternoon than it is at 5:30 in the morning.

Dawnise is really good at ignoring him and either sleeping through it or falling back to sleep. I, on the other hand, am not. And the cats figured out long ago that a pretty sure fire way to get my attention (and get me out of bed) is to make destructive sounding noises in a room just out of sight.

So, yeah… Three weeks in and it’s already getting old.

In other news, the UK’s third COVID wave seems to have peaked at 60k daily reported cases (a ~12% positivity rate in England) in mid July. So far much lower than the estimates – some as high as 100k per day.

The latest eyebrow-raising news is that the NHS has only recently started gathering and reporting data that differentiates people being admitted to hospital with COVID from those being admitted to hospital due to COVID.

That data shows that over the past month about 1 in 4 admissions are of people who test positive, but for whom COVID symptoms are not the cause of admission.

Hospitals were measuring and reporting what they were asked to measure and report. And from the perspective of a hospital, counting patients with COVID is reasonable and important. COVID infected patients demand more resources, in the form of increased isolation, PPE, etc., than non-COVID infected patients. So whether a patient arrives with a broken leg and tests positive, or comes in with low blood oxygen clearly due to COVID, that patient places more demands on the hospital. Knowing how many patients are admitted with COVID is a key data point for understanding the capacity of the health care system.

But health care system capacity wasn’t the only way the data was being interpreted by the media, the public, and seemingly by the government. As the vaccination program suppressed the link between infection and acute illness, public attention turned from case counts to more focus on hospitalization and mortality rates. And this reveals that recently, the hospitalization numbers haven’t quite represented what people thought they did.

The data being gathered told how many people were in hospital with COVID – and using that data to reason about the risk of being hospitalized due to COVID isn’t straight forward, indeed may be impossible.

But it was happening all the same.

Why is this data only being gathered now? I have seen no good answers. The Telegraph quotes Professor Carl Heneghan, director of the Centre for Evidence-Based Medicine at the University of Oxford, as saying: “This data is incredibly important, and this is information we should have had a very long time ago. We have been crying out for it for nearly 18 months.” (emphasis added) Going on to say “the Government might have made very different decisions about restrictions if it had access to data which actually measured the situation accurately.”

Were the decisions wrong? Hard to say. But making decisions that affect many millions of lives based on data that doesn’t mean what you think it means certainly seems … not great.

It’s also hard to say if the difference between what we were measuring and what people thought we were measuring has been consistent over time. It’s tempting to naively retroactively apply the 25% “over estimation” to hospitalization numbers from January – indeed that same article quotes Heneghan as saying “at the peak of the pandemic in January, we were talking about close to 40,000 patients in hospital – this new data suggests that back then around 10,000 of them were primarily there for other reasons” – but that’s almost certainly wrong. Nothing else about this virus has been stable over time, this seems unlikely to be the exception.

To be clear, I am not a statistician – I don’t even play one on television – clearly neither is Boris Johnson, and based on the quote above I have my doubts about Professor Heneghan, too. Having said that, I’m pretty sure a better past estimate could be had using long term hospital admissions data. Fortunately, that data exists, hopefully someone’s working on that as I type.

It takes context and understanding to turn “data” into “information,” and again to turn “information” into “knowledge.” Decision making, certainly on a national scale, demands rigor at each step.

If there’s a moral here, I think it lies somewhere between “lies, damn lies, and statistics” and “never attribute to malice that which is adequately explained by stupidity.”

And there’s certainly been no shortage of that.

A week from Monday, on the 19th of July, England plans to remove all remaining legal restrictions on behavior instituted due to COVID-19. No more limits on the size of indoor gatherings, no requirement to wear masks indoors, no more mandate for social distancing, and no more government guidance for those who can to work from home. Fully vaccinated travelers still need outbound and return PCR tests, but can skip quarantine on return from “amber list” countries.

People are being encouraged to ‘exercise judgement.’

Case counts are doubling roughly every 6 days.

The new health secretary; Sajid Javid, who replaced Matt Hancock when Hancock was observed “breaking social distancing rules,” says the UK must ‘learn to live with’ COVID. Maybe it’s me, but this isn’t the sort of statement I’d expect from someone charged with protecting public health when cases are growing this quickly.

Israel – where the majority of the population (56%) is fully vaccinated – has responded to their case count rising by reinstating a mask mandate, six months after having removed all restrictions.

So I give it a 7/10 chance that some set of restrictions are re-introduced before Christmas. I’d be happy to be wrong.

Also from the things-you-learn-to-live-with department, Dawnise and I find ourselves – for the second time – caring for a diabetic cat. We took Oscar to the local vet about two weeks ago, having noticed an uptick in his fluid consumption and, um, return.

They did an exam, drew blood, and found acutely elevated blood glucose leading them to suspect diabetes. A subsequent fructosamine panel reinforced the diagnosis. So he’s getting twice daily insulin injections, and both cats’ eating schedules have been strictly controlled – which I assure you no one in the house is particularly happy about.

He goes back in a week for follow-up blood work to adjust his daily dose.

If the idea of jabbing your cat with a hypodermic twice a day isn’t enough to get you irritated, consider that it also means you – or someone you trust to jab your cat with a hypodermic – needs to be home twice a day, on a pretty predictable schedule.

So that makes life in general, and travel particularly… complicated.

We had been starting to discuss a return visit to Seattle, once the quarantine-on-return requirement was dropped, and this throws a spanner in those works. We need to at least get him on a stable treatment plan before the two of us can consider vanishing at the same time.

Our hope – which may be pure optimism – is that we can get to the point where his condition can be controlled through diet. Unlike humans, cats with type 2 diabetes can experience spontaneous remission – we know, ’cause our last diabetic cat (Junior) “got better” after a period of diet control and treatment. Fingers crossed.

Not much other news of particular import – Dawnise is starting to occasionally venture out of the flat – shopping trips around London, solo and with friends. I’ve been fighting the good fight to remain engaged and motivated. Some days are better than others, but mostly I feel like I’ve long run out of fucks. Whatever I have now are to fucks what chicory is to coffee, or carob is to chocolate. Sorta similar looking, but you’d never mistake them for the real thing.

I guess this is what burnout feels like.

Another thing to add to the list of things I’d rather not to learn to live with.

Tomorrow marks two years since our arrival in the UK. It seems both forever ago and only yesterday that it had been a year, and if we hadn’t moved flats in the middle of the blur, there would have been even less to mark the passage of time.

Our plan had been to live here for “a couple of years” – but our plan certainly hadn’t been to live here for “a couple of years almost entirely in our flat.” Our plan had included things like exploring London, traveling around the UK, and visiting places in Europe we didn’t get to while we lived in Luxembourg. The pandemic had other plans, and as it stretched toward the end of last year, we started talking about what we wanted to do, and if we could figure out how to do that.

We sorta decided that unless the pandemic situation in America got a bunch better, and got a bunch worse in the UK, moving back without doing any of the things we came to do felt like something we’d regret.

Moving internationally takes work. We haven’t found it to be as hard as people expect, but it certainly takes effort, and comes with its fair share of stress (especially if you’re moving animals). Oh, and it’s not exactly cheap.

The hardest bit is typically immigration – getting permission to live and work in a country you’re not a citizen of. Both times we’ve lived abroad my work visa has been sponsored by my employer.

The term of my agreement to come to the UK was two years – and while extending that agreement was possible, there was no guarantee. Around April of last year I’d moved out of the group that I was part of when we moved here, and for several reasons it wasn’t clear the group I had joined was going see enough value in me being here that extending my stay would make sense to them. If they weren’t supportive, I didn’t have too many options, and none of them seemed great.

So I started working on a “Plan B.”

I engaged a local immigration law firm, and with their help and with some graciously written letters of support from a few former colleagues, I was able to petition the UK government to decouple my immigration status from my employment.

It took a couple months, but by the end of last year, I had a Plan B – and more options.

With that in my back pocket, I had a frank and honest conversation with the leadership in my org, and we mutually agreed that there were probably places I could be more valuable than where I was. So I started chatting with other teams and moved into a new team (again) earlier this year. As it turned out, the new team was amenable to extend my assignment, so a little paperwork later and our new plan is to be in the UK through the middle of 2022.

In other news, we’re both fully vaccinated – and by this time next week we’ll both be +2 weeks from our second dose (“maxinated”). The government is making optimistic noises that the four week delay to eliminating the last legal restrictions will stick – and that July 17th, we’ll be back to normal. “This time for real.” I’m not sure the data I can see supports that optimism, but then Boris’ government hasn’t established a particularly good track record of ahead of time decision making.

Still, with any luck the next year won’t be like the last year. We’d like to do some traveling, get back to Seattle for a visit or two, and generally speaking not spend another twelve months in our flat.

Fingers crossed.

If I had to sum up the UK government’s pandemic response succinctly, I’d say “better late than never, but frustratingly late.”

The UK lagged Europe in implementing non-pharmaceutical interventions, stubbornly insisted Christmas wouldn’t be canceled – only to go back into lock-down days ahead of the holiday – and inexplicably waited weeks while case counts in India went vertical before restricting travel into the UK.

A few weeks ago, I wondered what, in a few weeks, we would we wish we had done “now” instead of waiting to do it later.

We had been chatting over lunch with friends about the early signs that the Delta variant (a.k.a. the-variant-formerly-known-as-Indian) was spreading exponentially, and what could and should be done about it.

“Their only choice is to extend lock-down, and they can’t or won’t” a friend argued. I disagreed – arguing there were other possible responses – re-targeting and accelerating the vaccination program, for example – shifting supplies to the areas affected and and opening vaccination to the younger age groups likely to be socializing and thereby spreading the virus.

I wasn’t privy to enough information to argue that was the right thing to do, just that it was a thing that could be done, and that if it were to be done, doing it now would be better than doing it later.

A few weeks later the government has announced that the June 21st target to eliminate remaining restrictions will be missed due to rising case counts and hospitalization. They’ve been “surge vaccinating” in hot spots, and as of yesterday (15 June) accelerated access to vaccinations for younger age groups and reduced the inter-dose delay from ~12 to ~8 weeks.

Again I couldn’t help but wonder why couldn’t we decide to take these steps a few weeks ago?

There are very few “right answers” in life – mostly we swim in an ocean of trade-offs. We try to make the best decisions we can, given the situation we’re in and the information we have. And we hope not to regret our decisions later.

Many of us struggle to think clearly and in advance about what change(s) would make us change our decision. My experience has been that by thinking through those triggers, and playing “what if” with a goal of minimizing regret we can often make “better” decisions. Or at least make decisions we’d make again, if the choice was ours to make again.

A simple way of thinking about minimizing regret is to ask yourself, when faced with a decision between alternatives, given everything you know now which choice do you think will cause you more regret over time? What could happen, or what could you learn, that would change your choice? How likely do you think you are you to learn that thing, or for any of the possible triggers you identified to happen? Is it possible to change your choice once you’ve made it? Is it possible to change if you made the other choice? Is one direction easier? Cheaper?

What we regret as individuals depends heavily on what we value. You and I, faced with the same decision – and both of us trying to minimize regret – may come to opposite conclusions. We might not agree, and it might not be obvious why we disagree. Still, if we’ve been successful, and not just self-delusional, if faced with making the decision again both of us would repeat our choice.

Consider the decisions that the government has been lambasted for delaying. Between the time a decision was made to do nothing (e.g. the decision that there would be no Christmas lock-down, or the decision not to impose restrictions on travel from India to the UK) and the time that decision was reversed, what was learned? What changed? At what point was that outcome certain, or predictable with high confidence?

High stakes decision making with incomplete and inaccurate information is hard, I mean really hard. There are no A/B tests – no way to know, or convince others, what would have happened if we made the other choice. What would have happened if we had turned right. This has real and significant implications. If we take action to avoid a disaster, and the disaster never materializes, there will be voices – sometimes loud ones – asserting that the disaster never would have happened regardless, and our actions were unnecessary and in some way harmful.

This sentiment has become a louder undertone in the media in the UK of late, seeming to increase in volume as delaying the removal of lock-down restrictions past the June target became more likely. Past modeling of disease and resulting hospitalization and death have been wrong – overshooting the observed reality, sometimes significantly. Restrictions on freedoms and trade have a cost – in money, in livelihoods, in opportunity. These costs are real.

When making a trade-off between predictable economic damage and likely increased illness and loss of life, and knowing what you know, how would you minimize regret?

The 2021 Eurovision Finals are this Saturday, in Rotterdam. They’re being held in front of a live unmasked “test audience” of 3500 people. Last year we had colluded with friends of ours to get tickets to one of the semi-finals, had booked a place to stay and were all looking forward to the trip. I don’t have to tell you how that plan turned out.

Are these your plans?

Our best laid plans, yes.

Oh well, never mind.

Will Farrel (who I can’t say I’m generally a huge fan of) made a mockumentary to tide fans over. A bunch of prior year performers made cameos. That’s the origin of the the post title, by the way – and that character in the film is going to be delivering Iceland’s scores on Saturday.

Speaking of Iceland… their entry last year – Think About Things by Daði Freyr – was a favorite to win (Russia’s entry was another fan favorite). They’re back this year, and it seemed cruel and unusual that the band had to pull out of performing live when one of their member tested COVID positive. (Performers who would have been in last year were allowed to return, but had to come with a new song.)

At any rate, we watched the first and second semi-finals over the past few nights. Saturday we’ll likely have a couple friends over, order food, and watch the finals.

It’s another bit of normal, and I’m very happy to have it.

In less up-beat news, the India COVID variant I mentioned has done what things that grow exponentially do – it’s grown exponentially. Cases of that variant have grown 160% in the last week. That growth is against the backdrop of overall case counts declining – so it’s easy to miss, or ignore, when looking at the case charts.

The government has made repeated statements that most of those affected are eligible for vaccination but haven’t signed up to be vaccinated. Even assuming this is true, it neither solves the problem nor undoes the inexplicable delay to restrict travel from India as their COVID wave grew. In the hope of preserving the mid-June date for of relaxing remaining restrictions, second vaccinations for over 50s have been accelerated, and vaccination appointments have been opened for everyone 34 and older. In hotspot areas, vaccinations are being offered to everyone over 18. It’s a race, and the virus has a couple week lead, and unlike the immunity given by vaccination, the virus grows fast.

While on the topic of health – and bad news – Dawnise learned that a high school friend of hers has been diagnosed with cancer. Like too many Americans, she’s un or under-insured and has setup a go-fund-me to try to cover her potentially infinite care costs. The longer I spend living in countries with actual health care systems the less I can pretend to understand or rationalize this clearly broken state of affairs.

The UK is taking another step “toward normal” today. In England, indoor hospitality (read: pubs and restaurants) can resume; hosting parties of six people or two households. Outdoor gatherings up to 30 are okay, museums, theaters, and gyms can reopen. And snogging and shagging strangers is now legal again.

At the same time, there is significant concern about hot spots of “India variant” cases. The Telegraph reports (paywall) “total numbers have more than doubled in each of the past two weeks.” The official message from the government is that the planned reopening on June 21st is under threat, but today’s reopening will proceed as planned.

A recurring refrain in the UK is that Boris’ Tory government has taken many of its critical decisions a bit too late. Locking down. Restricting Travel. The timing of travel restrictions from India are currently top of the news cycle.

On June 1st, today will be “two weeks ago” – and there’s a little insistent voice in my head asking what we’ll wish we’d done, or hadn’t done, today when we look back in two weeks.

The scientific community is concerned – an article in The Guardian (paywall) quoted Professor Sir Mark Walport (you can never have too many honorariums ’round here) – chief scientific adviser until 2017 – who advised people continue remaining outdoors as much as possible, saying “my advice is that just because you can do something doesn’t necessarily mean you should.”

Wise words in many contexts.

The data emerging from the “India variant” hot spots seems to suggest the risk continues to be higest to the non-vaccinated. Fortunately there’s unlikely to be much overlap between young people not yet eligible for vaccination and those most likely to return to indoor activities.

That Telegraph article I mentioned? It reassures readers that the doubling in each of the last two weeks was “climbing from a very low base, with just 1,313 cases so far detected in total.” I guess the author never had to figure out how much wheat or rice ends up in the proverbial chess board.

People do not understand exponential growth.

Last week I read Michael Lewis‘ (The Big Short, Flash Boys, Moneyball) latest: The Premonition: A Pandemic Story. The inability to collectively grok exponential curves is a depressingly recurring theme. (The book is recommended, but not uplifting.)

On the “home front,” we’re both well. Dawnise is fully vaccinated, I’m between jabs. I’m anxious for my second, but reminding myself that the “first-doses-first” strategy has proven good for the collective, and the inter-vaccination duration seems to significantly improve efficacy, making it good for me individually.

Still.

I hate waiting.

Sometimes you don’t notice what’s missing until it comes back.

I hadn’t really noticed how odd it was to not see children outside until the UK largely returned to face-to-face schooling a couple weeks ago. I was on a cool down walk at the end of my run when – for the first time in a long time – I saw parents walking their kids to school.

It felt like the city had taken a deep breath. The first since late December, when the UK went back into lock-down, despite the government just days prior saying “canceling Christmas” would be inhumane and wasn’t an option on the table.

Last week – just over a year since the initial lock-down order – outdoor gatherings of six people (or two households) became permitted again. As the widely circulating meme cast it – now you and five friends could get drunk in a park.

We had a couple over and sat chatting on the chilly but sunny patio, drinking rosé and willing it to be warmer than it actually was. It was great to see other people again, and Dawnise and I were both pretty exhausted when they left, only a few hours later.

We might have forgotten how to socialize.

This coming Monday non-essential retail can reopen, and restaurants and pubs can serve customers outdoors (still subject to the so-called “rule of six”). When the weather cooperates we’ll consider venturing out to eat something we didn’t cook and wasn’t delivered by a dude (and it’s nearly always a dude) on a scooter.

Barring a spike in acute disease, that will be the regime until mid May.

Things otherwise are largely unchanged. We’ve marked six months in our “new” apartment – no leaks or other major issues to speak of.

Dawnise was invited for her first vaccination a few weeks back – just before the UK shifted to mostly administering second doses. I look forward to getting mine “soon.”

My phone tells me that in the year since I geared up to run in the cold I’ve run 770km – about 480 miles in old money. I’ve replaced my shoes once, and when the temperature got down near freezing I supplemented the wool base layer with a windbreaker, hat and gloves. I only skipped a handful of days, when it was icy, or driving rain. I still can’t say I like running, but the routine has become part of how I mark the passing of time. Like ordering more coffee, or coffee filters.

My practical driving exam, scheduled for December, was canceled due to the Christmas lock-down, and rescheduled to early May – which seemed impossibly far off. I got email the other day saying that testing has been set to resume, and that my test is expected to proceed as scheduled. If it does, and assuming I pass, it will be 10 months since I applied for my provisional license.

Fingers crossed.