The Oldie

The Doctor’s Surgery

- Theodore Dalrymple

Early on in the Second World War, the surgeon Wilfred Trotter pointed out in a letter to the Times that 600 extra road fatalities had occurred since the institutio­n of the blackout restrictio­ns – without a single German bomb having been dropped. The Germans had exacted a heavy toll – more than the bombing of Coventry – on the civilian population without doing anything.

Of course, it would have been wrong to conclude that blackout precaution­s would never be necessary, but it was a powerful reminder that doing a lot is not necessaril­y better than doing a little, and that in such situations timing of actions is all.

As it happens, I write this just as I am getting over a cold. I have now fully recovered. Was it the dreaded COVID-19? I will never know. The symptoms were not precisely those advertised but, as with all diseases, there is variation in the symptomato­logy. It could have been the disease and, if it was, my survival will have distorted the mortality rate a little and made the disease appear a tiny bit more dangerous than it is.

But it might not have been the disease, in which case I would be just as susceptibl­e to it now as I was before. (We don’t even know whether, and for how long, an infection might confer immunity on us, though it seems likely that we won’t get it twice.) Therefore, like so many others, I am faced with the option of being an ostrich with its head in the sand or a headless chicken running around, flapping its wings to no avail.

Unlike the Spanish flu, which had a marked predilecti­on for young adults, this latest epidemic illness kills mainly those who, like me, are over 70 (the death rate among detected cases over the age of 80, according to Chinese figures, is about 15 per cent).

The outlook is grim for those of our age treated in Intensive Care Units. Not only do most of us not survive, but many (if not most) of those who do survive will probably suffer from cognitive impairment. For them, life will never be the same again. An insufficie­ncy of ICU beds is possibly not an unmixed curse for our generation.

My inner ostrich comforts itself with the reflection that deaths from the disease in the whole world are comparativ­ely few so far, being approximat­ely a sixth of the number of deaths from cardiovasc­ular diseases in Britain alone during the same period.

But then my inner headless chicken points out that deaths from the disease are increasing exponentia­lly, that is to say extremely rapidly, in geometric rather than arithmetic progressio­n.

My inner ostrich replies that this cannot go on for ever; the growth will stall sooner or later, and in any case a projection is not a prediction. But, says my inner headless chicken… And so the dialogue continues between the two foolish birds contending for my soul.

Reluctantl­y, and without deep conviction, I come to the boring conclusion that the official advice, such as it is so far, is right. It is sensible for us old uns to isolate ourselves from the word as much as possible until the epidemic blows over, to avoid crowds, to have as few social interactio­ns as practicabl­e and to wash our hands as if everything in the world were feculent.

For myself, increasing­ly reclusive, I would not find self-isolation so very difficult and, given the state of the world, would be prepared to recommend it even in the absence of an epidemic.

But for the old who live in homes, the absence of visitors will be a real hardship. Is it better to survive in abandonmen­t than to die in the company of one’s loved ones?

 ??  ?? ‘We must be entering Japanese waters’
‘We must be entering Japanese waters’

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