Playing the blame game isn’t helpful
The dominant refrain of medical opinion as the Covid epidemic winds down is that, from the beginning, the Government’s response has been “too little, too late and too flawed”. By the time lockdown was imposed on March 23, “two months of potential prevention time had been squandered”, writes Professor Gabriel Scally in the British Medical Journal, while “the reckless policy of discharging older patients to care homes kick-started a further epidemic of infection”. Hence Britain’s mortality rate, the highest – bar Finland and Belgium – in Europe.
The wisdom of hindsight is a marvellous thing, but while in retrospect mistakes (inevitably) were made, the Government’s actions have been guided by their chief scientific and medical advisers throughout, hospitals were not overwhelmed (as they were elsewhere) and a complex package of economic support measures was put in place. As for the numbers, the interpretation of league tables of how well or badly countries have performed is fraught with uncertainty, as each nation has its own unique characteristics of ethnicity, age distribution, population density and prevalence of underlying health problems that need to be taken into account.
Blame-mongering is not helpful. On the contrary, it has, if anything, made the Government unnecessarily cautious about the imperative for a speedy return to normality. There is, notes media commentator Stephen Glover, an interesting historical comparison here with the 1968 Hong Kong flu pandemic that, despite causing four times as many fatalities around the world, scarcely impinged on people’s lives.
There were no economydestroying lockdowns, no travel restrictions or withdrawal of liberties, no hourly bulletins of death and disaster, no doctors berating Harold Wilson’s administration for its alleged ineptitude in tackling the virus. We might be better served in future if we took this more measured approach.
A feet of nature
The human foot is a biomechanical marvel, its distinctive anatomical feature, the longitudinal arch, providing both stability and forward propulsion. The stability comes from the weight-bearing surface running from the heel to the fourth and fifth toes, held together by a tough sheet of tissue, the plantar fascia, while the big toe acts as a lever, “elastic, mobile, dynamic organ of propulsion”.
As so often, it is only when some part of the body malfunctions that its true worth can be appreciated. The loss of flexibility of the big toe, hallux rigidus, puts pressure on surrounding muscles and ligaments that become painful and inflamed, causing secondary arthritic changes that may require corrective surgery.
Meanwhile, the more common inflammation of the plantar fascia as it inserts into the heel causes a pain similar to walking on broken glass – as I have recently been forcibly reminded, hobbling to the bathroom first thing. Five years ago, Danish physiotherapist Dr Michael Rathleff demonstrated, if counter-intuitively, that stretching and strengthening the fascia is superior to the standard regime of rest, topical application of ice and anti-inflammatories. The details of the thrice-daily heel-raising exercises are available on the internet (Google: Rathleff, plantar fasciitis), the efficacy of which he attributes to a combination of stimulating the collagen and “improving intrinsic foot strength”.
Itching to be solved
This week’s medical query comes courtesy of Mrs I S from Sunderland who is troubled several times daily with a spasm of intense itchiness running from the inside corner of her right eye to her nostril on the same side. “It drives me mad,” she writes and since the itch is on her face, she is reluctant to scratch lest it leaves a mark. A dermatologist she consulted advised it was not a skin problem and she would have to learn to live with it.
Recently these itchy spasms have become more frequent, especially at night; perhaps, she suspects, induced by warmth when lying against her pillow on the right side. Might anyone else, she wonders, be similarly afflicted?
‘Too little, too late and too flawed’ … the wisdom of hindsight is a marvellous thing