Tag Archives: Covid-19

Is over-emphasis on high temperature creating a headache for Covid testing labs?

As we all know, a high temperature is one of the most important indicators that someone is infected with Coronavirus. Except that it isn’t.

We all think it is, because it’s been widely publicised through government press conferences, ministerial interviews and advertising. It’s also the first symptom mentioned on the page of symptoms listed on the NHS website about Covid-19 symptoms.

We often see news reports featuring temperature measuring devices being used at work places, public events, educational establishments and airports. So it’s hardly surprising that many people who develop a high temperature will immediately think “Must get tested”. But, as the NHS also points out on its website, “A fever is your body’s natural response to many common illnesses”. The corollary to this is that it’s unsurprising that the test analysis system has been overwhelmed recently. I suggest that this is caused not by inconsiderate people in a panic but by over-simplistic, ill-targeted messaging …

A massive piece of ongoing research by health science company ZOE, endorsed by the Welsh Government, NHS Wales, the Scottish Government and NHS Scotland, suggests that fever or high temperature – on its own – is actually a quite unreliable early indicator that someone has the virus. Fever is a symptom that can be an important indicator in combination with others; but even then there are other symptom combinations which are much more reliable.

The COVID-19 Symptom Study is an app-based survey which, according to the company, is “the largest public science project of its kind anywhere in the world”. The app has been downloaded by over 4.2 million participants, who use it to report regularly on their health, with data being analysed in collaboration with researchers from King’s College London. The app is available from the App Store and Google Play.

Fever, when it occurs, is certainly one of the more important factors to look out for amongst under 18s and over 65s. But for the huge 18 to 65 year old demographic, representing about 40% of the population, it’s quite a long way down the list of priorities.

As we know, this disease is complex and its victims experience a wide range of effects, from no symptoms at all to death; it can clear up after ten days or leave people with a varied list of long-term after-effects (‘Long Covid’); and now it’s clear that it affects different age groups in different ways. Even then, it’s inconsistent: its effects on individuals may not be typical for their age group.

The simple messages being issued by the government are well-meaning. As someone who planned major advertising campaigns for over forty years until I retired recently, I’m only too aware of the importance of that well-used marketing mnemonic K.I.S.S. – “Keep It Simple, Stupid”. (I worked on a number of sometimes complex and multi-targeted international ad. campaigns aimed at recruiting volunteers for clinical trials – see this article I wrote on LinkedIn about this).

But I do believe that more people should be told about this kind of research. There are many who don’t have the inclination to dig deeper into what we do know about the virus. For them, the simplistic mottoes put out by the government have worked. But it’s essential that these messages are expanded to build more knowledge about the latest findings. It’s true that hospitals have not been overwhelmed – good communications achieved that objective. It’s now time to come to the aid of the testing labs.

People understand the rules of football; they can navigate the web and make online purchases; they can plan holidays abroad. It’s now time for them to learn more about the finer points of Covid-19. A more detailed and carefully thought-through communication programme is urgently required, targeted at the different demographics. Greater awareness and understanding is key to changing attitudes and actions. Generalising and over-simplification can be counter-productive.

So in my view, we should be moving swiftly into a much more targeted Phase II of messaging, in the same way that we are refining our targeting of restrictions in terms of movement, household meetings and lockdown.

 

Notes:

I have cut and pasted unaltered extracts from the COVID-19 Symptom Study to fit into my blog format. The website for the report can be found here, and as mentioned the app can be downloaded from the App Store and Google Play.

Picture credit: BodyPlus Infrarot-Thermometer – TrotecHealthCare / CC BY-SA (https://creativecommons.org/licenses/by-sa/3.0)

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Back to the Present as The Machine Stops

E.M. Forster, Alexandria, circa 1917

With all kinds of normal activity suspended around the world – at least for the time being – and citizens in their millions, if not billions, being confined to their homes by the pandemic, this machine we call society seems to be grinding to a halt.

E.M. Forster‘s short sci-fi story The Machine Stops was published in 1909 but in some ways seems spookily prescient of the current situation.

Forster (right) portrays a society in ongoing lockdown, each citizen confined to his or her own underground “cell”. The decor and furnishings are not exactly sumptuous, but okay if you like minimalism …

Imagine, if you can, a small room, hexagonal in shape, like the cell of a bee. It is lighted neither by window nor by lamp, yet it is filled with a soft radiance. There are no apertures for ventilation, yet the air is fresh. There are no musical instruments, and yet, at the moment that my meditation opens, this room is throbbing with melodious sounds. An armchair is in the centre, by its side a reading-desk — that is all the furniture. And in the armchair there sits a swaddled lump of flesh — a woman, about five feet high, with a face as white as a fungus.

We are never told precisely why things have arrived at this juncture. It may have been the result of war, of an environmental disaster or indeed the aftermath of a plague. Environmental disaster seems the most likely explanation as we are told that “The surface of the earth is only dust and mud, no life remains on it”.

It becomes clear that the two protagonists – Vashti and her son, Kuno – are in an isolation that is not of their own choosing. That’s not to say that, on the surface at least, they seem frustrated or depressed. Their every need (it appears) is catered for. They have all mod cons at their fingertips, including the automatic administration of medical treatments – and a kind of “home delivery” and other conveniences are just a button-press away.

There were buttons and switches everywhere — buttons to call for food, for music, for clothing. There was the hot-bath button, by pressure of which a basin of (imitation) marble rose out of the floor, filled to the brim with a warm deodorized liquid. There was the cold-bath button. There was the button that produced literature. And there were of course the buttons by which she communicated with her friends.

“[The] very first description of the internet in any detail was probably E.M. Forster’s The Machine Stops from 1909”, writes Jaron Lanier1, “decades before computers existed: ‘People never touched one another. The custom had become obsolete, owing to the Machine.’ It might still be the most accurate description. How Forster did it remains a mystery”.

Things are definitely not as idyllic as they seem. In reality, Vashti is terrified of the idea of leaving her underground cell and experiencing the outside world. She has a horror of direct experience. Self-isolation is in operation big-time. Vashti is never happier than when giving lectures to large groups of followers, as long as it doesn’t mean meeting them in the flesh. She conducts her lectures using a Zoom-like communication system.

The clumsy system of public gatherings had been long since abandoned; neither Vashti nor her audience stirred from their rooms. Seated in her armchair she spoke, while they in their armchairs heard her, fairly well, and saw her, fairly well.

Kuno has been to the outside world and wants to tell Vashti some awful truths about it. They can communicate via a Skype-like medium (bear in mind this was published in 1909), which Kuno uses to persuade Vashti to visit him on the other side of the planet, travelling in an “Air-Ship”. He needs desperately to talk to her face-to-face – even though it will involve her travelling half way around the world! Alison George points out why he feels that that is a price worth paying:

“A mother talks to her son by videoconference. She thinks it is ‘good enough’ to be able to communicate with him at all, whereas the son yearns to see her in person, recognising all the nuances that have been lost in the digitally mediated form of communication … Eventually, humans will be able to design technology offering substantive nature-like experiences. But my research tells me that, just as in Forster’s story, these will always be diminished compared with real nature. If this is true, then we should think of technological nature as a bonus, not as a substitute. Otherwise we might come to believe, as we have already to some degree, that ‘good enough’ is ‘good’.2

Forster knew nothing of TV or discussion programmes, radio or phone-ins, the internet or videoconferencing and VR concerts, of course. So it’s truly remarkable that the critique of technology in The Machine Stops has so many resonances with life today – I mean both the ‘old normal’ and our ‘new normal’. Maybe Vashti is right, that some kind of face-to-face communication is better than nothing. But to the extent that it becomes the norm to opt for virtual experiences, either from choice or force of circumstance, then maybe we become increasingly de-humanised and effectively part of Forster’s Machine.

During the visit, Kuno tells her that he is threatened with homelessness for daring to escape to the outside, without a permit. He fears telling her through the Machine, in case he is found out and reported to the Central Committee. Homelessness would mean death. He had emerged into Wessex by climbing up a ventilation shaft with his respirator. What he sees on the surface inspires and terrifies him as the story develops to its gripping conclusion and it becomes apparent that the machine is faltering, breaking down in ways that even the Mending Apparatus can’t handle.

There are many possible readings of the story. Is it a political allegory, Vashti standing for a passive member of the underclass, her son Kuno a rebel, kicking against an authoritarian regime? Is it primarily a call for individuals to think for themselves? Is it, perhaps, a warning that our precious environment will be destroyed if we don’t nurture it and care for it? Or does it seek to show that over-reliance on technology will lead to catastrophe? I’d venture to suggest that it could even be read as a struggle between our deepest thoughts and the need to conform – Id versus Ego, etc.

Forster’s own explanation seems to have been that technology was becoming a malevolent controlling force. The implication is that it would eventually take over completely. With this thought, perhaps he even foreshadows the concept of the technological singularity.

In Science As Nightmare: The Machine Stops, Silvana Caporaletti writes: “‘The Machine Stops’ basically expresses the same ethical and social preoccupations that inform all the other works of Forster, who repeatedly denounces the dangers of a materialistic ethos and of a general conformism imposed by rigid social conventions, exposing the spiritual barrenness and the emotional impoverishment generated by the repression of diversity, spontaneity and creativity”.3

Is Covid-19, then, just the latest symptom of a wider disease that is slowly engulfing humanity? Forster covered a lot of ground in this short tale, inviting us to consider whether growing authoritarianism, man-made environmental degradation, the de-humanising effect of an over-reliance on technology, artificial insemination, rampant materialism, moral and ethical decline and dumbing-down in many spheres are the defining characteristics of what we cheerfully call civilisation.

Or was Forster, writing about technology and one-party politics before two world wars, envisioning only the threats that technology posed, unaware of its potential abilities to combat the often deadly forces of Nature?

What wouldn’t we give for a return to the familiar, boring, predictable, comparatively carefree lifestyles, that most of us have grown up with? I’ve no doubt Forster would ask us to think twice about that. Perhaps we should listen to the words of some of those who have recovered from this horrendous disease and emerged like Kuno to see the world as it really is?

Advanced thinkers, like Vashti, had always held it foolish to visit the surface of the earth. Air-ships might be necessary, but what was the good of going out for mere curiosity and crawling along for a mile or two in a terrestrial motor? The habit was vulgar and perhaps faintly improper: it was unproductive of ideas, and had no connection with the habits that really mattered. So respirators were abolished, and with them, of course, the terrestrial motors, and except for a few lecturers, who complained that they were debarred access to their subject-matter, the development was accepted quietly. Those who still wanted to know what the earth was like had after all only to listen to some gramophone, or to look into some cinematophote.

 

1 Jaron Lanier, The suburb that changed the world, New Statesman 140, no. 5066 (August 15th, 2011), np.
2 Peter Kahn in Through a window, darkly …, Alison George, New Scientist 210, no. 2815 (June 4th, 2011), pp 32-33.
3 Silvana Caporaletti, Science as Nightmare: ‘The Machine Stops’ by E. M. Forster, Utopian Studies 8 (1997), no. 2: p 32.

Recommended online reading

Martyn Berry, Escape from the clutches of the Machine, New Scientist, 25th February, 1995


Image credit: plaque – Simon Harriyott from Uckfield, England / CC BY (https://creativecommons.org/licenses/by/2.0)

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