Man flu? – actually there are more important things to worry about

I want to start this week’s blog by saying a big THANK YOU to all those lovely folk on social media who have sent me get well wishes over the past few days. You are all very kind, and kindness matters. Always. Last Thursday night I went to bed feeling like I was coming down with a cold – I woke up feeling definitely unwell. Feeling unwell is not a state of being I usually contemplate. I have been relatively healthy most of my life with just the usual colds and coughs, a spell of depression and a couple of surgical interventions. No, I have always considered myself fortunate health wise. 

Over the 2 years or so of the pandemic I have avoided catching the virus, but I was beginning to think my good fortune had run out. By Friday night and not feeling much better I took another lateral flow test thinking I absolutely must have caught Covid as infection rates* are on the rise again. Once again it was negative.

I am a great believer in cognac and paracetamol as ‘catch all’ treatments for colds, flu, coughs and so on and I had self-prescribed both over the last few days. As I write this blog, I am feeling much better, so I guess whatever it was that made feel unwell is passing.

My reaction to feeling unwell and not knowing why, did make me reflect on how we all might have started to change our thinking about our own health, and where we might seek help from when we become ill. It is true to say that primary care services are at full stretch, sometimes making it difficult for folk to gain an appointment, virtual or otherwise. Across England, all emergency and urgent care services have seen a significant, and sustained exponential rise in presentations. In pre-pandemic times, in my own hospital, we would normally expect to see 250-270 people a day. At present we are regularly seeing 370+ patients a day. Worryingly, the numbers continue to grow each week.

Despite my colleagues’ best efforts, a patient’s journey through our hospital, either through being admitted or treated and discharged, can be severely delayed. At times, some individuals may have to wait for many hours to be seen and treated. We are not alone in dealing with these problems. Almost universally, emergency and urgent care services are seeing more individuals who are very sick. There are growing numbers of people presenting with high acuity challenging conditions, where their needs can be complex and unpredictable. All of which can take more time to carefully decide the most effective way of addressing and responding to these needs. Covid precautions add to these challenges. 

The ‘demand’ issue is one side of the coin. The other is making sure we can discharge people out of hospital in a timely way. Like many hospitals, we have significant numbers of patients in beds who are medically fit to be discharged, but have no appropriate place to be discharged to. Some of these folk will need rehabilitation, others, social and/or domiciliary care. All of which can be in short supply. The lack of availability of these services results from many issues. For example, a largely private sector domiciliary provision, many years of punitive reductions in local authority funding, and ever increasing numbers of frail and elderly folk in the population. As I lay in my sick bed, I also reflected on other, perhaps related, factors at play here.

Over the past 20 years or so, families in general have become more geographically dispersed and many communities have become insular and more inward looking. My siblings live all over England, but also in Australia and Bulgaria. Four of my grandchildren live in New Zealand. The concept of a ‘nuclear family’ has in many respects become a transient notion as the reality of ‘extended families’ becomes more common. Some of my grandchildren, for example, have more than two sets of grandparents. I can remember the important role my own grandparents played while I was a child, and they lived just around the corner from our house. My eldest daughter is now over 40 years old, but I can remember when she was born, the whole street we lived on at the time, both celebrated her birth and acted as wise advisors when things didn’t go quite as planned. During sleepless nights, teething, and toddlering, they were always there with some sage wisdom to offer. Of course, some things were based on pure folklore rather than fact. ‘Don’t sit on the hot radiator otherwise you will get piles’ was one I remember – complete bunkum.  

Another thing that is complete bunkum is that we have more extended families today because more people are getting divorced. In fact, the divorce rate in the UK has stayed at an average of 33.3% for the past 50 years. What might be more relevant is the length of time couples have been married before they divorce. Those married for 30 years or more are the group with the highest rate of divorce, with some 47% of couples getting divorced after this time. Which brings with it other problems at a time in life when you could do without them - in particular, isolation and loneliness. The harmful impact of being alone and isolated was something brought into the spotlight during the pandemic. For many reasons, this has become the reality for a much greater number of people than ever before. Research has shown that sudden, disrupted or a gradual lack of social connections can increase the likelihood of an early death by some 26%.  To put that into context, that is a risk comparable with smoking 15 cigarettes a day and is certainly higher than that caused by obesity and physical inactivity.

To put something else into context, that is my feeling unwell for a few days, today is day 25 of the invasion of Ukraine. We were told yesterday that some 6.5 million people are now displaced from their homes and communities within the country with a further 3.3 million refugees having fled to neighbouring countries. However difficult we might feel our own problems might be, let’s keep all those people impacted by this cruel war, and others like it that are still going on around the world, in our thoughts, hearts and prayers.

 

 

*As I write this blog, Covid infection rates are on the increase across the UK. On Friday, the Office for National Statistics reported that one in every 20 people in England were infected, whereas in Scotland the infection rate has hit a record high, with one in 14 people being infected.