Category Archives: Health Matters

Be well, stay well

Andrew Polmear, Health Matters

Why we really should wear masks

By Andrew Polmear, our intrepid wine and cheese man – it’s OK kids, he’s a retired doctor

Most of us are pretty good at wearing a mask in a public place, possibly because we’d get thrown out if we don’t. But have a look round on a bus or train and you’ll often see someone whose mask is useless – either below the nose or even round the chin. There are people, of course, who are exempt, but they wouldn’t be wearing one at all. Does it matter? How good is the evidence that wearing a mask saves lives?

Comparing different countries. The first sort of evidence is from countries where almost everybody wears a mask when they leave home. One careful study showed that transmission of SARS-CoV-2 (the virus that causes Covid-19) is 7.5 times higher in countries where mask wearing is not universal compared to those where it is. That’s not proof, of course – the difference may have been due to something else; they may also have been hand-washing, or distancing, or just not shaking hands, for example. But the masks probably help. A study of US states found that states in which mask-wearing was compulsory had slower disease growth rates than states where it wasn’t.

Studies that asked contacts of coronavirus cases whether they wore a mask or not, then checking whether or not they caught the disease. It’s not a reliable technique – it all depends on people’s memory and honesty. Roughly, wearing a mask seemed to result in half the risk of catching coronoavirus disease. But almost all of these cases were SARS or MERS, not Covid-19.

Lab studies. The final sort of study is done in a laboratory where they measure particles the size of the water particles that carry coronavirus. Researchers have looked at the different situations that arise. I’ll focus on where the contagious person is coughing:

  • The person coughing is masked: a mask roughly halves the number of particles getting out. (Warning – different studies come up with different figures, according to what size particles were measured and how far away from the person being tested.) A 3-layer homemade cloth mask does as well as a surgical mask. An N95 mask may do a bit better but it’s quite a bit more expensive. Whether it fits properly may be more important than what it’s made of.
  • The person with the mask is in the same room as the person coughing (who is not masked): there is benefit but it’s much less.
  • If both are masked the benefit is much greater at about 80%. But what really makes a difference is if both wear double masks – that is, a surgical mask with a fabric mask over the top. That reduces particle transmission by 95%. It may be that the double masking works more by ensuring a close fit, than by the ability of the extra mask to filter more particles. Try it, it’s quite comfortable!

Where should we wear those masks? Obviously in public enclosed spaces. Keeping 2 metres apart isn’t enough. Those masking studies I mention above were done 6 feet apart. I think masks should also be worn out of doors. If there are no crowds and a good breeze you would probably be all right, but you can never protect yourself against the panting jogger who pushes past you, or against bumping into someone as you round a blind corner. If you can smell the cigarette smoke of a smoker you are inhaling their breath.

Finally, what about in the home if a family member becomes ill or is a contact. There’s just one study on this, from Beijing. Transmission of Covid-19 was reduced by 79% if everyone in the household was masked. But there’s a catch. Masking has to be all the time, including before the person who becomes ill develops symptoms. That’s partly why Covid-19 is such a problem. The time when a person is most contagious is from 2 days before symptoms begin until 1 day after they start. If the person you live with is a contact you have time – mask up straight away, don’t wait for them to become ill. If they develop symptoms out of the blue you’ve probably missed the boat, but mask up anyway.

PS. You may be wondering whether higher quality masks would do better than the fabric and surgical masks described above. After all, an FFP2 mask is, by EU definition, one that filters out 94% or more particles (roughly the same as an N95 mask (the US equivalent) and a KN95 (the Chinese equivalent)). An FFP3 mask filters out 98% or more particles. The answer is no, not necessarily. They were designed for industrial use, not specifically for viral protection. Also, those EU tests do not attempt to mimic the human situation, with one person coughing, or talking, or even just breathing out, and another person breathing in. They may still be better than fabric or ordinary surgical masks, especially if properly fitted, but don’t expect 94% or 98% reduction in transmission. And, of course, don’t wear a mask with a valve in it – that would allow out any virus you are exhaling.

PPS. Those who wear glasses find masks a problem. Their moist breath fogs up the inside of the lenses. From all the people who have commented on this it is clear there’s only one solution: wear the mask high up on your nose and perch the glasses on top of it. One eye surgeon, who needs to wear glasses while operating, tapes the top of his mask to his nose, so it can’t slip down below his glasses.

This is an area of science where new information is coming out every day. By the time this article is published it may already be out of date. And please bear in mind that it is the opinion of one retired GP, not a leading scientist. Andrew regrets that he cannot enter into correspondence with individual readers.

Andrew Polmear, Health Matters

What’s Going On?

In the second of Andrew Polmear’s Covid reports, he looks at the Oxford AstraZeneca vaccine and the over 65s.

A friend has just emailed to say that she’s delighted that she’s had her first Covid vaccination – but disappointed that it was the Oxford/AstraZeneca version. She’s in her 70s and I guess she’s heard that a number of European countries will not be using the Oxford/AZ vaccine in people over 65. Indeed, President Macron of France has been the most outspoken, saying that “it’s quasi-ineffective in the over 65s” Yet our own Medicines and Healthcare Products Regulatory Agency, and the EU equivalent, have approved its use in all adults. So what’s going on?

The problem is that the Oxford study began with patients under 55 years old. They wanted to prove that it was safe in younger patients before giving it to the elderly. Once it was clear that it was safe they included adults of all ages. But when they reported their first results only 2 patients over 65 had the disease. Neither had been given the vaccine but the numbers were too small to say that that proved that the vaccine worked in the older patient. They could, however, say that President Macron was wrong to say it didn’t work. All that can be said is that they hadn’t proved it did work.

So why has the Oxford/AZ vaccine been approved for all ages? There are two reasons:

  1. The researchers measured the antibodies in the blood following administration of the vaccine. Subjects over 65 had a strong immune response, as measured in the lab. It was not quite as strong as in younger subjects but it was plenty strong enough.
  2. All other studies so far reported have shown that older people are protected by the other vaccines. Especially reassuring is the vaccine made by J&J which uses the same technology as the Oxford/AZ vaccine. It would be very odd if the Oxford/AZ vaccine didn’t behave in the same way.

My belief is that, like President Macron, politicians in those countries have confused ‘no evidence of benefit’ with ‘evidence of no benefit’. If the Oxford/AZ vaccine isn’t shown to be effective at all ages in the next few weeks, I’ll eat my hat.

This is an area of science where new information is coming out every day. By the time this article is published it may already be out of date. And please bear in mind that it is the opinion of one retired GP, not a leading scientist. Andrew regrets that he cannot enter into correspondence with individual readers.

Andrew Polmear, Health Matters, Uncategorized

Covid-19 and vaccines – a (retired) doctor writes…

Not only is Andrew Polmear our intrepid wine and cheese man, he’s also a retired doctor and asks… Does delaying the second dose till 12 weeks after the first put us at risk?

One of the joys of being a retired doctor is having the satisfaction of responding to people’s concerns about medical matters without the worry of being responsible for them. So I enjoy queries from friends; and of all the questions I’ve been asked about Covid-19, the commonest is about the 12 week delay between jabs. Is it safe?

The short answer is yes, but, of course, it’s a bit more complicated than that.

The first bit of the answer is the straightforward one that Matt Hancock, Health Secretary, gave when he announced the change. If you have a vaccine that’s in short supply it’s better to give everyone at risk a first dose rather than give some a second dose and others nothing at this stage. The first dose gives a better “bang for your buck”. That means Matt Hancock made the right choice for the country; but it doesn’t stop us, as individuals, wanting that second dose.

But does delaying that second dose reduce our protection?

Things are easiest to understand with the Oxford/AstraZeneca vaccine, because there’s published information about this. The Oxford researchers had intended to test a single dose. But after they’d started the trials they found that, when they gave a second jab to a small group, they got a better antibody response. They went back to the regulator and got permission to change the trial, so they could give a second jab 28 days after the first. However, by the time they gave their subjects the second dose, some were at least 90 days after the first. So they could compare the effect of early and late second jabs:

  • second dose given early (between 22 and 90 days after the first) – 76% of cases of Covid were prevented, with no sign that protection was tailing off towards the end (and none of those who did get Covid were bad enough to go to hospital).
  • second dose given late (more than 90 days) – 82% protection. What’s more, subjects had higher antibody levels than those who had an earlier second dose.

So, with the Oxford/AZ vaccine, we can say that a 90 day gap is fine, possibly even better than a 28 day gap.

With the Pfizer vaccine it’s more difficult because all of those taking part in the trial got the second dose at between 19 and 42 days after the first. So Pfizer are correct to say that there’s no evidence that delaying the second dose until 90 days is safe. The World Health Organisation hedges its bets by recommending that the gap go up to 6 weeks. So why does our own, highly regarded, Joint Committee on Vaccination and Immunisation recommend 3 months? There are two reasons:

  • The first is that most, possibly all, vaccines give better long-term immunity if the second dose is delayed. The HPV vaccine, for instance, given to girls and boys to protect against certain types of cancer, works best if the second dose is given between 6 months and two years after the first. Immunity from vaccination doesn’t fall off rapidly. It takes 2 – 3 weeks after a jab to develop. It doesn’t then suddenly disappear, at least not for months or years.
  • The second reason is a detailed look at the Pfizer trial. Patients in the week before the second jab were 89% protected against Covid-19. After the second jab they were 95% protected. Such a small improvement in protection from an early second dose isn’t statistically significant.

 So, the chances are that a delay in receiving a second dose of the Pfizer vaccine will do no harm. And it’ll certainly mean that more people will get their first jab sooner; which is good for everybody.

This is an area of science where new information is coming out every day. By the time this article is published it may already be out of date. And please bear in mind that it is the opinion of one retired GP, not a leading scientist. Andrew regrets that he cannot enter into correspondence with individual readers.

Brighton Life, Eating Out, Environment, Features, Health Matters

Back home for one more adventure

Gallery 2 Comments

What do you do after the jungles of French Guiana and Chicago? Jed Novick finds out

I’m outside the newly revamped Eddy, enjoying an afternoon drink and chat with Mark and Hatt, the new guardians of this particular galaxy. A car comes down the road and stops outside the pub. I don’t even notce, but Mark’s up and over there. Hatt turns, looks, smiles, carries on. Seconds later, a young lad, all muscles and tatts and with a face like a kid who’s been told to clear up his dinner plates, is walking over to the recycling bins carrying a lone bottle. He drops the bottle in the bin and throws us a half-hearted sneer, but Mark’s already back with us and the story is done. “He was just going to leave the bottle on the pavement” says Mark. “This is our community. We live here. We all live here. Have a bit of respect”. 

Hatt – Harriet Eaton – and Mark – Mark Reed – took over The Eddy in January and from there till now, it hasn’t been a straight line. But one look at Hatt and Mark and somehow you know they’re familiar with picaresque journeys. They’ve got stories.

She’s all bangles, tattoos and rings. An artist. Originally from West Sussex, the road to West Hill hasn’t been a straight one. Went to Paris when she was 18, worked in fashion, married a doctor. “He wanted to specialise in the tropical diseases. So we went and lived in South America for three years in French Guiana in a place called Maripasoula, right in the middle of the jungle. It’s like a tiny plane or three days on a boat to get out. So that was interesting. Mostly”. 

As you do when you find yourself in the middle of the jungle days away from anywhere, Hatt set up a textile business “because that’s what I’d done in Paris and that went really well – beach towels and robes” but then life intervened – kids, parents, school, the usual – and the path led back to Brighton working behind the bar in a pub not far from where we’re sitting now. 

Originally from Hastings, Mark also took a few detours before getting the keys to The Eddy. “I had a few pubs and clubs in Hastings, pubs and clubs in Brighton”. Anything I’d know? “Yeah. The old Club Savannah, which is where Club Revenge is now above Harry Ramsden”. How far are we going back here? “This is back in the early to mid-Eighties. Then I moved to America and I worked in the music industry in America, going on tour with bands for a number of years, lived out hotel rooms for about five. I worked for EMI and then I was a writer for a while and then my…  Then the music industry career got parlayed into partnerships in nightclubs and bars and restaurants in Chicago, um, over, uh, over a long period of time. And then alongside that, I also got into the car industry and worked for a major US Volkswagen dealership”. But then Mark’s life intervened…

So Mark came back after 25 years away, and Hatt taught herself how pubs worked and when the landlord of the pub where Hatt worked moved on… Well, opportunity knocks.  

Opportunity knocks and then opportunity pulls the rug away.  In January they got the keys. A couple of months later… the world stopped. Words like “global pandemic” and “lockdown” probably weren’t in the original business plan. What was the conversation like on March 19th, the night before the lights went out?  “We’ve got a lovely little film of the last night before we shut and there was great atmosphere and everybody was wow, this is our last night for a while.

“I think people just thought it was going to be about a month or a couple of weeks, and then we’d be back open again. And I think that we were sort of ignorant of how long it was going to be. But, you know, things happen and it’s just a question of how you look at it. For us, lockdown was fantastic. We just completely embraced it and changed the pub to who we are. Re-painted everything, cleaned everything, changed everything. The cellars, the toilets, everything.  It’s like being in my front room really, you know, we really, really have made it our own.

One sweet thing that came out of lockdown was that the idea of community really kicked in. “When we closed down, John at The Yeoman created a WhatsApp group for the four pubs on the block. We called ourselves The Manor and there’s definitely a sense of care between us, but yeah, it’s very sad that some of these pubs are too small to open. John’s been there for 15 years and his whole business plan has had to change. And it’s really tough”.

What do you want from all this? “The last owner was more…, um, he didn’t really understand the concept of the community, but that’s what we love. We live here. We live above the pub. It’s our home”.

Health Matters

Getting To Slee…zzzzz

SO SLEEP IS BECOMING a bit of an issue at the moment for many people. It is horrible not to be able to fall asleep, because your mind is out of control or waking up again in the early hours and not being able to go to sleep. Stress and anxiety are contributing hugely to this current issue of insomnia. To be able to go to sleep the brain needs to switch to the relaxed alpha state as opposed to being in the busy beta brain state. How do we get into that state? Meditation and relaxation techniques are key to calming ourselves down. We need sleep to function properly as lack of sleep will also compromise our body systems including the immune system. According to the Chinese Medicine body clock, waking up between 3 and 5 am is likely to do with adrenal exhaustion or between 1 and 3 am indicates the liver might be struggling for example. 

There are many reasons why we don’t sleep well so the key is to get to the root cause of the problem. Here are some other tips to get a better night sleep.

Avoid caffeine after 3pm. It is a stimulant and can take a long time to be eliminated from the body.

Alcohol, even though it can make us feel sleepy it tends to wake us up again in a couple of hours and it is difficult to go to back to sleep again.

Large meals in the evening should be avoided as they might promote a high insulin release which might lead to low blood sugar which then releases adrenaline into the blood stream and that would often wake us up and we might struggle to fall asleep again. 

Add more tryptophan foods into your diet. Tryptophan is the precursor to serotonin (the happy hormone which also helps us sleep). Include fish, legumes, avocado, bananas in your diet. A little bit of banana or an oat cake with a little avocado before bed could be beneficial.

Make sure your diet contains enough Magnesium as it is the nature’s tranquilliser, and finding a good Magnesium supplement might also help.

Aim to go to bed earlier 22.30 -23.00 and try not to use phones or computers two hours before bedtime.

Melatonin is a hormone secreted by
the pineal gland in the brain which
regulates our sleep wake cycle. To help
our body to make more melatonin
naturally, get out in the sunshine
during the day and at night sleep in a dark room. Bright lights inhibit the release of melatonin.  

Exercise regularly as this can often improve sleep patterns, but do not exercise too late as this could be stimulating for the body.

Reducing stress levels is key – meditation and yoga are great tools to help achieve this.

Helena Taylor

Book a free 20-minute call to discuss stress, female health and hormonal balance and how I might support you on your journey to optimal health.
Email: helena@nutritiouspantry.co.uk, www.nutritiouspantry.co.uk.

Brighton Life, Environment, Features, Health Matters

Lockdown Ideas: Global Sharing Week

Globally, we have enough surplus food, shelter and water to end poverty, hunger and homelessness. Global Sharing Week is the largest annual mass engagement campaign to promote and enable the sharing of vital resources with those who need them most, whilst protecting the planet at the same time. Created by the Brighton-based charity I created, The People Who Share, Global Sharing Week reaches over 100 million people worldwide. This year, with the world suffering the challenges of the Covid-19 crisis, Global Sharing Week will see a phenomenal online campaign to ensure that those in need receive the resources they need to survive the crisis. Projects and vital resources from food banks, to groups making PPE for frontline healthcare workers will be listed on a global map at globalsharingweek.org

Participation is open to all, everyone can play their part by adding projects and available resources to the Global Sharing Week map and sharing what’s there. Global Sharing Week helps us to demonstrate that where we have poverty, we can have prosperity, where we have loneliness, we can have community and where we have landfill we can have reuse.

The People Who Share is currently running Covid-19 Food Relief, a campaign to ensure that nobody in the UK goes hungry during the Coronavirus crisis. Currently, 1.5 million adults and 830,000 children in the UK are not getting enough food, whilst 53% of NHS workers are concerned about accessing supplies during the Coronavirus pandemic. (The Food Foundation, YouGov Poll, March 2020).

Covid-19 Food Relief is a mass call to action and a one-stop source of information to help people find food urgently, donate or volunteer. By making vital supplies easy to access, and galvanising the UK’s population to act now, we can help save lives. At The People Who Share, we believe that a united effort can mean that nobody goes hungry during this crisis.

Covid-19 Food Relief has been created to promote and support organisations including FareShare, The Trussell Trust, FoodCycle, Independent Food Aid Network, Meals for the NHS, The Careworkers’ Charity and many other community groups working on the frontline to ensure that everyone in the UK has sufficient food.

If you are hungry to help, you can volunteer or donate to a range of organisations working to provide #FoodRelief to those who need it most during the Covid-19 crisis at www.thepeoplewhoshare.com To get involved or find out more information email: foodreliefC19@thepeoplewhoshare.com Let nobody go hungry during the Covid-19 crisis.

 

Benita Matofska

Global Sharing Week 2019, saw 540 events take place in 211 cities across 49 counties on every continent, creating massive social impact. To get involved, find or register a project or shared resource head to globalsharingweek.org

 

 

Features, Health Matters

Gut instinct

How do we build a robust immunity?

Immunology has over the years been a fast developing field. It is clear to all of us today more than ever that building strong immunity will be something to strive for as it is the key to keeping dis-ease at bay.

The immune system is a complex integration of synergistic segments that are continuously bombarded by stimuli – from both internal and external sources. If we want to truly support our immune system we need to have a long look at our lifestyle, diet, exercise regime, stress management and sleep patterns. More stressed we are more the body uses vitamin C. If we don’t sleep enough less time the body has to repair and we are also likely to go for more alcohol or caffeine which are not helping. Movement of any kind is important to keep the lymphatic system healthy which produces B and T cells which are the special forces of the immune system. Many of us are now shifting our priorities around self-care. We want to feel calmer and are more intrigued about our immunity and about our body and health in general. These are good signs.  

Eating more plants and fermented food like fruit, vegetables, legumes, nuts and seeds are rich antioxidants and will help with decreasing inflammation in our bodies by fighting free radicals. Berries are rich in phytonutrients anthocyanidins which support the fight against bacterial, viral and fungal infections. They contain plenty of fibre which will support your gut function populating it with good bacteria which in turn can improve your immunity. Our gut contains 2/3 of the body’s immune system and it is the largest barrier against the outside world together with our skin. 

Book your free 20 minute chat with Helena to discuss any of your heath concerns and how she might be able to support your health. Please email helena@nutritiouspantry.co.uk to book your space.

Helena Taylor

Environment, Health Matters

Coronavirus Actions

  1. Think of others, consider your actions and be kind. All of us face the challenges of COVID-19 in some way, from needing basic provisions to help if we are unwell.
  2. Reach out to your neighbours. As self-isolation increases, stay connected and check in on one another for our physical and mental well-being. Share phone numbers and stay in touch. Continue reading Coronavirus Actions →
Features, Health Matters

Bright News Community Deliveries

IN THE COMING weeks, with isolation for the over-70s likely, we are seeing more and more local communities coming together and people offering their services to help others in need.

Vinod, Chair of WHCA and owner of the Bright News Convenience Store in Buckingham Road, has come on board to offer a local delivery service (within walking distance of the shop) for the vulnerable, less able and isolated among us.

Orders can be made by phone with a debit/credit card; they will be picked and delivered at an agreed time, with no direct personal contact necessary. If you fall into this delivery category, do call Vinod and Meena on 01273 708100. Continue reading Bright News Community Deliveries →

Health Matters

Ignore Fake Health Advice

THERE’S CURRENTLY NO known cure for Coronavirus but that hasn’t stopped a slew of useless health advice appearing on social media.

Home-made hand sanitiser

There have been many reports of shortages of hand sanitiser gel, as washing your hands is one key way to prevent spread of the virus. As reports of the shortages emerged in Italy, so did recipes for home-made gel on social media.

But these recipes were for a disinfectant better suited for cleaning surfaces and, as scientists pointed out, not suitable for use on skin. Alcohol-based hand gels usually also contain emollients, which make them gentler on skin, on top of their 60-70% alcohol content. Continue reading Ignore Fake Health Advice →