Health Matters – January 2023

• Covid Update
• Kraken
• NHS Perfect Storm
• Procrastination
• Prostate Cancer

1. Covid & Flu  –  let’s start by reminding ourselves of the twindemic – Covid is still here and flu is too! At the moment, flu is over 3 times higher than the Covid numbers in St Albans – so all those personal hygiene matters that we’ve talked about before are still critical!

At the moment there are 613 cases of Covid per 100,000 currently – well down from that peak of 2,967 on DEC 3rd; that’s down by over 30% on last week’s figure. But beware – the cases of flu are not falling by anywhere near that rate! And while we’re on the flu, it’s sobering to think back to the Autumn – we felt Covid was the worst that could happen. But ask anyone who’s had the flu or a winter cold which was worse – Covid or Flu – and it’s almost certain they’ll say the flu. That’s because we’ve had 2 years of low flu levels that have left us with less immunity!

And the numbers in hospital are significantly up since December

• In the Lister they’re up from 35 to 75; and
• In Watford from 23 to 77

That’s a real concern that they have almost trebled in a month. On a day-to-day basis, they are starting to come down as the post-Christmas peak is starting to work its way through the system!

2. The Kraken sub-variant – We have not talked about Covid variants and sub-variants for a while! The heavily mutated Omicron variant has been with us for well over 12 months, But whilst Omicron has been a constant, there have been over 650 sub-variants so far. We’ve been able to ignore the vast majority of these sub-variants as they have been sufficiently different from the main Omicron strain, but that’s no longer the case as an emerging sub-variant is a concern; it’s called the “Kraken” – that legendary sea monster that terrified our sailors!

Here’s the key point – the Kraken sub-variant accounts for 30% of new cases in the US but only 4% of cases in England – so will it lead to a new spike here? Kraken is very good at evading the antibodies created by vaccinations and prior infections. And whilst it’s not more serious than other vaccines, the experience of the States is that hospitalisations and deaths are at a 12-month high in New York and New Jersey!

Keep the hygiene regime going and let’s kill the Kraken here!

3. What’s wrong with the NHS? – There’s no doubt the NHS is in a state of crisis with the longest-ever A&E and Ambulance waiting times; strikes; and the ever-growing waiting times for elective surgery. Add to that the perfect storm of increased demand due to Covid at a time when the service is constrained by multiple factors. And politicians are all coming up with ways to fix the NHS. Well, I couldn’t resist coming up with my own solution – cut administration! I checked the website of four Surgeries in St Albans; they all have sections on there such as “Meet the Team”. What I did was to count how many medical staff (Partners, GPs, Paramedics, and Nurses) they had against how many admin staff. So what would you imagine it to be?

When I was running a business, if ever the admin budget got above 15% I’d be asking questions; so let’s give it some leeway, after all, Receptionists are in that Admin number and they’re front-line patient-facing staff. So let’s be generous and predict it at 35% Admin and therefore 65% Healthcare Professionals.

And here’s the point – we’d be way out; with a sample of 4 St Albans Practices, it’s 48% Healthcare Professional and 52% Admin. That’s crazy.

So what’s my conclusion to fixing the NHS – cut Admin by at least 25% and put that money to the front line with Healthcare Professionals. And that highlights the real problem! The Healthcare Professional workforce is way under headcount – by 9%! No wonder they’re talking about bringing back retirees, putting part-time staff on to full-time contracts, and taking more students on apprenticeships rather than full-time education.

4. Procrastination is a Killer – a somewhat dramatic headline but I hope I have your attention! New research conducted in Sweden has shown that people who procrastinate (taken from a procrastination index assessed at the start of the study) are more likely to experience disabling pain, poor sleep quality, more loneliness, and higher levels of depression.
Now the study wasn’t able to determine cause and effect – did procrastination mean that people put off going to the doctor, or did it mean that poor physical health leads to procrastination?

5. Prostate Cancer – as regular listeners will know the St Albans Podcast sponsors regular Health Matters webinars with top London Consultants – well I chaired one last night on Prostate Cancer with Professor Heather Payne (she said “call me Heather” at the start of the session!). There were 366 people registered and most of them actually turned up which was great.

One of the facts that Heather talked about is what makes men more likely to get Prostate Cancer? The factors are:

• Age – typically the curve starts in the 40’s and just keeps going up! Although it does start falling after the mid 70s
• Diet – Heather gave the example of Japan; Japanese men were very unlikely to get Prostate Cancer but Japanese men who moved to the US were much more likely to get it than those that stayed in Japan! So another factor is
• Obesity
• Ethnicity, and
• Family History – I’ve told my son and grandchildren to watch out!

But here’s what I found most interesting about Heather’s talk – in Prostate Cancer the cancerous cells are fed by testosterone; so the treatment fundamentally is to stop the production of testosterone. What Heather said last night was that in advanced cancer the cancer cells learn how to produce testosterone in order to feed themselves! Isn’t the body fascinating? You can see the video at https://www.youtube.com/watch?v=4thmXHNsFMQ It’s best to start around 4 minutes in – we had technical problems at the start!