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Why doesn’t it add up?

So, I’m going to do more on my “10 ways with … ” series later in the week, but right now this is an extra, as I can’t get my brain around some things and thought writing them down would help. I then thought there might be others with the same questions / ponderings, so decided to write on here (rather than just a piece of paper at home) in case I can help anyone else. It might not be in any very good order, or even full sentences, and certainly not complete

I am confused by the current vaccination program premise …

These are the “facts” we have been told that seem to relate. I do not put the word fact in inverted commas in an attempt to be difficult or suggest I don’t believe them, but because I can’t see how all of them can be fact … as I can’t figure out how they can all be correct at once – and this is why I am confused and struggling to make sense of the information.

Can anyone help?

SARS-CoV-2 is rife in the population

A proportion of people are asymptomatic with it, but can still spread it (this does not actually seem to be known for definite, although of course most viruses are spread prior to symptoms, or even from asymptomatic carriers)

Only 3-8% have had Covid so we are no where near herd immunity levels

1 in 11 people have antibodies (

Many people do not develop persistent antibodies, but should have T-cell immunity

Many NHS staff are exposed daily and are at risk from Covid Illness (but apparently most still haven’t had it??)

The NHS staff need the vaccine first to be safe (even though they’ve been exposed daily for months now)

A positive PCR = a case (even if asymptomatic)

Cases will fall as vaccination occurs

Vaccination does not prevent transmission only reduces symptoms (ie you are more likely to be asymptomatic??)

I can’t make all these add up. Can anyone else?

Thanks for your input! I would love to hear from other GP’s, Immunologists and virologists in particular.


Using Up and Using Spice

I recently had a conversation with a new acquaintance, Emma, from the Real Food Campaign, talking about herbs and spices and how to get people eating them. Nowadays it baffles me that many people don’t. … and don’t even know how to think about doing so. .. to the point that whilst I find Michael McIntyre hugely funny in the most part, I was totally perplexed by his sketch about the spice drawer – still funny, but to me total nonsense. (Michael McIntyre Spice Rack sketch) In our conversation the lovely Emma suggested that I could write something about how I use herbs and spices every day, and how and why they have become a staple in my kitchen. So here it is, and it is all about using up what’s left at the end of the week (or even using up what’s in the freezer because it’s been there so long and I’m not going to go shopping again until the freezer is nearly empty).

As I’ve mentioned before, on good weeks, and when life is stable I meal plan .. and yes spices come into my plans as, other than a traditional roast with lashings of good gravy, I just don’t really like plain food. But on busy / tired / unorganised weeks, I just go to the supermarket and get a joint of good quality meat, maybe a couple of portions of salmon or a pack of sausages, and some cheese and cream, along with the catfood and some seasonal fruit. The veg pitches up at my door on a Friday afternoon from my veg box delivery, and I then have a fridge full of random food. I understand that this is a nightmare for many people – fridge full of food but no obvious meals… what to do?

Early on in my cooking life when newly married but still at University, money was incredibly tight, and food wastage from the ‘random stuff in the fridge’ scenario was far too common a problem for me . So I developed what I call my “Using Up Using Spice” technique. I think the idea came to me in a rather roundabout way from learning that spices were often used either to mask the taste of food that was a bit past it, or to prolong the life of certain foods, along with the desire to create and maybe the desire to conjure up images of holidays.

This technique basically involves learning a few spice combinations and cooking methods that work to give a certain cultural “feel” to food and then using that as the basis of the meal, rather than using the main ingredients to try to drive a meal. It’s just an upside down way of looking at things, but (for me at least) it works.

Let’s say I roasted a large chicken on Sunday, but for various reasons only half of it got eaten and I now have enough to either serve again as roast chicken on a plate with veg for one meal, or to string it out for another 3 meal times if I’m more inventive. Along with this I have a slightly tired looking cabbage from last week’s veg box, some red peppers that came in the current veg box and some carrots ditto. In my cupboards I have some rice, some potatoes and a left over packet of wraps that are unopened and will be good for the next week or 2. I also always have coconut milk (I buy the condensed blocks you add boiling water to), tinned tomatoes, tinned beansprouts, tinned beans of various descriptions, tomato puree, frozen chilis (I buy fresh and bung them straight in the freezer) soy sauce, mayonnaise, lemons, salt and pepper, and a drawer full of herbs and spices from around the world.

My spice drawer – unlike Michael McIntyre’s mine gets regular use

So with the Use Up Use Spice method, there are options I see:

  1. I feel in the mood for warming Carribean-style food
  2. I want a real spicy zingy Thai / Asian-fusion type hit
  3. I fancy easy comforting jacket potato but without the boring and sugar filled baked beans it’s easy to go to
  4. It’s Mexican day
  5. I want a summery sort of vibe and to think of the Mediterranean
  6. Nothing but curry will do

Taking each one at a time here (off the top of my head as I write) is what I would do:

Carribean feeling food fuses creamy coconut with some chilli and often a bit of turmeric and maybe something sweet:

  • so in this instance I would peel and roughly chop the cabbage, pepper and carrot, and add it to a pan with some oil / butter to saute (fry gently in oil with the lid firmly on so as to steam it at the same time). Then I would chop the chicken into chunks, add that and some rice and stir to coat. Then finally tip in coconut milk, maybe some chicken stock and the chilli and turmeric. Season with salt and pepper and boil until rice is ready … then serve in bowls, maybe topped with a few pieces of tinned pineapple if I had any. You could easily omit the rice from the main dish, cook it separately and ladle the soupy broth over it if you preferred. … or if you live in one of those wonderful towns with a big market, and had planned this in advance, you could treat yourself to some plantain and slice it, fry in butter and serve on the side.

Spicy Asian food has a hit of various flavours, but the ones that bring it out to me are ginger and wasabi for a more Japanese feel, chilli, garlic and lemongrass for a more Thai feel, ginger and soy for a more Chinese feel.

  • In this example I would thinly slice the cabbage, carrots and peppers, and stir-fry, adding garlic if I had it. I’d then add some finely chopped chilli, lemongrass if I had it (you can get dried, or lazy paste, doesn’t have to be fresh) and / or ginger (fresh if you’ve got, but ground will do) to the pan and then tip in the chicken at the end. If there are enough veg this would be a whole meal in itself for me, and I would just serve it with lime to squeeze over if I had one on the fruit bowl (I usually do because of this way of cooking) and or some soy sauce, but I guess serving it with rice or noodles would be more common.

A good jacket potato to me is a) about getting the skin well cooked enough to scoop out all the potato and eat the skin with a knob of butter melting in it, and b) about making the filling the main part (or topping, as I have already scooped out the flesh onto a plate and need to just pile things on top of it).

  • With the ingredients we have today I would finely slice some cabbage and very quickly blanch it (as it’s a bit tired it would be chewy if eaten raw and blanching it will help), then either chop and roast the carrots and peppers, or just chop and leave raw. I would then mix all this with the chicken and some mayonnaise and season generously with paprika, black pepper and lemon juice, before spooning over my potato.

Mexican food is spicy and fresh tasting with flavours of chili, lime, avocado, cilantro, (in this country we usually just call it coriander … but it’s the leaf, a herb, not the the ground seed you get in spice jars, so I have recently started using the 2 words to differentiate which I am talking about)

  • Starting with the peppers and chicken I’d bung them in a frying pan with a little oil some chopped chili, fry up on high for a minute or 2 to start charring the edges. Then add some tinned tomatoes – although I think I’d drain the juice off a bit for this one. I’d sizzle fast for just a few minutes to reduce it down but keep it fresh and turn the heat off.
  • The cabbage and carrot I’d slice / grate / push through the grater on the food processor and tip into a bowl with a handful of cilantro (you can buy partially dried packets in the fresh herb isle, that last in the fridge for about 6-8 weeks), then add some mayonnaise and a large squeeze of lime, stirring to make a fresh and zesty coleslaw
  • I’d then grab the wraps out of the packet, wrap them in tin foil and put in the oven at 180C for about 5 mins whilst getting the table ready. … put everything out and everyone can help themselves. If it looks a bit short heat a tin or 2 of whatever beans you have, with added chili and fresh tomatoes or tomato paste (unless you are using baked beans) and add that to the mix. .. and if you happen to have an avocado, some cheese (grated) and/or some sour cream around put those out to.

Curry, by which I mean “generic Indian-feel food” – remember this isn’t the day you are making an authentic Indian feast with recipes – requires base ingredients of turmeric, cumin, coriander (spice), cinnamon, ginger and usually cardamom. These are all staples of my spice drawer, and as I have got more comfortable experimenting, I have added to the range with fenugreek (gives the pungent “it’s curry” smell), mustard seeds, cloves, fennel seeds and a variety of others – but they are additions.. not needed for this “Use Up Use Spice” kind of cooking. In this example I would have 2 or 3 pans going:

  • pan 1 – I’d heat some cumin seeds (and mustard seed as I have them) until fragrant, chop up the cabbage, add it with a bit of oil and stir to coat, then I’d add a tin of tomatoes a teaspoon of turmeric, and a whole chili (maybe pierced or sliced in half to give a stronger kick) and simmer for a few minutes then turn the pan off and leave to sit.
  • pan 2 – I’d heat some oil and add half to one teaspoon of each of the basic ground spices (not cardamom), then chop the chicken and stir in. I’d then stir in some rice, some garlic if I have it and some chicken stock and make a very plain biryani type dish.
  • pan 3 – I’d grate up the carrots finely, and check some online recipes to make Halva – in essence I think it is made by boiling carrots with milk, cardamom and a touch of sugar until soft and porridge-y .. this would be pudding.

Wow I’m hungry!

Sorry it is such a long post… rather a rambling look through my kitchen, or maybe my mind. I hope it helps if you are stuck using up food, and not letting things go to waste … and hey, I love doing this, so if you have a few random ingredients and don’t know what to do, feel free to ping through a comment and I’ll try to come up with something.

Keeping Chickens

So, we’ve been keeping chickens for a good 8 years now … we’re on our 3rd flock unfortunately due to a couple of fox incidents, and one of the new flock (only got them as young birds in March) died last week for unknown reasons. (Not avian flu, the rest of the birds are healthy, phew!) However other than these things they have been easy to care for, quite fun to have pecking around us and warbling away, and great for giving us eggs. They also provide great fertiliser for my veg as every now and then I dig the top layers of mud out of their run and add it to the compost (don’t use fresh chicken poo, it turns out it’s corrosive to vegetable leaves!!), and of course they convert some of our other food waste to good quality egg protein.

Recently however I’ve begun to wonder if they are financially worth keeping or if it’s just a ‘nice thing’ we are able to do. I think I started wondering as this “nice thing” is becoming more of a chore now that I’m the only one in the family who cleans out the shed. So I thought I’d do some maths and share it with you. As it turns out, the more I think about it, the harder it is to calculate.

Chicken Costs:

  • Each chicken costs us around £15-20 to purchase .. in total over 8 years we have purchased 18 chickens at a cost of around £300
  • A bag of feed costs about £10 and lasts us 2-3 weeks with 6 chickens
  • the straw for the shed costs £5 and lasts around 3-6 months depending on if the chickens are roosting inside or outside
  • the initial outlay of chicken wire and wood to create the run (we are using a shed in the garden that had already been converted into a coop, but needed to add a fox free run to it), feeder, water holder etc. came to around £100. If you needed to buy a chicken coop and wanted it as easy as possible with an attached run etc you’d pay £150 -£300 for a wooden one depending on size.
  • the extra bits such as a pink chlorine smelling powder, vermex pellets, anti-redmite spray, egg shell improver probably cost another £10 per year … although the chlorine powder was about £40 and we are still on the first tub.

So initial outlay of run, feeder, water holder, first 6 birds, first lot of straw/feed/health+cleaning products comes to around £250-£300

Since then the ongoing costs (including new birds) have been around £260 per year

Cost Savings:

Now, these are many and varied, and actually are quite difficult to quantify. Everything from the obvious ‘not buying eggs’, to the fact we eat less meat and fish (because we are eating eggs), to taking eggs instead of wine when we go round to friends for dinner. I would say this last one feels a bit ‘cheap-skate’ but I nestle them in a nice box – usually one from the veg box scheme – with a bit of straw and everyone oohs and aahs and seems to appreciate them. Sometimes something a bit different with a bit of thought is rather nice.

Below are the main costings I can work out.

  • Eggs of the welfare and environmental level I would buy (and that our chickens are kept at) cost 20p-30p each in the supermarket. Our 6 chickens between them provide on average 5 eggs a day for the first 2 years, then dropping off to 3-4 eggs a day for another year or two. So each chicken in it’s productive life provides us about 900 eggs…. or around £200 of eggs. This was loads more than I thought! … x 18 chickens means that if we’d bought the same number of eggs (which realistically we wouldn’t have done) we’d have spent £3,600 on eggs in the last 8 years
  • Meat and Fish we haven’t bought … really don’t know, but I’m going to guess at 2 less portions per person per week (including cold meats etc). Cost saving could be anything from £5 to the occasional £30 in a week.

My maths says this is around £800-900 a year (allowing for the fact we might not have bought so many eggs) … giving us a true saving of at least £500 per year!

We have also eaten 4 of our chickens as they were killed by a fox on a very very cold day, and then left on the ground and we found them within an hour. I’m not sure there was any cost saving there as we were a bit unprepared so had them gutted and plucked by the local butcher at a cost of £6 per bird, and there was not really a huge amount of meat on them. … Saying that it was the tastiest chicken stew I’ve had this side of the Channel.

So, it looks like it really is financially worth while. I guess when I look at that, the cleaning isn’t actually as bad as I think it will be, every week when I go out to do it. If anyone else was thinking that they might explore the idea, then for slightly more initial outlay there are some great “easy clean coops” if you don’t happen to have a disused and converted 8′ square shed at the back of your garden.

I’ll leave you with some pictures – they are quite cute really.

A second Lockdown?

I wrote this on the RCGP website a few days ago. As yet there has been minimal comment – I’m hoping more will come.

I’d be interested to know what anyone reading it on here feels. Do comment so I can see and understand other people’s views. Thanks 🙂

I have also included at the bottom a few links I personally think are well worth a watch / listen to / read. I don’t know what I think to Dr Yeadon’s claim that “the pandemic is over” … but I certainly, having heard the evidence, don’t dismiss it out of hand.

My RCGP post:

I am one of a growing number of GP’s I see and talk to who are far more concerned with ensuring we see and treat our patients fully, well and holistically rather than ensuring a culture of protectionism. I know that there will be a range of opinions as to how GPs need to do this, and obviously we need to stay well and safe ourselves to see and treat others. (The first rule of First Aid I learnt as a Brownie!) However, I am more and more baffled and perturbed that we are not as profession standing up together and calling out some of the utter rubbish that is being peddled. I am aware that others who have spoken up – well known people such as Dr Ellie, Dr Malcolm Kendrick, Prof Carl Henegan, Prof Tom Jefferson, Prof Sunetra Gupta to name a few, have been vilified and dismissed, so I don’t expect much different if / when I speak out, (although it will be less as I am not well known, just an on the ground part-time GP currently working in OOH) but I am also aware that we are only hearing one side of a story in the media and I am very worried about it. We are clinicians – this means we are trained to look at data, interpret it and then crucially to see it in the context of the whole patient, or even the whole community. However we are being presented sometimes misleading data, misnamed facts and to be quite honest some very odd interpretations. Some of this is exacerbated by the remarkably laughable (in less serious situations) pillar 2 Test and Trace. – The definition of “a case” has changed over the 6 months since the pandemic started, and we are now presented frequently with different streams of data that use different definitions. This along with the fact the the false positive and false negative rates of the test are not publicly quantified, the fact that ‘old virus’ can be picked up, and the fact that there is as yet no conclusive data on viral loads needed for transmission, make the situation almost unintelligible.
As GP’s I feel we need to stand together and to stand up to the ever increasing restrictions that are putting the poor and most socially vulnerable at more and more risk. I am fed up with patients not being allowed to have their relatives visit them in hospital (or even go with them to A&E) and I see this as the greatest barrier, in those I treat, to them being willing to go to hospital; I am fed up with the narrative that insists many die alone and not with loved ones present – and with the trauma that brings on both sides; and I am fed up with the narrative that says to struggling families “hugging your grandmother could kill her”. We know from our education, from experience and many years of academics in the field researching it, that loneliness kills; that those who don’t get enough human touch die more easily; and that socio-economics and health are intrinsically linked.
Why are we as a profession (and as a College) not standing together to say “no more inhumanity”, “no more lockdown”, “no more keeping families forcibly apart”?

Here is some of the evidence and reasoned opinions I am looking at. At the bottom is also the link (click the picture) to TimeForRecovery which is a group trying to gainer support for a different way to look at things and is fully in line with my previous posts on the subject.

Farming and Food prices

I had started writing a post about different ways to cook eggs (which I’ll finish for next week), when my Riverford vegetable box arrived at my door earlier today. As usual it contained a folded sheet of recycled, unbleached A4 card with a thought from Guy (the Riverford main-man) and a number of tips and recipes for some of the lesser known veg. I know I have posted Guy’s News on here a couple of times before, but I felt that this week’s is once again worthy of being spread far and wide. What Guy has written about, briefly, is the issue of farming practices that destroy the very environment they need in order to survive long term, in order to make enough money to survive in the short term.

It’s a topic that is worthy of a great deal more discussion, debate and media attention. In fact I think I will try to find out more and do a full post on it, to link in with this and my post on “the true cost of food

The economics of farming in our current political and cultural sphere are in need of a massive overhaul. We must look after our planet if we expect it to go on feeding an ever increasing number of us – and as Guy points out, looking after it at the point and in the places it is producing that food is surely an important place to start.

PS … sorry about the marks on the leaflet … it’s been buried with the onions!

Eating Cheaply, Healthily and Sustainably – part 5. Lentils

This is not part of my blog, but I really wanted to share this open letter, and ask anyone who is interested in the debates around Covid and Lockdown to read it and to share it.

Now, back onto topic.

I am an ambassador for The Real Food Campaign, and one of the ideas we recently came up with to add to the site was “10 ways to cook a ….”. So, as part of my “Eating cheaply, healthily and sustainably” series I thought I’d get started on this idea. Today is lentils.

Many people find the idea of lentils rather overwhelming: they don’t know what to do with them; or are aware of a vague notion that if not cooked properly they might be poisonous; or think that they all need soaking, and that sounds like far to much faff. To be honest I also had these fears for a long time. Then I discovered tinned lentils. Oh the relief. And then having discovered tinned lentils and learning all the things I could do with them, I found I was no longer afraid of the dried ones. I still used tinned lentils in some instances, but dried are cheaper and in most cases just as easy. .. and in fact lentils (unlike a lot of other pulses) do not need soaking.

Lentils are cheap ( at the time of writing a tin of green lentils cost 55p in Sainsburys, or a packet of 500g dried lentils cost £1.15), nutritious (best source of plant protein, full of fibre etc), and really quite sustainable ( They capture carbon and nitrogen, they grow well in arid areas, they support prevention of soil erosion.

so here are 10 ideas for lentils:

A: Stretching the Meat:

  1. Add a tin of green lentils to a packet of mince when making shepherds pie / bolognaise etc – it just makes everything go further.
  2. Add a tin of black lentils to any dark stew for a really rich gravy
  3. When you only have a few scraps of bacon left, or not enough sausages for everyone: Boil 1/2 a cup of red lentils in a few inches of water until they are soft – about 30 mins. Drain if needed and add in chopped bacon / sausages / ham etc and some veg bouillon (don’t cook in stock as they won’t soften due to the effects of the salt). Serve with a baked potato or similar

B: Red Lentils as the main event:

  1. My favourite ‘feed all my friends’ meal from university days: Boil up 1/2 cup red lentils per person in plenty of water until soft. Whilst cooking, chop up a variety of Mediterranean vegetables – courgettes, peppers, aubergines etc- and fry gently in some olive oil until soft and browning at the edges. Once the lentils are soft, drain if needed and return to the pan. Add the veg, lots of herbs – fresh or dried – and a tin of chopped tomatoes or passata. I sometimes also add a tin (drained) of artichoke hearts, or some sliced drained olives. Serve in big bowls with crusty bread
  2. Easy Dals – there are loads online. Here are a couple of my favourites
  3. Soup – lentil soup can be just a watered down (with good stock) version of the dals and mediterranean veg recipes above, but also a lentil soup itself can be very heartening. I will usually start with 1 onion sweated in butter until translucent, and then add a couple of bay leaves, and the lentils and water. To this you can add any veg and flavours you like and just cook until it’s all soft and soupy.

Other Lentils taking their place:

  1. Puy Lentils – these are a little bit more expensive – maybe around £3 for 500g dried – but still not an expensive food. Unlike other lentils they don’t break down, but remain separate once cooked. They are particularly good with wilted spinach, black pepper and a bit of cream / creme fraiche / soft cheese stirred in. For my veggie husband I would serve them in a bowl with a couple of poached eggs on top, for myself I prefer them topped with with a piece of baked salmon.
  2. Black lentils – I tend to buy these in tins – mainly as I haven’t found them dried! They are robust and feel somehow quite rich. I love them as an alternative to stewing beef. They make a great veggie version of a steak and ale pie – fry up some chopped mushrooms and onions in butter, add a few splashes of ale, add the (drained, if needed) black lentils and some chopped carrots, put a lid on and simmer gently for 30 mins to cook the carrots and let the flavours develop. Switch off the heat and leave until needed. (Often I would do this in the morning, then leave it all day until we’re ready to eat). When ready heat back up and thicken if required (corn flour works well) pour into a pie dish. Top with pastry – I cheat here, and use bought all-butter puff pastry – and whack in the oven for 20 mins until pastry is cooked. Serve with lots of green veg etc on the side.
  3. Mixed lentil Greek Salad – green, puy and black work well here. If using tins then open, drain and rinse well. Tip into a large bowl, add olive oil and vinegar ( I use white wine, red wine or cyder vinegar) and loads of chopped herbs, including a bit of mint. Stir well then add chopped up tomatoes, cucumber and feta. Toss gently together and serve on a bed of lettuce, with extra good bread if you are so inclined.
  4. Asian Fusion lentils – again, green, puy and black work well here. If using tins then open, drain and rinse well. Tip into a large saucepan, then add toasted sesame oil, a bit of soy sauce and any or all of: mirin, rice wine vinegar, lime juice. Heat briefly until hot and coated. Chop up some red chilli (or use chilli flakes if you don’t have fresh), grate fresh ginger and stir these in. In a frying pan or wok heat some oil and fry thin slivers of whatever veg you fancy – carrots, peppers, green beans, beansprouts – and some prawns / chicken / frying steak etc if you want. Once done tip these all into the lentils stir and serve. I put extra soy sauce and chilli on the table for family to help themselves to if they want.

So 10 ways with lentils. Good for you, good for your pocket and hopefully good for the planet. Happy cooking.

Further views on the Covid Pandemic and UK response

I will get back to food, planetary health, nutrition etc soon I promise – in fact it is all very tied up with the long term responses we can choose to make post-covid. (If you want a wonderful uplifting and inspiring view of the world in 10 years, changed for the better by this current crazy crisis have a listen to this: BBC food programe – Sitopia) However at the moment certain issues are driving most other things out of my mind. … and as I have already spent a good 3+ hours writing (letters) this week I thought I would be kind to myself by re-iterating some of those here. I make no apologies for today not being necessarily original thought, in fact I feel I must mention the blog of Dr Malcom Kendrick ( a GP in Cheshire who has also written about the same issues, however I do remain surprised that there are not more doctors loudly saying the same things. Is our voice being silenced – even just by the fear of saying something that offends or goes against the rhetoric? If so these are more dangerous times than I thought … and not from the virus we have named SARS-CoV-2, but from a far more insidious illness seen in most dystopian novels; of fear, suppression, subtle twisting of an ideal, and the growth of corrupted power. I hope not, but I fear it could be.

So the that have been bugging me are these:

  1. The Rule of Six
  2. The change in use of the word ‘case’

The rule of six I have not so far spent ages writing letters on. It is so blatantly flawed and without scientific or logical explanation that I don’t even know where to start. In my family it means that my parents can come and have dinner with me, my husband and children (as we have 2) but not go and have dinner with my sister, her husband and children (as they have 3) or my brother, his wife and children (also numbering 3, although the youngest is only 4 weeks old). It has made me so angry I don’t know what to write, or who to write to. Difficult rules, difficult decisions, things I don’t like but are clearly needed, I can cope with and I can stick to. This … well it beggars belief to me that there weren’t instant clamours for the resignation of such a numpty government (and believe me those are not the choice words that are actually going around my head) or huge protests stating that emotional the well-being of our families is actually important.

The change in the use of the word ‘cases’ – this is what I have been writing letters about. It might seems rather pinickity but I hope with the excerpts below you will see how crucial this is to getting the appropriate level response. As I wrote in one of the letters “I fear we are headed for total social catastrophe if the terminology is not correct and sorted.”

“At medical school we learnt about the behaviours of different organisms and the difference between being colonised and being infected. We also learnt about the difference between being a carrier and being a case. All of these terms seem to be being blurred, misused or not used where they should be, in the current situation. ….. “

“The government has a duty to the public in this country to be not only correct in its facts but also explain the conclusions that can be drawn from those facts (and those that can’t) and to ensure those are presented coherently and understandably.”

“…Historically, this definition (of the word case in a clinical context being someone who is significantly unwell with the disease in question) is of course because unless you were severely ill you would not have bothered a doctor, and any tests we had were not sensitive enough to pick up those who may be infected but asymptomatic. However this definition matters, as currently we are not comparing like with like. If we talk about the number of “cases” of Spanish Influenza we mean those who were ill enough to seek medical help and were then clinically diagnosed. The same for Swine Flu, and for SARS (CoV-1). These illnesses were not tracked through the general well population and we have no real data for the total infection rate within the populations concerned. In the early part of this pandemic all those who were tested were in hospital and the numbers we saw did therefore represent true cases. They were comparable to the cases of previous pandemics. Now we are testing someone who might have a mild fever but be otherwise well….”

“…This seems to me to be wrong. At present we don’t even know whether these are infections or simply colonisations, and so labelling them as ‘cases’ is not only misleading but dangerous when it then comes to then making policy on them.”

Many of us carry MRSA in our noses, I personally have been a carrier for years of Strep A in my throat, children can carry Neisseria Meningitides / Haemophilus Influenza / Respiratory Syncytial Virus … they are not ‘cases’ of those illnesses. In the same way a carrier of SARS-CoV-2 is not a case of Covid. The 2 are separate, are distinctive and cannot be treated as the same. Yet they are being treated as the same, and doing so is, I believe, causing significant mental and emotional harm to all of us. We need to speak out. We need to start seeing Covid-19 as an illness like other illnesses and as I said in my previous post on the subject, within the wider context of health and well-being.

ADDENDUM – added 14th September:

It’s also worth looking at this article and it’s rapid response below. I didn’t include them when I originally wrote this blog post as I hadn’t opened my week’s snail-mail … so hadn’t read it.

Flowers in my vegetable patch

This post is inspired by a question my grandfather asked me. He is a wonderful, wise 95 year old who, amongst other things such as writing letters, cooking dinner, visiting neighbours and ringing his grandchildren, still potters around his garden and makes his own compost. He knows more about growing vegetables than anyone else I know (except maybe my dad) yet was surprised when I told him I’d started putting flowers in my salad. His initial question of why (because I think it looks pretty, and they are edible) was quickly superseded by “what is their nutritional value?” .. in particular, do they contain any minerals we struggle to get elsewhere? I didn’t know and he effectively commissioned me to find out. … formidable force my grandfather, especially when it comes to learning – everyone should always want to learn and keep learning and keep their curiosity.

So, the flowers I have been putting in my salads have changed with the seasons … it started with my daughter asking if we “could have any blue food, like Percy Jackson” … so I looked up whether forget-me-not flowers (which in April and May we have in abundance in the wild back section of our garden) could be eaten. Turns out they can. So forget-me-nots and lavendar – both blue – got me thinking about eating flowers in general and as the season changed these edible blue dots gave way to rose petals and calendula, and now to nasturtium. .. In fact nasturtium I have discovered is a delicious and totally edible plant closely related to watercress in both taxonomy and taste.

My plan had been to create a table of edible flowers and their nutrients – both for my Grandfather, and to put on this blog, but unfortunately the information has been woefully hard to come by and the effort has not yielded enough result to continue. Most of the flowers I did find anything about contained vitamins B1, B2, B3, Manganese, Phosphorus (as phosphates) calcium, Iron, Magnesium and Zinc, several also contained vitamin C and vitamin E. … but whether the quantities of any of these – given the fact I would tend to use flowers decoratively in a dish rather than in abundance – would be enough to be meaningful in a diet is something I do not know.

What I have done below is to create a list of edible flowers – taken from looking at a variety of horticultural and herbalist websites. (garden-organic, RHS, Suttons, Thompson and Morgan, etc). There was plenty about the flavour of many of these flowers to be found easily online or in various herbalist books (James Wong is excellent here and also talks about what is poisonous and shouldn’t be eaten), but regarding nutrition, many of the online entries I was able to read (several scholarly articles have been published, but you have to subscribe to the journals) were not scientific and only had nebulous and unsubstantiated ‘facts’ about the flowers having health benefits ranging from ‘heart protection’ to ‘easing of joints’ and simply said things like ‘high in antioxidants’. I’d love it if anyone manages to find better or more information and could let me know via the comments.

Anyway, here is my list of edible garden flowers, I hope maybe it inspires you to add flowers to your food.

  • Alpine Pinks
  • Calendula
  • Carnation
  • Cornflower
  • Dahlia
  • Dandelion
  • Day-lily
  • Forget-me-not
  • Freesia
  • Fuchsia
  • Gladiolus
  • Hollyhock
  • Honeysuckle
  • Jasmine
  • Lavendar
  • Lilac
  • Magnolia
  • Nasturtium
  • Peony
  • Primrose
  • Rose
  • Scented Geranium
  • Sunflower
  • Tiger-lily
  • Violet
  • Wysteria

Covid-19: My views on the pandemic and the response

Over the last few weeks I have found it increasingly difficult to articulate what I believe and understand about Covid-19. It suddenly struck me that this is because I (unlike the government, the media and even SAGE it seems) do not see Covid-19 in isolation from the rest of life, health, illness, well-being and society. This blog is rather longer than my usual ones, and has actually taken me many, many hours to write, edit and think through. I will get back to my recipes, ponderings and thoughts on the climate in August, but for now I felt this was really important. I really hope you can make it through to the end, and I really hope if you are currently living with either fear or frustration, in this pandemic, it will help.

We live in a world with a multitude of beauty and a multitude of horrors. Our world is one of creation and destruction, one of rhythms and cycles, one where animals eat each other, wars break out (not just in the human species) and balance is always being forged and re-forged. Disease, illness, and infections are part of that, throughout the global species – animal and plant.  As a GP I deal with disease in the human population. … I see and treat people holistically as much as possible. No man is an island as the saying goes. We live in families, in communities and in our society … then we live in the global society called humanity on top of that. Health is a broad term that sits in the middle of our lives. Health is the absence of illness. The absence of disease …. Or Dis-Ease. … Health is in fact our total being, being in balance. .. mentally, emotionally and physically. Most doctors agree that we cannot have true health without all three of these things being ‘in balance’ in us. Research (and in fact just being aware of your own self) shows us that physical health is influenced hugely by mental and emotional health. A couple of basic examples are below.

There is good evidence at multiple levels within the body’s physiology that psychology, the nervous system functioning and our immune systems are all linked (termed “psychoneuroimmunology” or PNI),systems%20of%20the%20human%20body.

If we ignore this we will never treat people, only ever diseases … and that is something that as doctors we learn is not ok. It is something that doctors of old had to learn by trial and error, and we have to learn from their mistakes. Unfortunately, it is exactly what our current and recent government guidelines seem to be doing. Initially it felt like they were trying to strike a balance (treat the person), now it does not.

It is because of this (and the surrounding knowledge that comes from all of this) that I cannot condone lock-down and I cannot agree with ‘the science’ as it is currently being presented. 

In its pure form, science is the systematic intellectual and physical study of the structure and behaviour of the natural world, one thing at a time. It uses initial observations to come up with a simple 1 stranded question that can in time be answered. It turns that question into a hypothesis that through repeated experiment and observation can yield an answer. … An answer that will be the same every time you repeat the experiment.  Any decent GCSE science student will tell you that a good experiment should only have one changing variable; that confounding factors must be accounted for; and that results can only be trusted to the extent to which the experiment was done well. An A-Level student should be expected to also add in that a hypothesis can only ever be disproved (not proved) and that results can be extrapolated to some degree in some circumstances, but that increasing extrapolation results in increasing margin of error. This is basic science: observation and experimentation, yielding results that can then be interpreted to give conclusions.

The basic science around Covid-19 therefore must adhere to these principles. It therefore mainly comes from a lab. In the labs they isolate Sars-CoV-2 (the virus name – Covid-19 is the disease presentation name) they culture it, they experiment with it to answer questions such as: What does it do on this medium? Does light effect it? Does heat effect it? Will it replicate in all types of human tissue cells or only skin / mucosa / red blood cells? They might go on to drop different human immune compounds on it: Does this stop it? What about this one? What about this combination? Basically they observe it in the lab under different conditions (repeating each one many times to verify it) to see what it actually does. What it does in the here and now. These are the results. This is the basic science. The results are then interpreted, and maybe extrapolated and some predictions and suggestions are made… These interpretations and predictions are not the science: it is the scientists trying to give advice and suggestions about what might happen, given what they have observed happening. It is of course why they did all the basic science in the first place, but as we know, the greater the extrapolation, the greater the risk of being wrong. … However it is these thoughts and further hypotheses that are fed out to us by the media and the government as “The Science”, rather than telling us clearly what the basic science shows, and what we can then interpret from it. It might seem a pedantic point, but I think it is an important one. Without it we don’t know how much weight to give each piece of information. We lose the nuances.  For example, the basic lab science tells us that the virus can survive on hard surfaces in a laboratory. It also tells us we can pick it up on our skin from a surface, and that we can transfer it from our hands to our mouths. It also tells us that we can become infected when we have virus in our mouth and observation shows us that a few people with this virus can become very ill and even die.  However the media rhetoric is that us “The Science” tells us it is on all surfaces, if we touch a surface we will get the virus and we will die.  … In fact this is not even what the scientists concluded. It is a sensationalised version, and is untrue. It is fear-mongering.

On top of this issue above, mixed into the scientific enquiry and experimentation, and the ensuing conclusions drawn, is the mathematical modelling of epidemiology.  Epidemiology is not basic science, although it uses scientific thought processes. It (hopefully) uses scientific data that is collected, but then pulls this into a mathematical model along with statistical data. It is a systematic study (like science)… but (unlike basic science) not of one simple controlled variable. It uses population data, scientific data and statistical tests to come up with predictions about the future. It can give us an idea of the ‘likely best case scenario and likely worst case scenario’. It is a bit like the conclusion drawing and extrapolation of the scientists, but unfortunately it is a more complex process and so can’t ‘repeat and verify’ in the same way. The way Epidemiology verifies and modifies its hypotheses is to add more data over time and ask does this still fit the model? Over time this means that it can become incredibly helpful and accurate – significant amounts of data, from all over the world, and over a significant period of time, looking at how temperature, climate, population density, demographics,  and a multitude of other factors can influence whichever disease it is looking it. We rely on it for a lot of our understanding of disease and therefore also for finding things that might work in treatment. … However in the early stages of a new disease it is known to be crude in its estimates and at best to give only moderately accurate predictions. So in a few years, when this is behind us and there is a lot more data, and a lot more time, it is likely that a model will be created that is able to accurately predict the next Covid-19 flash. But currently that is not the case, and we must remember it is not pure basic science that gives us quick and simple answers.  However the current crude (early) models also are fed to us via the media along with the scientists’ conclusions and thoughts, as “The Science”.

With regards to the Covid-19 pandemic, there is even more of an issue. The original mathematical model used for Covid-19 has now been widely discredited. … more information was fed into the model and it did not fit. In a basic science field we would describe the equivalent as ‘disproving the hypothesis’ but epidemiology is not able to be so concrete … so it can only be discredited, which although in reality the same, sounds much more opinion based …. and the policy makers are therefore free to still use it to inform our policy.

Businesss insider article

Statistical modelling discussion forum, Columbia University, NY.

In any pandemic there will be an ‘excess’ of deaths – more than the norm for that time of year, or that population or that country. Not overwhelming our ventilator capacity was a very reasonable aim in the early part of the crisis – particularly with the mathematical models we were working with. However, rather subtly and without overt statement or explanation the mantra seems to have changed to suggest that no-one should get Covid-19.

So we need to stop and ask: What are the true objectives of our national response?

I suggest that the questions we need to ask are below:

Set A – Public health objectives

  1. What is the public health (PH) objective regarding Covid-19 as an isolated single issue?
  2. What response best meets that Covid-19 PH objective?
  3. Is the PH objective regarding Covid-19 reasonable when looked at in a total health context?
  4. Is the policy response to the Covid-19 issue reasonable when looked at in a total health context?

Within these PH questions lie these questions:

  • Are we saving lives:
    •  In the short term?
    • In the long term?
    • From Covid-19?
    • In total numbers?
  • Are we as a species going to gain long term immunity (full or partial) to Covid-19?
    • If so, is that something we should aim for?
    • If so, then by exposure or vaccine or both?

Alongside these we must ask: Is the response to Covid-19 allowed to increase the risks of other health issues?

  • Which health issues? – Physical health issues, mental health issues?
  • By how much?
  • For how long?

There are other questions about Track and Trace, asymptomatic patients / carriers, long term lung effects of severe disease, the inaccurate measuring of lethality (CFR vs IFR) but I think maybe I’ll leave that for another time or for someone else.

And then there are the broad ethical and moral questions:

  1. How much might we gain from re-evaluating our priorities and creating a greener economy?
  2. How much are we prepared to sacrifice our nation’s children and their future – from our economic collapse and from the psychological effects of the lockdown response?
  3. How much are we prepared to sacrifice our mental health for our physical lack of symptoms?
  4. How much we are willing to lose our freedom – to have a life, but not to live.

ALL of the above questions and their complex, (sometimes non-binary, sometimes individual specific) answers play in to the much more complex CLINICAL picture of how Covid-19 is affecting us as individuals and as a Nation / world.

The Covid-19 whole picture is a Clinical Medicine picture and Clinical Medicine is not a pure basic science.

Clinical Medicine uses basic science to inform as a start point and then uses observation, case studies, clinical experience, understanding of the patient in front of us, understanding of the social situation in which that patient lives, intuition, partnering with a patient in decision making, risk balancing and even an understanding of health economics to make a CLINICAL Judgement on what is the right course of action.

We are being led by a group of people (our government) who have no clinical understanding, and by a scientific (not clinical) Advisory Group (SAGE) that labours under the same problem. Science can only answer simple questions. Science cannot answer whether we should have lock-down and whether lock-down will be good for us and save lives. Science can answer questions like: Does this virus spread between people? How is this virus spread between people? Can this virus float around freely in the air to infect anyone? And therefore the scientists can interpret and extrapolate to give us answers to whether lock-down will reduce the risk of contracting Covid-19 … and therefore reduce the number of people from dying of Covid-19. I think we can clearly see the answer to that will be YES. Any illness that can transmit between people will of course have less people contracting it if people keep away from each other. You don’t need to be a scientist to come to that conclusion, if you have the scientific data from the questions science can answer.

The problem is that Will lock down and social distancing decrease the transmission of this virus?” is not the right question to ask.  If we simply ask that question we should ask it of all illnesses…. And the answer would be the same for any person-to-person-spread pathogen. The question that needs to be asked is “Should we have lock-down and social distancing?” This is not a science question. This is a philosophical question, a moral question, an ethical question…. And maybe a Clinical Medicine question.

Covid-19 does not exist in a background of zero other illness; nor does it exist in a vacuum of zero other things than can negatively affect health; nor do people exist in an easily controlled science experiment. We MUST look at the bigger picture. And the bigger picture is this:

Worldwide disease context:

  1. Air Pollution kills ~7 Million people worldwide per year … every year. These are preventable deaths by changing behaviours – but we don’t change our behaviours / legislate to prevent them and they are not in the news. (
  2. Malaria kills ~0.5 Million people per year …. every year. These are preventable deaths by providing mosquito nets to all in risky areas – but we don’t provide enough mosquito nets to help and they are not in the news. (
  3. Measles kills 100,000 plus per year … every year (140,000 in 2019). These are preventable deaths by providing a simple, cheap vaccine to all – but we don’t provide that vaccine and they are not in the news.
  4. Cancer kills ~9 Million people per year …. Every year.  Approx 3 Million of these deaths are from ‘easily preventable cancers’ … diet, smoking and lack of exercise / obesity. … but people don’t change their diet or their habits – and it’s not in the news. (
  5. Influenza kills ~650,000 people per year (worldwide) from direct respiratory causes, plus all the flu-related non-respiratory deaths we know we see every year. (
  6. Covid-19 has killed 580,000 people worldwide so far, obviously that death rate will still go up, but it is at least beginning to peter out in most countries as far as we can see. … Not because of lockdowns (although some public health measures can play a part to help decrease it faster), but because of how pandemics and epidemics behave. (

UK Holistic Health context:

  1. The usual death rate in the UK is ~9,000 per week. The highest death rate in the peak of the covid-19 pandemic was ~16,000.
  2. The usual death toll from seasonal flu in the UK is ~17,000 per year. This year it was only 1,692 (I have no idea why it was so incredibly low) and we don’t yet know what the 2020-21 season will bring. … So Excess Deaths from Covid-19 cannot yet be counted. … as they are counted as ‘excess for year x’
  3. The estimated extra deaths from late treatment of cancers is predicted to be ~7,000 up to ~35,000 ( This relies on mathematical modelling, but it is it modelling with a lot of data over a long time, so is likely to be reasonably accurate. (The lower figure relies on everyone waiting for their treatment to have slow cancer progression and for it not to have increased in cancer stage, the higher figure I think uses a model where all cancer stages have gone up by 1)
  4. The Covid-19 lockdown has cost the UK government an estimated £298 Billion for this financial year…. And the long terms costs of a shrunken economy have not yet been predicted.
  5. Socioeconomics significantly effects health outcomes … this is a complex correlation, but includes poorer diet, increased levels of smoking, decreased mental health, decreased education, increased domestic violence and many other things. (
  6. Unemployment is set to soar … This leads to worse socioeconomics and therefore worse long term health outcomes.(
  7. Domestic violence (the effects of which can last a lifetime) cases and reports have increased significantly and in the first 3 weeks of lockdown 14 women and 2 children were murdered by domestic household members.  (
  8. Child abuse cases (lifelong psychological harm) have gone up as has the demand for online obscene material. (,
  9. There have been an excess of deaths from Non-Covid causes throughout lockdown. As a GP I and many of my colleagues feel that these have been both directly due to lockdown, and due to the advice not to bother the doctors. These are the tragedies. The covid-19 deaths are part of the pandemic of covid-19. These others are due to the pandemic of fear.  (,,coronavirus%20(COVID%2D19).

So, Covid-19 is a pandemic. It will kill people.

The experimental science tells us

  1. it is passed person to person
  2. It is probably transmitted in droplets
  3. It seems to need access to our wet mucosa to actually infect us.

The observational science tells us:

  1. It seems to infect the elderly, those with poor metabolic health (e.g. males over 60 with diabetes and obesity) and / or low vitamin D levels more severely and therefore a greater proportion of those groups die. (the elderly tend to have lower vitamin d and poorer metabolic health)
  2. Fever, cough and or loss of smell/taste in are thought to be the commonest symptoms, but recent UK testing data indicates that 78% of people testing positive have no symptoms at all
  3. It creates breathlessness in some people – this seems to be a marker of worse infection or worse immune reaction
  4. A very small number of people have an unexpected and severe immune reaction to it (a cytokine storm) and this can unfortunately kill them (SARS like reactions)

The Epidemiology tells us that pandemics have graph plots that go up and come down again. At this point in time the epidemiology of this particular new virus is not fully understood as the maths modelling hasn’t had the time it needs to become accurate.

The wider picture tells us that stopping social interactions, stopping other health care, stopping education, closing businesses may help to ‘flatten the curve’, but have a huge overall detrimental effect. We have to weigh up what we think the right balance is.

For me the current balance is definitely wrong.

Pandemics are part of the natural rhythm of the world we live in, but they are made worse by human failings and the ‘successes’ of our species – overpopulation / overcrowding, pollution from industrial economies, pollution from consumerist economies, human-caused climate change.  On this occasion we have also made the recovery worse, and lost a lot of the successes we hold dear.

We should move out of lock down and social distancing, but ideally into a calmer, more nature based, culture. A culture where we appreciate our friends and family. A culture that maybe doesn’t need so many huge mass gatherings and long fossil fuelled journeys. A culture that promotes recovery for all … all people, all species. This would maybe make the losses we have created and endured in lockdown more worthwhile. It would maybe start to give us some tangible gains and even lessen the chances of future pandemics.

As an A-Level student I had to write a 3000 word essay arguing that “Man’s continued success will be his ultimate downfall”. I looked at the rise and fall of cultures, at the increased prevalence of diseases in built up areas, in the mental health of those living with lack of access to nature. I also looked at the climate effects that were known in the 1990’s of our ‘success’ … logging the rainforest, acid rain, rising sea levels, holes in the ozone layer. …. Man’s success is clearly going to be our ultimate downfall if we continue to measure success in the same way. If we don’t change our ways through this opportunity, it may end up a downfall by pandemic.

The Dutch Model

I started writing this last post in November 2019 … but it was winter and the mood maybe wasn’t right – what with Brexit being at the top of everyone’s mind. … But now I think the mood is right, and the time is critical. . .. in fact so critical that I am posting this early (was due for 1st July). We all know we must rebuild our economy AND our infrastructure in a more sustainable and greener way. We know that increased vitamin D helps immunity, we know that being outside in fresh air and exercising increase our well-being, we know too that well-being and immune health are linked.

So I am today writing about cycling.

Until November (when they inexplicably chose to move back to the UK despite the Brexit Crisis) I was fortunate enough to have relatives in the Netherlands, and had visited a few times in recent years. I will therefore start with some observations (and fact reading) I have made on my visits…

  • The Netherlands are the most densely populated country in the EU, and one of the most densely populated in the world. (488 people per km2)
  • People in the Netherlands therefore mainly live in small apartments, and as such they spend a lot of time out of them in the street cafe’s and such like
  • I hate crowds of people and the busy bustling streets of London … yet ….
  • Heading there always feels like a relief from the hustle, bustle and noise South East England.

It didn’t take me long to realise that it was the relief of not having the constant drone of traffic noise, and the constant need to hold my breath due to exhaust fumes that made all the difference.

The Dutch are more likely to own a bike than a car. .. in fact I found a 2018 study that said there are more bikes owned than total people in the Netherlands (1.3:1). It’s not a car free country, and their motorway usage has apparently gone up in the past 10 years … but … the cities are not built around car usage. … and so using a car in the city is difficult. … and so it is not really done. The infrastructure is built around bicycles.

Typical view, note cycle path lanes and cycle path traffic lights. 🙂

We currently don’t have anything like this. When the London bike scheme (Boris Bikes) was brought in, the bikes shared the bus lane – as they do in many cities in the country. I don’t know about you, but I’ve cycled on bus / bike lanes … and I do not feel safe. I used to do it to get to work at the hospital in Leicester I did my early jobs in. I wore a helmet, a big luminous yellow tabbard, and lumious yellow wrist cuffs for when I indicated. I still didn’t feel safe. I never want to cycle like that again and I would never allow my children to do so. It’s quite different in the Netherlands. Cycling there, in cities as well as on the cycling freeways that link cities is a pleasure. It doesn’t feel unsafe, even with no helmet and no yellow tabbard.

The roundabouts have their own cycle lanes, the cycle lanes have their own traffic controls and raised curb edges and best of all the motorised/engine-d traffic has to give way to the cyclist. On top of this the law says that if a cyclist and a motor-vehicle are both involved in an incident it will always be the motorists fault … ALWAYS. Not surprising the Dutch drive very carefully around their cycle-full roads.

Our Transport Secretary has said he is wanting to incentivise cycling and walking post-Covid-19…. We need to BUILD BACK BETTER as the current phrase goes. I think we need to go Dutch. I think we need to put the cyclist first in both law and infrastructure.

I hope we can get our government to think the same. I will be asking for this at “The Time is Now” Virtual Lobby on 30th June. I’d love you to join me.

Not my images, but we saw all of these combinations on our adventures. My daughter got very good at the ‘side saddle’ pose and still does it on my bike in the UK – which currently gets us some looks, but maybe can become more normal 🙂