{"id":48089,"date":"2020-07-21T17:24:22","date_gmt":"2020-07-21T16:24:22","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=48089"},"modified":"2020-07-21T17:24:22","modified_gmt":"2020-07-21T16:24:22","slug":"nick-hopkinson-castles-of-cloth-and-covid-19","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2020\/07\/21\/nick-hopkinson-castles-of-cloth-and-covid-19\/","title":{"rendered":"Nick Hopkinson: Castles of cloth and covid-19"},"content":{"rendered":"<p><span style=\"font-weight: 400\">Midsummer\u2019s day just past saw the 500<\/span><span style=\"font-weight: 400\">th<\/span><span style=\"font-weight: 400\"> anniversary of the <\/span><a href=\"https:\/\/www.historic-uk.com\/HistoryUK\/HistoryofEngland\/Field-of-The-Cloth-Of-Gold\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400\">Field of the Cloth of Gold<\/span><\/a><span style=\"font-weight: 400\">, the opulent tournament where Henry VIII and the French King Francis 1<\/span><span style=\"font-weight: 400\">st<\/span><span style=\"font-weight: 400\"> sought to cement peace between the two countries. Although the two kings were not supposed to compete directly, Henry insisted on a wrestling bout, which he quickly lost. The English court stayed in what appeared to be a magnificent specially built \u201cpalace\u201d, but its high walls were in fact just painted cloth and canvas.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Are there any lessons we can take now from a brash and brutal monarch, engaged in an unforced and self-destructive European conflict? Or from, if not a castle made of sand, at least one only of cloth?\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">In these covid times the difference between appearance and reality, between official pronouncements and official actions has been substantial. Unquestionably real, the all-cause mortality\u2014at least <\/span><a href=\"https:\/\/www.health.org.uk\/news-and-comment\/charts-and-infographics\/comparing-covid-19-impact-in-the-uk-to-european-countries\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400\">65,000<\/span><\/a><span style=\"font-weight: 400\"> excess deaths so far in the UK, each covid-19 <a href=\"https:\/\/www.economist.com\/graphic-detail\/2020\/05\/02\/would-most-covid-19-victims-have-died-soon-without-the-virus\">death<\/a><\/span><span style=\"font-weight: 400\">\u00a0premature. Also real, the two week delay between 9 March <\/span><span style=\"font-weight: 400\">when Italian reports that intensive care units there were overwhelmed and the introduction of the UK lockdown\u2014this delay potentially responsible for <\/span><a href=\"https:\/\/www.theguardian.com\/world\/2020\/jun\/10\/uk-coronavirus-lockdown-20000-lives-boris-johnson-neil-ferguson\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400\">half or more<\/span><\/a><span style=\"font-weight: 400\"> of those deaths\u2014approaching half a million years of human life unlived. Real too, the structural racism driving the <\/span><a href=\"https:\/\/www.cebm.net\/covid-19\/bame-covid-19-deaths-what-do-we-know-rapid-data-evidence-review\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400\">excess loss of black lives<\/span><\/a><span style=\"font-weight: 400\"> to the virus. Panglossian pronouncements about the supposed protective ring around <\/span><a href=\"https:\/\/www.independent.co.uk\/voices\/coronavirus-uk-care-home-crisis-ring-matt-hancock-commons-a9522561.html\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400\">nursing homes<\/span><\/a><span style=\"font-weight: 400\">, the elusive personal protective equipment (<\/span><a href=\"https:\/\/www.independent.co.uk\/news\/uk\/politics\/coronavirus-matt-hancock-ppe-nhs-health-secretary-doctor-death-lbc-a9487296.html\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400\">PPE) stockpile<\/span><\/a><span style=\"font-weight: 400\">, the \u201cworld-beating test and trace system\u201d stand in stark contrast to this.<\/span><\/p>\n<p><span style=\"font-weight: 400\">And yet, self-isolation, the lockdown, masks and the rest, have been an astonishing collective act of altruism by people to reduce the risk of those most vulnerable catching the virus. The pandemic has also exposed some ugly positions as unreal\u2014it is, after all, possible to house the homeless if we choose to do so. The jobs which turn out actually to matter invert assessments based on how much people are paid\u2014imagine a pivot towards caring and creative occupations. Burdensome appraisal systems based on distrust rather than professionalism seem not to be essential. Appealing as these indications for what the future might be after the pandemic are, the truth is that the coronavirus is driving disaster capitalism too\u2014a ratchet towards outsourcing\u2014witness the absurd spectacle of one consultancy company brought in to <\/span><a href=\"https:\/\/www.independent.co.uk\/news\/health\/nhs-test-and-trace-mckinsey-management-consultancy-review-a9621351.html\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400\">review<\/span><\/a><span style=\"font-weight: 400\"> the system set up by another, while existing public health infrastructure is sidelined.<\/span><\/p>\n<p><span style=\"font-weight: 400\">The Tudor courtiers dreamt of peace in Europe\u2014a better post-covid world is achievable too, but not inevitable or, without a major change in thinking, very likely.<\/span><\/p>\n<p><b><i>Nicholas S Hopkinson<\/i><\/b><i>, Reader in Respiratory Medicine, National Heart and Lung Institute, Imperial College, London, medical director of the British Lung Foundation and Chair of ASH. <\/i><a href=\"https:\/\/twitter.com\/COPDdoc\" target=\"_blank\" rel=\"noopener noreferrer\">@COPDdoc<\/a><\/p>\n<p><em><strong>Competing interests<\/strong>: none<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Midsummer\u2019s day just past saw the 500th anniversary of the Field of the Cloth of Gold, the opulent tournament where Henry VIII and the French King Francis 1st sought to [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2020\/07\/21\/nick-hopkinson-castles-of-cloth-and-covid-19\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":46993,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18889],"tags":[],"class_list":["post-48089","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nick-hopkinson"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - 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