Starting a daily blog in a time of uncertainty
“Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.”
Victor Frankl
Day 1.
There are moments that make you stop and think — to pause and reflect. In fact, there are many more opportunities than we take advantage of on a typical day. Most of these are inherently personal moments, that come and go as life carries on around us. The evolving situation with COVID-19 feels rather different. This is a global event, the full extent of which remains in the future. Right now, there is a lot of uncertainty. I sense a swell of public anxiety that is fuelled on the one hand by “fake news” and on the other by the ubiquity of 24h news streaming. There is a paucity of quality accurate news coverage.
And so, at this time I find myself deeply reflective and minded to write. Journaling was a key trait of the great Stoics, such as Aurelius and Epictetus. The daily practice of writing deployed as a meditative exercise. Now, via social, this can continue but also to contribute to a conversation in real-time. Today, rather than open my note book I open a document and start a daily blog. It feels appropriate to share and start a discussion. All my thoughts are my own save for anything wise which I will undoubtedly have borrowed from someone much wiser than me.
Where to start? With my thoughts on the current situation. COVID-19 is a big global event; things will not return to normal afterwards. Much of this will be bad, not least the total health implications. Many businesses will fail; all will be forced to adapt. But this won’t all be bad. Business travel is already plummeting; companies will realise that virtual meetings are easier, cheaper and greener. This should be a pivot point in the battle against climate change. Satellite photos from China have shown substantial reductions in pollution levels as social distancing measures were deployed, travel reduced and factories powered down.
I am no expert here, but I have read widely and deeply and it is clear to me that this is a dangerous virus. The aggressive policy measures in China have worked to slow the spread of this contagious pathogen, but still many have died (I’ll post links to a couple of excellent recent Twitter threads at the end of this article). The situation in Northern Italy is very worrying is clearly shows how big the impact will be on modern healthcare systems. Speaking to friends who doctors in Milan confirms these fears. A massive quarantine policy is now in place; it will be interesting to see the relative success of this versus the Chinese model. What will history say about our society and how we responded to this event? Many a future PhD will examine the medical, societal, geopolitical and economic impact of the COVID-19 pandemic.
What about my own anxieties? I am not worried about my individual risk; I appreciate that remains very low. However, I travel a lot for work. I am careful to ensure I fully justify each trip and maximise its worth. My area of expertise is inflammatory bowel disease (IBD), a different kind of global pandemic that can have a major impact on the lives of those affected. Travel to educate, raise standards and build global research partnerships has been a core professional activity for me over recent years. It is something I am good at. I try to maximise the exposure — tweeting slides, filming lectures and producing new original content. I have never felt that virtual learning can replace face-to-face interaction and discussion. But now is the time to work much harder to improve the virtual offering.
Meantime I, like many others, am now reviewing and revising my schedule for the coming months. I was looking forward to this period of travel and have been working very hard to prepare for it — new data, new content, new thinking, new visuals. Time on the road is for thinking and learning as well as educating. I find it deeply invigorating and rewarding. As soon as that feeling goes I will stop. And now? Some trips have been cancelled by the organisers. Others look set to still go ahead. Where is the balance between professional commitment / obligation and personal and social responsibility? I have friends and family at home and across the world, from my grandmother in a long-term care facility, my parents and my 6m old grandson down south to my wonderful sister living and working in America.
For people living with IBD I would like to reiterate my important message posted last week. Please continue to take your medicines. The biggest risk of picking up an infection of any kind is having active disease, or the steroids used to treat a flare. We will continue to update advice as more information becomes available. I am looking at ways we can transform our out-patient service using virtual appointments in the event our hospitals are overrun by COVID-19 cases. In this setting we will continue to provide as robust care as possible. Remember: wash your hands regular with warm soapy water for at least 20 seconds. Try to avoid unwell contacts. And please try to remain calm and keep about life as normally as possible.
These are a few of the issues I’ve been thinking through over the weekend … fortified by vigorous walks and bike rides with Rex and Naomi. My aim is to write every day and share my thoughts. I look forward to the challenge and the daily discipline that will be integral. Some days like today my musings will be very general and wide-ranging. Other days will be more focused — IBD clinical and research, plus new developments in genomics, digital health, AI and predictive analytics. And probably, I will start a vlog soon too. I don’t expect everyone will like it, but I ask you to be respectful whilst fully engaging in the conversation. It seems probable that we will be living a much more geographically isolated life than before, for a period of time at least. Let’s keep a sense of community as we do.